ACUSON Sequoia 3.5 (VB30) Measurement Configuration

SIEMENS Healthineers .. ACUSON Sequoia Ultrasound System Measurement Configuration 3.5 (VB30) 1 Unrestricted © Siemens Healthineers 2024 Unrestricted Speaker Notes: No speaker notes. Notes No. 1 Objectives SIEMENS. Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the Touch Screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Describe Custom Calculations • Discuss the OB tables • Review the report 2 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The first step in configuring the measurement features of the ACUSON Sequoia ultrasound system is to identify how to access the system configuration. Notes No. 2 Measurement configuration access SIEMENS . Healthineers ... 5C1 20 902 15L4 Workflow Abdomen Patient 2D Imaging L/R Flip UID Flip Biopsy Off Timer Review Report End Exam Auto TEQ Live Dua Harmonics Compounding Vide FOV Frequency InFocus Line Density H Mid 55 dB 3 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To access the measurement configuration menu on the ACUSON Sequoia ultrasound system, select the System Configuration icon from the upper left corner of the Touch Screen. Notes No. 3 Measurement & Report configuration home page SIEMENS . Healthineers ... System Configuration >> Systerh Settings > Workflow Enhancement General Exam Package Exam Specific Per Label Configuration Measurement & Report > Imaging Settings 20 Mode Calculation Deplay Area · Measurement & Report Measurement Measurement 20 Callpers [ Draw Dotted Lines Between Calipers Measured Touch Screen Measurement Config Touch Screen Measurement Config Both Results Report Calculations Custom Measurement Label Doppler Mode (Fetal M-Mode)LV CO Custom Measurement Label Custom Calculations (Fecal M-Mode)LV EF Report Velocity (Fetal M-Mode)LV Mass Custom Calculations Show Negative Symbol (Fecal M-Mode)LV SV CB Tables (Fetal M-Mode)LV Vol d > Annotations Heart Rate Tool (Fetal M-Mode)LV Vols Report (FetalAo RootIMPA Diam > Features OB Tables Number of Heart Cycles (Fetal)AoV Annulus Areas Transducer (Fetal)AoV Area (Vmax) (Fetal)AoV Area (VTI) > Connectivity & Network (Fetal)AOV ATIET > Peripheral Devices (Fetal)AoV SV >System Management (Fetal)AoViPV Annulus $ (FetalAPADxTAD (FetalJAR PHT (Fecal)BPDa (Fetal)CCO (FecalDCI (Fesal) Cor Sinus Length/Diam (Fecal)CTR Area (Fetal)CTR Circum (Fetal) Ductus V S/D Vmax Restore Defaults 4 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Once in the System Configuration, the measurement configuration section is located under the Measurement & Report (M & R) heading. There are six sub-groups in the M & R section: • Measurement • Touch Screen Measurement Config • Custom Measurement Label • Custom Calculations • Report • OB Tables These sub-groups will be discussed in detail throughout this presentation beginning with the Measurement option. Notes No. 4 Objectives SIEMENS. Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the Touch Screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Describe Custom Calculations • Discuss the OB tables • Review the report 5 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The first subgroup to be discussed is the Measurement option. Image: HOOD05162003330011 Notes No. 5 Measurement subgroup SIEMENS . Healthineers ... General tab System wide settings for: General Exam Package Exam Specific Per Label Configuration Calculations in Measurement Display Area • Dotted line between calipers 2D Mode 2D Calipers • Heart rate tool Draw Dotted Lines Between Calipers Show in MIA Calculations Show negative symbol Doppler Mode Ao Arch d/BSA AO Asc diBSA • Velocity Ao Asc Peak Grad AO d/LAS • Measurement Display Area (MDA) Show Negative Symbol Ao d/LA s (M-mode) Ao Root d/BSA configuration Heart Rate Tool Ao Sinus diBSA AO STJ diBSA Number of Heart Cycles AoV Ann Area AoV Ann Area (Post) AoV Ann s/BSA AoV Anni s/BSA (Post) AOV ATIET AOV ATIET (Post) AOV CI AoV CI (Post) AOV CO AOV CO (Post) AOV Peak Grad AOV Peak Grad (Post) AOV SI AOV SI (Post) Restore Defaults 6 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Measurement option contains four tabs that allow the user to configure the overall measurement settings for the ACUSON Sequoia ultrasound system. Use the Pointer to select one of the four tabs and display the available options. The active tab is highlighted in orange. The first tab, General, contains the options for system wide measurements settings such as: • Dotted line between calipers removal • Heart rate tool (number of cycles) • Show negative symbol (onscreen and report) Note: If “Show Negative Symbol” is not selected, values measured below the baseline will result in erroneous RI calculations. Measurement Display Area (MDA) configuration is also contained within the General tab. The user has the option to customize which calculations are displayed within the MDA by checking the box next to the desired calculation. Items that are not checked will not be displayed within the MDA. Note: The heart rate tool refers to OB. Notes No. 6 Measurement subgroup SIEMENS . Healthineers ... Exam Package tab Individual exam package settings for: General • Cine measurement behavior Exam Package Exam Specific Por Label Configuration • 2D measurement tool type Exam Package Abdomen • Doppler default tool type ONE Measurement Behavior Result Format Show Precision Erase in CINE IVS cm 0.00 • Volume Flow Tool 20 Tools LVPW cm 0.00 LVID cm 0.00 Individual label precision Volume Tool • 3 Distances *Stenosis Area %Stenosis Tool Show cm2 7 0.00 and unit Ellipse + Trace A (8) cm2 0.00 Generic Area Ratio Tool cm2 0.00 Trace Accel Show cm/s2 0.0 Doppler Tools Angle Default Tool Area Ratio 0.00 Velocity AT Show m Average Distance Volume Flow Tool cm 0.0 / 0.00 Volume C10 Show mm 0.00 Distance D Flow V 0.00 Heart Cycle D ( H ) 0.00 Restore Defaults: Abdomen 7 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Exam Package tab allows the user to individually configure each exam package with different default measurement tools and cine measurement behavior. These selections are system-wide and any new measurement label created for a given package (i.e., Abdomen, MSK, Carotid, etc.) will inherit these default settings automatically when the label is created. Options to alter these default settings on an individual label basis is contained within the Per Label Configuration tab, which will be covered later in this presentation. To customize the default settings for an exam package, use the Pointer and Set key to select the specific package from the drop-down menu, then choose the desired default tool options for 2D, Doppler and Volume Flow. The user can further customize the measurement label by selecting a unit and level of precision that will display in the report and the onscreen MDA when the label is used. Some labels, such as Acceleration, also contain the option to show or hide the resultant within the MDA. Notes No. 7 Measurement subgroup SIEMENS . Healthineers ... Exam Specific tab OB exam options for: Per Label Configuration • Date display types (screen) General Exam Package Exam Specific OB Exam Prostate Exam • Standard deviation Display OB/GYN Dates on the Screen Auto OB Prostate Specific Gravity LMPIDOC European - BPD outer to outer 1.0 • Ratio display types (report) O Clinical Age O US - BPD outer to inner O 1.05 EDD EFW • Measurement tool types Display Averaged GA or & SD on Touch Screen Gestational Age V Carotid bam • Auto OB Display Averaged GA or + SD in Measured Results Carotid Ratio Gestational Age Dist ICA Prax CCA Display Out of Range O Max ICA O Max CCA Prostate specific gravity options 2.5 O Mid ICA O Mid CCA Dist ICA O Dist CCA • 1.0 Cardiac Exam 1.05 Al Measure: Heart Cycles Measured • Doppler AM Mode Carotid Ratio default selections Restore Defaults 8 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Exam Specific tab contains options for prostate, carotid and OB exams. For OB exams, the user has the option of what information they would like to be displayed on the screen during imaging. Use the Pointer and Set key to check or uncheck the available options. The options for display include: • LMP/DOC • Clinical Age • EDD • EFW Default tool types for both maternal and fetal measurements are found here as well as the Auto OB measurement type. Be sure to check that the Auto OB measurement type (BPD outer to outer or outer to inner) matches the region you are installing the system in. Report display options for ratio, out of range, and gestational age type are other OB options found under the Exam Specific tab. Prostate exam specific gravity options, 1.0 and 1.05, are the only prostate related options listed in this tab. The default carotid ratio option is also available within this tab. The user has the option to select a specific segment for the ICA and CCA to be used for calculation of the ratio. If a specific segment is not desired, the option to use the maximum measured velocity, regardless of segment, can be selected. In this example, the system has been configured to use the maximum ICA velocity and the distal CCA velocity to calculate the ratio. Note that this configuration can be altered on a “per exam basis” on the report page of an open exam should the user desire a different option than what is configured here. Once the exam is closed, the changes made on the report page for the ICA/CCA segments will return to what is configured here in the Exam Specific tab. Notes No. 8 Measurement subgroup SIEMENS . Healthineers ... Per Label Configuration Labels can be configured on an individual basis for General Exam Package Exam Specific Per Label Configuration Unit Carotid Label Name : Dist CCA • Default Tool and Method Find Similar Labels 20 Distance label • Precision Bub Doppler RI-S/D Bub IMT • Default tool type DISECCA Dist CCA IMT Dist ECA Output Show Unit Precision • Method (Last, Max, Mean, Dist ICA Stenose Average) Dist Innom A Dist Subdav A 0.00 Dist Vert A 0.00 cm 0.00 • Show/Hide in MDA ECA Innom A 0,00 Mid CCA Mid CCA IMT 0.00 Mid ECA 0.00 Mid ICA Mid ICA IMT 0.00 Use Find Similar Labels option to change Mid Innom A 0.00 Mid Subclav A 0.00 multiple labels to the same settings. Mid Vert A Prax CCA 0.00 PTOIx CCA IMT TAMEK 0,00 Prox ECA Prax ICA Prox ICA IMT Mettere: [MitCCA 9 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The final tab is the Per Label Configuration. Under the Per Label Configuration, each label output can be modified based on unit, precision, default tool type, and display (show/hide) within the MDA, should the user desire a change from the default selection set in the Exam Package tab. Each default tool type can be further customized for method used for calculations last, max, mean, or average. Should a user wish to alter multiple labels of the same – measurement type within a package, the option to Find Similar Label(s) can be used. Select the Find Similar Label option and a list of all similar labels (based on measurement type) will appear in the space provided. The user then needs to check off each label they wish to be converted to the newly chosen settings. Notes No. 9 Objectives SIEMENS. Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the Touch Screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Describe Custom Calculations • Discuss the OB tables • Review the report 10 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Next, we will describe how to configure the layout of the Touch Screen on the ACUSON Sequoia ultrasound system. Image: HOOD05162003330011 Notes No. 10 Touch Screen Measurement Config SIEMENS. Healthineers ... System Configuration Show/Hide Export System Settings > Workflow Enhancement Package Configuration Touch Screen Layout Editor measurement dialogue box > imaging Settings Measurement Package Package Name packages Measurement & Report Show All Atidomen Measurement Cardiac Touch Screen Measurement Config Abdomen Imaging Mode Custom Measurement Label Breast 20 Custom Calculations Carotid Report Early 08 OB Tables Fetal Echo General Abdominal Vascular Renal Vascular Virtual Touch Custom Annotations GYN Re-order Features Ped Hip Create custom Transducer LEA measurement Connectivity & Network LEV Miscellaneous measurement Peripheral Devices MSK Prax Aorta Scherm Kidney Pre-Void Bladder INC packages Liver packages System Management Neo Head OB Mird Aorta Gh Wall Thickness Cortical Thickness Post-Void Bladder Pediatric Abdomen Pelvis Dist Aceta CBD OiD Create Package Deste Packaok Delete custom Page 1 > Import/Export Import Export packages 11 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The next section in the M&R system configuration is the Touch Screen Measurement Config. There are two tabs. The first tab is the Package Configuration where the user can: • Show/Hide an exam package by checking/unchecking the corresponding box • Re-order the package layout by using the up/down arrows. Re-ordering will be reflected on the displayed Touch Screen menu when a user selects the alternate exam package command in the upper right corner of the Touch Screen • Create new customized measurement packages for any exam • Delete custom measurement packages • Import or Export an entire package or packages as a .Calc file via