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ACUSON Sequoia™ Ultrasound System Virtual Touch Strain Imaging | VA11 Software Release

This quick reference guide helps you understand the strain imaging on the ACUSON Sequoia ultrasound system with the VA11 software.

ACUSON Sequoia Virtual Touch Strain Imaging Quick Reference Card Sequoia Using Strain imaging to qualitatively assess relative tissue stiffness Step 1 Position patient to obtain perpendicular plane to skin VT Strain • surface for optimal axial motion. Position compatible transducer* over area of interest and 18L6 • Breast TIB:0.06 optimize B-mode image. TIC:0.11 TIS:0.06 MI:0.60 Press VT (Virtual Touch) located on control panel. ~15fps • 95% 2D Select Strain tab, if needed. Mid • 3dB/DR65 Strain Roll trackball to position the region of interest (ROI). Color 0 • Map 0 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 QF: 92 Fig. 1: Left: B-mode image with ROI. Right: B-mode image with corresponding ROI displaying elastogram. Step 2 Use minimal compression; avoid lateral or rocking motion. • TIP Patient respirations or cardiac motion may be sufficient. 3/DR65 Strain Adjust axial motion or cease lateral movement if gray Color • 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 3cm QF: 0 < 50 (Fig. 2) indicates a less than optimal result; perform another acquisition. Fig. 2: A gray overlay box on elastogram indicates insufficient or excessive axial motion or, lateral movement. ............................. . . . . . . . . Step 3 Breast @ 14L5 DAX 5C1 Workflow Scan ~10 seconds, and then press Freeze; review cine to Patient 20 Virtual Touch • obtain desired frames. Imaging Review Strain DSW Rotate Zoom on the control panel to adjust the view scale. 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 - Frequency H Mid Color Map Index applied with transducer) 2: Inverted map - *Strain imaging is compatible with 18L6, 14L5, 10L4: General, Breast, Thyroid; 9EC4: Prostate. HOOD05162002896635 · Printed in Germany · Siemens Medical Solutions USA, Inc., 2018 SIEMENS Healthineers 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. On a live or frozen image, press Caliper. TIP Shadow may be used with the • strain ratio. Select Shadow if needed and press Set key. • Measure the right or left image and press Set key. • Select Delete on the control panel or Clear Screen on the touch screen • to delete the measurement. Strain Ratio Compares the relative stiffness of tissue within two ROIs (e.g., compares average strain of a lesion and average strain of the surrounding tissue). Strain Ratio On a frozen image, press Caliper. • Strain ratio = 1: Select Strain Ratio. stiffness of tissue in both ROIs is equal. • Place ROI 1 (ellipse) in surrounding tissue inside ROI and press Set key to • Strain ratio > 1: anchor each axis endpoint. lesion is harder than surrounding tissue. Roll trackball to place ROI 2 (ellipse) in lesion (same size and at same depth) • Strain ratio < 1: and press Set key to anchor each axis endpoint. lesion is softer than surrounding tissue. Strain ratio and average strain (%) for both ROIs are displayed in the • measured results. Note: Results reflect placement of ROI 1 in To display measurement in report, select Right or Left and either Mass 1, surrounding tissue; results will differ if ROI 1 • is placed in lesion. Mass 2 or Mass 3 measurement labels. Select Delete on the control panel or Clear Screen on the touch screen 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. 2 D (B)=1.05 cm • Select EI/B Ratio – A (area ratio) or, El/B Ratio - D • El/B Area Ratio=0.95 Select EI/B Ratio – D (distance ratio). 1 A (E)=0.81 cm2 • 2 A (B)=0.85 cm2 Measure lesion on elastogram and press Set key. % • Measure lesion on B-mode image and press Set key. El/B Ratio - A • 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. Select Delete on the control panel or Clear Screen on the touch screen to • delete the measurement. May be used as an indication of the likelihood of malignancy in breast lesions. When the ratio is > 1, the probability of malignancy is high.* *Barr, R.G. (2010). Real-Time Ultrasound Elasticity of the Breast. Ultrasound Quarterly, 26(2), 61-66. doi:10.1097/RUQ.0b13e3181dc7ce4. ACUSON Sequoia and Virtual Touch are trademarks of Siemens Medical Solutions USA, Inc. 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. · Order No. A91US-567-1C-4A00 · HOOD05162002896635 · Printed in Germany · CIT11960 06180.5 © Siemens Medical Solutions USA, Inc., 2018