SC2000 eSieScan Protocols and Calculations

Measurements, Calculations, and eSieScan workflow protocols course for the ACUSON SC2000™ Volume Imaging System You should now be able to: Identify the available calculations in order to customize measurements and measurement groups Access menus and tools Navigate measurement labels Define and manipulate the navigation tools Demonstrate how to access and modify a Report or Worksheet and Integrate eSieMeasure strategies into your workflow List the lab and user advantages of utilizing eSieScan Protocols Create and modify eSieScan Protocols Select an eSieScan protocol Scan with a protocol and Create and demonstrate eSieScan protocols on the SC2000 system Thank you! Click on the Wrench Icon to start from the user configuration menu, Chose the Measurements (tab) Select the Measurement Menu Configuration (blind) Two separate lists: Adult and Pediatric (Ped) Echo Ped Echo requires license The following are trademarks of Siemens Medical Solutions USA, Inc. (syngo® is a trademark of Siemens AG): ACUSON SC2000™ volume imaging ultrasound system eSieMeasure™ workflow acceleration package eSieScan™ Workflow Protocols RES™ enhanced resolution imaging syngo® Auto OB measurements syngo® eSieCalcs™ native tracing software syngo®.fourSight™ Workplace syngo® SC2000™ Workplace Measurements are configurable: Items may be deselected (unchecked) and hidden Items can be reordered within the measurement menu: Click and drag to desired spot Some restrictions Three generic categories exist for additional configuration flexibility: Will not populate (SR) Structured Reporting Groups that support series behavior may not be reconfigured: Examples: M-mode LV and M-mode LV/RV The entire series may be selected or deselected The entire series may be moved anywhere within the measurement menu Groups that do not support series behavior may be reconfigured: Example: Ap 4Ch Volume Measurements can be reordered within a group and individually selected/deselected Measurements may be re-configured outside of the group Customization of on screen displayed Doppler units: Report defaults to m/s DICOM SR will export in industry standard of cm/s Changes to the setup menu need to be “applied” and customizations should be saved to your system backup disk/drive. To access measurements: Freeze current mode Select the measurement ruler Generic Tools Explained: Distance:  Measures the length of a straight line, number (1) Trace: Measures the circumference of an irregular shape or the areas inside a manual trace, (2) Ellipse: Measures the major (D1) and minor (D2) axis, circumference, and area of an ellipse, (3) Angle: Determines the degree of the acute angle, (4) When you select a measurement label in the task pane: A green arrow displays next to the measurement label The required tool is automatically activated The caliper displays in the center of the image, Doppler spectrum or M-mode sweep After you complete a measurement, a checkmark is displayed next to the measurement label: If a measurement label has been completed and a checkmark displays next to the label, you can select the label and measure again For each measurement label, up to nine measurements are saved with the exam The patient report displays the mean value when multiple measurements exist Default measurements are grouped in a drop-down list: The Measurement GUI is shared with eSieScan Protocols and Thumbnails Use the drop-down to change active display Freeze the 2D image and use the Freeze/Cine wheel to advance to desired frame: Use the  “Go to ED” and “Go to ES” soft keys for the system defined frame Launch the measurement ruler and select the desired measurement Use the mouse to position caliper and click Select for second caliper While measurement is active you can toggle between 2 calipers using the Next key. Active caliper is green. See (yellow arrow). Use the select set key to toggle between a series of measurements: An active series is green and the active caliper is green Use the Delete Set key to remove the measurement All adjustments are saved when measurement(s) are entered Measurement(s) are entered when the: Image store is pressed Select to end the measurement is pressed Results display area is moved (RDA) Completed measurements will receive a confirmation check mark. To display the measurement report:: Use the Report (F1) key on the keyboard From the demographic screen select the Report and Worksheet banner Mark or Draw functionality is available in 2D and Doppler when performing a trace function: Mark is the default setting Use the Next key to set the points To move the RDA: Place the cursor on the RDA, press and hold select, drag and drop Feature is “set and forget” There are several displays of the report and worksheet.  