USB to another system Note: Custom equations will not be exported using this option. Exporting custom equations must be done using the Local Settings export or full Back-up and Restore under the System Management tab. This procedure is covered in the ACUSON Sequoia System Configuration PowerPoint. Notes No. 11 Touch Screen Measurement Config SIEMENS . Healthineers ... GI example Touch Screen mode Package Configuration Touch Screen Layout Editor Specialized Name measurement ng Mode Exam type Abdomen groups etit Label Libary Abdomen Label search General Renal Vascular Virtual Tour Custom field TAXA Modifier Abdomen Sub-groups AN AP Diam Prox Aorta Touch Screen Spleen Pre-Voet Bladder Indicates a folder layout grid Mal Aorta nitratic Duct G8 Wall Thickness Cartiol Thickness Phil-Voet Bladder of measurements AMA Tiam Dian (Pust Repuin) ABA Origin Dit Aorta CHO (i.e., volume) No DE AP Dum Master list of AD BIT AF Dam (Post Regalo As Df Trans Diam label options No BY Tran Diam (root Repaid) No Biacation Aft Anmit New Page Page 1 > Add new page Restore defaults Restore Defaults: Abdomen 12 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The second tab is the Touch Screen Layout Editor which allows the user to customize the layout of the Touch Screen measurement labels for each exam. The layout is done by mode. Once a specific exam is selected from the drop-down menu, a mirror image of the Touch Screen layout is displayed. Different specialized measurement groups and associated sub-groups are displayed at the top of the mirror image Touch Screen. A master list of labels associated with the selected exam type is displayed to the side of the Touch Screen layout grid. There is a label search field to aid the user in locating a desired label. Labels on the Touch Screen that contain a small gray triangle in the upper corner indicate a “folder” of continuous measurements, such as the length, width, and AP measurement for a kidney or spleen. The entire folder can be added to Touch Screen or just individual components such as [kidney] length. Folders are not customizable and new folders cannot be created. Labels with a modifier such as proximal or distal, have the modifier embedded into the label. If a new page needs to be added to the Touch Screen, use the New Page key. A total of 5 pages are possible with a maximum of 18 labels per page. Once a new page is added it cannot be deleted, however, if there are no labels located on that page it will not be displayed during live scanning/active measurement mode. White dots located below the Touch Screen visually indicate additional pages. To access additional pages for configuration, the user can select the directional arrow key on either side of the Page number indicator with the pointer. A Restore Defaults option is available in the bottom corner which will apply to the selected exam type only. Notes No. 12 Touch Screen Measurement Config SIEMENS . Healthineers ... Cardiac example Touch Screen mode Package Configuration reen layout Fa Cardiac Exam type Label Library Anatomy Folders Cardiac (two lines) Label search field M Mining Vetucity Custom Indicates a folder of measurements KVIO d PLAX PS. & PLAX MD if PLAK WWW & PRAX Touch Screen (i.e., volume) layout grid EVIO . PLAX A10 Mg ALO Liner An Root d A.AP DOIm & FAX (vor Dumm RVor Dum Master list of New Page Add new page label options Restore Defaulas Cardiac Restore defaults 13 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Note that the Touch Screen editor for the cardiac Touch Screen differs slightly from the general imaging Touch Screen layout. For cardiac, there are two lines of anatomy specific folders. Label groups belonging to a specific anatomical area, for example, Left Ventricle (LV), will be contained within these folders. All other configuration details (mode selection, search field, restore defaults, etc.) are the same as found on the GI Touch Screen Layout editor. Notes No. 13 Touch Screen Measurement Config SIEMENS. Healthineers ... Moving labels To move a label to different blank location on the Touch Screen: Package Configuration Touch Screen Layout Editor Use the Pointer and Set key to Ing Mode • Abdome highlight and “pick up” the label Measurement Label Library Move the label to the new blank Abdomen a General Abdominal Vascular Renal Vascular Virtual Touch Custom • location Abdomen • Use the Set key to “drop” the label in Prox Aorta Liver Spleen Kidney Pre-Void Bladder MC the new location Mid Aceta Pancreatic Duct Cortical Thickness Post. Void Bladder Click here to remove Gil Wall Thickness Dist Aorta CHO CHD New Page Page 1 > Restore Defaults: Abdomen 14 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Labels are easily moved around to different locations on the Touch Screen. To move a label to a new blank location, use the Pointer and Set key to “pick up” the desired label, then drag the label to the new blank location. Use the Set key to “drop” the label in place. Labels can also be easily swapped with one another on the Touch Screen. Use the Pointer and Select key to pick up the label to be moved. Drag the label to the new location and use the Set key to place the label. If a label already occupies the desired space, the existing label will automatically be pick up by the cursor when the label that is being transferred is “dropped”. The user can then move the “picked up” label to an alternate location. Restore Defaults will move all labels back to their original (factory) location. Notes No. 14 Touch Screen Measurement Config SIEMENS. Healthineers ... Removing a label Two options to remove a label: Package Configuration Touch Screen Layout Editor Pick up the label to be ing Mode • Measurement Label Library Abdomen removed Measurement Label Library Abdomen Drag label to master list Abdomen General Abdominal Vascular Renal Vascular Virtual Touch • and drop using the Set Uiver Livee AP key, or “Double click” on Lives Length Abdomen Miscellaneous tivee Segment 1 (SWE) Liver Segment 2 (5WE) Prox Aorta Liver Spleen Kidney Ivc the Touch Screen label Pre-Void Bladder Liver Segment 3 (5WE) Lives Segment 4a (SWE) Liver Segment 4b (SWE) Mid Aorta Pancreatic Duct G8 Wall Thickness Cortical Thickness Post-Void Bladder Lives Segment 5 (5WE) Liver Segment o (5WE) Oick here to remove Liver Segment 7 (Swt) Liver Segment 8 (SWE) MIIV Main HA Origin Maki RA Origin (Post Repair Mass 1 (5WE) Mass 7 Length New Page Page 1 > Restore Defaults: Abdomen 15 Unrestricted © Siemens Healthineers 2024 Speaker Notes: There are two options to remove a label from the Touch Screen and add it back into the master list of labels. The first is to pick up each label using the Pointer and Set key then drag the label to the master list and drop it. The second is a much faster removal process. The user positions the Pointer over the label to be removed and then “double clicks” the Set key. The label will automatically be removed from the Touch Screen and added back to the master list. Note: Labels must be removed one at a time. There is no option for removing multiple labels at one time. Notes No. 15 Touch Screen Measurement Config SIEMENS. Healthineers ... Adding a label Adding a label: Find the desired label in the master list Package Configuration Touch Screen Layout Edito • Name maging Mode • Pick up the label using the Pointer and Abdome 20 Set key Measurement Label Library Abdomen General Abdominal Vascular Renal Vascular Virtual Touch Custom • Move to desired location and place Modifier the label AAA [Post Repair] Abdomen Miscellaneous AMA (Post Repair) AAA AP Diam AAA AP Diam (Post Repair) Prox Aorta Liver Katney Pre-Void Bladder MA Sac Length AAA Sac Length (Post Repair) AMA. Trans Diam Mid Aorta Pancreatic Duct GB Wall Thickness Cortical Thickness Post-Void Bladder AAA Trans Diam (P Ah dist from SMA ARA Origin TIP Dikt Aorta AD BIf (Post Repair) AD Hi! AP Diam AD BH AP Diom (Post Repair) AD Bif Trans Diam To quickly add a label, double-click on the AD Bif Trans Diam (Post Repair) AD Bifurcation Art Anast label name in the master list – the label is New Page Page 1 > added to the next available label spot. Restore Defaults: Abdomen Remate node JD PACS down or network not available for sending 16 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To add a label to the Touch Screen, find the label in the master list using the search or scroll method. Highlight/pick up the label using the Pointer and Set key, then drag the label to the desired location on the Touch Screen. Drop the label using the Set key. If the location is already occupied by another label, the existing label will be automatically picked up by the pointer so it can be moved to another location. Another option to quickly add a label to the Touch Screen is to double-click on the label in the master list with the Set key. The label is automatically added to the Touch Screen. While this is a faster option, the label will populate the next “open” label spot, which may or may not be the desired location on the Touch Screen. If the user desires a different location for the label, it must be manually moved using the Pointer and Set key method. Notes No. 16 Touch Screen Measurement Config SIEMENS. Healthineers ... “Blank” measurement Touch Screens Not all exam packages have labels Package Configuration Touch Screen Layout Editor populated on the Touch Screen: Measurement Package Package Name • MSK Cardiac Abdomen Imaging Mode • Neo Head Breast 20 • TCI Carotid Early OB Fetal Echo General Abdominal Vascular Renal Vascular Virtual Touch Custom Custom labels must be created for these Ped Hip LEA exam packages. LEV Abdomen MSK LivET Spleen Pre Void Bilader MC Neo Head DE Mid Aorta Pancreatic Duct Corteal Thickness Prat- Void Bakder Pediatric Abdomen Pelvis Dat Aorta Create Package Import Expert 17 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Not all exam packages have labels populated on the Touch Screen. The exams with empty Touch Screens are: • MSK • Neo Head • TCI Custom labels must be created for these exams and added to the Touch Screen display. Use the Create Package option located within the Package Configuration tab. Note that the Create Package option can also be used to create new custom calculation packages for any other exam (cardiac or GI) that may be required by the user. Notes No. 17 Objectives SIEMENS. Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the Touch Screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Describe Custom Calculations • Discuss the OB tables • Review the report 18 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The next section will explain the homepage options for creating a custom label. Image: HOOD05162003330011 Notes No. 18 Custom measurement label subgroup SIEMENS. Healthineers ... Homepage layout System Configuration System Settings Workflow Enhancement Exam Exam Package Imaging Settings Abdomen xorn Package Measurement & Report Custom measurements Label Roc Abdomen Measurement Report Sectia 20 Too Abdomen Touch Screen Measurement Config Doppler Too Breast Custom Measurement Label ILiver Tx) Donot A New Carotid Custom Calculations [Rerial Tx] Donor A SR Templat (Stent Graft] Landing Site Copy SR Mappin Early OB Report [Stent Graft] Landing Site Trans Diam Fetal Echo OB Tables AAA GYN Annotations AAA (Post Repair) Ped Hip Features AAA dist From SMA LEA AAA Sac Length LEV Transducer AAA Sac Length (Post Repair) MSK › Connectivity & Network AAA Trans Diam Nowo H-kad › Peripheral Devices AAA Trans Diam (Post Repair) AD Bit System Management AD Bif (Post Repair) AD Bif Trans Diam AD Bif Trans Diam (Post Repair) Ao Stent Graft AD Stent Graft Trans Diam SR Mapping Aorta (Post Repair) Aceta Trans Diam Aceta Trans Diam (Post Repair) ARA ARA Origin 19 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The next M & R section is where the user can build custom labels and add them to the Touch Screen display. There is a drop-down list of all exam packages that can have custom labels added to them on the homepage for the Custom Measurement Label tab. Notes No. 19 Custom measurement label subgroup SIEMENS. Healthineers ... Homepage layout 1. Master list of all labels 2. Label management options Exam Package Abdomen Custom measurements Label Root: [Uver Tx] Dorior A 3 3. Display of label Report Section: Liver Transplant 2D Tools: Distance information/content Doppler Tools: Acceleration (Liver Tx] Donor A New Heart Cycle Vol Flow ¡Renal Tx] Donor A 5R Template: Vascular 4. SR Mapping options [Stent Graft] Landing Site Copy SR Mapping: Completed [Stent Graft] Landing Site Trans Diam AAA AAA (Post Repair) 2 AAA dist From SMA AAA Sac Length AAA Sac Length (Post Repair) AAA Trans Diam AAA Trans Diam (Post Repair) No Bif Ao BIT (Post Repair) 1 Ao Bit Trans Diam Ao Bif Trans Diarn (Post Repair) Ao Stent Graft No Stent Graft Trans Diam SR Mapping 4 Aorta Aorta (Post Repair) Aorta Trans Diam Aorta Trans Diam (Post Repair) ARA ARA Origin 20 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Once an exam package is selected: 1. Existing labels are displayed in the master list under the exam package name – any active or selected labels are highlighted in orange 2. Available functions – New, Edit, Copy, Delete 3. Active/selected label information is displayed, including default tool type(s) for 2D and Doppler and report section 4. The SR Mapping options The following slides discuss these sections in a greater detail. Notes No. 20 Custom measurement label subgroup SIEMENS. Healthineers ... Measurement master list display options 1. Measurement list options display • All measurements* Exam Package 1 • Custom measurements Cardiac Custom measurements • Exam type 2 Q Ao Abd New 2. Search box will match any part of the name Ao Arch d Ao Arch Distal Copy Ao Arch Trans Distal 3. Measurement master list Ao Arch Trans Prox Edit Ao Asc d Ao Asc Vmax 3 • Display is based on selected list (1) Ao Asc VTI • Alphabetical, scroll bar to view list Ao Coarct Diam Ao Coarct Vmax • Selected label is highlighted in orange Ao Desc Delete Ao Desc Vmax * Virtual Touch applications, Amniotic Fluid Index quadrants, Mean Sac Diameter, and 21 Volumes labels are currently unavailable for custom structured reporting. Unrestricted © Siemens Healthineers 2024 Speaker Notes: 1. The measurement master list can be displayed as • A full list of all measurements, including factory and custom labels • Custom labels only • Exam specific such as Abdomen, Breast, Carotid, Cardiac, etc. 2. A search box is available to easily filter out and find a specific label. Enter the label name into the search field and the master list will alter to display labels containing the search criteria. 