ACUSON Origin Custom Calculations Presentation

SIEMENS Healthineers ACUSON Origin Ultrasound System Custom calculations 1.0 software version 1 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The purpose of this presentation is to provide an overview for creating custom calculations on the ACUSON Origin ultrasound system. Notes No. 1 Objectives SIEMENS . Healthineers .. • Discuss Custom Calculations and SR mapping ACUSON • Step by Step for entering a Custom Calculation Origin • Discuss an additional calculation • Review Frequently Asked Questions Origin CC 2 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Let’s begin with an overview of custom calculations and structured reporting (SR) mapping. Notes No. 2 Creating custom calculations SIEMENS Healthineers .... Formula SR Mapping System Configuration Name Units recision Report Section RAVI ml/m2 V 2 V Right Atrium System Settings [RA Area s A4C.Vol,ml]/[(Calc)BSA,m2] Workflow Enhancement Imaging Settings Ensure the formula and units are correct and then click Save. Measurement & Report Show in Measured Results Save Cancel Show in Report Measurement Exam Package Result Labels Touch Screen Measurement Config General Calculations ATAN Min Min Of Any Custom Measurement Label TAN Max Max Of Any (Calc)BSA Custom Calculations COS Abs Mean Of Any (Calc)Clinical Age (Calc)Fibroid 1 Vol SIN First (Calc)Fibroid 2 Vol (Calc)Fibroid 3 Vol Units (Calc)Fibroid 4 Vol sqrt mm2 (Calc)Fibroid 5 Vol pi cm2 (Calc)GB Vol m2 log (Calc)Isthmus Mass 1 Vol Add 3 Unrestricted © Siemens Healthineers 2023 Speaker Notes: • Custom calculations can be added by accessing System Configuration > Measurement and Report > Custom Calculations • Custom calculations can be SR (Structured Report) mapped • Customized labels can be created to support new equations in System Configuration > measurement and Report > Custom Measurement label A few common custom calculations are: • Dimensionless Index (DI) for aortic valve: [LVOT VTI.VTI,cm]/[AoV VTI.VTI,cm] = no units • • Philips PI(TCD) equation: • PI(TCD) = PSV – ED/ Mean TCD where Mean TCD is PSV/3 + 2 x ED/3 • Right atrial ESV indexed to BSA (RAVi): • [RA Area s A4C.Vol,ml]/[(Calc)BSA,m2 ]= ml/m² • Stroke Volume indexed to BSA (SVi): • (3.14*([LVOT Diam s,cm]/2)^2)*[LVOT VTI.VTI,cm]/[(Calc)BSA,m2 ] Notes No. 3 Custom calculations SIEMENS Healthineers ... 1. Name of equation (14-character limit) Formula SR Mapping 2. Output units of equation Name Unit Precision Report Section 1 2 3 4 3. Decimal point precision 5 4. Report section 5. Area of equation input Ensure the formula and units are correct and then click Save. 6 Show in Measured Results Save Cancel Show in Report 6. Selection for display results Exam Package Result Labels 7. Exam package dropdown Abdomen 7 Accel 9 ATAN Min Min Of Any Time TAN Max Max Of Any 8. List of labels for equation input AMA 8 COS Abs Mean Of Any AAA (Post Repair) V2 PS SIN MA (Post Repair) AP First 9. Result label types of measurement needs to AAA (Post Repair) Diam ED 11 be specific AAA (Post Repair) Trans Diam Units sqrt MA AP mmis2 10. Input units AAA Diam pl cris? 10 AAA dist from SMA 109 m/s] 11. Mathematical input area MA Sac Length Add 4 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Theses are the fields used when creating a custom calculation. It is important to note when creating a custom calculation, if a customized label is needed, the custom label must be created first. 