ACUSON P500 2.0 Enhanced Needle Visualization

SIEMENS Healthineers Enhanced Needle Visualization ACUSON P500™ Ultrasound System, Release 2.0 Product and System Training HC US MSC S SET Unrestricted C Siemens Medical Solutions USA, Inc. 2017 Speaker Notes No speaker notes. 1 Objectives SIEMENS Healthineers Enhanced Needle Visualization Describe Clinical Solutions . Recognize Benefits . Explain Technology . Demonstrate Technique HC US MSC S SET Page 2 | Unrestricted C Siemens Medical Solutions USA, Inc. 2017 Speaker Notes No speaker notes. 2 Enhanced Needle Visualization SIEMENS Clinical Solutions Healthineers .. Enhances Needle Visualization During In-Plane Ultrasound-guided Procedures Clinical uses in vascular access, regional anesthesia and musculoskeletal (MSK) ultrasound include: Nerve blocks Corticosteroid injections PICC line insertions Biopsies HC US MSC S SET Page 3 | Unrestricted C Siemens Medical Solutions USA, Inc. 2017 Speaker Notes A new advanced application on the ACUSON P500™ ultrasound system release 2.0 is Enhanced Needle Visualization. Enhanced Needle Visualization enhances needle visualization (especially at steeper angles) during in-plane ultrasound-guided procedures. It provides clinical solutions for use in vascular access, regional anesthesia and musculoskeletal (MSK) ultrasound. Clinical uses include: • Nerve blocks • Corticosteroid injections • PICC (peripherally inserted central catheter) line insertions • Biopsies 3 Enhanced Needle Visualization SIEMENS Clinical Benefits Healthineers Improves Procedural Efficiency VF 13 5 ......... Increases needle reflection at MSK Tx Power 100% MI 0, 66 shallow, medium, and deep angles TIS 0.2 TIB D.2 ASC2 DTCE Med Dyn R 75 dB THI-12.0 MHZ b dB Maintains image quality of target 30 fps and surrounding structures Approach target with greater heck-shoulder accuracy, safety and confidence 2.5 cm HC US MSC S SET Page 4 | Unrestricted C Siemens Medical Solutions USA, Inc. 2017 Speaker Notes Visualization of the needle is optimal when the needle is perpendicular to the acoustic beam for maximum needle reflection which results in a sharper, clearer and brighter needle that is more quickly and more easily visualized. Upon initial puncture, it is crucial for the needle tip to be visualized before the needle is advanced in order to more accurately and safely approach the target. It is also crucial to maintain clear visualization and location of the target and surrounding structures (e.g., vessels) for greater accuracy and patient safety, reducing risk associated with interventional procedures. Prior to Enhanced Needle Visualization, this optimal perpendicular in-plane approach was not practical in the human body and early attempts at steering the beam towards the needle resulted in degradation of the target and surrounding structures. Enhanced Needle Visualization supports the optimal perpendicular approach by steering the ultrasound beam angle towards the needle at shallow, medium and deep angles, increasing the needle reflection (i.e., brightness) while maintaining the image quality of the target and surrounding structures for greater procedural efficiency during in-plane ultrasound guided procedures. Other factors influence visualization of the needle, including the transducer and imaging parameter settings, needle gauge, tissue type and user technique. 4 Enhanced Needle Visualization SIEMENS Healthineers Transducer Compatibility Compatible With All ACUSON P500 L10-5v Ultrasound System Linear Transducers VF13-5 VF16-5 VF16-5 Transducer VF10- VF13-5 Transducer VF10-5 Transducer L10-5v Transducer HC US MSC S SET Page 5 | Unrestricted C Siemens Medical Solutions USA, Inc. 2017 Speaker Notes Enhanced Needle Visualization is compatible with all ACUSON P500 ultrasound system linear transducers. Needle Visualization is available on all exams which utilize: • VF16-5 transducer • VF13-5 transducer • VF10-5 transducer • L10-5v transducer 5 Enhanced Needle Visualization SIEMENS Healthineers . Technology Transducer non-perpendicular to needle Principle of Enhanced Needle Visualization Practical approach Apply beam steering Extract only needle signal Transducer perpendicular to needle Optimal approach, but not practical Blend original & needle image Enhanced needle image HC US MSC S SET Page 6 | Unrestricted C Siemens Medical Solutions USA, Inc. 2017 Speaker Notes The ACUSON P500™ ultrasound system, Release 2.0 engineering team developed specific software to maximize Enhanced Needle Visualization on the system. The Enhanced Needle Visualization software algorithm involves three parts: 1. Obtains images at different steering angles and extracts the maximum value in each frame. 