syngo Application Software VE20: syngo Needle Guidance Job Aid

SIEMENS Healthineers CT HFP CT HPR HFP syngo Application Software VE20 PR $7.80 mm syngo Needle Guidance SL 1.0 SL 1.0 MPR 1073 MER RAO 61 / 0 293 RAO 151 / CAUD 5 AH HFP CT HPR HFP RF 5 cm 10 Em MPR LAO 29 / CAUD 85 VRT RAO 151 / CAUD 5 Effective date: 05.29.2020 | HOOD05162003097073 Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare, 2020 Unrestricted © Siemens Healthcare GmbH, 2020 syngo Needle Guidance SIEMENS Healthineers Table of Contents Introduction 3 syngo Needle Guidance workflow overview 4 syngo Needle Guidance workflow steps 5 syngo Needle Guidance configurations 11 Load the planning volume to 3D Sharing 12 Select the syngo Needle Guidance workflow 14 2 Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo Needle Guidance SIEMENS Healthineers Introduction Livo A 3D Sharing Q The syngo Needle Guidance application allows you to plan the paths of H HFP CT HER needles or other puncture or drilling instruments in the 3D volume. The Application Control |30 Shariva planned paths can be displayed on the live image to provide guidance Appication X for insertion procedures. Check needle path using Auto Flight Optionally. Create a new noodle path in the planning volume. ichne Path Progress Masala Tools Boasmark's Layouts Needde RA6 81 13 £ 209 46 1817 CAUSE One or more needle/puncture paths can be planned either on a 3D HER volume that has just been acquired (basic workflow) or on a 3D volume of the same patient from another examination (advanced workflow), e.g., a prior XA, CT, MR, or PET volume. F 1.6 1973 With syngo 3D Roadmap, the live image is overlaid to the 3D image 146 29 / CAUC 85 VRT RAD 151 / CAUD S including the needle paths. While adjusting and progressing the needle, the position can be controlled in needle direction (Bull's Eye View) as well as in two predefined views lateral to the needle path (Progression View 1/2). Introduction 3 Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo Needle Guidance SIEMENS Healthineers Workflow Overview 1 2 3 Planning: Registration: Progress Needle: Define Path: • Basic workflow: Use a planning volume • Select the Progress Needle workflow step. • Using syngo 3D Roadmap the live image is which has a valid registration to the current overlaid to the 3D image, including the • If required, use syngo 3D registration to examination e.g. a newly acquired XA register the 3D planning volume with the needle path. volume. examination patient so that it can be used for • The C-arm can be adjusted to needle • Advanced workflow: Use a pre-procedure 3D overlay. specific angulations; Bull's Eye View, volume which needs to be registered to the Progression View 1/2. examination patient e.g. a previously Registration is required when using a 3D volume acquired CT, MR or XA 3D volume. from another examination (advanced workflow). Workflow 4 overview Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo Needle Guidance SIEMENS Healthineers Workflow steps Basic workflow: Advanced workflow: Using an in-procedure DynaCT volume for planning Using an pre-procedure 3D volume for planning Acquire a 3D volume acquisition: Load the 3D volume: • Select a Dyna3D/DynaCT acquisition program. • Optional: Attach a radio-opaque grid on the skin of the • Load the planning volume to the 3D Sharing segment (see patient at the expected region of the skin entry point. pages 12 and 13). • Perform the acquisition. • The images are automatically loaded to 3D Sharing. Start Needle Guidance: Define Path • Select the Needle Guidance workflow from the Workflow Header or from the Application Control Progress Needle window (see pages 14 and 15). • The Define Path workflow step is automatically selected. Workflow 5 steps Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo Needle Guidance SIEMENS Healthineers Workflow steps Define Path: Define one or more needle paths and verify them. Define Path + • Select the Add Needle icon or select a needle in the Needle list. Progress Needle Tools Bookmarks Layouts • In an MPR or VRT view, click the target point and the entry point. Needle + The target point is marked by an arrow. In the Bull's Eye View, it is indicated by