MAMMOMAT B.brilliant - Breast biopsy - Stereo 2D biopsy (USA)

In this video you will get to know a typical stereo 2D biopsy examination. The examination is controlled at the workstation with preset examination parameters before you start. The examination inform the patient about the procedure. Select the required biopsy procedure. The system will let you know when you need. To attach and remove the needle holder, the projection view or PV icons on the images subdust card represent all necessary exposures. Once enabled for exposure. The first. PV icon will be yellow until you've positioned the patient and compressed the. Breast If the spacer plate option has been purchased, it has to be enabled in service. In the pop up select. The appropriate. Response regarding the use of a spacer plate Please note. The spacer plate is better suited for a horizontal biopsy. You can check the examination parameters in the acquisition subtus card. You can perform a biopsy in an upright seated position or with the patient in a recumbent lateral decubitous position. To ensure patient safety, use a. Dedicated biopsy chair. That locks into position. When the biopsy table is mounted, an A with a strikethrough symbol appears on the comfort guide Display it. Indicates that automatic movement is disabled. If you need to angulate the system, use the operational keys to manually move it before. You compress the breast. Prepare. Everything for the examination The breast must remain compressed until the end of the examination. Position the breast on the. Biopsy table. The suspected. Lesion should ideally be in the center of biopsy field of. View. Compress the breast by moving the compression plate downwards using the manual compression knob or the foot switch. The breast must be immobilized so that there is no possibility of movement. Any movement will affect the accuracy of the targeting. A green check mark appears on the Comfort Guide display when you have reached the minimum compression force of 15 Newton. We recommend a compression force of 40 to 60 Newton. Make sure that the. Breast is. Sufficiently compressed throughout the entire biopsy examination due to physiological. Reasons compression force may reduce during the compression phase after you have compressed the breast. The Scout projection view. Icon turns white. The 1st 2D. Scout Images The reference Scout. It is done at 0° to confirm that the area of interest is in the field. Of view when you use an automated exposure. Setting the scout is used to calculate a fixed exposure for the remaining images in the compression phase, press. And hold the exposure button as long as the signal is audible. Check the. Scout image to confirm that the area of interest is in the field of view. Click New if you are not satisfied with the scout image, reposition the breast or change the exposure or image processing parameters. Then repeat the scout exposure click. OK to confirm the exposure parameters and that the area of interest is in the field of view. The exposure mode changes from optos to manual because the image processing and exposure factors are locked in. You must. Not change the patient. Position again. If you include any hardware such as needles or biopsy devices into the image, it will not affect the image processing. Once the Scout exposure has been accepted by clicking OK, the first stereo pair is enabled. Press the exposure button until the stereo pair has been acquired. The swivel arm moves automatically to -15° for the first stereo exposure and to plus 15° for the second stereo exposure. The images of the stereo pair appear next to each other in the image area. After you have acquired the initial stereo pair images, set the reference point. All tools such as zooming, measuring, etc. Are deactivated so you can start the reference point confirmation immediately. Click the Set Reference Point icon. We recommend that you enlarge the image to accurately position the reference points. Open the Zoom from Point tool via the menu or with a right mouse click and magnify the reference point T shape. Exit the magnifying tool by pressing Escape. Check the reference points. The reference crosshairs must be accurately aligned with the reference points to ensure accuracy of biopsy targeting. To move the crosshairs, hover the mouse cursor over the cross. The icon changes to compass points. Click and hold the left mouse button to select and drag the crosshair to align with the T reference point. Repeat this. For the second stereo image reference point. Once aligned, confirm the reference. Point by clicking the selected. Target Mark. Icon the. System checks if the reference point is set within a 1 centimeter tolerance range. To see the whole field of view again, right click in the image and select Home Zoom pan next. You define the biopsy targets. Mark the biopsy target point with a left click into one of the images. A targeting cross appears in both stereo pair images along the horizontal line. Position the target crosses so that they mark the point of interest in both stereo images. We recommend using the Zoom from Target Mark tool. Right click into the image and select the tool from the popup context menu. Left click