Multix Fusion Max Turnover Workbook

Healthineers SIEMENS ..... : Healthineers Mailin Fusion Max Multix Fusion Max - VE21 Turnover Workbook SIEMENS Healthineers www.siemens-healthineers.us 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? 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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. pep.siemens-info.com 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 II. Contents ............................................................................................................................................................................4 III Course Overview .............................................................................................................................................................. 5 1. System Overview ..............................................................................................................................................................6 1.1 Generator Console........................................................................................................................................ 6 1.2 Emergency Stop ............................................................................................................................................ 6 2. Hardware Features .......................................................................................................................................................... 7 2.1 Detectors .........................................................................................................................................................7 2.2 Patient Table with Wireless Mobile Detector ...................................................................................... 11 2.3 3D X-Ray Tube .............................................................................................................................................12 2.4 Touch User Interface (TUI)........................................................................................................................13 2.5 Collimator Control Elements...................................................................................................................19 2.6 Wallstand .................................................................................................................................................... 20 3. FLC and Performing Patient Exams .......................................................................................................................... 21 3.1 General Workflow .......................................................................................................................................21 3.2 Basic Modes/Task Cards Overview.........................................................................................................21 3.3 Patient Tab (Patient Mode) ......................................................................................................................21 3.4 Examination Tab (Examination Mode) ................................................................................................ 23 3.5 Postprocessing Tab.................................................................................................................................... 26 3.6 Documentation Tab .................................................................................................................................. 28 4. PEX Editor ........................................................................................................................................................................30 4.1 PEX Editor Overview .................................................................................................................................. 30 4.2 Opening PEX Editor ................................................................................................................................... 30 4.3 Exam Tab.......................................................................................................................................................31 4.4 Organ Program Tab................................................................................................................................... 33 4.5 Param. Module Tab ................................................................................................................................... 34 4.6 Configuration Tab...................................................................................................................................... 36 5. User Settings ...................................................................................................................................................................37 5.1 Overview .......................................................................................................................................................37 5.2 DICOM Properties .......................................................................................................................................37 5.3 Site Info......................................................................................................................................................... 38 5.4 Image Delete and User Initials Notes ................................................................................................... 38 6. MAX Swap .......................................................................................................................................................................39 6.1 Attaching and Detaching Detectors ...................................................................................................... 39 6.2 Switching Between MAX Wi-D and MAX Mini.....................................................................................41 3 II. Contents 7. Quick Info .........................................................................................................................................................................42 7.1 Abbreviations............................................................................................................................................... 42 7.2 Status Messages and Display ................................................................................................................. 42 7.3 Cleaning ....................................................................................................................................................... 43 7.4 Technical Data ............................................................................................................................................ 44 8. Troubleshooting .............................................................................................................................................................46 8.1 System Movements and Functions........................................................................................................ 