CARE Technology - Combined Applications to Reduce Exposure - Somaris 10 - 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 10 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 3 Define CARE kV 2 5 Explain Dose Notification/ Dose Alert 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 X. This online training will offer you valuable insights into the CARE technology that helps to improve patient outcomes with solutions that deliver excellent image quality while lowering radiation exposure, 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_v2.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 X.ceed SOMATOM go.Now SOMATOM go.Up SOMATOM go.All SOMATOM go.Sim SOMATOM go.Top SOMATOM go.Open Pro SOMATOM X.cite SOMATOM X.ceed ? Somaris 10 CT Scanner Portfolio Somaris 10 CT Scanner Portfolio audf_care_tech_title_page_som_10_06.mp3 Please take a look at our broad range of Somaris 10 CT scanners. 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 1.5 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. CARE Dose4D More precise configuration of dose modulation Individual configuration for different body habitus and organs Specific modulation curves available ? D:\1381_CT_Grafik_Adapted_Dose_Curves.jpg 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 10* CARE Features * SOMATOM go.Now, SOMATOM go.Up, SOMATOM go.All, SOMATOM go.Top, SOMATOM X.cite, SOMATOM go.Sim, SOMATOM go.Open Pro Discover CARE Dose4D: Somaris 10 audf_care_tech_care_dose_10_intro_34.mp3 And this is how this feature works with Somaris 10 CT scanners. CARE Dose4D @ Somaris 10 CT Scanners Somaris 10 CT scanners: SOMATOM X.ceed ? CARE Dose4D @ Somaris 10 CT Scanners audf_care_tech_care_dose_10_scan_35.mp3 Please take a close look at the CT scanners from the Somaris 10 family. Setting the Curve Modulation @ Somaris 10 CT Scanners You can set the curve modulation for an organ characteristic in the Clinical Configuration: Select the Modulation tab in the Dose Configuration (Admin User right required). ? Setting the Curve Modulation audf_care_tech_care_dose_10_scm_clinic_36.mp3 You can set the curve modulation for an organ characteristic in the Examination Configuration. To do so, select the Modulation tab in the Dose Configuration. 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 10 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 ? CARE kV – Individual, Exam-Specific kV Settings audf_care_tech_care_kv_benefit_45.mp3 The CARE kV feature offers significant 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 10* CARE Features * SOMATOM go.Now, SOMATOM go.Up, SOMATOM go.All, SOMATOM go.Top, SOMATOM X.cite, SOMATOM go.Sim, SOMATOM go.Open Pro Define CARE kV: Somaris 10 audf_care_tech_care_kv_10_intro_60.mp3 Now let us define the CARE kV values for Somaris 10 scanners. CARE kV 70kV 80kV 90kV 100kV 110kV 120kV 130kV 140kV + 150kV + Sn150kV Sn100kV Sn110kV Sn120kV Sn130kV Sn140kV CARE kV – Somaris 10 | Values ? SOMATOM go.All SOMATOM go.Sim SOMATOM go.Top SOMATOM go.Open Pro SOMATOM X.cite SOMATOM X.ceed CARE kV – Somaris 10 | Values audf_care_tech_care_kv_10_scan_61.mp3 In this slide, you can see the CARE kV values for Somaris 10 CT scanners including the tin filter kV values. Table with 5 columns and 2 rows CARE kV optimized for CARE kV Quality ref. mAs @ 120 kV kV Q. ref. mAs eff. mAs - Non-Contrast - Bone / Calcium - Soft Tissue with Contrast - Vascular 95 Sn110 430 310 CARE kV slider replaced by simple and clear dropdown menu. Visible in exam designer only Editable Read-only CARE kV – Somaris 10 | Dropdown CARE kV Quality ref. mAs @ 120 kV guarantees consistent image quality in all scan modes including Routine, Sn-Protocols, TwinBeam and TwinSpiral DualEnergy. ? CARE kV – Somaris 10 | Dropdown audf_care_tech_care_kv_10_menu_62.mp3 In Somaris 10, the CARE kV slider is replaced by a simple and clear dropdown menu with only four settings: -Non-Contrast, -Bone / Calcium, -Soft Tissue with Contrast, and -Vascular.   