MAMMOMAT Revelation 2D & 3D Turnover Workbook

MAMMOMAT Revelation SEMENS 04:00 MAMMOMAT Revelation Insight BD, Tomosynthesis, & TiCEM Options Turnover Workbook MAMMOMAT Revelation Insight BD, Tomosynthesis, & TiCEM Options Turnover Workbook SIEMENS www.siemens-healthineers.us Healthineers HOOD05162003099109 Eff Date 06/12/20 www.usa.siemens.com/education I. Contact Information Summary Welcome to Siemens Healthineers Visit www.usa.siemens.com/clinicaleducation for more information regarding the current Siemens Siemens Healthineers is dedicated to helping you get the Clinical Training and Continuing Education portfolio. most out of your investment throughout the entire product life cycle and beyond. Our goal is to enable you Discover. Try. Buy. on webShop to take technology further, profitability higher, and patient care to the next level. Find the information, resources, and Do you want to “Discover. Try. Buy.” options, accessories, tools you need to get the most out of your recent and clinical education to make the most of your investment and stay up-to-date. imaging equipment? Discover images, case studies, Visit https://new.siemens.com/us/en.html. and video demonstrations with the latest clinical applications. Try advanced applications utilizing Clinical Training and Continuing Education free software trials. Buy applications, coils, clinical education, and accessories, conveniently at any time. Customer Care Center - Clinical Application Support: Visit www.usa.siemens.com/webShop today! Call 1-800-888-7436 Siemens Training Centers Troubleshooting assistance • Immediate assistance for software Siemens Clinical Education • applications and workflow issues Training Center – TDC2 110 Mac Alyson Court Please provide the Functional Location Number when • Cary, NC 27511 calling for assistance. Clinical Education Offerings: Call 1-888-221-8010 (follow the prompts) Classroom Training (Offerings, Registration • & Scheduling) Educational Symposia • On-site Training • Printed Self-studies • Virtual Education (Offerings & Registration) • Workshops & Fellowships • 2 II. Contents I. Contact Information Summary...........................................................................................................................2 II. Contents ..................................................................................................................................................................3 III Course Description ................................................................................................................................................4 III Agenda......................................................................................................................................................................5 Day One ....................................................................................................................................................................... 6 System Overview................................................................................................................................................. 6 Key Hardware Features ......................................................................................................................................7 Acquisition Workstation ..................................................................................................................................12 Examination Task Card ....................................................................................................................................14 Registering a Patient Using Scheduler ........................................................................................................16 Exercises ...............................................................................................................................................................17 System Operation ..............................................................................................................................................18 Exercises ...............................................................................................................................................................27 System Set-up.................................................................................................................................................... 29 Acquisition Workstation ..................................................................................................................................12 Examination Task Card ....................................................................................................................................14 Registering a Patient Using Scheduler ........................................................................................................16 Exercises ...............................................................................................................................................................17 System Operation ..............................................................................................................................................18 Day Two ......................................................................................................................................................................18 Exercises ...............................................................................................................................................................27 System Set-up.................................................................................................................................................... 29 Day Three .................................................................................................................................................................. 