BioMatrix Beat Sensor Troubleshooting

SIEMENS Healthineers BioMatrix Beat Sensor Troubleshooting OX HOOD051620033 00744 Template Effective Date: 10 Aug 2021| HILS 2223 Effective Date: 27 Sep 2022| HOOD05162003300744 Effective Date 27 Sep 2022 | HOOD05162003300744 Unrestricted © Siemens Healthineers, 2022 Unrestricted © Siemens Healthineers, 2022 Beat Sensor Troubleshooting SIEMENS Healthineers Table of Contents Hints for a Good Beat Sensor Signal 3 Pre-Measurement Adjustments 4 Hints for Protocol Management 5 Poor Beat Sensor Trigger and Signal Quality During Scanning 9 Missed Beat Sensor Training 12 Inverted Signal 13 Mistriggering due to Deep Breath-hold 9 Breath-Hold Position Changed During Scanning 10 Printing Results 16 Daily Maintenance 18 Weekly Maintenance 19 Monthly Maintenance 20 As-Needed Maintenance 23 Calibration 24 2 Effective Date: 27 Sep 2022| HOOD05162003300744 Unrestricted © Siemens Healthineers, 2022 Hints for a Good Beat Sensor Signal SIEMENS Healthineers • Beat Sensor triggering works best when the patient is SIEMENS. X X Healthineers Test 1/1/1989 M 2022.08.18-14:44:57 -... MR View&GO not agitated or fidgety during the examination i.e., is Cardiac Assist LOC .. + relaxed. 1 localizer 00:01 2 7 center on heart Automatic voice command Step 1 - localizer localizer_heart General W A relaxed patient is especially important during the 4 thorax_cor_tra Protocol Parameters No voice commands • Voice Commands 5 % AAheart_scout Beat Sensor Training step since this step is essential Execution Use local settings 6 define_lax Image Management Voice commands Automatic 7 cine_segmented_lax Auto Load to ensure optimal trigger quality during scanning. Copy References Before scan Hold breath (inhaled). 8 define_sax Preview After scan Continue breathing. 19 cine_segmented_sax Pause 10 + • The robustness of Beat Sensor triggering is best, when . Use myExam settings combined with an exhaled breath hold position or free Voice commands Automatic Before scan Hold breath (exhaled). breathing. Triggering may not be consistent or could After scan Continue breathing. Delete 10 s Skip Stop Pause Continue Pause fail if performing the breath-hold during inhalation. ... Addin Configuration ... OK Cancel Please note: In Siemens protocols, Exhale is set as the default breath holding position. ECG I O /min RR-1 0 m Physio Parameters Trigger source ECG Override cardiac cycle No sional from PERUI | Initial respiration learningphase active Don't move tablel 3 Effective Date: 27 Sep 2022| HOOD05162003300744 Unrestricted © Siemens Healthineers, 2022 Pre-Measurement Adjustments SIEMENS Healthineers Beat Sensor signal is suppressed during system 19 t1_tse_db D 20 trufi_3d_nav_fs_bh O adjustments and when it is not used as trigger source. 20 trufi_3d_nav_fs_bh 21 angio_f13d_sag_p2_aorta_ecg A flat line is visible in the Physio Display of the Beat Sensor 21 % angio_f13d_sag_p2_aorta_ecg Cardiac. 2 00:00 2 00:00 Go Go Cancel Delete Go Cancel Delete Skip Stop Pause Continue Copy&Go Skip Stop Pause Continue Copy&Go Please note: If you use Beat Sensor as a trigger source, the same coil selection is used for all protocols. This reduces the number of system adjustments. Beat Sensor Cardiac 69 min Beat Sensor Cardiac RR-I 869 68 /min RR-1 874 m ECG II ECG II 68 /min 68 /min RR-I 875 m RR-I 877 m O SAR Stimu SAR Stimu Inroom Exam myExam Injector Normal Exam Display Inline Injector Settings Settings Display Cockpit Control Stimu etting Settings Physio Display Displa myExam Cockpit Control Normal Mode Possible Mode Possible Preparing ... Adjusting (3D Shim Fieldmap) ... An adjustment in preparation 3D Shim in progress 4 Effective Date: 27 Sep 2022| HOOD05162003300744 Unrestricted © Siemens Healthineers, 2022 Hints for Protocol Management (1/4) SIEMENS Healthineers SIEMENS >> heart > MyoMaps > t2 map > t2map_trufi ? X 8 7 sec Auto @ 2 1.9x1.9x8.0 mm3 ~ 1.00 Routine Contrast Resolution Geometry System Physio nline Sequence Signal Cardiac PACE 1st Signal/Mode Beat Sensor/Trigger Average Cycle None If you want to create your own Beat Sensor protocols, ECG/Trigger Captured Cycle Beat Sensor/Trigger make sure that the Beat Sensor is activated in each Acquisition Window Pulse/Trigger Ext./Trigger 0.8 .6 4[s] program and program step. Breath-holds Trigger Pulse Trigger Delay 600 - ms Phases Select Physio > Signal > Select 1st Signal Mode: Beat TR 193.8 % ms Adaptive Triggering Sensor/Trigger or Beat Sensor/Retro. Segments 58 Please note: When prospective Beat Sensor triggering is used, click the Captured Cycle Box to automatically adapt Routine Contrast Resolution Geometry Routine Contrast Resolution Geometry Signal Cardiac PACE Signal Cardiac PACE the Acquisition Window and the Trigger Delay. 