ACUSON Sequoia 3.5 (VB30) Fusion Imaging Presentation

SIEMENS Healthineers SIEMENS Healthineers .. ACUSON Sequoia Ultrasound System Fusion Imaging 3.5 (VB30) 1 Unrestricted © Siemens Healthineers 2025 Speaker Notes: No speaker notes. Notes No. 1 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Define Fusion imaging • Review Fusion imaging clinical solutions • Recognize Fusion imaging benefits ACUSON Sequoia • Explain Fusion imaging setup and display • Demonstrate Fusion imaging workflow • Describe guide needle tracking • Apply troubleshooting tips 2 Unrestricted © Siemens Healthineers 2025 Speaker Notes: No speaker notes. Notes No. 2 SIEMENS Healthineers Fusion Imaging SIEMENS. Healthineers ... CT Transducer Abdomen edle Unplugged TIB:1.56 TIC:4.53 TIS:1.56 MI:1.20 12fps 98% 2D H Mid 0dB/DR60 Sequoia Mid PRF 1250 MRI 18 cm Fusion Imaging: Anatomic precision on CT or MRI combined with live Ultrasound 3 Unrestricted © Siemens Healthineers 2025 Speaker Notes: Previously, interventionalists had to compromise between anatomic precision and real-time imaging during complex interventional procedures. Performing interventional procedures under Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) guidance alone can be inefficient lacking the real-time capability desired for these procedures. Fusion imaging technology provides the benefits of the resolution and clarity of CT and MRI with the need for real-time imaging in interventional procedures. Notes No. 3 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Define Fusion imaging • Review Fusion imaging clinical solutions • Recognize Fusion imaging benefits ACUSON Sequoia • Explain Fusion imaging setup and display • Demonstrate Fusion imaging workflow • Describe guide needle tracking • Apply troubleshooting tips 4 Unrestricted © Siemens Healthineers 2025 Speaker Notes: No speaker notes. Notes No. 4 SIEMENS Healthineers Clinical solutions SIEMENS . Healthineers .. Abdominal and renal exams • Biopsy planning and guidance Transducer 2 1 D=45.8 mm :2 D=27.9 mm Netale • Ablation therapy guidance • Serial scan comparisons • Isoechoic lesion detectability • Multiple lesion discrimination 16cm 5 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Fusion imaging is a multi-modality diagnostic aid that can be used during an interventional procedure or outside of the procedure setting. It can be used for: • Interventional biopsy • Ablation therapy planning and guidance • Diagnostic role for serial scan comparison (e.g., changes in lesion size after treatment) • Targeting difficult-to-visualize lesions • Evaluation of multiple lesions with higher diagnostic confidence Fusion imaging is compatible with three exam types (abdomen, musculoskeletal (MSK), general) and four transducers (5C1, 4V1, 10L4, and DAX) for flexibility in covering the abdominal area and ease of intercostal scanning if needed. Notes No. 5 SIEMENS Healthineers Clinical solutions SIEMENS . Healthineers .. Musculoskeletal (MSK) exams Orthopedic, sports medicine and Transducer 3 eedie Unplugged MSK radiology applications • Diagnostic & therapeutic assessments . MKO1 AMKO1 • Shoulder • Deep pelvic nerves • Hip procedures • Guided injections • Guided aspirations • Soft tissue biopsy guidance 4.5cm 6 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Fusion imaging capability is available on the 10L4 transducer for MSK procedures and exams. Potential diagnostic and therapeutic applications in MSK procedures include: • Aspirations of fluid collections (e.g., abscess drainage) • Piriformis muscle injection • Sacroiliac joint injection • Pudendal and intercostal nerve perineural injections • Hamstring-origin calcific tendinopathy lavage (barbotage) • Soft tissue biopsies • MSK tumor biopsy Notes No. 6 SIEMENS Healthineers Compatible transducers SIEMENS. Healthineers ... General Abdomen MSK • 5C1 • 10L4 • 5C1 • 4V1 • 4V1 • DAX • • 10L4 DAX 7 Unrestricted © Siemens Healthineers 2025 Speaker Notes: The fusion imaging provided on the ACUSON Sequoia ultrasound system is compatible with the following transducers: • General – 5C1, 4V1, DAX, and 10L4 • Abdomen – 5C1, 4V1, and DAX • MSK – 10L4 Notes No. 7 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Define Fusion imaging • Review Fusion imaging clinical solutions • Recognize Fusion imaging benefits ACUSON Sequoia • Explain Fusion imaging setup and display • Demonstrate Fusion imaging workflow • Describe guide needle tracking • Apply troubleshooting tips 8 Unrestricted © Siemens Healthineers 2025 Speaker Notes: No speaker notes. Notes No. 8 SIEMENS Healthineers Fusion imaging benefits SIEMENS. Healthineers ... Increase diagnostic confidence during complex interventional procedures by combining the anatomic precision on CT or MRI with live ultrasound, 7 potentially helping to correlate indeterminate pathology or isoechoic Clinical lesions Value Improve procedural efficiency with exclusive, flexible tools for rapid and accurate alignment Operational Value Potentially avoid additional procedure cost, dose exposure and time by $ increasing access to real-time ultrasound imaging in interventional procedures Financial Value 9 Unrestricted © Siemens Healthineers 2025 Speaker Notes: The key clinical, operational, and financial benefits for Fusion imaging are displayed. The Fusion imaging provided on the ACUSON Sequoia ultrasound system has dramatically changed the workflow experience by bringing practicality to this technology: • Premium imaging • Direct access to controls • Automatic alignment that doesn’t require a repeat CT scan with fiducial markers Notes No. 9 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Define Fusion imaging • Review Fusion imaging clinical solutions • Recognize Fusion imaging benefits ACUSON Sequoia • Explain Fusion imaging setup and display • Demonstrate Fusion imaging workflow • Describe guide needle tracking • Apply troubleshooting tips 10 Unrestricted © Siemens Healthineers 2025 Speaker Notes: No speaker notes. Notes No. 10 SIEMENS Healthineers Setup SIEMENS. Healthineers ... Step 1: Connect transmitter cube to electronics unit (tracker box) A. Connect Cube to Tracker Note: Connector and port knobs B. Position Cube 60 cm + from Tracker Note: Rotate and gently push should match to enable secure C. Direct front of Cube towards Patient Connector towards port connection within 20-30 cm Note: Cube must remain stationary during use 11 Unrestricted © Siemens Healthineers 2025 Speaker Notes: Step 1: • Connect the Transmitter (Cube) to the electronics unit (Tracker box) as outlined • All components connect to the Tracker box, it is the “brains” for the Fusion imaging equipment • The Tracker box “tracks” the sensor location The transmitter Cube projects the electromagnetic field in which the transducer and needle sensors are tracked, so that the location and orientation of the transducer and needle can be determined. Notes No. 11 SIEMENS Healthineers Setup SIEMENS . Healthineers ... Step 2: Connect sensor to tracker SC1 O.O Sensors Insors Tr ACUSON 123X 1 2 3 X • Attach bracket • Connect • Tracker ports • Insert needle • Connect needle to Transducer Transducer 1–3 correspond sensor