www.siemens.

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MAMMOMAT Inspiration
Operator Manual
VB61 or higher
MAMMOMAT Inspiration
Operator Manual
VB61 or higher
 Legend

Indicates a hint
Is used to provide information on how to avoid operating errors or information emphasizing
important details

Indicates the solution of a problem

Is used to provide troubleshooting information or answers to frequently asked questions

Indicates a list item

Indicates a prerequisite
Is used for a condition that has to be fulfilled before starting a particular operation

Indicates a one-step operation

Indicates steps within operating sequences

Italic Is used for references and for table or figure titles

Is used to identify a link to related information as well as previous or next steps

Bold Is used to identify window titles, menu items, function names, buttons, and keys, for example,
the Save button

Blue Is used to emphasize particularly important sections of the text

UI text Is used for on-screen output of the system including code-related elements or commands

User text Is used to identify inputs you need to provide

Menu > Menu Item Is used for the navigation to a certain submenu entry

CAUTION
&$87,21
Used with the safety alert symbol, indicates a hazardous situation which, if not avoided, could
result in minor or moderate injury or material damage.
CAUTION 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

WARNING
:$51,1*
Indicates a hazardous situation which, if not avoided, could result in death or serious injury.
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

4 Operator Manual
Print No. XPW7-330G.620.61.01.02
 Table of contents

1 Introduction 9
1.1 Information about this Operator Manual 9
1.1.1 Operator Manual parts 9
1.1.2 Area of application 9
1.1.3 Required documents 9
1.1.4 Structure 9
1.1.5 Names and parameters 9
1.2 Use of the product 10
1.2.1 Intended use 10
1.2.2 Screening 10
1.2.3 Stereotactic biopsy 10
1.2.4 Patient group 11
1.2.5 Contraindications 12
1.2.6 Physical functionality 12
1.2.7 User profile 12
1.2.8 Conditions of use 12
1.2.9 Technical features 13
1.2.10 Frequently used operating functions 13
1.2.11 Operating functions regarding safety 13

2 Safety 15
2.1 General Information 15
2.1.1 Laws and regulations 15
2.1.2 Safety/protective measures 15
2.1.3 General safety information 22
2.2 Personal safety 24
2.2.1 Radiation safety 24
2.2.2 Mechanical safety 26
2.3 Equipment safety 29
2.3.1 Functional and safety checks 29
2.3.2 Cleaning, disinfection 32
2.3.3 Disposal 34

3 System overview 37
3.1 System description 37
3.1.1 Range of application 37
3.1.2 Automatic modes for optimized exposures 37
3.2 Overview of total system 37
3.3 X-ray stand - Design and functionality 38
3.3.1 X-ray tube unit and collimator 39
3.3.2 Display and control elements on the X-ray stand 40
3.3.3 Compression/Decompression 41
3.3.4 Foot switch 43
3.3.5 Object tables 44
3.4 Acquisition workstation - Design and function 48
3.4.1 TFT monitor 48
3.4.2 Control box 49
3.4.3 Radiation release 49

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 Table of contents

4 Operation 51
4.1 Unit 51
4.1.1 Preparations before start 51
4.1.2 Switching on/start-up 51
4.1.3 Calibration 52
4.1.4 Basic operation 60
4.1.5 Compression plate 62
4.1.6 Face shield 62
4.1.7 Angle and height adjustment 63
4.1.8 Compression/Decompression 65
4.1.9 Object lighting 68
4.1.10 Magnification table (Option) 69
4.1.11 Biopsy (Option) 71
4.1.12 Switching off 72
4.2 Workstation 73
4.2.1 Application program 73
4.2.2 High-resolution monitor (3MP monitor) 75
4.2.3 System messages 76
4.2.4 Status bar 77
4.2.5 Exiting the program 78

