Transcript
- Okay, welcome to the Fujifilm Sauna site
behind the scan webinar series.
My name is Lisa Francia
and today we have an exciting presentation
and demonstration of the new Cyte PX
showcasing our most advanced image clarity.
Before we begin, please be advised all attendees are muted.
You may type questions into the q
and a box in the toolbar located at the bottom
or side of your screen at any time.
This webinar is being recorded and we will conduct a q
and a session at the end of the program.
Now it's my pleasure to introduce our presenters For
today start to start.
We have Bill Medford who joined Fujifilm Cyte 10 years ago
as the lead MSK clinical specialist.
He is a certified sonographer
with over 42 years of experience.
Bill has held numerous invited faculty
positions over the years.
He is a member of the A IUM
and has been an AR D-M-S-M-S-K subject matter expert since
2015.
Next we have Craig Chamberlain, who is the director
of experience design.
Craig's been with Fujifilm for nine years.
The experience design team has the responsibility
for gathering user insights, developing innovative solutions
to user pain points, and designing the physical
and digital interactions our users have with cyte products.
Prior to Cyte, Greg was the president of Carbon Design Group
for seven years where he shepherded carbon's transformation
from design service company to one
of the nation's premier full service product
development consultancies.
That shift led to significant growth, revenue influence
and recognition by the international design community.
Sweeping the industrial design excellent gold awards
for medical products in 2009
and most recently recognized
with a silver industrial Design excellence award
for Cyte S two in 2016.
It's my great pleasure to introduce Craig
who will get us started today.
Thank you.
- Thank you Lisa. And as Lisa mentioned,
my name is Craig Chamberlain.
I head up the design team at here at Fujifilm.
SonoSite, it's my pleasure to be with you today.
SonoSite has a rich history
of delivering innovative solutions to our customers' needs.
With the SonoSite px, we're launching the first
of our next generation of point-of-care systems.
This product is a new platform built from the ground up
to deliver innovative solutions.
It incorporates new technologies
and new features to empower our users to accomplish more.
The Sono site PX would was born from real world clinician
needs and it delivers solutions
to overcome real workflow challenges.
My team as, as Lisa mentioned, has the responsibility
for capturing those user needs to
doing the physical
and digital design to meet those user needs.
We begin with a systematic approach of to observe, immerse,
and engage with our customers in their
daily healthcare lives.
The team traveled to the sites all over the world
and spent hundreds of hours with individual clinicians
and with groups to observe
and understand clinical workflows.
We brought back more than 400 data points
that lay laid the foundation
for the product development process for the Sono px.
Those data points show up in both the overall product
and the smallest details of our system.
A result of all that work is the SonoSite px.
We designed every detail of this system
to provide innovative solutions to customers in the point
of care clinician clinical settings
that they face every day.
Its purpose is
to assist our customers in improving patient outcomes
by providing the diagnostic confidence they need
for any patient anywhere, anytime.
The SonoSite PX supports many different use models within
the hospital and office environments.
Throughout the development process, we strove
to improve access, provide our clinicians
with confidence all the while keeping everything simple.
We accomplished this by making Sono site PX adaptable
to the many environments our clinicians provide care in
by delivering amazing image clarity
and by delivering workflow efficiency for every,
every clinician.
So let's go into the details of how we did this.
Well, I'm gonna start with the design details
'cause that's my department's business.
Sono site PX user interface is optimized.
So the digital design of our product, it's optimized
by exam type for each workflow you need to accomplish,
but there's an overriding issue that faces every clinician
as they start using ultrasound to treat their patient.
Is the system ready for me to use? That's the big question.
Often we see one patient's information appended onto the
previous patient's record with the Sono Cyte px.
We help our clinicians avoid that situation
by providing a big green button.
You see it right there on the control panel,
a big green button indicating the system is ready to go.
And when there's a patient study active,
we show a big orange button that says very clearly end study
to minimize the chance
of appending the next patient's information onto the
prior patient's record.
The Soto site PX has a hybrid user interface which presents
the most use controls, things like gain depth, save image,
save clip, and others in physical buttons
that are easily identified just by touch.
And we present the most used controls for each step
of your workflow on the digital control panel.
And that's all with an easy reach.
We know every detail matters With the SonoSite px,
we've reimagined the entire stand in the stand accessories.
