myNeedle Guide 2D Workflow Video - Part 1 (USA)

Welcome to the first part of the My Needle Guide 2D Workflow video. The software solution my needle Guide is part of my needle companion, a newly designed hardware and software package dedicated to CT interventional procedures such as biopsies or pain therapy treatments. My needle guide automatically displays the acquired intervention scans on the application monitor in the control room and in the examination room in a synchronized way. In addition, the acquired images are also displayed on the tablet, allowing you to interact with the images inside the examination room, for example, to monitor the movement of the surgical instrument to avoid injuries of sensitive structures such as vessels or nerves. The two D workflow is a basic implant procedure of my needle companion. In this video we will introduce to you how to prepare the required hardware components and how to perform the mind needle guide 2D workflow step by step at the acquisition workplace in the control room in Part 2 of the video we will explain to you how to perform the mind needle guide 2D mobile workflow with the iPad. Let's start with the hardware component preparation. 1st and in addition to the examination monitor, you need to have a second monitor in the control room, also called application monitor. It is connected to the console to display the mind Needle guide application. It allows you to view the acquired images on the screen, plan the needle path, interact with images and track the progress of the needle during the intervention. Now let's take a look at the required hardware components in the examination room. For the examination room an I joystick is available which provides controls to move the table. It can be mounted on the side rail on either side of the table. To do this, move the joystick sideways horizontally onto the rail and slightly downward. To remove the joystick, again, move it slightly upwards and sideways, horizontally away from the rail. Press the power on off key to switch on or off the joystick. In addition, a tablet dock is available to mount the tablet on the table. Mount the dock to the side rail of the patient table. With a cable connected to the joystick, you can charge the tablet on the dock while inserting the plug the black arrow marking has to be aligned with the black marking on the socket in order to fit in. To be able to control the most important intervention functionalities inside the examination room, an iPad is needed. If necessary, you can put the tablet in a sterile cover before mounting it on the tablet dock. You can place the iPad on the dock and adjust its height and angulation. If you don't want to use the tablet dock, you can also mount the iPad on the gantry. For the examination room, we also provide an in room monitor. It enables you to view and verify the acquired images, including measurements in the examination room, the in room monitor mirrors the second monitor of the console in the control room. Like this, a synchronized workflow is possible between the radiologist in the examination room and the tech at the console. Position. The in room monitor so that it is fully visible from the position of the operator. Now that we have the CT accessories prepared, we can start the my needle guide 2D workflow from the console in the control room on the examination monitor. First, register a patient as usual. Then select a desired intervention scan protocol. In a dedicated folder, 3 factory protocols are available for interventional procedures. After selecting one of the intervention protocols, the My Needle Guide application opens on the second monitor. In our 2D workflow, A3 segment layout is displayed by default. Other layouts are available. We will use an intervention phantom for this demonstration that is correctly placed on the table. We can now perform A to scan. In our 2D workflow, a regular diagnostic spiral range can always be used for needle path planning, which is already included in the factory protocol. If required, adapt the scan and Recon parameters for the spiral planning range in the SCAN task, perform the spiral planning range. The reconstructed axial planning images are not automatically loaded into my needle guide on the second monitor. For this reason, an important manual step needs to be performed on the second monitor. Select the Target segment on the My Needle Guide user interface. Then open the patient browser on the second monitor there right click the desired planning series and select load into my needle guide. In the context menu. The series is loaded into the target segment and all connected synchronized additional segments. Now before we go ahead with the next workflow step, let's go a little deeper into the functionality of the Mind Needle guide application on the user interface. The mind needle guide workflow header provides workflow controls, settings, man tools to plan a needle path on the first line of the header. You have the tools and objects menu where you can find many useful tools you can select which of them are important to the workflow and add them to your favourites to do so. Right click the icon and select add to favourites. Here for example we have already toggle through windowing presets, add distance measurement, save snapshot of selected segment, show hide laser crosshair and add angle measurement. A favorite tools can also be removed by right clicking them. On the second line of the header, we have the workflow steps the my needle guide 2D workflow is just a one step workflow named define path. Here we have the ad needle path function that we will use shortly. The next two icons represent change color and opacity and delete selected needle path by clicking this icon you can switch to the in Plainview needle oriented view in case of axial views you can directly jump into the slice containing the entry points of the selected needle path. Last but not least, there are two move buttons to define the target position for table movement, which can be triggered by the move key on the control box. Move to last scan position and move to selected axial slice position. Now we're all set for the next workflow step. The planning of a needle path. Click the add needle path icon on the workflow header. Please note the first click point defines your target, the second click the entry point for the needle. This order can be changed in the configuration if needed in the center segment, scroll through the images and find the lesion where you want to do a biopsy. Click one time to define the target point. Then drag the line like a rubber band. And click a second time somewhere on the skin to define the needle entry point. As a result on the label you can see the length of the needle, the X angle, which is the angle inside the axial scan played as well as the angle which is always zero when you draw a needle path in the same axial plane. You can even change the color of the needle path by clicking this button. And by clicking the recycle bin icon, you can delete a selected needle path. If you randomly scroll to some other images, you can always click the switch to the in Plainview needle oriented view icon to jump back to the slice containing the entry points of the needle path. To locate the needle entry point, the next step is to measure the distance between the entry points and the centerline which corresponds to the central gantry. Positioning laser laser light marker switch on the laser crosshair. By clicking the corresponding icon if needed. Then click add distance measurement on the workflow header and a sub task relevant to this tool opens on top of the segments. By two clicks on the image only you can now define the distance on the sub task toolbar. There are functions like. Select all objects, delete objects, etc. Another aspect also relevant to the workflow is layout selection. If you would like to work with reference images, you can select the 2D plus reference layout from the layout gallery after selecting it and two additional smaller segments name reference get displayed to upload images to the reference segment, proceed in the same way as in step five. When loading planning images into the application, you can use them to visualize, for example pre study scans or the planning scan. Which can be helpful during the intervention. These additional segments allow full 2D functionality. Let's go back to the three segment layout and continue with the next step of the two D workflow you have already defined the needle path. Now you would like to go to the entry point for this, simply select the center segment and click the switch to the. In Plainview needle oriented view icon on the workflow header, the segment automatically jumps to the slice containing the entry point. On the workflow header, click the move to selected axial slice position icon. The system will then ask you to press the move button on the control box to move the table to the target position, which is now the slice position containing the planned needle entry point. The next steps of the two D workflow will be taken place in the examination room using the tablet to know how to proceed, please watch the mind needle guide 2D Workflow Part 2.

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