ACUSON Origin Measurement Configuration Presentation

SIEMENS Healthineers ... ACUSON Origin Ultrasound System Measurement Configuration 1.0 software version 1 Unrestricted © Siemens Healthineers 2022 Unrestricted © Siemens Healthineers 2023 Unrestricted Speaker Notes: No speaker notes. Notes No. 1 Objectives SIEMENS . Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the touch screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Create a custom calculation • Discuss the OB tables O • Review report configuration 2 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The first step in configuring the measurement features on the ACUSON Origin ultrasound system is to identify how to access system configuration. Notes No. 2 Measurement configuration access SIEMENS . Healthineers ... System Configuration Control Panel Settings Patient Imaging Review Report End Exam 6 = Tab W E R T Y U P - - Caps Lock A S D F G H K L Enter .. .. Shift C V B N M N Delete Ctrl Alt 3 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To access the measurement configuration menu on the ACUSON Origin ultrasound system, select the System Configuration icon from the upper left corner of the touch screen. Notes No. 3 Measurement & Report configuration home page SIEMENS . Healthineers ... Measurement & Report System Configuration Measurement System Settings Workflow Enhancement general Exam Package Exam Specific Per Label Configuration Touch Screen Measurement Config Imaging Settings 20 Mode Calculation Display Area Custom Measurement Label Measurement & Report Measurement 20 Calipers Custom Calculations Touch Screen Measurement Config Draw Dotted Lines Between Calipers Bath Measured Results Roport Calculabons Custom Measurement Label Doppler Mode AD CULA S Report Custom Calculations Ao Root diBSA Report Ao Sinus d'RSA OB Tables 18 Show Negative Symbol Ao STJ diBSA OB Tables AcV Ann Area Annotations Heart Rate Tool AoY Ann Area (Post) ADV Ann SHBISA Features Number of Heart Cycles Ach Ann SIBSA (Post) › Transducer AOV ATIET Connectivity & Network AOW ATIET (Post) ADV CI Peripheral Devices NON CI (Post) System Management AOV CO NON CO (Past) AoV Peak Grad AOW Peak Grad (Post) ADV SI ACV SI (Post) AoV Site 2 Area AOV Site 2 Area (Post) ADV Site 2 5V AOV Site 2 SV (Post) Restore Defaults 4 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Once in System Configuration, the measurement configuration section is located under the Measurement & Report (M & R) heading. There are six sub-groups in the Measurement & Report section: • Measurement • Touch screen Measurement Config • Custom Measurement Label • Custom Calculations • Report • OB Tables These sub-groups will be discussed further in this presentation beginning with the Measurement option. Notes No. 4 Objectives SIEMENS . Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the touch screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Create a custom calculation • Discuss the OB tables O • Review report configuration 5 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The first subgroup to be discussed is the Measurement option. Notes No. 5 Measurement subgroup SIEMENS . Healthineers ... General tab System wide settings for: General Bam Package Exam Specific Fer Label Configuration 20 Mode Calculation Deplay Area • Dotted lines between calipers 20 Calipers • Show negative symbol Draw Dotted Lines Between Calipers Both Doppler Mode (Fetal M.Mode)LV CO • Heart rate tool (Fetal M-Mode)I.V EF Velocity (Fetal M-Mode)LV Mass Show Negative Symbul (Fetal M. Mode)I.V SV • Calculation display area (Fetal M Mode)LY Vol d Heart Rate Tool (Fetal M-Mode)L.V Vols configuration (Fetal)Ao Root MPA Diam Number of Heart Cycles (Fetal)AoV Annulus Areas (Fetal)AoV Area (Vmax) (Fetal)AoV Area (VTI) (Fetal)AOV ATIET (Fetal)AoV 5V (Fetal)AoVIPY Annulus $ (Fetal)APAD&TAD WN 80000000000000 (Fetal)AR PHT (Fetal)BPDa (FetalXCO (Fetal)C3 (FetalXCor Sinus LengthyDiam (Fetal)CTR Area (Fetal)CTR Circum (Fetal)Ductus V S/D Vmax Restore Defaults 6 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Measurement option contains four tabs that allow the user to configure the overall measurement settings for the ACUSON Origin ultrasound system. Use the Pointer to select one of the four tabs and display the available options. The active tab is highlighted in orange. The first tab, General, contains the options for system wide measurement settings such as: • Drawing dotted lines between the calipers • Showing the negative symbol for velocity measurements (both onscreen and in the report) • Heart rate tool (number of cardiac cycles) Note: Be sure to select “Show Negative Symbol”, so that Doppler velocity values measured below the baseline will not result in an erroneous resistive index (RI) calculation. The Calculation Display Area configuration is also contained within the General tab. The user has the option to customize which calculations are displayed within the report, or within the measurement display area (MDA), or within both. Notes No. 6 Measurement subgroup SIEMENS . Healthineers ... Exam Package tab Individual exam package settings for: General Exam Padage Exam Specific Per Label Configuration Cine measurement behavior Exam Paduge • Cardiac • 2D measurement tool type CINE Me ent Behavior Prechio Erase in CINE • Doppler default tool type IVS 0.00 20 Took LVPW 0.00 LVIO Volume Tool cm 0.00 • Volume Flow Tool 3 Distances Stenosis Area %Stenosis Tool 0.00 • Individual label precision and unit Ellipse . Trace 0.00 Generic Area Ratio Tool A (E) 0.00 Trace Acce El Show mas 0.00 Doppler Tools Angle O Default Tool Area Ratio 0.00 Velocity AT O Stow ms Average Distance 0.00 Volume Flow Tool 0.00 Volume C10 0.00 Distance D Flow cm 0.00 Heart Cycle Cm 0.00 Restore Defaults: Cardiac 7 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Exam Package tab allows the user to individually configure each exam package with default cine measurement behavior and measurement tools. These selections are system-wide and any new measurement label created for a given package (i.e. Cardiac, Abdomen, Carotid, etc.) will inherit these default settings automatically when the label is created. Options to alter default settings for an individual label are contained within the Per Label Configuration tab, which will be covered later. To customize the default settings for an exam package, use the Pointer and Set key to select the specific package from the drop-down menu, then choose the desired default cine measurement behavior and tool options. The user can further customize the measurement label by selecting the unit of measure and the level of precision that will display in the report and the onscreen MDA when the label is used. Some labels, such as Acceleration, also contain the option to show or hide the resultant within the MDA. Notes No. 7 Measurement subgroup SIEMENS . Healthineers ... Exam Specific tab • OB exam options for: General Exam Package Exam Specific Per Label Configuration • Date display types (screen) 08 Exam state Exam • Standard deviation Display OB/GYN Dates on the Screen Auto OB Prostate Specific Gravity LMPIDOC O European - BPD outer to outer O 1.0 1 Clinical Age US - BPD outer to inner 1.05 EDO • Ratio display types (report) EFW Measurement tool types Display Averaged GA or z SD on Touch Screen • Gestational Age Carotid Exam • eSie OB Display Averaged GA or z SD in Measured Results Carotid Ratio Gestational Age Max ICA Dist CCA Display Out of Range Max ICA O Max CCA Prostate specific gravity options O Prox ICA O Prox CCA • 1.5 O Mid ICA O Mid CCA O Dist ICA Dist CCA • 1.0 Cardiac Exam • 1.05 Al Measure: Heart Cycles Measured Carotid Ratio default selections Doppler • M Mode • Cardiac cycles assessed with AI measure: • Doppler Restore Defaults • M-mode 8 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Exam Specific tab contains options for OB, prostate, carotid and Cardiac exams. For OB exams, the user has the option of what information they would like to be displayed on the screen during imaging. Use the Pointer and Set key to check or uncheck the available options. The options for display include: • LMP/DOC • Clinical Age • EDD • EFW Default tool types for both maternal and fetal measurements are found here as well as the eSie OB measurement type. Be sure to check that the eSie OB measurement type (BPD outer to outer or outer to inner) matches the region you are installing the system in. Report display options for gestational age and out of range are other OB options found under the Exam Specific tab. Prostate exam specific gravity options, 1.0 and 1.05, are the only prostate related options listed in this tab. The default carotid ratio option is also available within this tab. The user has the option to select a specific segment for the ICA and CCA to be used for calculation of the ratio. If a specific segment is not desired, the option to use the maximum measured velocity, regardless of segment, can be selected. In this example, the system has been configured to use the maximum ICA velocity and the distal CCA velocity to calculate the ratio. Note that this configuration can be altered on a “per exam basis” on the report page of an opened exam should the user desire a different option than what is configured here. Once the exam is closed, the changes made on the report page for the ICA / CCA segments will return to what is configured here in the Exam Specific tab. For cardiac exams, the user can set the default number of heart cycles assessed when performing AI measurements on Doppler, DTI and M-mode. The options are 1, 2 and 3. The user can also increase or decrease the amount of heart cycles measured on the fly during an exam. Notes No. 8 Measurement subgroup SIEMENS . Healthineers ... Per Label Configuration tab Exam Specific • Labels can be configured on an General Exam Package Per Label Configuration individual basis for Cardiac Label Name : AR ED Velocity Default Tool and Method Find Sienilar Labels Average • Unit Doppler Velocity ARED Velocity • Precision AR ED Velocity (Post) AR Jet Area AR Jet Area (Post) • Default tool type AR Jet Ht Output Show Precision AR Jet Ht (Post) AR PISA RaSus • Method (Last, Max, Mean, Average) AR PISA Radius (Post) 0.00 AR Slope AR Slope (Post) • Show / Hide in MDA AR VC Width AR VC Width (Post) AR VI ARVII (Post) AR Vmax AR Vmax (Post) • Use Find Similar Labels option to change ASD Diam ASD Major multiple labels to the same settings ASD Minor ASD Sop Inf ASD Vmax Ao Abd No Arch Distal No Arch Trans Distal Ao Arch Trans Prox 9 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The final tab is the Per Label Configuration. Under the Per Label Configuration, each label output can be modified based on unit, precision, default tool type, and display (show / hide) within the MDA, should the user desire a change from the default selection set in the Exam Package tab. Each default tool type can be further customized for the method used for calculations – last, max, mean, or average. Should a user wish to alter multiple labels of the same measurement type within a package, the option to Find Similar Label(s) can be used. Select the Find Similar Label option and a list of all similar labels (based on measurement type) will appear in the space provided. The user then needs to check off each label they wish to be converted to the newly chosen settings and then select Apply To Similar Label. Notes No. 9 Objectives SIEMENS . Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the touch screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Create a custom calculation • Discuss the OB tables O • Review report configuration 10 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, we will describe how to configure the layout of the touch screen on the ACUSON Origin ultrasound system. Notes No. 10 Touch Screen Measurement Config SIEMENS . Healthineers ... Export Calc Frouge Frans Package System Configuration O Corddat O Abdomen Show / Hide Export > System Settings > Workflow Enhancement Package Configuration Touch Screen Layout Editor D Carosd dialogue box measurement D Early of > Imaging Settings Measurement Package Package Name packages Measurement & Report Name Show All v Cardiac Measurement Cardiac O LEA Exported Calc Packages Cak Touch Screen Measurement C D uv Abdomen aging Mode Cancel Custom Measurement Label Breast 20 Custom Calculations Carotid Report Early OB OB Tables Fetal Echo Dimension Vessels Simpson (Volume) RVIRA Valves LV Mass A-L. > Annotations GYN Re-order > Features Ped Hip PISA QpiQs Create custom > Transducer LEA measurement > Connectivity & Network LEV measurement > Peripheral Devices MSK LV d Series RVID d PLAX IVS d PLAX LVID d PLAX LVPW d PLAX packages packages > System Management Neo Head OB LVID & PLAX Pediatric Abdomen Pelvis No Root d LA A-P Diam's PLAX LVOT Diam's RVOT Diar Create Package Delete Package Delete custom Import / Export Import Export packages 11 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The next section in the M&R system configuration is the Touch Screen Measurement Config. There are two tabs. The first tab is the Package Configuration where the user can: • Show / Hide an exam measurement package by checking / unchecking the corresponding box • Re-order measurement packages by using the up / down arrows • Create a new customized measurement package for any exam • Delete a custom measurement package • Import or Export an entire package or packages as a .Calc file via USB to another system Note: Custom equations will not be exported using this option. Exporting custom equations must be done using the Local Settings export or full Back-up and Restore under the System Management tab. This procedure is covered in the ACUSON Origin Ultrasound System Configuration presentation. Notes No. 11 Create new custom calculation package SIEMENS . Healthineers ... Custom measurement packages can Package Configuration Touch Screen Layout Editor be created for any exam: ckage Package Name Name Show All V Select Create Package Cardiac • Cardiac Abdomen Imaging Mode • A dialogue box will appear Breast → Enter Package Name Carotid Early OB → Select specific Root Fetal Echo Dimensions Vessels Create Package GYN Package or None (empty) Ped Hip PISA Package Name Cardiac (2) LEA Select OK to save LEV Root Package Cardiac • MSK Neo Head OK Cancel OB Pediatric Abdomen Pelvis Create Package Delese Package Import Export 12 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Custom measurement packages can be created for any factory or custom exam preset. A custom measurement package can then be “attached” to its specific exam under Workflow Enhancements > Exam Association. The steps for exam association and creation are covered in the ACUSON Origin System Configuration presentation. To create a custom measurement package for an exam: • Select Create Package • A dialogue box will appear on the screen for you to: • Enter the Package Name – for example, “Cardiac (2)” • Select a specific Root Package or None for an “empty” package • Save the newly created package by selecting OK To add labels to the newly created custom package, select the package under the Touch Screen Layout Editor and populate the touch screen with the desired labels. Notes No. 12 Measurement package visibility and order SIEMENS. Healthineers ... All measurement packages are listed in the Package Configuration Touch Screen Layout Editor master list Measurement Package Package Name Name Show A General Change the visibility (“hide”) any General • Cardiac Imaging Mode package by unchecking the Abdomen 20 Breast associated box  → Carotid Early OB Default • Re-order packages within the list by Fetal Echo Modifier using the up / down arrows GYN Ped Hip LEA LEV MSK Neo Head OB Pediatric Abdomen TIP If a measurement package is not displayed on touch screen, check Create Package this tab for visibility import Export 13 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Measurement packages that are on the system (factory or custom) will be listed in the master list under the Package Configuration tab. Package order and visibility can be changed here. To change the visibility and “hide” a package, uncheck the box next to the chosen exam in the master list. To change the order in which the packages are displayed, use the “up” and “down” arrows on the right to move the package(s) to the desired location within the list. Re-ordering will be reflected on the displayed touch screen menu when a user selects the alternate exam package command in the upper right corner of the touch screen. Note that newly created custom measurement packages will appear at the bottom of the master list, not with the specific Root Package that was used as a base to create the custom package. TIP: If a measurement package is not being displayed on the touch screen, check this tab for visibility, as it may have been inadvertently unchecked. Unchecking the measurement package will remove it from the touch screen display. Notes No. 13 Touch Screen Measurement Config SIEMENS . Healthineers ... Touch screen Package Configuration Touch Screen Layout Editor mode Name Mode Cardiac 20 Exam type Measurement Label Library Cardiac Q Label search Vessels Simpson (Volume) RVIRA AR CERCA) FISA field Anatomy Folders Ad Aliasing Velocity PISA Op/Cs Al Alizing Velocity (out) AR set Ht Indicates a folder Touch screen LV d Series RVID & PLAX IVS & PLAX LVID d PLAX LVPW & PLAX of measurements layout grid RIF(PISA) (i.e. volumes or AR VC Wah LVID & PLAX linear measures in AND Major ASD Miner Ao Root d LA AP DUIm & PLAX tvor Dum's RYOT Dum a series) ABD Sco ist As Ab&cCardiac Master list of New Page Add new page label options Restore Defaults: Cardiac Restore defaults 14 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The second tab is the Touch Screen Layout Editor which allows the user to customize the layout of the touch screen measurement labels for each exam. The layout is separated by imaging mode. Once a specific exam package is selected from the drop-down menu, a mirror image of the touch screen layout is displayed. Different specialized measurement groups and associated sub-groups are displayed at the top of the mirror image touch screen. A master list of labels associated with the selected exam type is displayed to the side of the touch screen layout grid. There is a label search field to aid the user in locating a desired label. Labels on the touch screen that contain a small gray triangle in the upper corner indicate a “folder” of continuous measurements, such as the interventricular septum, left ventricle and posterior wall measurements. The entire folder can be added to the touch screen or just individual components. Folders are not customizable and new folders cannot be created. Labels with a modifier such as proximal or distal, have the modifier embedded into the label. If a new page needs to be added to the touch screen, use the New Page key. A total of 5 pages are possible with a maximum of 18 labels per page. Once a new page is added it cannot be deleted, however if there are no labels located on that page it will not be displayed during live scanning / active measurement mode. White dots located below the touch screen visually indicate additional pages. To access additional pages for configuration, the user can select the directional arrow key on either side of the Page number indicator with the pointer. A Restore Defaults option is available in the bottom corner which will apply to the selected exam type only. For cardiac, there are two lines of anatomy specific folders. Label groups belonging to specific anatomical areas, for example, vessels, will be contained within these folders. Note that the touch screen editor layout for general imaging exam types differs in that there is only one line for anatomical specific folders. Notes No. 14 Touch Screen Measurement Config SIEMENS . Healthineers ... Moving labels Move a label to a different blank location Package Configuration Touch Screen Layout Editor on the touch screen: maging Mode 20 • Use the Pointer and Set key to Measurement Label Ubrary highlight and “pick up” the label Cardiac • Move the label to the new blank Vessels Simpson (Volume) RVIRA Valves IVMISSAL location PISA • Use the Set key to “drop” the label in the new location IV d Serie RVID d PLAX IS & PLAX LVID & PLAX EVPW & PLAX LVID.s PLAX Ao Root e LA APDUm & FLAX RVOT Dum New Page Restore Defaults: Cardiac 15 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Labels are easily moved around to different locations on the touch screen. To move a label to a new blank location, use the Pointer and Set key to “pick up” the desired label then drag the label to the new blank location. Use the Set key to “drop” the label in place. Labels can also be easily swapped with one another on the touch screen. Use the Pointer and Set key to pick up the label to be moved. Drag the label to the new location and use the Set key to place the label. If a label already occupies the desired space, the existing label is automatically be picked up by the cursor when the label that is being transferred is “dropped”. The user can then move the “picked up” label to an alternate location. Restore Defaults will move all labels back to their original (factory) location. Notes No. 15 Touch Screen Measurement Config SIEMENS . Healthineers ... Adding a label Adding a label: Package Configuration Touch Screen Layout Editor aging Mode • Find desired label in the master 20 list Measurement Label Library • Pick up the label using the pointer Cardiac and set key Vessels Sampson (Volane) RVIRA LV Mess A.L. Alty Parametry C'est ABv Sae 2 Olam (Post) • Move to desired location and Aow Site 2 Diam Criunifiex Clum PISA drop the label Coronary A HY D NYC Colagund Diam RVIO d PLAX IS d PLAX EVID & PLAX LVPW & PLAX NS BADES PLAX LV d Series EVID & PLAX TIP To add a label quickly, double click MEPSAX NIPSAX No Root d LA AP DUm &PLAX tvor Dum's RVOT Dlamm IVC Diam on the label name in master list – LA AP Dan'S PLAK LA Diam if, exp label is added to next available spot New Page Restore Defaults: Cardiac 16 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To add a label to the touch screen, find the label in the master list using the search or scroll method. Highlight / pick up the label using the Pointer and Set key then drag the label to the desired location on the touch screen. Drop the label using the Set key. If the location is already occupied by another label, the existing label will be automatically picked up by the pointer so it can be moved to another location. Another option to quickly add a label to the touch screen is