MAMMOMAT B.brilliant - Breast biopsy - Tomo biopsy (USA)

In this video you will get to know a typical TOMO biopsy examination. The examination is controlled at the workstation with preset examination parameters. For the TOMO synthesis biopsy examination, make sure that no needle holder is. Attached to the biopsy tower. You can only. Perform the Tomo Scout if the biopsy tower is in the home position before you start. The examination inform the patient about the procedure. Select the required biopsy procedure. In the. Popup select the appropriate. Response regarding the use of a spacer plate. You can check the examination parameters in the Acquisition subtask card. The projection view or PV icons on the Images subtask card represent all necessary exposures. Once enabled. For exposure, the 1st. PV icon will be. Yellow until. You have positioned the patient and compressed the. Breast 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 and 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 the 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 first projection is a Tomo Scout Exposure 3D Scout image. For Tomo Scouts, the needle holder must be removed and the needle driver unit must be returned to the home position. If you are unsure where the area of interest is located exactly, a 2D Scout image may be taken prior to the Tomo Scout. We will not show this step in this. Video Press. And hold. The exposure. Button As long as the signal is audible, the swivel arm moves automatically during the. Exposure There is a short delay. While the tomo images are reconstructed. Once they have appeared, scroll through the slices to check that the region 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 parameters. Then repeat the scout image. Click OK to confirm that the region of interest is in the targetable. Field of view once the scout exposure has been accepted by clicking. OK, the system automatically. Shows the first view of the TOMO biopsy. Next, you set the reference cross. All tools such as zooming, measuring, etc. Are deactivated, so you can start the reference point confirmation immediately. We recommend that you enlarge the image to position the reference point accurately. Right click in the image and select the Zoom from Point tool from the context menu. Magnify the image by clicking over the T reference point. When you left click the image double S in size, a right click will. Reduce the image size. Press Escape to exit the magnifying tool or deselect the tool in the image drop down menu. Click on the Plus icon to activate the reference point. Check the reference point. The reference point and reference crosshairs must be aligned. To move the crosshair, hover the mouse cursor over the cross. The icon changes to compass points. Click and drag the crosshair to align with the T reference point. Confirm the reference point with the Confirm selected target mark icon. The system checks if the reference point is set within a 1 centimeter tolerance range. After you have confirmed your reference point, the system takes you back to the slice of the Tomo stack where you clicked OK. If a 2D scout was taken prior to the Tomo scout, you may have to manually select the Tomo stack icon on the Biopsy subtask card. Next, you define the biopsy. Targets Mark the biopsy target point with a click on any of the tomo slices. You can scroll through the tomo stack before confirming the target. Choose the slice where the lesion is shown. Clearly the target point can only be placed in the tomo slices, not in the 2D scout image. The target point position is identified in the image by a marker cross. If necessary, reposition the target marker cross with the mouse select. The cross. With a left click and move the marker cross. A default needle is configured for the procedure that you selected at the start of the examination, the. Needle and needle holder can be changed in the acquisition subtask. Card If the target is