The CARE kV Quality reference mAs at 120 kV setting guarantees consistent image quality in all scan modes including Routine Sn-Protocols, as well as TwinBeam and TwinSpiral DualEnergy. Table with 6 columns and 4 rows CARE kV & CARE Dose4D Mode CARE kV Relevant Contrast CARE kV Quality ref. mAs @ 120 kV kV Q. ref. mAs eff. mAs Full Vascular 95 Sn110 430 310 Manual kV Vascular 95 Sn110 430 310 Off - - Sn110 - 310 Visible in exam designer only Editable Read-only CARE kV – Somaris 10 | Settings Full: Scanner selects appropriate kV and effective mAs values according to “optimized for” setting. Same procedure as in On mode. Manual kV: User selects desired kV level, effective mAs is adjusted accordingly. Same procedure as in Semi mode. Off: This setting turns off both CARE kV and CARE Dose4D. User needs to set CARE kV and Effective mAs values. No modulation in this setting. This is different from Somaris 7, since CARE kV and CARE Dose4D are now linked. ? CARE kV – Somaris 10 | Settings 1.33 CARE kV_v2.mp3 Again, there are three settings available for CARE kV.   Full: The scanner will select the appropriate kV and effective mAs values according to the “optimized for” setting. Suitable kV value will now be chosen by the system. Manual kV: The user selects the kV level desired, and the effective mAs will be adjusted accordingly. Suitable kV value will now be chosen by the system. Off: This setting will turn off both CARE kV and CARE Dose4D. The user will need to set the CARE kV as well as the Effective mAs values. There will be no modulation in this setting. CARE kV – Somaris 10 | Manual kV If user selects a different kV value in the manual kV mode, the Quality reference mAs does not need to be adapted. The scanner will perform the adjustment in the background. ? Manual kV audf_care_tech_care_kv_10_manual_64.mp3 If the user selects a different kV value in the Manual kV mode, the Quality reference mAs does not need to be adapted. The scanner will perform the adjustment in the background. VA30 implements CARE kV grouping mechanism known from Somaris 7. CARE kV selects the same kV for all ranges within the CARE kV group. kV optimization criterion consists in the lowest sum of DLP values of the individual scan ranges. CARE kV Group CARE kV Grouping – Somaris 10 ? Grouping audf_care_tech_care_kv_10_group_mech_65.mp3 The CARE kV grouping function is available on Somaris 10 with the VA30  software.   VA30 implements the CARE kV grouping mechanism.   CARE kV selects the same kV level for all ranges within the CARE kV group.   The kV optimization criterion consists in the lowest sum of DLP  values of the individual scan ranges.   The CARE kV license shall be available. The CARE Dose4D & CARE kV shall be set to Full. All scan ranges added to a CARE kV group are scanned with the same kV value while other settings are retained. For scans within a CARE kV group with different limits, CARE kV selects the kV values within the defined limits for all scans of this CARE kV group. Only one group per study can be created. It can be used for abdomen multiphase scans to ensure the same kV is used for all phases. CARE kV Grouping – Somaris 10 | License ? CARE kV Grouping | License audf_care_tech_care_kv_10_group_license_66.mp3 To work with this function, the CARE kV license shall be available.   Both the CARE Dose4D and the CARE kV features shall be set to the Full mode.   All scan ranges added to a CARE kV group will be scanned with the same kV value while the other settings will be retained. If there are scans within a CARE kV group with different limits, CARE kV will select the kV values within the defined limits for all scans of this CARE kV group.   Only one group per study can be created.   The procedure can be used for abdomen multiphase scans to make sure that the same kV level is used for all phases. 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 Selection of the right scan mode by Somaris 10 scanner X-ray high ? X-ray low X-CARE 1.38 X-Care.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. The right scan mode will be selected by the Somaris 10 scanner. 