5 Patient data management 81

5.1 Connection of a virtual machine to the AWS (depends on
license) 81
5.2 Multiple connected RIS 81
5.3 Displaying rejected images 81
5.3.1 Deleting rejected images 82
5.3.2 Deleting all rejected images 82
5.3.3 Displaying rejected images 83
5.3.4 Restoring rejected images 83
5.3.5 Print list of rejected images 84
5.3.6 Displaying the status of rejected images 84
5.4 Reenter the examination 86
5.4.1 Continuing interrupted examination 86
5.4.2 Repeating image processing 88
5.4.3 Correcting projection views 88
5.4.4 Adding a projection view 89
5.4.5 KOS function 90
5.5 Description of autodelete function 91
5.5.1 Checking disk usage 91
5.5.2 Deleting studies after checking image flags and
expiration period 92
5.5.3 Re-checking disk usage 93
5.6 List of abbreviations in mammography 94

6 Examination 99
6.1 Examination task card 99
6.1.1 Layout of the Examination task card 99

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 Table of contents

6.2 Performing an examination 105

6.2.1 Registering the patient 105
6.2.2 Selecting different examination settings 106
6.2.3 Settings in the generator control field 108
6.2.4 Modifying projection views 110
6.2.5 Making an exposure 111
6.2.6 Correcting projection views 114
6.2.7 Repeating image processing 115
6.2.8 Repeating an image 116
6.2.9 Rejecting/repeating an image 117
6.2.10 Enquiring exposure data of an image 119
6.3 Post-processing examination images 119
6.3.1 Activating/deactivating tools 120
6.3.2 Division of the image area 120
6.3.3 Scrolling 121
6.3.4 Zooming and panning images 121
6.3.5 Magnifying glass 122
6.3.6 Pixel lens 123
6.3.7 Distance lines 123
6.3.8 Angle 124
6.3.9 ROIs 124
6.3.10 Image captions 125
6.3.11 Inverting images 126
6.4 Filming/printing examination images 127
6.4.1 Transfer to the film sheet 127
6.4.2 Film preview 127
6.5 Completing the examination 128
6.5.1 Finishing an examination 128
6.5.2 Procedure tracking with MPPS 129

7 Configuration 131
7.1 Examination configuration 131
7.1.1 Configuration of the procedures 131
7.1.2 Configuration of WH AWS transfer 131
7.1.3 Starting configuration 131
7.1.4 Configuring procedures 132
7.1.5 Viewing the exposure programs 141
7.1.6 Changing projection name 142
7.2 Transfer and archive configuration 144
7.2.1 Image selection for auto transfer destinations 144
7.3 MoodLight configuration (option) 146
7.3.1 Calling up the configuration window 147
7.3.2 Configuring colors 147

8 Technical description 153

8.1 Identification labels 153
8.1.1 X-ray stand labels 153
8.1.2 Labels on the acquisition workstation 160
8.2 Curves and diagrams 164
8.2.1 Anode heating and cooling curves 164
8.2.2 Heating and cooling curves of the X-ray tube
assembly 165
8.2.3 Emission curves 165

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 Table of contents

8.3 Technical specifications 167

8.3.1 General information 167
8.3.2 Environmental conditions 173
8.3.3 Mirror stand 174
8.3.4 Acquisition workstation 175
8.3.5 Tube assembly 175
8.4 Notice concerning electromagnetic compatibility (EMC) 176
8.4.1 Guidelines and manufacturer's declaration -
electromagnetic emissions 177
8.4.2 Guidelines and manufacturer's declaration -
electromagnetic immunity 178
8.4.3 Guidelines and manufacturer's declaration -
electromagnetic immunity 179
8.4.4 Recommended protective distances between
portable and mobile RF telecommunication devices
and the system 181
8.4.5 Essential Performance of the system and its possible
degration in case of electromagnetical distorsions 182
8.5 List of compatible components 182
8.5.1 Compatible components MAMMOMAT Inspiration 182

9 Appendix 185
9.1 Calibration form 185

10 Glossary 187

Index 191

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 Introduction 1

1 Introduction
To operate the mammography system accurately and safely, the operating
personnel have to have the necessary expertise as well as knowledge of the
entire Operator Manual. It has to be read carefully prior to starting up the
mammography system.