into sensor to • Attach sensor to to Transducer needle cannula tracker port Transducer tracker ports 1–3 and lock number 4 sensor to (audible click) bracket 12 Unrestricted © Siemens Healthineers 2025 Speaker Notes: Step Two: Connect the sensors to the tracker box as outlined. The transducer sensor provides transducer orientation information to the tracking system and connects to either: • Fusion imaging bracket (provides connection for ONLY the transducer sensor) • Needle Tracking bracket (This provides connection for transducer sensor AND needle guide) The distal tip of the needle sensor (.55 mm) provides needle orientation information to the tracking system. The needle sensor is inserted through an opening in the handle of the cannula (stylet or introducer) and locked into place. Note: The locking and unlocking of the needle will be apparent to the user when you hear a clicking sound. Notes No. 12 SIEMENS Healthineers Setup SIEMENS. Healthineers ... Tracker box Transducer sensor Cube and stand 13 Unrestricted © Siemens Healthineers 2025 Speaker Notes: 1. The tracker box is positioned on the back of the ultrasound system 2. The transmitter cube is connected to its stand and positioned facing the patient at a height level that is even with the patient area being scanned • Position the cube and keep out of the flow of traffic so that it will not be accidently bumped or moved • If it is moved after alignment has been performed, re-alignment will be necessary 3. The transducer, bracket and sensor are covered in a sterile sheath to prevent cross- contamination in the sterile field Note: When using needle guidance, a special sterile cover is used to cover the reusable handle of the needle sensor prior to insertion into the sterile, disposable stylet and introducer to ensure sterility once the needle handles are locked into position. Notes No. 13 SIEMENS Healthineers Transducer sensor tracking brackets SIEMENS. Healthineers ... 5C1 Bracket for Fusion Imaging Bracket with Verza Needle Guide • Transducer sensor mount only • Transducer sensor mount • Free-hand navigation • Disposable snap-on needle guide mount 14 Unrestricted © Siemens Healthineers 2025 Speaker Notes: There are two transducer sensor tracking brackets available from CIVCO Medical Solutions for all transducers that are compatible with Fusion imaging (4V1, 5C1, DAX, and 10L4 transducers): • The Tracking Bracket for Fusion imaging provides the transducer sensor mount only for free- hand navigation capabilities • The Tracking Bracket with Verza Needle Guide incorporates both tracking technology and needle guidance capabilities into a single reusable bracket. It provides both a mount for the transducer sensor and a disposable snap-on needle guide Notes No. 14 SIEMENS Healthineers Image layout – Fusion SIEMENS. Healthineers ... Navigator CT/MRI Live B-mode ultrasound Abdomen 712 workflow Patient 2D Fusion Imaging Scan Plan Fuse Review Report UR Flip WO Flip Timer Load volume Exit End Exam Supine Prone Reset Orientation Structures Manual Point Pan Reset Pan Seen the patient to watch the dide Press bitale. Innaize Scroll Plane Presets Bet XYZ Default On-screen prompt Image thumbnails Fusion imaging controls 15 Unrestricted © Siemens Healthineers 2023 Unrestricted © Siemens Healthineers 2025 Speaker Notes: The Fusion imaging monitor display has a clean, uncluttered layout that is easy to read. The Touch Screen allows direct access to controls and offers tab folder browsing (i.e., Scan, Plan, and Fuse modes have separate tabs containing their dedicated controls) with context- sensitive lighting for color-coded guidance. Active controls are blue while available inactive touch controls are grey. Notice the on-screen prompts for added guidance throughout the Fusion imaging exam (e.g., Scan the patient to match the reference data on the left side). Notes No. 15 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Define Fusion imaging • Review Fusion imaging clinical solutions • Recognize Fusion imaging benefits ACUSON Sequoia • Explain Fusion imaging setup and display • Demonstrate Fusion imaging workflow • Describe guide needle tracking • Apply troubleshooting tips 16 Unrestricted © Siemens Healthineers 2025 Speaker Notes: No speaker notes. Notes No. 16 SIEMENS Healthineers Workflow SIEMENS. Healthineers ... Import Register Activate Load Plan Fuse Scan 17 Unrestricted © Siemens Healthineers 2025 Speaker Notes: The basic steps when performing a Fusion imaging study are: • Import patient reference data (CT or MRI) to local database • Register the patient • Activate Fusion imaging • Load CT or MRI series into Fusion imaging • Plan – Segmentation markers, window-level, distance measurement • Fuse – Alignment: initial, auto, point, manual • Scan – Needle tracking and biopsy Notes No. 17 SIEMENS Healthineers Import SIEMENS. Healthineers ... Import the patient reference data into the local database using one of the following methods: • Import study from CD-DVD • Import study from USB • Query Retrieve study From PACs 18 Unrestricted © Siemens Healthineers 2025 Speaker Notes: The patient reference data can be imported into the ultrasound Patient Browser by using one of the methods listed. Note: The patient's name, patient ID, date of birth, and gender on the patient registration form entries are case sensitive and must match the corresponding information for the reference data. Notes No. 18 SIEMENS Healthineers Import SIEMENS. Healthineers ... USB/CD/DVD 1. Select Patient on the Touch Screen Patient Registration 2 Patient Browser 2. Select Patient Browser 1 atient 3. Select the drive location (USB drive or CD/DVD) and Query/Retrieve Job Status the path of the reference data Imaging 4. Select Import from off-line Patient Browser 3 ource Media Local Database Available: 879.0 GB / 894.3 GB 4 mport from off-line Period []Custom Range Show All 19 Unrestricted © Siemens Healthineers 2025 Speaker Notes: To import from Universal Serial Bus (USB) or Compact Disk (CD)/Digital Video Disk (DVD): 1. Select Patient on the Touch Screen 2. Select Patient Browser 3. From the Patient Browser select the Transfer drop-down menu and select Import from off- line Notes No. 19 SIEMENS Healthineers Import SIEMENS. Healthineers ... USB/CD/DVD 5. Highlight the studies you want to Import from off-line import by selecting the first study; then press Shift on the keyboard and Source Media A:1 select the last study Path 6. Select Import A:\ 1 CTABML2012-4-5-12-35-45-484.CT. . 0003.0028.2015.11.16.13.09. The system will now begin importing 4:CTABML2012-4-5-12-35-45-484.CT. . 0003.0029.2015.11.16.13.09 the patient reference data and the 14 CTABML2012-4-5-12-35-45-484.CT. . 0003.0030.2015.11.16.13.09 patient folder will be visible in the - CTABML2012-4-5-12-35-45-484.CT._.0003.0031.2015.11.16.13.09 Patient Browser when completed 5 14 CTABML2012-4-5-12-35-45-484.CT. . 0003.0032.2015.11.16.13.09 IL CTABML2012-4-5-12-35-45-484.CT. . 0004.0238.2015.11.16.13.05 4 CTABML2012-4-5-12-35-45-484.CT. . 0004.0239.2015.11.16.13.05 4 CTABML2012-4-5-12-35-45-484.CT. . 0004.0240.2015.11.16.13.05 LE CTABML2012-4-5-12-35-45-484.CT. . 