ACUSON Origin Stress Echo Presentation

SIEMENS Healthineers SIEMENS Healthineers ... ACUSON Origin Ultrasound System Stress Echo Package 1.0 software version 1 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The purpose of this presentation is to review configuration and workflow of a stress echo exam with the ACUSON Origin ultrasound system. SIEMENS Healthineers ACUSON Origin stress echo SIEMENS . Healthineers .. Key features Supports 7 user-definable factory default protocols Comprehensive wall motion scoring package Contrast Imaging Capability Staged measurements / 2D HeartAI Common user interface among platforms 2 Unrestricted © Siemens Healthineers 2023 Speaker Notes: We will begin by defining some key features of the ACUSON Origin Ultrasound System. The ACUSON Origin ultrasound system supports seven user-definable protocols, optional View Control workflow features, and a comprehensive wall motion scoring package. It also has a similar appearance and workflow to current platforms, providing consistency for users. SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Describe the user interface • Explain protocol configuration • Illustrate quick protocol configuration • Discuss step-by-step workflow • Describe stress echo review and image selection • Summarize quick exam 3 Unrestricted © Siemens Healthineers 2023 Speaker Notes: We will begin by describing the stress echo user interface. SIEMENS Healthineers User interface SIEMENS. Healthineers' ... Reference view (can be expanded) Region of Interest (ROI) Healthineers Live Treadmill 5V1 Reference View Cardiac TIS:0.71 Rest A MI:1.01 40fps view Acroled Selected 95% PLAY 2D H High Navigation PSAX -3dB/DR58 LD 2 UA 2 Panel AMC MapE/T5 NC P2 Post A2G Thumbnail panel PLAX 16cm 57bpm Lead Off PSAX ROI Size / Position 1 of 4 Unrestricted © Siemens Healthineers 2023 Speaker Notes: It is important to be familiar with the user interface. This is the stress echo layout screen throughout the Stress Echo exam. Once the Stress Echo option is selected from the touch screen, the controls for the Stress Echo package are available on the touch screen. Reference Image – Provides an image of the current view from Rest acquisition as a reference. This enables the user to be consistent when acquiring the different views throughout each stage of a stress echo. Navigation Panel– Displays the different views for each stage as well as the current view. It also displays how many images are acquired and selected for each stage. Region of Interest (ROI) – The portion of the clinical image that is included in acquisition. ROI Size / Position – Controls that are used to adjust the size and position of the ROI. Thumbnail Panel – Displays captured clips or images during the exam. Double-click a thumbnail to display the image in a full-screen review format. You can also add thumbnail images to the report. SIEMENS Healthineers Region of interest SIEMENS. Healthineers' ... To modify the ROI size / position: 5V1 Cardiac TIS:0.71 MI:1.01 40fps Press the left or right Set key to move between 95% • 2D H High position and size 3dB/DR58 LD 2 UA 2 MapE/T5 P2 • Modify ROI size / position using trackball 16cm 57bpm Lead Off Position Sue 5 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, we will discuss the region of interest. It is important to note, that the ROI is dynamic. The size and position may be modified according to preference or need. To modify the ROI size or position: • Press the left or right Set key to move between position or size • Modify ROI size or position using the trackball SIEMENS Healthineers Review and selection – touch screen SIEMENS . Healthineers ... 1. Selection Mode or Compare Mode Review 2. Defer Selection, Accept All, Reject, Add Patient 1 Stress Echo Review Imaging Selection Compare End Protocol 4 3. Image layout options (4 up recommended) Review Report Accept Selected II 4. Exam Review End Exam Accept All Defer Selection 2 5 Add Reject Text Overlays On Exam Review Left Margin Right Margin Sync Mode Playback Loop Aligned Cine Cunenit Current 1 of 1 6 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The following options can be found in Review and Selection during a stress echo: 1. Viewing Modes • Selection Mode – Allows the user to select from available images acquired for a view during each stage of a stress echo (one or multiple images can be selected) • Review Mode – Displays all images that have been selected for each stage 2. Selection Options • Defer Selection – Allows the user to skip selection for current view and continue to acquisition for the next view • Accept All – Selects all images acquired for the current view • Reject – Rejects all images acquired for the current view and takes the user back into acquisition mode • Add – Allows the user to add more images to the current view 1. Image Layout options – Changes the layout of images displayed on screen. For stress echo, the 4-up view is typically used and is the default. 2. Exam Review – Activates review mode and displays all images that have been acquired (versus only the ones that have been selected). SIEMENS Healthineers Image selection SIEMENS . Healthineers ... 