CARE Technology – Combined Applications to Reduce Exposure – Somaris 5 & 7 - USA

Continue Continue Add a Footnote/Source/ Disclaimer directly into the footer. Continue Continue CARE Technology ? CARE Technology – Combined Applications to Reduce Exposure Online Training – Somaris 5&7 This online training will offer you valuable insights into the CARE technology that helps to improve patient outcomes and making CT scanning safer. Discover CARE Dose4D 1 Understand X-CARE 4 Specify Hand CARE 3 Define CARE kV 2 5 6 Explain Dose Notification / Dose Alert Utilize CARE Dashboard and Identify CARE Profile Master Template HOOD05162003052540 | Effective Date: 26-Nov-2019 Welcome 1.1 Welcome.mp3 Welcome to the CARE Technology – Combined Applications to Reduce Exposure Online Training – SOMATOM 5&7. This online training will offer you valuable insights into the CARE technology that helps to improve patient outcomes and making CT scanning safer. FAST CARE for Patients To give medical professionals more time to take better care of their patients, our FAST CARE technology accelerates workflow and lowers radiation exposure to previously unseen levels, thus leveraging untapped potential in patient-centric productivity.​ ​ FAST – our Fully Assisting Scanner Technologies – make time-consuming and complex procedures faster as well as far more intuitive. ​ ​ CARE – our Combined Applications to Reduce Exposure – give you great image quality at low dose. This makes CT safer. ​ ? FAST CARE for Patients 1.2 FAST CARE for Patients.mp3 To give medical professionals more time to take better care of their patients, our FAST CARE technology accelerates workflow and lowers radiation exposure to previously unseen levels, thus leveraging untapped potential in patient-centric productivity. FAST – our Fully Assisting Scanner Technologies – make time-consuming and complex procedures faster as well as far more intuitive.   CARE – our Combined Applications to Reduce Exposure – give you great image quality at low dose. This makes CT  safer. SOMATOM Scope Somaris 5 CT Scanner Portfolio SOMATOM Perspective SOMATOM Scope Power P:\03_TransferProjekte\SI_CT\SI-CT021_ECR\01_Input\02_Kunde\03_Bildpool-Siemens\lowRes-pptx\SH_CT_38740_14_V3.jpg P:\03_TransferProjekte\SI_CT\SI-CT021_ECR\01_Input\02_Kunde\03_Bildpool-Siemens\lowRes-pptx\SH_CT_38740_14_V3.jpg ? Somaris 5 CT Scanner Portfolio audf_care_tech_title_page_som_5_03.mp3 The CT scanner portfolio in Somaris 5  includes the models depicted in this slide. SOMATOM Definition AS Somaris 7 CT Scanner (Single-Source) Portfolio SOMATOM Definition AS+ SOMATOM Confidence SOMATOM Definition Edge SOMATOM Edge Plus ? Somaris 7 CT Scanner (Single-Source) Portfolio audf_care_tech_title_page_som_7_sing_04.mp3 Here you can see the CT scanners of the single-source type from the Somaris 7 range. SOMATOM Definition Flash Somaris 7 CT Scanner (Dual-Source) Portfolio SOMATOM Force SOMATOM Drive \\ww005.siemens.net\meddfsroot\DE\MED\CT\apps\CRM-CTM-MarCom\Produkt_und_klinisches_Marketing\Drive\03_Images\02_3D_Renderings\01_FINAL\Healthineers\16_to_9_tif\SOMATOM_Drive_FullHD_0000.tif ? Somaris 7 CT Scanner (Dual-Source) Portfolio audf_care_tech_title_page_som_7_dual_05.mp3 The dual-source CT scanners in Somaris 7 are shown in this picture. Discover CARE Dose4D CARE Features Discover CARE Dose4D audf_care_tech_care_dose_intro_07.mp3 Our first chapter will introduce you to the CARE Dose4D concept.    CARE Dose4D* The Right Dose, Wherever and Whenever Needed Significant dose reduction with automated dose modulation for individual patient sizes and shapes while producing optimal image quality. It applies angular modulation to compensate for attenuation differences in anterior-posterior and lateral directions. Combination with CARE Dose Configurator possible. Benefits: Enables the right dose with mAs tailored to size and shape of individual patients Improves workflow via quality reference mAs value for automated dose modulation Offers pre-defined dose modulation settings for children and adults Scan with constant mAs CARE Dose4DTM: mAs based on topogram CARE Dose4DTM: Angular dose modulation * available with SOMATOM Spirit, SOMATOM Scope, SOMATOM Emotion, SOMATOM Perspective, SOMATOM Definition AS, SOMATOM Definition Edge, SOMATOM Definition Flash, SOMATOM Drive and SOMATOM Force ? The Right Dose, Wherever and Whenever Needed 1.7 The Right Dose.mp3 The CARE Dose4D Feature is available for various Siemens Healthineers CT scanners. CARE Dose4D modulates the dose according to the topogram, and uses a smaller dose for regions with low attenuation. It applies angular modulation to compensate for attenuation differences in anterior-posterior and lateral directions. CARE Dose4D can also be used in combination with the CARE Dose Configurator. This allows the users to configure CARE Dose4D even more precisely and to adjust it to the patient’s anatomy. It offers a selection of pre-defined settings and curves for children and adults. The users can set the modulation values for each scan region and for each organ individually. D:\1381_CT_Grafik_Adapted_Dose_Curves.jpg CARE Dose4D More precise configuration of dose modulation Individual configuration for different body habitus and organs Specific modulation curves available ? Adult Child Thorax Abdomen Position Max Position Mean tube current Mean tube current CARE Dose4D audf_care_tech_care_dose_modulat_09.mp3 With the help of CARE Dose4D, dose modulation can be configured more precisely. Different body habitus and organs can be configured individually. Specific modulation curves are available to this end. CARE Dose4D Reference Point Care Dose4D contains a reference point that specifies the tube current during a scan, and thus the image quality for a reference patient weighing 70-80 kg.​ ​ ? Attenuation Reference patient (70-80 kg) Reference point Quality ref.mAs Tube current (eff. mAs) CARE Dose4D Reference Point audf_care_tech_care_dose_ref_point_10.mp3 Care Dose4D contains a reference point that specifies the tube current during a scan, and thus the image quality for a reference patient weighing 70 to 80 kilograms.   CARE Dose4D Reference Curve A curve that passes through the reference point specifies how the tube current (eff. mAs) varies for patients according to the attenuation, which, in turn, depends on the size of the patient. This is the Care Dose4D curve. The tube current shall be increased for patients with a reference diameter larger than that of the 70-80 kg reference patient, and decreased for patients with a reference diameter smaller than this value. The image quality remains the same, regardless of the size of the patient. ? Attenuation Reference patient (70-80 kg) Reference point Quality ref.mAs Tube current (eff. mAs) CARE Dose4D Reference Curve audf_care_tech_care_dose_ref_curve_11.mp3 A curve that passes through the reference point specifies how the tube current (or effective. mAs ) varies for patients according to the attenuation, which, in turn, depends on the size of the patient. This is termed Care Dose4D curve. The tube current shall be increased for patients with a reference diameter larger than that of the 70-80-kilogram reference patient, and decreased for patients with a reference diameter smaller than this value.   Nevertheless, the image quality remains the same, regardless of the size of the patient. ​ The adaptation strength of each CARE Dose4D curve can be selected for each organ characteristic, and it can be modulated as follows:​ Very weak​ Weak​ Average​ (standard) Strong Very strong CARE Dose4D Reference Point | Adaptation Strength ? Attenuation Reference patient (70-80 kg) Reference point Quality ref.mAs (adult) Tube current (eff. mAs) very strong strong average week very weak CARE Dose4D Reference Point | Adaptation Strength audf_care_tech_care_dose_ref_point_stren_12.mp3 The adaptation strength of each CARE Dose4D curve can be selected for each organ characteristic, and it can be modulated as: Very weak, Weak, Average (or standard), Strong, and Very strong. Adaptation Strength | Patient Types The curve modulation can be specified for three patient types:​ ​ Child​ Thin adult​ Obese adult ? Patient Types audf_care_tech_care_dose_asps_types_13.mp3 The curve modulation can be specified for three patient types, namely:   Child, Thin adult, and Obese adult.   