One of the consistent frustrations
that we've heard from our clinicians is running over the
transducer cables with the wheels of the stand.
So we design the stand, the transducer cables,
the transducer holders
and the in our innovative cable management system
to eliminate the possibility
of the cable getting caught under a wheel when the
transducer is stored on the system.
Our stand has a basket, a lock,
lockable storage, gel storage.
And finally, just finally,
we've given you a wipes container holder.
No more taping a container onto the side of your stand,
but I think we can all agree that the most important details
that matter are the details you see in the actual image
because we understand image clarity isn't a specification,
it's an enabling transformation.
The sono site PX delivers the most advanced image clarity we
have ever offered on an ultrasound product.
It delivers proprietary speckle reduction technology,
improved color performance,
and a new family of transducers with new technology.
Let's talk about those transducers.
Sono side PX introduces our next generation of linear,
curved, and phased array transducers.
These transducers were developed specifically
for the sono site px
and they contain our most innovative technology.
They offer better experience for our clinicians
with an enhanced image clarity and versatile versatility.
The new sono site PX transducers offer an IPX rating
of IPX seven, which means they're immersible drop te.
They're drop tested to one meter and they're tested twist
and cycle and flex tested.
The cables are twist
and flex tested to 50,000 cycles
to ensure they're they're durable for you
and they're covered by our five-year warranty.
Of course, our new transducer naming conventions focus on
frequency instead of size
and these new transducers, I'll just introduce 'em.
Our P five dash one phased array transducer,
the C five one curve linear
and we have three linear transducers, the L 12 three,
the L 15 four, and the L 19 five.
And lastly, the intra cavity transducer, the IC ten three.
Let's take a look at a few
of these new transducers in details.
The new LT L 19 five is the highest frequency transducer
socy has ever produced.
For a traditional ultrasound system,
it provides incredible near field resolution while offering
a minimum scan depth of one centimeter,
you see it here on the screen with a small footprint
of 20 millimeters.
It is ideal for any superficial scanning including vascular
access, pediatrics and MSK.
And with that small footprint,
the L 19 five will effectively image the smallest patients
and get into those most difficult of spaces.
In this clip, you can clearly see
what you're seeing in this blood vessel
is actual RU red blood cells
and you can see how they're getting trapped
behind the valve leaflets as they co
as those blood vessels cos
through the vessel blood cells.
The P five one phased array transducer uses the same great
technologies as our P 19 transducer.
This transducer was designed with a single crystal
that provides higher sensitivity, produces less artifact,
and has better penetration.
The new speckle reduction technology
and faster frame rates seen on the sono cyte PX work
together with the P five one
to generate the superb cardiac imaging
that you see here along
with a new feature on the sono PX color Compare
color compare pride provides the ability
to simultaneously assess in both 2D and color.
However this transducer doesn't stop there.
It also included our optimum optimized exam types
for both abdomen
and lung making this the perfect assistant
for per performing cardiac, abdominal
and lung exams with a single transducer solution
also available on the Cardi on the cardiac
and abdominal exam types is right zoom,
right zoom improves the spatial resolution
and is beneficial for seeing in detail to the cardiac valves
as well as any structure where vis visualization
of really small details and measurements is important.
The new L 12 three has been designed to do the work of both
of its predecessors, the HFL 38
and the L 38, making it an extremely versatile transducer
with a wide frequency range
and a maximum depth of nine centimeters.
This transducer is capable of performing DVT studies,
visualizing deeper structures,
all while maintaining the near field resolution required
for more superficial nerve examinations.
The L 12 three allows for flexibility
and the opportunity to incorporate expanded use models.
This is a great transducer for ME
and critical care as it provides the ability
to do DVT nerve blocks
and IVs with a single transducer solution.
The updated L 15 four maintains the 50 millimeter transducer
face of our HFL 50 while introducing new lens materials
and matching and a matching layer technology
to expand its frequency range.
This provides both an important res improvement in
resolution and penetration
and the sono site PX takes takes the next step in needle
steep needle profiling with the ability
to visualize the needle from multiple angles
with a single system interaction.
So our auto need steep needle profiling is engaged
with the tap of a button on the touch pun touch panel.
All you have to do is choose right or left approach
and you'll clearly see the available enhancement area
on the clinical screen.