46 8.2 SID Tracking ................................................................................................................................................ 46 8.3 Collimation ..................................................................................................................................................47 8.4 The Message Field ......................................................................................................................................47 4 III Course Overview Learning Objectives Upon completion of this course, you will be able to: Correctly perform start-up and shutdown procedures • Identify the key hardware features of the Multix Fusion Max system • Describe the key features of the Fluorospot Compact Imaging System • Utilize the Examination task card to perform a patient procedure • Utilize the Postprocessing task card to adjust an image • Identify the MAX features of the system • Utilize the Documentation task card to send a study • 5 Turnover Workbook | Multix Fusion Max - VE21 1. System Overview 1.1 Generator Console Notes Switching On/Off System SIEMENS STOP On off Off STOP 2 WARNING! 1 Emergency Stop (see 1.2 Emergency Stop) 110 2 Exposure Release - When all parameters are set and you are ready to acquire the image, ensure the Ready symbol is displayed prior to pressing the Exposure button. The X-ray room and Fluorospot Compact are powered on and off by the buttons • located on the Generator Console. Press the ON button on the Generator ON/OFF console. • The system performs a self-test of the Fluorospot Compact - and Multix Fusion Max systems. Rebooting the System (A daily reboot of the system is strongly recommended). • Press the OFF button on the console - When the FLC has shut down (dark monitor), press O - the ON button 1.2 Emergency Stop Press one of the Emergency Stop buttons to turn off the controller and the motor for the height adjustment of the table top. All system movements and release of radiation become disabled. Release the Emergency Stop button by turning it clockwise. System movements and release of radiation are now enabled. NOTE: Emergency Stop button on the Remote Control Console is only available with the optional Ortho package. 6 Turnover Workbook | Multix Fusion Max - VE21 2. Hardware Features 2.1 Detectors Notes (3) (1) (2) (1) Detector MAX wi-D, to be used in table and wall stand and for free exposure (2) Detector MAX mini, for free exposures only (3) Detector indicators NOTE: Detector calibration should only be done by a trained facility service engineer. LEDs are provided on the detector (close to the handle), to give basic information on the detector behavior. Detector Indicators (5) (4) C (1) (2) (3) (1) Detector status LED (2) Wi-Fi status LED (3) Battery status LED (4) Infrared sensor needed for attachment of a detector (MAX swap (5) Power button Long push (switch off/on) 7 Turnover Workbook | Multix Fusion Max - VE21 Detector Battery Notes Charging the battery of the detector can be accomplished: with the detector in the closed table bucky tray (MAX Wi-D only). • with the detector in the closed wallstand bucky tray (MAX Wi-D only). • in the battery charger. • Detector overview uGym MAX dynamic MAX WI-D Patient Settings Sor Serial number 134602 Celibration ch 27-04-2016 28-04-2016 Wallstand V Table V Free Detoul for tee Disconnect OK Cenoel sorgen procrem | 1/21 Changing the Batteries The battery is located on the back of the MAX Wi-D and MAX Mini. Changing the battery is a 3 step process. It is recommended to power down the detector prior to removing the battery. 1. Locate the battery on the back of the detector 2. Turn the lock on the handle to the Unlock position 8 Turnover Workbook | Multix Fusion Max - VE21 3. Lift the battery and remove it Notes To insert a battery, insert the battery and turn the handle to the Lock position, then press the handle down. The Battery Charger In order to charge the battery, when inserting a battery in the charger (if present), ensure that the gray stripe on the battery is facing the triangle on the charger. Standard with the MAX Mini; optional with the MAX Wi-D • Charging time is approximately 4 hours in the battery charger • 4 LED’s will indicate the amount of charge on the battery • NOTE: It is recommended to turn the detector off before removing the battery. EEEEE 0-25% 25-50% 50-75% 75-100% 100% 9 Turnover Workbook | Multix Fusion Max - VE21 Notes Grids 1. Clip-on grids for MAX Wi-D will have either a 5:1 or a 15:1 grid ratio. Both will have a focus of 45 inches. 2. Clip on grids for MAX Mini will have a 5:1 grid ratio, with a focus of 45 inches. Attaching/Removing the grids 1. Insert the detector into the slot on the back of the grid, with the front of the detector facing the same direction as the front of the grid. 2. Push the detector down against the loading springs until the detector is secured inside the frame of the grid. 00 0 00 OC Ensure that the LED lights show through the LED openings on the grid. To remove the grid, press the detector down against the loading springs of the grid and pull the detector out. 00 000 0 (4) Jo 10 Turnover Workbook | Multix Fusion Max - VE21 2.2 Patient Table with Wireless Mobile Detector Notes Maximum table capacity 660 lbs. Table movements • If patient is over 440 pounds, movement of table is limited to raising and lowering. - If patient is under 440 pounds, all table movements are availble. - Accessories • Grid insertion/removal • For pediatric exposures, the grid can be removed - Stationary; 15/80 focused at 115 cm - Bucky Tray • SIEMENS .... The table bucky tray can be moved manually by pulling out the handle and moving the tray into position. 11 Turnover Workbook | Multix Fusion Max - VE21 2.3 3D X-Ray Tube Notes Ceiling Mounted Tube Support Movement of the 3D ceiling mounted tube support can be controlled by the handles and the touchscreen. The touchscreen displays The 3D ceiling-mounted tube support consists of the following components: 1 Lifting column (1). 2 X-ray tube unit 3 Touch User Interface 4 Handles for movement w/ (2) buttons (3) 5 Multileaf collimator (ACSS) (4) (4) (5) Movement Control Elements Left Side Com Tube rotation about the vertical axis Vertical tube movement up and down – manual Vertical tube movement up – motorized - Vertical tube movement down – motorized 12 Turnover Workbook | Multix Fusion Max - VE21 Right Side Notes Transverse tube movement transverse – detents (green LED) Longitudinal tube movement – SID detents to wallstand (green LED) - Tube angulation – cranial and caudal Tube movement transverse, longitudinal and vertical. This function (CO) is also found as a rocker switch at the end of the tube handles on both sides. NOTE: All tube movements, manual or motorized, are deadman functions. Releasing the button will stop the movement of the tube. 2.4 Touch User Interface (TUI) The color touchscreen displays essential information and enables the user to control multiple functions including mode (wall, table, etc.), SID Tracking, exposure values, etc. There are three different types of controls available on the TUI; push buttons, toggle buttons, and switch buttons. Consult the MFM Operator Manual (Section 1.6.2.3) for additional information. (3) (1) 117 +2.0 H (2) 102cm H/U/D I DO + The screen is divided into three areas: 1. Information field 2. Control field 3. Message field for system messages and OK status. 