to double-click on the label in the master list with the Set key. The label is automatically added to the touch screen but in the next available spot. While this is a faster option, the label may or may not be in the desired location on the touch screen. If the user wants the label in a different location, the label must be manually moved using the pointer and set key method. Notes No. 16 Touch Screen Measurement Config SIEMENS . Healthineers ... Removing a label Two options to remove a label: Package Configuration Touch Screen Layout Editor • Pick up the label to be removed aging Mode 20 and drag label to master list and Measurement Label Ubrary drop using the Set key Cardiac • Double-click on the touch Vessels Saapcon (Volume) RVIRA screen label PISA LV a Series LV d Series RVIO d PLAX IS d PLAX EVID & PLAX LVPW & PLAY LVID & PLAX No Root d LA A.P DUm & PLAX tvor Dums RVOT Dlamm New Page Restore Defaults: Cardiac 17 Unrestricted © Siemens Healthineers 2023 Speaker Notes: There are two options to remove a label from the touch screen and add it back to the master list of labels. The first is to pick up each label using the Pointer and Set key, then drag the label to the master list and drop it. The second is a much faster removal process. The user positions the Pointer over the label to be removed and double-clicks the Set key. The label will automatically be removed from the touch screen and added back to the master list. Note: Labels must be removed one at a time. Notes No. 17 Touch Screen Measurement Config SIEMENS . Healthineers ... “Blank” measurement touch screens • Not all exam packages have labels Package Configuration Touch Screen Layout Editor populated on the touch screen: Measurement Package Package Name Name Show All MSK • MSK General Cardiac Imaging Modit Custom labels must be created for this Abdomen 20 • Breast exam packages Carotid Early OB Detmit Custom Fetal Echo Modifier GYN Ped Hip LEA LEV MSK Neo Head OB Pediatric Abdomen Create Package Import Export 18 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Not all exam packages have labels populated on the touch screen. The MSK exam package has an empty touch screen. Custom labels must be created and added to the touch screen display if desired. Use the Create Package option located within the Package Configuration tab. Note that the Create Package option can also be used to create new custom measurement packages for any exam (cardiac or GI) that may be required by the user. Notes No. 18 Objectives SIEMENS . Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the touch screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Create a custom calculation • Discuss the OB tables O • Review report configuration 19 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The next section will explain the homepage options for creating a custom label. Notes No. 19 Custom measurement label subgroup SIEMENS . Healthineers ... Homepage layout System Configuration > System Settings > Workflow Enhancement Exam Exam Package > Imaging Settings Cardiac Exam Package Measurement & Report O Custom measurements Measurement Cardiac Touch Screen Measurement Config Cardiac Custom Measurement Label Ao Abd New Custom Calculations Ao Arch d Abdomen Ao Arch Distal Copy Report Ao Arch Trans Distal Breast OB Tables Ao Arch Trans Prox Edit Carotid > Annotations Ao Asc d > Features Ao Asc Vmax Early OB AO Asc VTI > Transducer Ao Coarct Diam Fetal Echo > Connectivity & Network Ao Coarct Vmax > Peripheral Devices Ao Desc Delete GYN Ao Desc Vmax > System Management Ped Hip Ao Diam d Ao Isthmus LEA Ao Root d Ao Sinus d LEV Ao STJd SR Mapping MSK Ao Thoracic AoV Annulus $ Restore SR Mapping Neo Head AoV Annulus $ (Post) AoV Area Planimetr AoV Area Planimetriast) AOV AT 20 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The next M & R section describes how the user can create custom labels that can then be added to the touch screen display. From the drop-down list, select the desired exam package where the custom label is required by the user. Notes No. 20 Custom measurement label subgroup SIEMENS . Healthineers ... Homepage layout 1. Master list of all labels Exam Package Cardiac 2. Label management options Label Root: Ao Abd Custom measurements 3 leport Section: Aorta 2D Tools: Distance 3. Display of label information / SR Template: Cardiac Ao Abd SR Mapping: Completed content New Ao Arch d Ao Arch Distal Copy 4. Access SR Mapping configuration Ao Arch Trans Distal Ao Arch Trans Prox Edit No Ascd 2 Ao Asc Vmax AO Asc VTI Ao Coarct Diam Ao Coarct Vmax 1 Ao Desc Delete Ao Desc Vmax Ao Diam d Ao Isthmus Ao Root d Ao Sinus d AO STJ d SR Mapping Ao Thoracic 4 AoV Annulus $ AoV Annulus $ (Post) AoV Area Planimetr AoV Area Planimetriast) AOV AT 21 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Once the exam package is selected: 1. Existing labels are displayed in the master list under the exam package name (the active / selected label is highlighted in orange) 2. Available functions – New, Copy, Edit, Delete 3. Active / selected label information is displayed, including default tool type(s) for 2D and Doppler, as well as the report section, and whether SR mapping is complete 4. Access the SR Mapping configuration and Restore SR Mapping The following slides discuss these sections in a greater detail. Notes No. 21 Custom measurement label subgroup SIEMENS . Healthineers ... Measurement master list display options 1. Exam package type • All measurements* Exam Package • Custom measurements Cardiac 1 Custom measurements 2. Search box can match any part of label name 2 3. Measurement master list Ao Abd New Ao Arch d • Display is based on selected criteria (1) Ao Arch Distal Copy Ao Arch Trans Distal • Alphabetical, scroll bar to view list Ao Arch Trans Prox Edit Ao Asc d • Selected label is highlighted in orange Ao Asc Vmax 3 Ao Asc VTI Ao Coarct Diam Ao Coarct Vmax Ao Desc Delete Ao Desc Vmax 22 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The measurement master list [3] displays according to selected options: • [1] By the selected exam package type • By custom measurement labels only within the selected exam package (if unchecked, all measurements including factory and custom labels will display) A search box [2] is available to easily filter out and find a specific label. Enter the label name into the search field and the master list will display labels containing the search criteria. The master list displays alphabetically and is based on the selected criteria. Notes No. 22 Custom measurement label subgroup SIEMENS . Healthineers ... Label management options New Exam Package Cardiac • Create/define a new custom 0 Custom measurements Label Root: Ao Root d (2) leport Section: Aorta measurement label 2D Tools: Distance SR Template: Cardiac Ao Abd SR Mapping: Completed New Copy Ao Arch d Ao Arch Distal Copy Ao Arch Trans Distal • Copy a selected factory label Ao Arch Trans Prox Edit No Ascd Ao Asc Vmax Edit AO Asc VTI Ao Coarct Diam Ao Coarct Vmax • Edit the selected custom label Ao Desc Delete Ao Desc Vmax Ao Diam d Delete Ao Isthmus Ao Root d Delete a custom (only) label Ao Root d (2) • Ao Sinus d SR Mapping Ao STJ d Ao Thoracic Restore SR AoV Annulus $ Mapping AoV Annulus $ (Post) AoV Area Planimetr AoV Area Planimetriat) 23 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Available custom label functions are: • New – user can create / define a new custom measurement label • Copy – user can copy a selected factory label and its existing parameters • Edit – user is able edit a custom label • Delete – user can delete a custom label (cannot delete factory labels) Notes No. 23 Custom measurement label subgroup SIEMENS . Healthineers' ... Label information • Highlighting a label displays a Exam Package summary of the measurement Cardiac 0 Custom measurements Label Root: Ao Root d (2) information Report Section: Aorta 2D Tools: Distance SR Template: Cardiac Ao Abd SR Mapping: Completed • Use as a quick reference for mode New Ao Arch d types, attached modifiers, tool No Arch Distal Copy Ao Arch Trans Distal types, or report section location Ao Arch Trans Prox Edit No Ascd Ao Asc Vmax • Displays general SR mapping AO Asc VTI Ao Coarct Diam information Ao Coarct Vmax Ao Desc Delete Ao Desc Vmax Ao Diam d Ao Isthmus Ao Root d Ao Root d (2) Ao Sinus d SR Mapping Ao STJ d Ao Thoracic Restore SR AoV Annulus $ Mapping AoV Annulus $ (Post) AoV Area Planimetr AoV Area Planimetriat) 24 Unrestricted © Siemens Healthineers 2023 Speaker Notes: A summary of the label’s parameters is displayed when selecting / highlighting a label in the master list. The default selections for the mode tools, any modifiers attached to the label, and where the label results will be displayed in the report are noted in the summary. The SR mapping template, and state of completion are also displayed. The SR mapping procedure will be covered later in this presentation. Notes No. 24 Custom measurement label subgroup SIEMENS . Healthineers ... Other available functions Other available functions include: Exam Package Cardiac • SR Mapping “quick access” key 0 Custom measurements Label Root: Ao Root d (2) leport Section: Aorta 2D Tools: Distance SR Template: Cardiac • Restore label defaults to any factory Ao Abd label that has been modified New SR Mapping: Completed Ao Arch d No Arch Distal Copy Ao Arch Trans Distal Ao Arch Trans Prox Edit No Ascd Ao Asc Vmax AO Asc VTI Ao Coarct Diam Ao Coarct Vmax Ao Desc Delete Ao Desc Vmax Ao Diam d Ao Isthmus Ao Root d Ao Root d (2) Ao Sinus d SR Mapping Ao STJ d Ao Thoracic Mapping AoV Annulus $ AoV Annulus $ (Post) AoV Area Planimetr AoV Area Planimetriat) 25 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Other options on the Custom Measurement Label homepage are: • A “quick access” to open the SR Mapping page • The Restore SR Mapping option will restore the factory SR mapping to a copied label, or one can delete any custom labels and their subsequent SR mapping Notes No. 25 Objectives SIEMENS . Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the touch screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Create a custom calculation • Discuss the OB tables O • Review report configuration 26 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Before we explain how to create a custom label, it is important to understand what DICOM Structured Report (SR) is and how it relates to custom labels. The next section reviews the basics of Structured Report (SR) Mapping and its associated terminology in order to better understand some of the steps involved in creating a custom label on the ACUSON Origin ultrasound system. Notes No. 26 What is DICOM and DICOM Structured Report (SR)? SIEMENS . Healthineers ... DICOM is an acronym for Digital Imaging and COmmunications in Medicine DICOM was the result of manufacturers and users of radiological imaging equipment attempting to standardize image exchange between different systems. The specification became the DICOM Standard. The development of DICOM Structured Reporting (SR) was an extension of the initial standard; it was created in order to communicate non-imaging information such as measurements or post-processing results, in a standardized way. 27 Unrestricted © Siemens Healthineers 2023 Speaker Notes: What is DICOM and DICOM Structured Reporting? DICOM is an acronym for Digital Imaging and COmmunications in Medicine. DICOM was the result of a joint venture between imaging manufacturers and users of imaging equipment in an attempt to standardize image exchange between different systems regardless of the manufacturer. The DICOM Standard is a specification that’s regularly updated after new content and corrections have been approved by Working Group 6 (a.k.a. “The Lords of DICOM”) and the voting DICOM members. DICOM Structured Reporting, or DICOM SR, is an extension of the initial standard. DICOM SR was created in order to communicate non-imaging parameters such as measurements or post- processing analysis, in a standardized way. A DICOM SR is an actual document that consists of structured or mapped data. This data defines the file content and organization for ultrasound procedure reports. This content can be read by a PACS or workstation and then translated into many different things – a report being one of the formats. To produce this report, additional software is required to translate the mapped content into a format that can be printed. Notes No. 27 DICOM SR and the ACUSON Origin Ultrasound System SIEMENS . Healthineers ... Why is DICOM SR important to the ACUSON Origin ultrasound system? In system configuration, the ACUSON Origin ultrasound system will allow the user to define custom measurements and associate a custom SR mapping to it. This custom data can be transferred as SR if it matches mapping expected by PACS / Offline reporting package. Expected “mapping” behavior is only achieved if during the creation and mapping of a new measurement label, the user follows the DICOM SR template structure. If the template structure is not followed, the measurement data will not be displayed in SR, as the PACS or offline workstation will not be able to “read” the data. 28 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Why is DICOM SR so important to the ACUSON Origin ultrasound system? What is different from past systems? While we have incorporated DICOM SR mapping on previous systems, we have not offered the ability to do custom SR mapping. The ACUSON Origin ultrasound system offers this custom feature in its system configuration. Custom SR data can be transferred to an offline workstation or PACS when a custom label is created, provided that the label is mapped with the expected behavior using the DICOM standard rules / template. Should the template structure not be followed, the offline workstation or PACS will not be able to “read” the data and the label will not be displayed in the structured report. How do we make data readable to the PACS or offline workstation when creating a custom Structured Report map? Notes No. 28 DICOM SR template data components SIEMENS . Healthineers ... The DICOM SR template has a specific set of rules for “coding” data for a readable transfer. The ultrasound data is constructed in sections (or “containers”) based on anatomy, which are further separated into “concept names”. Each concept name is associated with a coded “result” which defines the specifics of that result - measurements and other data - within the concept name. There are four templates supported by the DICOM standard for ultrasound. These are: • OB / Gyn • Vascular • Adult Echocardiography • Pediatric and Fetal Echocardiography 29 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To make data readable to a PACS or offline workstation, a DICOM SR template must be used that follows a very specific set of coding rules. These coding rules translate the ultrasound data to a PACS or offline workstation “language” by assigning a code value to each piece of ultrasound data to be transferred. The ultrasound data is constructed in sections based on anatomy (e.g. blood vessels of the head) or its related information (e.g. fetal biophysical profile). Each section contains “concept names” (e.g. length, peak systolic velocity, etc.) and each concept name is either a numerical value, a coded value, or a text value. The format of these values is defined in the DICOM Standard. There are four templates supported by the DICOM standard for ultrasound procedure reports. These are: • OB / Gyn • Vascular • Adult Echocardiography • Pediatric and Fetal Echocardiography Notes No. 29 DICOM SR template data components SIEMENS . Healthineers ... Template ID 5100 Vascular Structured Reporting “coding” rules Ultrasound Procedure Report • TID 5103: Blood Vessel of Head, Left • TID 5103: Blood Vessel of Head, Right Carotid Siphon Box • TID 5103: Blood Vessel of Head, Unilateral TID 5103: Artery of Neck, Left ........ ... ..... ... " Peak Systolic • • Anterior Cerebral Artery • TID 5103: Artery of Neck, Right • Carotid Siphon ................ • Central Retinal Artery Result • Etc. Result • Central Retinal Vein • Internal Carotid Artery Coded Entry • Middle Cerebral Artery “Result” • Ophthalmic Artery Result Result • Posterior Cerebral Artery • Etc. ................................................ ....... Section or Container Concept Names Context ID TID 5103 Example results for Example: Blood Vessel of Carotid Siphon such as: (11726-7, LN, “Peak Systolic Velocity”) • Peak Systolic Velocity L Head, Left Code • End Diastolic Velocity Code L • Diameter value meaning • Etc. Coding scheme Modifier designator 30 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Programming a custom SR map for a new or copied label is easily achieved if the “rules” are followed – not following these rules will result in the PACS not being able to read the entry and the label will not be displayed in the structured report. This diagram represents the sequence that needs to be followed when entering a new SR map. When thinking about the steps to map a label in a structured report, it might be easier to think about the components of the templates as “containers within containers”. Once you select a template to work with you need to start defining the different containers within that template during the mapping process. Remember that there are three templates to choose from – Vascular, OB / Gyn, and Pediatric / Fetal Echocardiography. In this example I have chosen the Vascular ultrasound procedure report template, which has a numeric template ID (or TID) of 5100, to walk you through the coding process. Within the vascular template exists a number of anatomical options, listed under the template heading on the side. Let’s pick the “Blood Vessel of Head, Left” to use for our example and represent this section of the template with a large orange box “container”. Inside that orange box are several smaller boxes that represent each of the many blood vessels found in the head – a few examples are listed on the front of the orange box. If we pick one of these smaller “vessel boxes” - for example the carotid siphon - there are additional containers within the carotid siphon “box” that define the various results that can be obtained for that vessel. These results, represented on the diagram with the small purple boxes, can be anything from a velocity or length, to even an imaging parameter, that are specific to the carotid siphon and need to be “coded” for the PACS to be able to read that result. The result, in this case the “peak systolic velocity”, is “coded” into three parts: • A “code value”, which specifies the term from the available list of terms • A “coding scheme designator” that specifies the dictionary that defines the term, such as SRT, DCM, or LN • A “code meaning” that makes a readable description of the term These three coding parameters must be entered into the ultrasound system to program the pathway for the SR map. Now that we have an in-depth understanding of the SR mapping process, let’s continue with the configuration information for creating custom labels. Note: The DICOM header information (institution info, patient info, exam info, equipment info, etc.,) is separate from Notes No. 30 the DICOM SR but part of the overall Comprehensive SR [for ultrasound]. 30 Objectives SIEMENS . Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the touch screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Create a custom calculation • Discuss the OB tables O • Review report configuration 31 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Now let’s describe the steps required to create a custom label. Notes No. 31 Defining custom measurement labels SIEMENS . Healthineers' ... Creating a custom label To create a custom label, begin by defining the Label Root " Modifiers 3 Measurement Type label basics: Ao Root d (2) 1 O Right / Left 4 1. Label Root (name) Exam Package Segments 5 Cardiac 2 None Prox ] Mid Dist Origin 2. Choose exam package Tools R Template SR Mapping 3. Select modifiers (if applicable) Imaging Mode 20 Mode * 2D Mode Tools Label 4. Measurement Type O Doppler Mode [] Angle O M Mode Area 5. Select segments (if applicable) Report Section Circumference Aorta Distance Ao Root d (2) Vol MOD Area Ratio [ Distance Ratio Stenosis [] Volume IMT . sequeed field Save All & Close Cancel All 32 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To create a custom label, all the parameters of the label must be defined. The custom label creation screen contains: 1. Define a label name, known as the “label root” • Name must be unique • Can have a maximum of 15 characters 2. Choose an exam package • Use the drop-down menu to select the exam package the label will be created for • The new label will inherit the default package characteristics when it is created – these characteristics can be altered in Per Label Configuration (if desired) 3. Select modifiers (if applicable) • Default is unchecked / not selected 4. Measurement Type • This option is only available and relevant in instances that apply to fetal measurements 5. Select segments if applicable • Used for vessels, MSK, etc., default selection is “none” • Modifier will be embedded into the label on the touch screen • Must manually de-select the “none” if the user does not want an undefined segment label Notes No. 32 Defining custom measurement labels SIEMENS . Healthineers ... Creating a custom label Once the label name and package basics are defined, three Label Root " Modifiers Measurement Type tabs are available to configure the label parameters: No Root d (2) O Right / Left Fetal Segments • Tools Exam Package Cardiac None Prox ] Mid Dist Origin • SR Template Tools R Template SR Mapping • SR Mapping Imaging Mode 20 Mode 2D Mode Tools Label O Doppler Mode [] Angle O M Mode Area Report Section Circumference Aorta Distance Ao Root d (2) Vol MOD Area Ratio Distance Ratio Stenosis ] Volume IMT Save All & Close Cancel All 33 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Once the label name and package basics have been defined, there are three tabs available to configure the label parameters. These tabs are: • Tools • SR Template • SR Mapping We will now discuss each tab and its contents. Notes No. 33 Defining custom measurement labels SIEMENS . Healthineers' ... Creating a custom label – Tools tab The Tools tab defines: Label Root " Modifiers Measurement Type 1. Imaging Mode Ao Root d (2) Right / Left Fetal Exam Package Segments • 2D Cardiac None Prox ] Mid Dist Origin Doppler Tools • R Template SR Mapping M-Mode Imaging Mode 2D Mode * • 2D Mode 1 Tools Label O Doppler Mode 2. Report Section