1st Signal/Mode Beat Sensor/Trigger 1st Signal/Mode Beat Sensor/Trigger Average Cycle No Signal ms Average Cycle No Signal ms Captured Cycle -not set- Captured Cycle 800 + 0 Acquisition Window 805 - ms Acquisition Window 741 + ms Trigger Pulse Trigger Pulse Trigger Delay 586 ms Trigger Delay 522 + ms TR 218.4 ms TR 218.4 + ms Segments 58 Segments 58 ¢ 5 Effective Date: 27 Sep 2022| HOOD05162003300744 Unrestricted © Siemens Healthineers, 2022 Hints for Protocol Management (2/4) SIEMENS Healthineers Hint: If you select Find… by right-mouse clicking on a program, the Find and Set myExam Cockpit - Explorer Parameters Dialog opens. Explorer Program Editor Browse Import Export Edit Simulate USER ... >> heart >> Cardiac Q br heart Localizer Cardiac Examination E Ventricular Function center on heart E IschemicHeartDisease E Myocarditis Edit ... El GOHeart FreeBreathing New EGOHeart IschemicHeartDise Find ... El library 9 localizer Paste Ctrl+V morphology Delete function Rename dynamic Print ... tissue characterization Export ... MyoMaps Check License flow Convert angiography Edit Properties ... angiography ce dynamic_test 6 Effective Date: 27 Sep 2022| HOOD05162003300744 Unrestricted © Siemens Healthineers, 2022 Hints for Protocol Management (3/4) SIEMENS Healthineers Now, you can change the Trigger source for the whole program at once. myExam Cockpit - Explorer myExam Cockpit - Explorer Explorer Program Editor Explorer Program Editor Browse Import Export Edit Simulate Browse Import Export Edit Simulate X × USER Find and Set Parameters Find and Set Parameters x Protocol Parameters Routine Contrast Resolution Geometr System Physio Inline Sequence History of Changes Voice Commands Name Q ische X Signal Cardiac PACE heart Execution Image Management 1st Signal/Mode None Cardiac Examination Location USER Auto Load None E Ventricular Function Type Measurement Step ECG/Trigger Beat Sensor/Trigger El IschemicHeartDisease Pulse/Trigger Name Ext./Trigger E Myocarditis Path Concatenations E GOHeart FreeBreathing USER/heart/Cardiac Examination/Ische ... Localizer USER/heart/Cardiac Examination/Ische ... localizer heart E GOHeart IschemicHeartDisease USER/heart/Cardiac Examination/Ische ... Beat Sensor training bh El library USER/heart/Cardiac Examination/Ische ... thorax_cor_tra 327.6 + ms [ localizer USER/heart/Cardiac Examination/Ische ... AAheart_scout Segments morphology USER/heart/Cardiac Examination/Ische ... define_lax function USER/heart/Cardiac Examination/Ische ... cine_segmented_lax dynamic USER/heart/Cardiac Examination/Ische ... cine_realtime_lax USER/heart/Cardiac Examination/Ische ... define_sax tissue characterization USER/heart/Cardiac Examination/Ische ... dynamic_test Accept Changes Cancel MyoMaps USER/heart/Cardiac Examination/Ische ... dynamic_stress flow dynamic_stress 00:11 angiography Cardiac Standard cine_segmented_lax 00:12 cine_realtime_lax 00:01 angiography ce Select all Unselect all Cardiac Standard O Cardiac Standard cine_segmented_sax 00:11 cine_realtime_sax 00:01 Cardiac Standard O Cardiac Standard Inject contrast agent. Go to Physio > Signal in the Protocol Parameters Card. Edit selected Cancel Select Beat Sensor Trigger as 1st Signal Mode. Select Name, Location and Type in the Find and Set Parameters Dialog. Then click Edit Selected. 7 Effective Date: 27 Sep 2022| HOOD05162003300744 Unrestricted © Siemens Healthineers, 2022 Hints for Protocol Management (4/4) SIEMENS Healthineers Protocols using retrospective SIEMENS >> heart >> function >> cine truff >> cine_trufi_retro SIEMENS >> heart >> function > cine trufi >> cine_trufi_retro Beat Sensor triggering do not General General Protocol Parameters Routine Contrast Resolution Geometry Protocol Parameters Routine Contrast Resolution require captured cycle setting. Geometry Voice Commands Voice Commands Execution Signal Cardiac PACE Execution Signal Cardiac PACE Image Management 1st Signal/Mode ECG/Retro Image Management 1st Signal/Mode Beat Sensor/Retro Select Physio > Signal > Select 1st Auto Load Average Cycle Auto Load Signal Mode: Beat Sensor/Retro. ECG/Trigger Average Cycle No Signal ms Copy References Copy References ECG/Retro Beat Sensor/Trigger Beat Sensor/Retro 0.8 O. Pulse/Trigger Pulse/Retro Calculated Phases Ext./Trigger Calculated Phases 25 + Ext./Retro TR 38.6 ms TR 39.0 + ms Segments 12 Segments 12 OK Cancel OK Cancel 8 Effective Date: 27 Sep 2022| HOOD05162003300744 Unrestricted © Siemens Healthineers, 2022 Poor Beat Sensor Trigger and Signal Quality During Scanning (1/3) SIEMENS Healthineers Perform the following steps to improve Beat Sensor quality: 1. 