29 Appendix A: Acronym Chart................................................................................................................................. 30 Appendix B: Phantom Image Acquisition for ACR Submission....................................................................31 Appendix C: Exercise TiCEM.................................................................................................................................. 35 3 III Course Description Course Overview: The purpose of this training session is to provide you with the skills and knowledge to operate your system. Course Objectives Upon completion of this training session, you will be able to: Correctly perform start-up and shutdown procedures. • Identify the key hardware features of the Relevation system. • Identify the differences between the available paddles. • Describe the key features of the syngo® interface on the acquisition workstation. • Correctly perform a patient registration. • Utilize the examination task card to perform a patient procedure. • List the steps needed to archive patient data. • Follow the steps necessary to complete a patient procedure. • List and perform Quality Control procedures. • Perform the Quality Control needed for the Reading Stations (if applicable). • Learning Materials The following instructional materials are referenced throughout this training session: System Owner Manual Provides the necessary knowledge and expertise to accurately and safely operate the system. Training Workbook Supports the System Owner Manual through “big picture concepts,” examples, stories, interactive exercises, and references to online documentation. This book is yours to keep, so you can write in the book. Downloadable Documents These documents provide quick reference tips to aid customers in “just-in-time” learning opportunities. 4 III Agenda Day One Revelation Intro • Start-Up/Shutdown Procedure • Review of Gantry and Console • Image Receptor • Accessories • Magnification • Integrated Control Panel • Acquisition workstation (AWS) • Registering a Patient • Performing a Patient Study • Day Two Archiving • Perform QC tests • Cleaning and Disinfection • Status Symbols • Work Status Information • Technical Data • Review Patient Images with Radiologist(s) • Patient Imaging begins • Day Three Patient Imaging continued • Review Patient Images with Radiologist(s) • Checklists • Review of all QC Procedures • Questions • Day Four (for sites with Reading Stations) syngo.Breast Care with radiologist(s) • syngo.Breast Care QC • PACS Retrieval at syngo.Breast Care • Questions • Patient Imaging Continued • 5 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Day One Notes System Overview Objectives After this session, you will be able to: Correctly perform start up and shut down procedures. • Identify the key hardware features of the Revelation system. • Identify the differences between the available paddles. • Describe the key features of the syngo interface on the acquisition workstation. • Correctly perform a patient registration. • Utilize the examination task card to perform a patient procedure. • Switching On/Start-Up The MAMMOMAT® Revelation system is started from the switched off mode. Starting the system from the switched off mode. Press the power ON button on the Control Panel. Once the HIPAA screen appears, • click the OK button. Sign in with your User Name and Password. Please note, passwords are case sensitive. This process takes approximately 7 minutes to be completed. Wait until the RED X is • gone in lower right corner between the pie and the computer. This means your system has completed start up. Complete the 90 - 90 “Single Touch” activation. Switching Off/Shutdown Go to the top Menu Bar, and click on Options, then select End Session and choose • Shutdown System. Confirm by clicking YES • System will automatically shutdown to a Standby Mode • Once the system has begun it’s countdown, press the off button on the control pad • and the system will completly shut down. For detailed start-up instructions and a visual diagram of the system, please see: Online User Manual located in the Help dropdown of your acquisition workstation • (AWS) 6 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Key Hardware Features Notes Overview This section will discuss key hardware features of the Revelation system. Emergency Stop Depressing (in an emergency): All system movements and X-ray radiation are stopped. Turning clockwise (when situation has been rectified): Unit drives and X-ray radiation are enabled again. Swivel Arm Raise swivel arm Turn swivel arm Turn swivel arm counter-clockwise clockwise Single touch button Field light on Lower swivel arm Single-Touch Feature Briefly press the single-touch button. The swivel arm automatically moves to the preset angle position for the next • projection view. The angle position is displayed on the stand display. • Press any keypad to stop movement. • The rotation movement stops in the current angle position. • Press the single-touch button again to resume movement. • The single-touch