The color performance mentioned earlier,
but the color performance on the sono site PX has been
enhanced to detect all flow types including low flow veins
and higher velocity regurgit
and jets all white while providing better edge definition.
For those these different types of flow,
these enhancements benefit both the the critical care
physician examining for cardiac performance along
with the rheumatologist for example, who's looking for signs
of inflammation in small joints.
The color improvements include improved color frame rates
and persistence, improve color maps that make flows pop
for cardiac and vascular exams
that brings out the lower velocity flows
and provides a better visual view of accelerating flow.
There is less motion artifact in color on both venous
and arterial exam types
and there's an improved flash artifact in color,
especially in and around the right ventricle.
So what does all this mean?
So to all this improved image clarity
and detail mean for you well, it allows clinicians
to see more and do more.
It empowers our users
to more easily interpret images including seeing finery
details and better tissue resolution
and to support faster diagnostic diagnostics.
Diagnostics and time to treatment.
Now we're gonna see these transducers in action.
I'm pleased to introduce Bill Medford,
our senior MSK specialists, who is going to take us
through the live demo bill.
- Thank you Craig. I am delighted to be here
and demonstrate what I think is for me as a sonographer
what is most exciting about our new platform, the px,
and that is image clarity.
With advanced image clarity, it's going to give all
of our end users increased confidence in what they're seeing
and I'm, I'm looking forward
to make showing you demonstrating some of that of
that anatomy to you today.
Before we get started with that though, I'd like
to just give a brief review of the user interface
and I want to congratulate Craig
and his team for listening
to our customers over the development process of this system
and incorporating their suggestions
and to what we have as a hybrid adaptable user interface
that incorporates at the bottom a tactile always
present interface that gives you access to all
of the functions that you're going to most commonly need
to get to, including gain depth, your touch pad
labeling, measuring freeze,
and saving individual images as well as video clips
and the various modes, scanning modes that you might be in.
Our adaptable touch screen interface above gives you access
to, gives you the ability to adapt
to whether you're scanning,
whether you're entering patient information,
if you're selecting a transducer and the examination preset
or whether you want to access the variety
of embedded videos to assist with education.
So let's start scanning now.
The two transducers that I'm going
to be showing you are the L 19 five
and the L 15 four transducer that Craig discussed with you
and we'll see what the image clarity differences are
in each of these.
So we're going to begin by selecting the
L 15 four in the nerve preset
and what you will see now on your screen is a picture on
picture presentation.
You'll see on the bottom left the user interface
and so that you can, while while you can't really read
what the buttons and
and the tabs say, you'll still be able
to see me moving about the user interface
as I'm demonstrating the anatomy we're going
to look at today.
So I'm gonna start up in the neck.
We're going to look with the fif L 15
to four megahertz transducer at the,
at the inner scaling muscles of the bra
or nerves of the brachial plexus.
So let's start out medially
and we see the thyroid gland
and I want you to notice right away the
amazing image clarity.
You see the isus there we see both sides of the gland 50
millimeter wide transducer face allows you to see from side
to side beautifully coming across.
You see the common carotid artery
and the intima as well as the jugular vein.
As we slide out more laterally
and inferiorly, we're going to see a cross
of the subclavian vein and the associated sles
or the adjacent sles of the
of the brachial plexus.
So here we see the subclavian vein fassal
of the brachial plexus.
As we work more proximally or toward the head
and we get to the inner scaling location,
we can see beautifully the multivesicular
appearance of the C five
and C six nerve roots, anterior scaling muscle here,
middle scaling here.
So let's now move to the L 19
to five again in the nerve preset.
I want you to notice how quickly the transducer
transitions from one transducer to the next
will begin again medially at the thyroid
common carotid jugular vein.
Notice that little adjacent perivascular node there
that I want you to notice how crisp
and clean the user inter the interfaces
are between structures.
We see a transverse view of subclavian vein.
We're at about a centimeter
and a half, nearly two centimeters.
So even though we're using a frequency as high
as 19 megahertz, the depth
of penetration is really quite good.
Even with a 19 megahertz transducer.
Here are those adjacent sles that we see
and as we work more proximally
and we get up inter scaling, look
how nicely presented the C five
and C six nerve roots are here.
Let's move back to the L 15 four
and take a look at the rotator cuff.
We see the supraspinatus tendon here.
I want you to notice how nice and crisp
and clean the cortical surface of bone is.