1.1 Information about this Operator Manual

1.1.1 Operator Manual parts

To improve readability, your complete Operator Manual has been broken down
into several individual Operator Manuals with thematically distinct content:
◾ Operator Manual - MAMMOMAT Inspiration system
◾ Quality Control manual
◾ Safety Hints - syngo VI10A
◾ Options

1.1.2 Area of application

This Operator Manual is valid for the following product:
◾ MAMMOMAT Inspiration

1.1.3 Required documents

Reference is made in this Operator Manual to the following documents:
◾ MAMMOMAT Inspiration Quality Control manual
◾ General cautions and warnings - syngo VI10A
◾ Supplied documentation for the monitor

1.1.4 Structure
Register This Operator Manual includes various registers. The first header line shows the
title of the register.

Chapter Every register can contain one or more chapters. The chapter title is in the
second header line.

Page numbers The footer contains the page numbers and the number of pages in the register.
Only the registers have consecutive page numbers.

1.1.5 Names and parameters

All names and data on patients and equipment that are used as examples in this
Operator Manual are entirely fictional.
Any resemblance to names of real persons and institutions is entirely
coincidental.

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 1 Introduction

All parameters and images shown in this Operator Manual are examples. Only
the parameters displayed on your system are relevant.

 The MAMMOMAT Inspiration may be shown with expanded equipment or

with optional accessories in some figures.

1.2 Use of the product

1.2.1 Intended use

The MAMMOMAT Inspiration system is intended for mammography exams,
screening, diagnosis, and stereotactic biopsies under the supervision of medical
professionals. Mammographic images can be interpreted by either hard copy
film or soft copy workstation.

1.2.2 Screening
The MAMMOMAT Inspiration is ideally suited for screening purposes: it offers a
high degree of patient comfort and care and features a low-dose concept. Smart
features such as one-click image access and positioning with the push of a
button greatly simplify handling and enable the clinical user to arrive at a
precise diagnosis with ease. Due to its high patient throughput and its future-
proof design, MAMMOMAT Inspiration meets the strategic demands of cutting-
edge clinical facilities, thereby offering excellent investment protection.

1.2.3 Stereotactic biopsy

A simple workflow was one of the main design objectives for the MAMMOMAT
Inspiration. The smart, ergonomic design and intuitive operation allow for fast,
smooth, and user-friendly stereotactic biopsy exams. For even more efficiency,
biopsy images have the same high image quality as regular mammography
images.
The MAMMOMAT Inspiration comprises the following system components:

X-ray stand MAMMOMAT Inspiration: Stand column with integrated generator, swivel arm,
compression unit, flat detector object table, 2 foot switches

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 Introduction 1

STOP

Acquisition workstation MAMMOMAT Inspiration: Control console table with radiation

shield (optional), PC, flat screen, keyboard, mouse, keypad

 CAUTION

Display of Acquisition Workstation used for diagnostic purposes.

Incorrect diagnosis!
◆ The display of Acquisition Workstation shall not be used for diagnostic
purposes. Use viewing workstation certified as diagnostic workstation.

MAMMOMAT Inspiration biopsy unit (optional): Needle holder/needle positioning device,

safety switch, compression plate, hand box

Body region The system is suitable for a large variety of clinical visualizations such as:
◾ Visualization of vessels, soft tissues
◾ Visualization of implants
◾ Visualization of biopsy needles
◾ Visualization of preparations

1.2.4 Patient group

The MAMMOMAT Inspiration can be used for examining all types of patients
except pregnant women. When this system is used, the relevant applicable
country-specific requirements must be complied with. Qualified medical
personnel decide whether a radiographic examination is suitable or not based
on the patient's health and physical condition.