a circle. Add N1 Color Delete • Needle • The entry point is marked by a line. In the Bull's Eye View, it is indicated by a cross. In-Plane Ortho View Auto Flight View Hint: It can be configured which point is set Initial Data Registra. RA WS 27.74 mm first, the target point or the entry point (see 27.74 mm 1 cm page 11). In-Plane view: • Select the In-Plane view. • All three MPRS and the VRT segment are automatically aligned to the defined path. • The upper right image segment shows an MPR view that contains the target point in direction of the Plan SL 2.0 MPR TOKA RAO 13/ CRAN 8 planned path. YC130 081121- CTA_001-DRINMFII HU XA VEIS0 0611 7 • The upper left image segment and the lower left image segment show MPR views orthogonal to each other that contain the defined path completely. • The lower right image segment shows a VRT view in the same orientation as the upper right MPR (Bull's Eye View). Play 30 K20 13/CRANS • Make sure that the C-arm symbol is not red in the VRT view. Workflow 6 steps Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo Needle Guidance SIEMENS Healthineers Workflow steps Define Path: Define Path Flight along need path Progress Needle Tools Bookmarks Layouts You can watch the flight along the needle path in the upper right MPR segment. Needle • Click the Auto Flight icon. + Add N1 Change Delete Needle You can stop the flight by clicking the Auto Flight icon. Color Needle • • You can correct the target and/or entry point by drag and drop. In-Plane Ortho View Auto Flight View • To restart the flight, click the Auto Flight icon again. VE Initial Data = Registra .. Data Hint: It can be configured that the auto flight starts automatically. Please check with your Siemens Healthineers Service representative. Define Path Select the Progress Needle workflow step Progress Needle Advanced workflow: Using an pre-procedure 3D volume for planning Perform syngo 3D Registration: • Select the syngo 3D Registration icon. • Select 3D/3D Registration (syngo 3D Fusion) or select 2D/3D registration (syngo 2D/3D Fusion). Workflow 7 steps Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo Needle Guidance SIEMENS Healthineers Workflow steps Progress Needle: In the Progress Needle workflow step you can: • Overlay the Live image to the 3D volume. Application Control 3D Sharing ? @ • Overlay the 3D Objects to the live image. Application Needle Guidance X E Close Object List Application To perform and monitor the planned needle procedure, three system positions are necessary: Registration missing: Register the planning volume to the Bull's Eye View: In this system position, the C-arm is angulated in the same direction as the active exam patient to enable C-arm positioning • needle path. This view is used to determine the skin entry point and to align the needle. Define Path Progress Needle Tools Bookmarks Layouts • Progression View 1 and Progression View 2: These two system positions are computed automatically and they are used for monitoring the needle progression. They provide two lateral views to the Needle N1 Color planned needle path taking system restrictions into consideration. Bulls Ey Adjusting the C-arm to the Bull’s eye view or the Progression View 1 or 2: • Select the needle, if necessary. • Select the required view, if necessary. Progres • Select the icon to adjust the C-arm to Bull's Eye View (selected as default). Objects on Live on 3D 30 Select the icon to adjust C-arm to Progression View 1. Live Registra • • Select the icon to adjust C-arm to Progression View 2. • Move the system to the position by activating the desired operating element, e.g. press down and deflect the C-arm joystick. • When the position is reached, the following message is displayed: Automatic run: Position reached. Workflow 8 steps Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo Needle Guidance SIEMENS Healthineers Workflow steps Progress Needle: Adjust the position in the Bull’s eye view H H • When the C-arm reaches the Bull's Eye View additional graphics appear on the Live image. • Adjust the tabletop position so that the graphics are aligned. • P The arrows indicate the tabletop movements required in order to align the triangle and A