13 Turnover Workbook | Multix Fusion Max - VE21 2.4.1 Information Field Notes System Mode or workplace– Wall mode cassette or detector, table mode cassette or • detector, and free exposure mode cassette or detector Tube angulation – table, wallstand or free exposure • +XXXº SID – table and wallstand. System must be detented for value to be displayed. Red icon • indicates conditions are not met so value cannot be calculated. I DO I DO XXXcm 75€ 30 Wallstand Tracking – conditions for wallstand tracking: • 450 750 09 HA ... DO ..... DO .06 1. Tube detented 2. Wall mode selected 3. Wallstand at 0 degree tilt 4. Detector inserted in wallstand 5. Tube angulation (none). Horizontal to wallstand Note: Tracking button on wallstand must be pressed and all conditions met for tracking to be active. A red tracking icon on the TUI means not all conditions for tracking are met or tube is “lost.” Grid - location and status of grid. Grid In, Grid Out, and Grid Error. • System Ready - X-ray can be released • V 14 Turnover Workbook | Multix Fusion Max - VE21 2.4.2 Control Field Notes Block System Movement - If enabled, all tube, table and wallstand movement controls are disabled. Top Alignment - When collimating top to bottom, the tube will move up to place the center of the X-ray beam higher on the detector. Very useful on patients with smaller chests. Wallstand tilt at 0 degrees • Tube detented • No tube angulation – horizontal to wallstand • Detector orientation of portrait only • Landscape orientation is detector at top position in bucky tray • Note: Top Alignment is automatically on when the detector is placed in the bucky wallstand in landscape orientation and it cannot be turned off. SID Tracking - Preconditions for SID with BWS include: BWS is tiltable and tilted to 90 degrees • Tube detended • Tube angle is 0 +/- 3 degrees • SID > 85 cm • Preconditions for SID with Patient Table include: Tube is in y-detent above table • too Hoo Tube is not in x- and y-detent above tilted BWS • Tube angle is 0 +/- 3 degrees • SID > 85 cm • A cassette or detector is inserted in the tray of the BWS • 15 Turnover Workbook | Multix Fusion Max - VE21 Increase Value Applies to kV, mAs, ms (exposure time) and density Notes correction (for AEC exposures). Function must first be selected before + Increase Value is active. Decrease Value Applies to kV, mAs, ms (exposure time) and density correction (for AEC exposures). Function must first be selected before - Decrease Value is active. Selection of small and large focal spots 0/0 Dose level (Low, Medium, High) H = Low (high sensitivity, U U = Med, D = High (low sensitivity) H/U/D Dose Value It is recommended to use the 2.5 setting for standard dose exposures. 2.50 uGy Density correction (for AEC only) Values range from +2 to -2, +2.0 in 0.5 increments. kV selector Values range from 40 to 150 and are based on the 117 Siemens exposure point system KV Selection of AEC chambers (dominant) Can be selected individually or in combination. 16 Turnover Workbook | Multix Fusion Max - VE21 2.4.2 Message Field Notes System will display a green check mark to indicate ready for exposure or any system or error message. STOP 2.4.3 Generator Operating Elements One Point Technique - for use with AEC only 4 HDO 117 2.0 I 115cm 8 kv H/U/D + - Two Point Technique – Manual kV and mAs. HDO 117 23. 115cm 8 KV MAS 0/0 + Three Point Technique – Manual kV, mAs and exposure time. Maximum exposure time is 2 seconds. HDO 117 23.7 110 115cm 8 KV MAS ms + - T 17 Turnover Workbook | Multix Fusion Max - VE21 2.8.5 Error Messages Notes Detector tray open X-ray will be prevented Table mode BWS mode. Exposure made (for table and wall bucky). Emergency Stop activated All system movements are blocked. X-ray is possible. STOP SID on wall bucky undefined. X-ray is prevented.” Undefined receptor (for table and wall bucky). Make sure detector is centered in bucky tray. X-ray is prevented. A Call Service. X-ray is possible. Generator not ready. X-ray is prevented 18 Turnover Workbook | Multix Fusion Max - VE21 2.5 Collimator Control Elements Notes O (8) (7) (6) E (5) M (9) (3) ( 4 ) (2) (10) (1) (1) (1) Rails for inserting collimator accessories (2) Collimator light localizer (full-field light and laser light); switches off automatically after 10-90 seconds. Call Customer Care to configure. (3) Manual setting for height of the radiation field. Turn knob right to open the collimator and left to close the collimator. (4) Manual setting for width of radiation field. Turn the knob to the right to open the collimator and left to close the collimator. (5) Motorized selection of copper filtration (6) Display field: Cu filtration, ACSS/Manual collimation, SID and current collimated field size. (7) Memory button: Restores collimation from previous exposure (8) Lever for rotating collimator: Limits are +/- 45 degrees (9) Buttons for entering SID for free exposures (10) Tape measure for SID (cm and in) 19 Turnover Workbook | Multix Fusion Max - VE21 2.6 Wallstand Notes Detector can be inserted in portrait or landscape orientation. Wallstand grids are color-coded: • Blue – 115 cm (45”) - Grey - 140 cm (55”) - Pink – 150 cm (60”) - Orange – 180 cm (72”) - The radiographer is responsible for selecting and • inserting the correct grid. Vertical movement (height adjustment) The detector unit can be moved vertically using the respective buttons at either side of the detector housing. Press the button for the manual vertical movement (5) and move the detector unit up or down to the required working height. or Press one of the buttons for the motorized vertical movement (8) to move the detector unit up or down to the required working height. Tilting Press the button (4) for unlocking the tilt mechanism and tilt the detector unit to the required position. The detector unit can be continuously tilted to the required position between 0º/vertical and +90º/horizontal or up to -20º 20 Turnover Workbook | Multix Fusion Max - VE21 3. FLC and Performing Patient Exams 3.1 General Workflow Notes High level overview There are four main steps to the workflow: Patient Task Card - Register a patient Examination Task Card - Examine the patient Postprocessing Task Card - Manipulate an image Documentation Task Card - Archive the exam/study 3.2 Basic Modes/Task Cards Overview The Fluorospot Compact (FLC)has four modes. Each mode is available on a task card: Depending on the state of examination, not all modes may be available. Patient Mode includes study lists, input of patient data and archiving as well as • basic settings Examination Mode includes organ program and parameter selection, and acquisition • Postprocessing Mode includes image review and postprocessing • Documentation Mode includes image review, hardcopy and DICOM send options • The default display on the monitor includes: Preregistered Patients - List of patients from RIS or patients that have been • manually entered. Examined Patients - List of patients that have been examined. This is where you can • burn a CD/DVD. Archiving Information - This screen is always blank and will never contain patient • information. . 