PEPconnect

Needle Guidance (InSpace) Job Aid

Needle Guidance (InSpace) Job Aid

Needle Guidance (InSpace) Job Aid Advanced Therapies - syngo Workplace SW VB21, VC10. **There is an additional job aid available on PEPconnect to determine SW version of the system. 1. A 3D volume has been acquired or loaded into the InSpace task card. 2. If a previous volume is loaded, 3D3D Fusion should be performed. An additional job aid for 3D3D Fusion is also available on PEPconnect. 3. Select the iGuide Needle Guidance icon from the Xray tab. Clip Tools Measure X-Ray A Live 4. The iGuide Needle Guidance dialogue box opens. a. Step 1: Define Path – Allows user to select Target and Entry Point (skin en- trance). b. Step 2: Check Views – Allows user to verify pathway is an achievable angle. i. Bull’s Eye View – Upper right segment ii. Progression View 1 – Upper left segment; orthogonal (90 degrees) to Bull’s Eye view. iii. Progression View 2 – Lower left segment; Bull’s Eye view with a CRAN/CAUD angulation applied. iv. Information – Lower right segment; text regarding planned path v. If any c-arm graphics are red, that angulation is not automatically achievable by the c-arm. Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 05/11/2020 | HOOD05162003092039 Healthineers Job Aid | Needle Guidance (InSpace) Effective Date: 05/11/2020 | HOOD05162003092039 c. Step 3: Progress Needle – Allows user to select specific view needed and auto- matically drive to that position by deflecting the joystick. Alignment of overlaid graphics is performed here as well as the progression of needle can be verified. iGuide Needle Guidance X iGuide Needle Guidance X iGuide Needle Guidance X Step 1: Define Path Step 1: Define Path Step 1: Define Path Please define path by selecting target and Step 2: Check Views Step 2: Check Views entry point with single mouse click Please check Progression Views. They Step 3: Progress Needle can be adjusted by rotating the volume in the upper left and lower left VRT view. Activate stand movement to reach Bull's Eye View Adjust table until overlaid graphics are aligned Check patient position by performing an overlay Align needle to Bull's Eye View Use Progression Views to check needle progress Decide if Control Scan is needed 153º, 0º -116º, 0º 154º, 30º A B LAO/RAO, CRAN/CAUD 100% Step 2: Check Views 3D Overlay Step 3: Progress Needle Step 3: Progress Needle 0% Close Suspend Help Close Suspend Help Close Suspend Help 5. Step 1: Define Path a. Select Target icon is automatically selected. Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 05/11/2020 | HOOD05162003092039 Healthineers Page 2 of 9 Job Aid | Needle Guidance (InSpace) Effective Date: 05/11/2020 | HOOD05162003092039 b. Left mouse click, in any view, on the desired target/location. Green circle will appear marking target point selected. Needle Guidance RES/MPR 6.0mm 2345234 7/7/1977 F LAO/RAO 0 DynaCT Body Nat Fill HU Normal [In. CRAN/CAUD -90 Siemens Training Center AXIOM-Artis 5/6/2020 12:53:50 AX W 2242 LL 34 c. The Entry Point icon will automatically be selected after target point has been defined. d. Left mouse click in, any view, on the desired entry point/location. Green cross will appear and will be connected to target circle. Needle Guidance RES/MPR 6.0mm 2345234 7/7/1973 F LAO/RAO 0 DynaCT Body Nat Fill HU Normal [In ... CRAN/CAUD -90 Siemens Training Center AXIOM-Artis 10.85 cm 5/6/2020 12:53:50 LL W 2242 34 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 05/11/2020 | HOOD05162003092039 Healthineers Page 3 of 9 Job Aid | Needle Guidance (InSpace) Effective Date: 05/11/2020 | HOOD05162003092039 e. When Target and Entry points are selected, the needle path is displayed as a green line. The length of the path is defined in centimeters. Both points can be adjusted by left click and hold and dragging points into different positions. Needle Guidance P RES/MPR 6.0mm 2345234 7/7/1977 F LAO/RAO O DynaCT Body Nat Fill HU Normal [In ... CRAN/CAUD -90 Siemens Training Center AXIOM-Artis 11.10 cm 12:53:50 AX W 2242 F C 6. Step 2: Check Views a. Verify all views are achievable (no red c-arm) and review path information. b. If the path needs to be adjusted, return to Define Path and repeat step 5e above. Lookatons InSpace Show Mogo Vog C pois Measure Volume LADIANO CAMPCALO A GRANUCAUO LAGRAD E CHNUNG Progression www't Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 05/11/2020 | HOOD05162003092039 Healthineers Page 4 of 9 Job Aid | Needle Guidance (InSpace) Effective Date: 05/11/2020 | HOOD05162003092039 7. Step 3: Progress Needle a. The Bull’s Eye automatic drive icon is selected. Activate stand movement (deflect joystick) to drive c-arm into position. Graphics are displayed on the LIVE monitor. When the system has completed movement to the Bull’s Eye position, it is now ready for the user to align the graphics so the ROI/Target is in isocenter. This is achieved by changing table height, longitudinal, and/or lateral position. b. Graphics displayed give the user guidance in which direction to move the system: H – Head, L – Left, R – Right, F – Foot. i. Move circle into center of 4 arrows on a system without a laser light. ii. Center triad symbol within the triangle on a system with a laser light. General graphics (Artis without laser positioner) Laser graphics (Artis with laser positioner) R R Position not adjusted Position adjusted Attention: If graphics are not displayed on the Exam room monitor, please make sure you are on the ARTIS Exam tab in control room. Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 05/11/2020 | HOOD05162003092039 Healthineers Page 5 of 9 Job Aid | Needle Guidance (InSpace) Effective Date: 05/11/2020 | HOOD05162003092039 8. Once system is in correct alignment, needle can be placed using the Bull’s Eye view. This can be performed under fluoroscopy or with the optional laser light. 9. Advance the needle and then proceed to Progression Views 1 and 2 to verify accuracy of needle placement and progress. Graphics will update with system movement and fluoros- copy. 3D Overlay (iPilot Dynamic) is activated and adjusting overlay percentage is possi- ble with joystick. a. Example of needle placement under fluoro in Bull’s Eye view. b. Example of Progression View 1 with distance graphics. Small distance markers = 0.5cm Large distance markers = 1.0cm Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 05/11/2020 | HOOD05162003092039 Healthineers Page 6 of 9 Job Aid | Needle Guidance (InSpace) Effective Date: 05/11/2020 | HOOD05162003092039 c. Example of Progression View 2 with distance graphics. Small distance markers = 0.5cm Large distance markers = 1.0cm d. Examples of all three views displayed with iPilot Dynamic. Body Net FII HU Normal [nepasa&D] iGuide Needle Guidance RES/SHADE/SURFIPERSP Step 1 Define Path GRANCALDO Step 2: Check Views iGuide Needle Guidance X Step 3: Progress Needle Step 1: Define Path Activate stand movement to reach Bull's Step 2 Check Views Eye View Adjust table until overlaid graphics are Step 3: Progress Needle aligned Check patient position by performing an Activate stand movement to reach Bull's Eye View overlay Align needle to Bull's Eye View - Adjust table until overlaid graphics are aligned - Use Progression Views to check needle Check patient position by performing an progress overlay ntrol Scan is needed Align needle to Bull's Eye View - Use Progression Views to check needle progress 10.77 cm - Decide if C ded 153ª. 0º -116". 0" 154%, 30" LAO/RAO CRANICAUD 153', 0º -116', 0" 154". 30" LAORAO, CRANICAUD 100% 3D Overlay 3D Overlay 0% 0% Close Suspend Help Close Suspend Help Bull’s Eye View with iPilot Dynamic Progression View 1 with iPilot Dynamic Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 05/11/2020 | HOOD05162003092039 Healthineers Page 7 of 9 Job Aid | Needle Guidance (InSpace) Effective Date: 05/11/2020 | HOOD05162003092039 ermal InSpace3D] CRANICAUD 80 iGuide Needle Guidance X Step 1: Define Path Step 2: Check Views Step 3: Progress Needle Activate stand movement to reach Bull's Eye View Adjust table until overlaid graphics are Check patient position by performing an overlay - Align needle to Bull's Eye View Use Progression Views to check needle progress - Decide if Control Scan is needed C 10,77 cm 153º, 0º -116º, 0º 154º, 30º LAO/RAO, CRAN/CAUD 100% 3D Overlay 0% Close Suspend Help Progression View 2 with iPilot Dynamic 10. Continue advancement of needle, following graphic guides and utilizing Bull’s Eye view and Progression Views, until target point is reached. 11. Additional spins could also be performed to verify needle path, if needed. 12. Additional notes: a. If during the case, the user wishes to no longer view the iGuide Needle Guidance graphics, user may choose to Close or Suspend workflow. Close icon will com- pletely end the iGuide Needle Guidance workflow and ALL path planning will be lost, additional 3D acquisitions will need to be performed or 3D3D Fusion repeated and ALL workflow steps repeated if user wishes to return to the workflow. Sus- pend icon will put the workflow on hold. When the user is ready to continue with graphics and return to existing workflow, click the iGuide Needle Guidance icon in the X-ray tab and user will be returned to workflow. b. iGuide Needle Guidance can also be performed from table side. Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 05/11/2020 | HOOD05162003092039 Healthineers Page 8 of 9 Job Aid | Needle Guidance (InSpace) Effective Date: 05/11/2020 | HOOD05162003092039 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 (hereinafter co llectively “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 cautio ns. 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 auth ority. 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 2020 Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84-0 siemens-healthineers.com Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 05/11/2020 | HOOD05162003092039 Healthineers Page 9 of 9

  • Needle Guidance
  • InSpace