ACUSON Sequoia 3.5 VB30 3D/4D OB Presentation

SIEMENS Healthineers SIEMENS Healthineers ... ACUSON Sequoia Ultrasound System 3D/4D Ultrasound Imaging Technology in OB 3.5 (VB30) 1 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The purpose of this presentation is to provide an overview of the ACUSON Sequoia ultrasound system using volume imaging in 3D and 4D. A short review regarding the terminology and technology: The volume transducers are the 9VE4 and the 7VC2, which are motorized mechanical transducers that performs 3D imaging and real time 4D imaging. During a 3D acquisition, a single mechanical (automated) sweep is performed and produces three orthogonal dimensions, or planes, as well as a volume rendering. During a 4D acquisition the transducer continuously acquires and displays the volume information. This method is also known as real-time 3D ultrasound. The time is considered the fourth dimension. Notes No. 1 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Outline activation and volume acquisition • 3D Freehand • Describe volume manipulation • Demonstrate optimization tools • Explain FlexPlane tool • Explain Multislice feature • Define volume store and editing • Describe reviewing stored volumes 2 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. Notes No. 2 SIEMENS Healthineers Activate 3D/4D SIEMENS. Healthineers ... Update Caliper ABC Freeze 3 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To enter 3D/4D imaging, press the 3D/4D key on the control panel. The default Setting for either 3D or 4D can be customized and saved within the preset. Notes No. 3 SIEMENS Healthineers Touch Screen SIEMENS . Healthineers ... 7VC2 5C1 10L4 9VE4 Workflow Patient 3 Setup 4 5 Imaging Surface Vascular Skeletal Review Report LightSource End Exam 6 VOI 1 2 Reset Curve 8 3D 4D 7 X 6 9 10 Quality Angle Mid 4 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Once activated the Touch Screen will display the 3D/4D Setup tab. The 3D and 4D function keys are available and the active function and will be backlit in orange. 1. 3D: Activates the 3D imaging function in order to perform an automatic sweep 2. 4D: Activates the 4D imaging function in order to view a real-time 3D image 3. Surface: Smooths the image contours, creating a soft sculptured appearance for highlighting surface features. Will use the mode specific selections for opacity percentage and threshold. 4. Vascular: (Minimum Intensity Projection) limits the display to minimum-value pixels with the lowest value along each projection of the volume. It is a helpful tool when visualizing hypo-echoic lesions and large vascular structures - e.g. adnexa area 5. Skeletal: (Maximum Intensity Projection) limits the display to maximum-value pixels with the highest value along each projection of the volume. May be useful for body structures in obstetrical imaging and intrauterine devices in gynecological applications 6. LightSource: The moveable LightSource helps increase depth perception, reveal surface details and can provide a deeper understanding of relational anatomy. 7. Reset Curve: Resets the curve of the VOI 8. Volume of Interest (VOI): Enables or disables the VOI. In acquisition mode this allows the entire field of view to be acquired. In rendering mode this activates the rendered volume region of interest 9. Quality: A higher quality setting acquires more slices and typically provides a more detailed reconstructed image. Available values are Low, Mid and High • High - scan line density with the highest setting enhances the detail resolution of the rendered volume, but decreases the volumes per second during acquisition • Mid - scan line density enhances the volumes per second during acquisition. This results in a limited loss of volume resolution • Low - scan line density has the lowest rendered volume quality, but the highest volumes per second during acquisition 10. Angle: The volume angle determines the distance of the volume sweep. A large angle is equivalent to a larger sweep. The angle range is 20 degrees to 145 degrees Notes No. 4 SIEMENS Healthineers Home base SIEMENS. Healthineers ... Update Starts acquisition Update Set Size, position and curve of the ROI/VOI Position Size Curve Home Base Display 5 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Update key starts the volume acquisition using either 3D or 4D depending on what the user has selected. Before entering a volume acquisition: • Select the Set key to toggle between VOI size, VOI position and ROI curve while using the trackball to adjust the areas of interest • The Region of Interest (ROI) and VOI curve graphics will change from a solid line to a dotted line during resizing and curve adjustment The Home Base display indicates the selected tool. Notes No. 5 SIEMENS Healthineers Volume monitor layout SIEMENS .... Healthineers ... 7VC2 OB TIB:0.48 TIC:1.27 TIS:0.48 MI:0.66 4.5vps 95% Volume imaging parameters 4D 0dB/DR65 Q Mid V 50 Th60 Op72 S3 Bro Con60 MPR MapD/T5 Vol MapA Volume display field Home base display Position Size Curve 6 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Volume acquisition imaging parameters such as Gain, Dynamic Range, Quality, Opacity, Brightness, et cetera, are displayed along the upper right side of the image. The image screen area contains the acquired volumes. The Home Base display indicates the functionality of the Update and Set keys. Notes No. 6 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Outline activation and volume acquisition • 3D Freehand • Describe volume manipulation • Demonstrate optimization tools • Explain FlexPlane tool • Explain Multislice feature • Define volume store and editing • Describe reviewing stored volumes 7 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. Notes No. 7 SIEMENS Healthineers Freehand 3D SIEMENS. Healthineers .. Freehand 3D is the sequential stacking of B-mode slices only in the elevational plane (slice thickness plane) and is acquired in a linear or rocked sweep • Measurements cannot be performed due to inaccuracies • B-mode 3D is available • Color Doppler is not supported 8 