syngo. Ultrasound Breast Analysis 3.0 | VA40 Quick Reference Guide

syngo®.Ultrasound Breast Analysis Quick Reference Guide Release 3.0 siemens-healthineers.com/abvs SIEMENS Healthineers .. Introduction 2 syngo®.Ultrasound Breast Analysis (sUSBA) Table of content is a software-only solution for offline review of 3D volume data and 2D images from the Set-up and Configuration 3 ACUSON S2000™ Automated Breast Volume sUSBA Work Area 6 Scanner (ABVS) ultrasound system. The software Patient Browser Functions 8 is optimized for breast ultrasound workflow, 3D Hanging Protocols 16 making 2D review and manipulation of 3D ABVS Hanging Protocols Prior Comparison 24 data more efficient than ever. It provides image General Hanging Protocols 28 analysis and reporting with comprehensive tools Study Display Tools 32 for data review – all in one place. The report Image Manipulation Tools 40 supports the American College of Radiology Orientation and Image Reset Tools 48 BI-RADS® ultrasound lexicon classifications. Slice Thickness and IP Settings 52 Marking Tools 54 Report and Finalization 64 Keyboard Shortcuts 70 Note: Images used in this guide are for educational purposes only. They have been modified or compressed, and may not reflect the actual image quality of the system. Set-up and Configuration 3 Starting sUSBA 1. Double-click the program icon V 3 - X on the desktop to start sUSBA. 2. Enter the following information into the data entry field: • User-name – admin • Password – 3dus 3. Select the Wrench icon to enter the Settings menu. X 3 Set-up & Configuration Set-up and Configuration 4 Setting-up a New User 1. Select the Users tab. Preferences and Settings 1 X 2. Select New User to create a profile. Personal Preferences System Settings| Server Network DICOM Network Users User Name Authentication Method Rights Last Name First Name Title 3. Enter the user information: 3 admin Password Admin Administrator syngo.Ultrasound Breast Analysis susbaservice Password Admin Service SUSBA doc1 Password User-name – admin Reporting physician application doc 1 • Jackie Password Admin admin Jackie Cyndi Password Admin User Cyndi • First name / last name /title User Account Password X 4. Select Set Password or double-click 4 Doctor: Doctor, Doctor the password box to select use your Enter password: ... windows password from the drop Confirm password: .... Save Cancel down menu. 2 New User Delete User Set Password 5. Press Save. 5 Save Revert Cancel Preferences and Settings X Personal Preferences System Settings |Server Network | DICOM Network Users User Name Authentication Method Rights Last Name First Name Title admin Password Admin Administrator syngo.Ultrasound Breast Analysis susbaservice Password Admin Service SUSBA 4 doct Password Reporting physician application doc1 Jackie Password Admin admin Jackie Cyndi Password Admin User Cyndi User Assigning rights 5 3 1. Select user type under Rights tab using the Preferences and Settings x drop-down menu. Personal Preferences System Settings Server Network DICOM Network Users 2. Press Save Use User Name Authentication Method Rights Last Name First Name Title admin Password Admin Administrator syngo.Ultrasound Breast Analysis . susbaservice Password Admin Service SUSBA 3. Select the logout icon doc 1 Password Reporting physicia Doctor Dr. Admin in the upper right hand Reporting physician Reviewer 1 corner of the screen to exit. 4. Creates a backup of user preferences and settings. Auto log-off can now be New User Delete User Set Password configured under Preference io 4 Save Revert Cancel and Settings then Personal 2 Preferences. Set-up & Configuration sUSBA Work Area 6 14 15 1 ineen > Dr. Doctor Work List doct ABVS. 012015 DOB F 1 012016 2 - X 3 SERIES & IMAGES 9 7 HE Current 30 US Study $2000 ABVS, 012015 $2000 ABYS, 012016 Coronal 113/411 1.0 mm 13 012016 US 012016 HH Right Breast DOB Sex F Transverse 191/318 1.0 mm DOB Sex F 0 82 6/22/2016 10:37 AM [0.82 6/22/2016 10:37 AM RAP R LAT R MED 4 R SUP Hi Led Breast LAP LLAT L MED L SUP Previous Reports Report Capture 10/4/2016. 12:22 PM OT Prior 30 US Studies 4/29/2013 US RAP R LAT 40 mm R MED LAP L LAT L MED RAP Sam 12.0 mm 10 Nipple: 27.5 mm 6 8 11 12 $2000 ABVS. 012016 US 012015 Sapittal 311 /697 1.0 mm DOB Sex F 0.75 6/22/2016 10:37 AM 3D US C/P General RESULTS F1: Finding BI-RADSO 0 All markings (0) All snapshots (0) 16 40 mm V O 11 5 RAP 12.0 mm 1100 mm RAP Nipple: 27.5 mm 120m 11h 1. Patient Browser 10. Lower-left corner menu provides tools to 7 2. Patient and study information adjust the display of 3D ultrasound images 3. Study Navigator 11. Breast body marker (pictogram) indicates position of the current slice relative to the 4. Reference Lines anatomy 5. Common Tools (Snapshot, Hide/Show 12. Nipple marker Overlays, Open Report) 13. Image information (including the name of the 6. Vertical scroll bar with slider to step through system used to acquire the image), view, slice the view in the indicated direction: Head to number, total slices, depth and magnification foot, right to left, or anterior to posterior of the image relative to the size of the image 7. Upper-right corner menu provides tools to acquisition mark findings, perform measurements, and 14. User Manual insert annotations 15. Preference Tab 8. Lower-right corner menu provides tools to remove changes to the image 16. Complete study / Defer 9. Upper-left corner menu provides tools to manipulate images sUSBA Work Area Patient Browser Functions 8 The patient browser displays Select the Binocular icon to the Worklist. When a