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Siemens MAGNETOM Avanto Operator's Manual
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Siemens MAGNETOM Avanto Operator's Manual

4 ch bi breast / 16 ch ai breast
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MAGNETOM Avanto,
MAGNETOM Verio
Operator Manual – 4 Ch BI Breast / 16 Ch AI Breast
syngo MR E11

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Summary of Contents for Siemens MAGNETOM Avanto

  • Page 1 MAGNETOM Avanto, MAGNETOM Verio Operator Manual – 4 Ch BI Breast / 16 Ch AI Breast syngo MR E11...
  • Page 3 MAGNETOM Avanto, MAGNETOM Verio Operator Manual – 4 Ch BI Breast / 16 Ch AI Breast syngo MR E11...
  • Page 4 Legend Indicates a hint Provides information on how to avoid operating errors or information emphasizing important details Indicates the solution to a problem Provides troubleshooting information or answers to frequently asked questions Indicates a list item Indicates a prerequisite A condition that has to be fulfilled before starting a particular operation Indicates a single-step operation Indicates steps within operating sequences Italic...
  • Page 5 WARNING consists of the following elements: ◾ Information about the nature of a hazardous situation ◾ Consequences of not avoiding a hazardous situation ◾ Methods of avoiding a hazardous situation MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...
  • Page 6 Legend 4 Ch BI Breast / 16 Ch AI Breast | Operator Manual Print No. MR-04010G.623.22.02.02...

  • Page 7: Table Of Contents

    4.3.3 Positioning the female patient 4.3.4 Performing the measurement Quality measurement 4.4.1 Quality measurement, head first 4.4.2 Quality measurement, feet first 5 Biopsy examination Biopsy - general 5.1.1 Procedure MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...
  • Page 8 Table of contents Preparation 5.2.1 Preparing the biopsy device 5.2.2 Positioning the biopsy device 5.2.3 Positioning the female patient 5.2.4 Attaching the marker Post/pillar method 5.3.1 Example: Wire localization Grid method 5.4.1 Localizing the lesion 5.4.2 Determine the coordinates 5.4.3 Inserting the introducer sheath/stylet 6 Maintenance Cleaning...

  • Page 9: Introduction

    Document/Text 4 Ch BI Breast 1,5T 4 Ch BI Breast 4 Ch BI Breast 3T 16 Ch AI Breast 1,5T 16 Ch AI Breast 16 Ch AI Breast 3T MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...

  • Page 10: Information About Branding

    Information about branding 1.2.1 Siemens Healthineers Siemens has recently reorganized its organizational group structure. The healthcare business now is a separate legal entity. This is manifested in our new brand name: While we have adopted this new brand name, the legal name of our company and the name of the Legal Manufacturer do not change.

  • Page 11: General Safety Information

    Follow the instructions in this manual, which explicitly explain the procedures and possible hazards. ◆ Train personnel with phantoms before using the biopsy device on female patients. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...

  • Page 12: Risks Related To Incorrect Handling Of The Coil

    General safety information When moving the patient table, the coordinates computed for the breast biopsy are deleted. However, it is still possible to print out the worksheet.  ◾ Print out the worksheet directly after the offset coordinates are generated. ◾...
  • Page 13 Lesion is missed, incorrect diagnosis ◆ Ensure that both marker and lesion are located as close as possible to the magnet isocenter - possible axial expansions are limited. If necessary, reposition the patient. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...
  • Page 14 General safety information  CAUTION Inaccurate detection of the marker tip through unfavorable selection of the slice location! Incorrect diagnosis ◆ Post/pillar method: to select the reference position, select only slices that run parallel to the marker (medial/lateral: transverse slices, cranio-caudal: sagittal slices). ◆...
  • Page 15 This action might bend the distal needle end and could injure the patient. Shorten the distal needle end with an MR Safe or MR Conditional tool and remove the remaining introducer sheath/stylet. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...
  • Page 16 General safety information 4 Ch BI Breast / 16 Ch AI Breast | Operator Manual Print No. MR-04010G.623.22.02.02...

  • Page 17: Description

    They are of modular design and consist of various components. 4 Ch BI Breast (1) Patient pad coil and insertion plate coil (2) Biopsy device (post/pillar method) (3) Frame 16 Ch AI Breast (1) Coil (2) Frame MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...