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Freehand 3D is the sequential stacking of B-mode slices only in the elevational plane (slice thickness plane) and is acquired in a linear or rocked sweep. Measurements are not available in a Freehand 3D volume due to the geometric inaccuracies. B-mode 3D is available and does not support color Doppler imaging. Notes No. 8 SIEMENS Healthineers Freehand 3D Overview SIEMENS. Healthineers ... Transducers Presets Acquisition Default setup Type 10EV3 GYN (Primary focus) Rocked GYN: VOI off; Quality Mid; Surface render 9EC4 GYN (Primary focus) Rocked GYN: VOI off; Quality Mid; Surface render All presets: Early OB; Prostate Early OB: VOI on; Quality Mid; LightSource render Prostate: VOI on; Quality Mid; Surface render 5C1 OB (Primary focus) Rocked OB: VOI on; Quality Mid; LightSource render 9C2 All presets: Abdomen; Abd-Difficult; Fetal Echo: VOI on; Quality Mid; LightSource render GYN; Fetal Echo GYN: VOI on; Quality Mid; Surface render Abdomen: VOI on; Quality Mid; Surface render Abd-Difficult: VOI on; Quality Mid; Surface render Additional Transducers that have the 3D Freehand technology: 10L4, 11M2, 11M3, 15L4, 18H6, 18L6, HLX Jane Bucholz | Clinical Development 9 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Here is a chart with the available transducers for Freehand 3D in obstetrics. Notes No. 9 SIEMENS Healthineers Comparison Touch Screens SIEMENS . Healthineers ... ~/ 10EV3 10LA ª 1 HLX Workflow 9EC4 Workflow Patient 30/40 Setup Patient BD Setup Imaging Imaging Surface Vascular Skeletal Surface Vascular Skeletal Review Review LightSource Report LightSourc End Exam End Exam VOI VOI eset Curve 3D 4D Reset Curve Rocked Linear Transmit Power Quality 95 % Mid Angle ransmit Power 120 Quality 95 % Mechanical transducers Freehand transducers Jane Bucholz | Clinical Development 10 Unrestricted © Siemens Healthineers 2024 Speaker notes: Here are the Touch Screen comparisons between the mechanical and Freehand transducers. Notice the additional tools for the Freehand 3D transducers. Freehand 3D transducers do not support the Angle option. Notes No. 10 SIEMENS Healthineers Freehand 3D workflow for curved Rocked in OB SIEMENS . Healthineers ... Fetal acquisition • Transducer aligned in either longitude or transverse to fetal anatomy • Find the middle of the target anatomy that you want to acquire • Angle transducer to where you want to start your acquisition • Perform single sweep from start to finish following timing of progress bar 11 Animations: Ondrej Culko Unrestricted © Siemens Healthineers 2024 Speaker Notes: To acquire a Freehand 3D volume in OB, place the transducer in either longitude or transverse to the fetal anatomy that you would like to acquire. Find the middle of the anatomy that you would like to acquire and angle the transducer to where you would like to start your acquisition. Perform a single sweep from start to finish following the timing of the progress bar. Notes No. 11 SIEMENS Healthineers Freehand 3D workflow for curved Rocked in OB SIEMENS ... Healthineers ... OB TIB:1.01 TIS1 H High o=1549 LD 2 Compound UAS MapC/T Clinical Data Age (EDD) 25w 5d 10cm EDD 9/25/2024 Position Sire Curve Total: 33 12 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Here is a video of a 3D acquisition of a fetal spine and using the different renderers. Notes No. 12 SIEMENS Healthineers Endovaginal Rocked acquisition SIEMENS . Healthineers ... Coronal uterus acquisition • Transducer aligned with the uterus in sagittal midline • Angle transducer towards right cornu (transducer handle towards left thigh) • Perform single sweep from right cornu to left cornu following timing of progress bar 13 Animations: Ondrej Culko Unrestricted © Siemens Healthineers 2024 Speaker Notes: To acquire a Freehand 3D of the uterus, place the transducer in the sagittal plane midline to the uterus. Angle the transducer towards the right side of the patient and the handle of the transducer should be next to the patients left thigh. Perform a single sweep from the right side to the left side of the patient and following the timing of the progress bar. Notes No. 13 SIEMENS Healthineers Freehand workflow for EV Rocked acquisition SIEMENS ... Healthineers ... 10EV3 GYN TIS:0.47 MI:0.74 24fps 95% 2D Mid OdB/DR65 c#1540 LD 2 Compound UA 3 MapB/T5 P2 Clinical Data X Total: 73 14 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Here is a video of acquiring a volume of a uterus. The endometrium is easily displayed using the Flexplane feature. Notes No. 14 SIEMENS Healthineers Volume Touch Screen SIEMENS. Healthineers ... 7VC2 0 5C1 A 10L4 6/ 9VE4 Workflow Patient 3D FlexPlane Multislice Editing Imaging MPR Review Report VR End Exam Reset All VOI 90º 180º 270º Reset Curve Reset Orientation Flip Sync BD 4D X Light DR 65 Map Tint 15 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Once a 3D volume is acquired, the Touch Screen displays the available functions for manipulation. The four tabs available are: • 3D • FlexPlane • Multislice • Editing Touch Screen selections are backlit in orange when activated and gray when available. Keys that are dithered out are not available in the current active mode but may be available in other modes. Some tabs contain additional options on the second page. Notes No. 15 SIEMENS Healthineers Display format SIEMENS .... Healthineers ... 7VC2 ZVC2 SC A 1014 5/ 9VE4 Workflow OB TIB:0.44 TIC:1.48 TIS:0.44 Patient 3D FlexPlane Multislice Editing MI:0.68 3.0vps 95% Imaging 3D MPR 11dB/DR65 Q Mid Review V 70 Th60 Op72 Report VR 1 2 3 4 Br-1 Con60 End Exam MPR MapD/T5 Reset All 180º 270º Vol: VOI MapA/T3 eset Curve Reset Orientation Flip Sync D Light DR Map 65 16 Unrestricted © Siemens Healthineers 2024 Speaker Notes: These are the user selectable layout options. 