1. Navigation panel 1 Healthineen Review 3 2. Image selected, indicated by a teal outline 3. Image not selected, indicated by X 2 7 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The image displayed demonstrates the look and functionality of the imaging screen during selection mode. 1. Navigation Panel – Displays the different views programmed into each stage of the stress echo. Also displayed, are the number of images that have been acquired and selected for each stage. A green check mark located to the left of the view name indicates that acquisition for that view has been completed. 2. Selected Image – When an image is selected for a view, it is outlined in teal. Multiple images can be selected and the number of selected images will appear in the Navigation Panel box. 3. Image Rejected – when an image is not selected for a view, a red X appears in the upper left-hand corner of the image. SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Describe the user interface • Explain protocol configuration • Illustrate quick protocol configuration • Discuss step-by-step workflow • Describe stress echo review and image selection • Summarize quick exam 8 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, we will illustrate protocol configuration. SIEMENS Healthineers System configuration SIEMENS . Healthineers' ... Select Stress Echo from System Configuration. System Configuration System Configuration Control Panel Settings System Settings Patient Workflow Enhancement > Imaging Settings aging Measurement & Report Review Annotations Report Features Protocols End Exam Stress Echo 4D Heart Nl 2D Heart N Tab Q W U o P AI Assist Caps Lock S D G H K L Enter Transducer >Connectivity & Network Shift Z X M Delete Peripheral Devices Ctrl Alt # == System Management 9 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To access stress echo configuration, select Configuration > Features > Stress Echo. SIEMENS Healthineers Stress echo configuration SIEMENS . Healthineers ... Stress echo configuration is divided Stress Echo Wall Motion Scoring into three sections: Protocols Stages Views Pharmacology Rest [] Select all views Treadmill Post V V 1. Protocols – protocol name Bicyck PSAX Regurgitant Volume O AC 2. Stages – stages within a protocol PISA A2C Mitral Stenosis 3. Views – views within each stage Aortic Stenosis Protocols Stages Views Add Copy to Delete View Name PLAX Apply to All Stages Image Settings Image Angle Settings Automatic Transducer Change Left Plane Angle View Labe 521 V 0 docrees PLAX Automatic Mode Change Right Plane Angle lew Label 20 PLAX 27 Enable Bi-Plane+ Restore Defaults 10 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Stress Echo configuration is divided into three categories: Protocols, Stages, and Views. Depending on the category selected, the options below will change. There are seven different factory default stress echo protocols. SIEMENS Healthineers Stress echo configuration – protocol settings SIEMENS . Healthineers ... • Protocols can be edited or a new protocol Stress Echo Wall Motion Scoring can be added Protocols Views Pharmacology Rest Treadmill • To add a new protocol select Add Bicycle Regurgitant Volume PISA Mitral Stenosis • Copy allows the user to copy and then VV VV VV Aortic Stenosis edit an existing protocol Add Copy Delete Protocol Name Treadmill • Delete removes the currently selected Protocol Settings Default Review Settings protocol from the list Display ROI Display Format E] Allow selection of multiple clips per view 4:1 [] Hide the navigation panel on the main screen as default Cropping Mode Playback Speed Protocol settings can be adjusted below Progression by Stage ES Only V 50% • Automatic C Manual Cap Sortin View O Stage Import Export Note: Protocols can be imported / exported. ................... Restore Defaults 11 Unrestricted © Siemens Healthineers 2023 Speaker Notes: As an example, we will discuss configuration of a Treadmill Continuous protocol. Protocols can be Imported and/or Exported. Add allows the user to add and build a new protocol. Copy allows the user to copy an existing protocol which can then be edited/customized. Use the arrows to change the order of protocols. Delete allows the user to delete a protocol, however, a factory default cannot be deleted. Protocols have two options for settings: Protocol Settings and Default Review Settings. All settings displayed on this slide are default settings for the selected protocol. Protocol Settings includes: • Display ROI – displays the region of interest for acquisition during the stress echo. • Allow selection of multiple clips per view – allows the user to select multiple acquisition clips for each view in a stage. • Hide the navigation panel on the main screen as default – hides the navigation panel on the left side of the monitor during a stress echo. • Progression type by stage – selection of Automatic or Manual progression type during the stress echo. Default Review Settings includes: • Display Format – format in which clips are displayed in Review. • Playback Mode – length of playback for an acquired clip in Review. Options include Full R- R, Adjusted, Diastole Only, and Systole Only. • Playback Speed – speed at which acquired clips play in Review. • Clip Sorting – sorting of acquired clips in Review. Options include By View and By Stage. Note: Default Review Settings can be changed during an exam from the touch screen while in Stress Echo Review. Restore Defaults restores original default settings to a factory protocol. SIEMENS Healthineers Stress echo configuration – stage settings SIEMENS . Healthineers ... • Multiple stages are configured into a Stress Echo Wall Motion Scoring protocol and are listed in the order they Protocols ..... Views occur within the exam Pharmacology Rest Select all views Treadmill Post O A4C Bicycle O A2C Regurgitant Volume PLAX • Add, Copy and Delete are available PISA PSAX Mitral Stenosis functions within stage settings Aortic Stenosis V VV Vvv Stage Capture Settings – image capture Add Copy Delete • ............ settings per stage Stage Name Stage Capture Settings Additional Settings Clip Capture Stage Timer Enter Selection Continuous Start with Undefined View 0 Off Do not enter • Additional Settings – includes stage timer, Clip Type Clip Length O Start at Beginning of Stage Atter View Capture: stage selection settings, and reference Beats Start at First Clip Store After Stage Capture Display the reference view image settings Apply to All Stages Reference View Baseline Stage O Previous Stage ........................ Restore Defaults 12 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Stages are listed in the order that they occur within the exam. The user can Add, Copy, or Delete a stage. The arrows can be used to change the order of the stages. Stages have two options for settings: Stage Capture Settings and Additional Settings. Stage Capture Settings includes: • Clip Store Type – use to select the type of clip capture. Options include Retrospective, Prospective, and Continuous. • Clips per Capture – determines how many clips will be stored for each view of the current stage. • Clip Type – configures clip capture to Beat or Time capture. Additionally, the number of beats or seconds can be set. • Clip Offset – sets the offset of clip capture to Time Offset or R-Wave Offset. Additionally, time in msec can be set for the Time Offset option. Additional Settings includes: • Stage Timer – a timer can be configured for each stage. This is particularly helpful in a Post stage for a treadmill stress echo. Options include Off, Start at Beginning of Stage, and Start at First Clip Store. • Enter Review – determines at what point the protocol enters into stress review so that images can be selected for Views. Options include: Do not enter, After View Capture, and After Stage Capture. • Display the Reference View – configure to Baseline or Previous Stage. SIEMENS Healthineers Stress echo configuration – view settings SIEMENS . Healthineers ... • Multiple views are configured into a stage tress Echo Wall Motion Scoring and are listed in the order they occur Protocols Stages within the exam Pharmacology Rest Select all views Treadmill Post PLAX Bicycle O PSAX Regurgitant Volume O A4C • Add, Copy to and Delete are available PISA 0 A2C VV VV functions within view settings Aortic Stenosis Add Image Settings – vary depending on Copy to Delete • View Name transducer (this example demonstrates PLAX Apply to All Stages Image Settings Image Angle Settings the 5Z1) Automatic Transducer Change Left Plane Arighe view Label 521 Jogrent PLAX Automatic Mode Change Right Plane Angle View Label 2D • Apply to All Stages – applies view settings 90 degrees PLAX Enable Bi-Plane+ to all stages within the protocol Restore Defaults 13 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Views are listed in the order that they occur within the exam. The user can Add, Copy to, or Delete a view. The arrows can be used to change the order of the views. Image Settings – vary depending on selected transducer (5Z1 is displayed) • Automatic Transducer Change – select default transducer for each view • Automatic Mode Change – select default imaging mode for each view • Enable Bi-Plane+ - available only with the 5Z1 matrix transducer Image Angle Settings (only available with the 5Z1) • Left / Right Plane Angle – configure default angle settings for each view (angle settings must be configured for all views within each stage; other imaging settings will be retained beyond the Rest stage) • View Label – labeled text which appears on capture image for each view SIEMENS Healthineers Factory stress echo protocols Pharmacolo Treadmill Bicycle Regurgitant PISA Mitral Aortic gy Volume Stenosis Stenosis • Rest • Rest • Rest • Rest • Rest • Rest • Rest • Low • Post* • Low • Post • Post • Post • Post Stages • Peak • Peak* • Recovery • Recov ery • PLAX • PLAX • PLAX • EF A4C • EF A4C • EF A4C • EF A4C • PSAX • PSAX • PSAX • EF A2C • EF A2C • EF A2C • EF A2C • A4C • A4C • A4C • Valve Color • Valve Color • MV Color • AV Color Views • A2C • A2C • A2C • MV Ann VTI • PISA • MV VTI • LVOT VTI • LVOT VTI • Regurgitant • AV VTI • Regurgitant VTI VTI * Continuous capture as default 14 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The following protocols are available as factory defaults. The factory protocols can be edited. SIEMENS Healthineers Stress echo configuration – Bi-Plane+ SIEMENS . Healthineers ... • Bi-Plane+ imaging is available as an Image Stress Echo Wall Motion Scoring Setting in view configuration when the 5Z1 is Protocols