ACUSON Origin Intima-media Thickness (IMT) Presentation

SIEMENS Healthineers ACUSON Origin Ultrasound System Auto Intima Media Thickness (IMT) with preview function 1.0 software version 1 Unrestricted © Siemens Healthineers 2023 1 Objectives SIEMENS. Healthineers .. • Discuss Auto Intima Media Thickness (IMT) technology • Discuss Measurement & Report (M&R) • Explain Auto IMT acquisition • Show Auto IMT video 2 Unrestricted © Siemens Healthineers 2023 Speaker Notes: We will begin by discussing Auto Intima Media Thickness (IMT) technology. Notes No. 2 Auto IMT with preview function > purpose SIEMENS . Healthineers .. • Measures two inner layers • Establishes risk profiles • Classifies patients with intermediate vascular disease • A vascular age will not be calculated 3 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Auto IMT with preview function can be performed in a few simple steps. After placing a region-of-interest (ROI) over the wall of the vessel, it Automatically locates and measures the thickness of the two inner layers of the carotid artery, the tunica intima and the tunica media. This technology will help to establish risk profiles, and to classify patients with intermediate vascular disease. Patients that already have calcified plaque present in the carotid artery, are usually excluded from having this evaluation. When complete, a vascular age will not be calculated. Notes No. 3 Auto IMT with preview function > purpose SIEMENS. Healthineers .. Normal Values Age 10 • ~ 0.4 - 0.5 mm 50 + • ~ 0.7 – 0.8 mm or more1 1 uptodate.com/contents/carotid-intima-media-thickness 4 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The normal IMT value at age ten is approximately 0.4 – 0.5 mm. For those who are 50 and older, the range is approximately 0.7 – 0.8 mm or more. 1 1 uptodate.com/contents/carotid-intima-media-thickness Notes No. 4 Auto IMT with preview function > technology SIEMENS Healthineers ... • All linear transducers • B-mode images • Frozen images/Review images • Guidance function – dotted vertical line • ROI (Region-of-Interest) placement .......... 5 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Auto IMT is available on all linear transducer B-mode images and can be performed on frozen images, zoomed frozen images and images in review. There is a dotted guidance line to the left of the ROI to help support more consistent alignment. Once the ROI is placed, a preview of the intima outline can be seen. The outline can be easily edited if adjustments are needed. Notes No. 5 Auto IMT with preview function technology SIEMENS Healthineers .... Auto IMT report results Output Show Unit Precision C10 mm V 0.00 V • Results seen are configurable mm V 0.00 • Per label configuration Max Mean 00 • Maximum and Mean Min 00 V • Minimum (optional) • Intima Media Thickness (IMT) – C10 (optional) • Japan required output 6 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Auto IMT results displayed in the report are configurable using the per label configuration page in System Configuration > Measurement & Report. The maximum and mean values are always displayed in the measurements display area (MDA). The C10 value is a measurement used in Japan and is automatically calculated when placing the dotted reference line at the origin of the bulb. The measurement is located 10 mm from the bulb origin, as shown in this enlarged view, indicated by the two triangles at the left edge of the intima tracings. Displaying the Minimum or C10 values are optional. The measurement and report package and steps to perform an IMT measurement will be covered later in the presentation. Notes No. 6 Objectives SIEMENS . Healthineers .. • Discuss Auto Intima Media Thickness (IMT) technology • Discuss Measurement & Report (M&R) • Explain Auto IMT acquisition • Show Auto IMT video 7 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, we will discuss the Measurement & Report (M&R). Notes No. 7 Auto IMT with preview function > measurement & report SIEMENS Healthineers ... General Exam Package Dam Spedi Per Labet Configuration System Configuration Parotid Name 1 Bulb Mod Santar Labels Too and Method Last Doppler RESID Measurement & Report Sub IMT Dist CCA Dist CCA IMT