patient open the Patient Browser: study is sent to the system, the available functions will appear in the menu: SIEMENS Heolthineers syngo.Ultrasound Breast Analysis Administrator Work Lists • Open Study • Query / Retrieve Patent Browser × Import Search Status Name Patient O Study Date Content Last Read By Modalties • At_COMPARE_A2 Anonymous 5/30/2019 2:57:06 PM Run Seaich 2 studies doct OT, US ABVS, 012016 012016 6/22/2016 10:21:50 AM 2 studies doct OT, US Workspace De Cup Breast, Comparison 11/30/2019 7:39:00 AM Z studies cyr US Demo Caso . Bosus D400-4 717/2016 9:52:24 AM WIR, US • Export Use this search as the default Demo Case - Current Prior 00001 6/22/2016 10:21:50 AM 2 studies Sae US Char Demo Case - Multi Modality doct 00002 1/19/2018 10:45:00 AM 3 studies doct CT, MG, US Search Parameters Demo Case - Tools 00003 9/28/2016 11:49:00 AM ADVS US • Prepare . MoVis_RUNUIC_808242 MeVis_RUNMC__. 7714/2015 3:21:20 PM 2 modica doct MG, US Local only > Training02Multiple Cysts Training02 9/28/2016 11:45:00 AM ABVS cyn OT M. Include local patients is search . TrainingOSIDC_12 Training05 9/28/2016 11:49:00 AM ABVS US Name . Training06IDC_12 Training06 9/28/2016 11:50:00 AM ABVS doc1 US OT • Reopen Patient D . Training07 Scar_FA_12 Training07 9/28/2016 11:53:00 AM ADVS Date of bich: Training 15tedu laryCA_12 Training 15 9/28/2016 11:58:00 AM ALMVS US Training 16Phyllodes_12 Training 16 5/28/2016 12:00:00 PM ABVS doct OT Training :308 Training308_ID 1/1/2000 2:50:00 PM Breast US Study date Training 309 Training309_10 1/1/2000 2:43:00 PM Breast US • Delete . Training 313 Training313_ID 1/1/2000 4:33:00 PM Breast US Accession No.º › Training 320 Training320_ID 1/1/2000 11:02:00 AM Breast doct US Refering physician: Training 321 Training321_ID 1/1/2000 4:53:00 PM Breast US Modalties IMG I MR M CT . US Impot Expert Prepare Reopen DICOM Retrieve Open Open a Patient Study 9 1. To open a study, first select Patient Browser X the patient name. Search Status Name Date of Birth Patient ID Study Date Accession Number Run Search + @ › Training 16Phyllodes_12 Training16 9/28/2016 12:00:00 PM 2. Select Open or double-click › Training 15MedullaryCA_12 Training15 9/28/2016 11:58:00 AM Workspace › Training07 Scar_FA_12 Training07 9/28/2016 11:53:00 AM on the patient name. Use this search as the default › Training06IDC_12 Training06 9/28/2016 11:50:00 AM Training05 9/28/2016 11:49:00 AM Clear Training05IDC_12 Delete Save .. If the study is completed, 1 Training02Multiple Cysts Training02 9/28/2016 11:45:00 AM • Search Parameters + ABVS, 012016 012016 6/22/2016 10:21:50 AM MeVis_RUNMC_008292 1/1/1971 MeVis_RUNMC_ ... 7/14/2015 3:21:20 PM double-clicking on the Local only Include local patients in search study will open it for Name Patient ID: review only. Date of birth: Study date: 3. To edit a study you completed, click patient Accession No.: Referring physician: name and reopen. If study Modalities: MG MR CT US has been completed by 3 2 another, you may open a Import ... Export ... Prepare Reopen Delete DICOM Retrieve Open copy and review, or select Prepare which will remove all previous findings. Tip The study will open in the Single Slice layout (default setting) unless a different Hanging is set in the Preference menu (F3). Patient Browser Functions Patient Browser Functions 10 Query /Retrieve 1. To retrieve a study on a DICOM node, Patient Browser X locate the search tool in the patient 1 Search Status Name Date of Birth Patient ID Study Date Accession Number browser. Run Search 4 7 › Training16Phyllodes_12 Training16 9/28/2016 12:00:00 PM › Training15MedullaryCA_12 Training15 9/28/2016 11:58:00 AM Workspace Training07 Scar_FA_12 Training07 9/28/2016 11:53:00 AM Training06IDC_12 Training06 9/28/2016 11:50:00 AM 2. Select the source from the drop- Use this search as the default Training0SIDC_12 Training05 9/28/2016 11:49:00 AM Clear Delete Save. Training02Multiple Cysts Training02 9/28/2016 11:45:00 AM down menu from the Search 2 Search Parameters ABVS, 012016 012016 6/22/2016 10:21:50 AM Local only 6 MeVis_RUNMC_008292 1/1/1971 MeVis_RUNMC_ ... 7/14/2015 3:21:20 PM Parameters area. Include local patients in search Name Patient ID • The default is Local only 3 Date of birth: . 3. Enter the patient name / ID or Study date: accession number. Accession No.: Referring physician: Modalities: MG MR CT US 4. Select Run Search . 5 5. Select the studies and select DICOM Import Export Prepare Reopen Delete DICOM Retrieve Open retrieve . 6. Delete the information in the Search window and reselect Local Only on the drop-down menu. 7. Select Run Search again and patient study will be listed in the browser. Import Studies 11 To import a study from a disk or a drive: 1. Select the patient name. 2. Select Import. 3. Select the data source. 4. Select Import. Patient Browser X Import x Search Status Name Date of Birth Patient ID Study Date Accession Number Run Search › Training 16Phyllodes_12 Training16 9/28/2016 12:00:00 PM Training15MedullaryCA_12 Training15 9/28/2016 11:58:00 AM Look in : F:\ABVS_Cases\ABVS D ... S For Field DEC2_016 Workspace › Training07Scar_FA_12 Training07 9/28/2016 11:53:00 AM Training06IDC_12 Training06 9/28/2016 11:50:00 AM My Computer Name Size Type Date Modified Use this search as the default › Training0SIDC_12 Training05 9/28/2016 11:49:00 AM 02Multiple Cysts_12 Fil ... der 5/15/2 ... :41 AM Clear Delete Save 1 SUSBA Training02Multiple Cysts Training02 9/28/2016 11:45:00 AM 05IDC_12 Fil ... der 5/15/2 ... :42 AM Search Parameters ABVS, 012016 012016 6/22/2016 10:21:50 AM 06IDC_12 3 Fil ... der 5/15/2 ... :42 AM MeVis_RUNMC_008292 1/1/1971 MeVis_RUNMC_ ... 