ACUSON Origin 4D Volume Fundamentals Presentation

SIEMENS Healthineers ACUSON Origin Ultrasound System 4D Volume Imaging Fundamentals 1.0 software version Unrestricted © Siemens Healthineers 2023 Speaker Notes: The purpose of this presentation is to become familiar with 4D imaging fundamentals using the ACUSON Origin Ultrasound System. Notes No. 1 Definitions and descriptions SIEMENS ..... Healthineers' ... Three-dimensional (3D) surface or volume rendered (VR) image Three dimensions include: • Width (lateral) x • Depth (elevational) z • Height (axial) y Unit of display is a voxel Unrestricted © Siemens Healthineers 2023 Speaker Notes: In 3D echocardiography, a volumetric pyramid of data contains three dimensions. They are the x-axis or lateral direction; y-axis or axial direction; and z-axis or elevational direction. A 3D surface or volume rendered image is displayed as a still image, whereas a four-dimensional (4D) image is displayed as moving structure(s). In the next slide, we will further define 4D volume imaging. An example of a 3D surface image would be a “fetal face” ultrasound exam. In echocardiography, we utilize 4D volume imaging. The unit of display in 3D / 4D imaging is called a voxel, but it can also be known as a volumetric pixel. A voxel is a unit of graphic information that defines the x, y, z points in a three-dimensional space. Notes No. 2 Definitions and descriptions SIEMENS .... Healthineers ... Four-dimensional (4D) full volume rendered (VR) image Also referred to as “real-time” 3D imaging 18 CC 5Z1 • Cardiac or “Live 3D” TIS:0.43 MI:0.95 21.0vps 95% 4D H Mid 4D refers to the three imaging dimensions 3dB/DR55 • MPR of geometry: height, width, depth T5 Vol: T7 • The fourth dimension is time A B C Unrestricted © Siemens Healthineers 2023 Speaker Notes: Four-dimensional (4D) volume echocardiography is sometimes referred to as real-time three- dimensional (3D) imaging of the heart. In 3D imaging, temporal resolution is expressed in terms of volumes per second (VPS), similar to frame rate, or frames per second (FPS), for 2D imaging. During 4D image acquisition, VPS needs to be sufficiently high enough to evaluate the fast motion of anatomical structures. A 4D full volume rendered image, contains three dimensions such as lateral, elevational, and axial, but also includes time. In this slide example, we see the 4D volume image and the three multiplanar rendered (MPR) images labeled A, B and C. MPRs are reference planes extracted from the volume. In the next slide, we will review the MPRs in greater detail. Notes No. 3 Volume imaging planes SIEMENS .... Healthineers ... Multiplanar reconstruction (MPR) imaging Left-to-Right Front-to-Back 521 Cardiac TIS:0.42 MI:0.85 Y 9.8vps 95% 4D H Mid 1dB/DR55 Q Mid 20 Th15 Axial Op70 S2 Br-8 Lateral A B Con50 MPR: MapD/T5 Vol: X MapE/T7 2 Elevational C Top-to-Bottom 81bpm Lead Il Unrestricted © Siemens Healthineers 2023 Speaker Notes: As previously mentioned, a volume image consists of three dimensions: lateral, elevational and axial. In the volume image dataset seen here, the first imaging plane in the box labeled A is the “Home” view in traditional 2D imaging. It is called the lateral plane, or “x” plane. The lateral plane allows the user to manipulate the width of the dataset from left-to-right. In the next box labeled B is the elevation plane, or “z” plane. This plane allows the user to manipulate the depth of a volume dataset from front-to-back. Finally, the axial plane, or “y” plane, is seen in the box labeled C. Here, the user can manipulate the height of the dataset from top-to-bottom. The axial plane displays the cross section of the lateral and elevational planes at the same time. Manipulating a colored axis marker changes the corresponding-colored plane. NOTE: The volume dataset displayed above is in a quad format, but it should be noted that multiple display layout options are available. Notes No. 4 X Y Z rotation controls SIEMENS. Healthineers ... Y Axial PW 2D Lateral CW X Update x ... x Measure Elevational Unrestricted © Siemens Healthineers 2023 Speaker Notes: On the ACUSON Origin ultrasound system, manipulation of the 4D volume dataset can be performed directly by utilizing X, Y, Z located on the control panel. Volume datasets can be manipulated or rotated during live imaging or 4D review. The user can rotate around the x-axis, with the “X” rotary control. The “Y” rotary control rotates the volume around the y-axis. Finally, if manipulation of the elevational plane or the z-axis is desired, the “Z” rotate spins the volume dataset. Notes No. 5 Axis marker manipulation icons SIEMENS. Healthineers ... Pan tool • Place cursor over area in orange • Allows panning of reference area center point Pan tool (single axis marker) • Place cursor over area in orange • Allows single axis marker PAN up/down, right/left Z Rotation tool (axis markers) • Place cursor over area in orange • Allows Z axis rotation of axis markers Unrestricted © Siemens Healthineers 2023 Speaker Notes: In this slide, let’s review the axis marker rotation and manipulation icons available on multiplanar rendered images (MPR’s). The Pan tool allows for repositioning along the reference lines. Both axis markers moved together within an MPR realigns the axis marker center point. Single axis marker movement can be performed repositioning the reference line up and down, or left and right. The Z rotation icon rotates the reference plane around the reference line. Notes No. 6 MPR Manipulation SIEMENS ..... Healthineers ... How-to-video • Axis markers stay hidden; tail is visible 70 9 5Z1 Cardiac TIS:0.43 MI:0.90 • Hover cursor over axis marker to show 16.3vps 95% • Press set key to select marker for movement 4D H Mid -4dB/DR65 Rotate / slide axis marker to desired position Q Mid • 20 Th15 and select set key to place Op70 S2 Br-8 Lock or unlock axis markers using touch Con50 • MPR: screen controls MapD/T5 Vol: MapE/T7 MPR Lock Lock Bi-Plane Unlocked Lock All Lock Bi-Plane Unrestricted © Siemens Healthineers 2022 Unrestricted © Siemens Healthineers 2023 Speaker Notes: In this release of the ACUSON Origin ultrasound system, note how the axis markers stay hidden until the user hovers over it for selection and manipulation. The axis marker tail stays visible at the end of each line. To reposition axis marker alignment, hover over the desired marker line. If markers are locked, hovering over the intersection of the MPR axis markers and pressing the set key