ACUSON Sequoia™ 3.5 VB30 VT Auto pSWE Quick Card

Quick Card Virtual Touch Auto Point Shear Wave (Auto pSWE) ACUSON Sequoia Ultrasound System 3.5 (VB30) siemens-healthineers.com/sequoia Using Virtual Touch Auto point shear wave (Auto pSWE) to obtain up to 15 individual shear wave velocity (Vs) measurements in meters per second (m/s) and elasticity (E) measurements in kilopascals (kPa) in the liver Step 1 DAX Step 3 PSWE UDFF Abdomen • Select compatible transducer1 • Select the Auto pSWE key from and the Abdomen exam preset the touch screen – the pSWE ROI Auto pSWE (region of interest) will enlarge once activated Step 2 • Liver Site 1 is active as the default measurement label • Press VT (Virtual Touch) located VT • If desired, select an alternate label on the control panel Note: • If No Label is selected, measurements will appear next to the image, but will not be sent to the report or added to the overall statistics. • If selected from the touch screen, the Ultrasound Derived Fat Fraction (UDFF) technology can be used simultaneously with Auto pSWE. Measurement values for both technologies will be displayed on the screen. 1 Auto pSWE is compatible with the Deep Abdominal Transducer (DAX) and the 9C2 transducer on the Abdomen exam preset. SIEMENS Healthineers . Step 4 Step 7 • Roll the trackball to position the ROI To enter the measurement into the at least 1.5–2 cm below the liver report: capsule • Press Image to store image Image • Ensure the “+” marker on the sample or line is parallel with the liver capsule • Press right or left Set key Step 5 Step 8 Update • Instruct the patient to suspend • Unfreeze; repeat steps 5–8 to acquire respiration; then press the additional measurements if required Freeze Update key on the control panel to begin acquisition Step 6 Liver Site 1 Step 9 Vs Median=1.05 m/s Report When the acquisition is E Median=3.3 kPa • Depth=5.5 cm • Select Report on the left side of the complete, the system touch screen automatically freezes, emits Liver Site 1 Measurements • one audible “beep”, and View, delete, store, print, or transfer Vs(m/s) E(kPa) D(cm) 1 0.92 2.5 5.5 displays the Vs Median and shear wave measurements 2 1.12 3.8 5.5 E Median values for up to 3 0.79 1.9 5.5 4 0.84 2.1 5.5 Liver Site 1 Liver Site 2 Liver Site 3 Liver Site 4 15 individually measured 5 1.09 3.5 5.5 Vs E Depth S E Depth Vs E Depth Vs Depth 6 0.98 2.9 5.5 m/s kPa cm m/s kPa cm m/s kPa cm m/s kPa cm sub-ROIs in the measure- 7 1.05 3.3 5.5 0.80 1.9 5.6 0.79 5.6 0.95 0.94 8 0.79 1.9 5.5 1.7 5.6 1.33 5.6 1.11 0.85 ment display area (MDA). 9 0.93 2.6 5.5 0.93 2.6 5.6 1.23 5.6 1.00 1.23 0.63 1.2 5.6 1.47 5.6 1.00 1.15 4.0 10 1.40 5.9 5.5 0.91 2.5 5.6 1.14 5.6 1.20 5.5 11 1.18 4.2 5.5 0.89 2.4 5.6 1.06 5.6 1.04 2.6 • Individual values for each 1.01 3.1 5.6 1.19 5.6 0.94 2.5 12 1.20 4.3 5.5 0.86 2.2 5.6 1.22 5.6 1.47 7.4 sub-ROI and associated 13 1.22 4.5 5.5 1.07 3.4 5.6 1.15 5.6 1.40 6.0 1.26 4.7 5.6 1.19 5.6 1.32 3.0 14 1.04 3.2 5.5 11 0.96 2.8 5.6 1.06 5.6 0.90 1.39 5.8 statistics will be displayed 15 1.22 4.5 5.5 1.16 4.0 5.6 1.24 5.6 1.36 5.0 1.20 4.3 5.6 1.18 5.6 1.34 10.7 on the imaging screen left Statistics 0.84 2.1 5.6 1.93 1.91 18.2 on on on of on on of on on on on on on a Vs(m/s) E(kPa) 1.09 3.6 5.6 1.86 1.65 panel once the image is Mean 1.05 3.4 Mean 0.96 1.24 Std Dev 0.18 1.1 Std Dev 0.17 0.29 0.29 stored or the Set key has 1.05 Median 0.93 1.19 1.20 1.26 Median 3.3 IQR 0.25 0.40 2.9 0.48 been pressed. 0.28 1.8 IQR/Median 0.33 0.33 0. 38 IQR/Median 0.27 0.5 Note: If Auto pSWE is used Overall Statistics : Liver Statistics Vs(m/s) E(kPa) in conjunction with UDFF, Mean 1.05 3.4 1.1 the UDFF value will not be Std Dev 0.18 Median 1.05 3.3 displayed in the left panel. IQR 1.8 IQR/Median 027 0.5 The UDFF value will only be displayed next to the image and in the patient report. 2 siemens-healthineers.com/ultrasound DAX Liver Site 1 Abdomen Vs Median=0.87 m/s TIB:0.86 E Median=2.3 kPa TIC:2.46 Depth=5.6 cm TIS:0.86 MI:1.38 20fps 95% 2D H Low Auto pSWE 0dB/DR60 c=1540 PSWE in the liver Best Practice Techniques1 . 