1. Displays all four quadrants 2. Displays the A-plane and rendered volume 3. Displays the A-plane and B-plane on top of the rendered volume 4. Displays any selected plane in a full view format Notes No. 16 SIEMENS Healthineers Reference point SIEMENS .... Healthineers ... • The reference marker is the pivot 7VC2 OB point to manipulate the Multiplanar TIB:0.48 TIC:1.27 TIS:0.48 Reconstruction (MPR) planes MI:0.66 4.5vps 95% • It represents the point where the A, B, odB/DR65 Q Mid V 50 and C plane intersect Th60 Op72 S3 Bro • Place the desired anatomy at the Con60 MPR: reference point to display in all three MapD/T5 Vol: MapA planes 3:1 VOI On 17 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The reference marker is the intersection point between the three orthogonal planes and is available with VOI on or off. Volume manipulation is facilitated by placing the reference point at the desired location. This subsequently becomes the pivot point around which the planes may be rotated along any of the three axes, without losing its position, as it remains displayed in all three orthogonal planes. MPR is the abbreviation of Multi-Planar Reconstruction also known as Multi-planar reformatting and is the term used to refer to the three orthogonal planes collectively. Notes No. 17 SIEMENS Healthineers VOI Size and curve SIEMENS .... Healthineers ... Start Position Size Curve Trackball before acquisition Setup Trackball during acquisition 18 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The VOI can be resized, repositioned and curved after acquisition. Use the Set keys to toggle between the tools. Position allows the user to pan the image to the desired location. Size enables resizing of the VOI. The user can use Curve to curve the render view line of the VOI box to exclude extraneous information if desired. A curved VOI will allow demonstration of out of plane anatomy, such as the endometrium on the rendered volume. During acquisition, Setup will appear in the Update key position on the Trackball to take the Notes No. 18 SIEMENS Healthineers user back to the Setup screen to start again. Notes No. 18 SIEMENS Healthineers Control Panel SIEMENS. Healthineers ... X Z O M PW CW c 2D 19 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The control panel of the system contains rotary dial keys that allow the user to manipulate the MPR slicing as well as the X, Y, and Z axes of the acquired volume. • The slicing function is manipulated using the 3D/4D control • The X axis is manipulated using the M-mode control • The Y axis is manipulated using the PW-Doppler control • The Z axis is manipulated using the Color Doppler control Note: The Update key can be used to toggle between the VOI manipulation tools including the Size, Position and Curve functions. Notes No. 19 SIEMENS Healthineers Quadrant selection SIEMENS .... Healthineers ... ZVC SC1 10L4 7VC2 5/ 9VE4 Workflow OB TIB:0.48 TIC:1:27 TIS:0.48 Patient 3D FlexPlane Multislice Editing MI:0.66 4.5vps 95% Imaging PdB/DR65 VR MPR A Review TheO Op72 Report C VR A B MPR End Exam MapD/T5 Vol: Reset All VOI 90º 180º 270º MapA Reset Curve Reset Orientation Flip Sync 3D 4D Light C VR X Map Tint 65 20 Unrestricted © Siemens Healthineers 2024 Speaker Notes: This allows the user to easily switch between the quadrants for manipulation. The quadrants are referred to as A, B, C, and VR, with quadrants A, B, and C containing the MPR planes of the volume. • A is the acquisition plane • B is the elevation plane • C is the coronal plane • VR contains the surface rendered volume In this example, the A-plane is selected and any manipulation using the X, Y and Z controls will apply only to that selected quadrant. The selected plane will be outlined in white on the imaging screen and backlit in orange on the Touch Screen. MPR is the abbreviation of Multi-Planar Reconstruction also known as Multi-planar reformatting and is the term used to refer to the three orthogonal planes collectively. Notes No. 20 SIEMENS Healthineers Volume rendering rotation SIEMENS .... Healthineers ... 7VC2 7VC 5C1 10L4 5/ 9VE4 Workflow OB TIB:0.44 TIC:1.48 TIS:0.44 Patient 3D FlexPlane Multislice Editing MI:0.68 3.0vps 95% Imaging 11dB/DR65 VR MPR Q Mid Review V 70" Th60 Op72 S3 Report C VR Br-1 Con60 MPR End Exam MapD/T5 Vol: Reset All VOI 180º 270º MapA/T3 eset Curve Reset Orientation Flip Sync 30 4D Light DR 65 Map Tint 21 Unrestricted © Siemens Healthineers 2024 Speaker Notes: This area allows the user to quickly rotate the rendered volume regardless of the selected plane. In this example the volume has been rotated 90 degrees. The Z axis control may also be used to adjust the volume however the VR quadrant must first be selected. Notes No. 21 SIEMENS Healthineers Touch Screen keys SIEMENS .... Healthineers ... JVC 5C1 10L4 5/ 9VE4 Workflow OB TIS:0.44 Patient 3D FlexPlane Multislice Editing MI:0.68 3.0vps 95% Imaging 3D 1dB/DR65 VR MPR Q Mid Review V 70 Th60 Op72 S3 Report C VR Br-1 Con60 MPR End Exam MapD/T5 1 Vol: Reset All VOI 90º 180 270 MapA/T3 2 eset Curve Reset Orientation Flip Sync BD 4D X Light 3 4 5 DR 65 Map Tint 22 Unrestricted © Siemens Healthineers 2024 Speaker Notes: 1. Reset All • Restores the default (or user-defined) settings of other parameters for all quadrants • User-defined settings are those that were in effect when the current volume was first displayed 2. Reset Curve restores the VOI curve to a linear orientation 3. Reset Orientation restores the default orientation for all quadrants 4. Flip reverses the render direction 5. Sync (synchronize) aligns the selected plane and volume orientation (VR) Notes No. 22 SIEMENS Healthineers Touch Screen keys SIEMENS .... Healthineers ... 