ARTIS icono (VE21A and higher) syngo TrueFusion

SIEMENS Healthineers syngo TrueFusion syngo Application Software ARTIS VE21 onwards Template Effective Date: 10 Aug 2021| HILS 2223 Effective Date: 10 Jun 2022 | HOOD05162003279040 Unrestricted © Siemens Healthineers, 2022 syngo TrueFusion SIEMENS Healthineers Table of Contents Introduction 3 System Requirements 4 Overview 5 Preparation of the ARTIS System 6 Activation of syngo TrueFusion 7 Connection to Ultrasound System 8 Preparation for registration at the Ultrasound System 9 Registration 10 Quality of Registration 11 Failed Registration 12 Overlay 13 Overlay Options 14 2 Effective Date: 10 Jun 2022 | HOOD05162003279040 Unrestricted © Siemens Healthineers, 2022 syngo TrueFusion SIEMENS Healthineers Introduction With syngo TrueFusion, relevant ultrasound images and anatomical landmarks demonstrated in Transesophageal echocardiogram (TEE) can be marked directly ARTIS pheno 15-25115 on the ACUSON SC2000 PRIME Ultrasound system and sent for fusion with the SIEMENS ARTIS live fluoroscopy image. The Fusion provides a common orientation of the target anatomy and location of pathology to help guide procedures and devices in the treatment of structural heart disease (SHD) procedures. 3 Effective Date: 10 Jun 2022 | HOOD05162003279040 Unrestricted © Siemens Healthineers, 2022 syngo TrueFusion SIEMENS Healthineers System Requirements • ARTIS icono or pheno with VE20 or higher ARTIS pheno • ACUSON SC2000 PRIME Ultrasound system version 5.0 or higher and the Z6Ms Ultrasound probe • The “Image-to-image” overlay feature requires ARTIS VE21 or higher and En DRC 294 WC 17:515 139) SC2000 6.1 or higher 4 Effective Date: 10 Jun 2022 | HOOD05162003279040 Unrestricted © Siemens Healthineers, 2022 syngo TrueFusion SIEMENS Healthineers Overview The fusion of Ultrasound data with the ARTIS live image is achieved via an X-ray image-based registration of the Ultrasound probe on the ARTIS image. TrueFusion requires a combined workflow of the Ultrasound operator and the ARTIS operator. The True Fusion workflow consists of the following workflow steps: Connection to Ultrasound system Registration Overlay The Ultrasound devices are After acquiring two X-ray Overlay of Ultrasound images, shown in a list. You select the fluoroscopy images, an initial landmarks, and/or valve Ultrasound device to connect. registration of the Ultrasound models to the X-ray image image is automatically started. using continuous X-ray-based registrations can be performed. Please note: The overlaid anatomical landmarks are based on the Ultrasound image and/or MPR from the time of the successful registration and independent of later/subsequent Ultrasound probe motion. 5 Effective Date: 10 Jun 2022 | HOOD05162003279040 Unrestricted © Siemens Healthineers, 2022 syngo TrueFusion SIEMENS Healthineers Preparation of the ARTIS System 1. If your system uses a large display, before starting syngo TrueFusion, 2. In the exam room, press the Layout Gallery key on the Pilot check that the current Large Display Layout includes the Ultrasound control module or choose General > Layout Gallery in the Onscreen segment as well as the 3D Sharing segment. menu to open the Layout Gallery. @ Live BD Sharing Display Layouts Scene Directory Reference Directory REF Next Scene Layout #2 3D Sharing Layout Layout #1 Info Right Bottom Info Right K Previous Scene 3D Sharing Layouts - Review Layout Gallery SD Sharing Layouts - Muliple Volume .. Loop all Scenes 3D Sharing Layouts - Compare Care Position 3D Sharing Layouts - 2D Viewing Start / Pause Scene 3D Sharing Volume Presets 3. You use the jog wheel to select the layout. On the exam room display, the possible jog wheel operations and the corresponding functions are shown. SIEMENS, HEALTHINEERS 1:42 O XRAY manually disabled Deselec ps. Bady 2 (2.0 's) < FL(-) Angio (7.5 pis) E 000.1 min 40cm 130cm 10- 2cm 12cm + Navigate Block Radiation Layout Example 4. In the control room, click the Layout Gallery icon in the information area to open Layout Gallery. 