  • Page 18: Ch Bi Breast

    Description Coil selection is a function of the type of examination to be applied. For imaging during a biopsy examination, the 4 Ch BI Breast is used. For high resolution breast imaging, the 16 Ch AI Breast is used. Both coils consist of two parts that are positioned on or in the frame.

  • Page 19: Ch Ai Breast

    First or Feet First orientation. The “Whole Body” option is required for examinations in the Feet First orientation. The 16 Ch AI Breast consists of two parts that are positioned in the frame. ( Page 17 Overview) MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...

  • Page 20: Breast Biopsy Device

    Description (1) Fixed coil elements (2) Coil plugs (3) Release to disconnect the two coil parts (4) Release to adjust the movable coil elements (5) Center marking (6) Opening for spectroscopy reference probe (7) Symbol: Using the coil without frame forbidden (8) Symbol: Using the coil with the frame only A description of the positioning aids is included in the accessory chapter.

  • Page 21: Configuration

    Description Please note that the scope of delivery from Siemens provides biopsy accessories only for training purposes. Accessories for the examination (needles, needle guide, height adjustable grid, etc.) need to be ordered separately, for example, from NORAS MRI products GmbH.
  • Page 22 Description Horizontal or vertical slat The breast is stabilized with the horizontal or vertical slat plates. They plates vary according to the examination method used (post/pillar or grid method). All horizontal or vertical slat plates just as the height adjustable grid can be adjusted in height using the lateral screws. (1) Horizontal or vertical slat plates for grid method: horizontal slat plate and height adjustable grid (2) Horizontal or vertical slat plates for the post/pillar method:...
  • Page 23 The marker or needle guide can be attached to both sides of the guide arm. In addition an angle (0°, 15° or 30° each in the direction of the thoracic wall or mamilla) can be set on both sides. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...
  • Page 24 Description 4 Ch BI Breast / 16 Ch AI Breast | Operator Manual Print No. MR-04010G.623.22.02.02...

  • Page 25: Breast Imaging

    Do not tie knots into the coil cable. ◆ Do not kink the patient pad coil. Preparing the frame 4.1.1 The 4 Ch BI Breast is positioned on or in the frame. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...

  • Page 26: Positioning The Coil

    Breast imaging ✓ MAGNETOM Avanto: All RF coils and cushions have been removed from the patient table. ✓ MAGNETOM Verio: The Spine Matrix is positioned on the patient table. For MAGNETOM Verio only: Position the side fixations on the side in the recesses along the edge of the table so that they are located along the side next to the frame.

  • Page 27: Positioning The Female Patient

    All RF coils have been removed from the patient table. ✓ MAGNETOM Verio only: The appropriate spacer cushion is positioned on the patient table. ✓ 4 Ch BI Breast is positioned on the frame and connected. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...

  • Page 28: Quality Measurement, Head First

    Breast imaging Quality measurement, head first 4.2.1 Position the 4 Ch BI Breast at the head end of the patient table. Connect the coil plug to coil socket 8 or 10. Place the respective plastic bottle into the left coil element. Align the laser-light localizer with the center marking (groove) of the coil.

  • Page 29: Using The 16 Ch Ai Breast

    Breast imaging Using the 16 Ch AI Breast 4.3.1 Preparing the frame ✓ MAGNETOM Avanto: All RF coils and cushions have been removed from the patient table. ✓ MAGNETOM Verio: The Spine Matrix is positioned on the patient table. For MAGNETOM Verio only: Position the side fixations on the side in the recesses along the edge of the table so that they are located along the side next to the frame.
  • Page 30 Breast imaging  When the Spine Matrix is not positioned: Lift the frame slightly along the side to position the coil elements. Place the support mat on the frame. Place the positioning aids and cushions best suitable for the current situation (especially when positioning the head). Observe the symbols on the sides of the abdominal pad and make sure the patient does not lean on these areas, as the pad may tilt sideways.

  • Page 31: Positioning The Female Patient

    Use the following accessories for the quality measurement: ◾ MAGNETOM Avanto: 2000 ml plastic bottle ◾ MAGNETOM Verio: 1900 ml plastic bottle + 3 cm spacer cushion MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...