Very important when we're looking at subtle step offs.
Reflecting small
occult fractures.
So crisp
and clean are the tendon fibers as they come down to
where they insert the distinction between tendon
and the overlying bursa is very well defined.
You can even clearly see where the bursa begins
or bursa ends and the bursal side of the cuff begins
and the overlying deltoid muscle.
We see more architecture with muscle than we've in the past.
Let's go to the 19.
A small footprint transducer is something
that I have not typically looked used
to look at the rotator cuff,
but having done rotator cuff sonography
for over 20 years, one of the hardest things
to look at is the bursal side of the cuff
and get the clarity necessary
to detect small bursal sided defects.
So this is the bural side of the rotator cuff
and if we scan down more distally, another area
of really important
to interrogate is a distal most insertion.
So see how nicely we can see the bursal side
of the tendon if there were tendon fibers frame
or if there's a little bit of volume loss here.
Historically that has been very, very difficult
to diagnose
with the L 19 transducer.
We can now very clearly indefinitely see the distal end,
which has also been very difficult to interrogate
for partial thickness tear.
Let's go back to the 15 four transducer.
We're going to go down into the elbow.
Now I want
to quickly identify a few structures in the elbow.
Notice the clarity right up against the skin.
You see the cephalic vein.
You can even see some red cell movement in
the cephalic vein.
Turning back to the short axis, the brachial artery.
If we look in the fascial plane
between the pronator muscle
here in the brachial radialis mu
or brachialis muscle, we see the median nerve.
We come to the other side of the arm
and we look in this white fascial plane
between the brachial radialis and the brachialis.
Look how clearly defined these two small branches
of the radial nerve are.
If we come back up to the center of the antecubital fossa
and we scan down distally,
we can see I'm gonna give myself just a little more depth
and if we turn the transducer long axis structure
that's historically very difficult to see,
becomes much easier, much more identifiable.
We see the distal fibers of the tendon here to
where it inserts onto the radial tube o.
Let's go back to the 19 megahertz
and even at two centimeters
of depth we can see the insertion
of the distal bicep tendon.
So subtle defects that we might want to better interrogate.
We can use frequency as high as 19 megahertz.
Now to look at that distal bicep tendon insertion,
let's go down to the wrist, reduce our depth,
and here we have the median nerve.
I want to demonstrate
how nicely we can see the ret
aum coursing over the top.
How clearly defined each
of the fassal in the median nerve are
and the more hyper coic epineurium.
If we slide over toward the ulnar, notice
how well we can now see the ulnar nerve
and the ulnar artery.
See the intimal layer of the ulnar artery.
We can follow this median nerve all the way up the arm,
see the adjacent ulnar artery.
I want you to notice the depth we're able to penetrate to,
to still be able to visualize this
as we work proximally.
Now it's coming back up more superficially
and we can follow it all the way up into the cubital tunnel
where it's going to sit adjacent
to the medial epicondyle.
There we can
even identify the overlying osborne's
ligament to check its integrity as well as we look
for subluxation.
Let's go back down to the wrist, turn to the dorsal side
and look at a very superficial nerve,
the superficial radial nerve.
We're going to first identify external
extensor lysis lister's tubercle.
Again, notice how well defined the bony landmarks are
over more distally
or more radially.
We see second extensor compartment.
Notice how nicely we can see the ret
aum curving over the top.
And if we go a little further distally
or radially, we're going
to identify very easily now a diff a structure,
very difficult to see in the past
and that's a superficial radial nerve,
an important structure to be able to identify
as injections are delivered
to assist with the que veins.
But you see it there,
you see it coming over the top
of the extensor lysis there.
And if we work more approximately,
we see it coming over the first extensor compartment there.
So this nerve historically difficult to see now just,
and again, notice about three millimeters
underneath the skin, maybe even only two
millimeters under the skin.
You can actually count the fascial of that nerve,
which demonstrate the amazing image clarity
with this transducer, which has got me
very excited about the image clarity
and the increased confidence that you're going to have
and identifying normal anatomy
and identifying subtle pathological changes
historically that you
otherwise might have been uncertain with.
So that ends our live demonstration.
I am, I thank you for attending today
and we wanna leave some time for questions.
So with that
we'll turn it over
to see if we have any questions we can answer for you.
- Great, thank you Bill for that excellent demonstration.