Adaptation Strength | Patient Size For patient sizes above the reference diameter: The following slides show the curve modulation behavior for patient weights above the reference point. ? Attenuation Reference patient (70-80 kg) Reference point Quality ref.mAs Tube current (eff. mAs) Patient Size audf_care_tech_care_dose_asps_above_14.mp3 Patients vary significantly in size. Some are above the reference diameter: The following slides show the curve modulation behavior for patient weights above the reference point.   Adaptation Strength | Patient Size Above For patient sizes above the reference diameter: ​ A strong or very strong curve modulation means an increase in tube current (compared to the average modulation) and therefore a reduction in image noise. ? Attenuation Reference patient (70-80 kg) Reference point Quality ref.mAs (adult) Tube current (eff. mAs) very strong strong average Patient Size Above audf_care_tech_care_dose_asps_strong_15.mp3 A strong or very strong curve modulation means an increase in tube current (compared to the average modulation) and therefore a reduction in image noise. Adaptation Strength | Weak Modulation A weak or very weak modulation means a decrease in tube current (compared to the average modulation) and therefore an increase in image noise. ? Attenuation Reference patient (70-80 kg) Reference point Quality ref.mAs (adult) Tube current (eff. mAs) average week very weak Weak Modulation audf_care_tech_care_dose_asps_weak_16.mp3 A weak or very weak modulation means a decrease in tube current (compared to the average modulation) and therefore an increase in image noise. Adaptation Strength | Patient Size Below For patient sizes below the reference diameter: The following slides show the curve modulation behavior for patient weights below the reference point. ? Attenuation Reference patient (70-80 kg) Reference point Quality ref.mAs Tube current (eff. mAs) Patient Size Below audf_care_tech_care_dose_asps_below_17.mp3 As to the patient sizes below the reference diameter, the curve modulation behavior for patient weights below the reference point is depicted in the next slides.   Adaptation Strength | Strong Modulation A strong or very strong curve modulation means a decrease in tube current (compared to the average modulation) and therefore an increase in image noise. ? Attenuation Reference patient (70-80 kg) Reference point Quality ref.mAs (adult) Tube current (eff. mAs) very strong strong average Strong Modulation audf_care_tech_care_dose_asps_below_st_18.mp3 A strong or very strong curve modulation means a decrease in tube current (compared to the average modulation) and therefore an increase in image noise.   Adaptation Strength | Weak Modulation A weak or very weak modulation means an increase in tube current (compared to the average modulation) and therefore a decrease in image noise. ? Attenuation Reference patient (70-80 kg) Reference point Quality ref.mAs (adult) Tube current (eff. mAs) average week very weak Weak Modulation audf_care_tech_care_dose_asps_below_we_19.mp3 A weak or very weak modulation means an increase in tube current (compared to the average modulation) and therefore a decrease in image noise.   Curve Strengths and Organ Characteristics | mAs Specific organ characteristic for specific patient sizes can be modified. If, however, image noise is inappropriate for patient sizes in that organ characteristic, consider adapting the quality reference mAs only. ? Curve Strengths and Organ Characteristics | mAs 1.19 Curve Strengths.mp3 Specific organ characteristic for specific patient sizes can be modified. If, however, image noise is inappropriate for patient sizes in that organ characteristic, consider adapting the quality reference mAs only.   Curve Strengths and Organ Characteristics | Image Noise This allows radiologists to increase or decrease the image noise for different types of patients. A different modulation can be selected for each organ characteristic. ? Attenuation Reference patient (70-80 kg) Reference point Quality ref.mAs (adult) Tube current (eff. mAs) strong average Curve Strengths and Organ Characteristics | Image Noise audf_care_tech_care_dose_csoc_radio_21.mp3 This allows radiologists to increase or decrease the image noise for different types of patients. A different modulation can be selected for each organ characteristic.   Curve Strengths and Organ Characteristics | Less Image Noise | Heavier Patients If less image noise is desired: For patients heavier than the reference value, select a strong or very strong curve modulation. ? Less Image Noise | Heavier Patients audf_care_tech_care_dose_csoc_less_heav_22.mp3 If less image noise is desired, select a strong or very strong curve modulation for patients heavier than the reference value.   Curve Strengths and Organ Characteristics | Less Image Noise | Lighter Patients If less image noise is desired: For patients lighter than the reference value, select a weak or very weak curve modulation. ? Less Image Noise | Lighter Patients audf_care_tech_care_dose_csoc_less_ligh_23.mp3 Select a weak or very weak curve modulation for patients lighter than the reference value to reduce the image noise. Curve Strengths and Patient Weight | More Image Noise | Heavier Patients If more image noise is acceptable: For patients heavier than the reference value, select a weak or very weak curve modulation. ? More Image Noise | Heavier Patients audf_care_tech_care_dose_cspw_more_heav_24.mp3 If more image noise is acceptable, select a weak or very weak curve modulation for patients heavier than the reference value.   Curve Strengths and Patient Weight | More Image Noise | Lighter Patients If more image noise is acceptable: For patients lighter than the reference value, select a strong or very strong curve modulation. ? More Image Noise | Lighter Patients audf_care_tech_care_dose_cspw_more_ligh_25.mp3 If more image noise is acceptable, and your patient is lighter than the reference value, select a strong or very strong curve modulation.   Curve Strengths and Patient Weight | Settings The settings have more influence the further the patient attenuation is away from that of the reference patient. ? Curve Strengths and Patient Weight | Settings audf_care_tech_care_dose_cspw_infl_26.mp3 The settings have more influence the further the patient attenuation is away from that of the reference patient.   Curve Strengths and Patient Weight | Adjusting Please note: Do not adjust the overall image quality level by modulating the curves. This should be done by increasing or decreasing the quality reference mAs. ? Curve Strengths and Patient Weight | Adjusting audf_care_tech_care_dose_cspw_note_27.mp3 Please note that the overall image quality level shall not be adjusted by modulating the curves. This should be done by increasing or decreasing the quality reference mAs value. Discover CARE Dose4D I Somaris 5* & Somaris 7** CARE Features * SOMATOM Scope, SOMATOM Scope Power, SOMATOM Perspective ** SOMATOM Definition AS, SOMATOM Confidence, SOMATOM Definition AS+, SOMATOM Definition Edge, SOMATOM Edge Plus, SOMATOM Definition Flash, SOMATOM Drive, SOMATOM Force Discover CARE Dose4D: Somaris 5 & Somaris 7 audf_care_tech_care_dose_5_7_intro_28.mp3 In the next section you are going to learn more about CARE Dose4D. The first part focuses on the use of this feature with Somaris 5 and Somaris 7 CT scanners. CARE Dose4D @ Somaris 5 & 7 CT Scanners Somaris 5 CT scanners Somaris 7 CT single-source scanners Somaris 7 CT dual-source scanners ? CARE Dose4D @ Somaris 5 & 7 CT Scanners audf_care_tech_care_dose_5_7_scan_29.mp3 This slide offers you an overview of the CT scanners from the Somaris 5 and Somaris 7 families. Please take a closer look at the Somaris 7 range, since it is represented by two different types of products, namely single-source and dual-source scanners. Setting the Curve Modulation @ Somaris 5 & 7 CT Scanners You can set the curve modulation for an organ characteristic in the Examination Configuration: ? Setting the Curve Modulation audf_care_tech_care_dose_5_7 scm_30.mp3 You can set the curve modulation for an organ characteristic in the Examination Configuration. To do so, please proceed as follows:   Setting the Curve Modulation @ Somaris 5 & 7 CT Scanners | Dose tab 1. Select the Dose tab. ? Dose tab audf_care_tech_care_dose_5_7 scm_dose_31.mp3 First, select the Dose tab.   