5C1 7VC2 ZVC 9VE4 Workflow OB TIB:0.48 TIC:1:27 TIS:0.48 Patient 3D FlexPlane Multislice Editing MI:0.66 4.5vps 95% Imaging 0dB/DR65 Surface Vascular Skeletal @ Mid Review The0 Op?? Report LightSource Bro 1 2 Con60 MPR End Exam MapD/T5 Vol: Inversion Up/Down Front/Back Left/Right MapA Down/Up Back/Front Right/Left , × 1 DR 65 Map 23 Unrestricted © Siemens Healthineers 2024 Speaker Notes: 1. Inversion: Renders the volume to display anechoic portions of the volume as echogenic areas, and echogenic areas as anechoic to allow for enhanced definition and evaluation of cystic structures, such as ovarian cysts and hydrosalpinx 2. The render direction options control the rotation of the volume rendering, allowing the user to quickly achieve the desired view Notes No. 23 SIEMENS Healthineers Surface SIEMENS .... Healthineers ... • Smooths the image contours • Creates a soft sculptured appearance for highlighting surface features • Uses the mode specific selections for opacity percentage and threshold • Includes eight tint options 24 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Surface rendering smooths the image contours, creating a soft sculptured appearance for highlighting surface features. Uses the mode specific selections for opacity percentage and threshold mode. This is especially helpful when interrogating soft tissue structures such as the fetal face or limbs for deformities. Notes No. 24 SIEMENS Healthineers Vascular SIEMENS .... Healthineers ... Limits the display to minimum-value pixels with the lowest value along each projection of the volume to aid in visualizing hypo-echoic lesions and large vascular structures • Fetal vessels, umbilical cord • Cystic structures • Abdominal vascularity 25 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Vascular rendering mode, also known as Minimum Intensity Projection (Min IP), limits the display to minimum-value pixels with the lowest value along each projection of the volume. It is a helpful tool when visualizing hypo-echoic lesions and large vascular structures such as the adnexal area or umbilical cord. Notes No. 25 SIEMENS Healthineers Skeletal SIEMENS .... Healthineers ... Limits the display to maximum-value pixels with the highest value along each projection of the volume to aid in visualizing hyper- echoic structures • Fetal Spine • Bony Structures • Intrauterine devices 26 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Skeletal rendering mode, also known as Maximum Intensity Projection or Max IP, limits the display to maximum-value pixels with the highest value along each projection of the volume. May be useful for body structures such as the fetal spine in obstetric imaging or intrauterine devices in gynecological applications. Notes No. 26 SIEMENS Healthineers LightSource SIEMENS .... Healthineers ... 7VC2 OB TIB:0.44 • Increase depth perception TIC:1.48 TIS:0.44 • Reveal surface details MI:0.68 3.0vps 95% Deeper understanding of relational 3D • 13dB/DR65 Q Mid anatomy V 70 Th60 Op72 S3 Bro Con60 MPR MapD/T5 Vol: MapA 27 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The moveable LightSource helps increase depth perception, reveal surface details and can provide a deeper understanding of relational anatomy. This enhances the aesthetic appearance and is often used to provide keepsake images for obstetric patients. Notes No. 27 SIEMENS Healthineers LightSource SIEMENS .... Healthineers ... TVC2 OB3 TIB:0.44 TIC:1.48 TIS 0.48 TIS:0.44 MI:0.68 3.0vps 3D 95% 6dB/DR65 3D Q Mid 13dB/DR65 V 50" Q Mid Th59 V 70" Op72 S1 Th60 B/2 Op72 Con60 S3 MPR Bro MapD/T5 Con60 Vol MPR MapD/T5 Vol MapA 28 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Included are examples of obstetrical images using LightSource on intrauterine and vascular structures. Notes No. 28 SIEMENS Healthineers LightSource SIEMENS . Healthineers ... 1. Select Light A 5C1 7VC2 6/ 9VE4 Workflow The light will default to on when a 1x1 Patient BD FlexPlane Multislice Editing display format is utilized Imaging VR MPR . . Review Report VR End Exam Reset All VOI 90" 180 270º 9 Reset Curve Reset Orientation Flip Sync 3D 4D X Light 1 Threshold Opacity Smooth Brightness Contrast Tint 60 72 O 50 29 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To use the LightSource mode: 1. Activate the Light, if necessary, by selecting the Light key on the Touch Screen Note: If defaulting to the 1x1 display format the light will be on by default, however in all other display formats the light will be off by default. Notes No. 29 SIEMENS Healthineers LightSource 7VC2 2. Use the trackball to adjust the point LightSource TIB:0.48 direction TIC:1.27 TIS:0.48 MI:0.66 4.5vps 95% 3. The arrow on the point LightSource icon indicates 4D 0dB/DR65 the direction the light is shining V 50º Th60 Con60 MapDITS Vol 3 2 Direction 30 Unrestricted © Siemens Healthineers 2022 Unrestricted © Siemens Healthineers 2024 Speaker Notes: After LightSource is activated: 2. Use the trackball to adjust the point LightSource direction 3. The arrow on the point LightSource icon indicates the direction the light is shining Notes No. 30 SIEMENS Healthineers VR – LightSource tints SIEMENS . Healthineers ... LightSource Tints provide 10EV3 A 15L4 9C2 Workflow • Diversity in tints and skin tones Patient FlexPlane Multislice Editing Imaging • A more even appearance to the Surface Vascular Skeletal Review surface render Report ightSource • Enhance gynecological features End Exam Inversion Up/Down Front/Back Left/Right Down/Up BackiFront Right/Left Available on the 7VC2 and the 9VE4 X transducers Threshold Opacity Smooth Brightnes Contras Tint 60 72 O 60 31 Unrestricted © Siemens Healthineers 2024 Speaker Notes: LightSource Tints provide diversity in skin tone while capturing additional clinical and diagnostic detail. The use of Tints provide a more even appearance to surface renderings. Tint is adjusted by selecting 3D and adjusting the soft key labeled Tint, when in LightSource. LightSource tints are available on the 7VC2 and the 9VE4: • 7VC2 - Nine LightSource Tint options • 9VE4 - Seven LightSource Tint options Notes No. 31 SIEMENS Healthineers VR – LightSource tints SIEMENS ... Healthineers ... 7VC2 9VE4 32 Unrestricted © Siemens Healthineers 2024 Speaker Notes: These examples display the nine LightSource Tint options available on the 7VC2 transducer and the seven LightSource Tint options available on the 9VE4 transducer. Here we can see the enhanced representation of skin tones and diagnostic detail. Notes No. 32 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Outline activation and volume acquisition • 3D Freehand • Describe volume manipulation • Demonstrate optimization tools • Explain FlexPlane tool • Explain Multislice feature • Define volume store and editing • Describe reviewing stored volumes 33 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. Notes No. 33 SIEMENS Healthineers Optimization tools SIEMENS . Healthineers ... 