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 10: RoutineSpiralAdultHeadXcare RoutineSpiralAdultHeadSnXcare RoutineSpiralAdultThoraxXcare RoutineSpiralAdultThoraxSnXcare RoutineSpiralChildHeadXcare RoutineSpiralChildHeadSnXcare X-CARE @ Somaris 10 Scanners ? X-CARE.png X-ray high X-ray low X-CARE @ Somaris 10 Scanners audf_care_tech_x_care_som_10_73.mp3 The X-CARE function with Somaris 10 is available in the protocols shown here.   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 1.45 CTDlvol_v2.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 10 CT Scanners Somaris 10 CT scanners: ? SOMATOM go.All SOMATOM go.Top SOMATOM go.Sim SOMATOM go.Open Pro SOMATOM X.cite SOMATOM go.Up SOMATOM go.Now SOMATOM X.ceed Dose Notification @ Somaris 10 CT Scanners audf_care_tech_dnda_dose_note_som_10_87.mp3 The Dose Notification function is also available with the following Somaris 10 scanners. Notification of Exceeded Dose | CTDI vol and DLP The Dose Notification monitors the CTDIvol as well as the DLP for each scan range. It informs you if the specified notification values will be exceeded when performing the scan. F:\DN2.JPG ? CTDIvol and DLP audf_care_tech_dnda_dose_note_ned_88.mp3 The Dose Notification feature monitors the CTDIvolume as well as the DLP for each scan range. It informs you if the specified notification values will be exceeded when performing the scan. Notification of Exceeded Dose | Warning Icon If you load a scan for which one or both thresholds defined for the next scan range exceed the notification values, a Dose Notification dialog box will appear. The corresponding scan range and parameters will display a yellow warning icon. F:\DN2.JPG F:\DN1.JPG ? Warning Icon audf_care_tech_dnda_dose_note_ned_warn_89.mp3 If you load a scan for which one or both thresholds defined for the next scan range exceed the notification values, a Dose Notification dialog box will appear. The corresponding scan range and parameters will display a yellow warning icon. SOMATOM go. VA30 – Dose Notification For each scan range, you can set a threshold for: CTDIvol (Dose Notification ref. CTDI [mGy] parameter) DLP (Dose Notification ref. DLP [mGy*cm] parameter) Z:\AN\_Course_Documents_Application_\CT\05_CT1SOMGO - go\VA20\in WORK\DN3.JPG ? SOMATOM go. VA30 – Dose Notification audf_care_tech_dnda_dose_note_som_go_90.mp3 For each scan range, you can set a threshold value for both: - the CTDIvolume, and - the DLP. 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 10 CT Scanners Somaris 10 CT scanners: ? SOMATOM go.All SOMATOM go.Top SOMATOM go.Sim SOMATOM go.Open Pro SOMATOM X.cite SOMATOM go.Up SOMATOM go.Now SOMATOM X.ceed Dose Alert @ Somaris 10 CT Scanners audf_care_tech_dnda_dose_alert_10_scan_97.mp3 The Dose Alert feature is available with these Somaris 10 scanners. The Dose Alert monitors the maximum value of the accumulated CTDIvol as well as the accumulated DLP in all z-positions of the entire protocol. It informs you if one of the specified alert values will be exceeded when performing the scan. Exceeding Dose Alert Values | CTDI vol and DLP F:\DN6.JPG ? CTDIvol and DLP audf_care_tech_dnda_dose_alert_exceed_z-pos_98.mp3 The Dose Alert feature monitors the maximum value of the accumulated CTDIvolume as well as the accumulated DLP in all z-positions of the entire protocol. It informs you if one of the specified alert values will be exceeded when performing the scan. F:\DN6.JPG Enter your: User Name (mandatory) Diagnostic Reason (optional) Dose Alert Password (mandatory) A Dose Alert password may be set in the User and Role Administration. Exceeding Dose Alert Values | User ? User audf_care_tech_dnda_dose_alert_exceed_ura_99.mp3 If you want to go on with the examination procedure although the Dose Alert values will be exceeded, you will have to enter your: User Name, Diagnostic Reason, and Dose Alert Password.   This time again, the User Name and the Dose Alert Password are required fields, whereas the Diagnostic Reason can be specified optionally.   