Sentinelle Manual Breast Biopsy Workflow

Sentinelle Manual Breast Biopsy Workflow Numaris X Software 1. Use the correct Grid Sheets associated with the correct Needle Vendor: A. Sheets are labeled Right Lateral/Left medial or Left lateral/Right medial 2. If performing a Unilateral biopsy, remove the medial coil and replace with the dummy plug: A. Use two single loop coils in the frames positioned to left or right breast B. Insert the sterile grid on side of approach C. Insert the glass immobilization plate on opposite side (Note: can set up with two grids when not sure of approach) 3. If performing a Bilateral biopsy, medial coil remains in place: A. Use two single loop coils in the frames positioned latererally one for right and one for left breast B. Insert a sterile grid in each frame C. The glass immobilization plates can be fixated to the medial coil providing a soild surface to compress against vs. the curved shape 4. Position the patient prone on the coil with taut compression of the grids Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Job Aid | Sentinelle Manual Breast Biopsy Workflow Effective Date:06/19/2020 |HOOD05162003094278 5. Insert the fiducial marker into the biopsy grid: A. The fiducial should be touching skin surface and in an area away from the target lesion B. Denote the fiducial position on the grid worksheet both in the patient and image view 6. Perform Localization measurements: A. 3 Plane Localizer B. Sag fl3d Fiducial Loc should include 2cm past area of interest and beyond grid surface until fiducial is visualized C. Slices should not be angled D. Ensure visualization of grid lines within the skin surface 7. Perform pre and post contrast enhancement sequences**: A. Fl3d sag and/or axial (radiologists preference) B. Slices should not be angled C. Post is typically ran at least twice with a longer contrast delay, due to compression or an additional phase could be added in leu of wait time 8. In MR View & Go on the Sagittal images locate the target lesion: A. Activate the ROI tool in the upper Rt corner menu Edit Commont Distance Lire CURRENT Pigal Lona Anaw Marker Angle Text T Spmedico Label **A licensed physician may choose to use FDA-approved contrast agents in conjunction with an MRI exam, based on his/her medical opinion and discretion and in accordance with the instructions for use and indications for use supplied by the pharmaceutical manufacturer for the contrast agents Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 2 of 7 Job Aid | Sentinelle Manual Breast Biopsy Workflow Effective Date:06/19/2020 |HOOD05162003094278 B. Draw a small mark on the lesion with a Lt click hold C. Rt click on the ROI and copy measurement i. Note the SP (slice position) for depth of target in bottom left text 12'10001 AL Delele Measurement Copy Measurement FoV 250.250 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 3 of 7 Job Aid | Sentinelle Manual Breast Biopsy Workflow Effective Date:06/19/2020 |HOOD05162003094278 9. Scroll out to the Grid and Skin surface: A. Rt Click and Paste to the current image B. Note Slice Position (SP) for skin surface measurement CURRENT 12/10/2010 34 1MA 1 FRM 54/64 AL 1:0cm SP L'91.0 SL' 2.51 Fol/ 250-250 AU Zoom 4.37 C. Note: Numaris XA20 software has a new option to use annotation (marker, arrow, or text) instead of ROI that would allow you to “apply annotation to whole stack” vs one image at a time. 10. Reference the ROI of lesion to the known placement of the Fiducial to determine where needle block should be placed within the grid: A. Counting the grid location blocks towards chest, nipple, head and foot B. Count each block just one time CURRENT 12/10/2019 2:26 53 PM 34 IMA 1 FRM 54/4 AL 10cm SPL91.0 SL 20 DV 250 250 Zcom 4.37 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 4 of 7 Job Aid | Sentinelle Manual Breast Biopsy Workflow Effective Date:06/19/2020 |HOOD05162003094278 11.Determine the correct placement of the needle within the needle block itself: A. Focusing on the single grid block, use the grid sheet to reference the ROI of lesion within the needle block B. After marking all these measurements on the Image view of the biopsy sheet, transfer the information to the Patient view side C. Note: Distance from skin surface to target lesion could also be measured on an Axial scan within 3D lamella using the distance tool in Upper Rt corner THALN Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 5 of 7 Job Aid | Sentinelle Manual Breast Biopsy Workflow Effective Date:06/19/2020 |HOOD05162003094278 12. Bring the Grid sheet into the room with the radiologist for a reference: A. Radiologist with place needle into corresponding location at determined depth – re- move the trocar and replace with the obturator 13.Additional post scan is performed to Confirm location of the needle and obturator prior to biopsy being performed A. Within MR View & Go select this scan and load to 3D for a reformatted view in all 3 orientations with cross reference IF De LI 14. Radiologist will place a clip at the biopsy site upon completion: A. Note: the clip is best visualized with a Non-Fat Sat fl3d Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 6 of 7 Job Aid | Sentinelle Manual Breast Biopsy Workflow Effective Date:06/19/2020 |HOOD05162003094278 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 collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright © Siemens Healthcare GmbH 2020 _______________________________________ Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84-0 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 7 of 7