anywhere in the image to enlarge both images simultaneously. The target marks are always in the center of the enlarged images. A right click reduces the size of the images. Exit the magnifying tool by pressing Escape on the keyboard. You can also deselect this function using the image drop down menu. It can be found in the main menu bar at the top of the screen. Use the check mark icon in the Biopsy subdus card to confirm your target. When the target is set, the corresponding coordinates appear on the biopsy subdus card with a corresponding target number. A default needle will be configured for the procedure that you selected at the start of the examination. The selected. Needle and needle holder can be changed in the acquisition subtus card. If the target is reachable with the selected needle, the target crosses are yellow. In our example, we use an Encore 10 gauge vertical needle with a dedicated needle holder. Our configured procedure gives us a pre fire and post fire projection view. The pre fire option shows you if the needle is in the correct place before firing the needle into the area of interest. Once the sampling notch of the needle is at the area of interest, use the post fire projection option to check the accuracy of the target relative to the needle notch. With the biopsy navigator, you can see the position of the target relative to the needle. The needle is indicated by a line on the navigator with the notch represented by a gap in the line of the needle. The blue box indicates the targetable biopsy volume. The target is indicated by a + orientated cross. The PA view on the biopsy navigator means that you are looking at the breast from behind the patient, IE from the chest to the nipple. If you toggle to the scout image with the arrow keys, you see the scout image viewed from above. In this example, the yellow target mark is the currently selected. Target. It is reachable with the selected needle. The orange target mark cannot be reached with the needle. Click the Transmit Selected Target Mark icon to transfer the targets to the System A. Confirmation message states which needle has been selected. Confirm this message. If no needle holder is mounted, the system will automatically drive to the position of the transmitted target. To prepare for biopsy, first attach the needle holder. When it is securely attached, the LED on top of the needle driver changes from orange to green. When this light is. Green Any automated movement is disabled to move. The needle holder in this state. One of the override buttons needs to be pressed while pressing a hand box button. The following is a description of a typical biopsy workflow. We assume that proper sterile technique is used for the. Procedure Administer the local anesthetic. You can use the needle guide to show where the needle will be inserted into the breast when a target has been transmitted and the needle holder has driven to the target. The hand box displays 3 numbers. The target number of the transmitted target. The configured length of the needle. And the safety distance from the detector. As soon as you press any button on the hand box, the display shows only zeros. This means the needle holder is at the transmitted target. Next, install the needle holder. Ensure that the needle is in the pre fire position. To have more control of when the needle will enter the breast, you can move the needle holder up. The tube can be angled to the side to allow more room to insert the needle or biopsy device. Slide the needle into the needle holder and through the needle guide. Ensure that the needle is clicked in securely onto the adapter plate or firing mechanism. If the needle holder was moved up. It has. To be. Lowered. To the target point, do this with the control box and the override button as there is a transmitted. Active target. The system will automatically stop at the zero position. Maintain control of the skin entry point and monitor the patient as the needle is inserted into the breast. Press and hold the exposure button on the control box until the stereo pair has been acquired. The system moves automatically during the pre fire exposure. Please note in this example the sampling notch is in an open position. This would normally be closed in a clinical exam until ready for sampling. Check that the needle tip is near your target. Fire the needle into the breast. You can now take a post fire stereo pair to make sure that the area of interest is adjacent to the notch of the needle. After confirming that the notches at the area of interest sample the tissue with the vacuum biopsy system. Activate the Inspect view tile. Place the. Specimen in the specimen tray. Close the. Specimen tray and insert it into the inspect bracket on the biopsy tower. Both the workstation monitor and the comfort guide display indicate on which side of the biopsy unit you need to insert the tray. Press the. Exposure button. The swivel. Arm angle 6° to the side of the specimen tray. Only the. Specimen tray is exposed. Check the. Specimen image for calcification. Additional tissue samples can be taken if required. To learn how to dismount the biopsy unit, see the relevant learning object on PEP Connect.