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 1 Introduction

1.2.5 Contraindications
Patients have to be informed about the hazards and safety measures during an
examination. Prior to the examination, it must be confirmed by a physician that
an examination is permissible, and checked whether increased precautions are
necessary.

1.2.6 Physical functionality

MAMMOMAT Inspiration universal X-ray system for screening and diagnosis with
digital detector and X-ray tube unit for examinations of breast tissue.

1.2.7 User profile

The system can be used properly only by suitably qualified medical personnel in
compliance with the relevant applicable country-specific regulations. This
requires operating personnel to be familiar with the Operator Manual. This
manual must be studied thoroughly prior to starting up the system. Special
attention must be paid to the following sections:
◾ General Safety Information
◾ Personal Safety
◾ Equipment Safety
◾ Maintenance

 CAUTION

Untrained personnel.
Unnecessary radiation exposure or incorrect diagnosis!
◆ Qualified personnel shall thoroughly study user documentation before
use. Country specific regulations to be considered.

Federal law 21 CFR 801.109 Caution: Federal law restricts this device to sale by or on order of a physician.

Training Instruction in the use of the system can take place either through application
training provided by a Siemens qualified application trainer or through self-
training based on this Operator Manual.

1.2.8 Conditions of use

The system is suitable for use in medical facilities such as hospitals or doctor's
offices. It can also be used in mobile units.
MAMMOMAT Inspiration may only be run in an environment approved or
authorized by the manufacturer. The system may not be operated in public
networks without firewalls or isolation.
Comply with the climate range specified in the ( Page 173 Environmental
conditions).

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 Introduction 1

 CAUTION

Operation in unsuitable environment.

Malfunction of system!
◆ The system may only be run in an environment approved or authorized
by the manufacturer. The system may not be operated in public
networks without firewalls or isolation. The climatic conditions specified
in the Technical Description register must be complied with.

Maintenance, cleaning and Refer to ( Page 29 Functional and safety checks)

disinfection

Service Service must be performed only by qualified technical personnel.

1.2.9 Technical features

Refer to ( Page 153 Technical description)

1.2.10 Frequently used operating functions

Refer to ( Page 99 Examination)

1.2.11 Operating functions regarding safety

Refer to ( Page 15 Safety)

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 1 Introduction

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 Safety 2

2 Safety

2.1 General Information

 The organization responsible for the safety of the medical device according
to IEC 60601 ff. is the user or the operator/operating company of the device.

2.1.1 Laws and regulations

If legally binding regulations govern the installation and/or the operation of the
product, it is the responsibility of the installer or the operator to observe these
regulations.
Modifying the medical product is not permitted.

Country-specific regulations The legally established country-specific regulations must be followed in all
countries. Deviating from this Operator Manual, values may be set according to
country-specific regulations.

CE marking This product is provided with a CE marking in accordance with the provisions of
Directive 93/42/EEC of June 14th, 1993, concerning medical devices.

Data security Data related to individual persons is subject to data protection. Ensure
compliance with all applicable laws and regulations.

Legally required tests Legally required tests must be performed at the specified intervals. These tests
include, for example:
◾ Constancy test according to the X-ray ordinance (§16 RöV) in the Federal
Republic of Germany.
◾ Tests based on DHHS guidelines (Department of Health and Human Services)
where applicable.

2.1.2 Safety/protective measures

Installation site The acquisition workstation must be placed outside the patient environment for
safety reasons.
The patient environment is determined by IEC 60601-1-1 as 1.5 m away from
the patient. If the spatial conditions do not permit this, there is the option to set
up the control console table up to a minimum of 750 mm from the
MAMMOMAT Inspiration, if additional protective measures are applied and the
safety distance of min. 500 mm to moving parts is maintained (refer to Project
Planning service documentation).
In the following illustration you can see an overview of the installation site of
the MAMMOMAT Inspiration.