Use the icons to select the desired information   Report Only (view)   Report and Worksheet (view)    Worksheet (view) eSieScan measurements are based on pattern recognition of learned values for both normal values and pathology: Best results with ECG; cardiac cycle is part of the learned value: Option requires purchasable license Can be performed in cine or review Shows last measured calc results in the Results Display Area, (RDA) In report/worksheet, results are combined with manual measurement results Doppler and M-mode; Attempts to measure the last three full heart cycles orthe best of three starting at the right or end of screen Available measurements and series are noted with icon, A. How to customize measurements How to navigate the measurement menus and tools How to navigate and edit the measurement report Introduction to eSie Measure Velocity: Velocity and Pressure Gradient, number (5) Trace: Velocity Time Integral (VTI) Peak Pressure Gradient (PkPG), Mean Pressure Gradient (MnPG), (6) Caliper Pair: Velocity (V), Pressure Gradient (PG) for each caliper, (7) Delta Caliper Pair: Difference in velocity at the two caliper positions (dv), time duration between the two caliper positions (dT), Heart Rate, Slope, Pressure Half Time (P1/2T), (8) M-Mode Delta Caliper Pair: Distance, time duration between the two caliper positions:  Slope, Heart Rate (dT->), (9) To make multiple measurements: Re-select the measurement from the list Re-measure Up to 9 measurements will be stored in the report Measurements beyond 9 will appear in the imaging screen but not the report Report will display an average of multiple measurements Edit report to get the desired result Final result will be sent in the SR for PACS reporting Probabilistic, Hierarchical and Discriminant (PHD): Root detection: Left, Right and Peak   Global structure identification   Shape regression model: Feature matching based on knowledge base Pulmonic Valve: PV Systolic Flow group: Includes: PV VTI, PV Vmax, PV Vmean, Mean Grad, Peak Grad, PV AT, & PVET RVOT Systolic Flow group: Includes: RVOT VTI, RVOT Vmax, RVOT Vmean, Mean Grad, Peak Grad, AT, & ET Tricuspid Valve: TR Flow group: Includes: TR Vmax, and Peak Grad Mitral Valve:Mitral Inflow group Includes: Decel Time, Decel Slope, MV E Vmax, MV P1/2 Time, MV Area, MV A Vmax, MV A/E, & MV E/A   MR Flow group: Includes: MR VTI, Vmax, Peak Grad, Mean Grad, AT, & ET Distinguish E-wave and A-wave A-wave missing E-wave & A-wave: Overlap vs. Separate ECG needed for MVI In cine: Freeze image Cine to desired frame Select desired Auto Measurement (AM) from measurement drop-down(1) Click on the AM Icon to launch Select to complete the measurement In static review: Select image in review Select desired Auto Measurement from measurement drop-down Click on the AM Icon to launch Select to complete the measurement In clip review: Select clip in review & pause Scroll to desired frame (Tip: Use “Go to ED” & “Go to ES”) Select desired Auto Measurement from measurement drop-down (1) Click on the AM Icon to launch Choose Select to complete the measurement, In static review: Select image in review Select measurement menu from drop-down tab in right task pane area Select desired Auto Measurement from measurement menu Click on the AM Icon to launch Left mouse click to complete the measurement In clip review:Select clip in review & pause Select “Go to ED” (or ES) or use movie control to scroll to desired frame Select measurement menu from drop-down tab in right task pane area Click on the AM Icon to launch PLAXd(s) Left Ventricle Left mouse click to commit measurements   Editing 2D-mode: (Note: Priority must be set to calcs!) Editing before committing measurements) When all tools are green (uncommitted state), use Next key to toggle through each set of  the series, (1) Use Select key to commit all calipers, (2) Editing after committing measurements When all tools are white (committed state), use Select set, (3) to reactivate first set of the series Use Next key to toggle to subsequent sets, (1) Use Select key to commit all sets, (2) Deleting before committing measurements: When all tools are green (uncommitted state), Delete Set key will delete all calipers, (1) Deleting after committing measurements: When all tools are white (committed state), use Select set to reactivate first set of the series, (2) Use Next key to toggle to desired sets, (3) Use Delete Set key to delete desired sets, (1) Editing M-mode: (Note: Priority must be set to calcs!) Editing before committing measurements: When all tools are green (uncommitted state), use Next key to toggle through each set of  the series Use Select key to commit all calipers   Editing after committing measurements: When all tools are white (committed state), use Select set to reactivate first set of the series Use Next key to toggle to subsequent sets Use Select key to commit all sets Deleting before committing measurements: When all tools are green (uncommitted state), Delete Set key will delete all calipers Deleting after committing measurements: When all tools are white (committed state), use Select set to reactivate first set of the series Use Next key to toggle to desired sets Use Delete Set key to delete desired