0004.0241.2015.11.16.13.09 À CTABML2012-4-5-12-35-45-484.CT. . 0004.0242.2015.11.16.13.09 6 Import Close 20 Unrestricted © Siemens Healthineers 2025 Speaker Notes: To import from USB or CD/DVD (cont.): 4. Select the drive location (USB drive or CD/DVD) and the path of the reference data 5. Highlight the studies you want to import by selecting the first study; then press Shift on the keyboard and select the last study 6. Select OK The system will now begin importing the patient reference data, and the patient folder will be visible in the Patient Browser when completed. Note: • The study must be on the root directory when selecting USB Stick from the drop-down list. Select the DICOM folder(s) and then OK to import a DICOM study. • If the DICOM folder/s is/are located in an Export folder created on the USB drive, the logical name E:\ may be selected. Double-click on the Export folder to select the DICOM folder and then select OK to import. Notes No. 20 SIEMENS Healthineers Import SIEMENS. Healthineers ... Query/Retrieve from PACS 1. Select Patient on the Touch Screen Patient Registration 2 Patient Browser 2. Select Patient Browser 1 Patient 3. Select Query/Retrieve on the 3 Query/Retrieve Job Status Touch Screen or Monitor Imaging Patient Browser 4. Enter the search parameters 4 5. Select the desired study to highlight ireport on off the Gentler 6. Select Import Study List CIV. TEST CY REPORT 24.02.08-19:53:3 203/2024 07:53:33 PM O x CV REPORT 24.02-08-19:42:0. Cadac 2/08/2024 07:42:07 PM C Y CV REPORT 24.02.08-19:150. Cardiac 304/2024 07:1005 PM C) I TESTICLE FER 8 RACEK 3.0 24.02.00-11:43:2. 28/2024-14:43:27 AM 24.02.07-17:066. 217/2024 05:06:56 PM 24.02.07-14:43-5- 2/7:2024 02/43:56 PM DEDAX 5 Atomen 27:2024 11:26:05 AM 28.16 OV DCDAX 24.07-07-03:31:3 .- Atermin 27/2024 09:31:21 AM TESTI, DAYI 24.02.01-11:11:3 7/1/20124 11:11:39 AM [ Il 11:514, DAY2 24.01.31-11:51:1. 13 1/2034 01:51:39 PM 0 1EST1, DAY2 24.01.31-09:14:02. 1/11/3024 09:14:04 AM O Y TEST LEE, DATI 24.01.30-12:43:35 1:30/20124 12:48:34 PM 24.01.30-11:2400 .. 133/2024 11:24:09 AM 3 TEST1, DAYS 1/03/2024 09:48:14 MM 6 Import 21 Unrestricted © Siemens Healthineers 2025 Speaker Notes: To import (query/retrieve) from PACS: 1. Select Patient on the Touch Screen 2. Select Patient Browser 3. Select the Query/Retrieve icon 4. Enter the search parameters 5. Select the desired study to highlight 6. Select Import Notes No. 21 SIEMENS Healthineers Register SIEMENS. Healthineers ... 1. Select Patient on the Touch Screen 2. Register the patient either from the Worklist or manually Default Virtual Touch Exam Packag robert Registration Dreact 2 Patient 1 Right Left Fritluse Imaging Review Mass 1 Mass 2 Mass 3 Report End Exam O % Clear Screen Edit Caliper Cine de Results 22 Unrestricted © Siemens Healthineers 2025 Speaker Notes: To register a Fusion imaging exam: 1. Select Patient on the Touch Screen to open the Patient Registration page 2. Register the patient as you normally would, either from the Worklist or manually Notes No. 22 SIEMENS Healthineers Activate SIEMENS . Healthineers ... ₱ Abdomen 1514 workflow Workflow Patient 2D Patient Fusion Panoramic Protocols Al Abdomen UR Flip UND Flip Biopsy Review Off Timer Arview Modality Compare Report Panoramic FUR FOV Report End Exam End Exam Auto TEQ Live Dual Clarity X Harmonics Compounding Wide FOV requeno InFocus Line Density H Mid 65 GB 23 Unrestricted © Siemens Healthineers 2025 Speaker Notes: After patient registration, the system defaults to imaging mode. Select the Workflow control and then select Fusion to activate Fusion imaging. Note: • Be sure the active probe(s) in ports 1–3 correspond to the tracking box ports 1–3. • A routine ultrasound exam can be performed prior to entering Fusion imaging if desired. Notes No. 23 SIEMENS Healthineers Tracking initialization SIEMENS . Healthineers ... SIEMENS A dialog box will indicate status Healthineers Live Fusion Navigator upon initialization Hide Show Delete 5C1 Show All Abdomen TIB:0.48 TIC 2.50 TIS:0.48 MI:1.05 19ps 98% 20 H Mid 9dB/DR60 Wait while tracking system is initializing . 24 Unrestricted © Siemens Healthineers 2023 Unrestricted © Siemens Healthineers 2025 Speaker Notes: The dialog box will indicate the status of the Fusion HW initialization: • It will vary depending on whether the transducer or needle sensors are attached correctly to the track box • If the transducer does not correspond to the correct port of the track box or if the Tracking Needle is in another port besides port 4 • If there is an issue with the tracking box itself Notes No. 24 SIEMENS Healthineers Activate SIEMENS. Healthineers ... Transducer 1 Transducer 1 Transducer 1 Needle Needle Needle Warning: Verify Tracking Warning: Verify Tracking Highest tracking Unable to perform sweep quality displays Unable to initialize. Please verify the sensor is within optimal range acquisition. Please verify the green bar across of the transmitter before sensor is within optimal range of re-initialization the transmitter before width of indicator re-acquisition. OK OK 25 Unrestricted © Siemens Healthineers 2025 Speaker Notes: There are two quality indicators located in the upper right corner of the image that indicate the transducer sensor (displays on top) and needle sensor (displays on bottom) are being tracked with high quality. Verify that the Transducer Quality Indicator and Needle Quality Indicator display a green bar across the width of the indicator for highest tracking quality. • If the indicator displays a yellow bar, move the transducer sensor or needle sensor closer to the transmitter cube or move the transmitter cube closer to the patient • If the cube is moved after alignment has been performed, re-alignment will be necessary • If the needle is unplugged, the Needle Quality Indicator will display the message “Needle Unplugged” • If the tracking quality is poor during Initialization (indicator displays a red bar), a warning message will appear on the screen • If tracking quality is poor during Auto alignment (indicator displays a red bar), a warning message will appear on the screen, an audible warning will sound, and clip capture will not proceed Notes No. 25 SIEMENS Healthineers Tracking quality indicator display SIEMENS . Healthineers ... Example of poor transducer and needle quality Live Samediwurde 999350 • Poor transducer quality (red) and poor needle 501 Abdomen quality (yellow) TIB:0.48 TIC:2.50 TIS:0.48 MI:1.05 19fps 98% 2D H Mid 9dB/ DR60 Rectify by moving the transducer sensor closer to the transmitter cube or moving the transmitter cube closer to the patient. Set Size Position 26 Unrestricted © Siemens Healthineers 2023 Unrestricted © Siemens Healthineers 2025 Speaker Notes: This is an example of poor transducer quality (red) and poor needle quality (yellow). Red text “Poor tracking quality is detected” will be indicated on the quality bar. As mentioned previously, this can be rectified by moving the transducer sensor closer to the transmitter cube or moving the transmitter cube closer to the patient. Notes No. 26 SIEMENS Healthineers Load volume SIEMENS . Healthineers ... • Select Load volume on the DAX Touch Screen Abdomen 712 Workflow Patient 2D Fusion Imaging Scan Review Report L/R Flip J/D Flip Timer Load volume Exit End Exam Biopsy Off Landmark Structures Track Needle Needle Tip Graphics Distance Measured Results Pan Reset Pan Delete 27 Unrestricted © Siemens Healthineers 2025 Speaker Notes: Select Load Volume on the Touch Screen to load the volume. This feature allows you to instantly access the patient browser, reducing user time and effort. Notes No. 27 SIEMENS Healthineers Load Volume SIEMENS. Healthineers ... 