1. Name of equation (14-character limit) 2. Output units of equation 3. Decimal point precision 4. Report section 5. Area of equation input 6. Selection for display results 7. Exam package dropdown 8. List of labels for equation input 9. Result labels when type of measurement needs to be specific (e.g. circumference or area; peak systolic vs end diastolic) 10. Input units 11. Mathematical input area (numbers, characters, functions – can also use keyboard) Notes No. 4 Structured reporting (SR) mapping SIEMENS Healthineers' .... 1. Select SR Mapping tab Custom Calculations Formula SR Mappin 1 Lt Lambert 2. Select appropriate SR LVOTIBSA R Template Text String for SR Rt Lambert LVOTIBSA Template . Fetal Ech New 2 Concept Code Meaning * Cardiac Index 3. Select SR Template section Copy Cardiac Coding Scheme Designator * SRT 4. Complete SR Mapping for SR Template Section . Left Ventricle 3 Code value . given equation F-32110 Measurement Method Continuity Equation by Velocity Time I V Delete 4 Finding Site Left Ventricle Outflow Tract Flow Direction Antegrade Flow SR Mapping Cardiac Cycle Point ak Systolic lage View Apical four chamber Save Cancel 5 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Custom calculations can be SR (Structured Reporting) mapped. 1. Select SR Mapping tab 2. Select appropriate SR Template 3. Select SR Template section 4. Complete SR Mapping for given equation Notes No. 5 Objectives SIEMENS . Healthineers .. • Discuss Custom Calculations and SR mapping ACUSON • Step by Step for entering a Custom Calculation Origin • Discuss an additional calculation • Review Frequently Asked Questions Origin CC 6 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Now, let’s look a step-by-step example for creating a custom calculation. Notes No. 6 System configuration menu access SIEMENS Healthineers ... • Select System Configuration icon System Configuration Patient System Settings • Main menu options listed Imaging Workflow Enhancement Review Imaging Settings Report Measurement & Report End Exam Measurement Touch Screen Measurement Config Custom Measurement Label Custom Calculations 7 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Select the System Configuration > Measurement and Report > Custom Calculations to create a custom calculation. Notes No. 7 Step-by-step example of creating a new custom calculation: SIEMENS Healthineers ... Left ventricular (LV) stroke volume (SV) indexed to BSA - (SVi) Custom Calculations Formula SR Mapping Name Units Precision Report Section New Copy Edit Ensure the formula and units are correct and then click Save. Show In Measured Results Save Cancel Show in Report Exam Package Result Labels Delete Abdomen Accel ATAN Min Min Of Am time TAN Max Max Of Any AAA VI COS Abs Mean Of Any AAA (Post Repair) V2 SIN AAA (Post Repair) AP PS SR Mapping AAA (Post Repair) Diam AAA (Post Repair) Trans Diam Units AAA AP mmisa AAA Diam cmis2 AAA dist from SMA misz AAA Sac Length Add 8 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Select New to enter the calculation page. Notes No. 8 Step-by-step: stroke volume indexed to BSA (SVi) SIEMENS Healthineers .... (3.14*([LVOT Diam s,cm]/2)^2)*[LVOT VTI.VTI,cm]/[(Calc)BSA,m2 ] 1. Create new equation name SVi Name Units Precision Report Section SVI 1 ml/m2 V LV 2. Make output units ml/m2 (3.14* 2 3 4 3. Set precision to 2 4. Select LV as report section Ensure the formula and units are correct and then click Save. 5. Use the calc functions and enter: Show in Measured Results Save Cancel Show in Report • ( Exam Package Result Labels 3.14 (π value) Cardiac ATAN Min Min Of Any • Q TAN