ARTIS icono/pheno (VE21A and higher) and syngo Application Software (VE21 and higher): myNeedle Companion Job Aid

SIEMENS Healthineers HFP CT HPR HFP PR 5 cm 5 cm myNeedle Companion SL 1.0 1073 SL 1.0 MPR MER RAO 61 / 0 293 RAO 151 / CAUD 5 AH HFP CT HPR HEP ARTIS icono/pheno VE21 and 97.80 mm syngo Application Software VE21 RF Version 2021 L 1.6 AO 29 / CAUD 85 W 1073 C 293 VRT RAO 151 / CAUD 5 Template Effective Date: 10 Aug 2021| HILS 2223 Job Aid Effective Date 19 Nov 2021 | HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 myNeedle Companion SIEMENS Healthineers Table of Contents Introduction 3 myNeedle Guide Workflow Overview 4 myNeedle Guide Workflow Steps 5 myNeedle Guide Configurations 11 Load the Planning Volume to 3D Sharing 12 Select the myNeedle Guide Workflow 14 2 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 Introduction SIEMENS Healthineers The myNeedle Guide application allows you to plan the Live A 3D Sharing Q o CT HFP CT HFR HEP paths of needles or other puncture or drilling Application Control H 3D Sharing ? O instruments in the 3D volume. The planned paths can be Application displayed on the live image to provide guidance for myNeedle Guide XE insertion procedures. Check needle path using Auto Flight. Optionally: Create a new needle path in the planning volume. One or more needle/puncture paths can be planned Define Path either on a 3D volume that has just been acquired (basic Progress Needle Tools Bookmarks Layouts Plan. workflow) or on a 3D volume of the same patient from Needle Path L 1.6 MPR RAO 81 10 1373 9. 1.0 293 MBR RAD 151 / CAUD 5 another examination (advanced workflow) (for example N1 HFP CT HER HED a prior XA, CT, MR, or PET volume). With syngo 3D Roadmap, the live image is overlaid to the 3D image including the needle paths. While adjusting and progressing the needle, the position can be controlled in needle direction (Bull's Eye View) as well F as in two predefined views lateral to the needle path 1873 LAO 29 / CAUC 85 VRT RAO 151 / CAUD 5 (Progression View 1/2). 3 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 myNeedle Guide SIEMENS Healthineers Workflow Overview 1. Planning 2. Registration 3. Progress Needle Define path: • Select the Progress Needle workflow step. • Using syngo 3D Roadmap, the live image is • Basic workflow: Use a planning volume • If required, use syngo 3D registration to overlaid to the 3D image, including the which has a valid registration to the current register the 3D planning volume with the needle path. examination (for example a newly acquired examination patient, so that it can be used • The C-arm can be adjusted to needle-specific XA volume). for overlay. angulations: Bull's Eye View, Progression • Advanced workflow: Use a pre-procedure View 1/2. 3D volume which needs to be registered to Please note: the examination patient (for example a Registration is required when using a 3D volume previously acquired CT, MR, or XA 3D from another examination (advanced workflow). volume). 4 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 myNeedle Guide SIEMENS Healthineers Workflow Steps Basic Workflow Advanced Workflow Using an in-procedure DynaCT volume for planning Using a pre-procedure 3D volume for planning Acquire a 3D volume acquisition: Load the 3D volume: • 1) Select a Dyna3D/DynaCT acquisition program. Load the planning volume to the 3D Sharing segment (see Optional: Attach a radio-opaque grid on the skin of the pages 12 and 13). patient at the expected region of the skin entry point. 2) 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 Progress Needle or from the Application Control window (see pages 14 and 15). • The Define Path workflow step is automatically selected. 