With the exceptional clarity, it's,
it's pretty clear you can see new things with ultrasound
and I'm wondering with the L 19,
can you list some additional uses that have been
otherwise difficult in point of care?
- Well we're, you know, I haven't scanned
with 19 megahertz too much yet,
but That superficial radial nerve was an example.
Certainly Laura, of things that we're going to see
that we haven't been able to see in the past.
We have, you know, in the pediatric population,
epi aile injuries in the elbow.
If you're looking at injuries
to the growth plate related to young men
or women who are throwers
and still have open growth plates, that's,
that might be some, somewhere you can look for sure
line placement in the, in the newborn can be problematic.
Certainly the 19 megahertz transducer is going
to be very helpful in,
in identifying vascular structures.
Historically difficult to see, as I mentioned,
exceptionally peripheral
and subcutaneous soft tissue structures
difficult to define in the past.
We're going to be able to see
- Wonderful.
- And I think just in general, you know,
recognizing pathologies that
with prior technologies left you with a question, is
that real or is it not?
I think we're going to have greater confidence
with the enhanced image clarity that we're,
that we're achieving with this,
these new high frequency transducers
and the number of channels that we now have with them.
- Wonderful. That's fantastic.
How is the color sensitivity on the L 19 five?
- The color sensitivity is wonderful
and I can demonstrate that if you'd like with the L 19.
There we go. These are very tiny vessels in the tip
of the finger that I, I think that you can see that
with directional doppler we can demonstrate quite well
if we go to color power doppler
again, we can see quite nicely.
- That's amazing.
- Okay. - And one more question in regards
to needle guided procedure.
Is the detection of the needle better with the SUNY px?
- Yes, that's a real improvement in
the ability to visualize the needle.
It takes, you don't have any longer the, the,
the steep, the medium
and the shallow needle advance that you have to select auto.
Auto steep needle, steep needle profiling
recognizes the needle as it's advancing
and allows you to see it, regardless of the
needle inclination.
And it's dramatically improved for in plain needle guidance.
- Fantastic. I think that is actually all
of our questions for today.
Craig, did you have one more slide to show?
- Yeah, I do. This has been the, the
behind the scan webinar series.
We have one more in, in the behind the scan series.
One more seminar. It's next week, October 7th
and next Wednesday.
And we invite you all back.
It would be great to, great to have y'all join us.
Discover every small detail. Aided by a new family of transducers, Sonosite PX can help clinicians more accurately visualize sonographic landmarks. Learn how our most advanced image clarity ever empowers physicians to provide more accurate, real-time diagnoses for faster treatment and increase in-house treatment options. See for yourself in this demo.
Craig Chamberlain has been with Fujifilm Sonosite for nine years, leading the Experience Design Team (XDT). The XDT has responsibility for gathering user insights, developing innovative solutions to user pain points, and designing the physical and digital interactions our users have with Sonosite products. In 2016, the XDT was recognized with a silver IDEA award for the Sonosite SII. Prior to Sonosite, Craig was President of Carbon Design Group for seven years, where he shepherded Carbon's transformation from a design services company to one of the nation’s premier full-service product development consultancies. That shift led to significant growth in revenue, influence, and recognition by the international design community, with Carbon sweeping the IDEA Gold awards for medical products in 2009.
Bill Medford joined Fujifilm Sonosite 10 years ago as the Lead Musculoskeletal Clinical Specialist. He is a certified sonographer, with credentials that include RDMS (abdomen and OB/GYN) and RMSKS (musculoskeletal). Bill brings 42 years of experience, with 22 years in musculoskeletal. Bill has held numerous invited faculty positions over the years. He is a member of the AIUM and has been an ARDMS MSK Subject Matter Expert since 2015.
This educational webinar is intended for healthcare professionals and not for patients or consumers. The material is provided for general educational purposes, as a reference and a supplement to professional experience, education and training, and should not be considered the exclusive source for this type of information. This educational webinar is not intended to recommend any device for a particular indication or to provide indications for use for any device. At all times, it is the professional responsibility of the practitioner to exercise independent clinical judgment in each particular situation. Fujifilm assumes no responsibility or liability for any misuse of the information imparted in this webinar. This educational webinar does not supplement, replace, or supersede device labeling, including instructions for use, which accompanies any FUJIFILM Sonosite product.