reachable with the selected needle, the target crosses are yellow. In a TOMO biopsy, the targeting box is a dotted line indicating the perimeter of the biopsy volume. The line is visible when the selected needle can reach the target. If this line is not visible, a different needle can be selected on the acquisition subtask card. If the targeting box appears, it indicates that the newly selected needle can reach the target. In our example, we use an Encore 10 gauge vertical needle with a dedicated needle. Holder. With this setup we can select the pre fire and or post fire options. With the fire options you can check the accuracy of the target. Open the biopsy navigator to 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 in the biopsy navigator means that you are looking at the breast from behind the patient eye, from the chest to the nipple. If you toggle to the scout image with the arrow keys, you see the scout image viewed from the top. Click Confirm to confirm your target and to close the biopsy navigator or the scout. Click the Transmit Selected Target mark icon to transfer the targets to the system. The system drives to the transmitted coordinates. 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. Any automated movement is disabled when this light is green. To move the needle holder in this state. One of. The override buttons needs to be pressed while pressing a hand box button. 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 that the needle holder is at the transmitted target. Next, install the needle. Make sure that the needle is in the pre fire position 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. 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. Check that the needle tip is near your target. Fire the needle into the breast and sample the tissue with the vacuum biopsy system. If required, a post fire image can be acquired to confirm the location of the needle. Notch proximity to target mark. 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 15 62 47 2/9/20 12 2/9/2024 1002 100 1/1/19 4:55 40 20 10 34 30 27 23.0 1/1/1955: 2/9/202 284 46 146 19800719 48 5:02 MAMMOMAT B.brilliant Breast biopsy - Tomo biopsy SIEMENS Starting the examination Tomo Biopsy Procedure: Mammogram - bil PV sequence: Display M .: Except mag/spot Auto Expose OPDOSE 27 kV Adv Patient Transfer Examination PEP Connect Training2 Open patient Operator: Viewing Filming Acquisition Post processing Close patient Images cc mlo Collimation ongoing 60-69 mm 64 mm 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 27 kV - + 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 Tomo - bilateral Tomo + 2D Standard - bilateral Tomo + 2D PRIME - bilateral QC-raw Tomo QC-processed Tomo Mammogram - bilateral - PRIME Patient Transfer Biopsy Left Tomo + Needle: Calibration needle Auto Exp. InSpect Biopsy Tomo 28 kV Advanced spec IN WH AWS Is the spacer plate in use? Yes No CC N L-CC TOMO SC Edit Examination Edit View Image Tools Scroll Qptions Help Acquisition mode: IPPG: F1 Metal in Breast RPG: Premia1_Bi Spacer Plate Holder: Needle: Calibration Procedure: Biopsy Left Tomo + Stereo Calibration Examination Edit View Image Tools Scroll Options Help Positioning the patient CC Examination Edit Select potient Select procedure Please attach and remove needle OPCOMP TUBE Compression (N) Thickness (mm) der Compressing the breast Cc DE Select patient and procedure at workstation. Select patient MIN Tomo scout Standard Ne Scan (L-CC TOMO SC) is in progress ... Projection processing for L-CC TOMO SC is in progress ... 100% Help PREVIEW Please release the X-ray button after finished exposure 86.3 mAs 1.5 mGy -25 deg PEP Connect, Tomo Biopsy: 4:54:31 PM Scale 239% o.p. mAs: 3.5 mAs Thickness: 64 mm Entrance Dose: 0.3 mGy Glandular Dose: 0.06 mGy Station: XPAWSBB 3a Rainbowstreet Unicomn City District 91052 DE Reconstruction is in progress. 