Pharmacology Select all views selected as the transducer Treadmill O PAX Bicycle O PSAX Regurgitant Volume . MC Select Enable Bi-Plane+ PISA O AX VV VVV • Mitral Stenosis Aortic Stenosis • Configure angles for the left and right planes Add Copy to Delete (note that this must be done for each view View Name MC Apply to All Stages Image Settagi Itioge Angle Settings separately in each stage) automatic: Transducer Changee View Labe 521 Automatic Mode Change Single plane angle settings are also configurable, 20 AZC • Enable Ili-Planes eliminating the need for the user to manually rotate the transducer while scanning Restore Defaults 15 Unrestricted © Siemens Healthineers 2023 Speaker Notes: • Bi-Plane+ imaging is available as an Image Setting in view configuration when the 5Z1 is selected as the transducer • Select Enable Bi-Plane+ • Configure angles for the left and right planes (note that this must be done for each view separately in each stage) • Single plane angle settings are also configurable, eliminating the need for the user to manually rotate the transducer while scanning SIEMENS Healthineers Stress echo configuration – Wall Motion Scoring SIEMENS . Healthineers ... • Wall Motion Scoring is available in the Stress Echo .............................................................................. Wall Motion Scoring stress echo package Wall Motion Scoring • Select a 16 or 17 segment model Segment Model • Wall motion scoring selections will O 16 Segments populate to the report O 17 Segments Restore Defaults 16 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Wall Motion Scoring tab under configuration includes options for 16 or 17 segments. User-selected wall motion scoring will populate to the report during an exam. SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Describe the user interface • Explain protocol configuration • Illustrate quick protocol configuration • Discuss step-by-step workflow • Describe stress echo review and image selection • Summarize quick exam 17 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, we will illustrate a quick, practical protocol configuration. SIEMENS Healthineers Quick protocol configuration SIEMENS . Healthineers ... 1. Highlight factory stress echo protocol Stress Eche Wall Motion Scoring Protocols Stages Views Pharmacology 1 Rest 2. Copy the highlighted protocol Treadmill Low Bicycle Peak Regurgitant Volume Recovery VV VV PISA 3. Change protocol name Mitral Stenosis Aortic Stenosis VV VVVVV 2 Add Copy Delete Protocol Name Pharmacology 3 Default Review Settings Display ROI Display Format E Ailow selection of multiple clips per view 4:1 [] Hide the navigation panel on the main screen as default Cropping Mode Playback Speed Progression by Stage ES Only 50% Automatic O Manual Clip Sorin New O Stage Import Export Restore Defaults 18 Unrestricted © Siemens Healthineers 2023 Speaker Notes: We will now illustrate a quick and easy way to configure a protocol. Because there is typically a standard type of protocol used for the different types of stress echoes, it is more efficient to copy a factory default protocol and simply modify it. To copy and modify a protocol, take the following steps: 1. Highlight a factory stress echo protocol 2. Select Copy to make a copy of the highlighted protocol 3. Change the protocol name 4. Make necessary adjustments according to user preference SIEMENS Healthineers Quick protocol configuration SIEMENS . Healthineers ... 4. Modify stage and view settings Stress Echo Wall Motion Scoring Protocol Stages Pharmacology Select all views Treadmill LOW O PLAX Bicycle PSAX Regurgitant Volume Recovery O MC VV Vv PISA 0 A2C Mitral Stonasis Aortic Stenosis v V V V V V Add Copy Delete Stage Name Stage Capture Settings 4 Additional Settings Clip Capture Clips Pur Captar Stage Dimer Enter Selection Prospective Off O Do not enter After View Capture Ap Type Clip Longe O Start at Beginning of Stage Beats O. Start at First Clip Store O After Stage Capture Apply to Al Stages Display the reference vieres Tip: Changes in the protocol configuration remain in place without having to save 19 Unrestricted © Siemens Healthineers 2023 Speaker Notes: 4. Modify stage and view settings according to user preferences Note: Previously configured protocols can be imported as well. SIEMENS Healthineers Stress Echo – System Configuration SIEMENS . Healthineers' ... How-to Video 5V1 Cardiac TIS:1.05 MI:1.05 47fps odB/DR60 16cm ... Lead Off 20 Unrestricted © Siemens Healthineers 2023 Speaker Notes: No speaker notes. SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Describe the user interface • Explain protocol configuration • Illustrate quick protocol configuration • Discuss step-by-step workflow • Describe stress echo review and image selection • Summarize quick exam 21 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, we will discuss the step-by-step workflow for stress echo. SIEMENS Healthineers Begin an exercise stress echo SIEMENS . Healthineers ... • Select Patient and enter patient Patient Registration Patient Browser information or select a patient from a modality worklist Patient Clear All Start Study Preregister Imaging • This is mandatory to begin a Revie stress echo Report End Exam < > Tab W U O X Caps Lock S D F G H K Enter Shift Z C V IN M Delete Ctrl Alt #4 22 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To begin a stress echo, a patient must be registered. By selecting Patient from the left side of the touch screen, and then New Patient, new patient information can be entered. The user may also select a new patient from a modality worklist if configured. SIEMENS Healthineers Activate stress echo protocol SIEMENS . Healthineers ... 