1. Select the patient’s Patient Browser Import from off-line name to highlight Source Media 2. Select the patient to A:1 highlight Source Media Path A:\ 3. Check the Local Database CTABML2012-4-5-12-35-45-484.CT. . 0003.0028.2015.11.16.13.05 thumbnails Available: 879.0 GB / 894.3 GB CTABML2012-4-5-12-35-45-484.CT. . 0003.0029.2015.11.16.13.09 4. Click Import CTABML2012-4-5-12-35-45-484.CT. . 0003.0030.2015.11.16.13.05 Import from off-line 14 CTABML2012-4-5-12-35-45-484.CT. . 0003.0031.2015.11.16.13.09 CTABML2012-4-5-12-35-45-484.CT. . 0003.0032.2015.11.16.13.09 4 CTABML2012-4-5-12-35-45-484.CT. . 0004.0238.2015.11.16.13.05 CTABML2012-4-5-12-35-45-484.CT. . 0004.0239.2015.11.16.13.09 1 Period 4 CTABML2012-4-5-12-35-45-484.CT. . 0004.0240.2015.11.16.13.09 Verify steps [] Custom Range 2 ICTABML2012-4-5-12-35-45-484.CT._.0004.0241.2015.11.16.13.09 Show All 2 14 CTABML2012-4-5-12-35-45-484.CT._.0004.0242.2015.11.16.13.09 - to Load 3 4 Import Close 28 Unrestricted © Siemens Healthineers 2025 Speaker Notes: To load the volume: 1. Select the patient’s name to highlight 2. Select the series icon to highlight 3. Check the thumbnails 4. Double-click series icon to load Note: • Individual thumbnail images can be deleted prior to loading to import a focused set of slices representing the anatomical area of interest (rather than importing all the slices in the CT/MRI series); however, highlighting and loading selected thumbnail images only is not supported. Fusion imaging is vendor neutral for CT and MRI. • The optimal slice thickness is between 1–5 mm: • 1 mm yields the greatest accuracy but may not be available • At 5 mm, there will be a 1 cm margin of error on alignment Notes No. 28 SIEMENS Healthineers Patient demographic mismatch SIEMENS . Healthineers ... If the patient demographics are not an exact match, a warning message will be displayed. Mismatched Data Verify that the patient information is correct and press OK to continue. A The patient identifying information is not an exact match. Confirm the identity of the patient. Press OK to continue Loading the patient data or press Cancel. OK Cancel 29 Unrestricted © Siemens Healthineers 2025 Speaker Notes: The ACUSON Sequoia system allows the user to fuse a study even if there is a patient demographics mismatch. This may occur if the reference study was performed at a different institution (e.g., Medical ID #, spelling). If the patient demographics are not an exact match, you will get this following warning message: The patient identifying information is not an exact match. Confirm the identity of the patient. Press OK to continue loading the patient data or press Cancel. Verify that the patient information is correct and press OK to continue. Notes No. 29 SIEMENS Healthineers Plan SIEMENS. Healthineers ... MPRs and volume Workflow Patient 20 Fusion Imaging Scan Fuse Review Report Seed Segmentation Line Segmentation Load volume Exit End Exam Seed Site Landmark Structures Level 40 Clear Foreground Seeds Clear Background Seeds Distance Measured Results Delete Reset Display Layout 4:3 Coronal Sagittal Axial Quadrant Presets Axial Default ( CC Defaults to center slice of CT/MRI Coronal moves posteriorly Sagittal moves towards patient’s left Axial moves inferiorly 30 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The system defaults to Plan mode after CT/MRI import. The system defaults to the center slice in the CT/MRI volume and the multi-planar reconstructions (MPRs) are displayed in a four-quadrant format. • To change the format, rotate the Layout rotary for either a 1:1 or 4:1 format • To highlight a different quadrant, rotate the Quadrant rotary • To Zoom, press and turn the Zoom rotary on the Control Panel to zoom the image • The cross-hair colors correspond to the anatomical reference planes (in the axial plane, located in the lower left quadrant, the green line corresponds to the sagittal plane and the blue line corresponds to the coronal plane) Use Coronal, Sagittal and Axial rotary controls to scroll through the CT/MRI planes and make measurements; add three-dimensional (3D) markers or plan a virtual needle path. • Turn the Coronal rotary knob clockwise to move to a more posterior slice in the CT/MRI; turn the knob counterclockwise to move to a more anterior slice • Turn the Sagittal rotary knob clockwise to move to a slice closer to the patient’s left in the CT/MRI; turn the knob counterclockwise to move to a slice closer to the patient’s right • Turn the Axial rotary knob clockwise to move to a more inferior slice in the CT/MRI; turn the knob counterclockwise to move to a more superior slice Notes No. 30 SIEMENS Healthineers Plan SIEMENS . Healthineers ... Segmentation markers and landmarks DAX Abdome 712 Workflow Patient 2D Fusion Line or Seed Imaging Segmentation Fuse Review Report Seed egmentation Line Segmentation VR Load volume Landmark End Exam Leed Sie Landmark Structures Window 490 Level 153 Clear Foreground ear Background Distance Measured Results Pan Delete Reset Display Seed Placement O • Visualized on CT/MRI and ultrasound in 3D • Aids in fine-tuning during alignments Foreground = Green • Assists with lesion correlation when there are multiple lesions or difficult-to-visualize lesions Background = Red 31 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Segmentation markers use Siemens Healthineers proprietary Knowledge-based Workflow technology to automatically detect and outline an area of interest in 3D so that it can be marked and viewed simultaneously in all imaging planes on the CT/MRI and the real-time ultrasound. Markers can assist with finetuning during alignments and aid in lesion correlation when there are multiple lesions or difficult-to-visualize lesions: • Line Segmentation works best with lesions that have well-defined borders • Seed Segmentation works best for lesions with irregular borders • Additional benefits of Segmentation markers include the ability to outline gross anatomy (e.g., kidney or portal vein) and allow the use as internal fiducial markers A Landmark is a single color-coded marker used to mark a corresponding point that can be viewed in all imaging planes on the CT/MRI and ultrasound. To set a Landmark: • Select Landmarks to set the required location for the landmark • The system displays a numbered, color-coded point marker on the image Note: • The landmark marker is very small, and the use of thicker CT/MRI slices may cause it to appear/disappear very quickly. • Markers can be temporarily hidden during the study by selecting the Hide check box located in the Navigator. Notes No. 31 SIEMENS Healthineers Plan SIEMENS . Healthineers ... Segmentation