3.3 Patient Tab (Patient Mode) Patient Patient Subtask Card Functionality available on the Patient subtask card includes: Call up input form to create a new study with a new Patient Settings Service • patient + Modify study data • Add a study to the selected patient • Delete selected study/studies • Protect/unprotect study • RIS RIS Apply/remove filter to study list • Update preregistered patients lists from HIS/RIS • 21 Turnover Workbook | Multix Fusion Max - VE21 Get worklist/search for patients/studies in HIS/RIS Notes • Close study • Registering a Patient To select a patient from the Preregistered list: 1. Click on the Patient tab. RIS 2. If your system has a RIS, press F11 or click this button. It will update the Preregistered Patients list from HIS/RIS. OR - - Click on the Get Worklist/Search icon to search for patients/studies in RIS the HIS/RIS. 3. Double click on the patient’s name to be examined or highlight the patient’s name and click on the Examination Tab. To Manually Register a Patient: 1. Click on the Patient Tab. 2. Click on the Patient Registration icon (Create New Study). 3. Populate all fields that have bold text. 4. If this is a patient with no data, click on the Emergency icon to start the examina- tion. You will be able to populate the data later. Settings Subtask Card Functionality available on the Settings tab include: Change general user settings • Patient Settings Service View Job Status • Create study statistics • Open PEX Editor • Enable/disable access for remote diagnosis • Clinical EXI Log • Recycle Bin (if configured) EXI • 22 Turnover Workbook | Multix Fusion Max - VE21 Service Subtask Card Notes Functionality available on the Service subtask card include: Service Login Patient Settings • Service Display test images & switch to Postprocessing • mode Display X-ray tube statistics • Perform Quality Control study • DO Remote Desktop Assistance • View Rejected Images statistics • 3.4 Examination Tab (Examination Mode) Examination Patient Resource Information The patient loads with all of the OGP’s for the exams ordered. If you can not see the entire list, click on the Eyeglasses icon to expand the list. Joe, Don 123456 0 0 X ANKLE AP Left X ANKLE LAT Left C CASSETTE 23 Turnover Workbook | Multix Fusion Max - VE21 Acquisition Parameters Notes All Organ Programs will populate with predefined acquisition parameters. These are based on an average adult patient and should be adjusted for body habitus and pediatric patients. *AEC Exposure: Sensitivity 400 = Detector Dose 2.5µgy Item Short description Define view position and image laterality KV 81 MAS KV Tube voltage [kilo volts] Dose 2.50 S 0.0 ms Pulse width [milli seconds] Focus MAS Product of tube current and time [milli ampere seconds] % 180 144 Dose Dose per exposure [uGy] Exposure correction (in exposure points) Focus Focus: Large/ 1 small % Tube utilization [per cent] Increase exposure time (dose reduction) S 000 Select measuring field (dominant) 24 Turnover Workbook | Multix Fusion Max - VE21 Exam Manager Notes If the Exam Manager is displayed, you will need to select the correct exam on the left side, click Replace in the center so the accession number stays the same, and click Examination. The Exam Manager is displayed whenever the exam name from the RIS is not recognized by the PEX Editor, or that exam name has not yet been programmed. This may also be used to add views not displayed in the list of protocols. This happens because the Exam Name from the RIS does not match what you have entered into the PEX Editor. Remember to correct the exam spelling in the PEX Editor. The triangle will appear when there is a RIS Mismatch. To fix this, refer to the section on “Entering Exam Names” in the PEX Editor section. Exam Manager Patient : Test , Testing Available Exams / Organ Programs Assigned Exams / Organ Programs · alphabetic by name Organ Programs by Exam C alphabetic by body part region C Organ Programs in acquisition order C alphabetically by acquisition type 9 Peri_ Template Fluoro_Arthrogram_Singleshot_BB Fluoro_Arthrogram_Singleshot_BW Fluoro_Barium 1fps_BB Fluoro_Barium 1fps_BW Fluoro_Barium 2fps_BB Fluoro_Barium 2fps_BW Fluoro_Barium 4fps_BB Fluoro_Barium 4fps_BW Fluoro_Barium Esophagram 2fps_BB Add Fluoro_Borium Esophagrom 2fps_BW Fluoro_Barium Singleshot_BB Fluoro_Barium Singleshot_BW Replace Fluoro_Barium Swallow 2fps_BB Fluoro_Barium Swallow 2fps_BW Fluoro_Chest_BW Fluoro_HSG_Singleshot_BW Fluoro_lodine 1fps_BB Fluoro_lodine 1fps_BW Fluoro_lodine 2fps_BB Favorites Organ Prog. T + Delete Details Accession Number: 852741 Details .. Study Description: PELVIS Scheduled Procedure Step: Cancel Image Subtask Card Image Tools Cropping Tool • Store Image • Navigation Buttons for Image Review • Send Image” • You are able to crop your image and review all images. Tools Subtask Card Store/Review Reference Images • Review Exam Protocol • NOTE: Monitor Display The information that populates in the four corners is configurable. The upper left side should show a white circle, meaning that the image is marked to be sent to the printer or PACS. 25 Turnover Workbook | Multix Fusion Max - VE21 The bottom left corner shows the Clinical EXI. This number has a low and high range Notes and is only one of the determining factors for checking if the image is under/ overexposed. 