Measurement Dist ECA Output Frechion Dist ICA Dist ICA IMT 0.00 Dist Inviom A Dist Subclav A 10.00 Dist Vert A 0.00 ECA 0.00 Innom A ED conis 0.00 Mid CCA Mid CCA IMT MD 0.00 MIS ECA 0.00 Mid ICA Mis ICA IMT PS cmnis y 0.00 Mid Incom A 0.00 Mid Subclav A SD 0.00 Mis Vert A 0.00 Prox CCA Prox CCA IMT TAME 0.00 0000 00 Prox ECA Prox ICA Prox ICA IMT 8 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Auto IMT technology allows the user to customize the values to display in the report and on the monitor in the MDA. Select System Configuration > Measurement & Report > Measurement. Next, select the Per Label Configuration tab at the top right and select the Carotid exam from the exam drop-down menu. Select Measurement & Report on the monitor and then select Measurement. Notes No. 8 Auto IMT with preview function > specific measurement SIEMENS Healthineers ... General Exam Package bam Specific Per Label Configuration Carotid Label Name y Dist CCA IMT Find Similar Labels a Datauit Tool and Method 20 IMT Last WOLMT Dist CCA Dist ECA Output Show Precision Dist ICA Unit Dist ICA IMMT 0.00 UIst Innom A 0.00 Dist Subclav A IMean Dist Vert A 0.00 ECA O 0.00 Innom A Mid CCA Mid CCA IMT Mi ECA Mid ICA MIJ ICA IMT Mid Innom A Mid Subday A Mid Vert A Prox CCA Prox CCA IMT Prox ECA Prox ICA Prox ICA IMT 9 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, select the measurement to be customized. In this example, the Dist CCA IMT measurement is selected. Select the 2D Default Tool drop-down menu for the Dist CCA IMT carotid exam measurement. There is only one option in this menu which is IMT, and it will already be selected. Notes No. 9 Auto IMT with preview function > default measurement method SIEMENS Healthineers ... General Exam Package Gam Spediti Per Label Configuration Carotid abel Name : Dist CCA IMT Find Sianilas Labiets Default Tool and Method IMT Last Max Bult Bulb IMT Dist CCA DIST CCA IMIT Min Dist ECA Outpot Dist ICA Unit Dest ICA IMT O.DO Dist Inriom A Mas Max 0.00 Dist Subclav A Dist Vert A Mein 0.DO ECA 0.00 Last Innom A Mid CCA Mid CCA IMT Mid ICA Average Mid Innom A Mid Subclav A Mid Vert A PIOx CCA PIOx CCA IMT Prox ECA Prox ICA Prox ICA IMT. 10 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Default Method drop-down menu allows the user to choose one IMT value to display in the report summary: the Minimum, Maximum, Last or Average number. If Average is selected, only the average of all measurements that were obtained will be displayed in the report Summary. The individual measurements that were saved can be found under the Edit Report option on the monitor or Touch Screen. During an examination, regardless of the method chosen for display in the report, the values in the MDA (measurement display area) will be from the current image measurements just performed. Notes No. 10 Auto IMT with preview function > output values SIEMENS Healthineers' .... General Exam Package bam Specinc Per Labet Configuration Carotid Label Name : Dist CCA IMT Find Similar Labels a Default Tool and Method IMT Bulb IMT Dist CCA Output Show Precision Dist ECA output Unit Dist ICA Precision Dist ICA IMT 0.00 C10 O mm 0.00 Dist Innoos A 0.00 Dist Subdav A Max 0.00 mm 0.00 V Dist Vert A ECA 0.00 Mean mm 0.00 Innom A Mid CCA Min Mid CCA IMT mm 0.00 V Mid ECA Mid ICA MIS ICA IMT Mid Innoms A Mid Subclav A Mid Vert A Prox CCA Prox CCA IMT Prox ECA PIOK ICA Prox ICA IMT 11 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, under Output, customize the output values to display in the onscreen MDA. The Maximum and Mean values will always appear in the MDA, although the C10 and Minimum values are displayed optionally and will only be shown in the MDA by checking the corresponding box in the Show column. Notes No. 11 Auto IMT with preview function > units and precision SIEMENS Healthineers ... General Exam Package Exam Specific Per Label Configuration mm Carotid Label Name : Dist CCA IMT Default Tool and Method Find Similar Labels mm 20 IMT abel Bulb Bulb IMT cm Dist CCA Dist ECA Output Show Unit Precision Dist ICA Dist ICA IMT Max 0.00 Dist Innom A 0.00 Dist Subclav A Mean Dist Vert A 0.00 0.00 ECA 10.00 Innoen A Mid CCA Mid CCA IMT O Mid ECA Mid ICA Mid ICA IMT 0.0 Mid Innom