enables repositioning of the center point. If axis markers are unlocked, the user may slide an individual marker line up / down or left / right. Hovering over an end point of the axis line enables rotation of the axis markers. Notes No. 7 Volume acquisition SIEMENS .... Healthineers ... • Optimal 2D imaging is essential to a 5Z1 Cardiac TIS:0.43 quality volume acquisition MI:0.93 15.3vps 95% 4D H Mid 2dB/DR65 • Prior to acquisition it’s important to Q Mid 20 Th15 evaluate all three reference planes for Op70 boundaries Br-8 Con50 MPR: MapD/T5 Vol: MapE/T7 • Alignment is important for assessment of specific anatomy Unrestricted © Siemens Healthineers 2023 Speaker Notes: 4D image quality is a reflection of the two-dimensional (2D) image quality. Thus, it’s essential to begin with the best 2D image possible. If the 2D image is not appropriately optimized, then the 4D image could be clinically nondiagnostic. Prior to acquisition it’s important to evaluate the multiplanar rendered (MPR’s) imaging planes to ensure areas of interest remain within the field-of-view. To adjust the MPR’s, the user can adjust the axis markers within each plane. It’s best to adjust the axis markers in the lateral and elevational planes. Use the axial plane for reference as it displays both the lateral and elevational plane simultaneously. In this example, the axis markers are aligned through the apex of the left ventricle in both the lateral and elevational planes. Notes No. 8 2D image optimization tools SIEMENS Healthineers ... UltraArt – auto speckle reduction algorithm DR (Dynamic Range) – range between • • Auto TEQ (Tissue Equalization Technology) – minimum and maximum signal intensity • auto B-mode optimization for image displayed • uniformity Increasing dynamic range can bring more information into image balanced with • Frequency & Harmonics lowering dynamic range to clean up noise • Lower frequency for penetration • Persist – frame averaging to smooth image • Higher frequency for detail resolution • Map • Gain • Harmonics reduce artifact and improve • Tint • TGC resolution • Line Density – adjusts number of scan lines Unrestricted © Siemens Healthineers 2023 Speaker Notes: 2D image optimization tools available on the ACUSON Origin ultrasound system are: • UltraArt – auto speckle reduction algorithm that allows the user to select preferred image parameters by choosing from one of four imaging options displayed on the touch screen • Auto TEQ (Tissue Equalization Technology) – auto B-mode optimization for image uniformity • Frequency • Lower frequencies have less resolution but greater penetration • Higher frequencies have better resolution but less penetration • Harmonics – reduces artifacts and improves image resolution • Line Density – adjusts number of scan lines • Increasing dynamic range can bring more information into the image balanced with lowering the dynamic range to clean up noise • DR (Dynamic Range) – range between minimum and maximum signal intensity displayed • Higher DR > means higher gray scale levels > means higher detail resolution • Persistence – frame averaging to smooth image • Map – change levels of B-mode gray scale • Tint – change B-mode color • Gain – uniform amplification of signal returning to the transducer • TGC – (time gain compensation) amplify signal gain at distances to compensate for attenuation Notes No. 9 4D image optimization tools SIEMENS. Healthineers ... UltraArt – auto speckle reduction algorithm DR (Dynamic Range) – range between • • Auto TEQ (Tissue Equalization Technology) – minimum and maximum signal intensity • auto B-mode optimization for image displayed • uniformity Increasing dynamic range can bring more information into image balanced with • Frequency & Harmonics lowering dynamic range to clean up noise • Line Density – adjusts number of scan lines • Map • Gain • Tint • TGC • Volume Enhance • C Vol Enhance • Priority Unrestricted © Siemens Healthineers 2023 Speaker Notes: 4D image optimization tools available on the ACUSON Origin ultrasound system are the same as 2D optimization features, but additionally provides volume enhancement for 4D B-mode and color volume enhancement for 4D color Doppler. • UltraArt – auto speckle reduction algorithm • Auto TEQ (Tissue Equalization Technology) – auto B-mode optimization for image uniformity • Frequency • Lower frequencies have less resolution but greater penetration • Higher frequencies have better resolution but less penetration • Harmonics – reduces artifacts and improves image resolution • Line Density – adjusts number of scan lines • Higher line density is more scan lines > better image resolution > lower frame rates • Lower line density is less scan lines > decrease image resolution > increase frame rates • DR (Dynamic Range) – range between minimum and maximum signal intensity displayed • Increasing dynamic range can bring more information into image balanced with lowering dynamic range to clean up noise • Map – change levels of B-mode gray scale • Tint – change B-mode color • Gain– uniform amplification of signal returning to the transducer • TGC – (time gain compensation) amplify signal gain at distances to compensate for attenuation • Volume Enhance – setting available from 0 to 5, where 0 is no enhancement and 5 is the most • C Vol Enhance – setting available from 0 to 3, where 0 is no enhancement and 3 is the most • Priority – available in color Doppler volume imagine; determines if B-mode or color Doppler will display when occupying the same voxel (lower priority means more B-mode and less color) Notes No. 10 Volume acquisition SIEMENS . Healthineers ... Optimize the 2D image 1. Press 4D • Further optimize 4D image as needed 1 Update 2. To acquire a volume, select 2 Capture key Tip: Ensure entire chambers are in field of view and have patient perform a breath hold to reduce motion of the heart. 11 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Once the desired image has been identified and properly optimized, press 4D on the control panel and further optimize the 4D image as needed. Next, select the Capture key on the control panel to obtain a full volume data acquisition. Tip: Before clip capture, ensure the entire cardiac chambers are in the field of view and have the patient perform a breath hold to reduce motion of the heart. Notes No. 11 4D touch screen layout (page 1) SIEMENS Healthineers ... 