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 2 Safety

150
(1)

ft)
m (5
.1,5
min

(2)

(1) X-ray stand

(2) Acquisition workstation

Explosion protection The system is not designed for operation in areas where there is an explosion
hazard.

Emergency STOP button If an emergency occurs in a movement of the system implying danger for the
patient, the operator or the system, press one of the red emergency STOP
buttons on the MAMMOMAT Inspiration at once.

(1)

ST OP
(2)

(1) Emergency STOP on both sides of the X-ray stand

(2) Emergency STOP on the control box at the imaging workstation

After engaging the emergency STOP button, the following should be observed:

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 Safety 2

◾ All unit drives will be switched off and all movements as well as radiation will
be interrupted.
◾ Decompression must be performed manually using the emergency unlocking
device at the head end of the compression unit. ( Page 42 Emergency
release)
◾ The emergency STOP button may not be reset (by turning it clockwise) until
the cause of the danger has been clearly detected and rectified.
Should the expected switch-off function not work, immediately press one of the
emergency shutdown switches. ( Page 17 Emergency shutdown switch)
Note: the system can only be disconnected from the power supply using the
emergency shutdown switch fitted during installation or by authorized service
staff.


If an error message appears during the examination, decompress using the
foot switch/hand switch if there is still power available or press the
emergency unlocking button if there is no power available.

 After release of emergency STOP button subsequent error messages might

be displayed. Please confirm these error messages and proceed.

Emergency shutdown switch If the MAMMOMAT Inspiration system is connected to an emergency shutdown
switch in the room, observe the following:
◾ The emergency shutdown switch must be operated at once if there is a
hazard for the patient, the operators, or the equipment.
◾ The entire system is immediately disconnected from the power supply.
◾ The system may not be put into operation again until the cause of the danger
has been clearly detected and rectified. In all other cases, for example, if the
equipment malfunctions, Siemens' Customer Service must be notified.

Implants In exposures with implants, fluctuations in image brightness may occur during
image post-processing due to exposure errors. To obtain optimal image quality
in these cases, it may be necessary to adjust the brightness by windowing.
Using the exposure table provided is recommended to prevent exposure errors
in exposures with implants.
( Page 108 Settings in the generator control field)

 WARNING

If breast implants are not taken into consideration, processing errors and
incorrect contrast settings will result in the examination.
Risk of injury during compression. Unnecessary radiation exposure if
repeat exposure is necessary!
◆ Ask the patient about existing implants prior to the examination. Provide
information about the risks of providing false information.

Archiving We urgently recommend that you archive the examination data as a routine at
regular intervals.

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 2 Safety

 CAUTION

Risk of loss of data due to rewritable CDs/DVDs.

The data on rewritable CDs (CD-RW) and DVDs (DVD-RW) can be
overwritten if the CD is full.
◆ Use only once writable CDs (CD-R) and DVDs (DVD-R) as permanent
storage medium.

 Make sure that no cables are disconnected during the current examination.

 CAUTION

The syngo-specific data storage on the local hard disk does not fulfill the
requirements for long-term archival.
Loss of data due to unsuitable storage medium!
◆ Promptly archive data on external storage suitable for long time
archiving, e.g. PACS or CD-R/DVD-R for medical use. It is recommended
to use auto-transfer rules.
◆ Don’t delete data from database before the archive request is
successfully finished and committed.

Security information Use of passwords

◾ Passwords must be stored in a safe place and must not be made available to
third parties.
◾ If a user suspects the unauthorized disclosure of a password, they must be
changed immediately.
◾ Written records of passwords are to be kept under lock and key.
Use of USB memory sticks and drives
◾ The use of USB memory sticks or drives can cause a virus or malware infection
of the system. Do not use USB memory sticks or drives from unknown
resources and perform virus check before connecting it to the system.
Data security
◾ Do not use the mammography system as archive or backup station.