markers and Landmarks DAX Abdome 712 Workflow Patient Fusion Line or Seed 2D Imaging Segmentation Fuse Review Report Seed Segmentation Line Segmentation VR Load volume End Exam Landmar Structures Window 490 Level 153 Clear Foreground lear Background Distance Measured Results Pan Delete Reset Display Seed Placement O • Visualized on CT/MRI and ultrasound in 3D • Aids in fine tuning during alignments Foreground = Green • Assists with lesion correlation when there are multiple lesions or difficult to visualize lesions Background = Red 32 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To activate a Line Segmentation: • Select Line Segmentation and place a caliper on the edge of the desired lesion • Press Set on the Trackball control to position the starting and end points of a line, from border-to-border, across the lesion • The system displays an outline around the area identified by the line segmentation To activate a Seed Segmentation: • Select Seed Segmentation; then select a Seed Size (Small, Medium or Large) • Use the Right Set key to select the Foreground (green) • Use the Left Set key and the trackball to highlight the area of interest and place the foreground seeds inside • Use the Right Set key to select the Background (red) • Use the Left Set key and the trackball to highlight the area interest and place the background seeds around the border • The system displays an outline around the area identified by the foreground and background seeds • After you are satisfied with the placement, select the Update key (Run Segmentation) on the trackball control to create a seed segmentation Notes No. 32 SIEMENS Healthineers Plan SIEMENS . Healthineers .. Window/Level DAX Abdome 712 Workflow Window = Contrast Patient Fusion Level = Brightness 2D imaging Scan Plan Fuse Window 400 Review Level 40 Report Seed Segmentation Line Segmentation VR Load volume Exit End Exam Seed Size Small Landmark Structures Window 490 Level 153 Clear Foreground Clear Background Seeds Seeds Distance Measured Results + Pan Delete Reset Display Increase/decrease Window ➔ slide right/left Layout Coronal Sagittal Axial Quadrant Presets Axial default Increase/decrease Level ➔ slide up/down 33 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Window/Level is available in Plan, Fuse, and Scan modes. • To increase/decrease Window (contrast), slide finger to the right/left inside the Touch Screen Window/Level box • To increase/decrease Level (brightness), slide finger up/down inside the Touch Screen Window/Level box • Turn the Presets rotary to select pre-defined optimization settings (e.g., Default, Abdomen/Pelvis, Bone, CTA [Computed Tomography Angiogram], Kidney, Liver) Note: Window/Level applies to the data set only, the real-time ultrasound is adjusted utilizing gain and dynamic range controls. Window/Level is only available in Fuse and Scan modes when an Alignment has been created. Notes No. 33 SIEMENS Healthineers Plan SIEMENS . Healthineers .. Distance and Pan 7L2 Workflow SHMIR Review Fusion Navigator Patient 20 Fusion 1 0-28.1 mm Imaging Scan Fuse Review Report Seed Segmentation ine Segmentation Load volume Exit A End Exam Send Stet Small Landmark Structures Window 400 Level 40 Clear Foreground Seeds Clear Background Seeds Distance Measured Results Pan Delete eset Display Deatoren measurement tools Layout 4:1 Coronal Sagitta Axial Quadrant Presets Axial Default Panning with the aide of zooming can increase the detail Measure a lesion or other area of interest of an area of interest 34 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Distance: Select to measure a lesion or distance to a lesion to help determine the needle length for the procedure. • Helpful in identifying approach and distance from insertion to target lesion • Distance can be used in conjunction with zoom and/or Pan to increase the detail of an area of interest Structures: Select to hide or display all planning data Measured Results: Will hide or display the distance value(s) Delete: Deletes a distance measurement VR: Select to display multi-planar reconstruction (MPR) with or without a volume rendering (VR) Reset Display: Select to restore the previous display (after panning or cycling through the slices of an MPR) Exit: Exits Fusion Notes No. 34 SIEMENS Healthineers Fuse SIEMENS . Healthineers ... Initial alignment DAX Abdome 712 Workflow Fusion Navigator Pode BbOW Delete Show AR Abdomen Patient TI8:0.40 2D Fusion TIC:2.50 TIS 0.40 MI:1.05 Imaging Scan Fuse Review HM Report UR Flip UID Flip Timer Load volume Exit End Exam Supine Prone Reset Orientation Structure Manual Paint Pan Reset Pan Scan the patient to match the Scroll Plane side. Press Initialize. Initialize Default Set XYZ CT/MRI reference image and on-screen prompt provide guided, instantaneous, and precise initialization. 35 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Initial alignment gives a quick visual orientation alignment to the patient’s head, feet, right, and left sides. Once activated, the CT/MRI data set immediately moves to align to the live ultrasound. To perform initial alignment: • Select the Fuse tab • Select the desired CT/MRI view using the Orientation rotary control • Select Prone or Supine based on the patient’s position • Use the X, Y, Z direction on the trackball controls during the initialization process to manually rotate the selected reference image plane • The system displays the message “Scan the patient to match the reference image on the left side. Press Initialize.” • Select the Update key from the trackball controls to initialize Notes No. 35 SIEMENS Healthineers Fuse SIEMENS . Healthineers ... Auto alignment SIEMENS Simulated Reflection Simulated Transmission Healthingers Fusion Navigator BROW DAX Show All Abdomen T18:0.55 TIC:2.73 TIS:0.55 20fps Begroting sweep for Simulated Image Actual Image Fusion imaging can utilize the CT in which Auto Alignment conducts a pixel-by-pixel the diagnosis was made versus requiring a fusion- alignment of the CT volume with the ultrasound specific CT with external fiducial markers. sweep based on tissue density. 