3.5 Postprocessing Tab Postprocessing The Postprocessing task card lets you make changes to the acquired image. It is divided into three subtask cards: 1. Process 2. Graphics 3. Rad Process Subtask Card Process. Graphics Rad Zoom/Unzoom image 1:1 pixel display • Invert grey scale • ~1:1 Flip image horizontal and vertical • R Window – Contrast and Brightness adjustment • Window Center = Brightness (move mouse up/ re - down) Window Width = Contrast (move mouse left/right) - Rotate image • Process. Graphics Rad Several rotational functions are available. Click - icon for the options. Images can be rotated by simply left clicking on the ~1:1 - image and, holding the left mouse button down, R rotate the image to the desired level. R CR R 26 Turnover Workbook | Multix Fusion Max - VE21 Graphics Subtask Card Notes Set laterality label (R/L marker) Process. Graphics Rad • Draw arrow • Draw distance/calibrate • 999 Remember to store the image with the - distance graphics as a new image. The graphics are “burned into” the image Draw angle XYZ • Enter text • Text can be placed anywhere in the image - You can build a list for text and comments and change the text size - Rad Subtask Card Cropping Tool – Will open to raw image and show collimation lines. Using your mouse, you can: Process. Graphics Rac Drag lines in, out, up. and down . • Drag the corners to new positions. Auto-cropping • Set black Left click and hold to draw your own new box. Auto-window • Right click and release (four times) to create Amplification 2.0 MY Auto • your own four input points. Click the OK button (blue check mark) • V. to accept changes. Amplification Tool - Used to adjust the contrast as cropped of the image Use the drop down box to select a new value • Process. Graphics Rad Higher numbers are darker, lower numbers • are lighter Auto-cropping Set black If there is a check mark in the “Auto” box, click to • Auto-window remove it so the drop down box displays Amplification 2.00 Auto Click OK button to accept changes” • V 14INx17IN 3 27 Turnover Workbook | Multix Fusion Max - VE21 3.6 Documentation Tab Notes Documentation The Documentation task card is where you archive patient studies. It is divided into three subtask cards: 1. Select 2. Film (if film printer is configured) 3. Send Select Film Send Select Subtask Card All images need to be marked with a white circle to be sent to the hardcopy camera or PACS. Mark all images • X Unmark all images • Mark/unmark single image • Create twin image horizontal/ vertical • Create quad image • Delete image(s) • 28 Turnover Workbook | Multix Fusion Max - VE21 Film Subtask Card Notes The Film subtask card can be set up with a default Select Film Send hardcopy camera and film size and layout per exam. Printer DicomPrint Film marked images DicomPrint, default • . . auto Inv. predef!! Preview marked images Name default • Show film status Size 14INx17IN • Layout 1 O Auto Scale 100% 57 Print as substracted Override configured settings Copies 1 : Anonymous Hide Text Send Subtask Card The Send subtask card can be set up with three default Select Film Send networks/PACS. Target 1 store Send marked images Target 2 Show send status Send exam protocol to the network as a Secondary Target 3 Capture image Send Exam Protocol as: Send a DICOM Dose Structured Report to the network • SC image Override the configured settings for the Send targets DICOM Dose SR • Override configured settings ? 29 Turnover Workbook | Multix Fusion Max - VE21 4. PEX Editor 4.1 PEX Editor Overview Notes Programs and Exams Editor is divided into five task cards: Exam • Enter your RIS exam names and OGP views - Organ Program • Edit technical factors - Fluoro Program (no function on this system) • Param. Module (N/A on the Multix Fusion Max system) • Configuration • Backup system - 4.2 Opening PEX Editor On the Patient Task Card > Settings Subtask Card click on this icon. The login screen will appear. Click the radio button next to Siemens • Enter the password that your Clinical Education Specialist gave you and click • the OK button. Bf PEX Editor X Programs and Exams Editor Viewing only Customer SIEMENS Password Ok OK Close 30 Turnover Workbook | Multix Fusion Max - VE21 4.3 Exam Tab Notes The PEX Editor opens up to the Exam subtask card. PEX Editor Exam Organ program Fluoro program Film Layout Param. Module Configuration OGP View Examination View TUES-LEFI + .- TOES-RIGHT ...... 9_Cassette_Template (d) 9_Peri_Template (d) + M UGI STUDY M 9_Scan_Template (d) Insert OGP UPPER EXT. INFANT MIN 2V BILAT(d) ..... M 9_Tomo_Template (d) + M UPPER EXT. INFANT MIN 2V LEFT(d) ..... C Abdomen, left side pos. (d) + ... UPPER EXT. INFANT MIN 2V RIGHT (d) C C-spine lat (d) You can also VOIDING CYSTO-URETHROGRAM C Cassette (d) drag&drop OGPs from WRIST 4 VIEW-BILATERAL C Femural neck axial (d) the OGP view to Exams + MM WRIST 4 VIEWS-LEFT ..... C Hip (d) in the Examination view WRIST 4 VIEWS-RIGHT M C Hip, with grid (d) + --- WRIST ARTHROGRAM ..... C Humerus lat (d) C Patella tangential (d) Remove OGP WRIST-BILATERAL M WRIST-LEFT ....... C Pelvis (d) WRIST-RIGHT ~ Dolvic with arid (d XR Nasal Bones(d) Group by @Name @ Body Part @Acq. type Sort by O Name Body Part Acq. type Exam parameters Default Exams OGP Parameters ExamName XR Nasal Bones Name for RIS XR Nasal Bones Add to favorites Filming Layout Network Node 1 Default Network Node Exam Level OGP Level Network Node 2 Fluoro Network Node 3 Rad Camera Default camera @ Auto Scale Auto Scale 0 % % o Automatically switch to next OGP after acquisition Store as new Store Exam Delete Entering Exam Names On the right side of the screen you see Examination View. This is where you will modify or create the listed exam names to match your site’s RIS Exam Names. (You will need to have a copy of your RIS Examination Names.) 1. Click on an exam name that closely matches one of your exams. 2. Populate the Name for RIS and Exam Name fields with the correct name. 3. When finished, click Store if you modified the name or click Store as New if you cre- ated a new name. 4. Continue until all exams are entered. NOTE: It is very important that you type in the name exactly as it appears on your list (word-for-word and spacing). If not, the study will not populate when you click on the patient to be examined. 31 Turnover Workbook | Multix Fusion Max - VE21 Adding/Removing OGP View in Examination View Notes 1. Examination Views can be customized with the views needed. The order of the views can also be customized. 2. Select the Examination View to be modified. Open the drop down box by double- clicking on it or clicking on the Plus Icon. 3. To add a new OGP view, find the correct one under the OGP View on the left side. Click on it one time and select the Insert OGP button in the center. (Be careful to choose the correct acquisition mode - T, W, X.). 4. To remove an OGP view from the Examination, click one time then click the Remove OGP button in the center. Exam Organ Program Fluoro Program Param. Module Configuration OGP View Examination View T ABDOMEN SUPINE (d) 0 Pex Database_VE10_Sept2014_Mas T ABDOMEN SUPINE Casette (d) + 0_RAD_Daily_Check(d) T ABDOMEN UPRIGHT (d) 0 Siemens CSE Test Programs(d) T AC JOINTS (d) 1 Position_Setup T ANKLE 0-3yrs (d) Insert OGP ABDOMEN 3 VIEWS_S(d) T ANKLE 4-12yrs (d) T ABDOMEN SUPINE (d) ...