Max Max Of Any • * (Cardiac)/VC Diam COS Abs Mean Of Any (M-Mode)Ao Diam d SIN (M-Mode)IVC Collapsed Diam (M First 5 (M-Mode)IVC Diam (M-mode) (M-Mode)IVS d Units (M-Mode)IVS s sqrt mm (M-Mode)LA Diam s pi cm (M-Mode)LV ET (M-mode) 0 e In log (M-Mode)LV Majors Add 9 Unrestricted © Siemens Healthineers 2023 Speaker Notes: In this step-by-step example, we will enter the custom calculation for stroke volume indexed to body surface area. 1. Create new equation name SVi 2. Make output units ml/m2 3. Set precision to 2 4. Select LV as report section 5. Use the calc functions and enter: • ( • 3.14 (π value) • * Notes No. 9 Step-by-step: stroke volume indexed to BSA (SVi) SIEMENS Healthineers .... 6. Select Cardiac for Exam Package labels Name Units Precision Report Section SVI ml/m2 v LV 7. Enter LVO in the quick search field (3.14*([LVOT Diam s,cm] A 8. Scroll down until you see LVOT Diam s • Click to highlight Ensure the formula and units are correct and then click Save. 9. Select Add Show in Measured Results Save Cancel Show in Report Exam Package Result Labels Cardiac 6 ATAN Min Min Of Any LVO 7 TAN Max Max Of Any (M-Mode)LVOT Diam s (M-mode COS Abs Mean Of Any LVOT Area d LVOT Area d (Post) SIN First LVOT Diam s 8 LVOT Diam s (Post) Units LVOT Ht d sqrt mm LVOT Ht d (Post) pi cm LVOT Vmax log LVOT Vmax (Post) Ado 9 10 Unrestricted © Siemens Healthineers 2023 Speaker Notes: In this example we will enter the custom calculation for cardiac indexing for LVOT and BSA with no units. 6. Select Cardiac for Exam Package labels 7. Enter LVO in the quick search field 8. Scroll down until you see LVOT Diam s 6. Click to highlight 9. Select Add Notes No. 10 Step-by-step: stroke volume indexed to BSA (SVi) SIEMENS Healthineers .... 10. Use the calc functions and enter: Name Units Precision Report Section SVI mi/m2 V LV • / (3.14*([LVOT Diam s,cm]/2)^2)*[LVOT VTI.VTI,cm] • 2 • ) Ensure the formula and units are correct and then click Save. • ^ Show in Measured Results Save Cancel Show in Report • 2 Exam Package Result Labels • ) Cardiac 11 ATAN Min Min Of Any LVO 12 • * AT TAN Max Max Of Any LVOT Area d (Post) Mean Grad COS Abs Mean Of Any 11. Select Cardiac for Exam Package labels LVOT Diam s Vmean LVOT Diam s (Post) Time SIN First 10 12. Enter LVO in the quick search field LVOT Ht d LVOT Ht d (Post) Units 13. Scroll down until you see LVOT VTI sqrt LVOT Vmax mm LVOT Vmax (Post) pi cm • Click to highlight LVOT VTI 13 0 e In log LVOT VTI (Post) 14. Select Add 14 11 Unrestricted © Siemens Healthineers 2023 Speaker Notes: In this example we will enter the custom calculation for cardiac indexing for LVOT and BSA with no units. 10. Use the calc functions and enter: • / • 2 • ) • ^ • 2 • ) • * 11. Select Cardiac for Exam Package labels 12. Enter LVO in the quick search field 13. Scroll down until you see LVOT VTI • Click to highlight Notes No. 11 14. Select Add Notes No. 11 Step-by-step: stroke volume indexed to BSA (SVi) SIEMENS Healthineers ... 15. Use the calc functions and enter: Name Units Precision Report Section SVI mi/m2 V 2 LV • / (3.14*([LVOT Diam s,cm]/2)^2)*[LVOT VTI.VTI,cm]/[(Calc)BSA,m2] 16. Select General Calculations for Exam Package labels Ensure the formula and units are correct and then click Save. 17. Scroll down until you see (Calc)BSA 19 Show in Measured Results Save 20 Cancel Show in Report • Click to highlight Exam Package Result Labels General Calculations 16 18. Select Add ATAN Min Min Of Any TAN Max Max Of Any • Note equation has a green arrow (Calc)BSA 17 Abs Mean Of Any (Calc)Clinical Age COS 19. Check to display results in MDA / Report (Calc)Fibroid 1 Vol SIN First 15 (Calc)Fibroid 2 Vol 20. Select Save (Calc)Fibroid 3 Vol Units (Calc)Fibroid 4 Vol sqrt Custom calculation is now stored in mm (Calc)Fibroid 5 Vol pi • cm2 the exam package (Calc)GB Vol m2 0 e In log (Calc)Isthmus Mass 1 Vol Add 18 12 Unrestricted © Siemens Healthineers 2023 Speaker Notes: In this example we will enter the custom calculation for cardiac indexing for LVOT and BSA with no units. 