DI Angle O M Mode 3 [] Area 3. Measurement tools associated with the chosen Report Section [] Circumference Aorta 2 Distance Ao Root d (2) 4 imaging mode, i.e. Distance, Area, Volume, etc. Vol MOD [] Area Ratio 4. Label display name options [] Distance Ratio [] Stenosis [] Volume IMT Save All & Close Cancel All 34 Unrestricted © Siemens Healthineers 2023 Speaker Notes: When selected, the Tools tab will be highlighted in orange. The Tools tab defines the: 1. Imaging Mode 2. Report section 3. Measurement tool 4. Label display name The imaging modes available for selection are – 2D, Doppler, and M-mode. Select the option by using the Pointer and Set key. The Report Section can be chosen from options listed in the drop-down menu. By default, the measurement will automatically be placed in the Custom Measurements section of the report. If another report section better suits the new label, it can be selected using the Pointer and Set key. Available tool options associated with the selected imaging mode will be displayed. Select the appropriate tool(s) from the list provided using the Pointer and Set key. Once a tool has been selected, the label option field will display the label root name beside it. The user has the option to change the display of the label in the MDA and on the Report if they want it to be different than the label root. Once all options are selected for the Tools tab, the SR Template tab will be available for selection. Notes No. 34 Defining custom measurement labels SIEMENS . Healthineers ... Creating a custom label – SR Template tab SR Template tab defines the: Label Root" Modifiers Measurement Type 1. SR Template AQ Root a (2) Right / Left Fetal Exam Package Segments 2. SR Template Section Cardiac E None E Pick I Mid Dist Origin Tools SR Template SR Mapping SR Template SR Template Section OB/GYN 1 Aorta 2 Fetal Echo Aorta Vascular Aortic Valve Cardiac Cardiac Shunt Study Coronary artery Hepatic Vein Inferior Vena Cava Left Atrium Lett Ventricle Left Ventricle Outflow Tract Mitral Valve Pericardial Cavity Pulmonary Artery *Required field Save All & Close Cancel All 35 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The SR Template tab begins the process of defining the SR Mapping for the new custom label. The first step is to select the SR Template where the label will be coded [1]. All adult cardiac custom labels will have the Cardiac SR Template selected. Recall that only four SR Templates exist – OB / GYN, Fetal Echo, Vascular, and Cardiac – everything must be coded within these four templates. The SR Template Section [2] contains a drop-down menu of anatomy that’s associated with the chosen SR Template - the user needs to populate what anatomy section the custom measurement will be related to, such as “aorta”. If nothing on the list fits the custom label contents, there is a User-defined Results option available. Once the SR Template has been defined, the SR Mapping can begin. Notes No. 35 Defining custom measurement labels SIEMENS . Healthineers' ... Creating a custom label – SR Mapping tab SR Mapping defines* Label Root" Modifier Measurement Type 1. Tools & Output AD Root a Right / Left Fetal Exam Package Segments 2. Text String for SR Cardiac 3. Concept Code Meaning Tools SR Template SR Mapping 4. Coding Scheme Designator Tools & Outputs Text String for SR 1 2 5. Code Value Concept Code Meaning Aortic Root Diameter 3 6. Measurement Method Coding Scheme Designator UN 7. Finding Site 4 Code value . 18015-8 5 Measurement Method 6 inding Site Aorta 7 Flow Direction Save All & Close Cancel All *Options shown for Cardiac label mapping – there are different options for GI label mapping 36 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The last tab, SR Mapping, is where the coding is defined. Coding must follow the DICOM rules for the SR Mapping to be “read” on the other end. Any deviation or mis-match with PACS and the coding will not be read. The measurement tool(s) selected in the first Tools tab are shown under the Tools & Outputs area [1]. The Text String for SR [2] is an optional field; it can be used to add some actual legible text or description to the input that can be read on the coded PACS printout. Other fields such as Measurement Method [6] and Finding Site [7] are also optional. Fields 3, 4 and 5 are not optional. When entering the required values for Concept Code Meaning [3], Coding Scheme Designator [4], and Code Value [5], you must confer with the PACS administrator to create these codes, as they will need to be entered on the PACS end in order to be read. (continued next slide) Notes No. 36 Defining custom measurement labels SIEMENS . Healthineers' ... Creating a custom label – SR Mapping tab (continued) SR Mapping defines* Label Root" Modifier Measurement Type 8. Flow Direction Ao Root a 2 Right / Left Fetal Exam Package Segments 9. Cardiac Cycle Point Cardiac None B Picar Mic Dist . Origin 10. Image View Tools SR Template SR Mapping 11. Measurement Orientation Tools & Outputs Measurement Method D Finding Site Use Save All & Close once all of the label configuration Aorta options are defined Flow Direction 8 Cardlac Cycle Point Diastole 9 Image View 10 Measurement Orientation 11 Next Output Save All & Close Cancel All *Options shown for Cardiac label mapping – there are different options for GI label mapping 37 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Additional optional SR Mapping fields for cardiac labels are Flow Direction [8], Cardiac Cycle Point [9], Image View [10] and Measurement Orientation [11]. Note that SR Mapping fields can differ between cardiac specific labels and general imaging (GI) labels. The options reviewed here are specific to cardiac labels and may or may not be displayed when creating a custom GI label. Once all the fields are populated, select the Save All & Close option to complete the label. Notes No. 37 Objectives SIEMENS . Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the touch screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Create a custom calculation • Discuss the OB tables O • Review report configuration 38 Unrestricted © Siemens Healthineers 2023 Speaker Notes: No speaker notes. Notes No. 38 Creating a new label SIEMENS . Healthineers ... • Select the Exam Package to add Exam Package the label to Cardiac Custom measurements Label Root: Ao Root d Report Section: Aorta 2D Tools: Distance SR Template: Cardiac Ao Abd SR Mapping: Completed • Select the New option New Ao Arch d Ao Arch Distal Copy Ao Arch Trans Distal Ao Arch Trans Prox Edit Ao Ascd Ao Asc Vmax Ao Asc VTI Ao Coarct Diam Ao Coarct Vmax Ao Desc Delete Ao Desc Vmax Ao Diam d Ao Isthmus Ao Root d Ao Sinus d Ao STJ d SR Mapping Ao Thoracic Aorta Prox 1 Restore SR AoV Annulus s Mapping AoV Annulus $ (Post) AoV Area Planimetr AoV Area Planimetriat) 39 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To create a new custom label, first select the exam package the label will be attached to from the drop-down menu on the custom measurement label homepage. Select the New key to advance the homepage to the next configuration screen to begin defining the label parameters. Notes No. 39 Creating a new label SIEMENS . Healthineers ... Tools tab • Enter the unique label name → Aorta Prox Label Root" Modifier Measurement Type Aorta Prox O Right / Left • Select Exam Package from drop-down menu → Cardiac Feta cam Package Segment Select Segments →  None,  Prox, etc. • Cardiac None 1 Prox Mid Dist ] Origin • Select Imaging Mode → 2D Mode Tools R Template SR Mapping • Select Report Section → Aorta Imaging Mode 20 Mode 2D Mode Tools Label O Doppler Mode Select Tool → Distance []Angle • O M Mode Area Select Save All & Close if SR Mapping is not required, Report Section 0Orcumference • Aorta Distance Aorta Prox otherwise select SR Template tab Vol MOD Area Ratio Distance Ratio Stenosis Volume IMT Save All & Close Cancel All 40 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The first step in defining the label parameters is to enter the label name in the Label Root field. The name must be unique and no more than 15 characters in length – in this example we are using a label root of Aorta Prox. Select the desired Exam Package from the drop-down menu. In this example we have chosen the Cardiac exam package. Note that the label will inherit the default setting of the chosen package for measurement unit and precision. If you desire a different unit or precision, you may edit those options for the label in the Per Label Configuration tab under Measurement option in the main M & R menu. Select the Modifiers and Measurement Type if the label necessitates. For this example, both options are left unchecked. Segments will be embedded into the measurement label. The default option is “none”, however any or all of the options can be checked for a custom label. The cardiac label we are creating has None and Prox checked. Selecting the Imaging Mode will determine what Tool options are displayed on the right side of the screen, as the tools are linked by mode. Our custom label, Aorta Prox, is a distance measurement available in 2D Mode. Note that the tool displays the label name next to it once selected. The user now has the option to change the display of the custom label within the MDA and the Report. For example, Aorta Prox could be altered to “Proximal Aorta” – this change would be reflected in what the user sees in the onscreen MDA and what is printed on the Report page. If SR Mapping is not required, the user can select the Save All & Close option to complete the label creation. In this example we are going to complete the SR Mapping process by selecting the SR Template tab. Note: The SR template tab is not available until all required fields within the Tools tab are completed. Notes No. 40 Creating a new label SIEMENS . Healthineers' ... SR Template tab Pre-selected SR Template → Cardiac • Label Root" Modifier Measurement Type Select the SR Template Section from Aorta Pro Right / Left Feta • drop-down menu → Aorta Exam Package Segments Cardiac Olst E Origin Tools R Template SR Mapping SR Template SR Template Section * DUGYN Fetal Echo Aorta Vaschitar Cardiac Save All & Close Cancel All 41 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Once in the SR Template tab, the Cardiac SR Template is automatically selected for the custom label being created since the cardiac exam package was chosen. Select the SR Template Section Aorta from the drop-down menu. Select the SR Mapping tab on the right to move to the final coding stage. Notes No. 41 Creating a new label SIEMENS . Healthineers ... SR Mapping tab Tools & Outputs →  beside all listed tools* • Label Root" Modifier Measurement Type Right / Left • Text String for SR → Optional field Aorta Pro Feta Exam Package Segments • Select Concept Code Meaning → Distance Cardiac • Coding Scheme Designator → linked to Concept Code Tools R Template SR Mapping Code Value → linked to Concept Code Tools & Outputs Text String for SR • Aorta Prox • Optional fields: Finding Site → Aorta Concept Code Meaning * Distance • Select Save All & Close to complete Coding Scheme Designator DCM Code value * 121206 Measurement Method inding Site Aorta Flow Direction Save All & Close Cancel All *Each tool will need to be selected and confirmed with the steps listed above. Only then will the SR Mapping be completed for the custom label. 