1. Select the appropriate cardiac 5V1 5Z1 Cardiac Workflow 2 transducer (5Z1, 5V1, 8V3, 10V4) 1 2. Select the Workflow tab at the top Physio right-hand portion of the touch screen Protocols 3. Select Stress Echo Physio Stress Echo ......... 3 23 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Once a new patient is registered continue with the following steps: 1. Select the appropriate cardiac transducer (5V1, 5Z1, 8V3, 10V4) 2. Select the Workflow tab at the top right-hand portion of the touch screen 3. Select Stress Echo SIEMENS Healthineers Activate stress echo protocol SIEMENS . Healthineers ... 4. Select desired protocol – an ROI appears on 2D Stress Echo Physio the image Exit 4 Pharmacology PISA 31 Treadmill Mitral Stenosis Bicycle Aortic Stenosis Regurgitant Volume 24 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Once a new patient is registered continue with the following steps: 4. Select the desired stress echo protocol from the pop-up window; an ROI will then appear on the imaging screen. SIEMENS Healthineers Rest stage – imaging screen SIEMENS .; Healthineers ... 1. Select Capture to acquire images for a view Hesithinkers> Review Senal number. 804279 System datetme. Friday, July 14, 2023 09:23 AM 2. Select from available clips Treadmill 3. Multiple clips can be selected with a single click on Reference View Rest the desired clip PLAX • Double click on last clip selection to progress to PSAX next acquisition MC 4. A teal outline appears on selected clips; an X immediately appears on non-selected clips 5. A check mark appears next to each view as it is completed 25 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To complete the Rest stage: 1. Select Capture to acquire images for each view 2. Select from available clips 3. Multiple clips can be selected • Double-click on the last clip selection to progress to acquisition for the next view. For example, if two clips are to be selected, single-click on the first one and double-click on the second (last) one. 4. A teal outline appears on selected clips; a red X appears on non-selected clips • Non-selected clips are automatically deleted upon exam completion. 5. A green check mark located to the left of the view name indicates that acquisition and selection for that view have been completed. In this example, acquisition and selection for the PLAX, PSAX, and A4C views have been completed, but the A2C view still needs to be completed. SIEMENS Healthineers Rest stage – touch screen SIEMENS . Healthineers ... • Defer Selection – continues to acquisition for Stress Echo Review next view; selection completed later Selection Compare End Protocol • Accept All – accepts all acquired images for current view Accept Selected • Reject – rejects all acquired images for current ccept All Defer Selection view and returns to acquisition mode dd Reject Text Overlays On Exam Review • Accept Selected – accepts all images selected and continues to the next view / stage within the protocol Left Margin Right Margin Sync Mode Playback Cine Page [Cimient Current Loop Aligned 1 of 1 • Add – returns to acquisition for current view to add more images 26 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The following touch screen controls are the most commonly used functions during the Rest stage of a stress echo: • Defer Selection – continues to acquisition for next view; selection completed later • Accept All – accepts all acquired images for current view • Reject – rejects all acquired images for current view and returns to acquisition mode • Accept Selected – accepts all images selected and continues to the next view / stage within the protocol • Add – returns to acquisition for current view to add more images SIEMENS Healthineers Post stage – continuous capture with view control SIEMENS . Healthineers ... To use touch screen for view control: 2D Stress Echo Physio Stage Post Cancel Protocol Pause Protocol End Protocol • Select the current view from the list on the touch screen or using the Update Key and press Next PLAX View PSAX A4C • Once a view is completed, a green check mark AZC appears • Once all views are completed, system enters Select Mode and image selection can be completed OR Next View TIP: The backward/forward control on the control panel may also be used to progress to the next view. Position Size 27 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The touch screen is also available for use during view control. To use the touch screen: • Select the current view from the list on the touch screen (current view is highlighted in orange) • Once acquisition for a view is completed, a green check mark appears • Once all view are completed, the system enters Review and image selection can be completed TIP: When view control is utilized, imaging parameters from Rest capture will be applied to Post capture. SIEMENS Healthineers Post stage – continuous capture without view control SIEMENS . Healthineers ... 