Setting the Curve Modulation @ Somaris 5 & 7 Scanners | Select 2. For each organ characteristic, select the desired curve modulation for children, thin adults or obese adults. Average is defined as the default setting. ? Select audf_care_tech_care_dose_5_7 scm_curve_32.mp3 Then, select the desired curve modulation for children, thin adults or obese adults for each organ characteristic. Average is defined as the default setting.   Options / Configuration / Examination / Dose Enabling/Disabling of CARE features (e.g. CARE Profile and Dose Notification) Activation of Dose Report Setting of values for Dose Alert (CTDIvol and DLP) Configuration of CARE Dose4D Setting the Curve Modulation @ Somaris 5 & 7 Scanners | Options ? Options audf_care_tech_care_dose_5_7 scm_opt_33.mp3 You have a number of options at your disposal: You can   Enable or disable the CARE features, Activate the dose report function, Set the values for Dose Alert, or Perform configuration of CARE Dose4D.   Discover CARE Dose4D I CARE Child CARE Features Discover CARE Dose4D: CARE Child audf_care_tech_care_dose_child_intro_37.mp3 At the end of this chapter, we are going to address the CARE Child feature in CARE Dose4D. Improvement of pediatric imaging with a range of targeted solutions that minimize radiation exposure and maintain diagnostic image quality with every scan.  Sensitive scanning for your smallest patients Benefits: 70 kV mode allows scan parameters to be adapted even to the smallest patients Optimized dose distribution and special modulation curves through CARE Dose4DTM Dedicated pediatric protocols covering a wide variety of clinical indications CARE Child – Optional Settings for Children * available with SOMATOM Definition AS, SOMATOM Confidence, SOMATOM Definition AS+, SOMATOM Definition Edge, SOMATOM Edge Plus, SOMATOM Definition Flash, SOMATOM Drive, SOMATOM Force ? Optional Settings for Children 1.34 Optional Settings.mp3 The CARE Child feature is available for Somaris 7 scanners. It significantly improves pediatric imaging with a range of targeted solutions that minimize radiation exposure while at the same time maintaining diagnostic image quality with every scan. It is suitable even for younger patients. With CARE kV and CARE Child, you can reduce the dose and optimize the contrast-to-noise ratio (also termed CNR ). Optional Settings for Children | Dose Due to their increased sensitivity to radiation, children shall be subjected to a lower radiation dose than adults similar in size. ? Dose audf_care_tech_care_dose_child_osc_sensit_39.mp3 Due to their increased sensitivity to radiation, children shall be subjected to a lower radiation dose than adults similar in size.   Optional Settings for Children | Option 1 There are two options available:​ ​ Option 1: Use a strong curve modulation for the specific child protocol to reduce the dose compared to an adult of the same size while maintaining an acceptable image quality. This has a greater effect for small children. ? Option 1 audf_care_tech_care_dose_child_osc_opt_1_40.mp3 There are two options available:   Option 1: Use a strong curve modulation for the specific child protocol to reduce the dose compared to an adult of the same size while maintaining an acceptable image quality. This has a greater effect for small children.   Please note: If you change the child setting from average to strong, this will automatically decrease the dose and increase the noise. Optional Settings for Children | Option 1 | Note ? Option 1 | Note audf_care_tech_care_dose_child_osc_note_41.mp3 Please note that if you change the child setting from average to strong, this will automatically decrease the dose and increase the noise. Optional Settings for Children | Option 2 Option 2: Reduce the quality reference mAs value to reduce the dose and increase the image noise for the specific child protocol compared to that used for an adult of the same size. This has the same effect for children of different sizes. ? Option 2 1.38 Optional Settings.mp3 - Option 2: Reduce the quality reference mAs value to reduce the dose and increase the image noise for the specific child protocol compared to that used for an adult of the same size. This has the same effect for children of different sizes. If you reduce the quality reference mAs, it will have a direct effect on the CTDIvolume. Reduction in the quality reference mAs value proportionately reduces the CTDIvolume. Change parameters in the Scan Protocol Assistant. Max Scantime SPRA Max Scantime SPRA Optional Settings for Children | Scan Protocol Assistant ? Scan Protocol Assistant audf_care_tech_care_dose_child_osc_spa_43.mp3 You can change the required parameters in the Scan Protocol Assistant.   CARE Features Define CARE kV Define CARE kV audf_care_tech_care_kv_into_44.mp3 In this chapter, the functionality of CARE kV in the context of Somaris 5 and Somaris 7 will be defined. Improvement of patient safety with technology that automatically adjusts tube voltage to the individual patients and the clinical indications. Benefits: Dose saving potential through optimized kV settings according to patient size and clinical task Simplified processes due to automatic alignment of mAs with the kV setting Enhancement of patient results with standardized settings for consistent image quality CARE kV – Individual, Exam-Specific kV Settings ? * Steps of 10 kV only available on selected scanners CARE kV – Individual, Exam-Specific kV Settings audf_care_tech_care_kv_benefit_45.mp3 The CARE kV feature offers improvement of patient safety with the technology that automatically adjusts tube voltage to the individual patients and the clinical indications. The benefits of CARE kV are: • Dose saving potential through optimized kV settings according to the size of the patient and the respective clinical task, • Simplified processes due to automatic alignment of mAs with the kV setting, and • Enhancement of patient results due to standardized settings for consistent image quality. Define CARE kV I Somaris 7** CARE Features * SOMATOM Scope, SOMATOM Scope Power, SOMATOM Perspective ** SOMATOM Definition AS, SOMATOM Confidence, SOMATOM Definition AS+, SOMATOM Definition Edge, SOMATOM Edge Plus, SOMATOM Definition Flash, SOMATOM Drive, SOMATOM Force Define CARE kV: Somaris 7 1.42 Define CARE kV.mp3 Now let us have a look at the CARE kV feature in Somaris 7. SOMATOM Definition AS CARE kV 70kV 80kV 90kV 100kV 110kV 120kV 130kV 140kV CARE kV – Somaris 7 CT Scanners (Single-Source) SOMATOM Definition AS+ SOMATOM Confidence SOMATOM Definition Edge SOMATOM Definition Edge Plus * some scanners offer tin filtration for CARE kV in dedicated protocols ? CARE kV – Somaris 7 CT Scanners (Single-Source) audf_care_tech_care_kv_5_7_single_50.mp3 In this slide, you can see the CARE kV values for Somaris 7 single-source CT scanners. SOMATOM Definition Flash CARE kV 70kV 80kV 90kV 100kV 110kV 120kV 130kV 140kV CARE kV – Somaris 7 CT Scanners (Dual-Source) SOMATOM Force SOMATOM Drive \\ww005.siemens.net\meddfsroot\DE\MED\CT\apps\CRM-CTM-MarCom\Produkt_und_klinisches_Marketing\Drive\03_Images\02_3D_Renderings\01_FINAL\Healthineers\16_to_9_tif\SOMATOM_Drive_FullHD_0000.tif + 150kV * some scanners offer tin filtration for CAREkV in dedicated protocols ? CARE kV – Somaris 7 CT Scanners (Dual-Source) audf_care_tech_care_kv_5_7_dual_51.mp3 Somaris 7 dual-source CT scanners and their kV values are presented in this picture. There are three different modes for CARE kV: Off Semi On CARE kV – Settings (Somaris 7 CT Scanners) ? CARE kV – Settings (Somaris 7 CT Scanners) audf_care_tech_care_kv_5_7_sett_52.mp3 Three different modes are available in CARE kV, namely Off, Semi and On. When Off is set, kV will remain on the same level: Select the kV you need, and the Quality ref. mAs if desired. Q. ref. mAs and Eff. mAs will not be adjusted if you change the kV! Definition of image quality CARE kV – Setting Off (Somaris 7 CT Scanners) ? Setting Off (Somaris 7 CT Scanners) audf_care_tech_care_kv_5_7_sett_off_53.mp3 When the Off mode is set, the kV value will remain on the same level: Select the kV you need and adjust the Quality reference mAs if desired. Please note that the quality reference mAs and the Effective mAs parameters will not be automatically adjusted if you change the kV value!   