36 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Auto alignment matches images by simulating CT from ultrasound based on tissue density. Fusion imaging can utilize the CT in which the diagnosis was made versus requiring an additional Fusion-specific CT scan with external fiducial markers, re-radiating the patient and increasing procedural cost. By conducting a 3D ultrasound sweep and gathering ultrasound data with strong anatomical features, the advanced algorithm aligns the ultrasound and CT dataset. The CT jitters or shakes after the sweep prior to alignment as an indication that the advanced algorithm is rapidly conducting a pixel-by-pixel alignment throughout both the CT dataset and the ultrasound 3D sweep based on tissue density. • Automatic alignment converts CT images (related to tissue density) to ultrasound images (related to changes in tissue density) for matching • Matches are performed on multiple slices simultaneously for 3D alignment Note: Auto alignment is available only for CT reference data. Notes No. 36 SIEMENS Healthineers Fuse SIEMENS . Healthineers ... Auto alignment DAX Abdomen Workflow Fusion Navigator Show Drinte Show All Atxtomen TI8:0.48 Patient 20 Fusion TIC:2 50 TI8:0.40 MI:1 66 Imaging Scan Plan Fuse 20 H Mid Review Report LUR Flip UID Flip Timer Load volume Exit End Exam Reset Alignment Save Alignment Undo Structures Window 420 Manual Poin Auto Pan Reset Pan To start Auto Alignment press Acquire Layout 2:1 Presets Pass Acquire again her 37 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: To activate Auto alignment: • Select Auto and follow the on-screen prompts • Before auto-acquiring, ensure the tracking quality is good (green) • Select Update from the Trackball controls and scan through the area in one direction at a steady rate • Select Update again to end the acquisition Note: The system supports acquisition lengths of up to 20 seconds. Notes No. 37 SIEMENS Healthineers Fuse SIEMENS . Healthineers ... Auto alignment techniques • Best after a reasonably close initial alignment DAX Abdomen • Requires a sweep containing strong anatomical features (e.g., TIB:0.55 TIC-273 TI5:0.55 major vessels, gallbladder, diaphragm, etc.) MI:1.06 28fps • Sweep during suspended respiration • Scan in a smooth, sweeping motion (gliding or rocking) in any direction • Maintain the same plane of scanning • Avoid rotating the transducer during the sweep • Avoid bowel gas and rib shadows Acquire 38 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Using good technique during the Auto alignment sweep will ensure a more accurate alignment. • Best after a reasonably close initial alignment • Requires a sweep containing strong anatomical features (e.g., major vessels, gallbladder, diaphragm, etc.) • Sweep during suspended respiration • Scan in a smooth, sweeping motion (gliding or rocking) in any direction • Maintain the same plane of scanning • Avoid rotating the transducer during sweep • Avoid bowel gas and rib shadows Notes No. 38 SIEMENS Healthineers Fuse SIEMENS . Healthineers .. Point alignment DAK 712 Workflow SIEMENS Abdome Wegithinkers Live Fusion Navigator Patient Fusion Hide Shoe Delarte DAX 2D Show AM Abdomen TIB:0.55 TIC:2.73 TIS:0.55 Scan Fuse M 1.06 BomBewul 95% Review 20 H Low 20B/ DR60 Report L/R Flip UID Flip Timer Load volume Exit End Exam Reset Alignment Save Alignment Undo Structures Manual Point Auto Pan Reset Pan Layout Transparency Presets Add Point 2 to Reference image Point alignment is a good method to use during Following on-screen prompts, select a challenging cases or when initial alignment is not reproducible landmark on the ultrasound and reasonably close. then on the CT/MRI. 39 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Point alignment matches specific points of anatomy placed on the ultrasound and the CT/MRI. To perform a point alignment: • Select Point and then follow the on-screen prompts • Select a reproducible landmark on the ultrasound (e.g., a vessel bifurcation [hepatic confluence, aortic bifurcation, portal vein bifurcation], lesion, upper pole of kidney) • Use the green arrow to select the same point on the CT/MRI and select Set • Repeat as needed to add points • Select Save Alignment to save the current alignment • The system updates the Navigator with an entry for the saved alignment Note: The point alignment method is useful on technically challenging patients or when initial alignment is not reasonably close. Notes No. 39 SIEMENS Healthineers Fuse SIEMENS . Healthineers ... Manual alignment Abdomen Workflow SIEMENS Heaitnineers Live Fusion Navigator Patient 2D Fusion Show All Imaging Scan Plan Fuse Review Report UR Flip UND Flip Timer Load volume Exit End Exam Reset Alignment Save Alignment Undo Structures Level 153 Manual Point Auto Pan Reset Pan Layout Presets Drag and drop alignment is Move ZY Manual alignment is a good method for quick fine tuning Manually drag and drop the CT/MRI data after a good Initial, Auto, or Point alignment. into alignment with the ultrasound image. 40 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: When Manual alignment is selected, the user manually aligns the reference data with the ultrasound image. To perform a manual alignment: • Select Manual • Select Move, Z or Y on the Right Set key to move the CT/MRI • Move positions the CT/MRI in the plane of the ultrasound image • Z rotates the CT/MRI clockwise or counterclockwise • Y rotates the CT/MRI around the vertical axis of the ultrasound image • Select the blended 1:1 image and then roll the trackball to position the CT/MRI in the required location on the ultrasound image • Select the blended image to anchor the position of the CT/MRI • Select Save Alignment to save the current alignment • The system updates the Navigator with an entry for the saved alignment Note: When imaging in the axial plane, manually align anterior to posterior or lateral to medial. When imaging in the sagittal plane, manually align anterior to posterior or superior to inferior. The Y-axis can be used for fine tuning. Notes No. 40 SIEMENS Healthineers Fuse SIEMENS . Healthineers ... Alignment method comparison Madeat Image Analysis 12 (2008)577-585 Medical Image Analysis manual ELSEVIER journal homepage: www.elsevier.com/locate/media multiple points Automatic CT-ultrasound registration for diagnostic imaging and image-guided intervention Wolfgang Wein“ *, Shelby Brunke", Ali Khamene ", Matthew R. Callstrom“, Nassir Navab" Departmentof Daponte Rodeogy, Mayo Ciate, Rocher , MN, LEA Retrieved from: fixed point http://far.in.tum.de/pub/wein2008ctusfusion/ wein2008ctusfusion.pdf automatic Time Accuracy Auto alignment minimizes time and maximizes accuracy. 41 Unrestricted © Siemens Healthineers 2025 Speaker Notes: A time versus accuracy comparison of the different alignment methods reveals that Auto alignment minimizes time and maximizes accuracy when compared to other alignment methods.* *Wein, W., Brunke, S., Khamene, A., Callstrom, M. R., & Navab, N. Automatic CT-ultrasound registration for diagnostic imaging and image-guided intervention. Medical Image Analysis, 12 (2008) 577-585. Retrieved from http://far.in.tum.de/pub/wein2008ctusfusion/wein2008ctusfusion.pdf Notes No. 41 SIEMENS Healthineers Fuse SIEMENS. Healthineers ... Layout and transparency Workflow 1:1 2:1 Patient 2D Fusion Imaging Scan Plan Fuse Review Report UR Flip UND Flip Timer Load volume Exit End Exam Reset Alignment Save Alignment Unda Structures Window 490 Manual Point Auto Reset Pan 1:3 Layout ransparenc Presets Default 42 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Rotate the Layout rotary control to change the display format: • 1:1 displays the blended image (US and reference data) in a full screen format • 2:1 displays the reference data on the left side of the screen and the blended image (US and reference data) on the right side of the screen • 1:3 displays the blended image on the left side of the screen; the right side of the screen displays MPRs and a VR Note: The system only supports 2:1 display layout in Fuse mode with CT/MR on the left side and the Ultrasound image on the right side when no images are fused/aligned yet. Rotate the Transparency rotary control to select the