BioMatrix Beat Sensor Ready to Operate

SIEMENS Healthineers BioMatrix Beat Sensor Ready to Operate OX Template Effective Date: 10 Aug 2021| HILS 2223 Effective Date: 27 Sep 2022| HOOD051620033300744 Effective Date 27 Sep 2022 | HOOD051620033300744 Unrestricted © Siemens Healthineers, 2022 Beat Sensor SIEMENS Healthineers Table of Contents How it Works 3 Benefits 4 Coil Positioning 5 Beat Sensor Learning Phase 7 Beat Sensor in Cardiac Assist Hip 8 8 Beat Sensor Training Knee 9 9 Sample Processing ECG versus Beat Sensor 11 10 Automatic Adaption to End Diastolic Phase Result Information 15 14 Printing Results 16 Daily Maintenance 18 Weekly Maintenance 19 Monthly Maintenance 20 As-Needed Maintenance 23 Calibration 24 2 Effective Date: 27 Sep 2022| HOOD051620033300744 Unrestricted © Siemens Healthineers, 2022 How it Works SIEMENS Healthineers B • Beat Sensor is a technology that enables you to perform a complete cardiac MRI exam without an ECG. • The Pilot Tone (PT) also known as Beat Sensor is close to the heart, and PTX local MR coils receive the signal in parallel with the MR signal. • The signal is separated into the different motion contributions and cardiac motion is enhanced. • The technology uses the heart’s own beating motion as the triggering source unlike an ECG, which only indirectly measures the onset of cardiac motion by detecting the electrical activity of the heart. signal • Beat Sensor triggering can be used in combination with the BioMatrix Signal intensity Body 12 Coil or BioMatrix Body 18 coil. Detection • The trigger point of the Beat Sensor signal corresponds to the hr acceleration phase of the systolic contraction. This point is depicted by an arrow in the physiological display and is used as a reference point for triggered measurements. time channels Beat Sensor Cardiac 57 /min RR-1 1052 ms Signal Processing 3 Effective Date: 27 Sep 2022| HOOD051620033300744 Unrestricted © Siemens Healthineers, 2022 Benefits SIEMENS Healthineers • Beat Sensor triggering supports all cardiac imaging techniques. AFR HLP • Beat Sensor eliminates the need to place electrodes on the patient and can speed up the workflow for CMR exams. RHP RPH • You don’t have to spend time shaving chest hair, using cleaning gel, and placing electrodes on patients. • It improves patient experience especially for patients who have sensitive skin (e.g., allergic to cleaning gel) and/or feel uncomfortable when technologists place the electrodes on their chest. ARH ARH ARH • It saves on supplies and reduces plastic waste when using the Beat Sensor. HLP HLP ARH ARH RPH ARH AFR HL RPH ARH ARH 4 Effective Date: 27 Sep 2022| HOOD051620033300744 Image Courtesy of Dr. Johan Dehem, Jan Yperman Hospital, Ieper, Belgium Unrestricted © Siemens Healthineers, 2022 Coil Positioning (1/2) SIEMENS Healthineers Position the BioMatrix Body Coil so the Beat Sensor ( ) is placed over the patient’s heart. • (1) BioMatrix Body 12 • (2) BioMatrix Body 18 Please note: For smaller patients correct positioning in H-F direction can be supported by cushions, so that the coil is not touching patient’s face. 1 2 5 Effective Date: 27 Sep 2022| HOOD051620033300744 Unrestricted © Siemens Healthineers, 2022 Coil Positioning (2/2) SIEMENS Healthineers • Secure the coil by sliding the belts through the flaps of the coil and lock them to the guides in the patient table. Check that the groove is clean. • Tilt the strap mounting devices slightly towards the table center and then insert the strap into the groove along the edge of the patient table. • Use positioning aids for patient comfort. • Check that the coil cable does not hang loose and does not have loops. 