5Z1 transducer 9F AN @ Lumos S OP Z6T 5Z1 Cardiac X CW2 Workflow Patient 4D Physio Imaging Multislice MPR Loc Review Lock Bi-Plane Report Reset Orientation Reset Cropping A B C Sync MPR A Sync MPR B Sync MPR C End Exam Bi-Plane+ MPR Lines Auto TEQ Cut Plane 3D Caliper × Harmonics Single V 4D Zoom Capture Type Prospective Frequency Line Density DR Size Position Clip Capture H Mid Mid 55 dB Vol Lat Elev Lat Elev Beats Sec Unrestricted © Siemens Healthineers 2023 Speaker Notes: Page 1 of the 4D touch screen layout for soft keys in live imaging with the 5Z1 transducer includes controls for: Frequency: Mid, H Mid (harmonics reduces VPS) Line Density: Low, Mid, High (lower line densities increases VPS) Dynamic Range (DR): 10 dB to 80 dB Size: enables changing the volume size for both the lateral and elevational planes (Vol), or the lateral (Lat) and elevational (Elev) planes separately Position: enables moving the volume position for the lateral (Lat) and elevational (Elev) planes Clip Capture: 1 to 8 beats, or 1 to 10 seconds Notes No. 12 4D touch screen layout (page 2) SIEMENS Healthineers ... 5Z1 transducer 9F AN @ Lumos S OP Z6T 5Z1 Cardiac X CW2 Workflow Patient 4D Physio Imaging L/R Flip UID Flip Review Report Reset Orientation Reset Cropping End Exam Free Plane Volume Enhance 2 X Cut Plane Wireframe MPR Thickness Maps Tint O MPR Vol MPR Vol Unrestricted © Siemens Healthineers 2023 Speaker Notes: Page 2 of the 4D touch screen layout in live imaging with the 5Z1 transducer includes controls for: Reset Orientation: resets the volume orientation to native state Reset Cropping: resets volume cropping to native state L/R Flip: flips the image from left to right U/D Flip: flips the image up and down Volume Enhance: 0 to 5 Cut Plane Wireframe: toggles the wireframe around the volume off and on (when orange, the wireframe around the volume rendering is visible and the wireframe is the color of the MPR the volume is synched to) MPR Thickness: 0 to 20 Maps MPR: adjusts the map of all three MPRs; maps available are A to G Maps Vol: only adjust the map of the volume rendering; maps available are A to F Tint MPR: adjusts the tint of all three MPRs; tints available are 1 to 11 Tint Vol: only adjusts the tint of the volume rendering; tints available are 1 to 10 Notes No. 13 4D color Doppler touch screen layout (page 1) SIEMENS Healthineers ... 5Z1 transducer Lumos ST 5Z1 Cardiac x CW2 Workflow Patient 4D Color (4D) Physio Imaging MPR Loc Review Lock Bi-Plane Report Reset Orientation Reset Cropping A B C Sync MPR A Sync Sync MPR B MPR C End Exam 2D + Color 2D Only Color Only Color Crop MPR Lines Cut Plane × Single V 4D Zoom Frequency Scale Baseline CROI Size CROI Position Filter Mid Lat Elev Axial Lat Elev Axial Unrestricted © Siemens Healthineers 2023 Speaker Notes: Page 1 of the Color 4D touch screen layout for soft keys in live imaging with the 5Z1 transducer includes controls for: Frequency: Low, Mid, High Scale: adjusts color Doppler scale Baseline: shifts the color Doppler baseline up and down C ROI Size: enables changing the color region of interest box size for the lateral, elevational, or axial planes C ROI Position: enables moving the color region of interest box position for the lateral, elevational, or axial planes Filter: 1, 2, 3, 4 Notes No. 14 4D color Doppler touch screen layout (page 2) SIEMENS Healthineers ... 5Z1 transducer Lumos ST OP ZET 5Z1 Cardiac X CW2 Workflow Patient 4D Color (4D) Physio Imaging Review Report Reset Orientation Reset Cropping End Exam C Vol Enhance 1 × Smooth Line Density Priority Maps 2 MPR Vol Unrestricted © Siemens Healthineers 2023 Speaker Notes: Page 2 of the Color 4D touch screen layout in live imaging with the 5Z1 transducer includes controls for: Reset Orientation: resets the volume orientation to native state Reset Cropping: resets volume cropping to native state C Vol Enhance: 0, 1, 2, 3 Smooth: 1, 2, 3, 4 Line Density: 1, 2 Priority: 1, 2, 3, 4 Maps MPR: A thru J Maps Vol: A thru J Notes No. 15 4D touch screen layout (page 1) SIEMENS Healthineers ... Z6T transesophageal transducer Lumos ST Z6T 5Z1 X CW2 Cardiac Workflow Patient 4D Physio Imaging Mitral Valve Multislice MPR Loc Review Lock Bi-Plane Report Reset Orientation Reset Cropping A B C Sync MPR A Sync MPR B Sync MPR C End Exam Bi-Plane+ MPR Lines Auto TEQ Cut Plane 3D Caliper × Single V 4D Zoom Capture Type Prospective Frequency Line Density DR Size Position Clip Capture Mid Mid 60 dB Vol Lat Elev Lat Elev Beats Sec Unrestricted © Siemens Healthineers 2023 Speaker Notes: Page 1 of the 4D touch screen layout for soft keys in live imaging with the Z6T transducer includes controls for: Frequency: Mid Line Density: Low, Mid, High (lower line densities increases VPS) Dynamic Range (DR): 10 dB to 80 dB Size: enables changing the volume size for both the lateral and elevational planes (Vol), or the lateral (Lat) and elevational (Elev) planes separately Position: enables moving the volume position for the lateral (Lat) and elevational (Elev) planes Clip Capture: 1 to 8 beats, or 1 to 10 seconds Mitral Valve: quick crop tool available with 4D TEE imaging that automatically synchronizes to reference place C, and the volume is automatically oriented with the mitral valve aligned to the “surgeon’s view” Notes No. 16 4D touch screen layout (page 2) SIEMENS Healthineers ... Z6T transesophageal transducer 9F AN @ Lumos S 26T 5Z1 Cardiac X CW2 Workflow Patient 4D Physio Imaging L/R Flip UID Flip Cool Down Review Report Reset Orientation Reset Cropping End Exam Free Plane Volume Enhance 1 X Cut Plane Wireframe MPR Thickness Maps Tint O MPR Vol 8 MPR Vol Unrestricted © Siemens Healthineers 2023 Speaker Notes: Page 2 of the 4D touch screen layout in live imaging with the Z6T transducer includes controls for: Reset Orientation: resets the volume orientation to native state Reset Cropping: resets volume cropping to native state L/R Flip: flips the image from left to right U/D Flip: flips the image up and down Cool Down: selection to enable cool down of the transducer by lowering the transmit power Volume Enhance: 0 to 5 Cut Plane Wireframe: toggles the wireframe around the volume off and on (when orange, the wireframe around the volume rendering is visible and the wireframe is the color of the MPR the volume is synched to) MPR Thickness: 0 to 20 Maps MPR: A to G Maps Vol: A to F Tint MPR: 1 to 11 Tint Vol: 1 to 10 Notes No. 17 4D color Doppler touch screen layout (page 1) SIEMENS Healthineers ... Z6T transesophageal transducer 0 0 9FAN Lumos ST 26T 5Z1 CW2 Cardiac X Workflow Patient 