In other words, the mAs value will not be influenced by the kV level you set. Two important steps to optimize customized protocols for CARE kV: Switch CARE kV to On. Set the dose optimization slider to the correct position. Definition of image quality CARE kV – Setting On (Somaris 7 CT Scanners) (1/3) ? Setting On (1/3) audf_care_tech_care_kv_5_7_sett_on_54.mp3 The CARE kV mode can be set to On. There are two important steps to optimize the protocol:   Switch the CARE kV feature to On, Set the dose optimization slider to the position appropriate for the indicated clinical task. If On is selected, the kV box on the Routine card will be dimmed. Suitable kV will now be chosen by the system. The dose will be optimized for the clinical task, e.g.: Non-contrast scans Soft tissue with contrast scans Vascular scans Move the dose optimization slider to the desired position (mouse or arrow keys). CARE kV – Setting On (Somaris 7 CT Scanners) (2/3) ? Setting On (2/3) 1.48 Setting On.mp3 If On is selected, the kV box on the Routine card will be dimmed. Suitable kV value will now be chosen by the system.   The dose will be optimized for the respective clinical task, such as: Non-contrast scans, Soft tissue scans with contrast media, or Vascular scans.   Use your mouse or the arrow keys to move the dose optimization slider to the desired position. Configuration of image quality and adaption You can determine the dose-optimized slider position to achieve the desired amount of image noise. Move slider to the left to make settings for non-contrast scans. This will optimize the noise levels, since there will be no iodine. If you move the slider to the right, this will increase the importance of iodine, and change the noise levels accordingly. Equal noise Soft tissue w/o contrast Soft tissue with CM Pure iodine contrast (CTA) Definition of image quality (“old“ CD4D parameters) Increasing importance Of iodine CARE kV – Setting On (Somaris 7 CT Scanners) (3/3)  The slider position should not be changed for the individual patient, but set once depending on the clinical task! ? Setting On (3/3) audf_care_tech_care_kv_5_7_sett_on_config_56.mp3 You can determine the dose-optimized slider position to achieve the desired amount of image noise.   Move the slider to the left to make settings for non-contrast scans. This will optimize the noise levels, since there will be no iodine. If you move the slider to the right, this will increase the importance of iodine, and change the noise levels accordingly.   The slider position should not be changed for the individual patient, but set once depending on the clinical task! You are free to select the kV you want, and Q. ref. mAs and Eff. mAs will then be calculated. Cases: Fixed kV desired in combination with the appropriate mAs value (e.g. clinical studies, where the follow-up scan requires the same kV setting as the prior scan) Demonstration of CTDI / Eff. mAs values which are taken when different kV settings are chosen Low kV setting required despite local tube power limits Definition of image quality Definition of image quality CARE kV – Setting Semi (Somaris 7 CT Scanners) ? Setting Semi (Somaris 7 CT Scanners) audf_care_tech_care_kv_5_7_sett_semi_57.mp3 When using the Semi setting, you are free to select the kV value you want. The Quality reference mAs as well as the Effective mAs values will then be calculated according to the dose-optimized slider position.   In the examples here, you can see that different kV values have been selected. The Effective mAs has been modified to maintain the same image noise according to the slider position.   The Semi mode can be used in the following cases:   You require a fixed kV setting in combination with the appropriate mAs value. This may be the case in clinical studies, where the follow-up scan requires the same kV setting as the previous one. You need to demonstrate which CTDI  or Effective mAs values will be taken when different kV settings have been chosen. Low kV settings are required despite local tube power limits.   If the same kV is needed for all scan ranges, we can group them. Adding to CARE kV group: Via the right mouse button it is possible to link the same CARE kV setting for all the chronicles. It is indicated in the chronicle. Removing from CARE kV group works the opposite way. CARE kV will select the kV value for the group which results in a lower sum of DLPs. CARE kV – Grouping (Somaris 7 CT Scanners) ? Grouping (Somaris 7 CT Scanners) audf_care_tech_care_kv_5_7_group_58.mp3 If the same kV level is needed for all scan ranges, we can group them to make sure that the same kV value will be used for all scans in the CARE kV group.   If you wish to add an item to a CARE kV group, use the right mouse button to link the same CARE kV setting for all the chronicles. It will be indicated in the chronicle by means of the link icon.   Removing items from a CARE kV group works the opposite way. CARE kV will select the kV value for the group, which results in a lower sum of DLPs. The kV range can be set (min. & max. kV) in Scan Protocol Assistant. For example: For vascular, you do not want to scan with 140kV (set max. kV to 120). For head, you do not want to scan with 80kV (set min. kV to 100). CAREkV_SPRA CARE kV – Configuration (Somaris 7 CT Scanners) ? Configuration (Somaris 7 CT Scanners) audf_care_tech_care_kv_5_7_config_59.mp3 The kV range – from the minimum to the maximum value – can be set in the Scan Protocol Assistant.   Vascular scans, for instance, do not require 140 kilovolts. So, you can set the maximum kV level to 120. The level of 80 kilovolts is not appropriate for head scans, so, you can set the minimum value of 100 kilovolts). Specify Hand CARE CARE Features Specify Hand CARE audf_care_tech_hand_care_intro_67.mp3 This chapter will address the issue of Hand CARE for intervention cases.   Hand CARE may reduce direct exposure to the physician’s hand during an intervention procedure by switching off the radiation for a fixed sector during the tube rotation. It is applied in the CT i-Sequence and i-Fluoro modes only. Three positions for which the exposure can be switched off: 10:00(1) – 12:00(2) – 2:00(3) Angle = 100° -> angle with tube current switched off Hand CARE 10:00 12:00 2:00 ? Hand CARE audf_care_tech_hand_care_position_68.mp3 The Hand CARE feature helps to reduce direct exposure to the physician’s hand during an intervention procedure by switching off the radiation for a fixed sector during the tube rotation.   It is applied in the CT i-Sequence and i-Fluoro modes only.   The exposure can be switched off for three positions: - ten o’clock position, - twelve o’clock position, and - two o’clock position. Understand X-CARE CARE Features Understand X-CARE audf_care_tech_x_care_intro_69.mp3 In our next chapter, we are going to gain a better understanding of X-CARE in scan protocols. X-CARE | Organ Dose Reduction for Dose-Sensitive Body Parts X-CARE.png Reduction in the organ dose for dose-sensitive body parts while maintaining image quality Benefits: Organ dose reduction for radiation-sensitive peripheral organs, e.g. eye lenses or breast Keeping the average CTDIvol constant with automated tube current adjustment Simple use by selecting the dedicated right protocols Application in scan modes where no mechanical tilt is possible X-ray high ? X-ray low X-CARE audf_care_tech_x_care_benefit_70.mp3 X-CARE is a feature that is aimed at the reduction in the organ dose. This helps to protect dose-sensitive body parts while maintaining image quality.   