5 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 myNeedle Guide SIEMENS Healthineers Workflow Steps Define Path Define Path Progress Needle Tools Bookmarks Layouts + Define one or more needle paths and verify them. Needle Path • + Select the Add Needle icon or select a needle in the Needle list. N1 • In an MPR or VRT view, click the target point and the entry point. • The target point is marked by an arrow. In the Bull's Eye View, it is indicated by a circle. • The entry point is marked by a line. In the Bull's Eye View, it is indicated by a cross. Hint: It can be configured which point is set PA 2 N3. 27.74 mm first, the target point or the entry point (see 7.74 mm 1 cm page 11). A.085-DR HaIFILIHU ... CTA_ DBI-DRINRIFIU HU .. HPL 1 3 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 (3) segment shows an MPR view that contains the target point in 226 SL 2.0 M.PR Thick RAO 13 / CRAN 8 direction of the planned path. AH AXIOMATOB CTA_08:-DR Na Fil HU HPL VC1 30 081121-2 XA VC130 067121- HFS 2 4 • The upper left image segment (1) and the lower left (2) image segment show MPR views orthogonal to each other that contain the defined path completely. • The lower right image segment (4) shows a VRT view in the same orientation as the upper right MPR (Bull's Eye View). Plans Make sure that the C-arm symbol is not red in the VRT view. KRO 131 CRANS 6 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 myNeedle Guide SIEMENS Healthineers Workflow Steps Define Path Define Path: Flight Along Needle Path Progress Needle Tools Bookmarks Layouts You can watch the flight along the needle path in the upper right MPR segment. • Click the Auto Flight icon. Needle Path + N1 • You can stop the flight by clicking the Auto Flight icon. You can correct the target and/or entry point by drag and drop. • To restart the flight, click the Auto Flight icon again. 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 a 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). 7 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 myNeedle Guide SIEMENS Healthineers Workflow Steps Application Control 30 Sharing ? 0 Progress Needle In the Progress Needle workflow step, you can: Application • Overlay the live image to the 3D volume. myNeedle Guide XE • Use Bull's Eye View to align needle. Use Progression Views to Overlay the 3D Objects to the live image. check needle position. To perform and monitor the planned needle procedure, three system positions are necessary: Define Path Progress Needle Tools Bookmarks Layouts • Bull's Eye View: In this system position, the C-arm is angulated in the same direction as the active needle path. This view is used to determine the skin entry point and to align the needle. Needle Path • Progression View 1 and Progression View 2: These two system positions are computed automatically N1 and they are used for monitoring the needle progression. They provide two lateral views to the planned needle path taking system restrictions into consideration. LAO CRAN LAO 90º Adjusting the C-arm to the Bull's Eye View or to the Progression View 1 or 2 CAUD • Select the needle, if necessary. RAO CAUD • Select the required view, if necessary. • Select the icon to adjust the C-arm to Bull's Eye View (selected as default). • Select the icon to adjust C-arm to Progression View 1. • Select the icon to adjust C-arm to Progression View 2. • Move the system to the position by activating the desired operating element. For example, press down and deflect the C-arm joystick. • When the position is reached, the following message is displayed Automatic run: Position reached. 8 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 myNeedle Guide SIEMENS Healthineers Workflow Steps Progress Needle H Adjust the position in the Bull's Eye View • 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 P • The arrows indicate the tabletop movements required in order to align the triangle and Tri- Star symbol. F F F • The Bull’s Eye View has been reached when the arrows disappear, and the triangle and 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. 