3. The master list display is alphabetical and based on the exam package that is selected. Note: Factory labels for Virtual Touch applications, Amniotic Fluid Index quadrants, Mean Sac Diameter, and Length/Width/AP (volumes) are not available for custom structured reporting. Notes No. 21 Custom measurement label subgroup SIEMENS. Healthineers ... Label management options New Exam Package • Create a new custom measurement MSK Label Root: NERVE 1 label Custom measurements Report Section: Custom Measurements a Modifiers: Right/ Left 2D Tools: Distance Edit NERVE 1 SR Template: Vascular New SR Mapping: Not Completed Copy • Edit the selected custom label Edit Copy • Copy a selected factory label Delete Delete • Delete a custom label SR Mapping 22 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Available custom label functions are: • New – user can create a new custom measurement label • Edit – user is able edit a custom label • Copy – user can copy a selected factory label and its existing parameters • Delete – user can delete a custom label Notes No. 22 Custom measurement label subgroup SIEMENS. Healthineers ... Label information • Highlighting a label displays a summary Exam Package of the measurement information Abdomen Custom measurements Label Root: [Liver Tx] Donor A Report Section: Liver Transplant 2D Tools: Distance • Use as a quick reference for mode Doppler Tools: Acceleration ILver Tx) Donor X Heart Cycle types, attached modifiers, tool types, New Vol Flow (Renal Tx] Donor A SR Template: Vascular or report section location (Stent Graft] Landing Site Copy SR Mapping: Completed [Stent Graft] Landing Site Trans Diam AAA • Displays general SR mapping AAA (Post Repair) AAA dist From SMA information MA Sac Length AAA Sac Length (Post Repair) AAA Trans Diam AAA Trans Diam (Post Repair) Ao Bif Ao Bif (Post Repair) Ao Blf Trans Diam Ao Bif Trans Diam (Post Repair) Ao Stent Graft Ao Stent Graft Trans Diam SR Mappin Aorta Aorta (Post Repair) Restore Sa Aorta Trans Diam Mapping Aorta Trans Diam (Post Repair) ARA ARA Origin 23 Unrestricted © Siemens Healthineers 2024 Speaker Notes: A summary of a label’s parameters can be displayed by selecting/highlighting a label in the master list. The default selections for the mode tools, any modifiers attached to the label, and where the label results will be displayed in the report are noted in the summary. The SR mapping template and state of completion are also displayed. The SR mapping procedure will be covered later in this presentation. Notes No. 23 Custom measurement label subgroup SIEMENS. Healthineers ... Other available functions Other available functions include: Exam Package • SR Mapping “quick access” key MSK Custom measurements Label Root: NERVE 2 • Restore label defaults to any factory Report Section: Custom Measurements Modifiers; Right / Left 20 Tools: Distance label that has been modified NERVE 1 New SR Template: Vascular SR Mapping: Completed NERVE 2 Copy Edit Delete SR Mapping 24 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Other options on the Custom Measurement Label homepage are: • A “quick access” key to jump the user to the SR Mapping page • A Restore SR Mapping option that will restore the factory SR mapping to a copied label or delete any custom labels and their subsequent SR mapping Notes No. 24 Objectives SIEMENS. Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the Touch Screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Describe Custom Calculations • Discuss the OB tables • Review the report 25 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Before we explain how to create a custom label, it is important to understand what DICOM SR is and how it relates to custom labels. The next section will review the basics of SR Mapping and the associated terminology in order to better understand the steps involved in creating a new custom label on the ACUSON Sequoia ultrasound system. Image: HOOD05162003330011 Notes No. 25 What is DICOM and DICOM Structured Reporting (SR)? SIEMENS. Healthineers ... DICOM is an acronym for Digital Imaging and The development of DICOM Structured Reporting (SR) COmmunications in Medicine was an extension of the initial standard; it was created DICOM was the result of manufacturers and users of to help communicate non-imaging information, such radiological imaging equipment attempting to as measurements or post-processing results, in a standardize image exchange between different standardized way. systems. This included: • Storage of the images and all relevant information • A network transfer mechanism These specifications became the DICOM Standard. 26 Unrestricted © Siemens Healthineers 2024 Speaker Notes: What is DICOM and DICOM Structured Reporting? DICOM is an acronym for Digital Imaging and COmmunications in Medicine. DICOM was the result of a joint venture between manufacturers and users of radiological imaging equipment to help standardize the image exchange between different systems regardless of system manufacturer. This included: • Storage of the images and all relevant information • A network transfer mechanism These specifications became the DICOM Standard. The DICOM Standard is a specification that is regularly updated after new content and corrections have been approved by Working Group 6 (a.k.a. “The Lords of DICOM”) and voting DICOM members. DICOM Structured Reporting, or DICOM SR, is an extension of the initial standard. DICOM SR was created to help communicate non-imaging parameters, such as measurements or post- processing, in a standardized way. DICOM SR defines the file content and organization (templates) for ultrasound procedure reports. Notes No. 26 What is a DICOM Structured Report (SR)? SIEMENS. Healthineers ... A DICOM SR is not: • A report that can be printed “as is” on the ultrasound system or offline printer • The customized reporting package • An “off the shelf” (or predefined) product A DICOM SR is • A document consisting of structured or mapped data that defines the file content and organization for ultrasound procedure reports This data is read by a PACS or offline workstation but requires additional software to translate the data into a format that can be printed as a tangible report. Ultimately, a DICOM SR is a highly organized transfer mechanism between the ultrasound system and PACS or workstation. 27 Unrestricted © Siemens Healthineers 2024 Speaker Notes: There is often confusion between what a DICOM SR actually represents, perhaps due to the name containing “report”. When we hear “report”, we automatically think of something that we can touch or see; thus, it is important to understand what DICOM SR is not before we discuss what it is. DICOM SR is not a report that can be printed “as is”, either on the ultrasound system or an offline printer. It is also not a customized reporting package or an “off the shelf” or “predefined” product. A DICOM SR is a document that consists of structured or mapped data. This data defines the file content and organization for ultrasound procedure reports. This content can be read by a PACS or workstation and then translated into many different things – a report being one of the formats. To produce this report, additional software is required to translate the mapped content into a format that can be printed. Ultimately, a DICOM SR is a highly organized transfer mechanism between the ultrasound system and PACS or workstation. Notes No. 27 DICOM SR and the ACUSON Sequoia Ultrasound System SIEMENS. Healthineers ... Why is DICOM SR important to the ACUSON Sequoia ultrasound system? In system configuration, the ACUSON Sequoia ultrasound system will allow the user to define custom measurements and associate a custom SR mapping to it. This custom data can be transferred as a SR if it matches the mapping expected by the PACS/Offline reporting package. Expected “mapping” behavior is only achieved if during the creation/mapping of a new measurement label the user follows the DICOM SR template structure. If the template structure is not followed, the measurement data will not be displayed in an SR, as the PACS or offline workstation will not be able to “read” the data. 28 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Why is DICOM SR so important to the ACUSON Sequoia ultrasound system? What is different from past systems? While we have incorporated DICOM SR mapping on previous systems, we have not offered the ability to do custom SR mapping. The ACUSON Sequoia ultrasound system offers this custom feature in its system configuration. Custom SR data can be transferred to an offline workstation or PACS when a custom label is created, provided that the label is mapped with the expected behavior using the DICOM standard rules template. Should the template structure not be followed, the offline workstation or PACS will not be able to “read” the data, and the label will not be displayed in the structured report. How do we make data readable to the PACS or offline workstation when creating a custom SR map? Notes No. 28 DICOM SR template data components SIEMENS. Healthineers ... The DICOM SR template has a specific set of rules for “coding” data for a readable transfer. The ultrasound data is constructed in sections (or “containers”) based on anatomy, which are further separated into “concept names”. Each concept name is associated with a coded “result” which defines the specifics of that result – measurements and other data – within that concept name. There are four templates supported by the DICOM standard for ultrasound. They are: • OB/Gyn • Vascular • Adult Echocardiography • Pediatric and Fetal Echocardiography 29 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To make data readable to a PACS or offline workstation, we must use a DICOM SR template and follow a very specific a set of coding rules. These coding rules translate the ultrasound data to a PACS or offline workstation “language” by assigning a code value to each piece of ultrasound data to be transferred. The ultrasound data is constructed in sections (or “containers”) based on anatomy (e.g., blood vessels of the head) or related information (e.g., fetal biophysical profile). Each section contains “concept names” (e.g., length, peak systolic velocity, etc.) and each concept name is either a numerical value, a coded value, or a text value. The format of these values is defined in the DICOM Standard. There are four templates supported by the DICOM standard for ultrasound procedure reports. They are: • OB/Gyn • Vascular • Adult Echocardiography • Pediatric and Fetal Echocardiography Let’s now take a visual look at the template pathway mapping structure so you can better understand the data that will need to be entered in to create a custom label with a custom SR mapping scheme. Notes No. 29 DICOM SR template data components SIEMENS. Healthineers ... Template ID 5100 Vascular Structured Reporting “coding” rules Ultrasound Procedure Report • TID 5103: Blood Vessel of Head, Left ........ ............................ • TID 5103: Blood Vessel of Head, Right Carotid Siphon Box Carotid Siphon Box • TID 5103: Blood Vessel of Head, Unilateral TID 5103: Artery of Neck, Left ........ ... " Peak Systolic • • Anterior Cerebral Artery Peak Systolic TID 5103: Artery of Neck, Right Velocity .............. • Carotid Siphon Velocity • • Etc. Central Retinal Artery Result • Result • Central Retinal Vein • Internal Carotid Artery • Middle Cerebral Artery Coded Entry “Result” • Ophthalmic Artery Result Result • Posterior Cerebral Artery • Etc. ................................................ ........ Section or Container Concept Names Context ID TID 5103 Example results for Example: Blood Vessel of Head, Left Carotid Siphon such as: (11726-7, LN, “Peak Systolic Velocity”) Peak Systolic Velocity M JL • Code • End Diastolic Velocity Code meaning • Diameter value Modifier Coding scheme • Etc. designator 30 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Programming a custom SR map for a new or copied label is easily achieved if the “rules” are followed – not following these rules will result in the PACS not being able to read the entry, and the label will not be displayed in the structured report. This diagram represents the sequence that needs to be followed when entering a new SR map. When thinking about the steps to map a label in a structured report, it might be easier to think about the components of the templates as “containers within containers”. Once you select a template to work with, you need to start defining the different containers within that template during the mapping process. Remember that there are three templates to choose from – Vascular, OB/Gyn, and Pediatric/Fetal Echocardiography. In this example, the Vascular ultrasound procedure report template was chosen, which has a numeric template ID (or TID) of 5100. Within the vascular template several anatomical options exist, listed under the template heading on the side. Let’s pick the “Blood Vessel of Head, Left” to use for this example and represent this section of the template with a large orange box “container”. Inside that orange box are several smaller boxes that represent each of the many blood vessels found in the head – a few examples are listed on the front of the orange box. If we pick one of these smaller “vessel boxes” – for example, the carotid siphon – there are additional containers within the carotid siphon “box” that define the various results that can be obtained for that vessel. These results (represented on the diagram with the small purple boxes) can be anything from a velocity or length to even an imaging parameter and are specific to the carotid siphon; they need to be “coded” for the PACS to be able to read that result. The result, in this case the “peak systolic velocity”, is “coded” into three parts: • A “code value”, which specifies the term from the available list of terms • A “coding scheme designator” that specifies the dictionary that defines the term, such as SRT, DCM, or LN • A “code meaning” that makes it a human readable description of that term It is these three coding parameters that must be entered into the ultrasound system to program the pathway for the SR map. Now that we have an in-depth understanding of the SR mapping process, we are now ready to continue with the configuration information for creating custom labels. Note: The DICOM header information (institution info, patient info, exam info, equipment info, etc.) is separate from the DICOM SR, but part of the overall Comprehensive SR [for ultrasound]. Notes No. 30 Objectives SIEMENS. Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the Touch Screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Describe Custom Calculations • Discuss the OB tables • Review the report 31 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The next section will explain the steps required to create a custom label for both GI and Cardiac imaging. Image: HOOD05162003330011 Notes No. 31 Defining custom measurement labels SIEMENS . Healthineers ... Creating a custom label To create a custom label, begin by defining the Label Root . 1 Modifiers Measurement Type label basics: NERVE 1 Right / Left Fetal 3 4 1. Label Root (name) Exam Package Segments MSK 2 El None [] Prox [] Mid Dist ] Origin 2. Choose exam package Tools SR Template SR Mapping 5 3. Select modifiers (if applicable) Imaging Mode 20 Mode' 2D Mode Tools Label 4. Measurement Type O Doppler Mode Angle O M Mode Area 5. Select segments (if applicable) Report Section Circumference Custom Measurements Distance [] Vol MOD Area Ratio Distance Ratio Stenosis Volume IMT Save All & Close Cancel A 32 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To create a custom label all the components or parameters of the label must first be defined. The custom label creation screen contains: 1. Define a label name known as the “label root” • Name must be unique • Can have a maximum of 15 characters 2. Choose an exam package • Use the drop-down menu to select the exam package the label will be created for • The new label will inherit the default package characteristics when it is created – these characteristics can be altered in Per Label Configuration (if desired) 3. Select modifiers (if applicable) • Default is unchecked/not selected 4. Measurement Type • This option is only available in instances that apply to fetal measurements 5. Select segments if applicable • Used for vessels, MSK, etc., default selection is “none” • Modifier will be embedded into the label on the Touch Screen • Must manually de-select “none” if the user does not want an undefined segment label Notes No. 32 Defining custom measurement labels SIEMENS . Healthineers ... Creating a custom label Once the name and package basics have been defined, there are three tabs to complete the label parameters: Label Root " Modifie Measurement Type NERVE 1 Right / Left IFetal • Tools Exam Package Segments MSK None Prox [] Mid Dist Origin • SR Template Tools SR Template SR Mapping • SR Mapping Imaging Mode 20 M 2D Mode Tools Labe O Doppler Mode Angle O M Mode Area Report Section [] Circumference Custom Measurements [] Distance Vol MOD [] Area Ratio Distance Ratio Stenosis Volume O IMT Save All & Close Cancel All 33 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Once the label name and package basics have been defined, there are three tabs available to complete the programming of the label parameters. These tabs are: • Tools • SR Template • SR Mapping We will now discuss each tab and their contents. Notes No. 33 Defining custom measurement labels SIEMENS . Healthineers ... Creating a custom label – Tools tab The Tools tab defines: Label Root" Modifiers Measurement Type 1. Imaging Mode NERVE 1 Right / Left Il Tetal 2D Exam Package Segments • MSK None Prox Mid [] Dist Origin • Doppler Tools SR Template SR Mapping • M-Mode Imaging Mode 20 Mode 2D Mode 1 Tools Labe 2. Report Section O Doppler Mode [] Angle O.M Mode 3 []Area 3. Measurement tools associated with the chosen Report Section 2 Circumference imaging mode, i.e., Distance, Area, etc. Custom Measurements Distance NERVE 1 4 Vol MOD Label display name options [] Area Ratio 4. [] Distance Ratio Stenosis Volume Use Save All & Close to complete the tool selections. IMT - Reaching field Save All & Close Cancel All 34 Unrestricted © Siemens Healthineers 2024 Speaker Notes: When selected, the Tools tab will be highlighted in orange. The Tools tab defines the 1. Imaging Mode 2. Report section 3. Measurement tools 4. Label display name All imaging modes are available for selection – 2D, Doppler, and M-mode. Select the option using the Pointer and Set key. The Report Section can be chosen from the options listed in the drop-down menu. By default, the measurement will automatically be placed in the Custom Measurements section of the report. If another report section better suits the new label, then it can be selected using the Pointer and Set key. All tool options associated with the chosen imaging mode will be displayed. Select the appropriate tool(s) from the list provided using the Pointer and Set key. Once a tool has been selected, the label options field will display the label root name beside it. The user has the option to change the display of that label in the MDA and on the Report if they wish it to be different than the label root. (Note: Further explanation of this field will be covered later in this presentation during the general imaging (GI) example for a custom label creation.) Once all options are selected for the Tools tab, the next tab becomes available for selection. Notes No. 34 Defining custom measurement labels SIEMENS. Healthineers ... Creating a custom label – SR Template tab SR Template tab defines the: Label Root " Modifier Measurement Type 1. SR Template CBD3 Right / ten Fetal 2. SR Template Section Exam Package Segments General None Prox. E Mid & Dist Il Origin 3. Anatomy or Vessel Tools SR Template SR Mapping 4. Coding Scheme Designator SR Template SR Template Section * 2 OB/GYN Artery of Abdomen Code Value Fetal Echo 5. )Vascular 1 Anatomy or Vessel * Cardiac 3 Coding Scheme Designator * Use Save All & Close to complete the SR Template 4 selections. Code value ' 5 Save All & Close Cancel All 35 Unrestricted © Siemens Healthineers 2024 Speaker Notes: 1. The SR Template tab begins the process of defining the SR Mapping for the newly created custom label. The first step is to select the SR Template the label will be coding within. For all custom labels created for exams outside of OB/GYN or Fetal Echo, the SR Template will be automatically selected – all adult cardiac custom labels will have the Cardiac SR Template selected and everything else will have the Vascular SR Templated automatically selected. This is due to the fact there are only four SR Templates that exist – OB/GYN, Fetal Echo, Vascular, and Cardiac – everything must be coded within these four templates. For measurement labels that have been created for the OB/GYN or Fetal Echo exams, you will have the option to select either OB/GYN or Fetal Echo. 2. The SR Template Section contains a drop-down menu of all the anatomy which is associated with the chosen SR Template – the user needs to populate is what anatomy section the custom measurement will be related to, such as “artery of the abdomen”. If nothing on the list fits the custom label contents, there is a User Defined Results section (shown here) than can be used. 3. Once the SR template section has been selected, the label is further broken down into specific anatomy or vessel. The drop-down menu will contain specific anatomical areas, such as “splenic artery”, that can be chosen using the Pointer and Set key. Note that if the User Defined Results has been chosen in the previous field, the drop-down menu will be blank. When the User Defined Results option is chosen, the system assumes that there is no matching anatomy or vessels to what you are trying to code. Therefore, the list is blank, and the user may enter the specific anatomy, such as “wrist” to the field. 4. Once the anatomy has been defined, the coding can begin. The coding must follow the DICOM rules discussed earlier in order for the SR Mapping to be “read” on the other end. Any deviation from the coding or mis-matching with the PACS, and the coding will not be read. The first field contains options for the Coding Scheme Designator. If you are coding a label that is not “user-defined” in the SR Template section, you will have a choice of three Coding Scheme Designators (“authors of code”) – SRT, LN, and DCM – which are all DICOM standard designators, and contained in the drop-down list. If you have selected User Defined Results in the SR Template Section, you will have to created your own Coding Scheme Designator. You must work with the PACS administrator to create this code, as it will need to be imputed on the PACS end in order to be read. When defining your own coding scheme designator, select the New option, and a dialogue box will appear on the screen. It must begin with “99”, which will be auto-populated in the dialogue box and be no more than 16 characters. Once the new coding scheme designator is created, it will appear in the drop-down list of options so that it can be used in future coding. Note: there is one additional code available in the drop-down menu – 99SIEMENS. The 99SIEMENS is what is known as a private tag and only used for internal (Siemens Healthineers) custom definitions. Do not use this code for any custom labels – you must define your own. 5. The last field, the Code Value, will automatically be populated if you have used a pre-defined template section and anatomy or vessel choice. If you are using a User Defined Results template, the code will need to be entered manually according to your custom coding scheme. Please remember, you must confer with the PACS administration to create this code value. Notes No. 35 Defining custom measurement labels SIEMENS . Healthineers ... Creating a custom label – SR Template options SR Template Section Anatomy or Vessel SR Template Section " Label Boot Modifiers Measurement Type Artery of Abdomen IN light Len Ill Fetal Artery of Abdomen Anatomy or Vessel Exam Packages Segments Artery of Lower Extremity Aorta General Artery of neck Aorta Artery of Upper Extremity Aortic Bifurcation Tools sa Template SIK Mapping Bladder Celiac Axis SR Template SR Template Section Blood Vessel of Head Common Hepatic Artery . OBUSYIN Artery of Abdomen Gallbladder Common Iliac Artery Hip (Single Concept Code) Gastroduodenal Artery Anatamy ar Vessel * . Candiac Hip (Double Concept Code) Inferior Mesenteric Artery Kidney (Single Concept Code) Infra-renal Aorta Coding Scheme Designator* Kidney (Double Concept Code) Left Branch of Hepatic Artery Liver Lumbar Artery de value . Proper Hepatic Artery Coding Scheme Designator Right Branch of Hepatic Artery Coding Scheme Designator * Code value linked SRT DCM to Anatomy or SRT Vessel entry Save As & Dire Cancel All LN 99SIEMENS New 36 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Here are examples for some of the drop-down menus for the SR Template tab. Note: Some of these menus may be different depending on which exam package type the user is working in. Notes No. 36 Defining custom measurement labels SIEMENS . Healthineers ... Creating a custom label – SR Mapping tab SR Mapping defines* Label Hoot Modifiers Measurement Type 1. Tools & Output NERVE 2 Right / Left Fetal Exam Package Segment 2. Text String for SR MSK M Piox M Mid Dist I Origin 3. Concept Code Meaning Tools SR Template SR Mapping 4. Coding Scheme Designator Tools & Outputs Text String for SR 2 D 5. Code Value 1 Concept Code Meaning Distance 3 6. Measurement Orientation Coding Scheme Designator . 