function has to be activated per working day. • Move the swivel arm with the setting buttons for rotation movements to between - • 90° and + 90°. The single-touch function is then active for 24 hours after this. If the system is re-booted any time during the day, the single touch will need to be reactivated with the swivel arm rotation movements between 90° and + 90°. Height adjustments are located on either side of the tube head and on foot pedals. • 7 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Compression Plate Notes Mounting the compression plate Insert the guide of the compression plate into the receiver on the compression unit. • The compression plate automatically locks in position. • Removing the compression plate Press the release button on the compression plate receiver and pull the compression • plate out. Stand Display The stand display is located at the base of the X-ray stand. From here you can view projection angle, thickness of compressed object, compression force. 219 0 O mm N Fletcher Mae 8 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Notes Force in Kilograms (kg) Pounds (lbs.) Newtons (N) 1 2.2 9.81 2 4.4 19.61 3 6.6 29.42 4 8.8 39.23 5 11 49.03 6 13.2 58.84 7 15.4 68.65 8 17.6 78.45 9 19.8 88.26 10 22 98.07 11 24.2 107.87 12 26.4 117.68 13 28.6 127.49 14 30.8 137.29 15 33 147.1 16 35.2 156.91 17 37.4 166.71 18 39.6 176.52 19 41.8 186.33 20 44.1 196.13 9 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Magnification Table (optional) Notes Using the magnification table obtains a 1.5x or 1.8x magnification of the object. The desired magnification must be selected upon ordering the system. OpComp Note: OpComp will function with flex paddles. • OpComp should not be used with spot magnification, implant views, or on patients • who have had recent breast surgery. OpComp is not activated by manual compression. • OpComp is regarded as a recommendation but all patients may not be able to • tolerate it. If breast is not taut, additional compression may be given. Procedure: 1. Set the object table to the correct height. 2. Position the breast and lower the compression plate onto the tissue. 3. Pre-compress the breast to 20-40 N (2-4 kg). “Press” on the foot switch until plate rests on the breast. 4. Perform optimized compression by pressing the foot switch again and keeping it steadily pressed, until the stand display signals and compression automatically stops. 5. Do not use the “pumping” technique to perform or this may override the function. 10 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Emergency Compression Release Notes (1) (1) (3) (2) (2) 1 Forcefully press the emergency release button (1) with one hand, and keep the button pressed. 2. Place the other hand under the compression plate (2) and press it upward. The patient can be removed from the compression plate. 3 First remove the hand from the emergency release button, and then remove the hand from the compression plate. Make sure the compression plate does not fall on the detector. If the emergency release button is blocked, proceed as follows: ® (1) (3) (2) 4 Forcefully press the emergency release button (1) with one hand, and press against the compression holder (3) with the other. The emergency release button is released. 5 Keep the emergency release button pressed. 6 At the same time, place your hand under the compression plate (2) and press it upward. The patient can be removed from the compression plate. 7 First remove the hand from the emergency release button, and then remove the hand from the compression plate. Make sure the compression plate does not fall on the detector. The system is automatically reset upon pressing the emergency unlocking device. Confirm the error message on the AWS monitor. 11 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Notes Revelation Plates There are a variety of compression plates (formerly “paddles”) for this system. Plates vary on flexibility and size. Available paddles at your facility will be discussed. For a detailed list of plates available for the Revelation system please see: Online User Manual located in the Help dropdown of your acquisition workstation • (AWS) Acquisition Workstation Overview This section will discuss design and function of the acquisition workstation and the syngo interface. Control Box ST OP (1) Emergency Stop All system movements and X-ray radiation are stopped. (2) Not used (3) Raise compression plate (decompression) Press and hold the button. Decompression begins (to 80mm). (4) Start radiation (exposure button) The button lights up yellow during irradiation (radiation display). MAMMOMAT readiness: Button flashes green. Exposure readiness: Button lights up solid green. (5) System Off (6) System On When the system is ready for operation, the button lights up green Logging In and Logging Off (If HIPPA is activated) To log in, type your unique username and password on the “log in user screen.” To log off: 1. Options (top tool bar not patient browser) 2. End Session 3. Log Off (click on 2nd icon) 12 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Configuring New Users Notes Log in as administrator or as user with administrator rights (username: syadmin, • password: adm$pwd$4$med plus the last 4 digits of the dongle). Go to Menu bar, Options, Security Configuration • Select User Management • Right-click on New select User • User of tab card: • Name – Name of the user account (= logon name). Note, that the name has to be • unique within the system. Full name – Information that helps identify the user (for example, first name, last • name and title of the user). Description – Further information about the user (for example, his/her • department). New password – The password that has to be entered by the user in order to log • on to a workstation. Password Requirements” • USERNAMES – have no minimal character requirements and are not case • sensitive PASSWORD Requirements - (Must be at least 8 characters and consist of at • least - 2 Upper Case, 2 Lower Case, 2 Numbers, 2 Special Characters)(Special characters – “ ? / \ [ ] : ; | = , + * ? < > are not allowed) Username and password cannot contain the same characters or your name. • Initials are acceptable. Password Examples: Jane Smith (JSmi1950!!) (JaSm1950!!) • Confirm password – For validation purposes, the password has to be entered a • second time. Member of tab card: • Lists all groups (for data access) this user is assigned to. • For the Super user select the “Administrators” and “Security Admins” groups. • When you select “Security Admins” a pop-up window will display. • Click YES. • Owner of tab card: • Lists all roles (for use cases or functional privileges) this user owns. • Select “Role Doctor” and “Role MTA.” Click Apply. • This is automatically selected under the Member of tab when YES is selected. • For more details and actual steps on this topic, please see: Online User Manual located in the Help dropdown of your acquisition workstation • (AWS) 13 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Examination Task Card Notes The examination task card is subdivided into the following areas: 1. Menu bar 2. Control area 3. Image area 4. Generator control field 5. Status bar 6. Info bar For a complete diagram of the examination task card, please see: Online User Manual located in the Help dropdown of your acquisition workstation • (AWS Generator Control Field JOPDOSE 50-59 mm 29 KV - + WIRh 50 mm Adv. (1) (2) (3) (4) (5) (6) (7) (8) (9) (1) Display and selection of exposure mode (manual, AEC, OPDOSE) (2) Display and selection of compression thickness range (OPDOSE only) (3) Display and selection of +/- kV (4) Display and selection of +/- mAs (only manual) (5) Display anode/filter combination (6) Overview of current detail parameter settings in Advanced dialog box (7) Display of currently set focus Small focus • Large focus • (8) Display of current compression thickness up to 30 N decompression • over 30 N of current compression thickness • (9) Button to call up Advanced dialog box to change detail parameters 14 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Exposure Parameters Used Notes 27 kV 30.6 mAs WIRh 0.6 mGy 0 deg 20 mm 46 N (1) (2) (3) After irradiation is completed, the exposure parameters used are displayed for your information. As soon as the completed image appears in the image area, these data are hidden again. (1) Exposure parameters (kV, mas, anode/filter combination, dose value) (2) Angle of rotation of the swivel arm (3) Compression parameter (thickness, compression force) Advanced Dialog Box After clicking the Adv. button on the screen, the Advanced dialog box is displayed. Detail parameters preset for the currently set exposure technique can be changed in the Options fields here. The standby mode of the exposure technique determines which options are available. Advanced Grid Position Auto Decompression OPCOMP AEC Segmentation Dose Level · On · On . On Normal @ Out Off Off Off Low Medium Low Out + PRIME Normal Medium High High OK Cance (a) Option On or Active (b) Option Off or Not active (a) (b) (c)| (c) Option not available (dependent on the exposure mode) (1) Overview of current settings of the detail parameters (same as generator control field) (2)Grid Position In and Out Out: for magnification and PRIME (3)Automatic Decompression On/Off On: if unit should automatically decompress following the exposure (4)OPCOMP (Optimized compression) On/Off (5)AEC segmentation On/Off (measurement range for automatic exposure control) On: for dynamic measurement of pixel values over the entire breast Off: to limit to small, predetermined measurement range (6)Low Dose Mode Five dose levels available. Default: Normal 15 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options syngo Patient Browser Notes The Patient Browser supports you with administration of the patient and examination data that are stored in the databases of your system. With the Patient Browser you can search for data in a fast and uncomplicated way and then process that data in the browser or in the task cards. For a complete description and explanation of patient browser functionality, please see: Online User Manual located in the Help dropdown of your acquisition workstation (AWS) Registering a Patient Using Scheduler To register a patient: 1. Click on Scheduler. 2. Click on Worklist, then select Update Worklist (if worklist is not scheduled to update automatically). 3. Click on folder with patient’s name. 4. Click on Patient, Register. 