9 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 myNeedle Guide 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. 10 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 myNeedle Guide SIEMENS Healthineers Configurations You can configure options for Needle Guidance in the configuration panel. Configurations • To open the configuration panel select: Settings > User Configuration. Automatic switch-on laser You can configure whether the laser is ? switched on automatically when Bull’s Eye Settings View is reached and the table is positioned User Configuration correctly. Service Portal Target first or entry first as You can configure which point is set first, the Expert-i Remote Connect needle direction target point or the entry point. Interventional View You can configure the orientation according Orientation or Radiological to the registered patient position of the • Select the 3D tab. Select the Workflows blind. View Orientation examination patient (Interventional View • Orientation) or the standard radiological • Select the workflow from the Select Workflows list. Workflows orientation (Radiological View Orientation). Select Workflow Aneurysm Analysis Aneurysm Analysis Aortic Valve Guidance Embolization Guidance EVAR Guidance myNeedle Guide Registration Segmentation 11 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 Load the Planning Volume to 3D Sharing SIEMENS Healthineers If you are using a pre-procedure 3D volume for planning, import the 3D Sharing Source Browser La Images Settings Menu Close Im Save Bo D Polyli ... Interacti ... Export t .. Parallel .. data to the Patient Browser before starting Overlay. Viewing Review loaded or acquired volumes. Review and Processing New acquisitions will replace existing volumes. Bookma Layouts Undock Image Directory 3D Sharing ? x Load the planning volume to the 3D Sharing segment V Send To Select All Deselect Multiple If the patient is the currently registered examination: All Scenes + 3D 3D REF/ Bookmarks Key Images Custom February 05, 2018, CT Facette 1) Open the Image Directory in 3D Sharing. 3D Sharing Q 2 VOLUME CT AN VOLUME AN VOLUME AN Source Browser Images Settings Menu Close Im ... Save Do ... Snapsho ... Viewing Review loaded or acquired volumes. 1/6: Topogramm 1.0 Tr60 2/6: WS KF 1.0 Br62 3/6: WS Bandscheibe 1.0 .. 2) Select the exam data, when the 3D volume was created. VOLUME CT AN VOLUME VOLUME AN AN 4/6: WS Bandscheibe 1.0 .. 5/6: i-Sequence 2.4 Br38 7/6: Schlüsselbilder 12 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 Load the Planning Volume to 3D Sharing SIEMENS Healthineers Do the following if the 3D volume data is not under the 3D Sharing Q C Sellings flew loaded or acquired volumes. New acquisitions will replace existing volumes. current examination (for example, if the data is from another Layouts E hospital and not matched to the current patient): Patient Browser Loost Date test 2 (4) Test 1 (3) Sesten py. Name, ID. Date, Description and Modelty (Coup) Q More Filters DICOM IT 1) Select the Patient Browser in 3D Sharing. Results (20 results. 1:50:15 AM) Series Patient Study Description Study Date and Time + Series Number Series Description Modaly Series Date and Time Series Art + Embolization_Guidance, Patient 1 Topogramm 1.0 Tr6D 2/5/2018 11:21:28 AM *1/1/1957, M. 2 WS KF 1.0 Br62 2/5/2018 11:23:07 AM bulBde 3 WS Bandscheibe 1.0 for 3D 2/5/2018:11:23:21 AM 3D Sharing Q TACE -Transarterielle Chempembolisation 8/24/2017 7:19:17 AM WS Bandscheibe 1.0 für 3D 2/5/2018 11:29:02 AM Patient, Cardiac 5 -Sequence 2.4 Br38 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 SouIco Browser 0020320995 950 3D Objects 2/5/2018 11:34:00 AM Patient, Cardiac *2/12/1959, F 234587B 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 2) Double-click on the required volume to open the *1/1/1934, M DL Facette 2/5/2018:11:24:32 AM volume in 3D Sharing. Confirm that the data is for the DL Facette 2/5/2018 11:24:32 AM CT Facette 2/5/2018 11:19:28 AM Patient, Neuro "2/12/1964, M current patient. 