4D Color (4D) Physio Imaging Mitral Valve MPR Loc Review Lock Bi-Plane Report Reset Orientation Reset Cropping A B C Sync MPR A Sync Sync MPR B MPR C End Exam 2D + Color 2D Only Color Only Bi-Plane+ Color Crop MPR Lines Cut Plane × Single V 4D Zoom Frequency Scale Baseline C ROI Size CROI Position Filter Low Lat Elev Axial Lat Elev Axial Unrestricted © Siemens Healthineers 2023 Speaker Notes: Page 1 of the Color 4D touch screen layout for soft keys in live imaging with the 5Z1 transducer includes controls for: Frequency: Low, Mid Scale: adjusts color Doppler scale Baseline: shifts the color Doppler baseline up and down C ROI Size: enables changing the color region of interest box size for the lateral, elevational, or axial planes C ROI Position: enables moving the color region of interest box position for the lateral, elevational, or axial planes Filter: 1, 2, 3, 4 Mitral Valve: quick crop tool available with 4D TEE imaging that automatically synchronizes to reference place C, and the volume is automatically oriented with the mitral valve aligned to the “surgeon’s view” Notes No. 18 4D color Doppler touch screen layout (page 2) SIEMENS Healthineers ... Z6T transesophageal transducer 9F AN Lumos ST 46T 5Z1 Cardiac X CW2 Workflow Patient 4D Color (4D) Physio Imaging Review Report Reset Orientation Reset Cropping End Exam C Vol Enhance O × Smooth Line Density Priority Maps 2 D MPR Vol Unrestricted © Siemens Healthineers 2023 Speaker Notes: Page 2 of the Color 4D touch screen layout in live imaging with the 5Z1 transducer includes controls for: Reset Orientation: resets the volume orientation to native state Reset Cropping: resets volume cropping to native state C Vol Enhance: 0, 1, 2, 3 Smooth: 1, 2, 3, 4 Line Density: 1, 2, 3 Priority: 1, 2, 3, 4 Maps MPR: A thru J Maps Vol: A thru J Notes No. 19 4D touch screen layout (page 1) SIEMENS Healthineers AcuNav Lumos 4D ICE ultrasound catheter 5V1 Lumos 5Z1 Intracardiac X CW2 Workflow Patient 4D Physio Imaging En Face Multislice MPR Loc Review Lock Bi-Plane Report Reset Orientation Reset Cropping A B C sync MPR A Sync MPR B Sync MPR C End Exam Bi-Plane MPR Lines Auto TEQ Cut Plane 3D Caliper × Harmonics Single V Frequency Line Density DR Size Position Clip Capture Mid Mid 60 dB Vol Lat Elev Lat Elev Beats Sec Unrestricted © Siemens Healthineers 2023 Speaker Notes: Page 1 of the 4D touch screen layout for soft keys in live imaging with AcuNav Lumos 4D ICE catheter includes controls for: Frequency: Low, Mid, High, Harmonics High Line Density: Low, Mid, High (lower line densities increases VPS) Dynamic Range (DR): 10 dB to 80 dB Size: enables changing the volume size for both the lateral and elevational planes (Vol), or the lateral (Lat) and elevational (Elev) planes separately Position: enables moving the volume position for the lateral (Lat) and elevational (Elev) planes Clip Capture: 1 to 8 beats, or 1 to 10 seconds En Face: quick crop tool available with 4D ICE imaging that provides quick orientation and rotates the volume facing forward auto aligned to the C plane Notes No. 20 4D touch screen layout (page 2) SIEMENS Healthineers ... AcuNav Lumos 4D ICE catheter 5V1 Lumos 5Z1 Intracardiac X CW2 Workflow Patient 4D Physio Imaging L/R Flip UID Flip Review Report Reset Orientation Reset Cropping End Exam Free Plane Volume Enhance 3 X Cut Plane Wireframe MPR Thickness Maps Tint O MPR Vol 8 MPR Vol Unrestricted © Siemens Healthineers 2023 Speaker Notes: Page 2 of the 4D touch screen layout in live imaging with AcuNav Lumos 4D ICE catheter includes controls for: Reset Orientation: resets the volume orientation to native state Reset Cropping: resets volume cropping to native state L/R Flip: flips the image from left to right U/D Flip: flips the image up and down Volume Enhance: 0 to 5 Cut Plane Wireframe: toggles the wireframe around the volume off and on (when orange, the wireframe around the volume rendering is visible and the wireframe is the color of the MPR the volume is synched to) MPR Thickness: 0 to 20 Maps MPR: A thru G Maps Vol: A thru F Tint MPR: 1 to 11 Tint Vol: 1 to 10 Notes No. 21 4D color Doppler touch screen layout (page 1) SIEMENS Healthineers AcuNav Lumos 4D ICE catheter 5V1 Lumos Intracardiac OP Z6T 5Z1 X CW2 Workflow Patient 4D Color (4D) Physio Imaging En Face MPR Loc Review Lock Bi-Plane Report Reset Orientation Reset Cropping A B C Sync MPR A Sync Sync MPR B MPR C End Exam 2D + Color 2D Only Color Only Bi-Plane Color Crop Cut Plane × Single V Frequency Scale Baseline ROI Size CROI Position Filter Low Lat Elev Axial Lat Elev Axial Unrestricted © Siemens Healthineers 2023 Speaker Notes: Page 1 of the Color 4D touch screen layout for soft keys in live imaging with AcuNav Lumos 4D ICE catheter includes controls for: Frequency: Low, High Scale: adjusts color Doppler scale Baseline: shifts the color Doppler baseline up and down C ROI Size: enables changing the color region of interest box size for the lateral, elevational, or axial planes C ROI Position: enables moving the color region of interest box position for the lateral, elevational, or axial planes Filter: 1, 2, 3, 4 En Face: quick crop tool available with 4D ICE imaging that provides quick orientation and rotates the volume facing forward auto aligned to the C plane Notes No. 22 4D color Doppler touch screen layout (page 2) SIEMENS Healthineers ... AcuNav Lumos 4D ICE catheter 5V1 Lumos Intracardiac OP Z6T 5Z1 X CW2 Workflow Patient 4D Color (4D) Physio Imaging L/R Flip UID Flip Review Report Reset Orientation Reset Cropping End Exam C Vol Enhance O X Cut Plane Wireframe Line Density Priority CROI Size Maps Lat Elev Axial MPR Vol Unrestricted © Siemens Healthineers 2023 Speaker Notes: Page 2 of the Color 4D touch screen layout in live imaging with AcuNav Lumos 4D ICE catheter includes controls for: Reset Orientation: resets the volume orientation to native state Reset Cropping: resets volume cropping to native state L/R Flip: flips the image from left to right U/D Flip: flips the image up and down C Vol Enhance: 0, 1, 2, 3, 4 Cut Plane Wireframe: toggles the wireframe around the volume off and on (when orange, the wireframe around the volume rendering is visible and the wireframe is the color of the MPR the volume is synched to) Line Density: 1, 2 Priority: 1, 2, 3, 4 Maps MPR: A thru G Maps Vol: A thru G Notes No. 23 4D imaging layouts – A B C planes & volume SIEMENS ... Healthineers' ... 