This useful feature allows organ dose reduction for radiation-sensitive peripheral organs, such as eye lenses or breast. It also keeps the average CTDIvolume constant by means of automated tube current adjustment. It is easy to use: All you need to do is to select the dedicated right protocols. This feature can be used in scan modes where no mechanical tilt is possible. Radiosensitive organs: Orbits Thyroid Breast Gonads The X-CARE feature makes it possible to reduce the dose to radiosensitive organs without compromising image quality. Conventional Technology Full radiation of breast Breast is always included in any diagnostic thoracic scan, but it is never an organ of interest. With X-CARE Dose reduction in breast No compromise in image quality Ideal for all dose-sensitive organs: e.g. breast, thyroid, lens X-CARE | Organ Dose Reduction for Dose-Sensitive Body Parts | Organs ? X-CARE | Organs audf_care_tech_x_care_organs_71.mp3 Radiosensitive organs are, for instance: - Orbits, - Thyroid, - Breast, and - Gonads.   The X-CARE feature makes it possible to reduce the dose to radiosensitive organs without compromising image quality.   X-CARE is available in Somaris 7: Head_Xcare HeadSeq_Xcare Thorax_Xcare ThorAbd_Xcare ThorAngio_Xcare Dedicated Child protocols X-CARE @ Somaris 7 Scanners with X-CARE without X-CARE Low dose High dose Dose distribution Dose reduction Source: Vollmar, Kalender - Reduction of dose to the female breast: a comparison of standard-protocol, bismuth-shielded partial and tube-current-modulated CT examinations, Eur Radiol 2008 SOMATOM Definition Flash Flash speed. Lowest dose. X-CARE Spatial res. 0.33mm ? X-CARE @ Somaris 7 Scanners audf_care_tech_x_care_som_7_72.mp3 The X-CARE function with Somaris 7 is available in the protocols listed in this slide.   Explain Dose Notification / Dose Alert CARE Features Explain Dose Notification / Dose Alert audf_care_tech_dnda_intro_74.mp3 This chapter will offer you insights into the Dose Notification and Dose Alert features. Dose Notification / Dose Alert The Dose Notification feature informs you if configured total CTDIvol or DLP values are exceeded for a single scan range.​ The Dose Alert feature alerts you prior to scanning if the configured total CTDIvol and DLP values are exceeded across all scan ranges within an examination. ​ ? Dose Notification / Dose Alert audf_care_tech_dnda_feature_75.mp3 The Dose Notification feature will inform you if the configured total CTDIvolume or DLP values are exceeded for a single scan range.   The Dose Alert feature shall warn you prior to scanning if the configured total CTDIvolume and DLP values are exceeded across all scan ranges within an examination.   Explain Dose Notification CARE Features Explain Dose Notification audf_care_tech_dnda_dose_note_intro_76.mp3 Let us look into the issue of Dose Notification in more detail. Are there any rules in your country concerning the applied dose? Do you know the IEC (International Electrotechnical Commission)? Are the customers on the safe side? The Dose Notification will tell when you exceed the configured CTDI and/or DLP for ONE scan range or autorange. Dose Notification informs the user if the selected dose for a patient requires a higher CTDI or DLP than configured. The parameters can be set for every scan range in the Scan Protocol Assistant. Please verify these values for your own country! Dose Notification ? Dose Notification audf_care_tech_dnda_dose_note_rules_77.mp3 Are there any rules in your country concerning the applied dose?   Are you familiar with the regulations of the International Electrotechnical Commission, IEC? Do you think that your customers are on the safe side?   The Dose Notification will let you know if you exceed the configured CTDI or DLP value for one scan range or for the autorange.   The Dose Notification feature also informs the user if a patient requires a higher CTDI or DLP value than the configured one.   The parameters can be set for every scan range in the Scan Protocol Assistant. Dose Notification | CTDI vol or DLP value The Dose Notification feature informs you if a configured CTDIvol or DLP value has been exceeded. Each configured Dose Notification value applies only to the specific scan range. It does not apply to other scan ranges within an examination. ? CTDIvol or DLP value 1.63 CTDIvol.mp3 The Dose Notification feature informs you if a configured CTDIvolume or DLP value is exceeded.   Each configured Dose Notification value applies only to the specific scan range. It does not apply to other scan ranges within an examination.   Dose Notification | Settings Before proceeding with scanning, you can confirm or correct settings that might otherwise lead to unnecessarily high exposures. You can also enter a diagnostic reason for exceeding the configured value. There are different ways this feature can be used in clinical practice. In general, it is the task of professional associations to recommend appropriate values and their usage. Diagnostic Reference Levels, if available, are issued by the local authorities in your country. The levels can vary between countries. ? Settings audf_care_tech_dnda_dose_note_correct_79.mp3 Prior to proceeding with scanning, you can confirm or correct settings that might otherwise lead to unnecessarily high exposures. You can also enter a diagnostic reason for exceeding the configured value.   There are different ways this feature can be used in clinical practice. In general, it is the task of professional associations to recommend appropriate values and their usage. Diagnostic Reference Levels, if available, are issued by the local authorities in your country. These levels can vary between countries. Dose Notification @ Somaris 5 & 7 CT Scanners Somaris 5 CT scanners: Somaris 7 CT single-source scanners: Somaris 7 CT dual-source scanners: ? Dose Notification @ Somaris 5 & 7 CT Scanners audf_care_tech_dnda_dose_note_scanner_80.mp3 Dose Notification is available with these Somaris 5 and Somaris 7 scanners. Notification of Exceeded Dose If the Dose Notification value for CTDIvol or DLP is exceeded for a scan range: The corresponding value is displayed in red on the Scan and Routine parameter cards. A configurable dialog box provides further details and prompts you to load the scan or cancel and correct the settings. You can also enter a diagnostic reason for exceeding the configured value. ? Notification of Exceeded Dose audf_care_tech_dnda_dose_note_exceed_81.mp3 If the Dose Notification level for the CTDIvolume or DLP value is exceeded for a scan range,   The corresponding value will be displayed in red on the Scan and Routine parameter cards. A configurable dialog box provides further details and prompts you to load the scan or cancel and correct the settings. You can also enter a diagnostic reason for exceeding the configured value. Configuration of Dose Notification Values | Assistant In the Scan Protocol Assistant, you can configure the Dose Notification values for a scan range: First select the desired scan protocols. Then switch to the Scan step. Enter the desired CTDIvol and DLP Dose Notification values. If you leave a value blank, the Dose Notification feature will not be active for this scan range. After that save the settings. ? Assistant audf_care_tech_dnda_dose_note_config_82.mp3 In the Scan Protocol Assistant, you can configure the Dose Notification values for a scan range. To do so:   First select the desired scan protocols. Then switch to the Scan step. Enter the desired CTDIvolume and DLP Dose Notification values. If you leave a value blank, the Dose Notification feature will not be active for this scan range. At the end, save the settings. Configuration of Dose Notification Values | Pre-Set ​Some scan applications, such as Bolus Tracking, have a pre-set maximum number of scans. When estimating the total CTDIvol and DLP values for these types of scans, it is assumed that all scans use the same dose values. For Dose Notification and Dose Alert it is assumed that the maximum number of