** T ANKLE AP (d) W ABDOMEN UPRIGHT (d) ..... T ANKLE AP Left (d) W ABDOMEN DECUB (d) ..... T ANKLE AP Right (d) T ABDOMEN 0-3yrs (8-14cm) (d) ..... T ANKLE BILATERAL (d) W ABDOMEN 4-12yrs (12-20cm) (d) T ANKLE LAT (d) ..... W ABDOMEN 12-16yrs (14-22cm) (d) T ANKLE LAT Left (d) Remove OGP C CASSETTE (d) T ANKLE LAT Right (d) ........... ABDOMEN FLAT & UPRIGHT_S(d) T ANKLE Left 0-3yrs (d) ABDOMEN UPRIGHT VIEW ONLY_S(d) T ANKLE Left 4-12yrs (d) ABDOMEN-ACUTE INCL PA CHEST_S( ..................................................... Group by O Name Body Part Acq. type Sort by O Name Body Part Acq. type 5. You are able to arrange the order of the views by clicking on the arrow. ABDOMEN 3 VIEWS_S(d) T ABDOMEN SUPINE (d) W ABDOMEN UPRIGHT (d) W ABDOMEN DECUB (d) T ABDOMEN 0-3yrs (8-14cm) (d) W ABDOMEN 4-12yrs (12-20cm) (d) W ABDOMEN 12-16yrs (14-22cm) (d) AMBPARTIR SUL 6. Checking the box Automatically switch to next OGP after acquisition allows the next view to populate during the exam. Make sure to click Store to save. Automatically switch to next OGP after acquisition 32 Turnover Workbook | Multix Fusion Max - VE21 4.4 Organ Program Tab Notes This tab shows the technical factors for the OGP views - to include AEC chambers to be activated, technique, collimation size, etc. It is used to modify or create an OGP View. This tab is opened by selecting an OGP View in the Exam Tab and then selecting the Organ Program tab, or double clicking on the OGP View. Modifying or Creating OGP View Begin by going to the correct acquisition mode in the Exam tab. C = Cassette exposure • T = Table exposure • W = Wall exposure • X = Free exposure • 1. Choose the OGP View to be modified, or (for a new OGP) a view that is similar to the one to be created. 2. Select the Organ Program tab or double left Exam Organ program click on the OGP View. Body Part Examined LSPINE Program Name T L-Spine a.p. (d) 3. For a new OGP View, change the name in the Acquisition Mode DR RAD Program Name box. Be sure to delete the (d) at Acquisition Type Table the end, but do not remove the acquisition mode (T, W, X). If only modifying the View, changes are not needed in this box. 4. Make any technical factor changes to the View Parameters, such as Technique and Collimation Size. 5. For a new OGP View, select the Store as New button at the bottom. For a modified view, select the Store button. X - Ray Parameters Presettings Mark Image PT Position Not defined Fluoro Program Set none Laterality Not Defined MField View position Not Defined Anatomically Correct View 1 pt Flip No change 1 pt with ext. exp 2 pt R / 9 3 pt 3 pt with AEC Rotate 90 180 @ 270 KV 81 Label R MAS ms Exp. Correction 0+ EP Dose 2.5 Stand Parameters Sensitivity 400 TOD not defined cm Tube Load 80 Grid 115 cm Grid rotation % Collimator 16.93 × 16.93 inches Focus Filter Type 0.0 Cu mm Stand Position W 45 NO angle MID Top Alignment V SID Tracking Tracking Store Store as new 33 Turnover Workbook | Multix Fusion Max - VE21 Notes 4.5 Param. Module Tab The Param. Module tab includes the following parameter modules: Body Part Examined: - Defines the body parts available for selection in Organ Programs. EXI Values: Define the maximum and minimum clinical EXI values as well as the target clinical EXI value. Min EXI - Minimum exposure index value - Max EXI - Maximum exposure index value - Target EXI - Target clinical exposure index for the examination. Used for - calculation of the Deviation Index (DI). NOTE: If the Target EXI is not set in the organ program, no DI will be calculated or displayed. In software versions before VE10, the Max. EXI and the Min. EXI values were used for calculation of the Deviation Index = DI. Exam Organ Program Fluoro Program Param. Module Configuration Body Part Examined Stand Position ABDOMEN Identifier c001 Delete Store Name X Fuss long view ax. New Collimator settings []Ignore for auto-cropping EXI Values Position: Undefined Identifier d001 Name default Store Position Store Parameters Min. EXI 125 Delete Activate Max. EXI 500 New Target EXI 250 Spatial Frequency Parameters Delete Store New Identifier 3001 Gradation Parameters Name Thorax pa - HC Diamond View ID 01 V Identifier d001 Diamond View Name Thorax pa - high contrast Name 1 Noise Reduction Shape 23 Edge Filter. Kernel Contrast 16 Edge Filter. Gain 0.53 Center 2048 Harmonization: Kernel 255 Offset 0 Harmonization: Gain 0.35 Delete Store New Delete Store New Trajectory Image processing parameters Import Image Batch Processing Manager 4.5.1 Defining Parameter Subsets 1. Enter a new Identifier and a new Name. Identifier: Identifier of the parameter displayed in other dialogs (4 characters: c, d or s followed by a number 000 – 999, e.g. c017): c = customer read-write access, d = default read-only access, s = service read-only access. Name: Name of the parameter (max. 20 characters - DICOM character set) 2. Define the parameters. 3. Click the New button. 34 Turnover Workbook | Multix Fusion Max - VE21 Select an entry and click the Delete button to delete a parameter set. Notes 4.5.2 Replacing a Parameter Set 1. Select an existing parameter set. 2. Define the parameters. 3. Click the Replace button. The revised parameters are now stored. NOTE: The parameter Identifier in Spatial Frequency Parameter and Gradation Parameters cannot be modified by pressing this button. Defining the Batch-Processing List For batch-processing of RAD images in Postprocessing mode, you can define an input list of processing parameters. Each entry of the list is one set of parameters which is used to parameterize the reprocessing of the active RAD image. The parameters are: Amplification factor / auto amplification - Gradation parameter module - Spatial frequency parameter module - Image comment - 1. Click Image Batch Processing Manager. Amplification Fa ... Auto Amplification Gradation Para .. Spatial Frequen ... |Image Text ANWE Save Table Add Row Delete Row Close 2. Click the Add Row button for every batch-processing to be created. 3. Change the required parameters by clicking into the cells and selecting/entering the required values. Id Amplification Fa ... Auto Amplification Gradation Para. Spatial Frequen ... Image Tex Active 1 0.5 1 Abdomen 2 1 2 Abdomen - HC 3 1.4 Abdomen - HC NR W Save Table Add Row Delete Row Close 35 Turnover Workbook | Multix Fusion Max - VE21 4. Click the Save Table button. If no image texts have been entered, image comments Notes are composed automatically. Id Amplification Fa ... Auto Amplification Gradation Para ... Spatial Frequen ... Image Text Active 1 0.5 1 Abdomen 0.5 1 Abdomen 2 2 Abdomen - HC 1.0 2 Abdomen ... 13 1.4 3 Abdomen - HC NR 1.4_3_Abdomen ... Save Table Add Rov Delete Row Close 5. Enable/disable rows by clicking the Active check box. 6. Click the Save Table button. 7. Click the Close button. 4.6 Configuration Tab This tab can be used to Exam Param . Module Configuration change the default Unite for password password, make a backup Collimator Size Inches Change Password Reset Customer Password of the database, and to import a database. Data Type Selection Siemens Default Database Export Import Language English Backup / Export Restore / Import Backup PEX Editor Merge Image Converter @ Flat detector After you finish making clude RIS Names .. Image Intensifier changes in the PEX Editor, it is very important to do Pex Versions a backup. Editor version: 7.9.11.0 Database version: 46 1. Click on Configuration. Store 2. Click on Backup/Export button. 