5Z1 & Z6T transducers 18 5Z1 Cardiac TIS:0.43 MI:0.95 21.0vps Review Multislice 95% 4D Report eset Orientation Reset Cropping MARC H Mid End Exam 3dB/DR55 MPR: MPR Lines T5 Vol: Free Plane Cut Plane 30 Caliper T7 4D Heart " Right Margin 00 A B 100% Fr11 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The following display option layouts are available in 4D volume imaging with both the 5Z1 and Z6T transducers. The display options are available during real-time imaging, and during post-processing in review. The A, B, and C planes correspond to the three different imaging planes that compose a volume image: • A plane – lateral plane (red) • B plane – elevational plane (green) • C plane – axial plane (blue) This layout is best used to ensure entire structures of interest are included in a volume for visualization and analysis. It’s also the best way to confirm that all color Doppler is captured within the region of interest. For example, if focusing on a regurgitant valve, the color Doppler region of interest (ROI) is adjusted in the A (azimuthal) and B (elevational) planes. The C (axial) plane is the only plane that simultaneously displays both the A and B planes to ensure that the color Doppler is not being cut off in any location. Notes No. 24 4D imaging layouts – A B C planes & volume SIEMENS ... Healthineers' ... 5Z1 & Z6T transducers 18 5Z1 Cardiac TIS:0.43 MI:0.95 MPR Lock 21.0vps Multislice 95% 4D Report eset Orientation Reset Cropping H Mid End Exam 3dB/DR55 MPR: MPR Lines T5 Vol: T7 Free Plane Out Mane 30 Caliper Single v AD Heart " Right Margin 00 A B C 00% Fr11 Unrestricted © Siemens Healthineers 2022 Speaker Notes: This is an example of the A, B and C planes with a smaller volume rendering when compared to the previous slide. This layout is also useful to ensure entire structures of interest are included in a volume for visualization and analysis. Notes No. 25 4D imaging layouts – A B planes & volume SIEMENS ... Healthineers' ... 5Z1 & Z6T transducers 18 5Z1 Cardiac Review TIS:0.43 MI:0.95 21.0vps Review Multislice 95% 4D Repert set Orientation Reset Cropping MPRA MARC H Mid End Exam 3dB/DR55 MPR: MPR Lines T5 Vol: T7 Free Plane Cut Mane 30 Cafper Single V AD Heart " Right Margin Ss a OC 00 A B C 00% Fr11 Unrestricted © Siemens Healthineers 2022 Speaker Notes: This image layout displays the A and B plane with the volume below. This can be useful when focusing on a particular structure. The orthogonal 2D planes can be used to adjust the axis markers within the MPRs. Notes No. 26 4D imaging layouts – A B planes & volume SIEMENS .... Healthineers' ... 5Z1 & Z6T transducers 18 5Z1 Cardiac TIS:0.43 MI:0.95 21.0vps Review Multislice 95% 4D Repert set Orientation Reset Cropping MPRA MORE MARC H Mid End Exam 3dB/DR55 MPR MPR Lines T5 Vol: Free Plane Cut Plane 30 Caliper T7 Single V 4D Heart " Right Margin Ss ds 00 A B C 100% Fr11 Unrestricted © Siemens Healthineers 2022 Speaker Notes: This image layout displays the A and B plane with a larger volume image to the right when compared to the previous slide. This can be useful when focusing on a particular structure. The orthogonal 2D planes can be used to adjust the axis markers within the MPRs. Notes No. 27 4D imaging layouts – A plane SIEMENS .... Healthineers' ... 5Z1 & Z6T transducers 18 5Z1 Cardiac TIS:0.43 MI:0.95 Multislice 21.0vps Review 95% 4D Report H Mid End Exam 3dB/DR55 MPR: Vol: 30 Calper AD Heart " Loft Margin Right Margin 00 A B C 100% Fr11 Unrestricted © Siemens Healthineers 2022 Speaker Notes: This option displays only the lateral A plane. Notes No. 28 4D imaging layouts – B plane SIEMENS ... Healthineers' ... 5Z1 & Z6T transducers 18 5Z1 Cardiac TIS:0.43 MI:0.95 21.0vps Review Multislice 95% 4D Report H Mid End Exam 3dB/DR55 MPR: T5 Vol: 30 Caliper T7 AD Heart " Right Maigin A B C 100% Fr11 Unrestricted © Siemens Healthineers 2022 Speaker Notes: This option displays only the elevational B plane. Notes No. 29 4D imaging layouts – C plane SIEMENS .... Healthineers' ... 5Z1 & Z6T transducers 18 5Z1 Cardiac TIS:0.43 MI:0.95 21.0vps Review Multislice 95% 4D Report H Mid End Exam 3dB/DR55 MPR: T5 Vol: 30 Cafper T7 AD Heart " Right Margin SS ds A B C 100% Fr11 Unrestricted © Siemens Healthineers 2022 Speaker Notes: This option displays only the axial C plane. Notes No. 30 4D imaging layouts – volume rendering SIEMENS .... Healthineers' ... 5Z1 & Z6T transducers 18 5Z1 Cardiac TIS:0.43 MI:0.95 21.0vps Review Multislice 95% 4D Report eset Orientation Reset Cropping MIRA MARC H Mid End Exam 3dB/DR55 MPR: MPR Lines T5 Vol: Free Plane T7 Cut Plan 30 Cafper Single V 4D Heart Right Margin SS de 00 A B C 100% Fr11 Unrestricted © Siemens Healthineers 2022 Speaker Notes: This option displays only the volume rendering. Notes No. 31 4D imaging layout options SIEMENS ..... Healthineers ... Lumos volume ICE catheter Intracardio 521 CW2 Workflow Patient Physio Imaging En Face Multislice MPR Lock Lock Bi-Plane Review Report Reset Orientation Leset Cropping A MPRA MPR B End Exam Bi-Plane MPR Lines . Auto TEQ Cut Plane 30 Caliper Harmonics Single V Frequency Line Dens Position Clip Capture A B C Mid Lat Una Beats Sec Unrestricted © Siemens Healthineers 2022 Speaker Notes: These are the 4D display layout options available when performing 4D imaging with the ACUSON Lumos Volume ICE catheter. Notes No. 32 Sync tool - MPR A SIEMENS ..... Healthineers ... Selecting Sync MPR A on touch screen synchronizes volume to reference plane A reference plane 14 76T: 39.0ºC Cardiac Review TIS:0.43 MI:0 80 30.5vps 95% 4D Color (4D) Review 4D Mid 3dB/DR60 Multislice MPR Lock MPR Mitral Valve Lock Bi-Plane T5 ol TR Reset Orientation Reset Cropping A B MPR A Sync MPR B MPR MPR Line Free Plan Cut Plane 3D Caliper Single V 4D Heart Al Left Margin Right Margin DR Playback Current Current 60 dB Cine Frs Beat 100% Fr46 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The Sync tool allows for quick synchronization of the volume to any of the MPR reference plane images. This volume render is synched to the A plane. Notes No. 33 Sync tool - MPR B SIEMENS ... Healthineers ... Selecting Sync MPR B on touch screen synchronizes volume to reference plane B 14 76T : 39.0ºC Cardiac Review TIS:0.43 MI:0,80 30.5vps 95% 4D Color (4D) Review 4D Aid 3dB/DR60 MPR Mitral Valve Multislice Lock Bi-Plane T5 of: T8 Reset Orientation Reset Cropping A B C MPRA MPRB MPRC MPR Lines Free Plane Cut Plane 3D Caliper Single V 4D Heart Al Left Margin Right Margin Playback Cine Current Current 50 dB Frs Beats 100% F146 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The Sync tool allows for quick synchronization of the volume to any of the MPR reference plane images. This volume render is synched to the B plane. Notes No. 34 Sync tool - MPR C SIEMENS ..... Healthineers ... Selecting Sync MPR C on touch screen synchronizes volume to reference plane C 14 67.6T: 39.0ºC Cardiac Review TIS:0.43 MI:0.80 30.5vps 959 4D Color (4D) Review 4D Mid 3dB/DR60 MPR Mitral Valve Multislice MPH LOCK Lock Bi-Plane Val: TB Reset Orientation Reset Cropping A B C Sync MPRA MPR B MPRC MPR Lines Free Plan Cut Plane 3D Caliper Single V 4D Heart Al Left Margin Right Margin DR Playback cine Current Current 50 dB Frs Beats] 100% Fr46 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The Sync tool allows for quick synchronization of the volume to any of the MPR reference plane images. This volume render is synched to the C plane. Notes No. 35 4D Zoom Setup SIEMENS Healthineers .. 