15. Use the calc functions and enter: • / 16. Select General Calculations for Exam Package labels 17. Scroll down until you see (Calc)BSA • Click to highlight 18. Select Add • Note equation has a green arrow 19. Check to display results in MDA / Report 20. Select Save • Custom calculation is now stored in the exam package Notes No. 12 Step-by-step: stroke volume indexed to BSA (SVi) SIEMENS Healthineers ... 148 5V1 Cardiac 1 LVOT VTI=24.44 cm TIS:0.95 LVOT Vmax=1.13 m/s MI:0.57 LVOT Mean Grad=2.2 mmHg 26fps LVOT SV=98.9 ml SVi=48.94 ml/m2 LVOT Peak Grad=5.1 mmHg H Mid 5dB/DR58 Mid 18cm OdB 104mm D Low 2mis 0.40 -9dB/DR70 GS 3.0 0.20 m/s -0.20 -0.40 -0.60 -0.80 1.00 -- 1.20 -1.40 706pm Lead II 13 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To calculate equations using body surface area (BSA), the user must enter the patient’s height and weight during patient registration. This enables calculation of BSA. The system will not display custom calculations with BSA in the equation on the MDA, or in the report, if the patient’s height and weight are not entered. Notes No. 13 Objectives SIEMENS . Healthineers .. • Discuss Custom Calculations and SR mapping ACUSON • Step by Step for entering a Custom Calculation Origin • Discuss an additional calculation • Review Frequently Asked Questions Origin CC 14 Unrestricted © Siemens Healthineers 2023 Speaker Notes: We will now discuss creation of an additional calculation. Notes No. 14 PI (TCD) equation SIEMENS Healthineers' ... Input PI (TCD) equation PI (TCD) = PSV – ED/ Mean TCD Formula SR Mapping where Mean TCD is PSV/3 + 2 x ED/3. Name Units Precision Report Section Rt MCA PI TCD 2 Transcranial This equation rearranges to PI TCD = 3 (PSV – ED) / 3 3.([Rt Prox MCA M1.PS,cm/s]-[Rt Prox MCA M1.ED.cm/s])/([Rt Prox MCA M1.PS,cm/s]+2.[Rt Prox MCA M1.ED.cm/s]) How to enter: Ensure the formula and units are correct and then click Save. 3*([Rt Prox MCA M1.PS,cm/s]-[Rt Prox MCA 4 Show in Measured Results Save Cancel M1.ED,cm/s])/([Rt Prox MCA M1.PS,cm/s]+2*[Rt Prox MCA El Show in Report Exam Package Result Labels M1.ED,cm/s]) TO 1 Time ATAN Min Of Any Q VI 2 TAN Max Max Of Any Rt PCA P1 V2 1. Input as above from the TCI exam package and find PS COS Abs Mean Of Any Rt PCA P2 appropriate label RI PCOA ED SIN First Rt Prox MCA MI Mean TCD 2. Select PS and ED from Result Labels to ensure PSV and Rt Prox MCA M2 Units ED are input correctly in the equation Rt Prox Ophthalmic A mm/s 3 Rt Terminal ICA cmis Rt Terminal Vert A log 3. Select cm/s as the correct input units for each label Rt Vert Atlas Loop Add 4. Save once input correctly 15 Unrestricted © Siemens Healthineers 2023 Speaker Notes: This is an additional calculation that you may be ask to enter. Input PI (TCD) equation PI (TCD) = PSV – ED/ Mean TCD where Mean TCD is PSV/3 + 2 x ED/3. This equation rearranges to PI TCD = 3 (PSV – ED) / 3 How to enter: 3*([Rt Prox MCA M1.PS,cm/s]-[Rt Prox MCA M1.ED,cm/s])/([Rt Prox MCA M1.PS,cm/s]+2*[Rt Prox MCA M1.ED,cm/s]) 1. Input as above from the TCI