7/14/2015 3:21:20 PM Local only 07Scar FA_12 Fil ... der 5/15/2 ... :42 AM 15MedullaryCA_12 Fil ... der 5/15/2 ... :43 AM M Include local patients in search 16Phyllodes_12 Fil ... der 5/15/2 ... :43 AM Name 012016 Fil ... der 5/15/2 ... :41 AM Patient ID MM-Studies Fil ... der 5/15/2 ... :43 AM Date of birth: Study date Accession No.: Referring physician: Modalities: MG MR CT US Files of type: DICOM Images ( *. dem) 4 2 mport ... Export .. Prepare Reopen Delete DICOM Retrieve Open Import Cancel Patient Browser Functions Patient Browser Functions 12 Export Studies To export a study to a DICOM node, drive, or Patient Browser × CD/DVD: Search Status Name Date of Birth Patient ID Study Date Accession Number Rus Search > Traising 15Phyllodes_12 Training15 5/25/2015 12:00:00 PM Traising 15MedullaryCA_12 Training15 5/28/2015 11:58:00 AM Workspace Training07 Scar_FA_12 Training07 9/28/2016 11:53:00 AM 1. Select the patient name. Use this search as the defaut Training06IDC_12 Training06 5/28/2016 11:50:00 AM Training05IDC_12 Training05 5/28/2016 11:49:00 AM Dalet w Training02Multiple Cysts Trainingo2 3/28/2015 11:45:00 AM 1 Search Parameters ABVS, 012015 012016 6/22/2016 10:21:50 AM MeVis RUNMC_008292 1/1/1971 MoVis RUNIC 7/14/2015 3:21:20 PM 2. Select Export. Local only I Include local patients in search atiert D. 3. Select the destination from the Export Menu. Date of birth: Study date 4. Select Export. Accession No.: Referring physician: Modalties IMG " MR M CT . US 2 Import .... Export Prepare Delate DICON Retreve Open Tip Users can export patient studies or the findings Export X and report to inserted media such as a CD/DVD, Type of Export 3 network drive or USB. Export to DICOM node Export to file system C:/Users/sUSBA . Export to CD/DVD Export entire study Mark study as archived . Only export findings and report Save report as PDF Export Cancel 4 Process Studies 13 To process a study: Patient Browser X Status Search D&w of Bith Status Details Study Dee Accession Number 1. Select the patient name. Ran Search Training16Phyllodos_12 Training 16 Local'Now 9/28/2016 12:00:00 PM Training15MedollaryCA_12 Training 15 Local'New 3/28/2096 11:50:00 AM Workspace Training07 Scar_FA_12 Training07 Local Now 9/22/2016:11:53:00 AM Use this search as the default TrainingOGIDC_12 Training06 Local'New 9/28/2016 11:50:00 AM Trainingos Local Doforsed 9/28/2016 11:49:00 AM 1 Delete 2. Select Prepare Training021Julfiole Cysts Training02 Local'Deferred 9/28/2016 11:45:00 AM Search Paraeseters ABVS, 012016 Local'Deferred 6/22/2016 10:21:50 AM . MeVis_RUNUC_008292 MeVia_RUNNIC_ ... Local'Defened 7/14/2015 3:21:20 PM Local only If Include local pabonts in search 3. The Status column and icon Name: Paient ID Date of birá indicate the progress of the operation. Accession No Referring physician: Modalcies I MG MUR ICT BUS 2 Note: When a sUSBA user is deleted in the import .. Export Prepare Respen Delate DICOM Retnore Opon system, all studies assigned to that user are automatically reprocessed. Patient Browser 3 x Search DAt & Bith Status Details Study Dele Accession Number Ran Seaich Training16Phyllodos_12 Training 16 Local'Now 928/2016 12:00:00 PM Training1%MedulleryCA_12 Training 15 Local'New 328/2016 11:50:00 AM Workspace Training07 Scar_FA_12 Training07 Local Now 9/28/2016 11:53:00 AM Use this search as the delauil TrainingOCIDC_12 Trainingos Lucal'New 3/28/2016 11:50:00 AM Delete Save TrainingOSIDC_12 Trainingos Local Now 9/28/2016 11:49:00 AM Training02tlultiple Cysts Training02 Local'Deferred 9/28/2016 11:45:00 AM Search Paraeseters ABVS, 012016 012015 Local'Deferred 6/22/2096 10:21:50 AM MeVas_RUNUC 008232 MeVis_RUNTIC_ ... Local'Defened 7/14/2015 3:21:20 PM Local only I Include local pobonts in search Tip Preparing a study will remove all markings and Nave Patient D edits and then display a “ +” in the status field Date of birà indicating it is ready for review tudy date: Accession No Referring physician: Modalcios I MG MUR ICT BUS import. Export keepen Delete DICOM Rethor Open Patient Browser Functions Patient Browser Functions 14 Study Navigator 1. Laterality Hanging (Right Breast) SERIES & MAGES 1 2. Laterality Hanging 2 (Left Breast) L MCD LOUP 3. Hanging Protocol 4. Results area – lists Findings, Markings, and Snapshots 3 CP 4 RESULTS 15 Patient Browser Functions 3D Hanging Protocols 16 Hangings “Hangings” are similar to the layout of film displayed on a light box. Each hanging combines 1 3D US and synchronizes segments for easy review. 2 C/P 1. Hangings for 3D images 3 General 2. Hangings for Current / Prior Comparison 3. Hangings for 2D images Tip Only if a patient had a prior study, will there be a third row of hanging protocols. Use the second row hanging to compare prior studies. Prior studies will be labeled in red. Laterality Hangings 17 1. The laterality hanging is labeled SERIES & IMAGES either Right Breast or Left Breast. Current 3D US Study 2. When selected, transverse is Right Breast RAP displayed on the top row. R LAT 1 R MED 3. Coronal views are displayed on the HE Left Breast bottom row as LAT, AP and MED LAP acquisitions. L LAT L MED 2 Tip If any of the above views were not acquired, the system displays only the views that were completed. -..... 3 3D Hanging Protocols 3D Hanging Protocols 18 MultiSlice 1 1. The MultiSlice hanging displays adjacent slices of the selected view. 3D US General SA MAGES Tip This view is helpful when comparing lesions found at different depths. 