CT/MRI transparency percentage in the different layouts which hides or shows the CT/MRI dataset overlay. Transparency assists with accurate alignment and is helpful during Manual alignment. • At 0% the aligned reference data will not be visible at all • At 50% the reference data will be visible partially • At 100% the reference data will be fully visible Notes No. 42 SIEMENS Healthineers Fuse SIEMENS . Healthineers ... Flip, Timer, Reset/Save Alignment, Undo 0 3 0 P Abdomen 712 Workflow DAX Abdomen Patient 2D Fusion TIS. 0.55 Imaging Scar Fuse Review Rcdo y LOW Report WIR Flip UID FIP Timer Load volume Exit End Exam Reset Alignment Save Alignment Jedo Structures Window 490 Level 153 Manual Point Auto Pan Reset Pan Layout Transparency Presets Default F 17cm Workflow tools are available in Auto, Point, and Manual Alignment 43 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Select L/R Flip or U/D Flip to change the image orientation. The on-screen orientation cube identifies the orientation of the patient (i.e., Anterior, Posterior, Right, Left, Head, Feet) whenever the CT/MRI data is displayed. Select Timer to activate the contrast imaging timer from within Fusion imaging. Select Reset Alignment to reinitialize the alignment. To save the alignment, select Save Alignment. The system updates the Navigator with an entry for the saved alignment(s). This is helpful when using a combination of alignment tools – the user can select a previously saved alignment in the Navigator and then select Show to restore the position of the CT/MRI and Ultrasound when the selected alignment was saved. (The next slide will give an example of Items displayed in the Fusion Navigator.) Select Undo to cancel the most recent adjustment made to the alignment. All adjustments performed can be cancelled in reverse sequence. Notes No. 43 SIEMENS Healthineers Fuse SIEMENS . Healthineers ... Navigator SIEMENS Healthineers Live Fusion Navigator Hide Show Delete Transducer 1 DAX Show All Abdomen TIB:0.55 Marker 01 TIC:2.73 Marker 02 TIS:0.55 Segmentation 01 MI:1.06 28fps Alignment 01 95% 20 H Low 2dB/DR60 F 17cm Pointer 44 Unrestricted © Siemens Healthineers 2023 Unrestricted © Siemens Healthineers 2025 Speaker Notes: The Fusion Navigator will display all Markers, Segmentations, and alignments made. Each Marker and Segmentation will have a corresponding colored “carrot”. This color corresponds to the colored segmentation or marker on the imaging screen. As mentioned in the previous slide, whenever an alignment is saved, it will be displayed in the Fusion Navigator. To Hide, Show, or Delete the entries in the Navigator, the box next to the entry needs to be checked with the TB pointer. Notes No. 44 SIEMENS Healthineers Scan SIEMENS . Healthineers ... Biopsy mode DAX Abdomen 1415 DAX Abdomen Biopsy Needle Guide TIB:0.57 Patient 2D Biopsy guidelines TIC:2.90 TIS:0.57 MI:1.19 Ienaging 1 7fos Scan show the area of interest Ferien 2D H Low -10B/DR60 Report LUR Flip UND Flip End ENam Biopsy Crack Needle Reset Par Layout 1:1 Biopsy: 51 Biopsy angle 1-5 are available with the 5C1, 10L4, and DAX. Layout is available in 1:1, 2:1, or 1:3 45 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Biopsy and needle tracking controls are available only when Scan is activated. Select Biopsy to open the Biopsy Needle Guide Angle dialog box. Here you can select the biopsy angle. Once the angle is selected, select OK; then the on-screen biopsy guidelines will be available. • Biopsy angles 1–5 are available when utilizing the 5C1, 10L4, and DAX transducers with Fusion imaging • Biopsy angles A–B can be when utilizing the 4V1 with Fusion imaging Select Track Needle to activate needle tracking. Notes No. 45 SIEMENS Healthineers Scan SIEMENS . Healthineers .. Biopsy mode DAX Abdome Workflow Fusion Navigator Patient domen 20 Fusion Show AR Imaging Scan Review Report UR Flip UD Flip Timer Load volume Exit End Exam Off Landmark Structures Track Need Needle Tip Graphics Distance Measured Results Pan Reset Pan Delete Use Pan to follow the needle Pan Biopsy angle 1-5 are available in Fusion imaging. Layout is available in 1:1, 2:1, or 1:3. 46 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Pan can be used when the Biopsy mode is enabled. This is a useful feature for visualizing the entire needle path. It is especially helpful when performing superficial exams, such as MSK, when the user may want to visualize the path of the needle from the skin line to the point of interest. To utilize Pan: • Select Pan to activate • Move the trackball to pan the image • Select Set on the Trackball controls to set the image • Select Reset Pan to return to the default position Notes No. 46 SIEMENS Healthineers Scan SIEMENS . Healthineers ... Supported imaging features Transducer 1 5C1 • Auto TEQ ultrasound technology Abdomen Needle Unplugged TIB:1.56 TIC:4.53 • Harmonic imaging TIS:1.56 MI:1.20 12fps 98% • Color Doppler (Auto alignment is not available in 2D H Mid color Doppler) 0dB/ DR60 C Mid • Biopsy 7dB/ General PRF 1250 • Contrast-enhanced Ultrasound (Auto alignment is not available in CEUS) 18 cm 47 Unrestricted © Siemens Healthineers 2025 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Fusion imaging supports the following imaging features: Auto TEQ: Tissue Equalization can be enabled by selecting the Auto TEQ control from the 2D tab on the Touch Screen Harmonics: Harmonics can be enabled by selecting the 2D tab on the Touch Screen and then selecting the Harmonics control Color Doppler: Press the Color mode knob to add color to the ultrasound image in all layouts (1:1, 2:1, 3:1); a Color tab on the Touch Screen contains the color Doppler controls for use while in Fusion imaging; press the Color mode knob again to exit color Doppler Biopsy: Used in conjunction with the biopsy guide Fusion sensor bracket Contrast: Press the Contrast knob on the control panel to enable contrast imaging; contrast gain is adjusted by turning the Contrast knob CW or CCW; press the Contrast control once more to exit Note: Auto alignment is not available in color Doppler or Contrast modes. Notes No. 47 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Define Fusion imaging • Review Fusion imaging clinical solutions • Recognize Fusion imaging benefits ACUSON Sequoia • Explain Fusion imaging setup and display • Demonstrate Fusion imaging workflow • Describe guide needle tracking • Apply troubleshooting tips 48 Unrestricted © Siemens Healthineers 2025 Speaker Notes: No speaker notes. Notes No. 48 SIEMENS Healthineers eTRAX Needle Tracking SIEMENS. Healthineers ... • Real-time display of needle tracking and orientation • Aids interventional procedures with targeted biopsy or ablation • GPS needle tracking provides greater accuracy during procedures • On-screen graphic tools for off-axis needle tracking • Use with or without CT/MRI data 49 Unrestricted © Siemens Healthineers 2025 Speaker Notes: eTRAX TM Needle Tracking provides color-coded 3D real-time needle location and orientation using guided (i.e., with the needle guide bracket with sensor) or free-hand navigation during biopsy and ablation procedures. GPS needle tracking provides greater needle placement accuracy, reducing the risk associated with interventional procedures. eTRAX Needle Tracking can be used with or without the CT/MRI data. eTRAX Needle Tracking can be an excellent tool for difficult cases, long approaches, or even a target that is near concerning structures (e.g., vessels). Notes No. 49 SIEMENS Healthineers eTRAX Needle Tracking SIEMENS . Healthineers ... DAX Workflow Patient 20 Fusion Imaging Scan Review Report L/R Flip WD Flip Timer Load volume Exit End Exam Biopsy Landmark Structures Off Track Needle Distance Measured Results Pan Reset Pan Delete Arm Activate Needle Tracking and Needle Tip Graphics from the The needle sensor Tracking Quality Indicator should Scan Tab. display green across width of indicator. 