42 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The final tab, SR Mapping, will finalize the tool coding and the label can be saved. Ensure that the distance tool has a checkmark beside it – if there are multiple tools listed, the coding procedure in this tab must be followed for each tool in order to complete the mapping. The top field, Text String for SR, is an optional field where Aorta Prox is inputted. Then select the Concept Code Meaning, Distance, from the drop-down menu; the Coding Scheme Designator and the Code Value automatically populate, as they are linked to the Concept Code Meaning. Aorta is selected from the drop-down menu for the optional field Finding Site. No additional optional fields are selected for this example, and we can now complete the label by selecting Save All & Close at the bottom of the page. Notes No. 42 Creating a new custom label using the copy label feature SIEMENS . Healthineers ... System Configuration > System Settings > Workflow Enhancement Exam Package > Imaging Settings Cardiac Measurement & Report Cardiac Label Root: Ao Abd Report Section: Aorta Measurement Abdomen 20 Tools: Distance Touch Screen Measurement Config Breast SR Template: Cardiac Carotid SR Mapping: Completed Custom Measurement Label Early OB NEW Custom Calculations Fetal Echo Copy Report GYN Ol Tables Ped Hip Edit LEA Annotations LEV › Features MSK Transducer Neo Head Connectivity & Network Ao Coarct Vmax Peripheral Devices Ao Desc Delete Ao Desc Vmax System Management Ao Diam d Ao Isthmus Ao Root d Ao Sinus d AO STJ d SR Mapping Ao Thoracic AoV Annulus s Mapping AoV Annulus $ (Post) AoV Area Planimetr AoV Area Planimetriast) AOV AT 43 Unrestricted © Siemens Healthineers 2023 Speaker Notes: If an existing label has the same or similar defined parameters desired for a new custom label, the user has the option to copy and edit an existing label for custom use. To create a custom cardiac label from an existing label, use the Pointer and Set key to select the cardiac exam package from the drop-down list on the Custom Measurement Label homepage. Notes No. 43 Copying a label SIEMENS . Healthineers ... 1. Select the label you want to copy Exam Package from the master list (selected label Cardiac Custom measurements Label Root: Ao Root d is back lit in orange) Report Section: Aorta 2D Tools: Distance SR Template: Cardiac Ao Abd New SR Mapping: Completed Ao Arch d Ao Arch Distal 2. Select Copy from the label Copy 2 Ao Arch Trans Distal Ao Arch Trans Prox management options Edit Ao Ascd Ao Asc Vmax Ao Asc VTI Ao Coarct Diam Ao Coarct Vmax Ao Desc Delete Ao Desc Vmax Ao Diam d Ao Root d 1 No Sinus d SR Mapping Ao Thoradc Aorta Prox 1 Restore SR AoV Annulus s Mapping AoV Annulus $ (Post) AoV Area Planimetr AoV Area Planimetriat) Summary of selected label’s parameters 44 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Once the cardiac exam package is selected, the homepage displays the following available selections: 1. Existing measurement labels are displayed – the selected label for copying is highlighted in orange • For this example, we selected the Ao Root d label to copy • Note the summary of the selected label’s parameters is displayed 2. In the label management options section, select Copy to advance the homepage to the next configuration screen to begin defining the label parameters Notes No. 44 Copying a label SIEMENS . Healthineers ... Defining label parameters 1. Define label root (name) abel Root Modifiers 3 Measurement Type Canias 2. Select Exam Package from Ao Root d (2) 1 O Right / Left 4 drop-down menu Exam Package 5 Cardiac 2 E None ] Prox Mid [ Dist [] Origin Ao Abd 3. Select Modifier An Archd Tools SR Template SE Mapping Ap Ach Dstal (if applicable) Ap Aich Trans Distal Imaging 20 Mode Ac Aich Trans Pros 20 Mode Tools Label 4. Measurement Type O Doppler Mode DI Angle O M Mode [] Area 5. Select Segment An Coorct Diam leport Section Circuimference (if applicable) Ao Desc Aorta Distance No Root d (2) Vol MOD AD Desc Viriax D Area Ratio Ao Diam d [] Distance Ratio D Stenosis O Volume Aorta Prox:1 Save All & Close Cancel All 45 Unrestricted © Siemens Healthineers 2023 Speaker Notes: When creating a new label using the copy feature, the label parameter’s will be filled with the copied label’s data. The user has the option to edit any of the data fields to suit their needs. For this example: 1. Enter Ao Root d (2) into the Label Root field • The label name must be unique and can have a maximum of 15 characters • For copied labels, the original label name must be altered in some way in order to create and save the new label 2. Choose cardiac Exam Package from the drop-down menu 3. Select modifiers (if applicable) • None is selected for this example 4. Measurement type • This option is only available in instances that apply to fetal measurements 5. Select segments (if applicable) • None is selected for this example Notes No. 45 Copying a label SIEMENS . Healthineers ... Tools tab The Tool tab defines the following abel Root Modifiers Measurement Type label parameters: Canias Ao Root d (2) Right / Left 1. Select the Imaging Mode for Exam Package Segment Cardiac E None ] Prox [ Mid [ Dist D Origin the label (2D, Doppler, etc.) Ao Abd An Archd Tools SR Template SE Mapping Ap Ach Dstal → 2D Mode Copy Ap Aich Trans Distal 1 20 Mode Ac Aich Trans Pros 20 Mode Toon Label 2. Select the Tool type O Doppler Mode DI Angle O M Mode [] Area (distance, time, etc.) 2 An Coorct Diam Report Section Orcuimference Ao Desc Aorta 3 Distance No Root 4 (2) → Distance Vol MOD AD Desc Viriax Area Ratio Ao Diam d 3. Select Report Section [] Distance Ratio Stenosis → Aorta O Volume Aorta Prox:1 Save All & Close Cancel All 46 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Once the copied label parameters are defined, the user advances through the same three tabs that were discussed earlier in the creation of a custom label. When copying a label, the information contained under each tab can be altered to suit the needs of the new copied label. The first tab is the Tool tab with the options to: 1. Select the imaging mode • 2D Mode is selected in this example 2. Select the tool type (distance, time, etc.) • Distance is selected in this example 3. Select the report section where label results will be displayed • Aorta is selected for this example Notes No. 46 Copying a label SIEMENS . Healthineers ... SR Template tab The SR Template tab allows the Moditien Measurement Type user to edit the copied label’s Cardiac Am fost a () 18 Feta data for the following: Cardiac ------ 1. SR Template type No Abd Ao Archd Tools SR Template SR Mappin No Ach Dstal → Cardiac A Aich Trans Distal R Template SK Template Section . Ac Aich Trans Plus Aorta 2 2. SR Template section Fetal Ech Cardlac 1 → Aorta An Coorct Diam Ao Desc AD Desc Viriax Ao Diam d An hoot Aa thoude Aorta Prox1 -- etry (Post) Save All & Close Cancel All 47 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To edit the copied label’s data in the SR Template tab, the user has options available for: 1. Selecting the SR Template type • The cardiac template is selected in this example 2. Selecting the SR Template Section • Aorta is selected from the drop-down menu in this example Notes No. 47 Copying a label SIEMENS . Healthineers ... SR Mapping tab The SR Mapping tab contains the following: Moditien Measurement Type Canias 1. Displays the measurement tool and 1 feta output type can Package Ao Abd 2. Allows edits to the copied label’s SR An Archd Tools SR Template SK Mapping Ap Ach Dstal mapping parameters for: Tools & Outputs Concept Code M Ap Aich Trans Distal Ac Aich Trans Pros Aortic Root Diameter 1 • Concept Code Meaning Coding Scheine Designator * • Coding Scheme Designator An Coorct Diam Code value 18015-8 Ao Desc • Code Value AD Desc Viriax Moisurement Method 2 Ao Diam d • Optional fields such as Text String, Finding Site Measurement Method, etc. Aorta Flow Direction 3. Use Save All & Close to complete the Aorta Prox:1 Cardiac Cycle Point SR Mapping selections Diastole 3 Save All & Close Cancel All 48 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The SR Mapping tab is the final tab that allows the user to alter the copied label’s structured reporting parameters. 1. The layout displays the measurement tool and output type • For this cardiac example distance is showing with a checkmark beside it 2. The selections down the right side allow the user to alter the copied label’s SR mapping for concept code meaning, coding scheme designator, code value and optional fields such as text string, measurement method, finding site, flow direction, cardiac cycle point, image view and measurement orientation 3. Once all fields are populated, select the Save All & Close option to complete the label • The custom label will now display in the cardiac exam package for per label configuration and is available for adding to the touch screen panel for use Notes No. 48 Objectives SIEMENS . Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the touch screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Create a custom calculation • Discuss the OB tables O • Review report configuration 49 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, we will describe how to create a custom calculation on the ACUSON Origin ultrasound system. Notes No. 49 Custom calculations SIEMENS . Healthineers ... Homepage layout 1. Master list of custom calculations Custom Calculations 3 Formula 8 Mappin 4 Lt Lambert 2. Calculation management options LVOTASA Sport Section Rt Lambert 1 LVOTINSA 3. Formula tab RENOT VILVILOmFICHAJESAm New 4. SR Mapping tab Copy Edit a and units are correct and then click Save System Configuration System Settings 2 Show In Report > Workflow Enhancement ant Labels Imaging Settings Delete Abdomin ATAN Measurement & Report TAN Measurement AMA Meat Of Art Touch Screen Measurement Config AMA (Post Repair Custom Measurement Label MA @Pod Repair) AP Custom Calculations SR Mapping KAA (Post Reply) Diam Report AAA (Post Repair) Trano Cum OB Tables AAA AP Annotations AMA Dan Features MA Gat from SMA Transducer AMA SacLength Connectivity & Network · Peripheral Devices System Management 50 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Select the Custom Calculations sub-group under the M & R section. 1. Existing custom calculations are displayed in the master list – any active or selected custom calculation is highlighted in orange 2. Available functions for custom calculation management are new, copy, edit, delete and SR Mapping 3. The Formula tab is where custom calculations are defined 4. The SR Mapping tab displays SR mapping configuration options The following slides discuss these sections in a greater detail. Notes No. 50 Defining custom formula sections SIEMENS . Healthineers ... 