1. Select Capture to begin acquisition • Select Capture to stop acquisition for current view • Select Capture again to begin acquisition of next view 2. When acquisition for the last view is completed, select End Capture on the touch screen • Select Pause Protocol on the touchscreen if additional images are needed Capture 3. System will enter Selection Mode once End Capture is selected Note: All images will be labeled as same view and will need to be renamed when selected. 28 Unrestricted © Siemens Healthineers 2023 Speaker Notes: If the user prefers to capture post stress images with continuous capture and view control: 1. Select Clip Store to begin acquisition • Select Clip Store to stop acquisition for current view • Select Clip Store again to begin acquisition of next view 2. When acquisition for last view is completed, select Clip Store to end capture • Select Pause Protocol if additional images are needed 3. System will enter Selection Mode Note: When using view control for Post stage acquisition, the views are labeled during acquisition. Once the Post stage is completed, the user will then select clips for each view in Selection Mode. SIEMENS Healthineers Rename View SIEMENS . Healthineers ... • If stress echo images are acquired without view control, all images will be labeled as the same view • In Review, using the Update Key, the PLAX Rename View option appears when PSAX A4C selected A2C POSE PSAX ......... 1.2) Rename View 29 Unrestricted © Siemens Healthineers 2023 Speaker Notes: If stress echo images are acquired without view control, all acquired images will be labeled as the same view and need to be renamed. In Review, use the Update key to access Rename View. A window will appear giving the user the option to select options for renaming. SIEMENS Healthineers Rename View SIEMENS. Healthineers' ... How-to-video colthinters Treadmill 5V1 Reference View Cardiac Rest A4C TIS:0.73 MI:0.99 36fps MC -1dB/DR57 LD 2 UA 2 MapC/T5 P2 Rest 28 Post 53 View Megared elected Post A4C PLAX PSAX MC AZC 17cm A3C 56bpm Lead 00:57 Acquired Clips 53 of 750 Next View 32 of 85 30 Unrestricted © Siemens Healthineers 2023 Speaker Notes: This video demonstrates the workflow for renaming a view. Simply press the Update key, which is labeled Rename View. Then choose the correct view for the currently selected image. SIEMENS Healthineers Add view SIEMENS . Healthineers ... 1 Add View can be used to add a view during a Add View Treadmill Continuous stress echo protocol: Reference View 1. Select Add View Rest Add View View Acquired Selected 2. Type in view name Available Views ... PLAX 3. Select OK A3C .. PSAX ALAX A4C A2C SAX Base RVOT TO 0 AX Mid AX Apex Post 0 A View SSAXX Acquired Selected PLAX PSAX A4C 2 RVOTI AZC TIP: Select Save to all Stages from the touch Duplicate name exists. screen to apply the new view to all stages. 3 OK Cancel Acquired Clips 8 of 750 31 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Add View can be used to add a view during a stress echo protocol. To add a view: 1. Select Add View 2. Type in view name 3. Select OK Note: If a view is added in one stage, it will not automatically duplicate to the next stage. (A better workflow may be to Pause Protocol to capture an image outside of the standard stages, unless a protocol is specifically built for an additional stage. For example, if a protocol is created to assess a valve at Rest and at Post, build that protocol and it will be available to choose at the beginning of the exam.) SIEMENS Healthineers Add stage SIEMENS . Healthineers ... Treadmill Continuous Add Stage can be used to add a stage during a stress Reference View echo: Rest View Acquired Selected 1 PLAX 1. Select Add Stage V PSAX 2. Select Stage Property Add Stage VMC 3. Type in Stage Name VA2C 4. Select OK Post View Acquired Selected Add Stage PLAX O PSAX Stage Property Post AMC AZC 2 Recovery Recovery View OK Cancel Acquired Select PLAX 3 PSAX MC A2C 32 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Add Stage can be used to add a stage during a stress echo protocol. To add a stage: 1. Select Add Stage 2. Select Stage Property – duplicates configuration settings for new stage 3. Type in Stage Name 4. Select OK Note: When a view is added, it will appear after the current stage. In the example displayed, the Recovery stage was added during the Post stage, therefore it appeared after the Post stage. SIEMENS Healthineers 2D HeartAI SIEMENS .. : Healthineers ... • 2D HeartAI analysis can be performed from a A4C ED A4C ES 66 1p stress echo image • Image must be selected from Exam Review • Provides biplane EF and volumes pre and post exercise ------ A4C Results (Beat 1 of 1) HR (bpm) 64 Bi-Plane Results LV LA RV RA LV LA EF (%) 615 GLS (%) 25.2 GLS FW (%) -20.3 GLS (%) 422 EF (%) 66.6 GLS (%) GLS (%) -25.2 ESV (ml) 426 FAC (%) 32.4 ESV (ml) 25.1 GLS (%) -27.1 ESV (ml) 438 SV (ml) 47.1 ES Axis (cm) 4.7 EDA (cm2) 145 ES Axis (cm) 4.0 SV (ml) 49.7 ES Axis (cm EDV (ml) 766 ESA (cm2) 98 EDV (ml) 74.6 ESV (mi) 29.5 ESV (ml) 24.9 33 Unrestricted © Siemens Healthineers 2023 Speaker Notes: • 2D HeartAI analysis can be performed