5. Verify patient information and insert initials in the operator box. 6. Click on Exam. For more details and actual steps on this topic, please see: Online User Manual located in the Help dropdown of your acquisition workstation (AWS) 16 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Exercises Notes Complete the following exercises Excercise 1 1. Register a patient 2. Pick screening procedure 3. Create a PAO that is RCC, RMLO, LMLO, LCC 4. Take first exposure 5. Insert an exaggerated RCC after the RCC 6. Take next exposure 7. Repeat XCC taken 8. Take remaining exposures 9. LCC is marked wrong, correct to LXCC 10. Verify images are marked correctly 11. Close patient and end examination 12. Open browser 13. Check Network job status 14. End session Exercise 2: 1. Reenter study of a patient on the local database 2. Correct image previously acquired (notice KOS file) 3. Change the view from a LCC to a RCC 4. Add a RML 5. Take image 6. Verify images are marked correctly 7. Copy to film sheet all images 8. Go to filming 9. Delete the right-sided images 10. Find expose film task and expose images 11. Go back to examination 12. Skip transfer rules 13. Close patient 14. End examination 15. Manual send/archive from browser raw and processed data 16. Check network job status 17. End session 17 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Day Two System Operation Notes Objectives After this session, you will be able to: List the steps needed to archive patient data. • Perform a patient procedure utilizing advanced functionality. • List and correctly perform the recommended quality control procedures. • Differentiate between breast density values utilizing Insight BD. • Insight BD Insight BD calculates sets of breast density values consisting of the following: Vfg: Volume of fibroglandular tissue (cm3) • Vb: Volume of whole breast (cm3) • Vbd: Volumentric breast density (%) • DGI: Density Grade Index • The values of Insight BD can be seen in the Acquisition sub task card. KELLY TESE Examination KELLY TEST • Insight BD 3/20/1983 103 P Open patient Acquisition Patient Name: KELLY TEST Acquisition mode: 808 Patient ID: 2345 Doncity grade for -MLO Standard 2D Viewing Study date: 03/20/18 Patient PPG: |FO_Gen1 Rig Left d INBD d Voume of fibroglandular (cm3) 24.67 737.80 Filming Voume of Breast (cm3) 556.45 1393 90 Voumetric Breast Density (95) 4:43 52.93 Density grade d Post processing Close patient Procedure: bilet mammo Images mAs: 174.7 mAs Angle: -0.9 Focus: large Magn. factor: 1.000 Comp. Force: 79 N Thickness: 69 mm Anode/Filter: W/Rh Entrance Dose: 8.2 mGy Glandular Dose: 1.73 mGy Operator: Institution: Training Center' Erlan. Station: XPWHAWSR1 3A Allee am Roetelheimpark 9. OPDOSE -+ Decomp Adv 18 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Insight BD works for standard CC and MLO views (not implants, ML’s, etc.) Notes • Insight BD works for FFDM and Tomosynthesis (middle projection used) • Density information is visible for tomo only in first and last view • Insight BD DGI correlates to ACR Bi-RADS categories • ELLY TEST Examination KELLY TEST 18 PM R-CC Open jadiera 4096 Acquisition mode R-CC PPO: FO_Gent NBD b Casa potere : 28 84.6 mAs Focus: large facfor: 1.000 Comp. Force: 84 N Thickness: 49 mm Anode/Filter: WIRh Entrance Dose: 3 2 mGy Glandular Dose: 0.92 mby Operator: Initutions Training Center Erlan Station: XPWHAWSR1 JA Alee am Roeteheimpark 9 OPDOSE 50.55 ciFI Breast Density values per image are visualized here. night BD Pooort Nome: KELLY TEST MID 2345 Bludrone _03/2010 d d Voume offit/ogtasolar com3) Voume of Grenit (cri3) Voumetic Erset Dentist%) 4 45 52:06 Dons ty grede Density grade for patient (DGI) is the overall grade Insight BD values can be seen for each breast and for the patient based on overall density grades assigned per breast. radiologist preference. A radiologist can choose either the highest or average value to be displayed 19 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Patient Procedures – Additional Functions Notes Image Attributes To locate technical, clinical, and patient factors: 1. Right click on image. 2. Factors are displayed. Repeat To repeat a selected view: 1. Right click and select Repeat from the dropdown menu. 2. Select reason for repeat. 3. Additional image is provided and can be acquired. 4. Both images will be sent to the Radiologist. Reject and Repeat To reject and repeat an image: 1. Right-click on and select Reject and Repeat from the dropdown menu. 2. Image selected will be rejected 3. Additional image is provided and can be acquired. Correct To correct a projection view: 1. Right-click on the affected image in the Images subtask card. 2. A pop-up menu is displayed. 3. Select the desired projection view. 4. Click on Yes to confirm the changes. Reprocessing Image Processing To reprocess an image: 1. Right-click on the affected image in the Images subtask card. 2. Confirm IP Set name is correct. Select the new image processing parameter group that is desired. 3. In the Display Markers selection list, select whether the projection view used is dis- played in the acquired image. 4. Click on OK. 5. Click on Yes to confirm the changes. Transfer To complete an InExam Transfer 1. Right click on the image you wish to transfer. 2. Notice white arrow as image is transferring. 20 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Reconstruct Tomo Scan (Tomo Option) Notes To select a different reconstruction parameter group (RPG): 1. Right click on affected image in the images subtask card. 2. Choose new RPG desired. 3. Click OK. 4. Delete any unwanted reconstructions prior to closing exam. Select/De-select Insight 2D or Insight 3D To select/de-select Insight 2D or Insight 3D: 1. Navigate to the Acquisition subtask card. 2. Check or uncheck the boxes accordingly. Archive Data to a DVD To archive patient data: 1. Open Patient Browser. 2. Select Transfer, Eject from DVD. 3. Insert DVD-R into tray and close. 