BioJet - User Manual. : Select biopsy needle type by biopsy core length from the list:

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1 BiJet - User Manual 1.1. The General Bipsy Functins Tracking and lcating bipsy psitins as well as assigning the lab results t the respective bipsies will help in fcal therapy and general therapy. Fr this reasn Encage Target Plus allws the user t plan the required bipsies. It is advantageus t use a tracking stepper in this case. The bipsy functins are lcated: On Regsiter Card: In the Drp-dwn menu: On the tlbar the Icns: The meanings f the icns are: and : Select bipsy needle type by bipsy cre length frm the list: : Display Bipsy Reprt : Display Bipsy Data Frm r : Shw r hide drawn tumr areas r : Shw r hide all bipsy guides and bipsy psitins r : Shw r hide unused bipsy needles r : Shw r hide nn-malignant bipsies In rder t use the bipsy functins calibrated ultrasund images must have been cllected as described abve. It is then advantages t draw in the required rgan cnturs (see chapter Drawing Organ Cnturs int Ultrasund Images and ther Image Types ). After that has been cmpleted swith t the register card. That register card includes all required bipsy functins as well as the fuctins required t draw recgnized tumr areas int the images.

2 BiJet - User Manual The bx lists the required bipsy functins: : Determin the x, y-psitin f a planned bipsy guide line by selecting this functin and the clicking at the required psitin in the main image windw. The psitin in the image is marked with a. The number designates the bipsy t be acquired. Only ne bipsy per guide psitin can be acquired. A right muse click will delete that mark. Until actual bipsies have been acquired the bipsy psitins will renumber autmatically. After that the numbers will always cunt upward and deleted psitins numbers will nt be reused. Thus it is advatagius t first definy all the x, y-psitin fr all bipsies planned. Up t 50 bipsies are pssible. : Mve a bipsy guide line. This functin nly wrks in lngitudinal display n bipsy guide psitins. If a planned bipsy pstin is t be mve smewhere else then fist click and the delete a planned psitin and the place the guide smewhere else. : Bend a bipsy guide line. This functin nly wrks in lngitudinal display n bipsy guide psitins.

3 BiJet - User Manual : Place a bipsy cre, i.e. cmplete a bipsy. The pisn f the cre defines the exact psitin in x-, y-, z-crdinates frm which the bipsy sample was taken. The psitin is marked as in the main image. A yellw clr markes the sample as undefined at the time. : After the bipsy samples have been analyized the biipsy cres can nly be benign r malignate. By clicking the bipsy mark it will change its clr t t designate a benign sample. In rder t g back t undefined just click the mark again with a right muse click. : After the bipsy samples have been analyized the biipsy cres can nly be benign r malignate. By clicking the bipsy mark it will change its clr t t designate a malignate sample. In rder t g back t undefined just click the mark again with a right muse click. :If tumrs haved been drawn int the images they can all be remved at nce after a prmpt if this icn is clicked. :This functin will delete all unused bipsy guide lines. After the bipsies have been taken the user can click the tl results: and display all the bipsy The Bipsy Number is unique and cannt be changed as it pints t the repective bipsy cre. If a bipsy guide line was placed but n bipsy taken that line number will nt be listed. The cre length is the length chsen frm the list accessable by clicking in the tlbar. The numbers under x, y, and z represent the center f the bipsy cre taken. The rigin is the central bttm pint n the general template (see chapter Calibrating the General Template t the Ultrasund Device und thus the Ultrasund Images ). These numbers cannt be changed. All ther entries are user selectable. This table will be transferred t the Bipsy Reprt. The table allws a simple entry f labratry data. By clicking n in the clumn the type f tissue can be selected

4 BiJet - User Manual frm. The Gleasn scre may als be selected frm a list. The remaining data can be marked as by clicking the reseptive bx. The entries that can be marked as psitive are: - PCI: Prstate Capsular Infractin - PNI: Peri-Nervus Invasin - ASAP: Atypical Small Acinar Prliferatin - PIN: Prstatic Intra-Epithelial Neplasia

5 BiJet - User Manual 1.2. The Lngitudinal Image Display n Register Card Bipsy In rder t access the lngitudinal display just click n register card. The display changes t: In this case 6 bipsy guide line have been psitined. T return t the transverse display click. The bx lists the available bipsy functins: : Determine the x, y-psitin f a planned bipsy guide line by selecting this functin and the clicking at the required psitin in the main image windw. The psitin in the