A Mid Subclav A Mid Vert A 0.00 PIOx CCA Prox CCA IMT PIOX ECA 0.000 Prox ICA Prox ICA IMT 12 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Unit drop-down menu allows the choice to display a millimeter or centimeter value in the MDA. The Precision drop-down menu enables the user to select up to three decimal places to show in the MDA. Notes No. 12 Auto IMT with preview function > edit report SIEMENS Healthineers ... CONSIEMENS Patient Report Patient History - Intima Media Thickness (IMT) Carotid Images Value Summary Comments RI Dist CCA IMT Moan 0.71 mm Max 0.78 mm - Carotid Assessment RI CCA LUCCA Rt CCA Plaque Description LI CCA Plaque Description RI CCA Diameter LL CCA Diameter Reduction Reduction Rt OCA Comments LE CCA Comments RE BIF LE BIF Rt BIF Plaque Description LI BIF Plaque Description Rt BIF Diameter Reduction LL BIF Diameter Reduction Rt BIF Comments Lt BIF Comments Edit Report: RE ICA LLICA Rt ICA Plaque Description Lt ICA Plaque Description Store Report Collapse All 13 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Edit report function, located under Report, allows the user to see the individual measurements that were obtained during the study. It also allows the user to delete measurements or change the Method value displayed in the report Summary. To enter the Edit Report page, select Edit Report from the Monitor or Touch Screen. Notes No. 13 Auto IMT with preview function > method SIEMENS Healthineers ... SIEMENS Healthineers Patient Report - Intima Media Thickness (A) Patient History Carotid Mean Max Method Method Images Summary Comments Rt Dist CCA IM 0.71 mm 0,78 m Max 0.68 0.78 0.71 0.78 Max 0.70 0.78 0.70 Last Carotid Assessment Avg RI CCA LE CCA Rt CCA Plaque Description Lt CCA Plaque Description Min Rt CCA Diameter Lt CCA Diameter Reduction Reduction FC CCA Comments Lt CCA Comments Max LE BIF 1 Fa EIF Plaque Description Lt BIF Plaque Description Fa BIF Diameter Reduction Lt BIF Dlameter Reduction Rt Baf Comments Lt BIF Comments Edit Report W N Colapse All tore Report Edited Value " 14 Unrestricted © Siemens Healthineers 2023 Speaker Notes: All measurements saved during the exam will be displayed there. Select the “X” next to a measurement to delete it. The Method or value to display in the report can also be changed here, which include Last, Average, Minimum, Maximum or any individual measurement saved. Note that the Minimum or C10 values can only be edited before beginning an exam. A carotid assessment package is also available, if desired. (arrow) Select Summary to go back to the Summary report page. Notes No. 14 Auto IMT with preview function > custom measurement label SIEMENS Healthineers' ... System Configuration 1 3 Latel Root DIST CCA 2 4 System Settings Creild No Nox Workflow Enhancement Sa Template Imaging Settings 70 Mode Measurement & Report O Doppler Mode O M Mode Measurement Touch Screen Measurement Config Custom Measurement Label 2 TEST CCA 2. Sore Al N Dose Concel All 15 Unrestricted © Siemens Healthineers 2023 Speaker Notes: (continued on next page) Entering Custom Measurements: To enter custom IMT measurements: 1. Select the System Configuration icon from the Touch Screen to enter System Configuration. 2. Select Measurement and Report and then Custom Measurement Label. 3. Select Carotid under the Exam Package drop-down. 4. Select the CCA, Bulb or ICA IMT measurement corresponding to the measurement being entered. Notes No. 15 Auto IMT with preview function > custom measurement label SIEMENS Healthineers ... Labet wot 5 7 Utsurvient Type DIRT CCA 2 Exam Package Carotid 6 8 R Template CCA Mods 70 Mode 9 Label O Doppler Mode O M Mode DIST CCA 2 10 Cancel AM 16 Unrestricted © Siemens Healthineers 2023 Speaker Notes: (continued from previous slide) Next: 5. Enter the name of the measurement in the Label Root field. 6. Select Carotid from the second Exam Package drop-down. 7. Select the Right / Left modifier so the measurement is available on both sides. 8. Select the Segment from the choices listed, Prox, Mid, Distal or origin, that corresponds to the added measurement. 9. Under the Tools tab, the Imaging Mode selected will be the 2D mode and be sure IMT is also selected in the right column. 