1 Coronal Side-by-Side 19 1 1. The Coronal Side-by-Side hanging icon 3D US 2. Left breast displayed in the coronal General pane of the selected view 3. Right breast displayed in the coronal pane of the selected view 3 2 Tip All tools are applied to both segments. This view is helpful when assessing symmetry. 1 3D Hanging Protocols 3D Hanging Protocols 20 Single Slice 1 V 1. Single Slice hanging icon 3D US 2. Large Coronal plane image General 3. Smaller Transverse plane image 4. Smaller Sagittal image plane TERESA M 2 3 1 4 US Wide 21 1. US Wide hanging icon 1 2. Large transverse plane image 3D US 3. Small Coronal plane image General 4. Small Sagittal plane image 2 4 1 3 3D Hanging Protocols 3D Hanging Protocols 22 Study Overview 1. Displays the coronal plane in all views SERIES & IMAGES Current 3D US Study 1 EB Right Breast RAP R LAT R MED O R SUP HE Left Breast LAP L LAT L MED O L SUP SERIES& MAGES 1 ....... 23 3D Hanging Protocols Hanging Protocols Prior Comparison 24 Prior Comparison Coronal Side-by-Side 1. Coronal plane hanging icon 3D US 2. Current study C/P 1 3. Most recent prior study, labeled with Prior in red text General ISA MAGES 3 2 Tip You can adjust the display of prior studies under the wrench icon (F3). 1 ... 3 Prior 1 3 Prior Comparison Transverse Side-by-Side 25 1. Transverse plane hanging icon 3D US 2. Displays the transverse plane of the selected view for the most recent C/P 1 prior study (Prior will appear in red text) General 3. Displays the transverse plane of the 2 selected view for the current study 3 3 1 Prior 1 3 Hanging Protocols Prior Comparison Hanging Protocols Prior Comparison 26 Prior Comparison Vertical Side-by-Side 1. Displays the transverse, coronal and sagittal plane of the selected view 3D US for the current study adjacent to C/P 1 the transverse, coronal and sagittal planes of the selected view for the General most recent prior study. Prior study is displayed in red text. SERIES& MAGE 1 Prior 1 1 Prior Comparison Horizontal Side-by-Side 27 1. Displays the the transverse, coronal and sagittal plane. The prior study 3D US will be labeled with Prior in red text. C/P 1 General ----- 1 Prior 1 1 Hanging Protocols Prior Comparison General Hanging Protocols 28 General Comparison Hangings General comparison hangings are used to compare 3D US, 2D US, Mammogram (2D and 3D US 3D), CT and MRI images, Secondary Captures, and General re-imported sUSBA finding images and reports. 1. 1 x 2 displays two large adjacent segments 1 2 3 2. 2 x 2 displays four quadrant segments 3. 2 x 3 displays six segments in a layout of 2 rows and 3 columns General Comparison Hangings 1 x 2 Display 29 1. 1 x 2 displays two large adjacent segments 3D US General 1 SERES& MAGES 145 1 General Hanging Protocols General Hanging Protocols 30 General Comparison Hangings 2 x 2 Display 1. 2 x 2 displays four quadrant segments 3D US General 1 SERES& MAGES 1 General Comparison Hangings 2 x 3 Display 31 1. 2 x 3 displays six segments in a layout of 2 rows and 3 columns 3D US General 1 1 Set-up & Configuration Study Display Tools 32 Tools include: RESULTS + 1. Sync Scrolling On / Off No Findings All markings (0) 2. Show/Hide DICOM Text All snapshots (0) 3. Show/Hide Markings 4. Show/Hide Orientation and tool overlays 5. Snapshot 1 2 4 5 3 Show/Hide Orientation and Tool Overlays 33 The Show / Hide Orientation and Tool Overlay manages which tool indicators are shown on the screen. When selected, the breast body markers, reference lines, Show ruler, scrolling tool and orientation indicators will not be visible. Hide O Study Display Tools Study Display Tools 34 Show /Hide DICOM Text The Show / Hide DICOM Text option controls the display of patient information. When selected, the date of the study, patient name and image Show XYZ identification number are not visible. (When DICOM Text is hidden, the Breast pictogram with the View name and associated data remains visible.) Hide RAP Skin: 11.5 mm Nipple: 27.0 mm 11 h Show/Hide Markings 35 The Show / Hide Marking option controls the display of the nipple marker, annotations, arrows, location and / or measurement markings. When selected, Show these markings will not be shown. Tip This may be useful when creating snapshots of lesions. Hide Study Display Tools Study Display Tools 36 Sync Scrolling On /Off The Sync Scrolling On / Off option controls the scrolling of the segment. When sync is on, the coronal side-by-side On hangings will scroll together. When turned off, segments will scroll independently. Off Snapshot 37 Snapshots are secondary captures of a displayed O L LAT image, for example, a single slice of a view or L MED 2D image. 1. Snapshots are included in the current finding and saved with the study. 2. If a finding does not exist, the program creates 3D US 1 a folder named Other Images C/P . General 3. To create a snapshot of a segment, select RESULTS the Snapshot icon and left-click the desired No Findings segment. Snapshot of a segment may also be 2 All markings (0) All snapshots (0) Open Full Screen B accessed on the right-mouse click when in a Invert F10 Snapshot of Segment .. S segment. ER Snapshot of Hanging. Alt+S Create Clip. Save As Image .... 