7. Post prandial DCM 4 Code value . 121206 5 Use Save All & Close to complete the SR Mapping Measurement Orientation selections. 6 7 ]Post-prandial * Required Field Previous Output Next Output *Options are for GI label coding – additional options for cardiac include Image View, Cardiac Save All & Close Cancel A Cycle Point, Flow Direction, Finding Site, and Measurement Method 37 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The last tab, SR Mapping, defines the tool(s) that were selected in the first Tools tab. Each tool is listed under the Tools & Outputs area [1]; note that each tool must be manually confirmed, as each individual output (Concept Code Meaning [3]) of a measurement tool has its own Code Value [5] according to the Code Scheme Designator or “author” [4]. The Text String for SR [2] is an optional field that can be used to add some “human” readable text or description to the input that can be read on the coded PACS printout. Additional field such as Measurement Orientation [6] and Post prandial [7] are also optional fields. Note that the additional or optional field will differ between general imaging and cardiac specific labels – these listed here are specific to GI labels and may or may not be displayed when creating a custom cardiac label. Once all the fields are populated, select the Save All & Close option to complete the label. The next slide will show examples of each drop-down menu in the SR Mapping tab area. Notes No. 37 Defining custom measurement labels SIEMENS . Healthineers ... Creating a custom label – SR Mapping options Each tool Tools Optional field for a abel loot Modifier Tools & Outputs output NERVE 2 Right /t Fetal text descriptor Distance Ratio parameter must Distance Ratio Exarn Package Segmen D1 MSK None I Origin Related to Tool be defined D2 Vol Tools SR Template R Mapping Concept Code Meaning Vol Tools & Outputs Text String for SR Distance Distance DZ. Flow Velocity D3 Concept Code Meaning " Blood velocity, minimum Distance Blood velocity, peak Diameter Coding Scheme Designator * Volume DCM Circumference Area Code value " Distance 1 of Ellipse 121206 Distance 2 of Ellipse Angle Optional fields Measurement Orientation Hip alpha angle Measurement Orientation L Post-prandial Concept code meaning Previous Output Next Output choice auto populates Anterior-Posterior the code value Longitudinal Save All & Close Cancel All Transverse 38 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Here are examples for each of the drop-down menus for the SR Mapping tab. Notes No. 38 Objectives SIEMENS. Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the Touch Screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Describe Custom Calculations • Discuss the OB tables • Review the report 39 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. Image: HOOD05162003330011 Notes No. 39 Creating a new label – GI example SIEMENS. Healthineers ... Exam Package MSK • Select the Exam Package Custom measurements to add the label to New • Select the New option New Mapping 40 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To create a new custom label, first select the Exam Package the label will be attached to from the drop-down menu on the custom measurement label homepage. Select the New key to advance the homepage to the next configuration screen to begin defining the label parameters. Notes No. 40 Creating a new label – GI example SIEMENS . Healthineers ... Tools tab • Enter the unique label name → NERVE 1 Label Root " Modifiers Measurement Type • Select the Exam Package from drop-down menu → MSK NERVE 1 Right / Left Il Fetal Select Modifiers →  Right/Left Exam Package Segments • MSK None Prox El Mid Dist Origin Select Segments →  None,  Prox, etc. • Tools SR Template Sit Mapping • Select Imaging Mode → 2D Mode Imaging Mode 20 Mode 2D Mode Tools Label • Select Report Section → MSK O Doppler Mode Angle O M Mode Area • Select Tool → Distance Report Section Circumference MSK Distance NERVE 1 • Select Save All & Close if SR Mapping is not required, Vol MOD Area Ratio otherwise select SR Template tab Distance Ratio Stenosis Volume Save All & Close Cancel All 41 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The first step in defining the label parameters is to enter the label name in the Label Root field. The name must be unique and no more than 15 characters in length – in this example we are using a label root of NERVE 1. Note that once the label is completed/saved it will automatically appear on the Touch Screen – no need to manually add it to the Touch Screen display. Select the desired Exam Package from the drop-down menu. In this example we have chosen the MSK exam package. Note that the label will inherit the default setting of the chosen package for their measurement unit and precision. Should you desire a different unit or precision, you may alter those options for the label in the Per Label Configuration tab under Measurement option in the main M & R menu. Select the Modifiers if the label contains laterality. The NERVE 1 example requires laterality thus the Right/Left option has been checked. Segments will be embedded into the measurement label. The default option is “none”, however, any or all the options can be checked off for a custom label. The MSK label we are creating has all the options checked and will display on the Touch Screen as NERVE 1, Prox NERVE 1, Mid NERVE 1, etc. Selecting the Imaging Mode will determine what Tool options are displayed on the right side of the screen, as the tools are linked by mode. Our custom label, NERVE 1, is a distance measurement available in 2D Mode. Note that the tool displays the label name next to once it is selected. The user now has the option to change the display of the custom label within the MDA and the Report. For example, the NERVE 1 could be altered to “NERVE 1 Distance” – this change will be reflected in the what the user sees in the onscreen MDA and what is printed on the Report page. If SR Mapping is not required, the user can select the Save All & Close option to complete the label creation. In this example we are going to complete the SR Mapping process by selecting the SR Template tab. Note: The SR template tab will not be selectable until all required fields within the Tools tab have been completed. Notes No. 41 Creating a new label – GI example SIEMENS . Healthineers ... SR Template tab Pre-selected SR Template → Vascular* • aber Root " Modifier Measurement Type • Select the SR Template Section from drop-down menu → NERVE2 Right/ Left Fetal User Defined Results Exalin Package Segments General None; I Prox. I Mia Dist : Origin • Select/input Anatomy or Vessel → Wrist Tools SR Template SR Mapping • Select or create new Coding Scheme Designator → SR Template SR Template Section + 99 MAYO OB/GYN User-defined Results Fetal Echo Vascular Anatomy or Vessel " Enter the Code Value → 1234567890 ** • Cardiac WRIST2 Selecting Save All & Close will stop the Coding Scheme Designator • 99 MAYO SR Mapping process *** Code value 1234567890 Save All & Close Cancel All * Will be automatically selected unless the label is created in OB/GYN or Fetal Echo ** The Code Value is linked to the Coding Scheme Designator 42 *** SR Mapping will be incomplete Unrestricted © Siemens Healthineers 2024 Speaker Notes: Once in the SR Template tab, the Vascular SR Template is automatically selected for the custom label we are creating. Recall that unless you are creating a label for the OB/GYN or Fetal Echo exam preset, the default will be Vascular for general imaging. The SR Template Section for the MSK NERVE 1 label will be User Defined Results, as there is no category within the Vascular SR Template that fits the description of the label we are creating. If you select the User Defined Results, every other required field on this page will be entered manually. For this example, enter WRIST into the Anatomy or Vessel – note that once the new terminology has been entered the first time it will remain listed in the drop-down menu for selection during future custom label creations. The next required field is the Coding Scheme Designator, otherwise known as the author of the coding. In our example, we are going to create a new coding scheme designator, 99MAYO, as all coding scheme designators must begin with “99”. The newly created coding scheme designator will also remain in the list for future label creations. The last required field, Code Value, will be automatically populated based on your previous entries if you use one of the standard DICOM authors (coding scheme designator), however, in this example, we have created our own, 99MAYO, so the code value must be manually entered. The code value for this example is 1234567890. Note that selecting Save All & Close at this point will not complete the SR Mapping – to complete the SR coding, you must complete the fields in the last tab. Select the SR Mapping tab on the right side to move to the final coding stage. Notes No. 42 Creating a new label – GI example SIEMENS. Healthineers ... SR Mapping tab Tools & Outputs →  beside all listed tools* • • Text String for SR → Optional field Labet Root " Modifiers Measurement Type NERVE 2 Right ( Lett Festal • Select Concept Code Meaning → Distance Exam Package Segment MSK PIOx Origin • Coding Scheme Designator → DCM Tools SR Template SR Mapping • Code Value → linked to Concept Code ools & Outputs Text String for SR D • Optional fields → None selected Concept Code Meaning . Select Save All & Close to complete Distance • Coding Scheme Designator . DCM Code value 121206 Measurement Orientation Post-prandial Previous Output Next Output Save All & Close Cancel A * Each tool will need to be selected and confirmed with the steps listed above. Only 43 then will the SR Mapping be completed for the custom label. Unrestricted © Siemens Healthineers 2024 Speaker Notes: The final tab, SR Mapping, will finalize the tool coding and the label can be saved. Ensure that the distance tool has a checkmark beside it – if there are multiple tools listed, the coding procedure in this tab must be followed for each tool to complete the mapping. The top field, Text String for SR, is an optional field, and is left blank for this label. Then select the Concept Code Meaning, Distance from the drop-down menu, and the Code Value will automatically populate, as it is linked to the Concept Code Meaning. No additional optional fields are selected for this example, and we can now complete the label by selecting Save All & Close at the bottom of the page. Notes No. 43 Creating a new label – GI example SIEMENS. Healthineers ... Custom label summary • Check listed label summary for accuracy Exam Package • Label will be listed in the master menu Exam MSK under exam Custom measurements Label Raat: NERVE 2 Report Section: Custom Measurements Q Modifiers: Right / Left 2D Tools: Distance • Label will be automatically added to the NERVE 1 SR Template: Vascular SR Mapping: Completed NERVE Z New Touch Screen upon completion Copy Use the Per Label Configuration to alter Edit • units or precision • Copy, Edit, Delete are all available Delete SR Mapping Mapping 44 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Once the label has been saved, a summary of the parameters will be displayed – note the SR Mapping has been Completed for our NERVE 1 label. The new label will be listed in the master list for the exam package. Any alterations to units or precision can now be done under the Measurements > Per Label Configuration tab. Any edits to the label name or coding can be done by selecting Edit. Custom labels can be deleted or copied and edited by selecting the appropriate commands, which are now selectable. Notes No. 44 Creating a new label – GI example SIEMENS. Healthineers ... Touch Screen • Custom label will automatically Package Configuration Touch Screen Layout Editor be added to the Touch Screen Measurement Package Package Name Modifiers (if selected) are Name Show All v MSK • embedded in the custom label Cardlac Imaging Mode Abdomen Access the Touch Screen Layout 2D • Breast Editor touch tab to change label Carotid Early OB Default Custom position if necessary Fetal Echo Modifiers GYN Ped Hip NERVE 1 Prox NERVE 1 Mid NERVE 1 ist NERVE 1 Origin NERVE 1 LEA LEV MSK Neo Head OB Pediatric Abdomen Create Package potete Package Import Export 45 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Navigate to System Configuration > Measurement & Report >Touch Screen Measurement Config > Package Configuration. The custom label will automatically be added to the Touch Screen under the Custom group. The label position can be changed by accessing the Touch Screen Layout editor. The label can also be moved between groups if more than one group exists for that exam type. Now that we have completed a custom GI label example, we will now cover a cardiac example using the Copy and Edit features to create a new custom label. Notes No. 45 Creating a new custom label using the copy label feature - SIEMENS. Healthineers ... Cardiac example System Configuration System Settings > Workflow Enhancement Exam Package > Imaging Settings Cardiac Measurement & Report Cardiac Label Root: Ao Abd Measurement Report Section: Aorta 2D Tools: Distance Touch Screen Measurement Config Breast SR Template: Cardiac Custom Measurement Label Carotid SR Mapping: Completed Early OB New Custom Calculations Fetal Echo Report GYN Copy OB Tables Ped Hip Edit LEA Annotations LEV > Features MSK Transducer Neo Head Connectivity & Network Ao Coarct Vmax Peripheral Devices Ao Desc Delete System Management Ao Desc Vmax Ao Diam d Ao Isthmus Ao Root d Ao STJd SR Mapping Ao Thoracic AoV Annulus s Restore SE AoV Annulus $ (Post) Mapping AoV Area Planimetr AoV Area Planimetriast) AOV AT 46 Unrestricted © Siemens Healthineers 2024 Speaker Notes: If an existing label has the same or similar defined parameters desired for a new custom label, the user has the option to copy and edit an existing label for custom use. To create a custom cardiac label from an existing label, use the Pointer and Set key to select the cardiac exam package from the drop-down list on the Custom Measurement Label homepage. Notes No. 46 Copying a label – Cardiac example SIEMENS. Healthineers ... 