5C1 5/ 9VE4 Workflow 5C1 10L4 5/ 9VE4 Workflow Patient 30 FlexPlan Multislice Editing Patient FlexPlane Multislice Editing Imaging Imaging VR MPR Review VR MPR A Review Report C Report VR End Exam End Exam Reset All vor 90 180' 270" Reset All VOI 90 180 270 Reset Curve Reset Orientation Flip Sync Reset Curve Reset Orientation Flip Sync 4D Light Light Opacity Smooth Brightness Contrast Tint DR Map Tin 60 34 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The VR and MPR keys activate specific tools applicable to the selected modes or quadrants. When VR is selected the soft keys will display adjustable parameters for the rendered volume (VR). When MPR is selected the soft keys will reflect parameters that will affect the MPR planes (A, B & C). Notes No. 34 SIEMENS Healthineers VR – Threshold SIEMENS .... Healthineers ... • Sets the threshold for the opacity curve • Removes small echoes or noise that contain values lower than the selected threshold • A lower setting creates a more saturated image • Available for VR mode only Threshold Threshold 47 O 35 Unrestricted © Siemens Healthineers 2024 Speaker Notes: When changing the threshold, all echoes below that level are enhanced in a pink color for a short interval and will be seen on the three MPR images. • Decreasing the value of Threshold will fill in the surface rendered volume with more low- level echoes (voxels). Soft tissues will be enhanced • Increasing the value of Threshold will remove low level echoes. It may help to enhance the image when noise, artifacts and/or low-level echo structures are present Note: Available for VR mode only Notes No. 35 SIEMENS Healthineers VR – Opacity SIEMENS ... Healthineers ... • Adjusts the percentage of opacity in the volume to create a softer or more sculptured appearance • Decrease the value for a more transparent look • Increase the value for more solid look • Available for VR mode only Opacity Opacity 18 68 36 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Opacity adjusts the percentage of the opacity level on the overall rendered volume density to create a more soft or sculptured appearance. Decrease the value for a more transparent look. Increase the value for a more solid look. The opacity level may be increased up to 86% to enhance pathology such as myoma, fibroma, endometrium disease or hemorrhagic cysts. Note: Available for VR mode only Notes No. 36 SIEMENS Healthineers VR – Smooth SIEMENS .... Healthineers ... • Adjusts the amount of smoothing applied in the rendered volume • Range is 0 – 4 • Available for VR mode only Smooth Smooth 3 O 37 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Smooth adjustments affect the display of the surface rendered volume. Select from a range of 0 – 4. Note: Available for VR mode only Notes No. 37 SIEMENS Healthineers VR – Brightness SIEMENS .... Healthineers ... • Adjusts the brightness of the rendered volume • An increase in brightness increases the saturation of voxels that have a higher and lower voxel value • Available for VR mode only Brightness Brightness 16 9 38 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Brightness enhances the voxel saturation. The optimal selection is dependent on the 2D gain during acquisition. Notes No. 38 SIEMENS Healthineers VR – Contrast SIEMENS .... Healthineers ... • Adjusts the percentage of contrast on the rendered volume • Increase the value for increased contrast or decrease for less contrast • Available for VR mode only Contrast Contrast 45 66 39 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Contrast allows greater visualization of voxels next to each other. An optimal contrast setting will enhance depth perception and delineation of anatomy such as the endometrium. Note: Available for VR mode only Notes No. 39 SIEMENS Healthineers VR – Tint SIEMENS .... Healthineers ... • Applies the selected Tint to the rendered volume in Surface/Vascular/Skeletal • Some Tint colors may require image adjustment • A separate tint control is available for the MPR’s and in LightSource 40 Unrestricted © Siemens Healthineers 2024 Speaker Notes: When VR is selected the Tint key applies the selection to the rendered volume. Determine which tint color is preferred for the volume display. It is recommended to adjust Tint prior to adjusting other parameters. Re-optimization for Threshold, Dynamic Range, Brightness and/or Contrast may be necessary after applying a different tint. Notes No. 40 SIEMENS Healthineers MPR – Dynamic Range SIEMENS .... Healthineers' ... • Adjusts the number of gray shades displayed • Increase for a softer image • Decrease for more contrast • Available in the MPR mode only DR DR 37 80 41 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Dynamic Range affects the number of gray shades that are displayed. Increase the Dynamic Range to produce a “softer” image; decrease Dynamic Range to produce an image with more contrast. Notes No. 41 SIEMENS Healthineers MPR – Map SIEMENS .... Healthineers ... • Selects a processing curve that assigns echo amplitudes to gray levels • Uses the same maps as 2D • Available for MPR planes Map Map D G 42 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Gray Map selection selects a processing curve that assigns gray shades to echo amplitudes. The maps affect all three MPR images. Notes No. 42 SIEMENS Healthineers MPR – Tint SIEMENS .... Healthineers ... • Applies the selected Tint to the MPR images • A separate tint control is available for the VR Tint Tint 4 7 43 Unrestricted © Siemens Healthineers 2024 Speaker Notes: When MPR is selected the Tint key applies the selection to the three MPR planes. Notes No. 43 SIEMENS Healthineers Power Doppler SIEMENS ... Healthineers ... • Applies colors to vascular structures based on flow amplitude • Activate prior to entering acquisition mode Power 44 Unrestricted © Siemens Healthineers 2024 Speaker Notes : Power Doppler may be activated prior to a 3D acquisition. Power Doppler applies colors to vascular structures based on flow amplitude (versus velocity information). Power demonstrates less angle dependence than Color Doppler and is useful for low volume, low velocity flow states, and to demonstrate presence or absence of flow. Directional Power Doppler applies color based on amplitude and direction of flow (towards or away from the transducer). Note: Power Doppler is not available in 4D imaging. Notes No. 44 SIEMENS Healthineers Measurements SIEMENS .... Healthineers ... 