  • Page 32: Quality Measurement, Head First

    Breast imaging ✓ All RF coils have been removed from the patient table. ✓ For MAGNETOM Verio only: The appropriate spacer cushion is positioned on the patient table. ✓ 16 Ch AI Breast is positioned in the frame and connected. ✓...
  • Page 33 Place the respective plastic bottles into the coil elements. Align the laser-light localizer with the center marking of the coil. Start the quality measurement. See: Coil operator manual, performing quality assurance (software) MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...
  • Page 34 Breast imaging 4 Ch BI Breast / 16 Ch AI Breast | Operator Manual Print No. MR-04010G.623.22.02.02...

  • Page 35: Biopsy Examination

    Clips can be deployed through the introducer sheath (depending on the biopsy device marker) after the biopsy or similar to wire placements. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...

  • Page 36: Preparation

    Biopsy examination Preparation All interventions for preparing and performing the biopsy are performed outside the magnet. The female patient remains on the patient table at all times. The following items should be explained or known prior to a biopsy: ◾ The lesion has been pre-localized through previous measurements (e.g.
  • Page 37 Ensure that the positioning unit is securely seated on the fixation unit and moved completely onto the tabs. Slide the fixation unit with the positioning unit on the notched guide rails of the base plate. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...

  • Page 38: Positioning The Biopsy Device

    Biopsy examination Preparing the grid Slide the height adjustable grid from above into the fixation unit. Slide the fixation unit with the height adjustable grid onto the notched guide rails of the base plate. Positioning the biopsy device 5.2.2 Within the frame, the biopsy device can be turned by 90˚ so that the breast can be stabilized for a lateral/medial or cranio-caudal access.

  • Page 39: Positioning The Female Patient

    The lesion should be centered inside the biopsy device to ensure optimal access. When the lesion is located close to the mamilla, position only the mamilla so that the lesion is easily accessible. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...

  • Page 40: Attaching The Marker

    Biopsy examination For lateral access: If the lesion is located near the axillary tail, use straps at the elbow to elevate the arm on the puncture side. For cranio-caudal access: Position the arm on the frame next to the body for easy access to lesions in the vicinity of the axillary tail or the breast wall.

  • Page 41: Post/Pillar Method

    The marker is eventually replaced by a needle guide. In it, either the introducer sheath/stylet combination (vacuum biopsy) or the core needle device (wire localization/clip) is inserted. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...

  • Page 42: Example: Wire Localization

    Biopsy examination  CAUTION Setting error during the post/pillar method! Incorrect diagnosis ◆ Ensure that the positioning unit is set to zero and fully slid in before determining the offset data. ◆ Fully attach the marker with screws. ◆ Later on position the needle on the same side as the marker was located on.
  • Page 43 Performing pre and post- Select a suitable 3D protocol. contrast imaging Activate Subtract on the Inline\Inline sequence card of the protocol. Position the 3D imaging volume in the localizer images. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...
  • Page 44 Biopsy examination  Do not use oblique slices, because they are not supported by the biopsy software. Start the pre-contrast measurement. Administer the contrast medium. Start the post-contrast measurement. Subtraction images are automatically computed and facilitate locating the lesions. Planning access to the lesion The following steps are required for planning access to the lesion: ◾...
  • Page 45 Setting the reference marker Select the image that shows the marker in full. and storing the position Click the top of the marker in the marker image by using the mouse. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...
  • Page 46 Biopsy examination The position is indicated by a pink crosshair. Set the crosshair to the correct position (at the top of the reference marker). Click the Store Marker Position button. The reference marker appears as a green cross in the image. The crosshair disappears.
  • Page 47  the offset data for each angle. Make sure to record each angle since the lesion may not be accessible from a specific angle. ( Page 59 Master copy) MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...
  • Page 48 Biopsy examination Marking the lesion The next step is to mark the lesion using an MR-compatible localization wire. ◾ Setting the offset data ◾ Attaching the needle guide to the positioning unit ◾ Inserting the core needle device ◾ Checking the position of the core needle device (control scan) ◾...
  • Page 49 Select Tools > Paste Image Position to transfer the position and orientation to the measurement protocol. Start the measurement. Positioning the marking wire When the position of the core needle device is correct: MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...
  • Page 50 Biopsy examination Move the patient table out of the magnet. Position the wire anchor of the marking wire in the lesion, and after that remove the core needle device from the breast. Verify the correct wire position by performing another measurement using the 2D protocol.