4. To create a snapshot of the entire work area, right-click in the segment then select snapshot of hanging from the shortcut (context) menu or press ALT + S 3 1 Alt + S . Study Display Tools Study Display Tools 38 Breast Body Markers Body Markers are graphic displays providing orientation information about the reference point in the displayed 3D ultrasound slice and the breast laterality. Additional data displayed below the body Coronal Sagittal marker includes: 1. Distance of the reference point from the skin line 2. Distance of the reference point from RAP Skin: 12.0 mm the nipple Transverse Nipple: 27.5 mm 11 h 3. Clock position of the displayed reference point in relation to the marked nipple Tip The view name and Breast graphic remain visible when hiding the DICOM Text overlay. 39 Study Display Tools Image Manipulation Tools 40 Display Tools Image manipulation tools, located in HEMENS Healthineers Dr. Doctor the upper left corner of each segment, Work Lists doc1 Training05IDC_12 DOB F | Training05 6 change the appearance of displayed SERIES & IMAGES images and optimize anatomy of interest. Current 3D US Study S2000 US Right Breast Coronal 109 / 463 1:0 mm These include: 0.81 O RAP R LAT Reference Point R MED • HE Left Breast • Window/ Level LAP L LAT • Invert L MED • Zoom / Pan SIEMENS Healthineers Dr. Doctor Work Lists doc1 Training05IDC_12 DOB F | Training05 • Magnifier 9 1 SERIES & IMAGES Reference Point R • Scrolling Current 3D US Study Window/Level W EH Right Breast 63 1:0 mm Invert F10 RAP R LAT Zoom/Pan Z R MED Magnifier M EH Left Breast LAP Scrolling L LAT L MED Combined Reference Point/Rotation Tool 41 The Reference Point tool Reference Point R deactivates the currently selected tool Window/Level W and reactivates the reference point Inver F10 (crosshair). Reference point tool has Zoom/Pan Rotate tool Z 3 functions embedded. Magnifier M • Reference Point – left-click mouse in Scrolling any segment to align all segments. • Scroll – depress middle mouse button or scroll wheel depending on your mouse. • Rotation – right-click along the periphery of any reference line to manually reposition it. All planes will rotate together. == Tip The keyboard shortcut for this frequently used tool is “R”. Image Manip- ulation Tools Image Manipulation Tools 42 Window / Level The Window / Level tool adjusts Reference Point R the image contrast and brightness. Window/Level W To adjust the contrast, left-click Invert F10 • in the image and drag the mouse Zoom/Pan Z side-to-side. Magnifier M To adjust brightness, left-click in the Scrolling • image and drag the mouse up and down. • Right-click and hold on the mouse within a segment also allows you to window / level. Tip The keyboard shortcut for this frequently used tool is “ W”. Invert 43 The Invert tool reverses the Reference Point R black and white settings in an image. Window/Level W Invert can also be accessed via a Inver F10 right-click within a segment from the Zoom/Pan Z pop-up context menu. Magnifier M Scrolling Tip The keyboard shortcut for this frequently used tool is “F10”. Image Manip- ulation Tools Image Manipulation Tools 44 Zoom/Pan The Zoom / Pan is a multifunction Reference Point R tool which adjusts the size and position Window/Level W of the displayed image. Invert F10 • To Zoom, left-click the Zoom / Pan icon. Zoom/Pan Z Keeping the icon in the periphery of the Magnifier M segment, move mouse up and down to Scrolling zoom in and out. • To Pan, move the cursor to the center of the image, left-click and hold down on the desired plane and move the mouse. - .... Tip The keyboard shortcut for this frequently used tool is “Z”. Magnifier 45 The Magnifier tool enlarges Reference Point R (magnifies) a specific region within the Window/Level W image. Left-click and drag mouse on Inver F10 the segment. Zoom/Pan Z Magnifier M Scrolling Tip The keyboard shortcut for this frequently used tool is “ M”. ..... Image Manip- ulation Tools Image Manipulation Tools 46 Scrolling The Scrolling tool steps through Reference Point R slices of an image. Left-click and drag Window/Level W the mouse up or down in the desired Invert F10 segment. Zoom/Pan Z Magnifier M Scrolling Tip The keyboard shortcut for this frequently used tool is “I”. 47 Image Manip- ulation Tools Orientation and Image Reset Tools 48 The Orientation and Image Reset tools are located in the lower right corner of the segment. 32000 ABVS. 012016 52000 ADYS, 012016 Transverse 100/310 1.0 mm 012016 US 012016 DOD S4x F Transverse 100/310 1.0 mm DOU Sex F 6/22/2016 10:37 AM 0 82 6/22/2015 10:37 AM R R 40 mm 40 mm RAP RAP 7.0 mm 7.0 mm Orientation Nipple: 23.5 mm Nipple: 23.5 mm 11h tth Home - Orientation Home A Orientation Tools 49 The Orientation tool changes the Coronal 3 displayed orientation of the selected view. This may be used when comparing Sagittal 2 views on the general comparison Transverse hanging. Orientation Home A b 82000 ABV8, 012016 US 012016 Transverse 188/318 1.0 mm DOB Sex F 0.82 6/22/20 16 10:37 AM R 40 mm Coronal 3 Sagittal 2 RAP Transverse 7,0 mm Nipple: 23.5 mm Orientation Home A & Orientation & Image Reset Tools Orientation and Image Reset Tools 50 Image Reset Tools The Image Reset tools remove changes Nipple Marker 5 made to the image, including: Rotation 6 • Nipple marker location Window/Level 7 .0 • Rotation Zoom/Pan 8 • Window/ Level All A ৳ • Zoom / Pan 52000 ABYS, 012016 US 012016 • All Transverse 188/318 1.0 mm DOB Sex F 0 82 6/22/2015 10:37 AM Tip The keyboard shortcut for this frequently R used tool is “A”. Nipple Marker 5 Rotation 6 Window/Level 7 RAP Zoom/Pan 8 Sur 7.0 mm Nipple: 23.5 mm AI A 11 . Home A A 51 Orientation & Image Reset Tools Slice Thickness and IP Settings 52 The Slice Thickness option (lower left Max IP corner of each segment) allows the user Mean IP to select the thickness of the slices Slice Settings ... displayed (0.5 mm–8 mm), as well as the slice overlap (None, 25%, 50%, or 75%). • Max IP limits the display to maximum- value pixels by selecting pixels Slice Settings × with the highest value along each Slice Settings projection of the volume. Slice overlap: None Slice thickness: L 111111111 1.0 mm • Mean IP limits the display to average- value pixels by selecting pixels with Save Cancel the arithmetic mean value along each 4 projection of the volume. 