sets Editing 2D mode: (Note: Priority must be set to calcs!) Editing before committing measurements: When all tools are green (uncommitted state), use tab key to activate first set Use right mouse click to toggle through each caliper Use left mouse click to commit all calipers   Editing after committing measurements: When all tools are white (committed state), use tab to reactivate first set of the series Use right mouse click to toggle to subsequent sets Use left mouse click to commit all sets  Note: Use movie control to scroll through all frames! Deleting before committing measurements: When all tools are green (uncommitted state), Delete key will delete all calipers Deleting after committing measurements: When all tools are white (committed state), use tab to toggle through the sets Use right mouse click to toggle to through calipers of set Use Delete key to delete desired sets Editing M-mode:  (Note: Priority must be set to calcs!) Editing before committing measurements: When all tools are green (uncommitted state), use right mouse click key to toggle through each caliper Use left mouse click to commit all calipers Editing after committing measurements: When all tools are white (committed state), use tab to reactivate first set of the series Use right mouse click to toggle through each caliper Use left mouse click to commit all sets Deleting M-mode: Deleting before committing measurements: When all tools are green (uncommitted state), Delete key will delete all calipers Deleting after committing measurements: When all tools are white (committed state), use tab to reactivate first set of the series Use right mouse click to toggle to desired sets Use Delete key to delete desired sets Use the Next key to adjust or delete a measurement performed with eSie Measure: Delete Set will remove the active set of measurements Same rules apply for entering measurements Always optimize in all modes before using eSie Measure for best results Use Priority to gain access to the Go to ED and Go to ES quick tools when making multi-measurements Strip mode measurements are from the end of the strip (right side) to the previous three consecutive cycles or best of the cycles To measure more than three consecutive strip mode cardiac cycles: Enter first three measured values Use Freeze/Cine wheel to advance or reverse to the next three cycles, placing them at the right side of the screen   Enabling SR: SR must be enabled for exporting calculations to pacsor reporting Siemens Representative should modify this setting To check the setting: User Configuration > Network/Printing (tab) > Store Configuration (blind) > SR box should be checked Edit the report from worksheet: Select the averaged value to edit and if performed; multiple measurements will display Select a value to delete and use the backspace or delete key on the QWERTY keyboard to remove Close the edit box and the new results value will display Upon successful completion of this course, you will be able to: Identify the available calculations in order to customize measurements and measurement groups ​Access menus and tools Navigate measurement labels Define and manipulate the navigation tools Demonstrate how to access and modify a Report or Worksheet Integrate eSieMeasure strategies into your workflow List the lab and user advantages of utilizing eSieScan Protocols Create and modify eSieScan Protocols Select an eSieScan protocol Scan with a protocol and Create and demonstrate eSieScan protocols on the SC2000 system LV Series includes only LV measurements (No RV): Includes: IVSd, LVIDd,LVPWd Includes: IVSs, LVIDs, LVPWs Calculations: LV%FS Teichholz LV SV Teichholz LV CO Teichholz LV EF Cubed LV EF Teichholz Retains Series behavior while eliminating RV measurements Select the link below to view a Video demonstration of eSie Measure. eSie Measure Demo eSie Measure Demo   What are the advantages to your lab by using eSieScan protocols? Brings continuity to studies performed: All users in a lab can perform the same study protocol Reading physicians can read all studies in the same order Views are not forgotten or left out Studies performed can be ICAEL ready Reduces keystrokes and study time: Modes auto-launch Capture times pre-determined What are the advantages to the user?  Automatic measurement initiation Automatic view labeling Automatic application entry Automatic capture setting changes Lessens risk of injury from repetitive motion Reduces learning curve on the system The system comes preloaded with factory default protocols. You can add new protocols but you cannot change a factory default. If you would like to modify a factory protocol you first need to copy that protocol. Once it is copied you are able to modify it. To create an eSieScan protocol: Choose the wrench icon at the top right hand corner of the screen, see number (1) This opens up a drop down menu, (2) Choose user configuration Choose the eSieScan protocols configuration blind This will bring up the factory protocols, (3). To create an eSieScan protocol, choose Add Protocol. When adding a new protocol, you will see the following dialogue box. After selecting ok, this screen appears. This is where you will choose the default capture settings. Determine Capture: Prospective / Retrospective, (1) Determine clips per capture and clip length, (2) Beats or seconds Can apply to entire protocol or change per view, (3) Name of stage can be displayed in upper left of each image field To customize the views in the protocol: Click Add step, (1) Name the step, (2) Determine the mode, (3) Selecting a series will perform all the series measurements or select a single measurement.  