6 Effective Date: 10 Jun 2022 | HOOD05162003279040 Unrestricted © Siemens Healthineers, 2022 syngo TrueFusion SIEMENS Healthineers Activation of syngo TrueFusion 1. syngo TrueFusion is activated in the exam room from the Onscreen Please note that it is also possible to activate the TrueFusion workflow menu. from the syngo Application Software in the control room. 2. The Onscreen menu is opened by pressing the key on the Pilot Viewing Review and Proc ... Review volu Application Control 3D Sharing control module. Viewing 3. Navigate within the Onscreen menu by deflecting the jog wheel. Overlay Active Workflows Application 4. Select TrueFusion from the Workflow menu. Follow the workflow Aortic Valve Guidance TrueFusion guidance on the exam room display. Congenital Heart Disease Guidance Review and Processing CTO Guidance Aneurysm Analysis 22.04.1 42:28 2.04.1 442:28 Aortic Valve Guidance 3D Body Nat Fill F TrueFusion Congenital Heart Disease Guidance 3D Sharing VRT 3D Sharing VRT 2 Workflow VA CTO Guidance Review and Processing 51 PM TrueFusion Viewing EP Planning Overlay Embolization Guidance Aneurysm Analysis EVAR Guidance Aortic Valve Guidance myNeedle Guide Congenital Heart Disease Gu ... Spine Guidance CTO Guidance Stenosis Analysis TrueFusion EP Planning 7 Effective Date: 10 Jun 2022 | HOOD05162003279040 Unrestricted © Siemens Healthineers, 2022 syngo TrueFusion SIEMENS Healthineers Connection to Ultrasound System To connect the Ultrasound system to the ARTIS system, ensure that the 3. A window appears on the Ultrasound system with the request to connect to Connect to Ultrasound workflow step is active on the ARTIS and at least the imaging system. Select Accept. one Ultrasound device is configured, connected, and switched-on. TrueFusion Connection Request There is a connection request from system ISKO38 1. If more than one Ultrasound system is configured, deflect the Do you want to accept this connection request ? jog wheel to select the Ultrasound system. The request will be automatically rejected if no selection is made within 30 seconds. SC2000 Accept Reject 157. 163.201.234 localhost 4. When connection is successful, the connection symbol indicates the OO connected Ultrasound device. × 2. Select the Ultrasound system by pressing on the OK button Connection accepted by SC2000 on the jog wheel. 5. The Registration workflow step is automatically selected on the ARTIS 4D application. 8 Effective Date: 10 Jun 2022 | HOOD05162003279040 Unrestricted © Siemens Healthineers, 2022 syngo TrueFusion SIEMENS Healthineers Preparation for Registration at the Ultrasound System 1. Registration of the Ultrasound and X-ray images is done via X-ray images of the Z6Ms Ultrasound probe. RA 2. For a successful probe detection, the internal structures of the probe need to be delineated in X-ray. Particularly, extreme tilts of the probe in the X-ray image like with transgastric views are not supported 1 . 3. The Registration workflow step requires coordination between the Angle = 90º Ultrasound operator and the ARTIS operator. LAO 41 / 0 RAO 49 / 0 Example registration Before starting the procedure, both operators should agree on a time 4. to start the registration workflow step. For registration, two fluoroscopy images a minimum of 30 degrees apart will be required for registration. 90 degrees would be ideal. 5. Select 4D mode on Ultrasound system and switch to Fusion mode. 4D F 1 The Ultrasound probe must be positioned from head to feet with a maximum 9 angle deviation of ±45 degrees. Otherwise,the registration will not be accurate. Effective Date: 10 Jun 2022 | HOOD05162003279040 Unrestricted © Siemens Healthineers, 2022 syngo TrueFusion SIEMENS Healthineers Registration The quality of registration depends on the orientation of the probe, the 2. Position the C-arm for the second position, e.g. for an RAO view. angular difference of the two projections, the zoom stage, overlapping Perform fluoroscopy briefly. with devices. 1. Position the C-arm for the first position, e.g. for an LAO view and RA perform fluoroscopy briefly. RA RA Angle = 90º LAO 41 / 0 RAO 49 / 0 3. The probe model is displayed on the two 2D images in a side-by-side layout (2D + 2D). Angular distance not supported Angle = 0º 4. The registration is automatically performed by detecting the TEE LAO 41 / 0 LAO 41 / 0 probe in the fluoroscopy images. 5. The Overlay workflow step is automatically selected. 10 Effective Date: 10 Jun 2022 | HOOD05162003279040 Unrestricted © Siemens Healthineers, 2022 syngo TrueFusion SIEMENS Healthineers Quality of Registration The Ultrasound transducer must be kept still between first and second fluoroscopy until Red: Bad quality registration registration is complete. • Good quality registration: The TEE probe is green. Green: Good quality registration • Poor quality registration: The TEE probe is red. • When registration is successful, the probe symbol will be indicated in the image in the HAL Overlay workflow step. • The Ultrasound examination cone will be graphically indicated in the X-ray image. RA LAO 42 / CAUD 24 X-ray image registered with Ultrasound image 11 Effective Date: 10 Jun 2022 | HOOD05162003279040 Unrestricted © Siemens Healthineers, 2022 syngo TrueFusion SIEMENS Healthineers Failed Registration In case of failed registration, redo the registration. Ensure through all stages that the Ultrasound probe is steady between X-rays from both angulations. 