scans will be applied. ? Pre-Set audf_care_tech_dnda_dose_note_config_max_83.mp3 Some scan applications, such as Bolus Tracking, have a pre-set maximum number of scans. When estimating the total CTDIvolume and DLP values for these types of scans, it is assumed that all scans use the same dose values. For Dose Notification and Dose Alert, it is assumed that the maximum number of scans will be applied. Exceeding Configured Dose Notification Values | Steps To exceed a Dose Notification value when medically necessary: Load the scan range. You can enter a diagnostic reason for exceeding the Dose Notification values. If the Dose Notification dialog box is turned off, you can proceed as usual. You can then load the scan range from the dialog box. ? Steps audf_care_tech_dnda_dose_note_exceed_medic_84.mp3 You have an option of exceeding a Dose Notification value if this is medically necessary. To do so:   Load the scan range. You can enter a diagnostic reason for exceeding the Dose Notification values. If the Dose Notification dialog box is turned off, you can proceed as usual. You can then load the scan range from the dialog box. Exceeding Configured Dose Notification Values | Log files After performing the scan, the following will be logged in the folder H:\SiteData\DoseLogs​: ​ Type (Dose Notification)​ Date and time​ Patient ID​ Diagnostic reason​ Scan range name​ Actual CTDIvol and CTDIvol notification value​ Actual DLP and DLP notification value The information will also be stored in the DICOM Dose SR (Structure Report). ? Log files audf_care_tech_dnda_dose_note_exceed_folder_85.mp3 After performing the scan, the associated data will be logged in a folder in the file browser under the following route: Turning Dose Notification Dialog Box On/Off ​To turn the Dose Notification dialog box on or off: Open the Examination Configuration from the Configuration Panel. Select the Dose tab. Select or clear the Dose Notification check box. ​Please note: If the configured Dose Notification values have been exceeded, they will be displayed in red on the Scan parameter card, even if the Dose Notification dialog box is turned off. ? Turning Dose Notification Dialog Box On/Off audf_care_tech_dnda_dose_note_turn_dose_86.mp3 To turn the Dose Notification dialog box on or off, proceed as follows:   1. Open the Examination Configuration from the Configuration Panel. 2. Select the Dose tab. 3. Select or clear the Dose notification check box.   If the configured Dose Notification values are exceeded, they will be displayed in red on the Scan parameter card, even if the Dose Notification dialog box is turned off.   Explain Dose Alert CARE Features Explain Dose Alert audf_care_tech_dnda_dose_alert_intro_91.mp3 In this part of the chapter, the Dose Alert feature will be explained in detail. Dose Alert The Dose Alert feature alerts you if the configured DLP value or CTDIvol value, accumulated at each position across all scan ranges in an examination, has been exceeded. The alert is displayed prior to loading the scan range if the accumulated CTDIvol or the accumulated DLP, plus the estimated values for the next scan range, exceed the configured Dose Alert values. The default value for the Dose Alert has been set to 1000 mGy for adults and 500 mGy for pediatrics, based on recent recommendations of the US Food and Drug Administration, FDA. ? Dose Alert audf_care_tech_dnda_dose_alert_feature_92.mp3 The Dose Alert feature warns you if the configured DLP or CTDIvolume value, accumulated at each position across all scan ranges in an examination, is exceeded.   The alert is displayed prior to loading the scan range if the accumulated CTDIvolume or the accumulated DLP, plus the estimated values for the next scan range, exceed the configured Dose Alert values.   The default value for the Dose Alert has been set to 1000 milligrays, based on recent recommendations of the US Food and Drug Administration, FDA. Dose Alert @ Somaris 5 & 7 CT Scanners Somaris 5 CT scanners: Somaris 7 CT single-source scanners: Somaris 7 CT dual-source scanners: ? Dose Alert @ Somaris 5 & 7 CT Scanners audf_care_tech_dnda_dose_alert_5_7_scan_93.mp3 The Dose Alert feature is available on these Somaris 5 and Somaris 7 scanners. Configuration of Dose Alert Values To configure the Dose Alert values: Open the Examination Configuration from the Configuration Panel.​ Switch to the Dose tab. Enter the desired CTDIvol and DLP alert values. You can enter different values for adult and child scan protocols.  Save the settings. ? Configuration of Dose Alert Values audf_care_tech_dnda_dose_alert_config_94.mp3 If you wish to configure the Dose Alert values, you have got to:   1. Open the Examination Configuration from the Configuration Panel. 2. Switch to the Dose tab. 3. Enter the desired CTDIvolume and DLP alert values. You can enter different values for adult and child scan protocols. 4. And always remember to save your settings.   Exceeding Dose Alert Values You should check the CTDIvol and DLP Dose Alert values carefully before exceeding them. To proceed: ​Check whether the scan parameters are suitable for the examination. You can continue or cancel and correct the values. Enter your User name (mandatory) and the Diagnostic reason (optional). ​If the dialog box contains a Password field, enter the Dose Alert password. Please note: After confirming the Dose Alert value, the scan protocol can no longer be saved. ​ ? Exceeding Dose Alert Values audf_care_tech_dnda_dose_alert_exceed_95.mp3 You should check the CTDIvolume and DLP Dose Alert values carefully before exceeding them.   Check whether the scan parameters are suitable for the examination. You can either continue or cancel and correct the values. Enter your User name (which is a mandatory requirement), and the Diagnostic reason (as an option). If the dialog box contains a Password field, enter the Dose Alert password.   Please note that as soon as you have confirmed the Dose Alert value, the scan protocol can no longer be saved. Configuration of Dose Alert You can set the Dose Alert password for the institution in the Local Service. You can find it in the Options menu under Service.​ ​ 1. Delete the text in the two Password fields and then log in.​ ​ 2. Navigate to the Application Specific Configuration.​ ​ 3. Enter the Dose Alert password twice.​ ​ 4. Save your changes. ​ ? Configuration of Dose Alert audf_care_tech_dnda_dose_alert_config_pass_96.mp3 You can set the Dose Alert password for the institution in the Local Service. You can find it in the Options menu under Service. To do this, proceed as follows:   1. Delete the text in the two Password fields and then log in. 2. Navigate to the Application Specific Configuration. 3. Enter the Dose Alert password twice. 4. Save your changes. Utilize CARE Dashboard CARE Features Utilize CARE Dashboard audf_care_tech_care_dash_intro_104.mp3 In the next chapter, we are going to address the CARE Dashboard feature. CARE Dashboard @ Somaris 7 CT Scanners Somaris 7 CT single-source scanners: Somaris 7 CT dual-source scanners: ? CARE Dashboard @ Somaris 7 CT Scanners audf_care_tech_care_dash_scan_105.mp3 The CARE Dashboard function is available on Somaris 7 scanners only. Overview of dose measures used for protocol optimization and training Indication of additionally available options to utilize full dose saving potential Active dose management with intuitive visualization Possibility of better training and protocol assessment CardioDBII CARE Dashboard ? CARE Dashboard audf_care_tech_care_dash_overview_106.mp3 CARE Dashboard offers an overview of dose measures used for protocol optimization and training.   