1/1/1955 54 112 15 62 47 1002 2/9/2024 2/9/20 9/2024 1+ 28 002 *1/1/1955 44.7 410_ 24 10 20 50 40 30 8.6 /1/1955 43.2 2024 44 882 2/9/202 19800719 48 5.9 MAMMOMAT B.brilliant Breast biopsy - Stereo 2D biopsy Patient Transfer Examination Open patient Operator: Viewing Procedure: PV sequence: Filming Acquisition Post processing Close patient Please attach and remove the needle holder on the Biopsy Unit for safety check up Starting the examination Examination Edit View Image Tools Scroll Qptions Help PEP Connect Stereo Biopsy Training Mammogram - bil Display Markers: Except mag/spot Auto Filming Auto Expose Mammogram - bilateral -... Images CC mlo OPDOSE Decomp Adv Mammogram - bilateral - Standard TiCEM - bilateral TiCEM - right TiCEM - left Mammogram + Mag - bilateral - Standard Mammogram + Spot - bilateral - Standard Mammogram - right - Standard Mammogram - left - Standard Magnification - bilateral Spot - bilateral Implant - bilateral Implant + Implant displaced - bilateral Constancy Test Patient Transfer Examination Edit View Image Tools Scroll Qptions Help QC-raw QC-processed Biopsy Left - Stereo Biopsy Right - Stereo Biopsy Left Tomo + Stereo Biopsy Right Tomo + Stereo Biopsy Left 2D + Tomo + Stereo Biopsy Right 2D + Tomo + Stereo Patient Patient Transfer Examination Edit View Image Tools Scroll Qptions Help holder. Procedure: Biopsy Right - Stereo Calibration needle R-CC ST, R-CC- ST Auto Film. Auto Exp. Biopsy Advanced Select patient Select procedure Please attach and remove needle OPCOMP MIN . TUBE Compression (N) Thickness (mm) Needle: Patient Transfer Examination Examination Edit View Image WH AWS Is the spacer plate in use? Yes No R-CC ST Transfer Examination Edit View Image Tools Scroll Qptions Help You have to compress the breast first if you want to do an OPDOSE exposure. Compression force below 15 N - targeting accuracy cannot be guaranteed. Acquisition mode: Stereo IPPG: F1 Metal in Breast Calibration Spacer Plate Holder: Needle: Calibration Positioning the patient Transfer Compression ongoing Grid positioning ongoing Focus change is ongoing 28 kV 60-69 mm 65 mm Patient Transfer Examination Edit View Image Tools Scroll Options Help D Please attach and remove needle Compressing the breast -C SIEMENS mages Select patient and procedure at workstation. MIN 2D scout Standard Ne 28 kV - 28 k 8 kV Please release the X-ray button after finished exposure 24 N IP Image processing is in progress ... Edit View Image Tools Scroll PEP Connect, Stereo Biopsy 4:29:48 PM KV: 28 Operator. Institution: Unicom//C8DC3-742Y1// Station: XPAWSBB1 3a Rainbowstreet Unicorn City District 91052 DEU Glandular Dose: 1.04 mGy OK New Examination Edit View Image Tools Scroll Options Help Focus: large Thickness: 65 4.7 mGy Entrance Dose Tools Scroll Entrance Dose: 4.7 n Image rejected. Thickness: 65 mm Transfer Examination Compression ongoing. Focus: lar 66 mm Edit View Glandular Do No image to display Y Z Need 0.9 mGy 25 N 4:30:35 PM mAs: 51.5 mAs Glandular Dose: 0.90 mGy auto Entrance Dose: 4.0 mGy X Y 2 Manual 55.7 mAs R-CC+ S-+ Image accepted Station: XPAW Anode/Filter W Stereo pair Comp. Force 25 N ar Dose: 0.90 mG Image accepted. Scale 174% o.p. 4:30:59 PM R-CC- ST to display mAs: 55.7 mAs 7 mAs Comp. Force: 24 N Entrance Dose: 4.4 mGy Glandular Dose: 0.97 mGy. Entrance Dose: 4 Edit View Image Tools Scale 174% o.p. PEP Connect, Stereo Biopsy 4:31:05 PM Focus: la Glandular Dose: 0.97 mGy 3a Rainbowstreet Unicom City Setting the reference cross Options Scale 1389% o.p. :4:31:05 PM R-CC+ ST Angle: -0.0 Institution: Unicom//C8DC3-742 .. Thickness 65 mm 3a Rainbowstreet Unicorn City ss: 65 mm Glandular Dose: 0.97 mGy 3a Rainbowstreet Unicom City .. tion: XPAWS Patient Transfer Examination Edit View Image Entrance Dose: 4.4 mGy Station: XPAWSBB1 Glandular Dose: 0.97 mGy 3a Rainbowstreet Unicom City . nce Dose: 4 Glandular Dos Comp Thickness: 65 mm Operator. ce Dose: 4.4 mGy Set Reference point ce Dose: 4.4 mGy Station: XPAWSBB1 