577889800-0 Patient, Neuro Examination 41/1/1949, F 111:5878 Series Search successfully completed Series Number Series Description Modalily Series Date and Time Series Art + 1 Topogramm 1.0 TrBD CT 2/5/2018 11:21:28 AM 2 WS KF 1.0 Br62 CT 2/5/2018 11:23:07 AM 3 WS Bandscheibe 1.0 für 3D CT 2/5/2018 11:23:21 AM WS Bandscheibe 1.0 für 3D CT 2/5/2018 11:29:02 AM -Sequence 2.4 Br38 CT 2/5/2018 11:43:13 AM 7 Schlüsselbilder CT 2/5/2018 11:44:19 AM 501 Dosisbericht SR 2/5/2018 11:49:44 AM 950 3D Objects SEG 2/5/2018 11:34:00 AM 13 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 Select the myNeedle Guide Workflow SIEMENS Healthineers You select the Needle Guidance workflow from the Application Control. 3D Sharing Q Ca Source Browser Images Settings Menu Close Im. Save Bo ... Snapsho. 30 Polyli ... Interacti .... Exportt ... Paratel. Viewing Review loaded or acquired volumes. Review and Processing New acquisitions will replace existing volumes. Bockma. Layouts Undock Viewing HFP CT HFP The Application Control may be docked (fixed) in the Workflow Header Overlay Active Workflows or undocked. You can undock the Application Control in the top-right corner of the 3D Sharing segment. Embolization Guidance EVAR Guidance my Needle Guide 10 cm SL 1.0 586 SL 1.0 MPR MPR 586 LAO 90 / 0 56 0 /0 nz CT HFP CT HFP 10 cm SL 1.0 MPR 586 0 / CAUD 90 56 RAO 1 / CRAN 10 364 14 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 Select the myNeedle Guide Workflow SIEMENS Healthineers When the Application Control is Docked Select the myNeedle Guide workflow step in the Workflow Header. 3D Sharing La 3D Sharing Q Browser Images Menu Close Im. Save Bo ... Snapsho. 30 Poly ... Interacti Export t .. Viewing Review loaded or acquired volumes. @ Review loa Images Settings Review and Processing New acquis ons will replace existing volumes. Bockma ... Source Browser Layouts Viewing HFP CT HEP Viewing Review loaded or a Overlay Active Workflows Review and Processing New acquisitions w Embolization Guidance Viewing EVAR Guidance Overlay myNeedle Guide Active Workflows 10 cm L Embolization Guidance SL 1.0 SL 1.0 MPR 586 MPR LAO 90 / 0 56 0/0 HFP ICT HFP EVAR Guidance myNeedle Guide 10 cm SL 1.0 MPR 0 / CAUD 90 RAO 1 / CRAN 10 15 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 Select the myNeedle Guide Workflow SIEMENS Healthineers When the Application Control is Undocked Select the myNeedle Guide in the application workflow step in the Application Control. Application Control 3D Sharing ?0 Application PATIENT, Needle Guidance IN 1.CARD program (15 #/s) may .. 08 MOYm' IO 000.0 @ Detector calibration needed plane B. SC myNeedle Guide X E Male, 1/1/1934 (85), ID 11. 1.CARD Exam Set p. 6.DSA program (VFR) TO 000.0 5.fluoro normal (15 p/s) Live A T 3D Sharing Q Review and Processing CT HFP CT Aneurysm Analysis aded volume is the Application Control 3D Sharing Aortic Valve Guidance Application XE Congenital Heart Disease Guidance myNeedle Guide Review and Processing Aneurysm Analysis aded volume is the CTO Guidance Aortic Valve Guidance Congenital Heart Disease Guidance CTO Guidance TrueFusion Layouts TrueFusion marks Layouts okmarks EP Planning Embolization Guidance EP Planning EVAR Guidance myNeedle Guide MPR Spine Guidance LAO 80 / 0 556 MPRO Embolization Guidance Stenosis Analysis EVAR Guidance myNeedle Guide Spine Guidance Stenosis Analysis OF CAUD 90 56 RAO 1 / CRAN 10 2 16 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021 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 2021 Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Telephone: +49 9131 84-0 siemens-healthineers.com 17 Effective Date: 19 Nov 2021| HOOD05162003220467 Unrestricted © Siemens Healthineers, 2021