CT Advanced Needle Path Planning Interventional workflow

CT Advanced Needle Path Plan- ning Interventional workflow Somaris 7 SOMATOM Definition CT systems with 3D Intervention Suite This job aid is designed as a learning tool to guide you through an advanced CT intervention workflow using needle path planning on the SOMATOM Definition family scanners. Protocol Selection Needle Path Planning is an alternative workflow that begins in i-Spiral mode. This provides routine axial, coronal, sagittal, VRT, and i-Virtual Tilt/Axial images for procedure planning. Note: Interventional scans are often performed with decreased doses. To ensure that the initial i- Spiral planning scan has the desired image quality, i-Precision View may be enabled. MAS 100 CARE Dose I-PrecisionView 200 % 120 - Preparation 1. Place the patient properly per the radiologist’s request. 2. In the Patient Model Dialog, ensure the patient orientation matches the patient's position on the table. 3. Isocenter the patient in the standard manner. 4. Select the desired Intervention protocol for the appropriate body region. 5. Select a 3D layout for automatic MPR images to display. Layout -3D user one 6. Select the appropriate side for the intervention monitor. This ensures the correct orienta- tion of the patient images (head/center/foot). Unrestricted | Published by Siemens Healthineers AG, 2024 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 12/10/2024 | QR700016414 Healthineers Planning 1. Acquire the topogram. 2. Perform the i-Spiral range to the area of interest with an open FoV. 3. For procedure planning, review the axial, coronal, sagittal, and i-Virtual Tilt/Axial images. Reference lines may be rotated in any plane until the desired needle path is achieved. 4. Open the interventional toolbar Path tab Once the desired path is planned. Intervention auto auto Favorites Workflow 2D 3D Path 5. Mark any segment's area of interest (red circle) using the first icon, Needle Target Point. 6. Using the second icon, Needle Entry Point, mark the desired skin entry location (light blue dot). In all planes, the CT scanner now displays the distance from the skin entry point to the target, X-axis angulation (right/left), and Z-axis angulation (head/foot) and can be ad- justed as necessary. Distance: 7.07 cm Angle (x-directionx -23 degrees Angle (7-direction 0 degrees. 201 192x4.2/p0.0 Unrestricted | Published by Siemens Healthineers AG, 2024 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 12/10/2024 | QR700016414 Healthineers Page 2 of 5 7. Using the last icon, Needle Oriented View, the MPRs will display along the plane of the needle path. 24.112 26.11 20-16:33 26.11.23- 16:32 45-GTD. 13.122 DND EN Intervention auto auto 8. Scroll through the system axial images to find the desired entry point designated by a light blue dot. 9. Ensuring that the desired axial target image is still selected (blue border), select the table position drop-down and the Same TP option. This will move the target skin entry point to the center of the gantry and in line with the transverse laser light. Move Out Same TP Last SP ht -1698.0 125.0 10. Save any images as a Key Image if desired from the toolbar. Note: If available, you can drag and drop from the browser into an open segment on the second monitor for reference. 11. Make any desired adjustments to Zoom/Pan. 12. Adjust the scan range as desired, ensuring that the range covers both the entry point and target. Procedure 1. With the table at the correct position, turn on the laser and mark the skin entry point. 2. The radiologist will begin the procedure by prepping the insertion area, administering lo- cal anesthetic, and placing the needle. 3. Activate the fifth icon, Auto Needle Detection. Auto needle detection attempts to find both the needle skin entry point and the needle tip (21g or larger works best). • If the needle tip is not found by auto needle detection, it may be manually marked as needed using the third icon, Mark Needle Tip. • Once the tip is marked, the scanner displays the updated distance to the target, X-axis, and Z-axis angulation. 4. Perform subsequent scans and correct the needle path toward the target. • Needle path planning will update the required angle adjustments upon each scan's completion. (Multiple needles can be toggled using the sixth icon, Single Needle De- tection.) Unrestricted | Published by Siemens Healthineers AG, 2024 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 12/10/2024 | QR700016414 Healthineers Page 3 of 5 Post-procedure 13. When the procedure has been completed and a post-procedure scan is desired, adjust the scan range and turn on the i-Precision view. 14. When all imaging is completed, select Cancel to exit intervention mode and end the exam. 15.Go to Patient > Browser > Local Database. 16. Select the patient and desired images to transfer to PACS. Additional Information Interventional Toolbar: Path Tab ntervention auto auto ori Wo TOW 2D Pall Needle Needle Needle Delete Auto Single Patient Needle Target Entry Tip Needle Needle Needle Oriented Oriented Point Point Point Path Detection Detection View View 1. If the path obscures the view, it can be removed by selecting Hide Graphics on the 2D Tab. Note: This will also dim all additional graphic tools, such as the Distance Ruler. If a new measurement is desired, it must be toggled back on. 2. The needle path will appear as a solid blue line when in the plane and on the selected slice of the planned path. It will appear as a dashed line in all other images or not in the plane. 3. When at the level of the planned target, the circle will appear bright red. It will be dark red at all other levels. 4. When at the level of the skin entry, the dot will appear light blue. It will be dark blue at all other levels. When using the same TP to mark skin entry, it is important that the correct image level is selected in the system axial segment and has a blue border (active segment). 5. MPR images will always appear in anatomical position with anterior UP on axial even when the patient is prone. The system axial will display as positioned unless mirroring has been enabled in the Recon Tab. Unrestricted | Published by Siemens Healthineers AG, 2024 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 12/10/2024 | QR700016414 Healthineers Page 4 of 5 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's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. 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. Copyright © Siemens Healthineers AG 2024 Siemens Healthineers Headquarters Local Contact Information Legal Manufacturer Siemens Healthineers AG Siemens Medical Solutions USA, Inc. Siemens Shanghai Siemensstraße 3 40 Liberty Blvd. Medical Equipment Ltd. 91301 Forcheim, Germany Malvern, PA 19355-9998 USA 278 Zhou Shu Road Phone: +49 9191 18-0 Telephone: +1-888-826-9702 Shanghai 201318 siemens-healthineers.com Customer Care Telephone: P.R. China +1-800-888-7436 Telephone: +1 847 304 7700 Unrestricted | Published by Siemens Healthineers AG, 2024 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 12/10/2024 | QR700016414 Healthineers Page 5 of 5