ARTIS icono ceiling QuantWeb vFFR workflow Job Aid - USA

SIEMENS Healthineers QuantWeb vFFR Workflow ARTIS icono/ pheno VE2x with syngo Application Software VE2x US Effective Date: 08/30/2022 I HOOD05162003298438 OUS Job Aid Effective Date 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022 Table of Contents SIEMENS Healthineers Starting QuantWeb 3 General Functions and Settings Toolbar 5 Preparation for Vessel Fractional Flow Reserve 6 Analysis Toolbar 7 vFFR Contour Detection 8 Preliminary Analysis 12 Report 13 Additional Measurements and Annotation Toolbar 14 Sharing the Results 15 2 OUS Effective Date: 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022 Starting QuantWeb - SIEMENS Healthineers Activating the Apps Segment QuantWeb features quantification of coronary -- -- -- -- and peripheral arteries, analysis of the left Live ventricle of the heart, and vessel Fractional Viewert Flow Reserve (vFFR) calculation. Apps Once suitable images have been loaded and Uni Box 1 Un Box 2 displayed in a Live or Viewer segment, select Un Box Wal 3 Apps for one of the other image segments. No Data Load The QuantWeb application is started in the Apps segment. Please note: The QCA3D, QVA3D and vFFR workflows require two angiograms of the artery which are at least 30 degrees apart from each CARO 30 9 K other. K 3 OUS Effective Date 13 Apr 2022| HOOD05162003269706 OUS Effective Date: 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022 Starting QuantWeb - SIEMENS Healthineers Sending the Image to Quant Click the Send to Quant icon to load the image ------- - in the Segment Menu > Apps tab. It can take a APPS Segment Menu & X Quant Images Calibration Analysis few seconds. AP Meassurent Send To Quant OCA Storing Apps OCIO Send To Quant 0 CARD 10 9 K K 4 OUS Effective Date 13 Apr 2022| HOOD05162003269706 OUS Effective Date: 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022 General Functions and Settings Toolbar SIEMENS Healthineers Relevant messages: Quant Calibration Anahyph Report All relevant user guidance, warnings and AP. 4 RAO 33,2ª / CRA 24.6" 4 LAO 51.5* / CAU 19.7" errors will be listed and can be reviewed. CICA User settings: Settings for manual obstruction analysis 11761 31/ 61 OCAIO reference type, local diameter, screen size settings and user guidance. ❶ Extra information: Licenses and manufacturer information. ? Button tooltips: Shows the names of each tool. ? 5 OUS Effective Date: 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022 Preparation for Vessel Fractional Flow Reserve SIEMENS Healthineers Process steps Please ensure: 1 The vFFR feature of the QuantWeb application is credits- Good contrast filling based. A key icon is shown with the number of remaining credits, which decreases by 1 when a patient study is closed. 2 Use the resting aortic root blood pressure, taken at the Optimal difference between two moment of image acquisition, as input for the vFFR projections is 90° workflow. 3 Acquisition by frame rate 15F/s is needed. Hold breath 4 vFFR analysis No table movement V 6 OUS Effective Date: 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022 Analysis Toolbar - SIEMENS Healthineers vFFR Contour Detection 1 1. Select the first projection image and ❶1 AP Quant Images Calibration Anthyth Report choose the vFFR analysis mode. VFFR 4 RAO 13.2- / CRA 24.6" 4 LAD 51.6 / CAU 197 195 The vFFR analysis workflow calculates the OCA. pressure drop across a lesion in a coronary QCA SINA EVA artery. 31 / 61 31/61 QVA OKCAID Please note: The availability of the analysis LVA modes is based on the licenses on your system. QCA3D QVA3D 7 OUS Effective Date: 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022 vFFR Contour Detection - SIEMENS Healthineers Marking a Vessel on the First Projection 2. 2 Select the optimal frame and mark the vessel scene using one of two methods: Marking a single vessel segment (only for a 2 single lesion): a) Set a starting point at the most proximal part (for example left main) of the vessel and end at the distal part of the vessel by double-clicking. b) Set multiple points by left-clicking inside the lumen of the vessel from the proximal part and end at the distal part by double- clicking. a b) D Please note: In QCA3D, QVA3D, and vFFR, calibration is not necessary. a) Marking the vessel (2 points) b) Marking the vessel (multiple) Detected the contour 8 OUS Effective Date 13 Apr 2022| HOOD05162003269706 OUS Effective Date: 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022 vFFR Contour Detection – SIEMENS Healthineers Selecting the Second Projection 3. Quant Calibration Analysis Report 3 Once the contour is drawn for the first Coronary Aralysla image, the second projection image can be utilized. Select the image from either from RAO 33.2" / CRA 24.6" 10 FPS the second projection guidance map or by directly