6 BiJet - User Manual image is marked with a. The number designates the bipsy t be acquired. Only ne bipsy per guide psitin can be acquired. A right muse click will delete that mark. Until actual bipsies have been acquired the bipsy psitins will renumber autmatically. After that the numbers will always cunt upward and deleted psitins numbers will nt be reused. Thus it is advantageus t first define all the x, y- psitin fr all bipsies planned. Up t 50 bipsies are pssible. : Mve a bipsy guide line. This functin nly wrks in lngitudinal display n bipsy guide line psitins. If a planned bipsy psitin is t be mved smewhere else then mve the muse pinter t the required guide line and hld the left muse buttn dwn. A blue line will then appear. Mve the blue line t the desired psitin and the release the muse buttn. Then yellw guide line will then jump t the psitin f the blue line. In case as bipsy has been taken a blue bx will appear and the functins wrks accrdingly. : Bend a bipsy guide line. This functin nly wrks in lngitudinal display n bipsy guide line psitins. If a planned bipsy psitin is t be bent smewhere then mve the muse pinter t the required guide line and hld the left muse buttn dwn. A blue line will then appear. Mve the blue line t the desired psitin and the release the muse buttn. Then yellw guide line will then jump t the psitin f the blue line. In case as bipsy has been taken a blue bx will appear and the functins wrks accrdingly. : Place a bipsy cre, i.e. cmplete a bipsy. The pisn f the cre defines the exact psitin in x-, y-, z-crdinates frm which the bipsy sample was taken. The psitin is marked as in the main image. A yellw clr marks the sample as undefined at the time. After mving t the next bipsy the guide line disappears. If the cre graphic is in the wrng psitin just left click the muse smewhere else alng the guide line and the cre will mve accrdingly. If the cre is t be remved then just click n the cre with the right muse buttn held dwn. : After the bipsy samples have been analyzed the bipsy cres can nly be benign r malignant. By clicking the bipsy mark it will change its clr t t designate a benign sample. In rder t g back t undefined just click the mark again with a right muse click.

7 BiJet - User Manual : After the bipsy samples have been analyzed the bipsy cres can nly be benign r malignant. By clicking the bipsy mark it will change its clr t t designate a malignant sample. In rder t g back t undefined just click the mark again with a right muse click. :If tumrs have been drawn int the images they can all be remved at nce after a prmpt if this icn is clicked. :This functin will delete all unused bipsy guide lines.

8 BiJet - User Manual 1.3. The Tumr Draw Functin If recgnized tumrs may be drawn int the image stack in the same way as the ther structures were drawn. Please see chapter Drawing Organ Cnturs int Ultrasund Images and ther Image Types fr mre details. Only the items that are different will be explained here. In this case 10 Tumrs numbered 1 t 10 may be drawn. The tumr draw functins can be fund n register card in the bx:. The meaning f the icns are the same as in f drawing rgan structures. In shrt: Draw functins are nly available if the image in the main windw is a nn-interplated image:, i.e. if the number between the brackets is nt 0.00 then an interplated image is displayed in the Encage Target Plus main windw and nt all draw functins are accessible. Tumrs can nly be drawn in the transverse image mde. That means that the buttn is displayed n this register page. Cnturs can be crrected in lngitudinal display as well by clicking then buttn nw displayed in lngitudinal prjectin and the buttn changes t. The image stack is. On the tp right the angle selectin bx appears:. As lng as the image is nt switched t live vide display additinal calibratin is nt required. This is nly necessary in case the image is switched t live. Hw this is dne is explained in chapter Crrecting Cnturs in Lngitudinal Display please see there. : This is the tumr select functin. The tumr visible in the bx is the ne that can be draw, cpied, pasted r interplated at the time being. After clicking select the structure t be drawn frm the selectin bx