1. Move the jog wheel to the left to select 2. Move the jog wheel to the right to select Remark: It is also possible to re-select the segment from the first segment, move the C-arm to the second segment, move the C-arm to the Onscreen menu. the first position and perform the second position and perform fluoroscopy. fluoroscopy. General Native A General 3D Sha 3D Sharing VRT 3D Sharing VRT 2 3D Sharing 3D Sharing Review General g VRT 3D Sharing VRT 2 Review RA 3. If the problem with the registration persists, check the Z6Ms Ultrasound probe head is clearly pictured/visible in the field of view without overlapping of other structures and zoom ≤32 cm. Angular distance not supported Angle = 0º 12 Angle = 69º 0 30/0 LA 30 / 0 Effective Date: 10 Jun 2022 | HOOD05162003279040 AO 307 0 RAO 39 7 0 Unrestricted © Siemens Healthineers, 2022 syngo TrueFusion SIEMENS Healthineers Overlay Upon a successful registration, the Overlay workflow step is automatically selected, and user guidance is available on the Acquisition exam room display. Transducer Z6Ms To set and overlay landmarks and valve models, the Ultrasound operator should pay attention to the probe indicator on Exam Preset TEE Cool Down State Off the Ultrasound system. The overlaid landmarks and valve models follow the C -arm and table movement. To overlay markers 1. Freeze the Ultrasound Image immediately after a green probe indicator appears. 2. Identify anatomical landmarks on the frozen Ultrasound image in preparation for overlay. SUSPEND TrueFusion 3. Select Send Landmarks Send Landmarks on the Ultrasound system. The landmarks are getting overlaid on the live fluoroscopy image. 4D F C-Arm On C-Arm To overlay valve models Follow Sync 1. Capture the Ultrasound image immediately after a green probe indicator appears. Image Overlay A B C Select AIT 2. Start eSie Valves on the captured sequence. 3. Create a valve model and sent it to overlay. 12 To overlay images Hide Show 1. Select Image Overlay Image Overlay A B C and select one of the Ultrasound MPRs on the Ultrasound device for Delete Display On A overlay. Send Landmarks 13 Effective Date: 10 Jun 2022 | HOOD05162003279040 Unrestricted © Siemens Healthineers, 2022 syngo TrueFusion SIEMENS Healthineers Overlay Options Please note, that after freeze of the Ultrasound image, you can move the The overlaid landmarks can be shown on both the ARTIS live image and on Ultrasound probe and the C-arm, which may cause the probe symbol to the 3D Sharing Screen. The display of the landmarks on the live image can appear red on the display in the exam room. be toggled on and off. This does not impact the accuracy of the fusion as landmarks. The Live A Overlay () Echo image position potentially incorrect TrueFusion Undock too ber to continue with TrueFusion landmarks and fusion is based on the Ultrasound image at the time of the Live on 30 Define settings for the Overlay visualization Blending KX HL freeze. A R IRP 102 RA RAO 41 / CRAN 2 14 Effective Date: 10 Jun 2022 | HOOD05162003279040 Unrestricted © Siemens Healthineers, 2022 syngo TrueFusion SIEMENS Healthineers Overlay Options • Hiding landmarks can be done from the Ultrasound or the ARTIS • To overlay new markers/landmarks, perform a new registration from system. either the Overlay or Registration step. • To hide overlaid landmarks, select the icon on the Object list or from the Onscreen menu. • If the probe has moved significantly, it is recommended to repeat the Application Control 3D Sharing Registration step with two angulations. Application TrueFusion XE Sensis General 3D Sha ... 3D 3D Wizard Probe could not be detected. Improve detection by centering probe in image, angulating C-arm, increasing zoom. EF Save Bookmark + Save Angulation Bookmark Connect to Ult. Registration Tools Bookmarks Layouts Reset All Orientations Overlay Review Dvna4D Show | Object Color Echo Geometry Hide All Objects WL1 Landmarks Save onlapsTot 1 3D Reconstruction ... 2 V 4 15 Effective Date: 10 Jun 2022 | HOOD05162003279040 Unrestricted © Siemens Healthineers, 2022 Disclaimer SIEMENS Healthineers Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Please note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (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. Copyright © Siemens Healthcare GmbH 2022 Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Telephone: +49 9131 84-0 siemens.com/healthineers 16 Effective Date: 10 Jun 2022 | HOOD05162003279040 Unrestricted © Siemens Healthineers, 2022