10. Select Save All & close to finish. Notes No. 16 Auto IMT with preview function – position on touch screen SIEMENS Healthineers .... System Configuration Package Configuration Touch Screen Layout Esto System Settings Imagine Mode > Workflow Enhancement Carotis 20 g Settings Measurement Label Library Measurement & Report Carotid Detaa Measurement Modifiers Touch Screen Measurement Config Diet CCA DM CCAIMT Dit BIST CCA IMTE PTEK DEST CCA IST DON ICA had CAST CCA IMT NET DIEST CCA IST DIMICA Dat ICA MIT DM Innom A Dit Subclaw A(Carotid Dof Vert AlCaratic Innom A Mid CCA Mid CCAIMT Mid DIST CCA IMT3 Mid ICA Mid ICA MT Mid menor A New Page 17 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To ensure the custom label is in the desired position, select System Configuration > Measurement & Report > Touch Screen Measurement Config. The Carotid measurement package should still be selected. Select Touch Screen Layout Editor tab and notice the two tabs below, Default and Custom. The Default Touch Screen layout is seen first. Select the Custom tab to see the new custom measurement. Notes No. 17 Auto IMT with preview function > moving measurement SIEMENS Healthineers ... System Configuration Package Configuration ouch Screen Layout tens System Settings ging Mode Workflow Enhancement Carcela > Imaging Settings 20 Measurement & Report rement Label Library Measurement Carotid Touch Screen Measurement Config Modifiers DEST CCA OM DIST CCA E Dist DIST CCA 2 Olek here to remove New Page 18 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To move this measurement to the first page, use the Set key to select the measurement. Roll the trackball and measurement to the Measurement Label Library on the left. Press the Set key to drop the measurement into the Library. Notes No. 18 Auto IMT with preview function > placement on touch screen SIEMENS Healthineers ... System Configuration Package Configuration touch Screen Layout tato System Settings ing Mode Workflow Enhancement >Imaging Settings Measurement & Report Carotid Measurement Touch Screen Measurement Config THE CCA DA ECA Fres CA MERCA PESE CCA IMT DIKA CHEICA Dist DIST CCA IMTE MARICA BIT OUR CCA TNT DORICA MT New Page 19 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Now select the Default tab and select the new measurement with the Set key. Roll the trackball to the position desired on the page and press Set to drop it into position. Notes No. 19 Objectives SIEMENS . Healthineers .. • Discuss Auto IMT technology • Discuss M&R • Explain Auto IMT acquisition • Show Auto IMT video 20 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Now we will explain Auto IMT image acquisition. Notes No. 20 Auto IMT with preview function > acquisition – step one SIEMENS Healthineers' ... • Select compatible transducer and Carotid exam preset • Acquire an image of the carotid artery and bulb • Press Freeze 21 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Performing an IMT measurement can be performed in a few simple steps. First, select a linear transducer and the Carotid preset, as Auto IMT is not available on the non-linear transducers. Acquire an image of the distal carotid artery and bulb. Ensure the vessel image is perpendicular to the ultrasound beam and clearly shows the intimal lining. Press Freeze. Notes No. 21 Auto IMT with preview function acquisition – step two SIEMENS Healthineers' ... • Press Measure on the control panel • Select an IMT measurement from the Touch Screen Dist CCA IMT • Reference line and ROI appear 22 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, press Measure on the control panel. Select an IMT measurement on the Touch Screen and the dotted vertical reference line and the ROI will appear on the image. Notes No. 22 Auto IMT with preview function acquisition – step two SIEMENS Healthineers' ... Guidance function – dotted vertical line supports consistent alignment Guide ROI is: • 1 cm from the guide • 1 cm in length ROI 1 cm 1 cm | 23 Unrestricted © Siemens Healthineers 2023 Speaker Notes: This is an example of the reference line and ROI magnified. The reference line is 1 cm from the ROI. The ROI is 1 cm in length. Notes No. 23 Auto IMT with preview function acquisition – step three