4. Select Study in Patient Browse.r 5. Select Transfer, Archive to. 6. Choose destination and click Archive. 7. To see all pre-selected cases, Click Transfer, Local job status. 8. Once the recording starts, in the bottom right-hand corner of the monitor, the recording icon will be displayed. 9. Once the recording is complete, the icon will no longer be displayed. To verify study has been recorded on the DVD-R: 1. Click on CDRW and the patient’s name will display 21 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Query or Retrieve Patient Data Notes To retrieve studies from a PACS that have been deleted from the local database: 1. Open patient browser 2. Select patient 3. In dropdown, select Search and the Patient Search screen will display 4. Type in any information in the search fields and select the Node or PACS to search from 5. Click on the Search button to begin the search 6. All patients found will display 7. Click on the study you want to import 8. Once the studies are imported, a message will display that studies have been imported successfully For more details and complete calibration procedures, please see: Quality Control Manual • For a complete list and detailed instructions on how to perform each of the Quality • Control Procedures please reference the Quality Control manual. Cleaning and Disinfection Overview When cleaning the parts that come into contact with the patients during an exam, it is not necessary to turn off the system. These parts are: Compression plates • Object table • Face shield • Cleaning All parts of the unit that come into contact with the patient must be cleaned prior to examination. Clean the dust from the ventilation slots on the detector on a regular basis. Caution: Using incorrect cleaning agents can accelerate the aging process of the plastics. Caution: Cleaning agents must not penetrate into the equipment. For more details and complete cleaning and disinfection procedures, please see: Online User Manual located in the Help dropdown of your acquisition workstation (AWS). 22 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Status Symbols Notes Status The status of a projection view (modifications, exposure progress) is identified by corresponding symbols in the protocol control. Icon Definition Icon Definition Projection view according to Radiation is released mlo default, exposure scheduled Projection view changed, Projection view acquired, mlo* exposure scheduled image transmission runs I O Projection view according to IP Projection view acquired, mla default, magnification image processing ongoing O Projection view changed, Image finally acquired mlo* magnification exp. scheduled Proj. view selected for exp, Exposure interrupted mlo waiting for sys ready for exp Projection selected for Image rejected mlo exposure, system is ready Projection view selected for exposure, system is ready mlo Note: Some prerequisites have not been fulfilled (e.g., magnification exposure without magnification tablet) exposure is possible Projection view selected for Problem with the exposure system is ready MAMMOMAT (e.g. no mlo Note: Some prerequisites have mlo connection), exposure not not been fulfilled (e.g., possible compression plate not installed) exposure not possible If the red or yellow icons light up, your intervention or appropriate safety measures are required. Work Status Information The work status indicates the process or editing stage that the patient and the examination data (for example, images) has reached. The work status is only displayed for data stored in the local database. In tree view, it is displayed beside the object icon in the navigation area of the Browser. When image stamps are switched off, it is additionally displayed in a column of the contents area (depends on configuration). The work status consists of a 7-part string (as follows): 23 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Received/Workflow/Printed/Archived/Exported/Sent/History available Notes Received: The 1st part shows whether data has been received over the network from other nodes or imported from a local drive. /R/: All data received or imported /r/: Only parts received or imported / /: No data received Workflow: the 2nd part shows how far the examination and the edits have progressed. You can edit the workflow status. It is only available for the studies and series. /com/: Study or series has been completed /rea/: Study or series has been read or reassessed /ver/: Study or series has been verified Printed: The 3rd part shows whether the data object (e.g., study or series) has been printed or exposed on film or printer. /P/: All data printed /p/: Only partly printed / /: No data printed Archived: The 4th part shows whether data has been archived on a network node or to local archive media. /AC/: Archived and committed from an archive node /AF/: Archived but commitment failed /A?/: Archived and waiting to be committed from an archive node /AV/: Archived and verified on a local device (DVD, MOD, CD-R) /A/: All data Archived /a/: Only partly Archived / /: Not Archived Exported: The 5th part shows whether data has been exported to a local device or to other nodes. /E/: All data exported /e/: Only partly exported / /: Not exported 24 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Sent: The 6th part shows whether data has been sent over the network or to other Notes nodes (e.g., report stations or wards). /SC/: Sent and committed from a network node /Sf/: Sent but commitment failed /S?