7VC2 TIB:0.38 TIC:1.55 TIS:0.38 MI: 1.22 3D x ... x 13dB/DR65 Q Mid Caliper V 50 Th60 Op72 S2 Bro Con60 MPR MapD/T5 Vol: MapA 1 AC=24.15 cm GA=28w 3d 45 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Measurements may be performed on the MPR planes. The measurement function is not available on the rendered volume. Notes No. 45 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Outline activation and volume acquisition • 3D Freehand • Describe volume manipulation • Demonstrate optimization tools • Explain FlexPlane tool • Explain Multislice feature • Define volume store and editing • Describe reviewing stored volumes 46 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. Notes No. 46 SIEMENS Healthineers FlexPlane SIEMENS . Healthineers ... Visualization of anatomy along 7VC2 2 5C1 10L4 6/ 9VE4 OB Workflow • any plane or shape Patient 3D FlexPlane Multislice Editing • Reduces planar manipulation Imaging (X-Y-Z) Line Clear All Slice 1 Review Report Trace Spline Slice 3 Slice 2 End Exam 180º 2700 TO Hide Line Undo Reset Orientation X Flip Line Thickness Tint 2mm Rotate Line otate Slice Brightness Contrast O 60 47 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The FlexPlane tool allows the user to obtain and visualize anatomy of any shape along any plane. This is especially useful when imaging complex or irregularly shaped structures, anatomy and abnormalities and reduces the need for planar manipulation. Notes No. 47 SIEMENS Healthineers FlexPlane SIEMENS .... Healthineers ... 27 7VC2 7VC2 OB TIB:0.34 TIB: 0.38 TIC:1:42 TIC:1.55 TIS:0.34 TIS:0.38 MI:1.05 MI:1.22 90% 95% 3D 3D 26dB/DR65 10dB/DR65 Q Mid Q Mid V 50" V 50 Th55 Th60 Op62 Op72 SO S2 Br14 Con63 Con60 MPR: MPR: MapD/T5 MapD/T5 Vol: Vol: MapA/T3 48 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The fetal spine or abdomen may also be assessed with the FlexPlane tool. The flexible rendering as well as customizable cross-sections of the vertebrae or abdominal structures can provide valuable diagnostic information. Notes No. 48 SIEMENS Healthineers FlexPlane SIEMENS .... Healthineers ... 65 TIC 1.5 18 0.38 HIS 1 56 ME.1.1 3D 3D dB/DR65 dB/DR65 Q High Q High V 80 V 80 Th60 Th60 Op72 Op72 S4 SA Con60 Con60 MPR MapD/T5 Vol MapA/T3 MapA/T3 49 Unrestricted © Siemens Healthineers 2024 Speaker Notes: FlexPlane can also be useful when evaluating intracranial structures during obstetrical exams. This may be especially relevant when fetal position is not optimal for static imaging of specific structures. Notes No. 49 SIEMENS Healthineers FlexPlane SIEMENS . Healthineers ... 7VC2 10L4 OB 5C1 / 9VE4 Workflow Patient 3D FlexPlane Multislice Editing Imaging Line Clear All Slice 1 LL Review Report Trace Spline Slice 3 Slice 2 End Exam 180º 270º Hide Line Undo Reset Orientation Flip Line Thickness 2mm Rotate Line Rotate Slice Brightness Contrast Tint O 60 50 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The user can choose from: • Line – A straight line in any direction • Trace – A Freehand line traced in any direction • Spline – An open spline controlled by selecting the set key along the path of the spline Notes No. 50 SIEMENS Healthineers FlexPlane SIEMENS .... Healthineers ... TVC2 TIB 0.39 TIC:1.57 TIS:0.39 MI:1.27 30 13de/DR86 Q Mid Thec Op72 Bro Congo MFR MapCVTS Val MapA/T3 Redraw Redraw Start Start Set Set Draw Draw Position 1 2 3 51 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Once the desired option is chosen: 1. Press either Set control to begin the line 2. Press either Set key again to end the Line/Trace tools or to change the direction of the Spline tool (Double-click either Set control to end the Spline) 3. To redraw the line, press the Update control 4. The line thickness controls the slice thickness and may be changed by rotating the soft key (Off will display only the MPR) Note: The rendered slice will be displayed from top (slice beginning) to bottom (slice ending) in the direction of the tool used. Notes No. 51 SIEMENS Healthineers FlexPlane SIEMENS .... Healthineers ... Zvc2 SC1 10L4 5/ 9VE4 Workflow 27 7VC2 OB3 TIB:0.34 TIC:1.42 Patient 3D FlexPlane Multislice Editing TIS:0.34 MI:1.05 90% Imaging 3D Review Line Clear All Slice 1 26dB/DR65 Q Mid V 50" Th 55 Report Trace Spline Slice 3 Slice 2 Op62 2 Br2 End Exam Con63 1 MPR 180º 270º MapD/T5 Vol: T3 TOT Hide Line Undo Reset Orientation 3 Flip Line X Thickness Brightness Contrast Tint 2mm Rotate Line Rotate Slice 60 52 Unrestricted © Siemens Healthineers 2024 Speaker Notes: 1. Up to three slices may be created and will be displayed in the format chosen 2. The system will display the slices in the format chosen 3. The rendered slice may be quickly rotated using the predetermined degrees or by selecting the Rotate Slice soft key Notes No. 52 SIEMENS Healthineers FlexPlane SIEMENS . Healthineers ... 