4D Zoom optimizes selected region of interest to SVI ap Lumos CW2 Workflow increase resolution and enhance visualization Patient Physio Imaging 1. Select 4D Zoom Setup UR Flip UND Flip Exit Review Report 2. Use soft key to adjust elevational box position End Exam Bi-Plane+ 3. Use trackball and set key to change box size Auto TEQ and/or position around anatomy of interest 1 Harmonics DTI 4D Zoom Capture Type Prospective * X 4 4. Press update key or 4D Zoom to display 4D Angle Elev Position zoomed region of interest 4 Elev Position 4D Zoom 2 3 Position Size Elev Size Unrestricted © Siemens Healthineers 2023 Speaker Notes: 4D zoom imaging optimizes the selected region of interest to increase resolution and enhance visualization. 4D Zoom Setup is accessible on the touchscreen when scanning with the 4D enabled imaging transducers. This is useful when imaging if the user desires to improve image quality during magnification of specific anatomy such as cardiac valves. To acquire a live 4D zoom image: 1. Select 4D Zoom Setup on the touch screen 2. Use the soft key on the control panel to adjust the elevational box position 3. Use the trackball and set key to change the size and position for the regions of interest 4. Select the update key on the control panel, or select 4D Zoom from the touchscreen to display the zoomed region of interest Notes No. 36 4D Zoom setup SIEMENS ... Healthineers ... Example video 5Z1 Cardiac TIS:0.39 MI:1.00 59fps 95% 2D 1dB/DR55 MapD/T5 :13cm 82bpm Lead In Set Size: Position Unrestricted © Siemens Healthineers 2022 Unrestricted © Siemens Healthineers 2023 Speaker Notes: This video demonstrates a practical example of a focused 4D image of the aortic and mitral valves using the 4D Zoom setup workflow. Notes No. 37 Single V workflow tool SIEMENS . Healthineers ... • Area of interest showing reference point and viewing direction • Volume displays only the area the user defines • Place reference point on or just above the area of interest within MPR • Extend arrow through area of interest • Adjust box edges to area of interest Unrestricted © Siemens Healthineers 2023 Speaker Notes: A common pain point in volume imaging is the inability to easily crop through a dataset. Single V is a quick cropping tool that allows the user to refine the display of anatomy of interest in the volume quadrant. Single V makes cropping quick and seamless. Single V is available during live imaging and from review. Notes No. 38 Single V workflow tool SIEMENS .... Healthineers ... To activate, select Single V on touch screen 30 5Z1 Cardiac TIS:0.43 • Position cursor at area of interest, select Set Start key MI:0.99 19.0vps 95% • Drag arrow across anatomy of interest 4D • Press Set End key • Rotate Box Width soft key to change box width Color (4D) Review Mitral Valve Multislice MPR Lock Lock Bi-Plane Reset Orientation Reset Cropping A MPR Lines Free Plane Dual V D Caliper Single V Reset to Start 100% F167 4D Heart Nl Cine Left Margin Right Margin Cument Playback Cine Current 60 d Fis Beats Box Width Pointer Unrestricted © Siemens Healthineers 2022 Speaker Notes: To activate Single V, select Single V on the touch screen • Place cursor at the starting point of view for the area of interest within the MPR and press the Set Start set key on the control panel • Position arrow at the end point within the MPR and select the Set End set key • Modify box width by rotating the Box Width soft key • If wanting to start box placement over, select Reset to Start on the touch screen • Single V is now set but the user can still manipulate the volume using the X, Y, Z controls on the control panel Note: Dual V becomes available on the touch screen once the Single V quick crop tool has been placed. Notes No. 39 Single V workflow tool SIEMENS ... Healthineers' ... To activate, select Single V on touch screen = Cardiac TIS:0.42 • Position cursor at area of interest, select Set Start key MI:0.85 9.8vps 95% • Drag arrow across anatomy of interest 4D H Mid -1dB/DR55 Q Mid • Press Set End key V 20 Th 15 Op70 • Rotate Box Width soft key to change box width S2 Br-8 Color (4D) Review Con50 MPR: MapD/T5 Vol: Mitral Valve Multislice MPR Lock MapE/T7 Lock Bi-Plane Reset Orientation Reset Cropping A MPR Lines Free Plane Dual V D Caliper 1bpm Lead 11 Single V Reset to Start 4D Heart Nl Left Margin Right Margin Cument Cine Current 60 d Playback Fis Beats Box Width Unrestricted © Siemens Healthineers 2022 Speaker Notes: To activate Single V, select Single V on the touch screen • Place cursor at the starting point of view for the area of interest within the MPR and press the Set Start set key on the control panel • Position arrow at the end point within the MPR and select the Set End set key • Modify box width by rotating the Box Width soft key (click) • If wanting to start box placement over, select Reset to Start on the touch screen • Single V is now set but the user can still manipulate the volume using the X, Y, Z controls on the control panel Note: Dual V becomes available on the touch screen once the Single V quick crop tool has been placed. Notes No. 40 Dual V workflow tool SIEMENS .... Healthineers' ... Z6T : 39.2ºC • After completing Single V workflow Cardiac TIS:0.43 MI:0.81 • Select Dual V on touch screen Dual V 95% 4D Mid 4D display now provides an enface view dB/DR60 • from the opposing Single V angle wapQ/T5 Vol: simultaneously MapA/T8 • Left reference image is primary imaging plane • Right volume demonstrates the opposing Single V workflow view • Available during live imaging and