/: Sent and waiting to be committed from a network node /S/: All data sent /s/: Sent / /: No data sent History available: The 7th part shows whether changes have been made to the data record, thereby creating a history. For instance, modifying the patient’s name or rearranging images will create a history record. /H/: History available / /: No history available, no changes have been made 25 Technical Data Mammography Unit Manufacturer Siemens Model Name MAMMOMAT Revelation Type of recording system used with this unit Full Field Digital Is the unit specifically designed for and dedicated to Mammography? Yes Tube Target Material Tungsten Tube Filter Material Rhodium/Titanium Exposure Control Manual or AEC Is kVP and mAS indicated on the AEC exposure? Yes Is the unit equipped for magnifiation mammography? Yes Nominal focal spot size for magnification .15 Nominal focal spot size for screening .3 Image receptor sizes available Other - 24x30 Grid (Bucky) sizes available Other - 24x30 Grid Type Moving/Reciprocating grid Grid Ratio 5:1 Grid Frequency 31 lines per cm Is a compression paddle available for each bucky size? Yes Is initial power driven compression available? Yes Does the system have fine adjustment compression controls? Yes Compression force 3kg(6.5lbs) to 20kg(44lbs) Image Receptor and Display Type of Detector Siemens Amorphous Selenium Pixel Format (Matrix size) of Image x=2816, y=3584 (24x30) Detector Element Size 85 microns Is film screen used with this unit? No Pixel format of monitor (Image matrix) 2816x3584 26 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Exercises Notes Complete the following exercises. Excercise 1 1. Register a patient 2. Pick a procedure 3. Create a PAO – RCC, LCC, LMLO, RMLO 4. Take first two images 5. Correct LCC to be RXCC 6. Reprocess RXCC to take markers on or off 7. Verify all images are marked correctly 8. Expose LMLO 9. Add LCC and make it the next exposure 10. Complete final exposure 11. Is the breast density displayed on each image? (if applicable) 12. What is the average density for each breast grade? (if applicable) 13. What is the density grade for the patient? (if applicable) 14. Close patient 15. Skip auto transfers 16. End exam 17. Manually send raw and processed data to correct destinations 18. Check network job status 27 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Excercise 2 Notes 1. Verify that auto-enable first PV is active 2. Choose patient from scheduler (double click) 3. Verify patient info and click exam 4. Disable first exposure 5. Choose tomo procedure 6. Take all 4 exposures 7. Click on the RCC 8. View tomo slices 9. Click on “First view” 10. Adjust bounding box 11. Perform reconstruction using Insight 2D and 3D 12. Delete unwanted reconstructions 13. Verify all images are marked correctly 14. Close patient/skip auto transfer 15. End examination 16. Open browser 17. Manual send data to appropriate destinations (Cad, PACS, Reading station) 18. Check network job status 19. End session 28 Turnover Workbook | MAMMOMAT Revelation with Insight BD, Tomosynthesis & TiCEM Options Day Three System Set-up Notes Objectives After this session, you will be able to: Follow the steps necessary to complete a live patient procedure. • List and perform QC procedures. • Complete necessary paperwork to conclude twenty-four (24 hour) applications visit. • Patient Procedures This day is reserved for patient procedure hands-on training including: Patient Imaging Display • Review patient images with radiologist(s) • Checklists • Review of all QC procedures • Questions • 29 Appendix A: Acronym Chart Term Description AEC Automatic Exposure Control Auto decomp Auto decompression AWS Acquisition Workstation C Celsius Cm Centimeters Exp Exposure mode FFDM Full-Field Digital Mammography HIPAA Health Insurance Portability and Accountability Act imp implant IPPG Image Processing Parameter Group DPPG Dual Processing Parameter Group kV Kilovoltage MAG Magnification mAs Milliamperage per second Max. Comp. force Maximum compression force mm Millimeters MPPS Modality Performed Procedure Step MU Mammounit N Neutrons Opcomp Optimum Compression OpDose Optimal Dose PAO Procedure Acquisition Order PV Projection View PVS Projection View Sequence RIS Rad ROI Region of Interest sec Second UI User Interface WH Women’s Health TiCEM Titanium Contrast Enhanced Mammography CEM Contrast Enhanced Mammography CEM_A_MC Contrast Enhanced Mammography Motion Compensation LE Low Energy HE High Energy Insight BD Insight Breast Density Vfg Volume of fibroglandular tissue (cm3) Vb Volume of whole breast (cm3) Vbd: Volumentric breast density (%) DGI: Density Grade Index 30 Phantom Image Acquisition for ACR Submission Mammomat Revelation 2D Phantom: 1. Register the patient manually. 2. Select a screening procedure from the Procedure dropdown on the Open pa- tient subtask card. 3. Select Opdose for the Exposure Mode. 4. Position the phantom with the chest wall side of the phantom completely flush with the chest wall side of the image receptor. 5. Compress to Opcomp. 6. Perform an exposure. 3D Phantom 1. Register the patient manually. 2. Select a screening procedure from the Procedure dropdown on the Open pa- tient subtask card. 3. Change icon in gallery to Tomo only. a. Right click and select Modify. b. Select acquisition: Tomo c. Select LCC. 4. Select Opdose for the Exposure Mode. 5. Position the phantom with the chest wall side of the phantom completely flush with the chest wall side of the image receptor. 