2. Thresholding (image segmentation) and noise filtering is applied to obtain the needle image only. 3. Blends the zero (i.e., non-steered) image frame with the extracted needle frame. To summarize, the steered needle signal is extracted and blended with the original image to produce the optimal result. 6 Enhanced Needle Visualization SIEMENS Healthineers .. VF 10-5 VF10-5 Breast Breast Tx Power 100% Tx Power 100% MI 1.12 MI 1.12 TIS 0.2 TIS 0.2 TIB 0.2 TIB 0.2 ASC 2 ASC 2 DTCE Med DTCE Med Dyn R 75 dB Dyn R 75 dB THI 8.0 MHZ THI 8.0 MHZ 0 dB 0 dB 60 fps 35 fps Without Enhanced Needle Visualization With Enhanced Needle Visualization HC US MSC S SET Page 7 | Unrestricted C Siemens Medical Solutions USA, Inc. 2017 Speaker Notes The image on the left displays the needle when Enhanced Needle Visualization is OFF compared to the image on the right which displays the needle when Enhanced Needle Visualization is ON. Notice how much sharper and brighter the needle is throughout its full length, displaying a clear delineation of the needle and detailed beveled tip. 7 Enhanced Needle Visualization SIEMENS Technique - Activate and Select Enhancement Levels Healthineers Activate on Left Panel Needle Enhance 1 Needle Enhance 2 Needle Enhance 3 of Monitor Needle Visual Needle Enhance 2 Or UD 1 UD 2 HC US MSC S SET Page 8 | Unrestricted C Siemens Medical Solutions USA, Inc. 2017 Speaker Notes Needle Visualization provides three needle enhancement levels which incrementally increase the brightness of the needle for operator preference. Needle Enhance 1 is the dimmest level, Needle Enhance 2 is a medium brightness level and Needle Enhance 3 is the brightest level. To utilize the feature, activate Enhanced Needle Visualization by selecting Needle Visual from the left panel of the monitor (or select an assigned User-defined key) and then select Needle Enhance from the left panel of the monitor to adjust the enhancement levels from 1-3. Note: Use a recommended needle size of 16-10 gauge. The system disables the following features and functions during Enhanced Needle Visualization: Advanced SieClear spatial compounding, changing to a trapezoid image format and adjusting the angle of the field of view. Notizen 8 Enhanced Needle Visualization SIEMENS Healthineers Technique - User Defined Keys Custom Keys To Assign Needle Visualization Depth and Zoom Knob Direction Increase Depth @ Clockwise Counter-Clockwise Increase Zoom Clockwise · Counter-Clockwise UD 1 UD 2 Key Function Select Config Print/Store 1 Image Store Print/Store 2 Image Store Select Custom Keys Clip Store Clip Store Left Pedal Freeze Under Key Function, select User Right Pedal Image Store Defined 1 or User Defined 2. User Defined 1 None User Defined 2 << Steer Steer >> Select Needle Visualization. Text A Configure New Key Text B DVR Not Used Needle Visual. Pointer CW HC US MSC S SET Page 9 | Unrestricted C Siemens Medical Solutions USA, Inc. 2017 Speaker Notes To assign Needle Visualization to a User Defined key, select Configuration > Custom Keys > Key Function > User Defined 1 or User Defined 2. 9 Enhanced Needle Visualization SIEMENS Technique - Beam Angle Selections Healthineers Needle Shallow Medium Deep Visual UR Flip Needle Left Enhance Angle Shallow Angle Medium Angle Deep HC US MSC S SET Page 10 | Unrestricted C Siemens Medical Solutions USA, Inc. 2017 Speaker Notes Enhanced Needle Visualization provides 3 beam Angle selections, Shallow, Medium and Deep, to optimize needle visualization at various biopsy target locations. The system changes the angle of the dotted line on the image. The angles vary by transducer as follows: • VF10-5 Shallow: 8 degree Medium: 18 degree Deep: 28 deg ree • L10-5v Shallow: 8 degree Medium: 18 degree Deep: 28 deg ree • VF13-5 Shallow: 8 degree Medium: 13 degree Deep: 18 deg ree • VF16-5 Shallow: 15 degree Medium: 25 degree Deep: 35 deg ree Notizen 10 Enhanced Needle Visualization SIEMENS Technique - Left / Right Flip Healthineers Needle Beam Steered to Left Beam Steered to Right Visual L10-5v Small Parts L10-5v Small Parts JR Flip Needle Tx Power 100% MI 0.90 Tx Power 100% Enhance TIS 0.2 MI 0.90 Left TIB 0.2 TIS 0.2 DTCE Low TIB 0.2 Dyn R 65 dB DTCE Low THI 8.0 MHZ Dyn R 65 dB 0 dB THI 8.0 MHZ 44 fps 0 dB 44 fps Angle Shallow Angle Medium Angle 4 cm Deep 4 cm HC US MSC S SET Page 11 | Unrestricted C Siemens Medical Solutions USA, Inc. 2017 Speaker Notes If needle approach is preferred from the opposite side, the direction of the steered acoustic beam can be reversed Left / Right by selecting L/R Flip from the left panel monitor controls. 11 Questions HC US MSC S SET Page 12 | Unrestricted @ Siemens Medical Solutions USA, Inc. 2017 Questions? SIEMENS Healthineers Now's our time to inspire the future of healthcare together Engineering success. Pioneering healthcare. Speaker Notes No speaker notes. 13