1. Select the label you want to copy Exam Package from the master list (selected label Cardiac is back lit in orange) Custom measurements TAD Root d Report Section: Aorta 20 Tools: Distance SR Template: Cardiac 2. Select Copy from the label management Ao Abd New SR Mapping: Completed Ao Arch d options Ao Arch Distal Copy 2 Ao Arch Trans Distal Ao Arch Trans Prox Ao Asc d 1 Ao Asc Vmax AO Asc VTI Ao Coarct Diam Ao Coarct Vmax Ao Desc Ao Desc Vmax Ao Diam d AO STJ d SR Mapping Ao Thoracic AoV Annulus s bestoro S AOV Annulus $ (Post) AoV Area Planimetr AOV Area Planimetriast) AOV AT Summary of selected label parameters 47 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Once the cardiac exam package type is selected, the homepage displays the following available selections: 1. Existing measurement labels are displayed – the selected label for copying is highlighted in orange • For this example, we are selecting the Ao Root d label to copy • Note the summary of the selected label’s parameters is displayed 2. In the label management options section, select Copy to advance the homepage to the next configuration screen to begin defining the label parameters Notes No. 47 Copying a label – Cardiac example SIEMENS . Healthineers ... Defining label parameters 1. Define label root (name) Exam Package 2. Select Exam Package from Label loot" Modifiers Measurement Type Cardiac TAPSEZ Right / Left Fetal drop-down menu 1 Custom measurements Exam Package 3 4 Segments origin 3. Select Modifier (if Cardiac 2 None [ Prox [] Mid O Dist An Ati No Arch'd applicable) Tools SR Template SH Mapping Ao Archi Distal Copy 5 Ao Arch Trans Distal Imaging Mode M Mode 4. Measurement Type Ao Arch Frans Prox: O 2D Made Tools Label Ao Asc H Doppler Mode An Asc Vinex Distance M Mode 5. Select Segment (if AD ASE VTI [] Heart Rate Ab Coatct Diam Report Section 0 M-Slope applicable) Ao CODICE Vmax Time Ao Desc Detexto Ao Desc Vmax An Diam d AG Ithmus Ao Root.d. Ao Sirin d Ao STI d SA Mapping Ao Thoracic AoV Annulus's Restore SE AGY Annulus y (Fout) Mapping applied field AoV Area Plinimetry AoV Area Planimetriast) AOV AT Save All & Close Cancel All 48 Unrestricted © Siemens Healthineers 2024 Speaker Notes: When creating a new label using the copy feature, the label parameter’s will be filled with the copied label’s data. The user has the option to edit any of the data fields to suit their needs. For this example: 1. Enter TAPSE2 into the Label Root field • The label name must be unique and can have a maximum of 15 characters • For copied labels, the original label name must be altered in some way to create and save the new label 2. Choose cardiac Exam Package from the drop-down menu 3. Select modifiers (if applicable) • None is selected for the label TAPSE2 4. Measurement type • This option is only available in instances that apply to fetal measurements 5. Select segments (if applicable) • None is selected for the label TAPSE2 Notes No. 48 Copying a label – Cardiac example SIEMENS . Healthineers ... Tools tab The Tools tab defines the following label parameters: Exam Package Label Root" Modifier Measurement Type Cardiac TAPSE2 Right / Left fetal 1. Select the Active Mode for the label Custom measurements am Package Segment (2D, Doppler, etc.) Cardiac 2 None [ Prox [] Mid CDist @ origin No Abd New An Arch'd Tools SR Template SR Mapping → M Mode ho Arch Distal Copy ho Arch Trans Distal Imaging Mode 1 M Mode 2. Select the Tool type (distance, time, etc.) Ao Arch Trans Prox Fair O 2D Mode Took Label Ao Ase d O Doppler Mode Ao Asc Vmax Distance TAPSEZ M Mode → Distance AO Ase VTI Heart Rate Ao Coarct Olam Report Section 3 O M.Slope 2 Ap Coarct Vinax 3. Select Report Section Time Ao Desc Deluta Ao Desc Vitalx Ao Dtam d → Right ventricle (RV) Ap Isthmus Ao Roots ho Skins d SI Mopping Ao Thoracic AOV Arinulus $ AOV Annuluts s (Post) Mapping AOV Area Planimetr ADV Area Planimetriast) AOV AT Save All & Close Cancel All 49 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Once the copied label parameters have been defined, the user advances through the same three tabs that were discussed earlier in the creation of a custom label. When copying a label, the information contained under each tab can be altered to suit the needs of the newly copied label. The first tab is the Tool tab with the options to: 1. Select the active mode when the label is displayed • M Mode is selected in this example 2. Select the tool type (distance, time, etc.) • Distance is selected in this example 3. Select the report section where label results will be displayed • RV is selected for this example Notes No. 49 Copying a label – Cardiac example SIEMENS . Healthineers ... SR Template tab The SR Template tab allows the user to edit the copied labels data for Exin Package Label Root " Modivers Measurement Type the following: Cardiac TAPSE light & Left 1 Fetali Customn measurements Exam Package Segments 1. SR Template type Cardiac No Nod → Cardiac An Arch d Tools SR Template SR Mapping An Arun Dital Copy An Archi Trans Distal SR Template 2. SR Template section sia Template Section . Ao Arch. Trans Prox OBIGYN Right Ventricle NO ASCU Fetal Echo → Right ventricle Ao Asc Vmax Vascular AQ ASC VII Cardiac Na Caarct Diam 1 2 Ao Coarct Vrutas Ao Desc Delete Ao Desc Vmax Ao Isthmia Ao Root u Aa Sinus d SIE Mappany Ao Thoracic AOV Annulus's AoV Annulus's (Post) AOV Arna Planimetr AOV Area Planimetrieost) ADV AT Save All & Close Cancel AR 50 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To edit the copied labels data in the SR Template tab, the user has options available for: 1. Selecting the SR Template type • The cardiac template is selected in this example 2. Selecting the SR Template Section • Right ventricle is selected from the drop-down menu in this example Notes No. 50 Copying a label – Cardiac example SIEMENS . Healthineers ... SR Mapping tab The SR Mapping tab contains the following: 1. Displays the measurement tool and Exam Package Label Root Moditiers Measurement Typit output type General NERVE2 IT Right / Left Fetal Custom measurements 2. Allows edits to copied labels SR Q Exum Package Seginieits mapping parameters for: Took SR Template R Mapping Tools & Outputs axe String for Sit • Concept Code Meaning 1 Concept Code Meaning • Coding Scheme Designator Distance • Code Value Coding Scheme Designator DCM Optional fields such as Text String or 2 • Code value . Measurement Method 121206 Measurement Orientation 3. Use Save All & Close to complete the SR Mapping selections O Post-prandial Mapping Boahessel Previous autoin Need dutout 3 Save All & Close Cancel All 51 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The SR Mapping tab is the final tab that allows the user to alter the copied label’s structured reporting parameters. 1. The layout displays the measurement tool and output type • For this cardiac example, distance is showing with a checkmark beside it 2. The selections down the right side allow the user to alter the copied labels SR mapping for concept code meaning, coding scheme designator, code value, and optional fields, such as text string, measurement method, finding site, flow direction, cardiac cycle point, image view, and measurement orientation 3. Once all fields are populated, select the Save All & Close option to complete the label • The custom label will now display in the cardiac exam package for per label configuration and is available for adding to the Touch Screen panel for use Notes No. 51 Create new custom calculation package SIEMENS. Healthineers ... Custom calculation packages can be created for any exam: Package Configuration Touch Screen Layout Editor Select Create Package Measurement Package Package Name • Show All " General • A dialogue box will appear Cardlac maging Mode Abdomen → Enter Package Name 20 Breast Carotid → Select specific Root Package or Early 08 Detail Custom Fetal Echo None (empty) GYN Modifiers Create Package Ped Hip LEA Package Name LEV General (2) MSK Root Package General Neo Head OK Cancel Pediatric Abdomen Create Package • Select OK to save Dulute Fuckage Import Export 52 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Custom calculation packages can be created for any factory or custom exam preset. These custom calculation packages can then be “attached” to their specific exams under Workflow Enhancements > Exam Association. The steps for exam association and creation are covered in the ACUSON Sequoia System Configuration presentation. To create a custom calculation package for an exam: • Select Create Package • A dialogue box will appear on the screen for you to • Enter the Package Name – for example, “Knee” or “Shoulder” for an MSK exam • Select a specific Root Package or None for an “empty” package • Save the newly created package by selecting OK To add labels to the newly created custom package, select the package under the Touch Screen Layout Editor and populate the Touch Screen with the desired labels. Notes No. 52 Calculation package visibility and order SIEMENS. Healthineers ... All calculation packages are listed in the Package Configuration Touch Screen Layout Editor master list Measurement Package Package Name Name • Change the visibility (“hide”) of any General General package by unchecking the associated Cardiac Imaging Mode Abdomen box  → 20 Breast Carotid • Re-order packages within the list by Early OB Default Fetal Echo using the up/down arrows GYN Ped Hip LEA LEV MSK Neo Head OB TIP Pediatric Abdomen Create Package To display a calculation package, check this Billets Package tab for visibility. Import Export 53 Unrestricted © Siemens Healthineers 2024 Speaker Notes: All calculation packages that are currently on the system (factory or custom) will be listed in the master list under the Package Configuration tab. Package order and visibility can be changed here. To change the visibility and “hide” a package, uncheck the box next to the chosen exam in the master list. To change the order in which the packages are displayed, use the “up” and “down” arrows on the right to move the package(s) to the desired location within the list. Note that newly created custom measurement packages will initially appear at the bottom of the master list; they will not appear with the specific Root Package that was used as a base to create the custom package. Tip: If a calculation package is not being displayed on the Touch Screen, check this tab for visibility, as it may have been inadvertently unchecked. Unchecking the calculation package will remove it from the Touch Screen display. Notes No. 53 Objectives SIEMENS. Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the Touch Screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Describe Custom Calculations • Discuss the OB tables • Review the report 54 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Now we will discuss Custom Calculations and how to input new calculations into the ACUSON Sequoia ultrasound system. Image: HOOD05162003330011 Notes No. 54 Custom Calculations SIEMENS. Healthineers ... Custom Calculations are clinical calculations that System Configuration are specific to a user, department, institution, or System Settings region that are not available as factory calculations. Workflow Enhancement Imaging Settings • System Configuration > Measurement & Report Measurement & Report > Custom Calculations Measurement Touch Screen Measurement Config • The tool will not let users save a mathematically Custom Measurement Label incorrect formula Custom Calculations Repor • Provides utility for a variety of equations from OB Tables simple volumes to regression formula Annotations Features • Full accessibility for General Imaging, Cardiac, Transducer and Shared Service Connectivity & Network Peripheral Devices System Management 55 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Custom Calculations are clinical calculations that are specific to a user, department, institution, or region that are not available as factory calculations Custom Calculations are available for configuration by selecting System Configuration > Measurement & Report > Custom Calculations. • The tool will not let users save a mathematically incorrect formula • The tool provides utility for a variety of equations from simple volumes to a more advanced regression formula • Custom Calculations have full accessibility for General Imaging, Cardiac, and Shared Service Notes No. 55 Custom Calculations SIEMENS . Healthineers ... System Configuration System Settings Workflow Enhancement Custom Calculations Formula SR Mapping Imaging Settings Formula 1 Measurement & Report Name Linits Pechion Report Section Measurement Formula 1 Congenital Heart Disease Touch Screen Measurement Config New Max( Ap Arch Distal,con].[An Arch Trans Distal,cml) Custom Measurement Label Custom Calculations Copy Report OB Tables Edit Ensure the formula and units are correct and then dick Save. Show In Messureit Results Save Annotations Show In Report Features Exam Package Abdomen Result Labels Transducer Connectivity & Network Delete Accel Min Of Ally Peripheral Devices TAN Max Mix Of Any System Management cos Ans Mean Cif Any AAA (Post Repaar) AMA (Post Repair) AP PS SR Mapping AAA (Post Itupair) Diarn AAA (Post Repair) Trains Diam Units AMA AP AAA Diam AAA dist fronti SMA AAA Sac Length 56 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To begin a new Custom Calculation: • Select System Configuration > Measurement & Report > Custom Calculations • Select New to begin a new Custom Calculation Copy allows users to copy and modify existing custom calculations. Edit allows users to reopen an existing Custom Calculation for modification. Notes No. 56 Custom Calculations SIEMENS . Healthineers ... 1. Name of equation (14-character limit) Formula 1 Mapping 2 3 4 2. Output units of equation Name Units Precision Report Section 3. Decimal point precision 4. Report display area 5. Area of equation input 5 6. Display results in onscreen measurement Ensure the formula and units are correct and then click Save. display area or within Report 6 Show in Measured Results Cancel E Show in Report 7. Exam package drop-down 9 Result Labels Library of labels to create an equation Exam Package 8. 7 Abdomen Accel ATAN Min Min Of Any 9. Result labels when type of measurement Q Time TAN Max Max Of Any needs to be specific AAA Abs Mean Of Any AMA (Post Repair) COS V2 10. Input units AAA (Post Repair) AP SIN 8 First ED 11 11. Mathematical input area AAA (Post Repair) Diam AMA (Post Repair) Trans Diam Units sqrt AAA AP mm/sa AAA Diam cmisa AAA dist from SMA log misa AAA Sac Length Add 10 57 Unrestricted © Siemens Healthineers 2024 Speaker Notes: 1. Name of equation (14-character limit) 2. Output units of equation 3. Decimal point precision 4. Report display area 5. Area of equation input 6. Display results in onscreen measurement display area or within Report 7. Exam package drop-down to choose calculation components 8. List of available labels to create an equation 9. Result labels when type of measurement needs to be specific e.g., circumference or area; peak systolic vs end diastolic 10. Input units 11. Mathematical input area – the system keyboard can also be utilized for input Notes No. 57 Custom Calculations – entry SIEMENS . Healthineers ... Basic entry of a Custom Calculation: Formula 1. Select New 2 3 4 Name Units Precision Report Section 2. Enter a unique formula name (14-character limit) Now 1 3. Select output Units Copy 4. Select result Precision Ensure the formula and units are correct and then click Save. 5. Select appropriate Exam Package Show in Measured Results Save Cancel Show in Report 6. Select a label from the exam package Package Result Labels library and choose the input Units and 5 Delete men Accel ATAN Min Min Of Any results label for that measurement TAN Max Max Of Any 7. Select Add to add measurement to cos Abs Mean Of Any 6 (Post Repair) V2 equation area PS SIN (Post Repair) AP First 8. Use calculator functions to enter SR Mapping 8 AAA (Post Repair) Diam ED AAA (Post Repair) Trans Diam Units 6 mathematical equation AAA AP mmis2 AAA Diam pi cmis AMA dist from SMA log mis2 AM Sac Length Add 7 58 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Basic entry of a Custom Calculation: 1. Select New 2. Enter a unique formula name (14-character limit) 3. Select output Units 4. Select result Precision 5. Select appropriate Exam package 6. Select a label from the exam package library and choose the input units and results label for that measurement 7. Select Add to add measurement to equation area 8. Use calculator functions to enter mathematical equation Notes No. 58 Custom Calculations – entry cont. SIEMENS. Healthineers ... Basic entry of a Custom Calculation (cont.): Formula SR Mapping 9. Select Report Section area for formula Units Precision Report Section results to display 9 10. Check for accuracy and no red lines New 11. Select Show in Measured Results to 10 display results in MDA 11 Ensure the formula and units are correct and then click Save. 12. Select Show in Report to display formula Show in Measured Results 13 Cancel results in the report Show in Report 12 Exam Package Result Labels 13. Select Save Delete Abdomen Accel ATAN Min Min Of Any Time TAN Max Max Of Any COS Abs Mean Of Any AMA (Post Repair) V2 AAA (Post Repair) AP PS SIN First SR Mapping AAA (Post Repair) Diam ED AAA (Post Repair) Trans Diam Units AAA AP sqrt mmis2 AAA Diam pi cmis? AMA dist from SMA log mist AMA Sac Length Add 59 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Basic entry of a Custom Calculation (cont.): 9. Select Report Section area for formula results to display 10. Check for accuracy and no red lines. 11. Select Show in Measured Results to display results in the measurement display area 12. Select Show in Report to display formula results in the report 13. Select Save A Custom Calculations Quick Card is available for use. Notes No. 59 Custom Calculations SIEMENS . Healthineers ... SR Mapping 1 4 1. Select SR Mapping 2. Select appropriate SR Custom Calculations Formula SR Mapping Lt Lambert Template LVOTIBSA SR Template ext String for SR Rt Lambert OB/GYN LVOTIBSA 3. Select SR Template Fetal Echo 2 New Concept Code Meaning " Copy O Cardiac Cardiac Index section Coding Scheme Designator . 4. Complete SR Mapping for SR Template Section " given equation Left Ventricle Code value " F-32110 Measurement Method 3 Continuity Equation by Velocity Time | V Delete Finding Site Left Ventricle Outflow Tract V Flow Direction Antegrade Flow se Mapping Cardiac Cycle Point Peak Systolic Image View Apical four chamber v * Required field Save Cancel 60 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Custom Calculations can be SR mapped using the SR Mapping tab. 1. Select SR Mapping 2. Select appropriate SR Template 3. Select SR Template section 4. Complete SR Mapping for given equation Notes No. 60 Objectives SIEMENS. Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the Touch Screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Describe Custom Calculations • Discuss the OB tables • Review the report 61 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Now we will discuss the OB tables for both configuration and adding custom tables to the ACUSON Sequoia ultrasound system. Image: HOOD05162003330011 Notes No. 61 OB Tables tab SIEMENS . Healthineers ... Homepage layout OB tables homepage configurable options: System Configuration > System Settings Default OB Author Default Of Author Custom GA Table Custom Growth Curves • Workflow Enhancement Imaging Settings Gestational Age Growth Analysis Measurement: Author Measurement Author • Custom GA Table k + Measurement & Report AC Lasser Hadlock Measurement APTDXTID Tokyo* AFI Moore Custom Growth Curves Touch Screen Measurement Config BinocD Tongsong AFI 2 Moore • Custom Measurement Label Hadlock AR3 Moore Custom Calculations APTDxTIO Tokyo Report CRL Hadlock BPD Merz OB Tables EFW Age Osaka+ Cerebellum Verburg › Annotations Hadlock Ost Magna Nicolaides › Features Foot Mercer Clavicle Sherer Transducer Osaka" CHI Hadlock Connectivity & Network Rempen EFW Hadlock Peripheral Devices Hadlock FL Hadlock Jeanty Foot Chitty Systern Management Rempen FTA Osaka OFD ASUM 2003 GSD Hellman Jeanty HC Hadlock Jeanty Campbell Jeanty LI CP Ratio Ebbing US Age (Ultrasound Age) EFW (Estimated Fetal Weight) Average Hadlock (BPD, HC. AC, FL) 62 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The OB Tables section has three tabs: • Default OB Author – authors can be selected from the drop-down menu associated with the growth parameter • Custom Growth Curves – the user can add/create custom gestational age tables • Custom Growth Curves – the user can add/create custom growth curves Notes No. 62 OB Tables tab SIEMENS . Healthineers ... Default OB Author • Select default author from drop-down System Configuration menu for each parameter System Settings Default OB Author Custom GA Table Custom Growth Curves Workflow Enhancement • Custom tables will have an asterisk (*) Imaging Settings Gestational Age Growth Analysis Author Measurement Measurement & Report Measurement Lasser NC Hadlock in the table name Measurement APTEXTTD Tokyo AH Moore Touch Screen Measurement Config BinocD Tongsong AH 2 Moore Factory tables will not have an Custoen Measurement Label Hadlock AH 3 Moore • Custom Calculations Cerebellum APIDXTTO Tokyo asterisk (*) in table name Report Hadlock BPD Metz Oll Tables EFW Age Osaka* Cerebellum Verburg Annotations Hadlock Cist Magna Nicolaides Features Foot Mercer Davide Sherer Transducer FIA Osaica" Hadlock Connectivity & Network GSD Rempen EFW Hadlock HC Hadlock FI Hadlock Peripheral Devices HI ASUM 2003 Foot Chitty System Management MSD Onitty Osaka OFD GSD Hellman Tibia Lasser HC Hadlock Ulina Merz HCIAC Campbell Jeanty LI CP Ratio Ebbing US Age (Ultrasound Age) EFW (Estimated Fesal Weight) Average Hadlock (BPD, HC, AC, FL) 63 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To select the default author/table for the OB calculations: • Use the Pointer and Set key to access the drop-down menu next to the chosen measurement parameter • Select the appropriate author table Custom tables will have an asterisk (*) in the table name whereas factory tables will not include an asterisk. Notes No. 63 OB Tables tab SIEMENS. Healthineers ... Custom GA Table Two options to create a custom Default OB Author Custom GA Table Custom Growth Curves gestational age (GA) table: Measurement AC 1. Manually input a new table Author Name Units ASUM 2003 1 New JSUM 2003 Hadlock 2. Copy an existing table JSUM 2003 Copy Gestational Age 2 Lasser Weeks Days 250 days Merz 10.00 15 3.0 16 10,50 16 0.0 16 11,00 16 4.0 16 11:50 17 16 12.00 17 4.0 18 12.50 18 18 13.00 18 BL 13,50 19 0.0 18 14.00 19 10 14.50 20 0.0 15.00 20 20 15,50 21 0.0 20 Restore Defaults: AC 64 Unrestricted © Siemens Healthineers 2024 Speaker Notes: There are two options for creating custom gestational age tables: 1. The user can manually input a new table 2. The user can copy an existing table Notes No. 64 OB Tables tab SIEMENS . Healthineers ... Custom GA Table – copy existing table • Highlight desired table Default OB Author • Select Copy Custom GA Table Custom Growth Curves Measurement • Change Author name or leave copied AC Author Name name with number ASUM 2003 New JSUM 2003 (2) Hadlock ISUM 2003 Copy Gestational Age Alter data (if required) Insert Row Before • Lasser Weeks Days 25D days Merz 10.00 15 3.0 16 Insert Row After • Validate table Table is valid. Delety 10.50 16 0.0 16 Delete Row 11.00 16 4.0 16 • If table is valid, select Save 11.50 17 0.0 16 Clear All 12:00 17 4.0 18 12.50 18 0.0 18 00'EL 18 4.0 18 13.50 19 0.0 18 14.00 19 4.0 18 14.50 20 0.0 18 15.00 20 D'E 20 21 20 Validate Table Save Cancel Ensure the table entries are correct and then click Save 65 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To copy an existing table: • Use the Pointer and Set key to highlight desired table • Select Copy • Change Author name or leave copied name with number in parentheses • Alter any data fields (if required) • Select Validate to have the system validate the field data entries • If the table is valid, select Save Notes No. 65 OB Tables tab SIEMENS . Healthineers ... Custom GA Table – create new • Select New Default OB Author Custom GA Tabla Custom Growth Curves • Name table and select units Measurement . - Required field uthor Name • Input table data – use the “tab” key ASUM 2003 Author to advance Hadlock Gestational Age: JSUM 2003 Insert Row