Station: XP Windowing Windowing on Selection Windowing on Succeeding Color Lookup Table .. Invert Reject InBD Values Home Window Magnify by 2.0 Minify by 0.5 Eit to Segment Acguisition Size Zoom Factor Zoom From Point Zoom/Pan Zoom/Pan on Selection Zoom/Pan on Senes Zoom From Target Mark Scale 1389% o.p. PEP Connect, Stereo Biopsy Thicknes Institution: Unicom//C lar Dose: 0.97 mGy Com mGy Glandular Dose: Esc 4.4 mGy /: 28 np. Force: 24 N 3a Rainbowstreet Unicorn City ... Force Focus: larg mAs: 55.7 mA Comp. Forc Post processin Confirm selected target mark. Glandular Dose: 0.97 mGy 3a Rainbowstreet Unicorn City Thickness: 65 mm :Operator. mAs: 55 Edit View Image Tools Scroll Show scout Show navigator Hide all target marks Show selected and transmitted target marks Show all target marks Image Attributes. Correct ... Reprocess .. Direct Comparison Select All Graphics Paste Mark Fit to Segment Home Zoom/Pan Edit Commen Trainin Defining the biopsy targets Focus: large: Institution: Unicorn//C8DC3-742 ... ce Dose: 4.4 mGy. Glandular Dose: 0.97 mGy: 3a Rainbowstreet Unicorn City ... Thickness: 65 mm: Operator. Entrance Dose: 4.4 mGy: Station: XPAWSBB1 Entrance Dose: 4.4 mGy: # OX Y Z Scale 174% o.p .: PEP Connect, Stereo Biopsy NA Glandular Dose: 0.97 mGy 3a Rainbowstreet Unicorn City ... Tools Scroll Options Help Examination Edit View Image Tools le: -0.0 Comp. Force: 24 Station: XPAV Cancel Correct .. Reprocess. PastR Edit Comment mAs: 55.7 ndular Dose: 0.97 mGy R-CC-+ ST mAs 55.7 m ce Dose 5 mm Angle Vindowing on Succeeding Color Lookup Table ... Zoom Factor .. Entrance Dose 4 4 mGy Comp Force 24 N Scale 347% o.p. PEP Connect, Stereo Biopsy Force 24 N Comp Force 24 mAs 55.7 mAs Confirm selected target mark 1 R -14.2 4.9 Post processing Confirm selected target mark 7 Need Selecting the needle Scale 347% o.p. Calibration r Needle Standard Ne BD Magnum MN1416_Full_SLH_horz BD Magnum MN1416_Half_SH_vert BD_Magnum_MN1410_Full_SLH_horz Bard_Encor_10G_SH Brevera_9G_L130_full_horz Brevera 9G L130 half vert Encor_10G_SLNH_horz Encor_10G f SH vert bowstre Encor_10G_SNH_vert Encor_10G_horz Encor_10G_vert Encor Vert Needle: Encor_10G Biopsy Navigator mAs: 55.7 m Image Edit Stereo 1:1 g Stereo 2:1 First view Tomo projections Slices Insight 2D Insight CEM TiCEM twin view Display preview Display targeting aid Show scout for targeting Show Biopsy Navigator Show Virtual Paddle Hole No Text Customized Text All Text View PA view Confirm Entrance Glan kV: 28 Glandular Dose: 0.97 mGy: x Biopsy Navigator Needl 2 R -5.9 43.2 Encor Post probessing ation 2 R -5.9 8.6 Traini 43.2 E Encor ransmit selected target mark Will this needle and needle holder be used for the target in transmission: (Encor_10G_vert (Core/Vacuum core Kes # OX Y OX Y The needle holder is moving to position. inbowstreet Uni Preparing for biopsy dvanced Anode 43.2 Enco MAMMOMAT B.brillian Installing the needle Comp. Force MAMMOMAT ainbowstreet Uni e Dose Oper Edit View Image Tools Scroll Qptions Help Dose Pre-fire exposure 64 mm R-preCC-+ ST R-preCC+ S-+ OX Y Z R-preCC-+ ST - Acquisition in progress 0 deg 19 N 4:39:36 PM Glandular Dose: 0.98 mGy 3a Rainbowstreet Unicom City ... 4:39:42 PM Saving processed image .. Scroll Qptions Help 3a Rainbowstreet U R-postCC-+ ST Inspect 4:40:45 PM 4:40:51 PM R-postCC+ S-+ Examination Edit 4:43:07 PM 4:43:13 PM Exposing the specimen Institution: Unicom//C8DC3-742 ... R-SPEC InSpect spec InSpect Please insert Specimen cup according to the side indicated on stand display. 63.0 mAs - Name Patient Attach inspect box on the right side. R 5.9 R -5.9 Tools Scroll Qptions Help 4:46:42 PM Scale 346% o.p. mAs: 63.0 mAs Thickness: 64 mm Entrance Dose: 0.0 mGy Glandular Dose: 0.00 mGy kV: 23 63.0 mAS ml Skip EndExam Transfer Rules Open Scheduler Examination successfully ended. Automatic movement is disabled. Please remove the needle holder 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. 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