It indicates additionally available options to utilize full dose saving potential. You can benefit from active dose management with intuitive visualization. Moreover, this feature is a useful aid to ensure better training and protocol assessment. Identify CARE Profile CARE Features Identify CARE Profile audf_care_tech_care_profile_intro_107.mp3 Our last chapter focuses on CARE Profile. CARE Profile @ Somaris 7 CT Scanners Somaris 7 CT single-source scanners: Somaris 7 CT dual-source scanners: ? CARE Profile @ Somaris 7 CT Scanners audf_care_tech_care_profile_scan_108.mp3 The CARE Profile function is available with the Somaris 7 scanners depicted on this slide. Potential to improve patient safety by visualizing the tube current profile along the scan range next to the topogram Precise assessment of mAs values Direct access to FAST Scan Assistant to modify scan parameters Tip: Please check plausibility of the planned dose profile before activating the scan. ohne conflict CARE Profile | Patient Safety ? Patient Safety audf_care_tech_care_profile_som_7_109.mp3 The CARE Profile feature helps to improve patient safety by means of visualizing the tube current profile along the scan range next to the topogram.   It ensures precise assessment of mAs values, and offers direct access to FAST Scan Assistant where you can modify scan parameters.   However, you should always check plausibility of the planned dose profile before activating the scan.   CARE Profile displays different colors and patterns to the left of the topogram segment: Different patterns Different colors Spiral HR / 2D Sequence 3D Sequence Cardiac CARE Profile | Colors and Patterns ? Colors and Patterns audf_care_tech_care_profile_som_7_color_110.mp3 CARE Profile displays different colors and patterns to the left of the topogram segment.   Green CARE Profile Eff. mAs needed for the scan can be applied by the scanner. Load is possible Yellow CARE Profile Eff. mAs (in combination with other parameters) needed for the scan exceeds the limit of the system. Yellow peak CARE Profile The system cannot deliver the Eff. mAs that is needed for the entire scan range. Load is NOT possible Load is possible CARE Profile | Green and Yellow CARE Profile ? Green and Yellow CARE Profile audf_care_tech_care_profile_som_7_gr_yel_111.mp3 The CARE Profile feature communicates with users by means of colors and their combinations.   The green CARE Profile means that the Effective mAs value needed for the scan can be applied by the scanner. The load function is possible in this case.   The all-yellow CARE Profile indicates that the Effective mAs value (in combination with other parameters) needed for the scan exceeds the limit of the system. Loading will not be possible here. The yellow peak CARE Profile shows that the system cannot deliver the Effective mAs value that is needed for the entire scan range. The load function is possible in this case, too. Green striped peak CARE Profile. The Eff. mAs exceeds the system limit in this region. Load is possible  If you click Load: The striped part will be removed. The peak mAs will be cut to the max. mAs. Not relevant for image quality issues with CARE Dose4D. The length and the strength of the striped range will affect the decision. CARE Profile | Green Profile ? Green Profile audf_care_tech_care_profile_som_7_load_112.mp3 The green striped peak CARE Profile indicates that the Effective mAs value exceeds the system limit in this region. Loading is possible here.   If you click Load: The striped part will be removed, and The peak mAs value will be cut to the maximum mAs.   This, however, has no relevance to image quality issues with CARE Dose4D.   Also, the length and the strength of the striped range will affect the decision. Please note: What is the difference? IQ loss is negligible. IQ loss can be expected. No action required. Action recommended. CARE Profile | Image Quality (IQ) ? Image Quality (IQ) audf_care_tech_care_profile_som_7_note_113.mp3 Please note the difference between the green striped and the yellow peak profile:   With the green striped peak CARE Profile, the loss of image quality is negligible. No further action is required here. With the yellow peak CARE Profile, however, the loss of image quality can be expected. Additional action is recommended in this case.   Please note: The Adjust button will prolong the scan time to bring the peaks down to manageable tube current levels. Please review the scan time after clicking the Adjust button. Load and/or Adjust functions available: CARE Profile | Load/Adjust ? Load/Adjust audf_care_tech_care_profile_som_7_adjust_114.mp3 Please note that you have a Load or respectively Adjust function at your disposal.   The Adjust button will prolong the scan time to bring the peaks down to manageable tube current levels. Please review the scan times after clicking the Adjust button.   Please note: It can be switched off in: Options/Configuration/Examination/Dose When CARE Profile is switched off, it will appear in case of a conflict! CARE Profile | Turn Off ? Turn Off audf_care_tech_care_profile_som_7_off_115.mp3 The CARE Profile function can be switched off. To do so, go to: Options/Configuration/Examination/Dose.   When the CARE Profile feature is switched off, it will nonetheless appear in case of a conflict!   CARE Profile Summary For scan modes with continuous table movement, for instance, for spiral ranges, CARE Profile is displayed as a curve in z-direction along the topogram segment. For sequence ranges, the CARE Profile is displayed as bars. The mAs slightly exceeds the system limits for some regions. Loading the scan range is recommended, since the impact on the image quality will be negligible. The CARE Profile peak will be lowered to the maximum possible mAs in this case. In case of an image quality conflict, the theoretically optimal tube current profile cannot be applied because it exceeds the maximum possible tube current. In the yellow areas in z-direction, the image quality may be reduced. ? CARE Profile Summary audf_care_tech_care_profile_summary_7_10_117.mp3 Let us summarize what we learned about the functionality of CARE Profile. The following three examples will help us.   For scan modes with continuous table movement, for instance, for spiral ranges, the CARE Profile is displayed as a curve in z-direction along the topogram segment. For sequence ranges, the CARE Profile is displayed as bars.   If the mAs value slightly exceeds the system limits for some regions, loading the scan range is recommended, since the impact on the image quality will be negligible. The CARE Profile peak will be lowered to the maximum possible mAs value in this case.   In cases of an image quality conflict, the theoretically optimal tube current profile cannot be applied because it exceeds the maximum possible tube current. In the yellow areas in z-direction, the image quality may be reduced. ? Course Review Congratulations. You have completed the CARE Technology – Combined Applications to Reduce Exposure Online Training – Somaris 5&7 online training. Select the numbered buttons below to review the material before proceeding to the final assessment. Understand X-Care Specify Hand CARE Define CARE kV Discover CARE Dose4D 1 1 2 2 3 3 3 4 4 4 5 5 5 6 6 6 Utilize CARE Dashboard and Identify CARE Profile Explain Dose Notification / Dose Alert Course Review Utilize CARE Dashboard and Identify CARE Profile CARE Dashboard Overview of dose measures used for protocol optimization and training CARE Profile Somaris 7* Improve patient safety by visualizing tube current profile along scan range next to topogram Precise assessment of mAs values Direct access to FAST Scan Assistant Displays different colors und patterns Green CARE Profile: Load possible Yellow CARE Profile: Load not possible Yellow peak CARE Profile: Load possible Click on Load à striped part removed, peak mAs cut to the max. mAs Click on Adjust à prolong scan time to bring peaks down * SOMATOM Definition AS, SOMATOM Confidence, SOMATOM Definition AS+, SOMATOM Definition Edge, SOMATOM Edge Plus, SOMATOM Definition Flash, SOMATOM Drive, SOMATOM Force Explain Dose Notification / Dose Alert Assumed that maximum number of scans is applied Dose Alert / Dose Notification issues and dose information not recorded and saved anymore Table with 2 columns and 2 rows Dose Notification Feature Dose Alert Feature Informs you if configured total CTDI vol or DLP values are exceeded for a single scan range Each value applies only to specific scan range Task of professional associations to recommend appropriate values