3. Click on C Drive and click GO. Do the same for the D Drive. Import PEX Editor NOTE: Each import replaces the current database and cannot be undone unless database has been backed up so be careful not to replace the original or most recent backup. Consider making a backup of current database before importing a new one. On the local hard disk (e.g. drive C: and D:) the number of backups is limited to 10. For more details and diagrams of the PEX Editor, please see the online User Manual located by pressing the F1 key on the keyboard while on the Patient tab on your Fluorospot Compact. 36 Turnover Workbook | Multix Fusion Max - VE21 5. User Settings 5.1 Overview Notes User Settings are customizable settings that include sending of dose reports, modifying auto delete of old exams, and turning on/off reject analysis. To get to the User Settings, in the Patient Tab, select the Settings subtab. Choose the Wrench Icon on the top left.. USER SETTINGS DICOM Image Display Examination Site Info Exam Properties and Print Pr ... Properties Manage ... - ON - Image Delete Acquisition Patient Order Registrati ... 5.2 DICOM Properties In the Sending tab of the DICOM Properties, it is possible to select rather or not to auto send the dose report as well as the background color of the dose report. Background Color of Exam Protocol Notes It is possible to send the Exam Protocol (exposure data, fluoro time, number of images, etc.) over the network with the patient images. These are sent as an SC, or secondary capture image. The background color of this SC image can be selected as black or white. DICOM Properties X General Protocol codes Sending Printing Store Card / Flugro Storage Commitment Waiting time hours Number of retries Worklist query RIS Timermi Modalities to query CR DX RF Other Modality Performed Procedure Step Auto MPPS after series Study Complete Method Auto on entering Patient mode M Show dialog Mark Order O Acquisition date and time Anatomic order number EXI value for DICOM Physical o Clinical OK Apply Cancel 37 Turnover Workbook | Multix Fusion Max - VE21 5.3 Site Info Notes This tab allows for input of Institution name, screen saver wait time, and patient demographics to be displayed for each exam. Site Info X Institution Name Ysio Institutional Department Name Cary, NC Screen saver Wait Time min Patient Demographic Data Accession No. Request ID Patient ID Date of birth Patient list Single study mode Multi study mode Display image receptor size in . cm o inch Daylight saving time Automatic activation OK Apply Cancel 5.4 Image Delete and User Initials Notes User initials can be part of the DICOM header with the images or for Reject Analysis User Settings • Auto Delete • User Initials – enter user initials in the dialog box when a patient is registered • Use as DICOM operator name – user initials will be inserted into DICOM header • mage Delete X Auto delete Enable auto delete Hard disc fill level 60 Deletion size 14070 Activation time 20:13:40 Activation date . Daily Weekly Conditions Images sent Images filmed Images stored on CD/DVD User confirmation Archiving information Maintain deleted studies Recycle Bin Enable Auto send from recycle bin User initials Use user initials Use as DICOM operators name Rejected Images Analysis Enable rejected images analysis Provide user related analysis Password Change Password protected OK Apply Cancel 38 Turnover Workbook | Multix Fusion Max - VE21 6. MAX Swap 6.1 Attaching and Detaching Detectors Notes Detaching a Detector To detach or disconnect the MAX Wi-D or MAX Mini from the system, click on the Detector Overview icon to open the Detector Overview information window. eteulol ohervieu Examination MAX dynamic MAX WI-D Patent Seitige | Sander oral nunha 114612 Weilstand Detector attachnon Do youwert to detector? Deleslor typo:MAX MI-D, Saricl Free number 134800 Cancel OK. Con ca @ Sal -term pregamitnl Select the wireless detector you wish to detach, then click on Disconnect. Confirm that you want to detach this detector, and the detector is now detached from this system. NOTE: If the detector is just removed from the room and not detached, it may cause problems with performance and workflow with the system. 39 Turnover Workbook | Multix Fusion Max - VE21 Attaching a Detector Notes For a detector to be attached, or connected, to the Multix Fusion Max, the system must first know the serial number of the detector and it’s calibration data. To do this, follow these steps: 1. Locate the infrared sensor on the front of the Fluorospot Compact. It is located in the upper right hand corner. 2. Make sure the Fluorospot Compact is in the Patient tab. Then click on Detector Overview. 3. Hold the wireless detector you wish to attach in front of the infrared sensor. This should be done along the edge of the detector, between the indicator lights for the wireless network and the detector status. 4. Confirm the message on the Fluorospot Compact about the attachment. 5. This detector is now attached to the system. Note: Exporting and Importing of calibration data is a function done by Siemens Service. SIEMENS ... :: : .. . ... ( DD . . . C 40 Turnover Workbook | Multix Fusion Max - VE21 6.2 Switching Between MAX Wi-D and MAX Mini Notes It is possible to exchange the MAX Wi-D and MAX Mini between systems. On the Fluorospot Compact, click on the detector you wish to use. Select the portable detector to use for free acquisition Detector 1339D1 Detector 133908: NOTE: If both the MAX Wi-D and the MAX Mini are attached and ready for use, select the appropriate detector for use or put the Wi-D in the table or wall bucky. In the Patient tab of the Fluorospot Compact, in the lower right hand corner, is the detector overview icon. Click on it and you will see the detector overview screen. This will show you what detectors are currently connected to the system, what the serial number is (MAX Wi-D and MAX Mini) and the latest calibration data. 41 Turnover Workbook | Multix Fusion Max - VE21 7. Quick Info 7.1 Abbreviations Notes FLC - Fluorospot Compact, the operating system FD - Flat Detector BWS - Bucky Wall Stand Wi-D - Wireless detector OGP - Organ Program, a set of parameters for acquisition T - Table Bucky Acquisition W - Wall Bucky Acquisition X - Tabletop or Free Exposure 7.2 Status Messages and Display Ready OUD 5 +0 2% hu Symbol Short description Ready for acquisition Not ready OT Free hard disk space 100% 0% OUD OUD Free DVD space OUD) DVD OUD 100% 0% Detector temperature is not within required range. Detector calibration has expired. Software update is available. 