exam package and find appropriate label 2. Select PS and ED from Result Labels to ensure PSV and ED are input correctly in the equation 3. Select cm/s as the correct input units for each label 4. Save once input correctly Notes No. 15 PI (TCD) equation SIEMENS Healthineers' ... An equation must be made for each label and laterality MEMCAMICO 1 LEMCAN TCD 3 Report Section How to Enter: NON MIA 3*([Lt Prox MCA M1.PS,cm/s]-[Lt Prox MCA 4 5 2 M1.ED,cm/s])/([Lt Prox MCA M1.PS,cm/s]+2*[Lt Prox MCA M1.ED,cm/s]) 6 Exam Paduige Abforen Mas Of Apy Milan CE Any 1. Select Rt MCA PI TCD from Custom Calculations repository MMA AP 2. Select Copy 3. Rename for the correct laterality 4. Hover over Rt and type Lt within equation 5. The equation will alert users when there is a discrepancy by underlining in Red and will not allow user to Save 6. Once input select Save and it will save to the repository 16 Unrestricted © Siemens Healthineers 2023 Speaker Notes: An equation must be made for each label and laterality How to Enter: 3*([Lt Prox MCA M1.PS,cm/s]-[Lt Prox MCA M1.ED,cm/s])/([Lt Prox MCA M1.PS,cm/s]+2*[Lt Prox MCA M1.ED,cm/s]) 1. Select Rt MCA PI TCD from Custom Calculations repository 2. Select Copy 3. Rename for the correct laterality 4. Hover over Rt and type Lt within equation 5. The equation will alert users when there is a discrepancy by underlining in Red and will not allow user to Save 6. Once input select Save and it will save to the repository Notes No. 16 PI (TCD) equation > MDA SIEMENS Healthineers' ... 5V1 Rt Prox MCA M1 TCI PS=121.38 cm/s TIC:1.08 ED=48.79 cm/s MI:0.62 MD=47.60 cm/s 11fps TAMx=72.45 cm/s TAMn=47.32 cm/s 2D RI=0.60 Mid PI=1.02 2dB/DR60 Mean TCD=72.99 cm/s c=1540 RT MCA PI TCD=0.99 LD 2 UA 2 MapC/T5 P3 C 16cm Pen 50mm OdB 50 P2/LD1 PRF 3289 S2/Pr4 .00 MapF/F2 2D + Color D 0.50 Pen GS 4.0 PRF 3906 -m/s F 165 17 Unrestricted © Siemens Healthineers 2023 Speaker Notes: This is an example of an image showing the calculation results in the measurement display area. Notes No. 17 Objectives SIEMENS . Healthineers .. • Discuss Custom Calculations and SR mapping ACUSON • Step by Step for entering a Custom Calculation Origin • Discuss and additional calculation • Review Frequently Asked Questions Origin CC 18 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Lastly, we will review frequently asked questions about custom calculations. Notes No. 18 Frequently Asked Questions SIEMENS . Healthineers .. Can I make a whole new general calculation tool that isn’t dependent on a label measurement? No, you cannot make a new general equation without a label being assigned. Note: Indices such as PI, RI, Mean TCD have a general tool or measurement on the system or derived from auto trace. Custom Doppler and all custom equations must be made using labelled measurements For example, if you want to make PI (TCD) equation or a new Mean TCD equation, it must be assigned to a vessel eg Rt Dist Vert, Rt Prox MCA M1. Tip: Using the copy function for each side makes this faster to input Why can’t I enter any input or output unit in the equation? The input and output unit for the entered equation must be correct and align with the input units used to create the equation regardless of the unit used when performing the examination. Note: Always refer to the reference document, article or study and ensure that the units used are correct. 