Add by selecting the Add Measurement icon. The protocol will not advance until all the commands under the view are completed:  The view PLAX below contains a 2D clip, 2 measurement series and 2 static images Use Add Store Image to take multiple static images without advancing Step name could be used as an annotation on the image if Display View Name is checked. This appears in the upper left data field on the image   Check all modes that apply when creating a view. For example if you want to use PW Doppler but want Color Doppler also then check the following: 2D, Color, PW   When a protocol will include the same capture length for all views, create all the views first and the go back to the protocol screen and click the Apply to Protocol icon for clip capture   A view can contain a clip as well as static capture for measurements. Add an image store when you want to have measurements both in Diastole and Systole. Move the store image up and down to the desired location To select an eSieScan protocol:. Begin on the new patient screen  Select the desired protocol in the workflow list This list can be limited by hiding any protocols not in use. The default protocol list is: Cardiac Limited adult echo complete adult echo Volume adult echo Pediatric echo 4D Pharm stress four stage 2D exercise stress 2 stage 2D Pharm stress 2 stage 2D Pharm stress 4 stage Any protocols that are not desired may be hidden from view. Protocol will load in the Graphic User Interface (GUI) on the right side of the screen: Protocol will be paused when it initially loads Select the Resume Protocol icon to begin: Protocol can be paused and resumed as desired Green triangle will follow the current view When a step is completed, a validation check mark is displayed. To skip a measurement use the Delete Set in the soft key options, (1). The measurement is skipped and a red X will take the place of the check mark, (2). Re-select a completed view to add an additional clip or static capture image: Green triangle will move back To skip a view, select a view past the current view Green triangle will move forward and skipped view will not have a check mark Initiating a mode or measurement not in the protocol will automatically pause the protocol allowing the user to scan free form: Resume protocol when ready While using a protocol, thumbnails can be viewed via the Review key or through the drop-down menu of the GUI: Select the drop-down or eSieScan protocol and change to Thumbnails Double click with the Select key to launch thumbnail into full screen review. Right click with the Next key to delete or export the thumbnail. When the protocol is completed, you can continue to add clip captures or static images as desired The protocol can be ended with the end protocol icon An ended protocol cannot be restarted. To review here are some eSieScan Protocol highlights. eSieScan: Allows automatic transition of modes ( color, spectral, 2D) User can clip or static capture to advance to next defined step User can proceed as planned to next step or skip to another step by selecting that step Each protocol step is highlighted as it advances There is instant recognition of the next step LV or LV/RV Series includes only LV measurements (no RV): Includes: IVSd, LVIDd, LVPWd Includes: IVSs, LVIDs, LVPWs Calculations: LV Mass (ASE), LV FS%, LV EF% Retains Series behavior while eliminating RV measurements Deselected by default Ao/LA Series: Includes: AOd& LAs Calculations: LAs/AOd& AOd/LAs Does not include Aortic Cusps Separation Select the link below to view a Video demonstration of eSie Measure M-Mode. eSie Measure M-Mode Demo eSie Measure M-Mode Demo   Aortic Valve: AoV Systolic Flow group Includes: AoV VTI, AoVVmax, AoVVmean, Mean Grad, Peak Grad LVOT Systolic Flow group: Includes: LVOT VTI, LVOT Vmax, LVOT Vmean, Mean Grad, Peak Grad, LVOT AT, & LVOT ET AR Flow group Includes: AR DT and AR Slope Select the link below to view a Video demonstration of eSie Measure AO valve Doppler systolic flow, eSie Measure AO Valve Doppler Systolic Flow Demo eSie Measure AO Valve Doppler Systolic Flow Demo   Adding measurements: Click the measurement tab for the current view Measurements available for the current mode selected Choose the measurement group and available options will be below  **Flexibility between eSie Measure and manual measurement