from a stress echo image • User must be in Exam Review to select an image for 2D HeartAI analysis • Provides biplane EF and volumes pre and post exercise SIEMENS Healthineers Staged measurements SIEMENS . Healthineers ... Klient Report • Staged measurements are available for up to 20 stages KV OF AC MOO 1530 -4 1520 • Will display in report by stage measurement LYSVAK UDO 41:27 am 41:37 was performed in 23.00 mm 23.09 • Available for select Doppler and B-mode 130.7 - measurements LY SY MICMOO storm ipod 34 Unrestricted © Siemens Healthineers 2023 Speaker Notes: • Staged measurements are available for up to twenty stages • Will display in report by stage measurement was performed in • Available for select Doppler and B-mode measurements SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Describe the user interface • Explain protocol configuration • Illustrate quick protocol configuration • Discuss step-by-step workflow • Describe stress echo review and image selection • Summarize quick exam 35 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, we will describe stress echo review and image selection. SIEMENS Healthineers Image selection SIEMENS . Healthineers' ... 1. Navigation panel Healthintern Review 3 Reference Vi 2. Image selected, indicated by a teal outline 1 3. Image not selected, indicated by X 2 36 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The image displayed demonstrates the look and functionality of the imaging screen during selection mode. 1. Navigation Panel – Displays the different views programmed into each stage of the stress echo. Also displayed, are the number of images that have been acquired and selected for each stage. A green check mark located to the left of the view name indicates that acquisition for that view has been completed. 2. Selected Image – When an image is selected for a view, it is outlined in teal. Multiple images can be selected and the number of selected images will appear in the Navigation Panel box. 3. Image Rejected – when an image is not selected for a view, a red X appears in the upper left-hand corner of the image. SIEMENS Healthineers Image selection SIEMENS . Healthineers ... • Once images are acquired, the application will automatically advance to Selection Mode • If desired, change the layout SIEMENS Treadmill X X Reference View .. X • Toggle through pages to review and select images Page 14 of 20 37 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Once images are acquired, the application will automatically advance to Selection Mode. If desired, the user can change the layout. Four up display layout is typically used during stress echo. Toggle through the pages to review and select images. SIEMENS Healthineers Stress Echo Review SIEMENS . Healthineers ... • Once selection is completed, the Navigation Panel Rest 16 displays a green check mark beside all views View Acquired Selected V PLAX • The number of selected views also appears to the V PSAX By View right of each view V A4C By Stage V A2C Text Overlay On Sort By View EDIES Split • Compare option is available Post 54 View Acquired Selected • Images can be sorted By View or By Stage V PLAX 35 Compare Wall Motion V PSAX 5 Scoring V A4C Reference Compare to V A2C Rest Post Acquired Clips 70 of 750 38 Unrestricted © Siemens Healthineers 2023 Speaker Notes: • Once selection is completed, the Navigation Panel displays a green check mark beside all views • The number of selected views also appears to the right of each view • A Compare option is available and allows the user to select two images for comparison (example: Rest and Post images of the same view) • Images can be sorted By View or By Stage SIEMENS Healthineers Exam Review SIEMENS . Healthineers ... • Exam Review option for stress echo is available Review Patient Stress Echo Review • Allows the operator to review multiple images Imaging Selection Compare End Protocol simultaneously; also includes all images that were Review acquired throughout stress echo exam Report Accept Selected End Exam Accept All Defer Selection • Select Stress Echo Review to return to Review and select Modes Add Reject ext overlays Exam Review ...... Left Maio Right Margin Sync Mode Playback Loop Aligned Cine Page 2 of 2 39 Unrestricted © Siemens Healthineers 2023 Speaker Notes: While in Stress Echo Review, Exam Review is available on the touch screen. • Allows the operator to review multiple images simultaneously; also includes all images that were acquired throughout stress echo exam • Select Stress Echo Review to return to Review and select Modes SIEMENS Healthineers Wall Motion Scoring SIEMENS .. : Healthineers ... Wall Motion Scoring Rest PLAX Post PLAX Aneprysmal Enatis bo Interpret Set natscored sogncm, lo Normal TIP Use the Set not scored segments to Normal and Set all segments to Normal options for efficiency. 