ACUSON Sequoia™ Ultrasound System Virtual Touch Strain Imaging | VA25 Software Release

ACUSON Sequoia ultrasound system VA25 SW release Virtual Touch Strain Imaging Quick Reference Card siemens-healthineers.com/ultrasound Using Strain imaging to qualitatively assess relative tissue stiffness Step 1 VT Strain • Position patient to obtain perpendicular plane to skin surface for optimal axial motion 18L6 • Position compatible transducer1 over area of interest Breast TIB:0.06 TIC:0.11 and optimize B-mode image TIS:0.06 MI0.60 15fps • Press VT (Virtual Touch) located on control panel 95% 2D Mid • Select Strain tab, if needed 3dB/ DR65 Strain Color 0 Map 0 • Roll trackball to position the region of interest (ROI) • Press Set key and roll trackball to resize ROI Note: The B-mode image and elastogram display in live, dual format (Fig. 1). The elasticity imaging bar (located above the grayscale bar) represents the range of gray or color shades available for depicting tissue stiffness from SF (soft) to HD (hard). 3.5cm OF : 92 Fig. 1: Left: B-mode image with ROI. Right: B-mode image with corresponding ROI displaying elastogram. 1 Strain imaging is compatible with 18L6, 14L5, 10L4: General, Breast, Thyroid; 9EC4: Prostate. SIEMENS Healthineers Step 2 10L4 Thyroid TIB:0.08 • Use minimal compression; avoid lateral or TIS:0.08 rocking motion MI-1.15 1.6fps 95% Tip: Patient respirations or cardiac motion may 2D H High be sufficient. @dB/DR65 Strain Color 0 • Adjust axial motion or cease lateral Map 1 movement if gray overlay box appears on elastogram (Fig. 2) • Maintain QF > 50 Note: The system displays a real-time quality factor (QF) score. A QF value > 60 (Fig. 1) indicates minimal global motion artifact. A QF value < 50 (Fig. 2) indicates a less than optimal result; perform another acquisition. 3cm OF: 0 Fig. 2: A gray overlay box on elastogram indicates insufficient or excessive axial motion or, lateral movement. Step 3 10L4 Breast 20 14L5 DAX A 5C1 Workflow • Optimize elastogram, and then press Freeze; Patient 2D Virtual Touch review cine to obtain desired frames Imaging Strain SWE Review • Rotate Zoom on the control panel to magnify the image Report End Exam • If desired, rotate Color to select a color map • If desired, rotate Map Index: Live Dual 0: Standard default map - × 1: Normalized map (compensates for - non-uniform stress applied with Frequency Color Map Inde transducer) H Mid O O 2: Inverted map - 2 siemens-healthineers.com/ultrasound Measurements Shadow Shadow Duplicates and displays a measurement on the adjacent image for a comparison of lesion size and/or location. Tip: Shadow may be used with the strain ratio. • On a live or frozen image, press Caliper • Select Shadow if needed and press Set key • Measure the right or left image and press Set key • Select Delete on the control panel to delete the measurement Strain Ratio S Strain Ratio ROI 1 (Reference) Compares the relative stiffness of tissue within two ROIs (e.g., compares Strain Ratio ROI 2 (Mass) average strain of a lesion and average strain of the surrounding tissue). Strain ratio = 1: • On a frozen image, press Caliper stiffness of tissue in both ROIs is equal. • Select Strain Ratio Strain ratio > 1: lesion is harder than surrounding tissue. • Place ROI 1 (Reference) in surrounding tissue inside ROI and press Set key to anchor each axis endpoint Strain ratio < 1: lesion is softer than surrounding tissue. • Roll trackball to place ROI 2 (Mass) in lesion (same size and at same Note: Results reflect placement of ROI 1 in depth) and press Set key to anchor each axis endpoint surrounding tissue; results will differ if ROI 1 is placed in lesion. • Strain ratio and average strain (%) for both ROIs are displayed in the measured results • To display measurement in report, select Right or Left and either Mass 1, Mass 2 or Mass 3 measurement labels • Select Delete on the control panel to delete the measurement Note: Strain Ratio is not available when using Color 1 or 2 or, Map Index 2. Elasticity imaging / B-mode (EI/B) ratio % El/B Distance Ratio=1.00 1 D (E)=1.05 cm • On a live or frozen image, press Caliper El/B Ratio - D 2 D (B)=1.05 cm • Select EI/B Ratio – A (area ratio) or, % El/B Area Ratio=0.95 Select EI/B Ratio – D (distance ratio) 1 A (E)=0.81 cm2 • El/B Ratio - A 2 A (B)=0.85 cm2 • Measure lesion on elastogram and press Set key • Measure lesion on B-mode image and press Set key • The EI/B ratio is displayed in the measured results • To display measurement in report, select Right or Left and Mass 1, Mass 2 or Mass 3 measurement labels 1 Barr, R. G., De Silvestri, A., Scotti, V., Manzoni, F., Rebuffi, C., Capittini, C. and Tinelli, C. (2019), • Select Delete on the control panel to delete the measurement Diagnostic Performance and Accuracy of the 3 May be used as an indication of the likelihood of malignancy in breast Interpreting Methods of Breast Strain Elastography: A Systematic Review and Meta-analysis. J Ultrasound lesions. When the ratio is > 1, the probability of malignancy is high.1 Med, 38: 1397-1404. doi:10.1002/jum.14849. siemens-healthineers.com/ultrasound 3 For the proper use of the software or hardware, please always use At Siemens Healthineers, our purpose is to enable healthcare the Operator Manual or Instructions for Use (hereinafter collectively providers to increase value by empowering them on their journey “Operator Manual”) issued by Siemens Healthineers. This material is towards expanding precision medicine, transforming care delivery, to be used as training material only and shall by no means substitute and improving patient experience, all enabled by digitalizing the Operator Manual. Any material used in this training will not be healthcare. updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the An estimated 5 million patients globally everyday benefit from our training. The Operator Manual shall be used as your main reference, innovative technologies and services in the areas of diagnostic and in particular for relevant safety information like warnings and therapeutic imaging, laboratory diagnostics and molecular medicine, cautions. as well as digital health and enterprise services. Note: Some functions shown in this material are optional and might We are a leading medical technology company with over 170 years not be part of your system. of experience and 18,000 patents globally. With more than 48,000 dedicated colleagues in 75 countries, we will continue to innovate Certain products, product related claims or functionalities described and shape the future of healthcare. 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. ACUSON Sequoia and Virtual Touch are trademarks of Siemens Medical Solutions USA, Inc. Siemens Healthineers Ultrasound owns the rights to all images. Siemens Healthineers Headquarters Legal Manufacturer Siemens Healthcare GmbH Siemens Medical Solutions USA, Inc. Henkestr. 127 Ultrasound 91052 Erlangen, Germany 22010 S.E. 51st Street Phone: +49 9131 84-0 Issaquah, WA 98029, USA siemens-healthineers.com Phone: 1-888-826-9702 siemens-healthineers.com/ultrasound Published by Siemens Medical Solutions USA, Inc. · HOOD05162003086357 · 8988 0620 online · ©Siemens Medical Solutions USA, Inc., 2020