42 Turnover Workbook | Multix Fusion Max - VE21 7.3 Cleaning Notes The following substance classes may be utilized for the entire system excluding the monitors and touchscreens. Aldehyds • Alkylamines • Quaterny Compounds • Guanidine Derivates • Peroxide Compunds • Pyridine Derivatives • Organic Acid • Chlorine Derivatives • Household Detergents • Please keep in mind substances with Quaterny Compounds and Chlorine Derivatives must not be used on stainless steel surfaces. Cleaning and disinfecting the monitors and touchscreens please note: The following substance classes are recommended: • Aldehydes - Chlorine Derivatives - Alcohol - The following substance classes must not be used: • Peroxide Compounds - Gasoline - Regarding the disinfecting “effect” of the substance classes, please note: The following substance classes have no disinfecting “effect” and are only cleaning • substances: Household Detergent - The following substance classes have disinfecting “effects”, but cannot be used for all germs. The knowledge regarding the effect for specific germs must come from the hygiene officer from the site/hospital. Aldehydes • Alkylamines • Quaterny Compounds • Peroxide Compounds • Pyridine Derivatives • Organic Acid • Chlorine Derivatives • Alcohol • 43 Turnover Workbook | Multix Fusion Max - VE21 7.4 Technical Data Notes Patient table Max. patient weight 300 kg • Table grid Stationary; 15/80; focused grid: 115 cm • Wall stand Detector Tiltable from – 20° to + 90° with 0° detent • MAX Wi-D Detector (Optional) Dimensions (Active Area) 34.9 x 42.5 cm • Active area matrix 2356 x 2872 pixels • Pixel size 148 microns • Scintillator Cesium Iodide • Acquisition depth 16 bits • DQE in %, 2 µGy (RQA5) 66% at 0.05 lp/mm • Data transmission < 2 sec. preview, <5 sec. full image • Thickness 19 mm • Weight 3 kg • Max. load capacity 150 kg with patient recumbent • 100 kg with patient standing Battery Lithium ion, rechargeable, exchangeable • Charging time 3 hours in battery charger • Battery operation time Up to 525 images • Up to 3.5 hours during normal use Up to 6 hours in standby mode Charging location Table detector tray, wallstand detector tray, • battery charger Clip-on grids (optional) 5:1, 85 lines/cm, 115 cm focus; 15:1, 80 lines/ • cm, 115 cm focus 44 Turnover Workbook | Multix Fusion Max - VE21 MAX Mini (Optional) Notes Dimensions (Active Area) 28.4 x 22.8 cm • Active area matrix 1538 x 1920 pixels • Pixel size 148 microns • Scintillator Cesium Iodide • Acquisition depth 16 bits • DQE in %, 2 µGy (RQA5) 66% at 0.05 lp/mm • Data transmission < 1.5 sec. preview, <3.5 sec. full image • Thickness 16 mm • Weight 1.6 kg • Max. load capacity 150 kg with patient recumbent • 100 kg with patient standing Battery Lithium ion, rechargeable, exchangeable • Charging time 3 hours in battery charger • Battery operation time Up to 525 images • Up to 3.5 hours during normal use Up to 6 hours in standby mode •Charging location Battery charger • MAX Dynamic Input fields (active field) 42 x 42.6 cm (full format), 30 x 30 cm • (zoom 1), 22 x 22 cm (zoom 2), 15 x 15 cm (zoom 3) Scintillator Cesium iodide • Pixel size 148 microns • Spatial resolution 3.4 lp/mm • Matrix Up to 2840 x 2874 pixels • Acquisition depth 16 bits • DQE >65% (at 0.05 lp/mm) • Modulation depth >63% (at 1 lp/mm) • Anti-scatter grid Stationary, Pb 15:1, 80 lines/cm, focused at • 125 cm removable Tabletop-detector distance 7.3 cm • Five selectable solid state measurement fields • Measurement fields adjusted according to collimation and zoom format • Imaging System Image display < 1.5 sec. preview, <3.5 sec. display • Image storage capacity 50,000 images • Image size Approx. 9 MB • 45 Turnover Workbook | Multix Fusion Max - VE21 8. Troubleshooting 8.1 System Movements and Functions Notes It is possible to disable system movements and functions by using the Disable button in the Set Up tab on the 3D overhead tube. Some points to remember are: When not activated, the icon will be gray and black. All system • movements should be possible. When active, the icon will be backlit. All buttons on the tube, wall • bucky and table are disabled and no system movement is possible. 8.2 SID Tracking SID Tracking, or Source to Image Distance Tracking, allows the user to change the height of the all buck or table and have the tube follow to maintain the SID. This can be done at the table or wall bucky. When SID Tracking is active, the icon will be backlit. Some conditions must be met for SID Tracking to function: Wall Bucky The wall bucky is tiltable and is tilted to 90 degrees (horizontal) • X-ray tube must be detented in X and Y planes above tilted wall bucky • X-ray tube angulation must be 0 degrees • SID must be greater than 35 inches • The detector must be inserted into the wall bucky tray • Table Bucky The X-ray tube is in detent to the table bucky grid • X-ray tube angulation is 0 degrees • SID is greater than 35 inches • The detector must be inserted into the table bucky tray • If these conditions cannot be or have not been fulfilled when the SID Tracking button is pressed, then the icon will appear dark pink. This indicates that SID Tracking is lost. The function is active, but not all of the requirements for tracking have been met. HEO 46 Turnover Workbook | Multix Fusion Max - VE21 Here are some things to look for when SID Tracking is lost: Notes 1. If at the wall bucky, make sure the bucky is horizontal and not tilted 2. Make sure the X-ray tube is not angled more than 0 degrees 3. If at the table bucky, make sure the table height is not too high or low, meaning the tube cannot maintain an SID greater than 33 inches When it comes to Top Alignment and SID Tracking, the optimal workflow is to fulfill all of the requirements for that function first, then activate the function with the icon. 8.3 Collimation ACSS stands for Automatic Collimator Size Selection. Simply put, this is automatic collimation: when active, you cannot collimate larger than the detector size, but you can collimate smaller. ACSS has a couple of conditions that must be met for it to be active: The bucky tray must be pushed all the way in (table or wall) • The detector must be centered in the table bucky tray in landscape (crosswise) or • portrait (lengthwise) orientation Key Points 1. When the bucky tray is pushed in, ACSS will be displayed on the LCD display of the tube. This indicates that ACSS is active. 2. If you see ‘Manual” on the tube after pushing the bucky tray in, then ACSS is not active. This is usually a result of not pushing the bucky tray all the way in, or the detector is not centered when in landscape or portrait orientation in the table bucky tray. Remember, ACSS only applies to exposures in the table and wall bucky. It does not apply to tabletop exposures. OGPs Each OGP has a set collimation size located within the program parameters. Collimation size will adjust when a different OGP View is selected manually or via the automatic drop down function. 8.4 The Message Field V Ready 182568 The Message Field is the area of the Touch User Interface next to where the system • green “Ready” field is displayed with the check mark, indicating an exposure can be made. This is also the area where system error icons are displayed. • 47 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. HOOD05162003036442 Printed in USA · 2019 · ©Siemens Healthcare GmbH, 2017