53 Slice Thickness & IP Settings Marking Tools 54 Marking tools are found in the upper right Location Marker L corner of each segment. Measurement D Use Marking tools to: Text Marking X • Mark locations Arrow Marker C • Perform measurements • Add annotations (text) Training02Multiple Cysts Training02 DOB Sex O • Insert arrows 10/4/2011 3:15 PM 10008. 0090y Training Location Marker 55 Location Marker L 1 Measurement D The Location Marker records an area Text Marking X \ of interest on a current 3D ultrasound image Arrow Marker C and is displayed on all three orthogonal views (coronal, sagittal and transverse). Create Location Marker X To Mark a location: Add to finding: 2 Create new finding. Finding name: Finding Select the Location Marker tool and Finding comment: 1. click on the desired area. Interpreting Physician's Comment: 2. Modify the information in the dialogue box: • Finding Name • BI-RADS® Category • Finding Comments • Interpreting Physician’s Comments 3. Select Create for a new finding. Select Save when editing a finding. Tip If the finding folder doesn’t pop up, right- click on the finding then left-click edit. 3 Create Cancel Marking Tools Marking Tools 56 Measurement Marker 1. Press the shortcut key “D“ on the keyboard or 5. Right-click on the measurement to delete left-click the Measurement icon in the a single measurement or to delete all upper right hand corner of the segment. measurements. 2. Drag the pointer to the area of measurement. 6. Measurement results can be found in the 3. Left-click to place the first point, drag the Results area listed in the Study Navigator. pointer to the 2nd point and left-click to lock 7. To finalize a measurement, start another the measurement. measurement or double-click on the existing 4. If a Finding Folder exists, a dialog box will measurement turning it from yellow to white. pop-up for you to choose: 8. Finalized measurements are displayed in Add the measurement to the existing white. a. Finding Folder. b. Create a new Finding Folder. c. Create a measurement without assigning it to any Finding Folder. Tip Left-click on a completed measurement to reactivate the measurement. Location Marker 57 Measurement D 1 Text Marking X 3 Arrow Marker C Edit Location Marker x SERIES & IMAGES 4 Add to finding CYST 1 #1 RAP Finding name: CYST 1 RMED Finding comment Interpreting Physician's Comment: RAP RMD 6 Saw Cancel Marking Tools Marking Tools 58 Text Annotation Marker 1. Select the Text Annotation Marker 4. Right-click on the annotation to delete the from the upper right corner menu or press selected text or all markings. the shortcut “X”. 5. Create or assign a finding. 2. Left-click to create the annotation. 3. Left-click, press Return or Enter to set the marking: a. Press Shift+Enter for a line break. b. Double-click on the marking to edit the text. Tip Make sure the marking creation dialog box is disabled. Location Marker L Q 59 SERIES & IMAGES Measurement D Transverse 181/348 18 mm Don Ser F Text Marking X 1 LLAY Arrow Marker C LIVED H.AP 2 ELAT CP General RESULTS to RAP Marking Tools Marking Tools 60 Arrow Marker 1. Select the Arrow Marker from the upper right corner menu or press the shortcut “ C“. 2. Left-click the desired location and place the arrow. 3. Resize or adjust the orientation of the arrow by left-clicking on the end of the arrow. 4. Create or assign a finding (you may also left-click and hold on the arrow to drag it to a new location). Location Marker L 61 SERIES & IMAGES Measurement D Trapaarse 184/348-1 8 mm Don Ser F A LAS Text Marking X LLAY Arrow Marker C 1 LIVED 2 General RESULTS UNSE Al makcapi di V RAP Marking Tools Marking Tools 62 Reviewing Images in a Study 1. Left-click the hanging icon option of choice 4. Left-click in an area in any segment to align an to view the images to be read. area of interest within the transverse, coronal, a. Use the mouse wheel to scroll through or sagittal datasets. the slices. 5. Left-click to turn sync off and then left-click b. Use the mouse pointer for moving the on the area of interest in each volume. Reference Point. 6. Turn Sync back on and scroll volumes c. All segments of a 3D hanging are together. automatically synchronized. 7. To compare the 3D Ultrasound images to 2. To view multiple 3D images of one breast 2D Ultrasound images or images of other side-by-side, select the Lateral Hanging modalities, left-click on the General selection of this breast. (Click on “Right Breast” or icon on the bottom row of the navigation “Left Breast” in the Study Navigator.) menu. 3. The slice thickness can be preset and saved 8. Select images to compare from the Series in Preferences (F3) to any size from 0.5 mm Menu on the left and drag and drop them to 8.0 mm. (The most common is 1.0 mm.) into the space. 63 Marking Tools Report and Finalization 64 Review the Report The Report contains the following information: TrainingOGIDC_12. Training06. 