1. Hide Line 7VC2 5C1 OB 2 10L4 6/ 9VE4 Workflow 2. Undo Patient 3D FlexPlane Multislice Editing 3. Flip Line Imaging 4. Thickness Line Clear All Slice 1 Review 5. Rotate Line Report Trace Spline Slice 3 Slice 2 6. Rotate Slice End Exam 180º 270º 1 Hide Line 2 Undo Reset Orientation 3 Flip Line 4 Thickness Tint 2mm 5 Rotate Line 6 Rotate Slice Brightness Contrast O 60 53 Unrestricted © Siemens Healthineers 2024 Speaker Notes: 1. Hide Line: Removes the Slice line from the reconstructed image 2. Undo: Reverts the line position or visibility from the latest modification 3. Flip Line: Reverses the area of the render plane with respect to the thickness (available for .5mm – 20mm thickness) 4. Thickness: Adjusts the slice thickness of the rendered volume (Off will enable the MPR and will allow measurements to be activated) 5. Rotate Line: Rotates the FlexPlane slice in a clockwise or counter-clockwise position 6. Rotate Slice: Rotates the entire active slice image in a clockwise or counter-clockwise position Notes No. 53 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Outline activation and volume acquisition • 3D Freehand • Describe volume manipulation • Demonstrate optimization tools • Explain FlexPlane tool • Explain Multislice feature • Define volume store and editing • Describe reviewing stored volumes 54 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. Notes No. 54 SIEMENS Healthineers Multislice display layout SIEMENS .... Healthineers ... PVC2 5C1 A 1014 5/ 9VE4 7VC2 Workflow OB TIB:0.39 TIC:1.57 TIS 0.39 Patient 3D FlexPlan Multislice Editing MI-1.27 95% 3D Imaging 13dB/DR65 Q Mid V 70" Th60 Review Op72 Report Con80 MPR MapD/T5 Vol End Exam MapA × Slices Distance Position of Slices 2 mm 0 mm Range Position 55 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Multislice tab contains options for viewing multiple slices of the selected MPR plane at the same time. It is often referred to as a Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) view. Select the desired plane as previously discussed using the A, B and C keys. The area outlined in orange allows the user to choose the desired layout. This controls how many slices are displayed on the imaging screen. Note: Once entering MultiSlice, the rendered volume is disabled. Notes No. 55 SIEMENS Healthineers Multislice display layout SIEMENS .... Healthineers ... 7VC2 OB TIC. 1.57 TIS:0.39 MI:1.27 95% 3D 13dB/DR65 Q Mid V 70 Th60 Op72 S2 Conso MPP. Vol MapA 56 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Let’s review the two image examples: • The left image displays a 4:1 format with a 2x2 layout and the defined slices from the selected plane • The right image displays a 3x3 grid layout and the defined slices of the selected plane • The orange arrows indicate the center slice in the range appearing as a yellow line on the slice graphic and a white outline on the displayed plane The user may rotate the slices in X, Y, and Z axis while in Multislice mode. Notes No. 56 SIEMENS Healthineers Multislice optimization SIEMENS .... Healthineers ... 7VC 5C1 10L4 / 9VE4 Workflow HIB.0.3 TIS.O. Patient 3D FlexPlane Multislice Editing 95 3 13dB/DR6 Imaging QM V 70 Review Opi Report C MapDIT End Exam Map Slices Distance Position of Slices Range Position 2 mm 0 mm 57 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The soft keys allow the user to define the options for Multislice display. Notes No. 57 SIEMENS Healthineers Multislice graphic SIEMENS ... Healthineers' ... • Solid yellow line – Center slice displayed with white outline around corresponding slice • Solid white line – Displayed slices • Dashed white line – Available slices 58 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Slices soft key defines how many slices are available. These slices can further be adjusted using additional tools covered in the next slides. Notes No. 58 SIEMENS Healthineers Slices SIEMENS .... Healthineers ... • Defines the number of slices evaluated • Options are 1 – 17 • May be adjusted further using additional optimization tools Less Slices More Slices 59 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Slices soft key defines how many slices are available. These slices can further be adjusted using additional tools. Notes No. 59 SIEMENS Healthineers Distance SIEMENS .... Healthineers ... • Defines the distance between slices • Options are 0.5 mm - 50 mm • Slice graphic will reflect changes • Increase for global view of region • Decrease for greater detail Less Distance More Distance 60 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Distance soft key allows the user to define a specific distance between slices in the region of interest. Increase the distance to spread out the displayed slices in order to obtain a more global view of the region. Decrease the distance to reduce the area between slices and provide greater detail. Notes No. 60 SIEMENS Healthineers Position of Slices SIEMENS ... Healthineers .. • Defines the area of interrogation • The slice graphic will indicate the position of the slices • Indicated by the slice graphic lines • Anatomy outside of the slice graphic is not available for display 61 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Position of Slices soft key enables the user to define the area of the scanned anatomy that they wish to interrogate. Notes No. 61 SIEMENS Healthineers Range Position SIEMENS ... Healthineers ... • Defines the slices displayed at any given time • Rotate to scroll through the available slices previously selected • Slice graphic reflects the area currently displayed • Number of white solid lines on the graphic is dependent on the selected layout Higher Range Position Lower Range Position 62 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Range Position soft key allows the user to choose which slices will be displayed on the current screen and is represented by the solid white lines. This is equivalent to scrolling through the slices. Notice that the position of the slices, indicated by the dashed white lines, has not changed. Notes No. 62 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Outline activation and volume acquisition • 3D Freehand • Describe volume manipulation • Demonstrate optimization tools • Explain FlexPlane tool • Explain Multislice feature • Define volume store and editing • Describe reviewing stored volumes 63 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. Notes No. 63 SIEMENS Healthineers Image and volume storage SIEMENS .... Healthineers ... OdB.DR Clip Image Inical Data 64 Unrestricted © Siemens Healthineers 2024 Speaker Notes: When acquiring volume images, the volume will automatically be stored any time an image or clip is acquired. This enables the user to perform further manipulation on any image or clip acquired while in 3D/4D mode. The volume clip will be exported in .avi format. Press the Image control to save individual images. To store a 4D clip press the Clip control. The default clip length or type (Prospective vs Retrospective) may be adjusted on the second page of the Touch Screen menu, or in System Configuration > Imaging Settings > Capture Settings. Alternatively, you may hold down the clip control for up to 10 seconds for a customized clip capture. Stored volumes are marked with a cube graphic. Stored 4D volume clips are marked with a cube containing a “play” icon. Note: The maximum length of volume 4D Cine store is 10 seconds. Notes No. 64 SIEMENS Healthineers Additional controls SIEMENS .... Healthineers ... 