6 Effective Date: 27 Sep 2022| HOOD051620033300744 Unrestricted © Siemens Healthineers, 2022 Beat Sensor Learning Phase SIEMENS Healthineers • When you plug in the coil, an initial Beat Sensor learning phase is automatically triggered. This is shown on the touchscreen. • This learning phase takes 20 seconds. • The quality of the signal might be affected by any kind of movement, e.g., movement of patient or medical staff in examination room. • The cabin door should be closed to avoid radio frequency interference. i Beat Sensor learning phase is active Info Info Beat Sensor Cardiac /min RR-1 0 ms Beat Sensor Cardiac 73 /min RR-1 815 ms Resp RF () /min RP () ms Resp RF 19 /min RP 3060 ms External Signal II EF 0 /min EP 0 ms External Signal II EF 0 /min EP 0 ms COIL PLUGGED BM Body 18 Physio Physio 7 Effective Date: 27 Sep 2022| HOOD051620033300744 Unrestricted © Siemens Healthineers, 2022 Beat Sensor in Cardiac Assist SIEMENS Healthineers In the Cardiac Patient View within the Cardiac General Parameters Breath-Hold Parameters • Assist workflow, a new Beat Sensor Training Exam Strategy breath-hold Breath-Hold Capability 15 Cardiac Assist LOC + selection is available. Beat Sensor Training no Auto Breath-Hold Commands V English (United ... 1 Localizer 00:01 If Beat Sensor Training is activated, the training Pause Between Breath-Holds 10 2 center on heart • 3 steps are added to the workflow and the Trigger localizer_heart 00:05 4 thorax_cor_tra 00:29 Source is changed to Beat Sensor. Physio Parameters 5 % AAheart_scout 00:14 Trigger source ECG 6 define_lax 00:01 → For all triggered protocols used in the Cardiac Override cardiac cycle 7 cine_segmented_lax 00:07 Assist, the Trigger source is automatically changed 0 ms to Beat Sensor. General Parameters Breath-Hold Parameters Cardiac Assist LOC + Exam Strategy breath-hold Breath-Hold Capability 15 Localizer 00:01 Beat Sensor Training yes Auto Breath-Hold Commands English (United ... 2 Pause Between Breath-Holds 10 + center on heart 3 localizer_heart 00:05 4 % Beat Sensor training bh 00:14 Physio Parameters 5 thorax_cor_tra 00:29 6 AAheart_scout 00:14 Trigger source Beat Sensor 7 define_lax 00:01 Override cardiac cycle 0 ms 8 Effective Date: 27 Sep 2022| HOOD051620033300744 Unrestricted © Siemens Healthineers, 2022 Beat Sensor Training – Usage of Siemens Programs SIEMENS Healthineers Cardiac Assist LOC + After you have completed the initial localization of the heart with the 1 Localizer 00:01 untriggered localizer and localizer_heart program steps, you can 2 center on heart perform the Beat Sensor training step dependent on the suceeding localizer_heart 00:05 W workflow. 4 Beat Sensor training bh 00:14 The Beat sensor training step combines two functionalities: thorax_cor_tra 00:29 Storing the coil selection for subsequent program steps that use 6 AAheart_scout 00:14 • Beat Sensor triggering. 7 define_lax 00:01 • Performing a calibration scan. The Beat Sensor training step is part of the heart/localizer/trufi bh, Cardiac Assist LOC + heart/localizer/trufi_fb or the heart/localizer/tfl_db program and the 1 To minimize motion artifacts, advise ... Cardiac Assists workflows. 2 Inject contrast agent. 3 localizer 00:01 You can choose between two Beat Sensor training steps: Beat Sensor training bh (breath-hold) and Beat Sensor training fb (free breathing). 