8292017 Training06IDC_12, Training06, Ultrasound Report: Training06IDC_12 Signature • Patient’s Name and Study Information Report Summary Identification Information Training06IDC_12 Patient Interpreting Physician Doctor Name Trainingde BI-RADSO Categories Patient ID Left Breast: Appendix of Images • Finding Information and Birth Date Highly suggestive of malignancy (BI-RADS® 5) Finding #1 - Highly suggestive of malignancy (BI-RADS® Study ABVS 9282016 Right Breast 5) Location Body Marker Study Date Negative (BI-RADS® 1) Referring Physician LLAT • Measurements Interpreting Physician's Comment • Snapshots Comments Findings in this Study • Finding #1 : Highly suggestive of malignancy (BI-RADS" 5) View name : LLAT Position: 02 o'clock • BI-RADS® Information Distance to skin: 15.0 mm Distance from nipple: 90.0 mm • Physician Name and Signature Measurements: . Length (LLAT/mediallateral): 4.5 mm . Length (LLAT/superion/inferior): 5.5 mm . Length (LLAT/anterior/posterior): 6.5 mm Page 1 of 5 Created with sUSBA 2.0 (217025) Page 2 of 5 Created with sUSBA 2.0 (217025) 1. Left-click Report icon 65 or Alt+R to view the report. 3D US Findings in this Study Finding #1 : Incomplete (BI-RADS® 0) 2. Information cannot be edited C/P View name: RAP Position: 11 o'clock on the report. Distance to skin: 12.0 mm General Distance from nipple: 26.5 mm a. Editing can only be done in RESULTS 3 the Finding Folder or on + the image. F1: Finding BI-RADS® 0 (Right) 2 ] RAP Location Marker 3. The Report will demonstrate RAP 18.5 mm (mediolateral) RAP 16.0 mm (anteroposte. pathology as well as: xyz RAP Follow RAP Arrow Marker a. Position All markings (5) All snapshots (0) b. Distance from the nipple c. Distance from the skin d. Snapshot of the area of interest e. Measurements if done O 4. To print the report, left-click the 1 4 Print button at the top of the report. Report & Finalization Report and Finalization 66 Review the Report Reporting options are now: Tip If the system is set to auto- Tip Once a study is completed, No Reporting transfer to PACS, the report it may be opened again as a • is automatically sent with “Read-only” file unless Reopen • Basic Reporting the created snapshots after is selected on the Patient completing the study. Browser. • BI-RADS® Reporting a. This allows the same user that completed it to reopen Patient Browser × the study with complete Search Status Name Patient ID Study Date Content Last Read By Modalities review capabilities. A1_COMPARE_A2 Anonymous 5/30/2019 2:57:06 PM 2 studies doct OT, US Run Search ABVS, 012016 012016 6/22/2016 10:21:50 AM 2 studies doct OT, US b. Or left-click the patient name Workspace D. Cup Breast, Comparison 2019 11/30/2019 7:39:00 AM 2 studies doct US w Use this search as the default Demo Case - Bonus DO004 7/7/2016 9:52:24 AM 2 studies MR. US Demo Case . Current Prior DO001 6/22/2016 10:21:50 AM 2 studies doct US and then select Prepare to Clear Delete Saw .. Demo Case - Multi Modality DO002 1/19/2018 10:45:00 AM 3 studies doct CT. MG, US Search Parameters Demo Case . Tools DO003 9/28/2016 11:49:00 AM ABVS US also allow the case to be MeVis RUNMC_008292 MeVis RUNMC ... 7/14/2015 3:21:20 PM 2 studies doct MG, US Local only Training02Multiple Cysts Training02 9/28/2016 11:45:00 AM ABVS doct O reopened. However, all the M Include local patients in search Training05IDC_12 Training05 9/28/2016 11:49:00 AM ABVS doct US Name + TrainingDGIDC_12 Training05 9/28/2016 11:50:00 AM ABVS doct US markings and findings will be Patient ID: Training07 Scar_FA_12 Training07 9/28/2016 11:53:00 AM ABVS doct OT Date of birth: + Training15MedullaryCA_12 Training15 9/28/2016 11:58:00 AM ABVS US Training 16Phyllodes_12 Training 16 9/28/2016 12:00:00 PM ABVS OT deleted, making it essentially Training 308 Training308_ID 1/1/2000 2:50:00 PM Breast US Study date: Training309 Training309_ID 1/1/2000 2:45:00 PM Breast US a new study. Training313 Training313_ID 1/1/2000 4:33:00 PM Breast doc1 US Accession No.: Training320 Training320_ID 1/1/2000 11:02:00 AM Breast doc1 US Referring physician: Training321 Training321_ID 1/1/2000 4:53:00 PM Breast doct US Modalities: MG W MR CT . US Import Export Prepare Reopen Delete DICOM Retrieve Open Complete the Study 67 1. To complete a study, select the Complete or 5. To finish review, click Complete. Defer icon (or press F12) in the Study Navigator. 6. To allow a second read, click Complete Preliminary. 2. A confirm box will appear and a selection is required to close a study. 7. When Complete is selected, a dialogue box will appear to export either the entire study 3. To pause the review of the currently open or findings and the report to the desired case, click Defer and close. destination. 4. To continue reviewing the study, click Cancel. 8. Save Report as PDF. Tip When a study is completed if configured, all finding snapshots and the report are automatically sent to your archive device. Report & Finalization Report and Finalization 68 3D US Export x C/P Type of Export General Export to DICOM node Close or Complete Study C:/Users/sUSBA 7 Do you want to close or complete this staty? RESULTS 2 O Export to file system + Export to CD/DVD Deler & Case F1: Finding BI-RADS® 0 (Right) Export entire study Mark study as archived RAP Location Marker Only export findings and report 8 Save report as PDF RAP 18.5 mm (mediolateral) RAP 16.0 mm (anteroposte ... Export Cancel RAP Follow R AP Arrow Marker All markings (5) All snapshots (0) 1 Close or Complete Study × ? Do you want to close or complete this study? Study Training05IDC_12, 9/28/2016 11:49 AM has 2 findings. Complete Complete preliminary Defer & Close Cancel 5 6 3 4 The report default assigns a 69 BI-RADS® 1 to any study that is Preferences and Settings × completed without findings. Personal