7VC2 5C1 10L4 / 9VE4 Workflow Patient 3D FlexPlane Multislice Editing Imaging Volume Editing Animation Review Report End Exam Undo All Redo Last Undo Las Line Open Spline Closed Spline × 4 65 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To edit and remove unnecessary structures, select the Editing tab on the Touch Screen. There are three tools available for editing: • Line • Open Spline • Closed Spline Notes No. 65 SIEMENS Healthineers Line SIEMENS .... Healthineers ... K 66 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To use the Line editing tool: 1. Select Line 2. Using the trackball and Set keys draw a line delineating a border for the removal area 3. Place the scissor icon in the image segment that you want to remove, and press Set 4. The area in which the scissor icon is placed will be removed Notes No. 66 SIEMENS Healthineers Open Spline SIEMENS .... Healthineers ... 67 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To use the Open Spline editing tool: 1. Select Open Spline 2. Using the trackball and Set keys draw a line segment delineating a partial border for the removal area 3. Continue to use the trackball and Set keys to add as many connecting segments as desired, then either double click the Set key or select the Update key to end 4. Place the scissor icon in the image segment that you want to remove, and press Set 5. The area in which the scissor icon is placed will be removed Notes No. 67 SIEMENS Healthineers Closed Spline SIEMENS .... Healthineers ... 68 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To use the Closed Spline editing tool: 1. Select Closed Spline 2. Using the trackball and Set keys draw a line segment delineating a partial border for the removal area 3. Continue to use the trackball and Set keys to add as many connecting segments as desired, then either double click the Set key or select the Update key to end 4. The system will automatically draw a line from the first caliper to the last caliper closing the spline 5. Place the scissor icon in the image segment that you want to remove, and press Set 6. The area in which the scissor icon is placed will be removed Notes No. 68 SIEMENS Healthineers Additional edit controls SIEMENS .... Healthineers ... 7VC2 5C1 10L4 / 9VE4 Workflow Patient 3D FlexPlane Multislic Editing Imaging Volume Editing Animation Review Report End Exam Undo All Redo Last Undo Last Line Open Spline Closed Spline X 69 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Undo All: • Reverses all edits performed by replacing all removed areas Undo Last: • If one or more edits have been completed the last area removed will be undone • If an editing function is active, the last line segment or caliper placement will be undone Redo Last: • If one or more edits have been completed the last edit reversed using the Undo Last key will be redisplayed • If an editing function is active, the last line segment or caliper placement reversed using the Undo Last key will be redisplayed Notes No. 69 SIEMENS Healthineers Animation SIEMENS .... Healthineers ... 5C1 10L4 / 9VE4 Workflow 7VGZ TIB.0.48 Patient 3D FlexPlane Multislic TIS 0.48 Editing MI:0.66 4.5vps 95% Imaging Volume Editing Animation a Mid Review The0 Op 12 Report MPR End Exam 2 3 X Reset Orientation Speed 4 Medium Set Set Set First Last 1 70 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The animation tab allows the user to display the rendered volume in motion through a user- defined arc or rotation. 1. Use the trackball so set the first and last position of the animation 2. Choose from a rocking motion or repetitive loop 3. Select the Play icon to begin the animation motion 4. Adjust the speed of the animation using the rotary soft key Notes No. 70 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Outline activation and volume acquisition • 3D Freehand • Describe volume manipulation • Demonstrate optimization tools • Explain FlexPlane Tool • Explain Multislice feature • Define volume store and editing • Describe reviewing stored volumes 71 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. Notes No. 71 SIEMENS Healthineers 3D/4D review volume data SIEMENS .... Healthineers .. Review Patient FlexPlane 3D/4D Review Multislice Editing Imaging VR MPR B II Review Report VR End Exam Reset Al VOI 90º 180º 270º Reset Curve Reset Orientation Flip Sync 10 Light Threshold Opacity Smooth Brightness Contrast int 60 72 O 60 72 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To review the stored volumes, press the Review key on the Touch Screen. Stored volumes are marked with a cube graphic. Stored volume clips are marked with a cube containing a “play” icon. To manipulate a stored volume: • Use the pointer and set key to select the desired volume • Select the 3D/4D tab to activate the volume editing features • If a 4D clip has been activated, you may use the cine review controls as required • To see the Light option on the Touch Screen, the user must select LightSource on page 2 first Note: Images stored from the Review tab will be saved as 2D images. To save a volume ensure that you are in the 3D/4D tab before storing. Notes No. 72 SIEMENS Healthineers Trademarks and disclaimers SIEMENS . Healthineers ... ACUSON Sequoia is a registered trademark of Siemens Medical Solutions USA, Inc. 73 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. Notes No. 73 SIEMENS Healthineers Thank you for your enthusiasm! SIEMENS . Healthineers ... Questions? 74 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. Notes No. 74