ACUSON Sequoia™ 3.5 VB30 VT Strain Quick Card

Quick Card Virtual Touch Strain Elastography - Breast Mass Strain Imaging ACUSON Sequoia Ultrasound System 3.5 (VB30) siemens-healthineers.com/ultrasound Using Strain Imaging to qualitatively assess relative tissue stiffness Step 1 VT Strain • Position the patient to obtain a perpendicular plane to the skin surface for optimal axial motion 18L6 • Position a compatible transducer1 over the area of Breast TIB:0.06 TIC:0.11 interest and optimize B-mode image TIS:0.06 MI:0.60 15fps 95% • Press VT (Virtual Touch) located on control panel 2D Mid 3dB/DR65 • Select the Strain tab Strain Color 0 Map 0 • Roll the trackball to position the region of interest (ROI) • Press the Set key and roll trackball to resize ROI Note: The B-mode image and elastogram display in live, dual format (Fig. 1). The elasticity imaging bar (located above the grayscale bar) represents the range of gray or color shades available for depicting tissue stiffness from 3.5cm QF: 92 SF (soft) to HD (hard). Fig. 1: Left: B-mode image with ROI. Right: B-mode image with corresponding ROI displaying the elastogram. 1 Strain imaging is compatible with transducers 18L6, 14L5, 15L4, and 10L4 for Breast and Thyroid, and with the 9EC4 transducer for Prostate. SIEMENS Healthineers . Step 2 10L4 Thyroid TIB:0.08 TIC:0.21 • Use minimal compression; avoid lateral or TIS:0.08 rocking motion MI:1.15 16fps Tip: Patient respiration or cardiac motion 2D H High may be sufficient. OdB/DR65 Strain Color 0 • Adjust axial motion or cease lateral Map 1 movement if a gray overlay box appears on the elastogram (Fig. 2) • Maintain QF > 50 Note: The system displays a real-time quality factor (QF) score. A QF value > 50 (Fig. 1) indicates a minimal global motion artifact. A QF value < 50 (Fig. 2) indicates a less than optimal result; perform another acquisition. Bcm OF: 0 Fig. 2: A gray overlay box on the elastogram indicates insufficient or excessive axial motion or lateral movement. Step 3 Breast Workflow Patient 2D Virtual Touch • Optimize the elastogram and then press Freeze; review cine to obtain the desired Imaging Strain SWE frames Review • Rotate Zoom on the control panel to Report magnify the image End Exam • If desired, rotate Color to select a color map Live Dual × • If desired, rotate Map Index: 0: Standard default map - 1: Normalized map (compensates for Frequency Color Map Index - non-uniform stress applied with Mid the transducer) 2: Inverted map - 2 siemens-healthineers.com/ultrasound Measurements Shadow Shadow Duplicates and displays a measurement on the adjacent image for a comparison of lesion size and/or location. Tip: Shadow may be used with the strain ratio. • On a live or frozen image, press Caliper • Select Shadow if needed and press the Set key • Measure the right or left image and press the Set key • Select Delete on the control panel to delete the measurement Strain Ratio Strain Ratio ROI 1 (Reference) Compares the relative stiffness of tissue within two ROIs (e.g., compares Strain Ratio ROI 2 (Mass) average strain of a lesion and average strain of the surrounding tissue). Strain ratio = 1: • On a frozen image, press Caliper Stiffness of tissue in both ROIs is equal. • Select Strain Ratio Strain ratio > 1: The lesion is harder than the surrounding tissue. • Place ROI 1 (Reference) in the surrounding tissue inside the ROI and press the Set key to anchor each axis endpoint Strain ratio < 1: The lesion is softer than the surrounding tissue. • Roll the trackball to place ROI 2 (Mass) in the lesion (same size and at Note: Results reflect placement of ROI 1 in the same depth) and press the Set key to anchor each axis endpoint surrounding tissue; results will differ if ROI 1 is placed in the lesion. • The strain ratio and average strain (%) for both ROIs are displayed in the measured results • To display the measurement in the report, select Right or Left and either Mass 1, Mass 2, or Mass 3 measurement labels • Select Delete on the control panel to delete the measurement Note: Strain Ratio is not available when using Color 1 or 2 or Map Index 2. Elasticity imaging/B-mode (EI/B) ratio % El/B Distance Ratio=1.00 1 D (E)=1.05 cm • On a live or frozen image, press Caliper El/B Ratio - D 2 D (B)=1.05 cm • Select EI/B Ratio – A (area ratio) or % El/B Area Ratio=0.95 Select EI/B Ratio – D (distance ratio) 1 A (E)=0.81 cm2 • El/B Ratio - A 2 A (B)=0.85 cm2 • Measure the lesion on the elastogram and press the Set key • Measure the lesion on the B-mode image and press the Set key • The EI/B ratio is displayed in the measured results • To display the measurement in the report, select Right or Left and Mass 1, Mass 2, or Mass 3 measurement labels 1 Barr, R. G., De Silvestri, A., Scotti, V., Manzoni, F., Rebuffi, C., Capittini, C. and Tinelli, C. (2019), • Select Delete on the control panel to delete the measurement Diagnostic Performance and Accuracy of the 3 May be used as an indication of the likelihood of malignancy in breast Interpreting Methods of Breast Strain Elastography: A Systematic Review and Meta-analysis. J Ultrasound lesions. When the ratio is > 1, the probability of malignancy is high.1 Med, 38: 1397-1404. doi:10.1002/jum.14849. siemens-healthineers.com/ultrasound 3 For the proper use of the software or hardware, please always use At Siemens Healthineers, we pioneer breakthroughs in healthcare. the Operator Manual or Instructions for Use (hereinafter collectively For everyone. Everywhere. Sustainably. As a leader in medical “Operator Manual”) issued by Siemens Healthineers. This material is technology, we want to advance a world in which breakthroughs to be used as training material only and shall by no means substitute in healthcare create new possibilities with a minimal impact on the Operator Manual. Any material used in this training will not be our planet. 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All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. ACUSON Sequoia and Virtual Touch are trademarks of Siemens Medical Solutions USA, Inc. Siemens Healthineers Ultrasound owns the rights to all images. 1 Personalization of diagnosis, therapy selection and monitoring, after care and managing health. Siemens Healthineers Headquarters Manufacturer Siemens Healthineers AG Siemens Medical Solutions USA, Inc. Siemensstr. 3 Ultrasound 91301 Forchheim, Germany 22010 S.E. 51st Street Phone: +49 9191 18-0 Issaquah, WA 98029, USA siemens-healthineers.com Phone: 1-888-826-9702 siemens-healthineers.com/ultrasound Published by Siemens Medical Solutions USA, Inc. · QR700011297 · 15692 0924 online · ©Siemens Medical Solutions USA, Inc., 2024