review AD Z 65bpm Lead 11 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The Dual V navigation tool provides quick cropping of an area of interest within the volume displaying opposing viewing angles simultaneously. After completing the Single V workflow tool, Dual V becomes available on the touch screen. Select Dual V on the touch screen to display the opposing views simultaneously. The user can still manipulate the volume using the X, Y, Z controls on the control panel. Press the update key to enable edit of the start and end points. Notes No. 41 Single V to Dual V workflow SIEMENS ..... Healthineers ... Example video 18 5Z1 Cardiac TIS:0.42 MI:0.85 9.8vps 95% 4D H Mid 1dB/DR55 Q Mid V|20% Th15 Cp70 S2 Br-8 Con50 MPR MapD/T5 Vol: MapE/T7 100% Fr1 Cine Pointer Unrestricted © Siemens Healthineers 2022 Speaker Notes: This slide contains a quick demonstration of the Single V to Dual V workflow. In this instance, the Single V cursor and arrow are placed across the mitral valve. Adjustment is made to the box width on the soft key. Dual V is selected on the touch screen and rotation of the Z control on the control panel is used to rotate the volume. Notes No. 42 Mitral Valve tool SIEMENS ... Healthineers ... Z6T transesophageal transducer Select Mitral Valve on touch screen • Synchronizes volume to reference plane C • Automatically orientates the volume with mitral valve aligned to “surgeon’s view” 76T : 38.8ºC Review Cardiac TIS:0.43 H MI:0.80 30.5vps 4D Review 4D Mid Mitral Valve Multislice MPIN LOCK 3dB/DR60 Lock Bi-Plane MPR: T5 Vol: T8 Reset Orientation Reset Cropping A B C Sync MPRA Sync MPR B MPRC MPR Lines Free Plane Cut Plane 3D Caliper Single V 4D Heart Al Left Margin Right Margin DR Playback Cine Current Current 60 dB Frs Beats 100% Fr92 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The mitral valve quick crop tool is available during 4D transesophageal imaging. This feature is enabled during live imaging and from review. Select Mitral Valve on the touch screen and the dataset automatically synchronizes to reference place C, and volume is automatically oriented with mitral valve aligned to the “surgeon’s view”. Note that rotation of the 4D volume can still be performed directly by utilizing X, Y, Z located on the control panel. Notes No. 43 En Face tool SIEMENS ... Healthineers ... AcuNav Lumos 4D ICE catheter Select En Face on touch screen • Synchronizes volume to reference plane C • Automatically orientates volume facing forward 5V1 76T : 38.8ºC Lumos Intracardiac CP 267 521 CW2 Workflow Cardiac TIS:0.43 H MI:0.80 4D Physio Update with Lumos image 30.5vps 4D when available Mid 3dB/DR60 En Face Multislice Lock Bi-Plane MPR: T5 Vol: T8 Reset Orientation Reset Cropping A B MPRA MPR B MPRC Bi-Plane MPR Lines Auto TEQ Cut Plane 3D Caliper Harmonics Single V Frequency Line Density DR Size Position Clip Capture Mid Mid 60 dB Vol Lat Elev Lat Elev Beats Sec 100% Fr92 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The en face quick crop tool is available during volume ICE imaging with the AcuNav Lumos 4D ICE catheter. This feature is enabled during live imaging and from review. Select En Face on the touch screen and the dataset automatically synchronizes to reference place C with the volume facing forward. Note that rotation of the volume can still be performed utilizing X, Y, Z located on the control panel. Notes No. 44 Cut Plane and Color Crop SIEMENS .... Healthineers ... 15 76T: 39.1ºC Cardiac 0 ? 0 / 9FAN ap Lumos ST Cardiac X CW2 Workflow TIS:0.76 MI:1.36 15.5vps Patient 4D Color (4D) Physio 95% 4D Imaging Mid Mitral Valve 3dB/DR60 Review MPR T5 Report Reset Orientation Reset Cropping MPRA MPR B MPRC Vol: T8 End Exam C 2D + Color 2D Only Color Only Bi-Plane+ Color Crop MPR Line Low OdB General PRF 5102 Cut Plane Th15/Op70 Single 4D Zoom Frequency Scale Baseline ROI Size ROI Position Lat Fley Axd) Filte 100% Fr39 Unrestricted © Siemens Healthineers 2022 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The 4D volume imaging tool Cut Plane allows the user to cut into the volume rendering for the respective MPR that the user is synched to. This function is available in real-time imaging, or from review during 4D post-processing. Additionally, when performing 4D color Doppler imaging and selecting Cut Plane as seen here, the Color Crop defaults to selected on. Notes No. 45 Free Plane tool SIEMENS ..... Healthineers ... Example video 30 5Z1 Review Cardiac TIS:0.43 MI:0.99 Patient 4D Review 19.0vps 95% Imaging 4D Mitral Valve Multislice Review Report Reset Orientation Reset Cropping MPRA MPR B MPR C End Exam MPR Line Free Plane Cut Plane 30 Caliper Undo Crop Retain Crop Single V 4D Heart Al totate Plane Position Plane DR Cine XY Playback Rotate Plane XY Position Plane 100% Fr67 Pointer Unrestricted © Siemens Healthineers 2022 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Free Plane tool allows the user to freely move a crop plane around the volume, cropping into the volume as desired. Manipulation of the free plane is performed on the soft keys Rotate Plane and Position Plane, as well as the track ball. To retain free plane cropping performed on the dataset, be sure to select Retain Crop on the touch screen. This function is available in real-time imaging or from review during 4D post-processing. Note that rotation of the 4D volume can still be performed directly by utilizing X, Y, Z located on the control panel. Notes No. 46 MPR Lines & Slice Sync SIEMENS ..... Healthineers ... Know where you are 5Z1 MPR Lock Cardiac Lock Bi-Plane TIS:0.43 27 Z61:38.9ºC MI:0.99 Cardiac TIS 0.43 19.0vps MEO.83 18.0vps MPRA MPR B MARC 95% 4D 4D 3dB/DR54 MPR Lines Slice Sync 3D Caliper AD Heart Al G Unrestricted © Siemens Healthineers 2022 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The 4D volume imaging tools MPR Lines and Slice Sync allow the user to quickly target an area of interest. This function is available in real-time imaging or from review during 4D post-processing. Selecting MPR Lines on the touch screen and manipulating the axis markers within the MPR automatically synchronizes the axis marker overlay within the volume. Once the MPR Lines tool is active, Slice Sync is available. Slice Sync is the reverse of MPR Lines. Selecting Slice Sync on the touch screen, use the cursor to move the axis markers within the volume which automatically synchronizes the MPR axis markers to that location. Notes No. 47 4D Multislice SIEMENS .... Healthineers ... 