SIEMENS Healthineers' ... • Roll trackball and place the dotted reference line at the desired position • Press Update (Preview) key to enter Preview mode • Roll trackball to erase - press Update to re-enter Preview mode again • Press either Set key to enter Edit mode • Press Update (End) to save the measurement and enter in the report End Set set Edit 24 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, roll the trackball and place the dotted reference line at the desired position with the ROI over the desired area of the CCA posterior wall. Protocols will vary from institution to institution; therefore, placement of the ROI varies. Once the ROI is placed, a preview of the intima outline will be displayed. The outline can be easily edited by pressing the Update key to enter the Preview mode. The user will now see the two teal lines tracing the intima. The user can roll the trackball again to reposition the reference line and ROI. Next, press Update again to re-enter Preview mode. Once satisfied with the placement, press either Set key to enter the Edit mode. Notes No. 24 Auto IMT with preview function acquisition – step four SIEMENS Healthineers ... • Editable tracing will be teal • Use trackball, cursor and Set keys to adjust • Press Update (End) to save measurement • Press Capture to store the image and save the measurement to the report Set 25 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Once in Edit mode, the more anterior trace will now be teal, indicating the line that can be edited. Use the trackball and the cursor to readjust the tracing if needed. Place the cursor where you want the new trace to be and press either Set key to adjust the line. When finished editing the top tracing, roll the trackball posteriorly, if desired. Now, the more posterior line will be teal, indicating it can be edited. Use the cursor, trackball and Set key to adjust the tracing, if desired. Press Update (End) to complete the measurement and store it in the report or press Capture to end editing, store the image, and enter the measurement into the report. The lines will turn yellow when set. Notes No. 25 Objectives SIEMENS . Healthineers .. • Discuss Auto IMT technology • Discuss M&R • Explain Auto IMT acquisition • Show Auto IMT video 26 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Notes No. 26 SIEMENS Healthineers ... Healthineers Frozen 10L4 Carotid TIB:0,25 TIC:0 68 TIS:0 25 MI:1:15 52fps 95% 2D H High 8dB/DR60 c=1540 Fr86 Cine Margins 27 Unrestricted © Siemens Healthineers 2023 Speaker Notes: This is a video showing the Auto IMT with Preview function. Start by acquiring the image with the vessel wall perpendicular to the ultrasound beam so the intimal lining will pop. Use the jugular vein as a window, if able. Ask the patient to valsalva and help to distend it. Rotate the Zoom control to enlarge the image, if desired. Press Caliper and select an IMT measurement from the Touch Screen. Roll the trackball and place the ROI over a section of the posterior wall of the CCA. Press Update to enter Preview mode. Roll the trackball if adjustments are needed. Press Update to re-enter Preview mode or press Set to enter the Edit mode and adjust the tracings, if needed. To edit a tracing, roll the trackball and the cursor to the anterior tracing and place the cursor where you want to adjust it. Notice the active tracing to be edited is teal. Repeat the same steps with the posterior tracing. Press Update or Image to end editing and enter the values into the report. Notes No. 27 Summary SIEMENS. Healthineers .. • Discuss Auto IMT technology • Discuss M&R • Explain Auto IMT acquisition • Show Auto IMT video 28 Unrestricted © Siemens Healthineers 2023 Speaker notes: In conclusion, we have: Discussed Auto IMT technology Discussed M&R Explained Auto IMT acquisition Shown an Auto IMT video Notes No. 28 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 O r i g i n i s a trademark 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 29 Unrestricted © Siemens Healthineers 2023 Notes No. 29 Thank you SIEMENS . Healthineers .. for your enthusiasm! Questions? HOOD05162003112111 30 Unrestricted © Siemens Healthineers 2023 Speaker Notes: No speaker notes. Notes No. 30