and usage Reference level issue of local authorities Notification of Exceeded Dose displayed in red on Scan and Routine parameter cards When exceeding medically necessary: enter diagnostic reason Yellow warning icon in dialog box when one or both thresholds defined for next scan range exceed notification values Thresholds can be set for each scan range for CTDI vol and DLP Alerts prior to scanning if configured total CTDI vol and DLP values (Dose Alert values) are exceeded across all scan ranges within examinations Default value: 1000 mGy for adults, 500 mGy for pediatrics Check Dose Alert values carefully Understand X-Care Reduction in the organ dose for dose-sensitive body parts while maintaining image quality. For radiation-sensitive organs: Orbits, Thyroid, Breast, Gonads Keeps CTDIvol constant (in average) Simple use Application in scan modes where no mechanical tilt is possible Please note: Reducing the dose to radiosensitive organs, reduces the risk. high Specify Hand CARE Reduces direct exposure to physician’s hand during interventions by switching off radiation for a fixed sector during tube rotation In CT i-Sequence and i-Fluoro modes only Three positions for which exposure can be switched off: 10:00 (1) – 12:00 (2) – 2:00 (3) Angle = 100° → angle with tube current switched off 10:00 12:00 2:00 Define CARE kV Technology that automatically adjusts tube voltage to the individual patients and clinical indications. Improvement of patient safety Dose saving potential Simplified processes Enhancement of patient results Learn about CARE Dose4D The Right Dose, Wherever and Whenever Needed Significant dose reduction ​ Automated dose modulation for individual patient sizes and shapes (mAs tailored) Pre-defined dose modulation settings → Optimal image quality Settings have more influence the further away from the reference patient Please note: Do not adjust the overall image quality level by modulating the curves. This should be done by increasing or decreasing the quality reference mAs. CARE Child: Optional settings for children, due to increased sensitivity to radiation. Disclaimer 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 2023 Siemens Healthineers Headquarters\Siemens Healthcare GmbH\Henkestr. 127\ 91052 Erlangen, Germany\Telephone: +49 9131 84-0\siemens-healthineers.com ? Disclaimer Assessment Welcome to the assessment. For each question, select your answer and then select Submit. You will have 3 attempts to take this assessment and to successfully pass this course. You must receive a score of 80% or higher. You will receive your score when you have completed the assessment. Start Assessment Select the best answer. ? Question 1 of 5 There are 3 different modes for CARE kV: Dual, Off, Semi Off, Semi, On No Contrast, On, Dual Contrast, Semi, Off Multiple Choice Select the incorrect answer. ? Question 2 of 5 CARE kV – setting SEMI mode Fixed kV is desired in combination with the appropriate mAs value kV will be adapted by patient size in combination with the appropriate mAs value Low kV setting can be defined even of local tube power limits Freedom to select the desired kV; Q. ref. mAs and eff. mAs will then be calculated Multiple Choice Select the best answer. ? Question 3 of 5 Where can you configure the curve modulation for the different organ characteristic? Options / Configuration / Examination / Patient Options / Configuration / Examination / Dose Service mode by CSE Options / Configuration / E-Logbook Multiple Choice Select the best answer. ? Question 4 of 5 What is no benefit of CARE Dose4D? Enables the right dose with mAs tailored to size and shape of individual patient Less dose / less noise Offers predefined dose modulation settings but for adults only Improves workflow via quality reference mAs value for automated dose modulation ? Multiple Choice Select the best answer. ? Question 5 of 5 If the Dose Notification value for CTDIvol or DLP is exceeded for a scan range ... a yellow warning box appears and scanning is not possible on the Scan and Routine parameter cards, the corresponding value is displayed in red nothing will happen stop the examination and take the next patient Multiple Choice Retry Assessment Results %Quiz2.ScorePercent%% %Quiz2.PassPercent%% Continue YOUR SCORE: PASSING SCORE: Assessment Results You have exceeded your number of assessment attempts. Exit You did not pass the course. Select Retry to continue. Congratulations. You passed the course. Exit To access your Certificate of Completion, select the Certificates tab from the learning activity overview page. You can also access the certificate from your PEPconnect transcript. ? You have completed the CARE Technology – Combined Applications to Reduce Exposure Online Training – Somaris 5&7 . Completion details, certificates tab Navigation Help Select the icon above to open the table of contents. Click Next to continue. Next Welcome Slide The timeline displays the slide progression. Slide the orange bar backwards to rewind the timeline. Click Next to continue. Next Timeline Select the X to close the pop-up. Click Next to continue. Next Layer Slide Select Submit to record your response. Click the X in the upper right corner to exit the navigation help. Assessment Slide Question Bank 1 care_tech_som5_7_usa 1 CARE Technology 1.1 Welcome 1.2 FAST CARE for Patients 1.3 Somaris 5 CT Scanner Portfolio 1.4 Somaris 7 CT Scanner (Single-Source) Portfolio 1.5 Somaris 7 CT Scanner (Dual-Source) Portfolio Learn about CARE Dose4D 1.6 Discover CARE Dose4D 1.7 The Right Dose, Wherever and Whenever Needed 1.8 CARE Dose4D 1.9 CARE Dose4D Reference Point 1.10 CARE Dose4D Reference Curve 1.11 CARE Dose4D Reference Point | Adaptation Strength 1.12 Patient Types 1.13 Patient Size 1.14 Patient Size Above 1.15 Weak Modulation 1.16 Patient Size Below 1.17 Strong Modulation 1.18 Weak Modulation 1.19 Curve Strengths and Organ Characteristics | mAs 1.20 Curve Strengths and Organ Characteristics | Image Noise 1.21 Less Image Noise | Heavier Patients 1.22 Less Image Noise | Lighter Patients 1.23 More Image Noise | Heavier Patients 1.24 More Image Noise | Lighter Patients 1.25 Curve Strengths and Patient Weight | Settings 1.26 Curve Strengths and Patient Weight | Adjusting 1.27 Discover CARE Dose4D: Somaris 5 & Somaris 7 1.28 CARE Dose4D @ Somaris 5 & 7 CT Scanners 1.29 Setting the Curve Modulation 1.30 Dose tab 1.31 Select 1.32 Options 1.33 Discover CARE Dose4D: CARE Child 1.34 Optional Settings for Children 1.35 Dose 1.36 Option 1 1.37 Option 1 | Note 1.38 Option 2 1.39 Scan Protocol Assistant 1.40 Define CARE kV 1.41 CARE kV – Individual, Exam-Specific kV Settings 1.42 Define CARE kV: Somaris 7 1.43 CARE kV – Somaris 7 CT Scanners (Single-Source) 1.44 CARE kV – Somaris 7 CT Scanners (Dual-Source) 1.45 CARE kV – Settings (Somaris 7 CT Scanners) 1.46 Setting Off (Somaris 7 CT Scanners) 1.47 Setting On (1/3) 1.48 Setting On (2/3) 1.49 Setting On (3/3) 1.50 Setting Semi (Somaris 7 CT Scanners) 1.51 Grouping (Somaris 7 CT Scanners) 1.52 Configuration (Somaris 7 CT Scanners) 1.53 Specify Hand CARE 1.54 Hand CARE 1.55 Understand X-CARE 1.56 X-CARE 1.57 X-CARE | Organs 1.58 X-CARE @ Somaris 7 Scanners 1.59 Explain Dose Notification / Dose Alert 1.60 Dose Notification / Dose Alert 1.61 Explain Dose Notification 1.62 Dose Notification 1.63 CTDIvol or DLP value 1.64 Settings 1.65 Dose Notification @ Somaris 5 & 7 CT Scanners 1.66 Notification of Exceeded Dose 1.67 Assistant 1.68 Pre-Set 1.69 Steps 1.70 Log files 1.71 Turning Dose Notification Dialog Box On/Off 1.72 Explain Dose Alert 1.73 Dose Alert 1.74 Dose Alert @ Somaris 5 & 7 CT Scanners 1.75 Configuration of Dose Alert Values 1.76 Exceeding Dose Alert Values 1.77 Configuration of Dose Alert 1.78 Utilize CARE Dashboard 1.79 CARE Dashboard @ Somaris 7 CT Scanners 1.80 CARE Dashboard 1.81 Identify CARE Profile 1.82 CARE Profile @ Somaris 7 CT Scanners 1.83 Patient Safety 1.84 Colors and Patterns 1.85 Green and Yellow CARE Profile 1.86 Green Profile 1.87 Image Quality (IQ) 1.88 Load/Adjust 1.89 Turn Off 1.90 CARE Profile Summary 1.91 Course Review 1.92 Disclaimer 1.93 Assessment 1.100 Completion