Tri-Star symbol. • The Bull’s Eye View has been reached when the arrows disappear and the triangle and F F Tri-Star symbol are aligned. Positioning the Needle using the laser positioner: • If configured: the laser positioner will turn on automatically when the Bull’s Eye View is reached. If automatic switch-on is disabled: you can switch on the laser manually. Press the membrane key on the FD. • A crosshair is displayed on the skin of the patient. • Point with the tip of the syringe or biopsy needle to the skin of the patient in the center of the crosshair. • Position the proximal end of the plunger handle so that it is also centered in the crosshair. • Perform fluoroscopy to check needle position/direction. Prick the needle. Workflow 9 steps Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo Needle Guidance SIEMENS Healthineers Workflow steps Progress Needle: Progress the needle under fluoroscopy: Ensure that: ✓ The stand/table is still in the position for Bull's Eye View. ✓ The entry point has been marked on the skin. • Hold the needle with a needle holder to avoid direct X-ray exposure to your fingers. • Adjust the direction of the needle under fluoroscopy. • Insert the needle. • Select Progression View 1. • Drive the C-arm to Progression View 1. • Start to progress the needle under fluoroscopy control. • The Live image shows the live fluoro or Roadmap image together with the overlaid objects. • If required, you can drive the system to Progression View 2 to confirm the needle position. Control scan: • To verify the current needle position you can perform a control scan. • A control scan can be a Dyna3D or DynaCT acquisition. Workflow 10 steps Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo Needle Guidance SIEMENS Healthineers Configurations Configurations: You can configure options for Needle Guidance in the Configuration Automatic switch on laser: You can configure whether the laser is Panel. switched on automatically when Bull’s Eye View is reached and the table is positioned correctly. • To open the Configuration panel select: Options > User Configuration. Target first or Entry First as needle direction: You can configure which ? Settings point is set first, the target point or the entry point. User Configuration Interventional View Orientation or Radiological View Orientation: You Service Portal can configuration the orientation according to the registered patient Expert-i Remote Connect position of the examination patient (Interventional View Orientation) or the standard radiological orientation (Radiological View Orientation). • Select the 3D tab. • Select the Workflows blind. • Select the workflow from the Select Workflows list. Workflows Select Workflow Needle Guidance Configuration 11 Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo Needle Guidance SIEMENS Healthineers Load the planning volume 1 If you are using a pre-procedure 3D volume for planning, 3D Sharing Source Images Settings Menu Close Im ... Save Bo ... Snapsho SD Polyla .. Interacti. Export t ... Paraallo Viewing Review loaded or acquired volumes. import the data to the patient browser before starting Review and Processing New acquisitions will replace existing volumes. Bookma Layouts Undock Image Directory 3D Sharing ? × Overlay. Send To Select AN Deselect All Scenes + 3D 3D REF/ Bookmarks Key Images Custom Load the planning volume to the 3D Sharing segment February 05, 2018, CT Facette 2 If the patient is the currently registered examination: VOLUME ANL VOLUME VOLL AN 1. Open the Image Directory in 3D Sharing. 2. Select the exam data, when the 3D volume was 1/6: Topogramm 1.0 Tr60 2/6: WS KF 1.0 Br62 3/6: WS Bandscheibe 1.0 ... created. ANLUME VOLUME AN LUME 4/6: WS Bandscheibe 1.0 ... 