0 3 0 / 9FAN 22 Lumos ST 267 Cardiac X CW2 Workflow 30 5Z1 Cardiac TIS:0.43 Patient Physio MI:0.99 19.0vps Imaging 95% Multislice 4D Review Report General Parasternal Apical C End Exam Slices Distance osition of Slices 2 mm 0 mm Range Position Slices 5 Distance Position of Slices 2 mm 0 mm Unrestricted © Siemens Healthineers 2022 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The 4D volume imaging tool Multislice allows the user to make multiple slices through an area of interest within the volume. This function is available in real-time imaging or from review during 4D post-processing. Various display options are available. Multislice positioning options available on the touch screen are General, Parasternal, and Apical C. Soft key controls for Multislice are: • Slices - increase the number of slices from 1, 3, 5, 7, 9, 11, 13, 15, 17 • Distance - change slice distance from 0.5 mm to 50 mm (in 0.5 mm increments) • Position of Slices - move the slice positions from -80 mm to 80 mm (in 1 mm increments) Notes No. 48 3D Caliper tool SIEMENS .... Healthineers ... Custom label what you need • Create custom label on desired MPR 5Z1 • Custom label overlays on volume 3D Caliper Cardiac TIS:0.43 MI:0.99 22.0vps 95% Cardia 10LA 1014 1415 4D Workflow H Mid 0dB/DR60 MPR Patient 40 Physio 3D Caliper T5 Vol: Imaging T7 Anterior Leaflet Exit Review XAnterior Longo Report Lef Right Mitral . Anterior Leaflet End Exam Inferior Superior Tricuspid Medial Latera Aortic Anterior Posterior Septal Pulmonar Clear Screen Hide Result 56bpm Lead Il Unrestricted © Siemens Healthineers 2022 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The 3D Caliper tool allows the user to mark and create custom labels. This tool is available during live 4D imaging, or in 4D volume review. Select 3D Caliper on the touch screen. Use the trackball and set key to place a point at the desired position over any of the multiplanar views. Then select a custom label from either the pre-defined labels on the touch screen, or select the keyboard icon on the touch screen to enable free text. The custom labeled reference point is overlayed onto the volume image. In this example, we see the anterior leaflet of the mitral valve is labeled. To keep the label over the volume and continue working in 4D imaging mode, select the 4D tab on the touch screen. Notes No. 49 3D Caliper tool SIEMENS ..... Healthineers ... Point to point measure 3D Caliper 5Z1 Cardiac TIS:0.43 MI:0.99 22.0vps 95% cardia SC SV 10L4 4D Workflow (.1, . 2) - 4.65 cm H Mid -0dB/DR60 MPR Patient Physio 3D Caliper T5 Vol: Imaging T7 Exit Review Report Left Right Mitral End Exam Inferior Superior Tricuspid Medial Lateral Aortic Anterior Posterior Septal Pulmona Clear Screen Hide Results 62bpm Lead II Unrestricted © Siemens Healthineers 2022 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The 3D Caliper tool allows point to point measurements. This tool is available during live 4D imaging, or in 4D volume review. Select 3D Caliper on the touch screen. Use the trackball and set key to place points around the desired anatomy for measurement within any of the multiplanar views. Check the boxes on the touch screen next to the points to measure and select the linked icon from the touch screen. Measurement result between the connected points is displayed and the measurement is overlayed onto the volume image. In this example, we see a generic point to point measurement along the mitral annulus. Note that these measurements will not go to the report. The image should be captured to make the measurement available for review. To keep the measurement overlay on the volume and continue working in 4D imaging mode, select the 4D tab on the touch screen. Notes No. 50 4D volume color Doppler SIEMENS ..... Healthineers' ... O @ D / 9FAN 22 Lumos ST Cardiac Workflow 5Z1 Cardiac Patient 4D Color (4D) Physio MI:0.84 13.5vps Imaging 95% 4D Review H Mid -3dB/DR55 Report Reset Orientation teset Cropping MPRA MPR B MPR C C Mid End Exam 2D + Color 2D Only Color Only Color Crop MIPR Line Cut Plane Single 4D Zoom Frequency Scale Baseline ROI Size ROI Position Filter Let Eley Ads Lat Eley A C ROI Size C ROI Position Lat Elev Axial Lat Elev Axial Unrestricted © Siemens Healthineers 2022 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The 4D volume color Doppler region of interest (ROI) box positioning is set using the soft keys C ROI Size and C ROI Position. Press either soft key, or the touch screen, to toggle between the MPR (lateral, elevational, axial) for the corresponding color box manipulation. Note that rotation of the 4D volume can still be performed using the X, Y, Z controls located on the control panel. Tip: In Bi-Plane+ imaging, turn on color Doppler and set the color region of interest (ROI) and then launch into 4D to minimize the need of color ROI manipulation from the soft keys during 4D color volume imaging. Notes No. 51 Trademarks and disclaimers The products/features mentioned in this document may not be commercially available in all countries. Due to regulatory reasons their future availability cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details. ACUSON Origin is a trademarks of Siemens Medical Solutions USA, Inc. At Siemens Healthineers, our purpose is to enable healthcare providers to increase value by empowering them on their journey towards expanding precision medicine, transforming care delivery, and improving patient experience, all enabled by digitalizing healthcare. An estimated five million patients worldwide everyday benefit from our innovative technologies and services in the areas of diagnostic and therapeutic imaging, laboratory diagnostics and molecular medicine as well as digital health and enterprise services. We’re a leading medical technology company with over 120 years of experience and 18,500 patents globally. With over 50,000 employees in more than 70 countries, we’ll continue to innovate and shape the future of healthcare. Siemens Healthineers Headquarters Manufacturer Siemens Healthcare GmbH Siemens Medical Solutions USA, Inc. CO Henkestr. 127 Ultrasound 91052 Erlangen, Germany 22010 S.E. 51st Street Phone: +49 9131 84-0 Issaquah, WA 98029, USA siemens-healthineers.com Phone: 1-888-826-9702 siemens-heathineers.com/ultrasound Unrestricted © Siemens Healthineers 2023 Thank you for your enthusiasm! SIEMENS Healthineers ... Questions? QR700000601 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Questions? Notes No. 53