ACUSON Sequoia™ Ultrasound System Virtual Touch Strain Imaging | 2.5 (VA50) Software Release

Quick Reference Card Virtual Touch™ Strain Imaging ACUSON Sequoia™ Ultrasound System (VA50) siemens-healthineers.com/ultrasound HOOD05162003358599 | Effective date 19-Jun-2023 Using Strain imaging to qualitatively assess relative tissue stiffness Step 1 VT Strain • Position patient to obtain perpendicular plane to skin surface for optimal axial motion • Position compatible transducer1 over area of interest and optimize B-mode image • Press VT (Virtual Touch) located on control panel 20 • Select Strain tab, if needed • Roll trackball to position the region of interest (ROI) • Press 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 SF (soft) to HD (hard). Fig. 1: Left: B-mode image with ROI. Right: B-mode image with corresponding ROI displaying elastogram. 1 Strain imaging is compatible with 18L6, 14L5, 15L4, 10L4: General, Breast, Thyroid; 9EC4: Prostate. SIEMENS Healthineers . Step 2 Thyroid TIBO • Use minimal compression; avoid lateral or rocking motion Tip: Patient respirations or cardiac motion may be sufficient. Strain • Adjust axial motion or cease lateral Map 1 movement if gray overlay box appears on elastogram (Fig. 2) • Maintain QF > 50 Note: The system displays a real-time quality factor (QF) score. A QF value > 60 (Fig. 1) indicates minimal global motion artifact. A QF value < 50 (Fig. 2) indicates a less than optimal result; perform another acquisition. Fig. 2: A gray overlay box on elastogram indicates insufficient or excessive axial motion or, lateral movement. Step 3 0 0 0 1944 Optimize elastogram, and then press Freeze; 20 • review cine to obtain desired frames • Rotate Zoom on the control panel to magnify the image • If desired, rotate Color to select a color map • If desired, rotate Map Index: 0: Standard default map - 1: Normalized map (compensates for - non-uniform stress applied with 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 Set key • Measure the right or left image and press 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: lesion is harder than surrounding tissue. • Place ROI 1 (Reference) in surrounding tissue inside ROI and press Set key to anchor each axis endpoint Strain ratio < 1: lesion is softer than surrounding tissue. • Roll trackball to place ROI 2 (Mass) in lesion (same size and at same Note: Results reflect placement of ROI 1 in depth) and press Set key to anchor each axis endpoint surrounding tissue; results will differ if ROI 1 is placed in lesion. • Strain ratio and average strain (%) for both ROIs are displayed in the measured results • To display measurement in 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 EV/B Ratio - D 2 D (B)=1.05 cm • Select EI/B Ratio – A (area ratio) or, % EU/B A Ratio=0.95 Select EI/B Ratio – D (distance ratio) A(E) 0.81 cm' • FI/B Ratio - A A (B) =0,85 cm • Measure lesion on elastogram and press Set key • Measure lesion on B-mode image and press Set key • The EI/B ratio is displayed in the measured results • To display measurement in 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, our purpose is to enable healthcare the Operator Manual or Instructions for Use (hereinafter collectively providers to increase value by empowering them on their journey “Operator Manual”) issued by Siemens Healthineers. This material is towards expanding precision medicine, transforming care delivery, to be used as training material only and shall by no means substitute and improving patient experience, all enabled by digitalizing the Operator Manual. Any material used in this training will not be healthcare. updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the An estimated five million patients worldwide everyday benefit from training. The Operator Manual shall be used as your main reference, our innovative technologies and services in the areas of diagnostic in particular for relevant safety information like warnings and and therapeutic imaging, laboratory diagnostics and molecular cautions. medicine as well as digital health and enterprise services. Note: Some functions shown in this material are optional and might We’re a leading medical technology company with over 120 years not be part of your system. of experience and 18,500 patents globally. With over 50,000 employees in more than 70 countries, we’ll continue to innovate Certain products, product related claims or functionalities described and shape the future of healthcare. in the material (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. 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. Siemens Healthineers Headquarters Manufacturer Siemens Healthcare GmbH Siemens Medical Solutions USA, Inc. Henkestr. 127 Ultrasound 91052 Erlangen, Germany 22010 S.E. 51st Street Phone: +49 9131 84-0 Issaquah, WA 98029, USA siemens-healthineers.com Phone: 1-888-826-9702 siemens-healthineers.com/ultrasound Published by Siemens Medical Solutions USA, Inc. · HOOD05162003358599 · Effective date 19-Jun-2023 · 13781 0523 online · ©Siemens Medical Solutions USA, Inc., 2023