5/6: i-Sequence 2.4 Br38 7/6: Schlüsselbilder Load the 12 planning Effective Date: 05.29.2020| HOOD05162003097073 volume Unrestricted © Siemens Healthcare GmbH, 2020 syngo Needle Guidance SIEMENS Healthineers Load the planning volume 1 If the 3D volume data is not under the current examination, Live A 3D Sharing Q Swings WHERE 30 Puytis ExportI Viewing Review loaded or acquired volumes. New acquisitions will replace existing volumes. Lockms ... Layouts E for example if the data is from another hospital and not Patient Browser matched to the current patient: Local Deta test 2 (4) jeet 1 (3) 2 Seron by Name, ID. Date. Desenption and AMtouslity (Cat 4) More FiltersY DIGON Export Correct Select the Patient Browser in 3D Sharing. Series 1. Results (20 results, 1:50:15 AM) Patient Study Description Study Date and Time + Series Number Series Description Modality Series Date and Time Series Alt + Embolization_Guidance, Patient Topogramm 1.0 TrBD 2/5/2018 11:21:28 AM *1/1/1957, M WS KF 1.0. Br62 2/5/2018 11:23:07 AM Double click on the required volume to open the bd184e 3 2. WS Bandscheibe 1.0 für 3D 2/5/2018 11:23:21 AM TACE - Transarterielle Chemoembolisation 8/24/2017 7:18:17 AM WS Bandscheibe 1.0 für 3D 2/5/2018 11:28:02 AM Patient, Cardiac 5 -Sequence 2.4 B138 2/5/2018 11:43:13 AM 7 Schlüsselbilder 2/5/2018 11:44:19 AM *11/11/1911, M 501 Dosisbericht 2/5/2018 11:49:44 AM volume in 3D Sharing and confirm that the data is for 0020328995 950 3D Objects 2/5/2018 11:34:00 AM Patient, Cardiac *2/12/1959, F 234587B the current patient. Patient, Healtineers *11/10/1960. M 2019.02.12-20:48:41-STD-1.3.12.2.1107.5.99.3 Patient, Needle Guidance Instances *1/1/1934, M 11 DL Facette 2/5/2018 11:24:32 AM DL Facette 2/5/2018 11:24:32 AM CT Facette 2/5/2018 11:19:28 AM Patient, Neuro 71 2/12/1964, M 577889800-0 Patient, Neuro Examination *1/1/1949, F 111+587R Search successfully completed Load the 13 planning Effective Date: 05.29.2020| HOOD05162003097073 volume Unrestricted © Siemens Healthcare GmbH, 2020 syngo Needle Guidance SIEMENS Healthineers Select the Needle Guidance workflow You select the Needle Guidance workflow from the 3D Sharing Q 88 Co Browser Images Sollings Mon Close Im_ Save Bo. Snapsho. 30 Polyã_ Interacti Export Paradvd Viewing Review loaded or acquired volumes. Review and Processing New acquisitions will replace existing volumes. Bockma ... Layouts Undock Application Control. Viewing HFP CT HFP Overlay Active Worktows EVAR Guidance The Application control may be docked (fixed) in the workflow Needle Guidance Spine Guidance header or undocked. You can undock the application control Stenosis Analysis in the top right corner of the 3D Sharing segment. 10 cm SL 1.0 SL 1.0 MPR 586 MPR 586 LAO 90 / 0 56 010 nz HFP CT HFP 10 cm 586 0 / CAUD 90 56 VRT RAO 1 / CRAN 10 294 Select the 14 workflow Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo Needle Guidance SIEMENS Healthineers Select the Needle Guidance workflow 1. When the Application control is docked: Select the 2. When undocked: Select the Needle Guidance in the Needle Guidance workflow step in the Workflow Header. application workflow step in the Application Control. 3D Sharing = 88 PATIENT, Needle Guidance D. 1.CARD program (15 9s) Male, 1/1/1934 (85), 10 11-1.CARD Exam Set G.DSA program (VFR) 0.00 MOYEN E0 000 0 0 8 40 cm la 235 cm O Detector calibration needed plane B. SC Browser Menu Close Im. Save Bo. Snapsho. 30 Polyli Interacti Export _ Paraled Viewing Review load or acquired volumes. < 5.tuoro normal (15 p/s) Review and Processing New acquitgions will replace existing volumes. Bookmna. Layouts Live 3D Sharing Q Viewing HFP CT Overlay Active Worktows EVAR Guidance Needle Guidance Application Control Spine Guidance Stenosis Analysis Aneurysm Analysis Aortic Votre Quidance volume Corgantal Heart Disease Quitange CTO Guidance TrueFunzion EP Planned 10 cm MPRO O Entoization Guidance EVAR Gustanse Needis Quidance Sone Gadarea LAO 90 /0 Dienous Analysis to bookmarks sored Spero 10 cm OF CAUD 90 56 RAO 1/ CRAN 10 BYCAUD SO 36 HAD 1/ CRAN 10 Select the 15 workflow Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 SIEMENS Healthineers 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 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. The information in this material contains general technical descriptions of specifications and options as well as standard and optional features that do not always have to be present in individual cases. Certain products, product related claims or functionalities described in the material (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 16 Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020