A Dose Alert password may be set in the User and Role Administration. F:\DN6.JPG In case of a Dose Alert for an i-Sequence range in a CT-guided intervention, the Do Not Show Again check box is displayed in the Dose Alert dialog box. If you enable the Do Not Show Again check box and then confirm the Dose Alert, the Dose Alert will not be shown again for the next i-Sequence scans. Do Not Show Again Exceeding Dose Alert Values | Check box ? Check box audf_care_tech_dnda_dose_alert_exceed_do_not_100.mp3 In case of a Dose Alert for an i-Sequence range in a CT-guided intervention, the Do Not Show Again check box is displayed in the Dose Alert dialog box. If you enable the Do Not Show Again check box and then confirm the Dose Alert, the Dose Alert will not be shown again for the next i-Sequence scans. You can configure the Dose Alert thresholds for both adult and child examinations in the Administration Portal. The child threshold values are used if the scan protocol contains at least one scan range with Child as patient type, otherwise the threshold values for adults are used. F:\DN7.JPG The corresponding scan range and parameters display a red error icon. Configuration of Dose Alert | Administration Portal ? Administration Portal audf_care_tech_dnda_dose_alert_config_error_101.mp3 You can configure the Dose Alert thresholds for both adult and child examinations in the Administration Portal. The child threshold values are used if the scan protocol contains at least one scan range with Child as patient type, otherwise the threshold values for adults are used.   The corresponding scan range and parameters display a red error icon. In the User Management you can configure a password for the Dose Alert! Please consult the dedicated presentation! F:\DN6.JPG F:\Dose007.jpg F:\Dose008.jpg Configuration of Dose Alert | User Management ? User Management audf_care_tech_dnda_dose_alert_config_um_102.mp3 In the User Management, you can configure a password for the Dose Alert!   Please consult the dedicated presentation as this is a multiple step procedure. Dose Alert / Dose Notification issues and dose information will NOT be recorded and saved to H:\siteData\DoseLogs anymore. The information will now be recorded in the Dose Report. The Dose Report can be sent to an extra network node. F:\DoseReport.JPG Dose Report ? Dose Report audf_care_tech_dnda_dose_alert_dose_rep_103.mp3 The Dose Alert and Dose Notification issues as well as the dose information will no longer be recorded and saved to the local folder.   The information will now be recorded in the Dose Report. The Dose Report can be sent to an extra network node. 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 10 CT Scanners Somaris 10 CT scanners: ? SOMATOM go.All SOMATOM go.Top SOMATOM go.Sim SOMATOM go.Open Pro SOMATOM X.cite SOMATOM go.Up SOMATOM go.Now SOMATOM X.ceed CARE Profile @ Somaris 10 CT Scanners audf_care_tech_care_profile_som_10_scan_116.mp3 The Somaris 10 scanners depicted here feature the CARE Profile function. 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. CARE Profile Summary If the topogram covers the scan range only partially , all uncovered parts are yellow. In the yellow areas in z-direction, the image quality may be reduced or the dose might be increased. In other words: In the yellow areas, the applied mAs values will probably be not optimal. The topogram does not cover the scan range at all. The tube cooling time exceeds 10 minutes. ? CARE Profile Summary audf_care_tech_care_profile_summary_10_118.mp3 In these three examples, we can see that   If the topogram covers the scan range only partially, all uncovered parts will be yellow. In the yellow areas in z-direction, the image quality may be reduced or the dose might be increased. In other words, in the yellow areas, the applied mAs values will probably be not optimal.   If the topogram does not cover the scan range at all, the current dose settings will prevent scanning in this situation.   