4 center on heart 5 localizer_heart 00:05 6 Beat Sensor training fb 00:43 7 AAheart_scout 00:14 8 define_lax 00:01 9 cine_cs_fb_lax 00:02 9 Effective Date: 27 Sep 2022| HOOD051620033300744 Unrestricted © Siemens Healthineers, 2022 Beat Sensor Training – Using Your own Programs SIEMENS Healthineers Guidance Parameters 1 Add the Beat Sensor training step to your measurement program. Check coil coverage and adapt if necessary. 2 Start the Beat Sensor training step to perform the learning phase and SP1 the calibration scan. 3 Instruct the patient to remain still during the learning phase. The Beat Sensor training step plays out a series of RF pulses at different time intervals and does not generate any images. SP4 10 Effective Date: 27 Sep 2022| HOOD051620033300744 Unrestricted © Siemens Healthineers, 2022 ECG Versus Beat Sensor – Trigger Time Point SIEMENS Healthineers • In general: • ECG triggers on the beginning of the saltatory conduction. ECG I 57 /min RR-1 1047 ms • Beat Sensor triggers on the fastest cardiac contraction in the beginning of the systole. • Beat Sensor trigger occurs after the ECG trigger (R-wave), but Beat: Sensor Cardiac before the pulse trigger. 57 /min RR-1 1052 ms • The trigger time differences for ECG and Beat Sensor are normally between 120 and 200ms. ECG Pulse Beat Sensor 11 Effective Date: 27 Sep 2022| HOOD051620033300744 Unrestricted © Siemens Healthineers, 2022 ECG Versus Beat Sensor – Image Examples (1/3) SIEMENS Healthineers ECG BEAT SENSOR ALH Aortic Valve Aortic Valve with ECG with Beat Sensor 12 Effective Date: 27 Sep 2022| HOOD051620033300744 Unrestricted © Siemens Healthineers, 2022 ECG Versus Beat Sensor – Image Examples (2/3) SIEMENS Healthineers ECG BEAT SENSOR RFA Left ventricular outflow tract Left ventricular outflow tract with ECG with Beat Sensor 13 Effective Date: 27 Sep 2022| HOOD051620033300744 Unrestricted © Siemens Healthineers, 2022 ECG Versus Beat Sensor – Image Examples (3/3) SIEMENS Healthineers ECG BEAT SENSOR AHR Short axis stack Short axis stack with ECG with Beat Sensor 14 Effective Date: 27 Sep 2022| HOOD051620033300744 Unrestricted © Siemens Healthineers, 2022 Automatic Adaption to End Diastolic Phase SIEMENS Healthineers • The Beat Sensor signal contains lots of information from which the position of the R-wave and pulse trigger can be estimated relative to the Beat Sensor trigger. • This information is used to define the acquisition window for prospective triggering and also enables automatic shift of data acquisition to end diastole. • Depending on the protocol, the trigger delay or TR is updated to shift data acquisition to end diastole. Routine Contrast Resolution Geometry System Physio Inline Sequence Routine Contrast Resolution Geometry System Physio Inline Sequence Routine Contrast Resolution Geometry System Physio Inline Sequence Signal Cardiac PACE Signal Cardiac PACE Signal Cardiac PACE 1st Signal/Mode ECG/Trigger 1st Signal/Mode Beat Sensor/Trigger 1st Signal/Mode Pulse/Trigger Average Cycle 990 + 10 ms Average Cycle 990 + 9 ms Average Cycle 1000 + 0 Captured Cycle 990 + 10 Captured Cycle 990 + 9 Captured Cycle 1000 + 0 Acquisition Window 931 - ms 0.8 1.6 4[s] Acquisition Window 808 - ms 0.8 1.6 4[s] Acquisition Window 601 + ms 0.8 1.6 4[s] Breath-holds Breath-holds Breath-holds Trigger Pulse Trigger Pulse Trigger Pulse Trigger Delay 657 ms Phases Trigger Delay 531 ms Phases Trigger Delay 327 - ms Phases TR 2/3.8 |ms Adaptive Triggering 276.9 - ms Adaptive Triggering TR 273.8 - ms Adaptive Triggering Segments 67 4 Segments 67 Segments 67 4 ECG Beat Sensor Pulse 15 Effective Date: 27 Sep 2022| HOOD051620033300744 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 Effective Date: 27 Sep 2022| HOOD051620033300744 Unrestricted © Siemens Healthineers, 2022