50 Unrestricted © Siemens Healthineers 2023 Unrestricted © Siemens Healthineers 2025 Speaker Notes: Select Scan and then select Track Needle to activate eTRAX Needle Tracking. To enable or disable the tracking of the needle tip (green circle), select Needle Tip Graphics. The tracking quality indicator for the needle sensor displays a green bar across the width of the indicator when tracking quality is high. If the indicator displays a yellow bar, move the transmitter cube closer to the patient. Notes No. 50 SIEMENS Healthineers eTRAX Needle Tracking SIEMENS . Healthineers ... On-screen Graphics: • Red = needle is above and/or to the right of the image plane • Blue = needle is below and/or to the left of the image plane • Green circle indicates needle tip is outside of the image plane • When the green circle is no longer visible, the needle tip is within imaging plane 51 Unrestricted © Siemens Healthineers 2023 Unrestricted © Siemens Healthineers 2025 Speaker Notes A red graphic indicates the part of the needle on the right side or above the ultrasound image plane, depending on the orientation of the transducer. A blue graphic indicates the part of the needle on the left side or below the ultrasound image plane, depending on the orientation of the transducer. When the needle is in the imaging plane, there are no graphics between the yellow dotted lines, and the needle is now visualized. The green circle graphic indicates that the needle tip position is outside the image plane. When the green circle is no longer visible, the needle tip is in the imaging plane (not necessarily in the target). The margin of the displayed green circle error is +/- 5 mm, which is the same error margin as the tracked tip of the needle. Note: It may be helpful to think of the green circle as a laser pointer, representing the needle tip when outside the imaging plane. Notes No. 51 SIEMENS Healthineers eTRAX Needle Tracking SIEMENS. Healthineers ... CIVCO Medical Solutions eTRAX • Sensor-based needle tracking • The sensor is a wire within the needle cannula • The tip of needle is tracked in all planes • Needle cannula sizes include: • 12GA cannula • 14GA cannula • 16GA cannula • 18GA cannula 52 Unrestricted © Siemens Healthineers 2025 Speaker Notes: Siemens Healthineers uses sensor-based needle tracking. Only the tip of the needle is tracked. The eTRAX Needle Tip Tracking System for use with the ACUSON Sequoia system is available from CIVCO Medical Solutions and includes: • 12GA cannula (accepts 14 GA or smaller instruments) • 14GA cannula (accepts 16 GA or smaller instruments) • 16GA cannula (accepts 18GA or smaller instruments) • 18GA cannula (accepts 20GA or smaller instruments) Needle lengths are available at 6 cm, 8 cm, 10 cm, 13 cm, 15 cm, and 17.7 cm. The needle sensor in the distal tip provides needle orientation information to the tracking system. The needle sensor is inserted through an opening in the handle of the cannula (aka stylet or introducer). It is the reusable component of the two-part coaxial system, while the needle cannula is the disposable component. A special sterile cover is used to cover the reusable handle of the needle sensor prior to insertion into the sterile, disposable cannula to ensure sterility once the needle handles are locked into position. Note: The reusable devices may be cleaned or disinfected according to the manufacturer’s instructions. Remove visible contaminants and clean/disinfect with common germicidal or antiseptic. Notes No. 52 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Define Fusion imaging • Review Fusion imaging clinical solutions • Recognize Fusion imaging benefits ACUSON Sequoia • Explain Fusion imaging setup and display • Demonstrate Fusion imaging workflow • Describe guide needle tracking • Apply troubleshooting tips 53 Unrestricted © Siemens Healthineers 2025 Speaker Notes: No speaker notes. Notes No. 53 SIEMENS Healthineers Fusion imaging SIEMENS. Healthineers ... Troubleshooting tips After powering on the ultrasound system, ensure that the power light on the tracker box is illuminated in green. If it is not, follow the instructions below: • Check that the tracker box is turned on • Wait a few minutes for the tracker box to complete initialization • Disconnect/reconnect the power cord connection to the tracker box and to the power source (inside system side panel) If an error message appears indicating the Fusion imaging system cannot initialize, follow the instructions below: • Ensure that all components are securely connected • Disconnect/reconnect the USB to the back of the tracker box and to the ultrasound system and/or the S-video cable. This should only be performed when the system is powered down. 54 Unrestricted © Siemens Healthineers 2025 Speaker Notes: After powering on the ultrasound system, ensure that the power light on the tracker box is illuminated in green. If it is not: • Check that the tracker box is turned on • Wait a few minutes for the tracker box to complete its initialization • Disconnect/reconnect power cord connection to the tracker box and to the power source (inside system side panel) If an error message appears indicating the Fusion imaging system cannot initialize: • Ensure that all components are securely connected • Disconnect/reconnect the USB to the back of the tracker box and to the ultrasound system and/or the S-video cable (this should only be performed when the system is powered down) Notes No. 54 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Define Fusion imaging • Review Fusion imaging clinical solutions • Recognize Fusion imaging benefits ACUSON Sequoia • Explain Fusion imaging setup and display • Demonstrate Fusion imaging workflow • Describe guide needle tracking • Apply troubleshooting tips 55 Unrestricted © Siemens Healthineers 2025 Speaker Notes: No speaker notes. Notes No. 55 SIEMENS Healthineers Trademarks and disclaimers SIEMENS. Healthineers ... ACUSON Sequoia and TEQ are trademarks of Siemens Medical Solutions USA, Inc. eTRAX and Verza are trademarks of CIVCO. CIVCO is a registered trademark of CIVCO CUSON Medical Solutions. Sequoia O 56 Unrestricted © Siemens Healthineers 2025 Speaker Notes: No speaker notes. Notes No. 56 SIEMENS Healthineers Thank you for your enthusiasm! SIEMENS. Healthineers ... Questions? 57 Unrestricted © Siemens Healthineers 2025 Speaker Notes: No speaker notes. Notes No. 57