selecting the thumbnail images. Please note: 4 is the series ID of an existing series image that is close to the green area where optimal angulation is located on this map and X indicates the current C-arm angulation. RAO 90º LAO 4 CRA & CAU CRA 8 X 35 /61 < > 3 CAU O RAO-90º LAO 9 9 OUS Effective Date 13 Apr 2022| HOOD05162003269706 OUS Effective Date: 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022 vFFR Contour Detection – SIEMENS Healthineers Marking the Vessel on the Second Projection Once a contour is drawn on the first image, on the 10 FPS second image so-called epi-polar lines are shown for: • The extremes from the other viewing direction • The viewing direction from the first to the second projection D 5 5 After the contour detection on the second projection, it automatically determines the common image point, the red dot. If it has been placed in the wrong area, please drag it to the right point manually. 32 / 61 O < > 10 10 OUS Effective Date 13 Apr 2022| HOOD05162003269706 OUS Effective Date: 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022 vFFR Contour Detection - SIEMENS Healthineers Calculating the vFFR 6 5. Enter resting aortic pressure. Then select Quant Images Calibration Analysis Report Vessel Fractional Flow Reserve Calculate vFFR. 10 FPS ❹ 6 ❺ 160 mmHg Calculate vFFR 32 / 61 -1 O O < > 90 mmHg 44 remaining credits Systolic pressure 160 mmH Calculate vFFR ? Diastolic pressure 90 mmHg 44 remaining credits Segment 11 OUS Effective Date 13 Apr 2022| HOOD05162003269706 OUS Effective Date: 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022 Preliminary Analysis SIEMENS Healthineers The vFFR value is calculated as the ratio of the Quant Images Calibration Analysis Report pressure distal to the stenotic lesion to the Quantitative pressure proximal to a stenotic lesion. Coronary Analysis Diameter Diameter Reference diameter vFFR VFFR mm 2.9 vFFR 0.92 OO 2 1.7 AP 9.02 mmHg 1 0 0 Systolic pressure 150 mmHg 5 10 15 20 mm 0 10 15 20 mm O Results Diastolic pressure 90 Segment mmHg Lesion Diameter 1.73 mm Percentage Stenosis 31.49 % Reference Diameter 2.52 mm Obstruction length 4.40 mm 12 OUS Effective Date: 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022 Report SIEMENS Healthineers 1. Select the Report tab. If there is more than one page use the < or > arrow to move forward and Quant Images Calibration Analysis Report Vessel Fractional Blaun Besanye backward. vFFR Results Page 1 / 2 2. Store the report in the Patient Browser on 3D reconstructed vessel Results the ARTIS system. RAO 12.2ª VFFR 0.61 CRA 56.9º 1.0 AP 40.16 mmHg Pressures 150/78 mmHg Obstruction length 27.20 mm 0.9 Position of lesion 58.80 mm Please note: You can also open the stored report via Diameter Area Lesion 0.91 mm 0.64 mm the Patient Browser in the image segment Viewer1, 0.8 % Stenosis 69.05 % 90.42 % Reference 2.92 mm 6.72 mm2 Viewer2 and 3D sharing. 0.7 Report creation date 24/03/2022 HELIOS Institution name Amper- 0.6 Klinikum Dachau Acquisition date 18/12/2014 D Rotation RAO 12.2 º A V 20.5 Angulation CRA 56.9 Diameter 13 OUS Effective Date: 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022 Additional Measurements and Annotation Toolbar SIEMENS Healthineers Measure the length of the distance Quant Images Calibration Analysis Report Quantitative Coronary Analysis Measure the angle between the two lines 0.1255 mm/Pixel Measure the area of the polygon A Add the text with the arrow A 14 OUS Effective Date 13 Apr 2022| HOOD05162003269706 OUS Effective Date: 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022 Sharing the Results SIEMENS Healthineers By clicking on the Share icon, you can share the Apps segment and the results in the control room with the Apps segment in the examination room. QUANTWELL, @ Live A & 19cm Ref1 A QUANTWEB Quant. .... 1.CARD program_3 (15.0 f/s) Image Information 13122.110754 c 5.fluoro normal (15.0 p/s) Share Quant ¿porll QuantWeh 7:20 PM Image Information 12122110754 Page 2 / 2 120 14 1 1 3.12 2.1667.5 5 000.0 min 1001 155.30 14121519 0.00 uGym3 2194 0.00 mGy image framed 0.00 uGym2 Angulation CRADS' 0.00 mGy Ret1 8 Ref2 8 @ 19cm 11235cm 11.122.1 @ 19cm 47.100419530 11235cm Sap Leguance UID 000014121510 215.4. Play/Pause LAD MIT- 6% RellA limage 11. Angulation CRA 4S" ** Image + Scene !!! 710 mm O No corimunication with ACE, SC O Please note: The exam room display layout should include the Apps segment. 15 OUS Effective Date: 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022 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. Please 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. © Siemens Healthcare GmbH 2022 Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Telephone: +49 9131 84-0 siemens-healthineers.com 16 OUS Effective Date: 13 Apr 2022| HOOD05162003269706 Unrestricted © Siemens Healthineers, 2022