Preferences System Settings Server Network DICOM Network Users Local settings Data handling Monitor for SUSBA: Monitor Remaining space warning level: 30 GB Local cache size (client only): 50 GB Remaining space fill level: 20 GB Access control Automatic data clean-up: Every day Automatically log off users: after 15 minutes Default export option: Export only findings and report Automatic study caching Printing and reports Retrieve S2000 studies from the default DICOM node Hospital name: All For the last: 3 years Hospital logo: ... Apply DICOM tag filtering Remove DICOM tag: . No reporting No tag selected Basic reporting M Use BI-RADS® Retrieve additional studies from the default DICOM node Report language: American English . All Images in reports: M Location marker snapshots . For the last: 3. years Apply DICOM tag filtering M Measurement snapshots Modalities: MG MR CT OT US Arrow snapshots DICOM tag: Text marking snapshots No tag selected M Manually created snapshots Save Revert Cancel Report & Finalization Keyboard Shortcuts 70 Shortcuts Functions Shortcuts Functions Open sUSBA Help and Info F1 F10 Invert Screen F11 Hide or Display Study Navigator F2 Open the Patient Browser F12 Close the Case F3 Open the Preferences Tool Change the selected segment to F4 Open the Print Tool 1 transverse orientation F5 Study Overview Hanging 2 Change the selected segment to sagittal orientation F6 MultiSlice Hanging F7 Side-by-Side Hanging 3 Change the selected segment to coronal orientation F8 Single Slice Hanging Resets the nipple marker to the 5 original position F9 US Wide Hanging Shortcuts Functions Shortcuts Functions 71 6 Resets images in all segments to their original orientation G Hide breast body marker, reference lines and scroll bar Resets images in all segments to Displays or hides all markings 7 their default W / L settings H Note: This shortcut does not remove 9 Centers and magnifies the image the breast body marker to fit within the segment I Activate scrolling tool Removes all changes made with A L Activate location marker tool the image manipulation tools M Activate magnifier tool Open and close full-screen view B of a segment (one on one R Activate reference point tool image) S Create a snapshot of the active C Activate arrow marker tool segment D Activate measurement tool T Hide text overlay Keyboard Shortcuts Keyboard Shortcuts 72 Shortcuts Functions Shortcuts Functions W Activate window/ level tool Alt + T Open monitor test image X Activate text marking tool Alt + Tab Allow switching between windows (applications) Activates and deactivates Y synchronized scrolling of images Change the appearance of or hide the Reference Point Cycles Z Activate Zoom / Pan tool Crtl + R through the selections for the Alt + D Opens a window with DICOM display of the reference lines, tags for the selected segment including hide reference lines Alt + F4 Log out and quit sUSBA Right Arrow Go to the next View Alt + R Open Report View Left Arrow Go to previous View Alt + S Create a snapshot of the work Up Arrow Scroll toward the top of the scrolling slider area Shortcuts Functions Shortcuts Functions 73 Scroll toward the bottom of the Home / End Go to first/ last slice Down Arrow scrolling slider Shift + Go to the next patient with an Up Arrow Increase slice thickness . unread current study Shift + Increases magnification in the Decrease slice thickness Down Arrow + active segment Decreases magnification in the - active segment Tip Keyboard shortcuts for software version VA40. Keyboard Shortcuts Breast Imaging Portfolio 74 Siemens Healthineers offers a range of breast imaging products – the ACUSON S2000 Automated Breast Volume Scanner, ACUSON Juniper, ACUSON NX Series, ACUSON Redwood, and ACUSON Sequoia. ACUSON NX3 Elite ACUSON NX3 ACUSON NX2 ACUSON ABYS. ...... HELX ACUSON S2000 Automated Breast Volume Scanner ACUSON NX Series 75 Juniper Redwood CUSON Sequoia ACUSON Juniper ACUSON Redwood ACUSON Sequoia The products /features mentioned in this document may not Note: Some functions shown in this material are optional be commercially available in all countries. Due to regulatory and might not be part of your system. reasons their future availability cannot be guaranteed. Please contact your local Siemens Healthineers organization Certain products, product related claims or functionalities for further details. (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory Images used in this guide are for educational purposes only. requirements, the future availability of said Functionalities They have been modified or compressed and may not reflect in any specific country is not guaranteed. Please contact the actual image quality of the system. your local Siemens Healthineers sales representative for the ACUSON Juniper, ACUSON NX Series, ACUSON Redwood, most current information. ACUSON S2000 and ACUSON Sequoia are trademarks of The reproduction, transmission or distribution of this Siemens Medical Solutions, USA, Inc., and syngo is a training or its contents is not permitted without express registered trademark of Siemens Healthcare GmbH. written authority. Offenders will be liable for damages. BI-RADS is a registered trademark of the American College All names and data of patients, parameters and configuration of Radiology. dependent designations are fictional and examples only. Siemens Healthineers Headquarters Legal 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. · Order No. A91US-653-1C-4A00 · Printed in Germany · 8991 0620 ©Siemens Medical Solutions USA, Inc., 2020