The tube cooling time exceeds 10 minutes. ? Course Review Congratulations. You have completed the CARE Technology – Combined Applications to Reduce Exposure Online Training – Somaris 10 course. Select the numbered buttons below to review the material before proceeding to the final assessment. Explain Dose Notification / Dose Alert Understand X-CARE Define CARE kV Learn about CARE Dose4D 1 1 2 2 3 3 3 4 4 4 5 5 5 Identify CARE Profile Course Review Identify CARE Profile CARE Profile Somaris 10* Scan modes with continuous table movement: CARE Profile displayed as curve in z-direction Sequence ranges: CARE Profile displayed as bars * SOMATOM go.Now, SOMATOM go.Up, SOMATOM go.All, SOMATOM go.Sim, SOMATOM go.Top, SOMATOM go.Open Pro, SOMATOM X.cite 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 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 FAST kV keeps dose at approx. same level CARE kV ensures lower dose while maintaining same image quality (signal-to-noise ratio) Discover 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: On, Full, Manual kV Full, Manual kV, Off Semi, On, Manual kV On, Full, Semi Multiple Choice Select the incorrect answer. ? Question 2 of 5 CARE kV - Grouping Only one group can be created in one study The CAREDose4D & CAREkV is set to Manual kV The CAREkV license must be available All scan ranges that are added to a CAREkV group are scanned with the same kV value while the other settings are retained Multiple Choice Select the best answer. ? Question 3 of 5 Where can you configure the curve modulation for the different organ characteristic? Technical Configuration Clinical Configuration - Dose Configuration - Modulation Clinical Configuration - Reading Not possible at all Multiple Choice Select the best answer. ? Question 4 of 5 Which of the following is no benefit of CARE Dose4D? Offers predefined dose modulation settings but for adults only Less dose / less noise Enables the right dose with mAs tailored to size and shape of individual patient 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 You have completed the CARE Technology Combined Applications to Reduce Exposure Online Training – Somaris 10 . To access your Certificate of Completion, select the Launch button drop down on the course overview page. You can also access the certificate from your PEPconnect transcript. Completion 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 Technology Somaris X 1 CARE Technology 1.1 Welcome 1.2 FAST CARE for Patients 1.3 Somaris 10 CT Scanner Portfolio Discover CARE Dose4D 1.4 Discover CARE Dose4D 1.5 The Right Dose, Wherever and Whenever Needed 1.6 CARE Dose4D 1.7 CARE Dose4D Reference Point 1.8 CARE Dose4D Reference Curve 1.9 CARE Dose4D Reference Point | Adaptation Strength 1.10 Patient Types 1.11 Patient Size 1.12 Patient Size Above 1.13 Weak Modulation 1.14 Patient Size Below 1.15 Strong Modulation 1.16 Weak Modulation 1.17 Curve Strengths and Organ Characteristics | mAs 1.18 Curve Strengths and Organ Characteristics | Image Noise 1.19 Less Image Noise | Heavier Patients 1.20 Less Image Noise | Lighter Patients 1.21 More Image Noise | Heavier Patients 1.22 More Image Noise | Lighter Patients 1.23 Curve Strengths and Patient Weight | Settings 1.24 Curve Strengths and Patient Weight | Adjusting 1.25 Discover CARE Dose4D: Somaris 10 1.26 CARE Dose4D @ Somaris 10 CT Scanners 1.27 Setting the Curve Modulation 1.28 Define CARE kV 1.29 CARE kV – Individual, Exam-Specific kV Settings 1.30 Define CARE kV: Somaris 10 1.31 CARE kV – Somaris 10 | Values 1.32 CARE kV – Somaris 10 | Dropdown 1.33 CARE kV – Somaris 10 | Settings 1.34 Manual kV 1.35 Grouping 1.36 CARE kV Grouping | License 1.37 Understand X-CARE 1.38 X-CARE 1.39 X-CARE | Organs 1.40 X-CARE @ Somaris 10 Scanners 1.41 Explain Dose Notification / Dose Alert 1.42 Dose Notification / Dose Alert 1.43 Explain Dose Notification 1.44 Dose Notification 1.45 CTDIvol or DLP value 1.46 Settings 1.47 Dose Notification @ Somaris 10 CT Scanners 1.48 CTDIvol and DLP 1.49 Warning Icon 1.50 SOMATOM go. VA30 – Dose Notification 1.51 Explain Dose Alert 1.52 Dose Alert 1.53 Dose Alert @ Somaris 10 CT Scanners 1.54 CTDIvol and DLP 1.55 User 1.56 Check box 1.57 Administration Portal 1.58 User Management 1.59 Dose Report 1.60 Identify CARE Profile 1.61 CARE Profile @ Somaris 10 CT Scanners 1.62 CARE Profile Summary 1.63 CARE Profile Summary 1.64 Course Review 1.65 Disclaimer 1.66 Assessment