  • Page 51: Grid Method

    Marker block is seated in the opening of the height adjustable grid. Recommended position is central in the grid (C4) for ease of marker identification. Move the table into the magnet tunnel and perform a measurement. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...

  • Page 52: Determine The Coordinates

    Biopsy examination Use the software to generate slices that run parallel to the grid. The lesion can be localized. 5.4.2 Determine the coordinates Draw a ROI around the lesion and transfer it to all other slice images. Scroll through the slab to the image which best shows the grid opening of the height adjustable grid.

  • Page 53: Maintenance

    Never clean and disinfect the coil in immersion baths or under running water. ◆ Never sterilize the coil. ◆ Disassemble the components of the biopsy device and process them individually. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...

  • Page 54: Cleaning

    Maintenance Cleaning 6.1.1 Clean the components after each application (within 30 min). Do not use any abrasive cleaners or organic solvents or solvent- based cleaners (such as petrol-based cleaners, alcohol or stain removers). Clean the components to ensure that all blood or tissue residues have been removed from the components, including cleaning materials.

  • Page 55: Accessories

    Accessories Accessories Biopsy accessories Please note that the scope of delivery from Siemens provides biopsy accessories only for training purposes. Accessories for the examination (needles, needle guide, height adjustable grid, etc.) need to be ordered separately, for example, from NORAS MRI products GmbH.

  • Page 56: Coil Accessories

    Accessories Side fixations Coil accessories Specific positioning aids are available for the following coils and are included in their delivery volume. 7.2.1 General positioning aids The following positioning aids are available to ensure safe and comfortable patient positioning: Abdominal pad Foot support roller Head rest 4 Ch BI Breast / 16 Ch AI Breast | Operator Manual...

  • Page 57: 16 Ch Ai Breast

    Cushion to stabilize the breast Support mat Medial cushion Wing cushion large Wing cushion small Accessories for quality assurance 1900 ml plastic bottle Spacer cushion 3 cm 2000 ml plastic bottle MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...
  • Page 58 Accessories 4 Ch BI Breast / 16 Ch AI Breast | Operator Manual Print No. MR-04010G.623.22.02.02...

  • Page 59: Master Copy

    Master copy Master copy MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...
  • Page 60 Master copy The following graphic shows the master copy of the disposable height adjustable grid. 4 Ch BI Breast / 16 Ch AI Breast | Operator Manual Print No. MR-04010G.623.22.02.02...
  • Page 61 Master copy The following graphic shows the master copy of the reusable fixed grid. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...
  • Page 62 Master copy 4 Ch BI Breast / 16 Ch AI Breast | Operator Manual Print No. MR-04010G.623.22.02.02...

  • Page 63: Appendix: Information About Legal Manufacturer

    Please note that this manual may also contain information about  medical devices that are NOT legally manufactured by Siemens. These medical devices are either only distributed by Siemens, or only mentioned for additional information. In the following table you will find information about the medical device, the corresponding legal manufacturer and, if applicable, the authorized representative.
  • Page 64 Appendix: Information about legal manufacturer 4 Ch BI Breast / 16 Ch AI Breast | Operator Manual Print No. MR-04010G.623.22.02.02...

  • Page 65: Index

    Grid method 51 Horizontal or vertical slat plates Reference marker] 45 Post/pillar method 41 Compression 40 Breast biopsy device 20 Breast positioning Safety information Cranio-caudal access 39 Introducer sheath/stylet 52 MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-04010G.623.22.02.02...
  • Page 66 General 11 Target coordinates 46 4 Ch BI Breast 25 16 Ch AI Breast 29 Wire localization Access to the lesion 44 Biopsy channel 47 Checking position 49 Core needle device 49 Lesion marker 46 Localizer 43 Marking the lesion 48 Needle guide 48 Offset data 48 Positioning the marking wire 49...
  • Page 68 Please note: For products that are not legally manufactured This device bears a CE mark in accordance with the by Siemens but distributed, please refer to the Appendix of provisions of Council Directive 93/42/EEC of June 14, 1993 this manual!

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