1 Relearn Click on Settings icon/Relearn in Physio Display area. Make sure, that there is no patient motion. Beat Sensor Cardiac 38 /min ECG I RR-4 1561 ms 78 /min RR-1 762 ms Shortavic Al CCC Trianon Relerun Statistics Beat Sensor Cardiac @ 51 /min RR-I 1154 ms Reset Statistics Slow Medium Fast Example of poor signal quality: Trigger signal is variable during O SAR Stimu Status Inroom Exam Inline myExam Injector Stimu ¥ Scan Bars acquisition. Settings Settings Display Display COCKPIT Control Mode Possible Help Beat Sensor Cardiac 73 /min RR-I 815 ms Beat Sensor Cardiac ~ 51 /min RR-1 1154 ms Initial Beat Sensor Cardiac learningphase active. Don't move table! Example of good signal quality after Relearn. 9 Effective Date: 27 Sep 2022| HOOD05162003300744 Unrestricted © Siemens Healthineers, 2022 Poor Beat Sensor Trigger and Signal Quality During Scanning (2/3) SIEMENS Healthineers Perform the following steps to improve Beat Sensor quality: myExam Cockpit - Explorer Explorer Program Editor Browse Import Export Edit Simulate X 2a Repeat training step 2b Repeat training step SIEMENS ... >> heart >> localizer >> trufi fb Beat Sensor localizer_trufi_multislice 00:03 Check coil selection. If Relearn does not If Beat Sensor signal is still Q beat sensor training fb X center on heart head solve the situation, repeat the protocol poor, use alternative Beat Table Positioning Strategy c-spine localizer_trufi_heart 00:03 Beat Sensor training bh/fb. Sensor training fb/bh t-spine I-spine Beat Sensor training fb 00:43 step. Generic Views whole-spine localizer_trufi_2-chamber 00:01 neck soft tissue thorax localizer trufi_4-chamber 00:01 heart [2] localizer_heart 00:05 [ Cardiac Assist [1] localizer_trufi_short_axis 00:05 Cardiac Basic El Ventricular Function Beat Sensor Training El IschemicHeartDisease El Myocarditis yes El GOHeart FreeBreathing [1] Beat Sensor training bh 00:14 E GOHeart IschemicHeartDisease El library Cardiac Basic localizer [1] AAheart_scout 00:12 E trufi_triggered El trufi Beat Sensor Cardiac Basic El tfl_db Beat Sensor define lax 00:01 El trufi_fb Beat Sensor [1] Etrufi interactive Cardiac Marker Localization morphology function dynamic 10 Effective Date: 27 Sep 2022| HOOD05162003300744 Unrestricted © Siemens Healthineers, 2022 Poor Beat Sensor Trigger and Signal Quality During Scanning (3/3) SIEMENS Healthineers Perform the following steps to improve the Beat Sensor quality: 3 Check and re-position the coil. Check hints for Coil Positioning in Ready to Operate Job Aid. Then, unplug and re-plug coil and repeat training step. + Beat Sensor training bh 00:14 Cardiac Basic 11 Effective Date: 27 Sep 2022| HOOD05162003300744 Unrestricted © Siemens Healthineers, 2022 Missed Beat Sensor Training SIEMENS Healthineers Guidance Parameters ? Beat Sensor training was not performed prior to the Beat Sensor triggered scan. Position the slices as shown in the example images. Run the Beat Sensor Training step and then proceed with the scan. Beat Sensor triggering not possible. Run a Beat Sensor training step before proceeding. MR scanner AF X Beat Sensor triggering is not possible. Run a Beat Sensor Training step, then repeat X the scan. OK 12 Effective Date: 27 Sep 2022| HOOD05162003300744 Unrestricted © Siemens Healthineers, 2022 Inverted Signal SIEMENS Healthineers ? The Beat Sensor Signal is inverted. Inverted signal • Rerun the Beat Sensor Training step, check for the signal stability and correctness and then proceed with scanning. • For Ejection Fraction (EF) evaluation, cine scans with an inverted Beat Sensor signal should not be combined with a "normal" Beat Sensor triggering. Volume curves might be incorrect due to different Correct signal shape End Diastolic (ED) and End Systolic (ES) times. 13 Effective Date: 27 Sep 2022| HOOD05162003300744 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 14 Effective Date: 27 Sep 2022| HOOD05162003300744 Unrestricted © Siemens Healthineers, 2022