1. Name of equation / calculation (limit is 14 characters) Formula SR Mapping 2. Output units of equation Name Units Precision Report Section 1 2 V 3 4 3. Decimal point precision 5 4. Display area in Report 5. Area where equation is manually entered Ensure the formula and units are correct and then click Save. Cancel 6. Check for display in MDA and Report Show in Measured Results Save Show in Report 6 7. Exam package that equation will be created from Exam Package Result Labels Cardiac 7 ATAN Min Of Am 8. List of labels available to create equation Mean Grad TAN Max Max Of Any 9. Result labels when type of measurement needs to be RVOT Diam PLAX Vmean 9 COS Abs Mean Of Any RVOT Diam PSAX 8 specific; i.e., circumference or area; peak systolic vs SIN RVOT Diam SCLAX First 11 end diastolic RVOT ET RVOT Vmax Units sqrt 10. Input units RVOT Vmax (Post) mm RVOT VTI 10 11. Input area of mathematical numbers, characters and RVOT VTI (Post) SVC A Duration functions (can also use keyboard) Add 51 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The following sections are available when creating a custom formula: 1. Name of equation / calculation (limit is 14 characters) 2. Output units of equation 3. Decimal point precision 4. Display area in Report 5. Enter the equation in the space provided 6. Check for display in MDA and Report 7. Exam package that equation will be created from 8. List of labels available to create equation 9. Result labels when type of measurement needs to be specific; i.e., circumference or area; peak systolic vs end diastolic 10. Input units 11. Input area of mathematical numbers, characters and functions (the keyboard can also be used) Notes No. 51 Defining SR mapping SIEMENS . Healthineers' ... 1. Select SR Mapping Custom Calculations Formula SR Mapping 2. Select appropriate SR template Lt Lambert LVOT/BSA SR Template 2 Text String for SR (defaults to Cardiac if cardiac Rt Lambert OB/GYN LVOTIBSA Fetal Echo labels are used) New Concept Code Meaning * Vascular Cardiac Index Copy Cardiac 3. Ensure template section is Coding Scheme Designator * SRT correct Edit SR Template Section " Left Ventricle 3 Code value 4. Fill sections appropriately for F-32110 given equation Meas Measurement Method 4 Continuity Equation by Velocity Time | V Delete 5. Select Save Finding Site Left Ventricle Outflow Tract V Flow Direction Antegrade Flow 1 SR Mapping Cardiac Cycle Point Peak Systolic Image View Apical four chamber * Required field 5 Save Cancel 52 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To configure SR Mapping for a custom calculation: 1. Select SR Mapping 2. Select the appropriate SR Template 3. Select the SR Template Section 4. Input the fields accordingly for the given equation • As previously discussed in SR mapping for custom labels, to make data readable to a PACS or offline workstation, a DICOM SR template must be used that follows a very specific set of coding rules. • You must confer with the PACS administrator when entering required values for Concept Code Meaning, Coding Scheme Designator, and Code Value. You must work with the PACS administrator to create these codes, as they will need to be entered on the PACS end in order to be read. 5. Once all required fields and other desired variables have been defined, select Save to complete SR Mapping. Notes No. 52 Creating a custom formula SIEMENS . Healthineers ... Example – LVOT/BSA 1. Create the new equation name Formula SR Mapping 2. Make output units blank Name Units Precision Report Section LVOTIBSA 3. Select output precision in decimal places 1 2 3 5 [LVOT VTI.VTI,cm]/[(Calc)BSA,m2] 4. Select labels for input from exam package(s) 5. Select LV for the report section Ensure the formula and units are correct and then click Save. 6. Select Save Show in Measured Results 6 Save Cancel Show in Report Exam Package Result Labels General Calculations Min Of Any Equation entered as: ATAN 4 TAN Max Max Of Any [LVOT VTI.VTI,cm]/[(Calc)BSA,m2 ] (Calc)BSA COS Abs Mean Of Any (Calc)Clinical Age SIN (Calc)Fibroid 1 Vol First (Calc)Fibroid 2 Vol (Calc)Fibroid 3 Vol Units (Calc)Fibroid 4 Vol mm2 (Calc)Fibroid 5 Vol cm2 (Calc)GB Vol (Calc)Isthmus Mass 1 Vol Add 53 Unrestricted © Siemens Healthineers 2023 Speaker Notes: This example demonstrates how to enter a custom formula for cardiac indexing: 1. Enter the name for the new equation (LVOT/BSA) 2. Leave output units blank and input the equation 3. Select LVOT VTI from Cardiac Package (TIP: type LVOT to shortcut to all LVOT measurements) 4. Select BSA from General calculations 5. For the report section, select LV 6. Select Save after entering the custom equation Note: Equations must adhere to algebraic order of operations. Notes No. 53 Measurement Display Area (MDA) and Report view SIEMENS. Healthineers ... Example - LVOT/BSA MDA Store Report Value Method AoV Stenosis AoV Area (VTI) LVOTVTI 11.66 cm Avg 11.66 AoV Area (Vmax) LVOT Vmax 0.61 mls Avg 0.61 1 LVOT VTI=11.66 cm AR Arca & RF (PISA) LVOT Vmax=0.61 m/s LVOT VII 11.66 cm Avg 11.66 LVOT Mean Grad=0.8 mmHg LVOT/BSA=6.59 AR RF (Doppler) LVOT Peak Grad=1.5 mmHg LVOTVTI 11.66 cm Avg 11.66 15cm 97mm LV Value Method LVOT -40 LVOTVTI 11.66 cm Avg 11.66 LVOT Vmax 0.61 mls Avg 0.61 20 LVOT Peak Grad 1.5 mmHg LVOT Mean Grad 0.8 mmHg cm/s LVOTIRSA 6.59 -- 20 Mitral Valve Value -- 40 MV Stenosis MV Area (VTI) -- 60 LVOT VII 11.66 cm Avg 11.66 -- 80 54 Unrestricted © Siemens Healthineers 2020 Unrestricted © Siemens Healthineers 2023 Speaker Notes: From the previous slide’s example, we can appreciate the custom calculation results in the MDA on the left, as well as in the selected report section of the left ventricle (LV) on the right. Notes No.54 Objectives SIEMENS . Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the touch screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Create a custom calculation • Discuss the OB tables O • Review report configuration 55 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Now we will discuss the OB tables for both configuration and adding custom tables to the ACUSON Origin ultrasound system. Notes No. 55 OB Tables tab SIEMENS . Healthineers ... Homepage layout OB tables homepage configurable options: Default OB Autho Custom GA Table Custom Growth Curves • Default OB Author Gestational Age Growth Analysis Measurement Author Measurements Author • Custom GA Table AC Hadlock AC Hadlock APTOXTID Tokyo AFI BinocD Tongsong AFI 2 • Custom Growth Curves BPO Hadlock AFI3 Cerebelliam Hill APTOXTID Tokyo CHI Hadlock HPD Hadlock EFW Age Osaka" Cerebebum Verburg FI Hadlock Cist Magna Nicolaides Foot Mercer Clavide FTA Osaka" GSD Rempen EFW THIC Hadlock FL Hadlock Jeanty Foot Chitty MSD Rernpen FTA OFD ASUM 2003 GSD Tibla Jeanty HC Jeanty HOAC Campbel Jeanty LE CP Ratio Ebbing Us Age (Ultrasound Age) EFW (Estimated Fetal Weight) Average Hadlock (BPD, HC, AC, FL) Restore Defaults 56 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The OB Tables section has three tabs: • Default OB Author – authors can be selected from the drop-down menu associated with the growth parameter • Custom Growth Curves – the user can add / create custom gestational age tables • Custom Growth Curves – the user can add / create custom growth curves Notes No. 56 OB Tables tab SIEMENS . Healthineers ... Default OB Author • Select default author from drop-down Default Of Author Custom GA Table Custom Growth Curves menu for each parameter Age Growth Analysis Mcrarement: Author Measurement • Custom tables will have asterisk (*) in the Hadlock APTDETTO Tokyo* table name Tongsong AR2 Hadlock AR3 • Factory tables lack asterisk (*) in table APIDETTO Hadlock name ETW AgE Osaka* Cerebellum Hadlock Os Magna Mercer Clarkde FTA Osaka* GSD Rempen EFW Hadlock ASUM 2003 Foot MSD Ovtty FIA OrD Hadlock Hansmann Merz HCIAC LL CP Ratio US Age (Ultrasound Age) ETW (Estimated Fetal Weghd) Average Hadlock (BPD, NC. AC, FI) Restore Defaults 57 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To select the default author / table for the OB calculations: • Use the Pointer and Set key to access the drop-down menu next to the chosen measurement parameter • Select the appropriate author table Custom tables will have an asterisk (*) in the table name whereas factory tables will lack the asterisk in the table name. Notes No. 57 OB Tables tab SIEMENS . Healthineers ... Custom GA Table Two options to create a custom ustom Growth Curves gestational age (GA) table: Measurement 1. Copy an existing table Author Name ASUM 2003 Now SUM 2003 2. Manually input a new table ISUM 2003 Copy Gestational Age Lasser AC Weeks Days 2SD days 10.00 15 3.0 16 10.50 16 16 11.00 16 40 16 11.50 0.0 16 12,00 12.50 13.00 10 13.50 14.00 14.50 15.00 15.50 20 Restore Defaultse AC 58 Unrestricted © Siemens Healthineers 2023 Speaker Notes: There are two options for creating custom gestational age tables: 1. The user can copy an existing table 2. The user can manually input a new table Notes No. 58 OB Tables tab SIEMENS . Healthineers ... Custom GA Table – copy existing table • Highlight desired table default On Au ustom Growth Curves • Select Copy Anaturemeot - Required field Author Name • Change Author name or leave copied ASUM 2003 JSUM 2003 (2) Hadocs name with number JSUM 2003 Gestational Age Insert Row Before Lasser Days 2SD days 10.00 15 3.0 16 • Alter data (if required) Insert Rouw After 10.50 0.0 16 Delete Ro 11.00 16 4.0 16 • Validate table Table is valid. 11.50 17 0.0 16 Clear All 12.00 17 40 18 • If table is valid, select Save 12.50 18 0.0 13.00 13.50 0.0 18 14.00 18 14.50 0.0 18 15.00 3.0 20 15 50 Validate Table Cancel imune the Latile entries are correct and then click Save 59 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To copy an existing table: • Use the Pointer and Set key to highlight desired table • Select Copy • Change Author name or leave copied name with number in parentheses • Alter any data fields (if required) • Select Validate to have the system validate the field data entries • If the table is valid, select Save Notes No. 59 OB Tables tab SIEMENS . Healthineers ... Custom GA Table – create new • Select New Default OB Author Custom GA Tab Custom Growth Curves • Name table and select units Measurement - Required field • Input table data–use the “tab” key to ASUM 2003 New Author Hadlock advance JSUM 2003 Copy Gestational Age Weeks Insert Row Before Lasser Day's 2SD days Insert / delete rows as required Edit Insert Row After Merz • Delete Delete Row • Validate table Clear All • Complete the SR Mapping process (if required) • Select Save to complete table Validate Table SR Mapping Save Cancel Ensure the table entries are correct and then click Save Restore Defaults: AC 60 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To create a new gestational age table: • Select New • Type in the author’s name / name of the table and select the table units • Input table data–use the “tab” key to advance through the data fields; All fields must be populated • Insert / delete rows as required (options are located on the side of the table) • The maximum number of weeks that can be entered on the table is 43 • Validate table • Complete the SR Mapping process (if required) • Select Save to complete table Note: If the table is found to be “not valid” due to a data entry error, the system will display a message onscreen indicating the row where the error is detected. Notes No. 60 OB Tables tab SIEMENS . Healthineers ... Custom Growth Curves • Steps to add custom growth curves are Default OB Author Custom GA Table like custom GA tables using Copy or New Growth Curv Measurement Custom growth curves require a Low / Author Name Low/High Range . - Required field • ASUM 2003 New ASUM 2003 (2) 54/95% High range selection – options are: CFEF Chitty Copy GA Insert Row Before weeks Days LOW ( Low (5%) Mean (50%) High (95%) ▪ 5%/95% Deter Row Grumbach (twins) Edit 11 0.0 52 60.2 Insert Row After Hadlock 12 54.8 63 71.2 INTERGROWTH-21st Delete 0.0 Delete Row ▪ 10%/90% 13 0.0 65.8 74 82.2 Jeanty 14 0.0 75.8 84 92.2 Clear All ▪ 3%/97% JSUM 2003 15 0.0 87.8 96 104.2 Merz 16 0.0 97.8 106 114.2 Nicolaides Verburg 17 0.0 107.7 120 132.3 ▪ +/- 1.5SD 0.0 118.7 143.3 19 0.0 127.7 140 LEL 152.3 ▪ +/- 2SD 20 0.0 138.7 151 163.3 21 0.0 147.6 164 180.5 ▪ +/- 1SE Validate Table SR Mapping Save Cancel • Maximum number of weeks that can be Ensure the table entries are correct and then click Save entered is 43 Restore Defaults: AC 61 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Custom growth curves can also be added in the same manner as custom gestational age tables using the Copy or New key options. Customs growth curves require a low / high range selection from the drop-down menu. Available sections are: • 5%/95% • 10%/90% • 3%/97% • +/- 1.5SD (Standard Deviation) • +/- 2SD • +/- 1SE (Standard Error) Tables must be validated, and the SR mapping completed (if required) before the system will allow the table to be saved. Note: The maximum number of weeks that can be entered in a custom growth curve is 43. Notes No. 61 OB Tables tab SIEMENS . Healthineers ... Custom Growth Curves Flexibility with input Custom Growth Curves • Low/High percentile range options 1 2 • Custom defined Low/High percentile - 0.1–99.9% Author Name Units Low/High Range * - Required field AUTHOR mm V 5%/95% % - % • Auto calculation of Low/High percentile 5%/95% GA AC 10%/90% Insert Row Before ROW weeks Days Low (5%) Mean (509 3%/97% %6) +/-1SD Insert Row After 2 +/-1.5SD -1-2SD Delete Row 3 +/-1SE 4 Clear All 5 62 Unrestricted © Siemens Healthineers 2023 Speaker Notes: 1. Section one shows the selectable Low/High range options. 2. Section two shows that the Low/High percentile can be customized anywhere from 0.1% - 99.9% . Check the box to enable. The system will automatically calculate the Low/High percentile depending on which you enter first. Notes No. 62 Objectives SIEMENS . Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the touch screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Create a custom calculation • Discuss the OB tables O • Review report configuration 63 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, we will review the Report on the ACUSON Origin ultrasound system. Notes No. 63 Report configuration tab SIEMENS . Healthineers ... Homepage layout • Organ based / anatomic reporting Report Content Assessments Comments Report Template structure Report Sections • Homepage contains four configurable Patient History option areas: - Patient History • Report Content - Institution Abd Organs • Assessments - Liver Liver Shear Wave Elastography Measurements (pSWE) • Comments - Liver Shear Wave Elastography Measurements (SWE) - Liver Ultrasound Derived Fat Fraction Measurements (UDFF) Report Template - Gallbladder and Pancreas • - Spleen Renal - Kidneys Side-by-Side - Kidneys - Bladder Aorta - Aorta & Iliac Arteries Ahd Grafts Collapse All Collapsed by default - Expanded by default Restore Defaults 64 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The layout of the report on the ACUSON Origin ultrasound system is organ / anatomically based. There are four sections available for configuration: • Report Content • Assessments • Comments • Report Template Notes No. 64 Report configuration tab SIEMENS . Healthineers ... Report Content 1. Default option to collapse all or expand all report content Report Content Assessments Comments Report Template Roport Sections 2. Expand / collapse option for individual sections Patient History Patient History 3. Check  option to show / hide report Institution 2 sections * organs Liver Liver Shear Wave Elastography Measurements (p5WE) Liver Shear Wave Elastography Measurements (SWE) 3 Liver Ultrasound Derived Fat Fraction Measurements (UDFF) *Hidden sections will not show on a Gallbladder and Pancreas printed report even if a measurement is performed for that section Kikineys Side-by-Side Ita Aorta & Mac Arteries Collapse All 1 Restore Defaults 65 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Report Content section allows the user to determine what results will be displayed at the end of an exam. 1. The user has the option to expand all areas or collapse all areas or individual sections when the report is displayed. There is a default setting located at the bottom of the page to expand or collapse all. 2. Individual sections can be expanded or collapsed by using the Pointer to click on the “+” or “ ” next to the section content. - 3. The user also has the option to show or hide sections in the report by checking or unchecking the section under the Show column. Note that if a section is hidden (unchecked) the results in that section will not be shown on the report, even if there are measurements taken involving that section. If the user needs to display these results, they will need to go to the system configuration and check the box to “show” the results. Notes No. 65 Report configuration tab SIEMENS . Healthineers ... Assessments Pre-loaded list of assessments from factory: Report Content Assessments Comments Report Template • Abdomen Assessments • Gyn Carotid • Early OB (fetal & maternal) RI-CCA LECCA Create Custoin Assessment Items Rt CCA Plaque Description Lt CCA Plaque Description Type: Lt CCA Diameter • Fetal Rt CCA Diameter Reduction Reduction Checklist Rt CCA Comments Lt CCA Comments O Comment Text Box • Maternal RT BIF Lt BIF Rt BIF Plaque Description Lt BIF Plaque Description Label: • Hip Rt BIF Diameter Reduction Et BIF Diameter Reduction Rt BIF Comments Lt BIF Comments • Fetal Echo RE ICA Carotid Rt ICA Plaque Description LI ICA Plaque Description • Rt ICA Diameter Reduction LEICA Diameter Reduction Check  option to show / hide assessment Rt ICA Comments Lt ICA Comments RLECA LLECA in report Rt ECA Plaque Description Lt ECA Plaque Description Restore Defaults: Carotid 66 Unrestricted © Siemens Healthineers 2023 Speaker Notes: There is a pre-loaded list of assessments from factory for certain exam types: • Abdomen • Gyn • Early OB (fetal & maternal) • Fetal • Maternal • Hip • Fetal Echo • Carotid As with the report content, the user can show / hide any assessment text by checking / unchecking the box for the assessment text. Notes No. 66 Report configuration tab SIEMENS . Healthineers ... Add custom assessment item Two types of custom assessment items can be added: • Checklist Create Custom Assessment Items • Comment text box Type: To add a custom assessment: . Checklist • Select assessment type and enter label in field . Comment Text Box • Select Add Assessment label can be moved around custom area Label • only Test Label Add 67 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Custom assessments can be added to the report page either as a checklist or a comment (text) box. To add a custom assessment: • Select the Type of assessment to be added • Manually enter the assessment / label name in field provided • Select Add Custom assessment labels will appear at the bottom of the report. They can be reordered in this section but cannot be relocated into the list of factory assessments. Notes No. 67 Report configuration tab SIEMENS . Healthineers ... Delete custom assessment item To delete a custom assessment item: Report Content Assessments Comments Report Template • Highlight the desired label Assessments Select Delete Abdominal • Liver Create Custom Assessment Items Echotexture Type Fatty Infiltration Checklist Portal Hypertension O Comment Text Box Portal Vein Focal Lesions Lesion Elasticity Liver Comments Gallbladder Gallbladder Comments CBD CBD Comments CHD CHD Comments Delete Restore Defaults: Abdominal 68 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To delete a custom assessment item: • Use the Pointer to highlight the desired label • Select Delete Note: Custom assessment labels cannot be edited, only deleted. Notes No.68 Report configuration tab SIEMENS . Healthineers ... Comments Pre-defined comments can be added to the report Report Content Assessments Report Template Comments For Exam Package • Select the exam package General • Enter comment in the space Exam within normal limits. provided Recall exam x2 weeks Gallbladder removed. Select Add Technically difficult exam. • • Re-order (if required) with the directional arrows To delete a comment • Highlight comment • Select Delete Delete Restore Defaults: General 69 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Pre-defined comments can be added to the report. To add a comment to the report: • Select the exam package from the drop-down list • Enter the desired comment in the space provided • Select Add • Re-order (if required) with the directional arrows To delete a comment: • Highlight comment • Select Delete Comments can be re-ordered by using the directional arrows at the side of the list. Notes No.69 Report configuration tab SIEMENS . Healthineers ... Report Template • Customized logo and text can be added to the report via USB Report Content Assessments Comments Report Template Site Information • 3 layout options for logo and text Institution Logo Details Details Layout Layout • Logo file must be JPEG or PNG ing 1 Layout1 SIEMENS Large Bold 3 lines of text can be added and Healthineers .. Line 2 • Medalum Roman customized for style and font Load Remove Line 3 Restore Defaults 70 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The final tab, the Report Template, contains options for customization of the Report includes the addition of a site logo and / or three lines of text (“institution details”). To add a site logo, insert a USB into the USB port containing a JPEG or PNG of the desired logo. Select Load to view the file contents of the USB on the screen. Highlight the desired logo from the files that are displayed and select Load Image from the bottom of the dialogue window. The logo will be added to the Logo window area. To remove the logo, select the Remove key located below the logo window. In addition to a customized logo, a custom statement or institution details of up to 3 lines and 32 characters per line, can be added to the report. To add a customized statement, use the Pointer to activate one of the three available Text areas and type in the desired text. Once the text is entered the user can further customize the font type and style by using the drop-down menu beside each text line. Once the logo and / or details have been entered, there are three report template layouts to choose from. Use the drop-down menu to select the desired layout – a schematic of the layout will appear below the drop-down field detailing the layout of the logo and text. Notes No.70 Summary SIEMENS . Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the touch screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Create a custom calculation • Discuss the OB tables O • Review report configuration 71 Unrestricted © Siemens Healthineers 2023 Speaker Notes: No speaker notes. Notes No.71 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 72 Unrestricted © Siemens Healthineers 2023 Notes No.72 Thank you for your enthusiasm! SIEMENS . Healthineers ... Questions? QR700000603 73 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Questions? Notes No.73