9 BiJet - User Manual names are user definable.. The structures setup functin is described belw. The After clicking this icn the selected tumr cntur can be drawn (draw mde) with the muse by mving the muse while hlding dwn the left muse buttn at the same time. Alternatively, the cntur is als drawn by clicking individual pints n the selected rgan cntur. As sn as the cursr gets near the psitin frm where the rgan was drawn a dted line shws hw the cntur will be cmpleted. If the prpsal is crrect just let g f the left muse buttn and the rgan is aut-cmpleted. is the quick draw functin. By clicking a few pints n an tumr cntur and then duble clicking at the end a cntur is autmatically entered.. The vlumes f the tumrs drawn are displayed in the bx abve. The vlume is cnstantly updated as sn as the tumr cnturs n ther image planes have been cmpleted. After clicking this icn (r pressing [Ctrl] [C]) the cntur selected in n the image plane within the main Encage Target Plus is cpied. After clicking this icn (r pressing [Ctrl] [V]) the stred cntur is pasted int the image in the main Encage Target Plus windw at the same psitin frm which it was cpied. Pressing the [Page ] r [Page ]-key while,, r is selected will result in transferring the selected cntur t the next thumbnail image. This is equivalent t pressing [Ctrl] [C], then clicking the next thumbnail and then pressing [Ctrl] [V]. This is the rubber banding tl. After clicking the icn, pints appear n all cnturs. These pints are the supprts f the drawn cnturs. The muse may be mved t any cntur supprt pint. As sn as the cursr sees the cntur it will change frm an arrw t a hand with a pinted finger. By depressing the left muse buttn n a supprt pint the pints n the cntur change t. By mving the muse with the left muse buttn pressed the cntur will fllw the muse mvement. By mving ne f the red squares, the shape f the cntur will change accrdingly. A supprt pint may be deleted by clicking the desired pint with the right muse buttn. Alternatively, pints may be added by clicking the desired cntur psitin with the left muse buttn.

10 BiJet - User Manual If a cntur has been drawn n tw nnadjacent image planes, the cnturs f the selected structures n the images between the nes already drawn will be filled in. The psitin and shapes f the cnturs are interplated. After clicking this tl the rgan structures can be mved. The muse must be psitined n the structure brderline and the left muse buttn held dwn. The structure will then fllw the muse mvements. By clicking this tl with the left muse buttn the selected structure in n the image plane displayed in the main Encage Target Plus windw is deleted. By clicking this tl with the right muse buttn the selected structure in n all image planes are after a prmpt. This is the und / red buttn. The last actin can be reversed by clicking the und / red buttn. As sn as an actin pertaining t ne plane nly such as draw, rubber banding, delete structures, r thers have be dne, the icn changes its appearance frm t if the functin has nt been used befre. A secnd click n the buttn reverses the change back t the start case befre the first click n the buttn. :If tumrs have been drawn int the images they can all be remved at nce after a prmpt if this icn is clicked. This functin is fund in the bx at the tp f the register card. In rder t define the Tumr names and clrs g t the drp-dwn menu and then the menu appears. After clicking with the left muse buttn the fllwing dialg bx pps up:

11 BiJet - User Manual All data displayed in this menu can be stred as default (see chapter String / Lading Structure Data (Preset) ). T change anything just click n the respective bx and change accrdingly. T stre any changes just click.

12 BiJet - User Manual 1.4. The Bipsy Reprt The bipsy reprt is accessible after clicking in the tlbar. The reprt will appear in its wn windw. An additinal menu is at the tp f the windw having the fllwing functins, that can be clicked n. :Shw r hide the dcument map : G t first page : One page backward : One page frward : G t last page : Refresh : Print reprt After clicking this functin a specials printer menu pps up. The menu depends n the printer used. : Switches the page layut : Printer page layut - After clicking this functin a specials printer menu pps up. The menu depends n the printer used. : Exprt the reprt either t MS Excel r create a PDF file. This can be selected frm a drp-dwn menu After clicking and selecting EXCEL r PDF the bx appears: required. T pen the data file please pen EXCEL first and then imprt the file.. Please stre the data where : The size f the display can be selected here. If this functin is clicked the size can als be selected with the muse wheel : After typing in a wrd, that wrd is searched fr after clicking The fllwing data is at the tp f all reprt pages:

13 BiJet - User Manual - Name f the hspital and the department - Patient name - Treatment date and time - Name f the treatment plan The first page includes the patient and study data. The secnd page (pssibly mre pages are required t display all results) displays the bipsy psitins and data n the cre lengths.

14 BiJet - User Manual The third page (pssibly mre pages are required t display all results) displays the bipsy results entered int the bipsy after clicking details. in the tlbar. See chapter The General Bipsy Functins fr mre

15 BiJet - User Manual The last pages display the images including all cnturs and ther items drawn int the images.

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