40 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Wall motion scoring is available at the end of a stress echo exam. The user is able to select scoring values from 1-5 (Normal, Hypokinetic, Akinetic, Dyskinetic, Aneurysmal) and Unable to Interpret. Display options for the report include: Bullseye, View Plane, and Both. • Set not scored segments to normal – sets any segments not already scored to normal • Set all segments to normal - sets all segments to normal; individual segments can then be changed to a different value • Clear all segments – clears all currently scored segments SIEMENS Healthineers Wall motion scoring SIEMENS . Healthineers ... Res • Select the bull’s eye icon to view the segments in a bull’s eye format • This provides a global display of all the segments Post Post Rest Rest Post Post 41 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Select the bull’s eye icon to view the segments in a bull’s eye format and display a global format of the wall segments. SIEMENS Healthineers End the stress echo protocol SIEMENS . Healthineers ... 1. Select End Protocol on the touch screen 1 2. Select OK (a message will alert the user of any views that have not been completed) End Protocol • Standard imaging screen will be available • If desired, capture non-stress images • Selecting End Study from the touch screen will end the study End Stress Echo Protocol completely One or more views have not been completed. Do you want to omit the views and end the protocol? Unable to modify or resume after ending the protocol. 2 OK Cancel 42 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To end the stress echo protocol: 1. Select End Protocol on the touch screen 2. Select OK (a message will alert the user of any views that have not been completed) • Standard imaging screen will be available • If desired, capture non-stress images • Selecting End Study will end the study completely. SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Describe the user interface • Explain protocol configuration • Illustrate quick protocol configuration • Discuss step-by-step workflow • Describe stress echo review and image selection • Summarize quick exam 43 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, we will summarize how to do a quick stress echo demo. SIEMENS Healthineers Quick stress echo exam SIEMENS . Healthineers ... • Determine the stress echo workflow and customize a protocol • Begin the study • Obtain images outside of the stress echo • Launch the stress echo protocol • Evaluate the flexibility of the protocol by using View Control or without using View Control • Demonstrate how to pause the protocol and take additional images 44 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Before the demo, determine the customers stress echo workflow and customize a protocol based on their preferences. Begin the study: • Obtain images outside of the stress echo • Launch the stress echo protocol • Evaluate the flexibility of the protocol by using View Control or without using View Control • Demonstrate how to pause the protocol and take additional images SIEMENS Healthineers Summary SIEMENS . Healthineers ... • Describe the user interface • Explain protocol configuration • Illustrate quick protocol configuration • Discuss step-by-step workflow • Describe stress echo review and image selection • Summarize quick exam 45 Unrestricted © Siemens Healthineers 2023 Speaker Notes: In summary, we have covered the following topics: • Describe the user interface • Explain protocol configuration • Illustrate quick protocol configuration • Discuss step-by-step workflow • Describe stress echo review and image selection • Summarize quick exam SIEMENS Healthineers Stress Echo – Things to remember Clip Capture: Max number of views: 20 • Retrospective – up to 4 clips Max number of stages: 20 • Prospective – up to 5 clips • Continuous – up to 750 clips Clip Length (per one clip): • Retrospective – up to 10 secs/10 beats *For Contrast Stress Echo protocol: Must create separate protocol and have the views set with Contrast • Prospective – up to 10 secs/10 beats mode on. Turning on contrast at baseline does not set it • Continuous – up to 5 secs/5 beats as part of baseline save parameters. 46 Unrestricted © Siemens Healthineers 2023 SIEMENS Healthineers Trademarks and disclaimers The products/features mentioned in this document may not be commercially available in all countries. Due to regulatory reasons their future availability cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details. ACUSON O r i g in i s a trademarks of Siemens Medical Solutions USA, Inc. At Siemens Healthineers, our purpose is to enable healthcare providers to increase value by empowering them on their journey towards expanding precision medicine, transforming care delivery, and improving patient experience, all enabled by digitalizing healthcare. An estimated five million patients worldwide everyday benefit from our innovative technologies and services in the areas of diagnostic and therapeutic imaging, laboratory diagnostics and molecular medicine as well as digital health and enterprise services. We’re a leading medical technology company with over 120 years of experience and 18,500 patents globally. With over 50,000 employees in more than 70 countries, we’ll continue to innovate and shape the future of healthcare. Siemens Healthineers Headquarters 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-heathineers.com/ultrasound 47 Unrestricted © Siemens Healthineers 2023 SIEMENS Healthineers Thank you for your enthusiasm! SIEMENS . Healthineers ... Questions? 48 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Questions?