Before Lasser Week's Days 250 days • Insert/delete rows as required Merz Insert Row After Delete Row • Validate table Clear All • Complete the SR Mapping process (if required) • Select Save to complete table 57 Mapoinit Cancel Ercoure the table entries are correct and then click Save 66 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To create a new gestational age table: • Select New • Type in the author’s name/name of the table and select the table units • Input table data–use the “tab” key to advance through the data fields; all fields must be populated • Insert/delete rows as required – options are located on the side of the table • The maximum number of weeks that can be entered on the table is 43 • Validate table • Complete the SR Mapping process (if required) • Select Save to complete table Note: If the table is found to be “not valid” due to a data entry error, the system will display a message onscreen indicating the row where the error is detected. Notes No. 66 OB Tables tab SIEMENS . Healthineers ... Custom Growth Curves • Steps to add custom growth curves are like custom GA tables using Copy or New Default OB Author Custom GA Table Custom Growth Curves Measurement Custom growth curves require a Low/High Author Name Units Low High Range - Required field • ASUM 2003 ASUM 2003 (2) 5%/95% range selection – options are: CHEF Chitty Copy Insert Row Before Deter Row wooks ., Days Low (5%) ( Mean (50%) High (95%) • 5%/95% Grumbach (twins) D.O 43.8 52 60.2 nert Row After Hadlock 12 0.0 54.8 63 71.2 • 10%/90% INTERGROWTH-21st Jeanty 13 0.0 65.8 74 82.2 Delete Row JSUM 2003 14 0.0 75.8 84 92.2 Clear All 3%/97% Merz 15 0.0 87.8 96 104.2 • Nicolaides 16 107.7 8'26 106 114.2 Verburg D.O 120 132,3 • +/- 1.5SD 19 81 0.0 118.7 131 143.3 D.D 127.7 140 152.3 • +/- 2SD 10 20 20 D.D 138.7 151 163.3 21 D.D 147.6 164 180.5 • +/- 1SE Validate Table Si Mapom Cancel • Maximum number of weeks that can be Ensure the table entrles are correct and then click Save entered is 43 67 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Custom growth curves can also be added in the same manner as custom gestational age tables using the Copy or New key options. Customs growth curves require a low/high range selection from the drop-down menu. Available sections are: • 5%/95% • 10%/90% • 3%/97% • +/- 1.5SD (Standard Deviation) • +/- 2SD • +/- 1SE (Standard Error) Tables must be validated, and the SR mapping completed (if required) before the system will allow the table to be saved. Note: The maximum number of weeks that can be entered in a custom growth curve is 43. Notes No. 67 OB Tables tab SIEMENS . Healthineers ... Custom Growth Curves Flexibility with input Custom Growth Curves • Low/High percentile range options 2 • Custom defined Low/High percentile - 1 Author Name Units Low/High Range - Required field 0.1–99.9% AUTHOR mm V 5%/95% % - % • Auto calculation of Low/High percentile 5%/95% GA AC 10%/90% Insert Row Before ROW weeks Days Low (5%) Mean (509 3%/97% +/-1SD Insert Row After +/-1.5SD 2 -1-2SD Delete Row 3 +/-1SE 4 Clear All 5 68 Unrestricted © Siemens Healthineers 2024 Speaker Notes: 1. Here section one shows the selectable Low/High range options. 2. Section two shows that the Low/High percentile can be customized anywhere from 0.1%– 99.9% . Check the box to enable. The system will automatically calculate the Low/High percentile depending on which you enter first. Notes No. 68 Objectives SIEMENS. Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the Touch Screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Describe Custom Calculations • Discuss the OB tables • Review the report 69 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Next, we will review the Report on the ACUSON Sequoia ultrasound system. Image: HOOD05162003330011 Notes No. 69 Report configuration tab SIEMENS . Healthineers' ... Homepage layout • Organ-based/anatomic reporting Report Content Assessments Comments Report Template structure Report Sections • Homepage contains four configurable Patient History option areas: - Patient History • Report Content - Institution Abd Organs - Liver • Assessments Liver Shear Wave Elastography Measurements (pSWE) • Comments - Liver Shear Wave Elastography Measurements (SWE) - Liver Ultrasound Derived Fat Fraction Measurements (UDFF) Report Template - Gallbladder and Pancreas • - Spleen Renal - Kidneys Side-by-Side - Kidneys - Bladder Aorta - Aorta & Iliac Arteries Ahd Grafts Collapse All Collapsed by default - Expanded by default Restore Defaults 70 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The layout of the report on the ACUSON Sequoia ultrasound system is organ/anatomically- based. There are four sections available for configuration: • Report Content • Assessments • Comments • Report Template Notes No. 70 Report configuration tab SIEMENS . Healthineers ... Report Content 1. Default option to expand or collapse all report content Report Content Assessments Comments Report Template Report Sections 2. Expand/collapse option for individual sections t History 3. Check  option to show/hide report nstitution 2 sections* Organs iver liver Shear Wave Elastography Measurements (p5WE) liver Shear Wave Elastography Measurements (SWE) iver Ultrasound Derived Fat Fraction Measurements (UDFF) 3 allbladder and Pancreas pleen idneys Side-by-Side Poneys edder Corta & mac Arteries Collapse All 1 Collapsed by Split - Expanded by dated) Restore Defaults *Hidden sections will not show on a printed report even if a measurement is 71 performed for that section. Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Report Content section allows the user to determine what results will be displayed at the end of an exam. 1. The user has the option to expand areas or collapse areas or individual sections when the report is displayed. There is a default setting located at the bottom of the page to expand or collapse all. 2. Individual sections can be expanded or collapsed by using the Pointer to click on the “+” or “ ” next to the section content. - 3. The user also has the option to show or hide sections in the report by checking or unchecking the section under the Show column. Note that if a section is hidden (unchecked), the results in that section will not be shown on the report, even if there are measurements taken involving that section. If the user needs to display these results, they will need to go to the system configuration and check the box to “show” the results. Notes No. 71 Report configuration tab SIEMENS . Healthineers' ... Assessments Pre-loaded list of assessments from factory: Report Content Assessments Comment Report Template • Abdomen Assessment • OB Fetal Carotid • OB Maternal RI CCA LECCA Create Custoin Assessment Items • Early OB Fetal Rt CCA Plaque Description Lt CCA Plaque Description Type: Rt CCA Diameter Lt CCA Diameter • Early OB Maternal Reduction Reduction Checklist Rt CCA Comments Lt CCA Comments O Comment Text Box • GYN Rt BIF LE BIF • Carotid Rt BIF Plaque Description Label: Lt BIF Plaque Description Rt BIF Diameter Reduction Et BIF Diameter Reduction • Lt Hip Description Rt BIF Comments Lt BIF Comments • Rt Hip Description RE ICA LIKA Rt ICA Plaque Description LI ICA Plaque Description • Fetal Echo Rt ICA Diameter Reduction LEICA Diameter Reduction Rt ICA Comments Lt ICA Comments ... Check  option to show/hide assessment in Rt ECA LIECA Rt ECA Plaque Description Lt ECA Plaque Description report. Restore Defaults: Carotid 72 Unrestricted © Siemens Healthineers 2024 Speaker Notes: There is a pre-loaded list of assessments from the factory for certain exam types: • Abdomen • OB Fetal • OB Maternal • Early OB Fetal • Early OB Maternal • GYN • Carotid • Lt Hip Description • Rt Hip Description • Fetal Echo As with the report content, the user can show/hide any assessment text by checking/unchecking the box for the assessment text. Notes No. 72 Report configuration tab SIEMENS. Healthineers ... Add custom assessment item Two types of custom assessment items can be added: • Checklist Create Custom Assessment Items • Comment text box Type: 1 Checklist To add a custom assessment: Comment Text Box 1. Select assessment Type 2 2. Enter label in field Label: Test Label 3. Select Add 3 Add Assessment label can only be moved around custom area of the report. 73 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Custom assessments can be added to the report page either as a checklist or a comment (text) box. To add a custom assessment: 1. Select the Type of assessment to be added 2. Manually enter the assessment/label name in field provided 3. Select Add Custom assessment labels will appear at the bottom of the report. They can be reordered in this section but cannot be relocated into the list of factory assessments. Notes No. 73 Report configuration tab SIEMENS . Healthineers ... Delete custom assessment item To delete a custom assessment item: Report Content Assessments Comments Report Template • Highlight the desired label Assessments Select Delete Abdominal • Liver Create Custom Assessment Items Echotexture Type Fatty Infiltration Checklist Portal Hypertension O Comment Text Box Portal Vein Focal Lesions Labet! Lesion Elasticity Liver Comments Gallbladder Gallbladder Comments .. ........ CBD CBD Comments CHD CHD Comments Delete Restore Defaults: Abdominal 74 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To delete a custom assessment item: • Use the Pointer to highlight the desired label • Select Delete Note: Custom assessment labels cannot be edited only deleted. Notes No. 74 Report configuration tab SIEMENS . Healthineers ... Comments Pre-defined comments can be added to the report Report Content Assessments Report Template Comments For Exam Package • Select the exam package General • Enter comment in the space Exam within normal limits. provided Recall exam x2 weeks Gallbladder removed. Select Add Technically difficult exam. • • Re-order (if required) with the directional arrows To delete a comment • Highlight comment • Select Delete Delete Restore Defaults: General 75 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Pre-defined comments can be added to the report. To add a comment to the report: • Select the exam package from the drop-down list • Enter the desired comment in the space provided • Select Add • Re-order (if required) with the directional arrows To delete a comment: • Highlight comment • Select Delete Comments can be re-ordered by using the directional arrows at the side of the list. Notes No. 75 Report configuration tab SIEMENS. Healthineers ... Report Template • Customized logo and text can be added to the report via USB Report Content Assessments Comments Report Template Site Information • Three layout options for logo and text Institution Logo Details Details Layout Layout • Logo file must be JPEG or PNG Layout1 SIEMENS .. Large Bold Three lines of text can be added and Healthineers .. Line 2 • customized for style and font Load Filmook Line 3 Restore Defaults 76 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The final tab, the Report Template, contains options for customization of the Report includes the addition of a site logo and/or three lines of text (“institution details”). To add a site logo, insert a USB into the USB port containing a JPEG or PNG of the desired logo. Select Load to view the file contents of the USB on the screen. Highlight the desired logo from the files that are displayed and select Load Image from the bottom of the dialogue window. The logo will be added to the Logo window area. To remove the logo, select the Remove key located below the logo window. In addition to a customized logo, a custom statement or institution details, such as address, of up to three lines and 32 characters per line, can be added to the report. To add a customized statement, use the Pointer to activate one of the three available Text areas and type in the desired text. Once the text is entered, the user can further customize the font type and style by using the drop-down menu beside each text line. Once the logo and/or details have been entered, there are three report template layouts to choose from. Use the drop-down menu to select the desired layout – a schematic of the layout will appear below the drop-down field detailing the layout of the logo and text. Notes No. 76 Summary SIEMENS. Healthineers ... • Identify access to system configuration • Outline the measurement subgroup • Describe the Touch Screen configuration • Explain custom measurement labels • Homepage layout • What is DICOM SR? • Steps to define a custom label • Create a new custom label • Describe Custom Calculations • Discuss the OB tables • Review the report 77 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. Image: HOOD05162003330011 Notes No. 77 Trademarks and disclaimers SIEMENS. Healthineers ... ACUSON Sequoia and Virtual Touch are trademarks of Siemens Medical Solutions USA, Inc. syngo is a registered trademark of Siemens Healthineers AG 78 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. Image: HOOD05162003330011 Notes No. 78 Thank you for your enthusiasm! SIEMENS. Healthineers ... Questions? 79 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. Notes No.79