19 Unrestricted © Siemens Healthineers 2023 Notes No. 19 Frequently Asked Questions cont’d SIEMENS . Healthineers .. Why does the custom equation I’ve input show a negative, even though I have chosen in system configuration to not show a negative and only show an absolute value? You must enter Abs(XXX…) around the entire custom equation – as below: Abs(([(TCI)Rt Prox Vert A.PS,cm/s]/3)+2* ([(TCI)Rt Prox Vert A.ED,cm/s]/3)) If the user creates a custom calculation and makes it an absolute value, if that calculation is then put into another custom calculation, will it use the absolute value or its true mathematical value? True mathematical value – the equation will always be correct. But it will never show a negative if input with Abs(XXX)…) Why can’t I enter a custom calculation? Ensure you are not in an active exam / study. - If no, check that you haven’t made a measurement on a labelled measurement while not in a study. - For either, you will have to end the exam and then re-enter system configuration. - 20 Unrestricted © Siemens Healthineers 2023 Notes No. 20 Frequently Asked Questions cont’d SIEMENS. Healthineers .. Can I compare opposite sides in the same equation, so right and left Name Units Precision Report Section CIA ratio V in the same equation? [Rt CIA.PS,cm/s]/[Lt CIA test.PS,cm/s] Yes. However, the equation will not save. The inputs are setup to only 2 Ensure the formula and units are correct and then click Save, save if you have the same side in the equation. Show in Measured Results Save Cancel Show In Report Exam Package 1 Result Labels A workaround is to: Abdomen V2 ATAN Min Of Any PS Create a custom label measurement of that label and rename so its TAN Max Max Of Any - LI CIA Aneurysm Diam ED COS Abs Mean Of Any “Rt” or “Lt” Lt CIA Aneurysm Trans Diam Lt CIA AP SID SIN First Remove the modifiers in custom labels Lt CIA Diam MD - Create a new name so you can distinguish it LI CIA test Units - Lt CIA Trans Diam mm/s Lt CIV Diam cmis Lt CIV Reflux Time 1. Create custom label and find in Exam Package Lt CIV Vmax Add 2. Insert into equation, now you will be able to Save 21 Unrestricted © Siemens Healthineers 2023 Notes No. 21 Frequently Asked Questions cont’d SIEMENS . Healthineers .. Why are my left and right custom calculations displaying the wrong way on the report? It depends on which one you entered first – always input the right side first and then copy and make the left side. This will ensure they are located correctly in the report. Can I SR map custom calculations/equations? Yes, you can, refer to slide 5. Tool will SR map to Cardiac, Vascular, OB/GYN and Fetal Echo templates, same as custom measurement labels. Why can’t I find the Cardiac section in the Report Section? The Cardiac report section is broken up into the many domains of the heart e.g. Aortic valve, LV, RV diastolic function etc. Scroll through the dropdown and find the part of the heart that the cardiac equation makes the most sense in. You can also place it in the Custom Measurements. 22 Unrestricted © Siemens Healthineers 2023 Notes No. 22 Summary SIEMENS . Healthineers .. • Discuss Custom Calculations and SR mapping ACUSON • Step by Step for entering a Custom Calculation Origin • Discuss additional calculations • Review Frequently Asked Questions Origin CC 23 Unrestricted © Siemens Healthineers 2023 Notes No. 23 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. 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 24 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Notes No. 24 Thank you for your enthusiasm! SIEMENS . Healthineers .. Questions? QR7# 25 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Question? Notes No. 25