16cm Cooling 6 Fig. 1: Optimal technique Fasting for at least 4 hours In the non-fasting state, the liver can have falsely elevated values. Position patient supine or in a slight Optimal positioning improves intercostal access and clearly (30°) left lateral decubitus position with visualizes an artifact-free area of the liver. the right arm raised above the head Ensure the transducer is perpendicular Inaccurate or invalid measurements can result if the transducer is to skin surface and use ample gel not perpendicular to the skin line and/or there is a loss of contact between the transducer and the skin. Optimize the B-mode image and avoid Optimize the B-mode image to maximize the uniformity and rib shadows (Fig. 1) brightness of the parenchyma. Rib shadows on either side of the ROI result in poor generation and propagation of the shear wave from the Acoustic Radiation Force Impulse (ARFI) push pulse. Take measurements in the right lobe of Placing the ROI in an artifact-free area devoid of vessels, large ducts, the liver, at least 1.5–2 cm below the and/or fluid-filled structures, such as cysts, is recommended to liver capsule (Fig. 1) using an intercostal obtain reproducible results. scanning approach Align “+” marker on the sample line Non-parallel alignment can result in inaccurate measurements – parallel to the liver capsule (Fig. 1) tilt or rock the transducer to achieve proper alignment. Perform the acquisition during Instruct the patient to breathe normally and then to momentarily suspended respiration; the patient may stop breathing during the acquisition. When the acquisition is resume normal breathing after audible complete, the system freezes and emits one audible “beep”; “beep” is heard the patient can then resume normal breathing. For Auto pSWE, maintain an Indicates variability of measurements lie within a reasonable Interquartile Range (IQR)/Median ratio variability range. It is the recommended quality control measure of ≤ 0.6 for values in kilopascals and for adequate technical quality. The IQR/Median ratio for elasticity ≤ 0.3 for values in meters per second in units of kPa will be twice the IQR/Median ratio for shear wave velocity in units of m/s as the conversion of m/s to kPa is nonlinear. 1 Barr, RG, et al. (2020), Update to the Society of Radiologists in Ultrasound Liver Elastography Consensus Statement. Radiology, 00:1-12. doi.org/10.1148/radiol.2020192437. https://pubs.rsna.org/doi/10.1148/radiol.2020192437. siemens-healthineers.com/ultrasound 3 For the proper use of the software or hardware, please always use At Siemens Healthineers, we pioneer breakthroughs in healthcare. the Operator Manual or Instructions for Use (hereinafter collectively For everyone. Everywhere. Sustainably. As a leader in medical “Operator Manual”) issued by Siemens Healthineers. This material is technology, we want to advance a world in which breakthroughs to be used as training material only and shall by no means substitute in healthcare create new possibilities with a minimal impact on the Operator Manual. Any material used in this training will not be our planet. 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All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. ACUSON Sequoia and Virtual Touch are trademarks of Siemens Medical Solutions USA, Inc. Siemens Healthineers Ultrasound owns the rights to all images. 1 Personalization of diagnosis, therapy selection and monitoring, after care and managing health. Siemens Healthineers Headquarters Manufacturer Siemens Healthineers AG Siemens Medical Solutions USA, Inc. Siemensstr. 3 Ultrasound 91301 Forchheim, Germany 22010 S.E. 51st Street Phone: +49 9191 18-0 Issaquah, WA 98029, USA siemens-healthineers.com Phone: 1-888-826-9702 siemens-healthineers.com/ultrasound Published by Siemens Medical Solutions USA, Inc. · QR700011299 · 15687 0924 online only · ©Siemens Medical Solutions USA, Inc., 2024