41% finished. OK Tools Scroll Qptions Help Comp. Force: 60 se: 0.06 mGy New Trainin KV: 28 L-postCC-+ ST Reconstruction of L-CC TOMO SC is in progress: storing volume ... Patient Transfer Examination Scale 274% o.p. mAs: 91.0 mA Angle: 0.0 Slice Thickness: 1.0 mm Slice Height: 64 mm of 64 mm Entrance Dose: 7.2 mGy Operator OX Y Z Need auto 1.0 mm PEP Connect, Tomo Biopsy Glandular Dose: 1 Focus: large # OX Y Z ht: 41 mm of 64 mm Transfer Examination Slice Height: 35 mm of 64 mm Operator. V: 28 Slice Height: 8 mm of 64 mm mages gle: 0.0 Image rejected Image rejected. You have to compress the breast first if you want to do an OPDOSE exposure Decomp Comp. Force: 6 Compression ongoing 29 kV 70-79 mm 71 mm 67 mm No image to display Y Z 90.3 mAs 4:55:53 PM mAs: 3.6 mAs p. Force: 54 N Station: X IP kV: 28 mAs: 95.0 mAs Comp. Force: 54 Slice Height: 67 mm of 67 mm mGy View mage Scale 239% o.p .: kV: Image accepted. Entrance Dose: 0.3 perator View Setting the reference cross T_PR L.CC S mAs: 3.6 mAS Comp. Force: 54 N 3a Rainbowstreet Unicorn City District 91052 DEL 66 mm Edit View Image ce Dose: 0.3 mGy Windowing Windowing on Selection Windowing on Succeeding Invert Reject InBD Values Home Window Magnify by 2.0 Minify by 0.5 Eit to Segment Zoom From Point Zoom/Pan Zoom/Pan on Selection Zoom/Pan on Series Zoom From Target Mark mAs: 3.6 mA 6 mAs Transfer Examination Edit View Image Tools Scroll Qptions Help 54 N Oper 1 000 Glandular Dose Comp. F Angle As: 3.6 Magn. Glandular Dose 0.06 mGy Station: XPAWSBB1 s: 3.6 mAs Esc Inver Home Zoom/Pan As: 3.6 mAs View Image Set Reference point. Examination Edit View Image PEP Connect, Tomo Biopsy mo Biopsy mAs: 95.0 mAsi Slice Height: 53 mm of 67 mm Tools mA Defining the biopsy targets Slice Height: 53 mm of 67 mm- Entrance Dose: 7 6 mGy 3a Rainbowstreet Unicorn City District 91052 DE Confirm . Force: 54 Comp. Force: 54 N. Tomo B eft Tomo + Stereo Transfer Examination Edit View Image Biopsy Navigator PA view Selecting the needle Needle Standard Ne Anode/F BD Magnum MN1416_Full_SLH_horz BD Magnum MN1416_Half_SH_vert BD_Magnum_MN1410_Full_SLH_horz Brevera_9G_L130_full_vert ATEC_9G_SH Brevera_9G_L130_half_vert Brevera_9G_L130_half_horz Encor_10G_SLNH_horz Encor_10G_SNH_vert Encor_10G_half_SLNH_horz Encor_10G_half_horz Encor_10G_horz Encor_10G_vert Encor Vert b 2:1 g Stereo 2:1 First view Ctrl+F3 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 X Biopsy Navigator 1.63 mGy Image ht: 48 mm of 67 mm Slice Height: 47 mm of 67 mn 46 mm of 67 m 1 R -2.2 23.0 46.0 Preparing for biopsy Force: 54 N Slice Height: 46 mm of 67 mm Entrance Dose 7 6 m Glandular Dose: 1. 1 R -2.2 23.0 46.0 ransmit selected target mark Will this needle and needle holder be used for the target in transmission: (Encor_10G_vert (Core/Vacuum core # OXY Edit View 23.0 46.0 Encor Encor The needle holder is moving to position. L-preCC-+ ST 10 mm 46 mm of 67 mm L-preCC-+ST Manual 63.5 mAs L-preCC+ S-+ 46.0 Encor Pre-fire exposure 1 R -2.2 23.0 46.0 Encor 23.0 46.0 E STOP 0 deg 48 N Image processing is in progress ... Examination Edit View Image Tools 4:59:59 PM Scale 174% o.p. to display Entrance Dose: 5.0 mGy Glandular Dose: 1.10 mGy 1.1 mGy Thickne ckness Saving processed image .. 5:00:04 PM 3a Rainbowstreet Unicom City Examination Edit View Image Tools Scroll Qptions Comp. Force 5.0 mGy 10 mG 3a Rainbowstreet Unicorn City . 23.0 4 1.10 m Station: XPAW ation: XPAW Filter Thick Glandular Dose: 3a Rainbowstreet Unic L-postCC+ S-+ 38 N Saving processed image ... 5:01:28 PM Entrance Dose: Exposing the specimen 5:01:34 PM 11 mGy 65 mm Entrance Dose: 5.0 L-SPEC InSpect Please insert Specimen cup according to the side indicated on stand display Scroll Qptions Help Entrance Dose: 5.0 mG Entrance Dose: 5.0 mcy Entrance Dose Glandular Dose: 1.1 FOCUS Name Patient Attach inspect box on the right side. 0.0 mGy 5:02:50 PM Scale 346% o.p. mAs: 63.0 mAS Thickness: 65 m Glandular Dose: 0.00 mGy 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. 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