6. Compress to Opcomp. 7. Perform an exposure. SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2019 Healthineers Job Aid | Phantom Image Acquisition for ACR Submission Effective Date: XX/XX/XXXX | HOOD/HILS 8. After reconstruction is complete, you will need to adjust the bounding box and reconstruct the image. This will make the phantom smaller for submis- sion. a. Select the First View icon. 8 b. Activate the bounding box by clicking on the blue box. c. Open the bounding box top to bottom. TOMO TEST 9.03.21-17:19:22-DST-1.3.12.2 121/20993 1:01 PM R-CC 4096 2048 257 PR R-CC Scale 106% o.p. PGI: b KV: 28 mAs: 5.0 mAs Angle: -0.0, 0.0 ocus: large Magn. factor: 1.000 Comp. Force: 86 N Thickness: 43 mm Anode/Filter: W/Rh Glandular Dose: 0.06 mGy Operator: VH nstitution: Peace Harbor Hospital Station: PHMC_MG01 100 9th street Florence OR 9743 d. Click the Reconstruct button. Reconstruct ... e. Select the default RPG. Reconstruction of scan ? Please select the reconstruction parameter group from the list for the selected scan (projection view: R-MLO TOMO PRIME) and press OK. Reconstruction parameter group name: Empire ....................... Insight 3D OK Cancel Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2019 Page 2 of 4 Job Aid | Phantom Image Acquisition for ACR Submission Effective Date: XX/XX/XXXX | HOOD/HILS 9. Scroll to the desired slice. 10.Export the slice ONLY. NOTE: This needs to be done from the local database. a. Find the folder on the local database. b. Locate then select the desired slice number in the icons below. c. Click on the Transfer menu then select the desired destination (e.g. USB, DVD, etc.). Transfer Edit View Worklist Filter Sort Private Import Ctrl+1 Archive to DVDRW if saving to a DVD ACTIVE LO ... Send to ... Export to ... Eject from DVDRW Eject from ... 01 Finalize Medium and Eject from DVDRW 17 Local Job Status ... Ctrl+L Network Job Status ... Ctrl+N Import from Off-line. Export to Off-line. if saving to a USB Record Off-line Files 101 11. Verify the correct vs. incorrect phantom image for submission: 9.03.21-17:19:22-DST-1.3.12.2 .... 9.03.21-17.19:22-DST-1.3.12.2 .... INCORRECT 3.21:01 PM 3308 257 257 -CC TOMO R-CC TOMO MPIRE EMPIRE CORRECT cale 245% o.p. Scale 109% o.p. V: 28 As: 125.8 mAs kV: 28 ngle: -0.0 As: 125.8 mAs ocus: large Angle: -0.0 omp. Force: 86 N Focus: large lice Height: 35 mm of 43 mm Comp. Force: 86 N lice Thickness: 1 mm Slice Height: 35 mm of 43 mm node/Filter: W/Rh Slice Thickness: 1 mm landular Dose: 1.53 mGy Anode/Filter: W/Rh perator: VH Glandular Dose: 1.53 mGy stitution: Peace Harbor Hospital Operator: VH tation: PHMC_MG01 Institution: Peace Harbor Hospital 00 9th street Florence OR 9743 Station: PHMC_MG01 400 9th street Florence OR 9743 Open patient Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2019 Page 3 of 4 Job Aid | Phantom Image Acquisition for ACR Submission Effective Date: XX/XX/XXXX | HOOD/HILS Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (herein- after collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright © Siemens Healthcare GmbH 2019 ………………………………………………………… Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Telephone: +49 9131 84-0 siemens.com/healthineers Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2019 Page 4 of 4 Appendix C: Exercise TiCEM 1. Register a patient 2. Select TiCEM procedure 3. Complete contrast conditions box 4. Click ok and timer starts 5. Acquire all LE and HE images (how long do you need to wait before first exposure?) 6. Select the RCC image and “Recombine: for “Motion Compensation” 7. Click on the LCC and display the “CEM” image 8. Click on the RMLO and what is the time since injection 9. Close patient/skip auto transfer 10. End examination 11. Open browser 12. Manual send data to appropriate destinations (Cad, PACS, Reading station) 13. Check network job status 14. End session 35 On account of certain regional limitations of sales rights and service availability, we cannot guarantee that all products included in this brochure are available through the Siemens sales organization worldwide. Availability and packaging may vary by country and is subject to change without prior notice. Some/All of the features and products described herein may not be available in the United States. The information in this document contains general technical descriptions of specifications and options as well as standard and optional features which do not always have to be present in individual cases. Local Contact Information Siemens Medical Solutions USA, Inc. Siemens reserves the right to modify the 40 Liberty Blvd. design, packaging, specifications and Malvern, PA 19355-9998 options described herein without prior notice. Please contact your local USA Siemens sales representative for the Telephone: +1-888-826-9702 most current information. siemens.com/healthcare Note: Any technical data contained in Legal Manufacturer this document may vary within defined Siemensstrasse 1 tolerances. Original images always lose a certain amount of detail when Forchheim, Germany 91301 reproduced. Phone: +49 9131 84-4746 siemens.com/healthcare Siemens Healthcare Headquarters Siemens Healthcare GmbH Healthcare Sector Henkestr. 127 91052 Erlangen Germany Phone: +49 9131 84-0 siemens.com/healthcare Published by Siemens Healthcare GmbH · Order No. HOOD05162003099109 · Printed in USA · 06/15/2020 · ©Siemens Healthcare GmbH, 2017