Uninterruptable Power Supply (UPS) To ensure that no data (patient data, image data) get lost if there is an unstable
power supply and to protect the operating system (with all components), we
recommend that you install a UPS.

Anyone who connects additional equipment to the medical device


configures the system and is therefore responsible for ensuring that the
system configuration in its current version complies with the relevant
standards (e.g. system standard IEC/EN 60601-1-1 and/or other applicable
standards). In the case of queries please contact your local contact person.

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 Safety 2

Use of accessories The use of accessories that do not comply with the relevant safety requirements
of this system can result in a reduced safety level of the combined system.
When choosing accessories, the following aspects must be considered in
particular:
◾ Use of accessories close to the patient.
◾ Proof that the accessories have been safety tested according to the applicable
IEC 60601-1 guideline and/or IEC 60601-1-1 harmonized national standard.

Software The system and user software used in this product is protected by copyright.

 CAUTION

Danger from unapproved modifications to software.

Possible system malfunction due to virus contamination!
◆ Do not install any software but the approved software.
◆ Do not connect the workstation to the Internet.
◆ Protect the workstation from unauthorized access with a password.

 CAUTION

Danger from unauthorized access.

Possible loss of images!
◆ Protect the workstation from unauthorized access with a password.

 CAUTION

Connection of external computer equipment.

System malfunction!
◆ Don't connect any external devices to the interfaces of the acquisition
workstation (e.g. USB port) which haven't been delivered with the
system.

 CAUTION

Remote Service session during an ongoing examination

Abort or disturbance of an examination!
◆ Before remote service can be started, a user confirmation is necessary.
Please finish the examination before confirming.

Checks, tests Before the system is used for examinations, the user must ensure that all safety-
relevant devices function correctly and that the system is ready for operation.
Important functional tests and checks must be made at certain time intervals.
( Page 29 Functional and safety checks)

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 2 Safety

Information on the maintenance plan The tests and inspections required by national laws or regulations, such as DHHS
for checking the system regulations or RöV (constancy tests), are not part of the activities listed in the
Siemens maintenance plan.
If national laws or regulations specify more frequent checking and/or
maintenance, this must be observed.
Maintenance work should be performed by trained technical personnel only. To
keep the system in an optimum condition, we recommend that you conclude a
maintenance contract.
If you have any questions relating to maintenance/maintenance contract please
contact the appropriate Siemens Customer Service office.

 CAUTION

Lack of maintenance.
Injury to persons or damage to equipment!
◆ Ensure the performance of maintenance activities according to the
defined intervals and content.

Checking the system Initial maintenance for a new system is performed after 24 months and includes
all maintenance activities.

System/components

System/Components
Visual inspections
Mammography unit
Mechanical safety
Electrical safety
Radiation releases
Quality test
Concluding steps

Options

MoodLight
Magnification table
Biopsy attachment
Tomosynthesis Option
2nd monitor

Installation, repair Modifications of or additions to the product must be made in accordance with
the legal regulations and generally accepted engineering standards.

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 Safety 2

Being manufacturer, assembler, installer or importer, Siemens cannot take any

responsibility for the safety features or for reliability and performance
characteristics of the equipment, if:
◾ installation, equipment expansions, readjustments, modifications or repairs
are not carried out by persons authorized by us;
◾ components affecting safe operation of the system are not replaced by
original spare parts in case of malfunction;
◾ electrical installation of the room concerned does not meet the requirements
of the VDE 0107 regulation, or the corresponding national regulations;
◾ the product is not used in accordance with the Operator's Manual.
On request, we will make technical documents for the product available to you
at a charge which will be invoiced. However, this does not imply approval to
perform repairs. We accept no responsibility for repairs performed without our
express written approval.
We suggest that you obtain a report indicating the nature and extent of the
work performed from the persons carrying out such work. The report must show
any changes in rated parameters or operating ranges, as well as the date, the
name of the firm, and a signature.

Installation All information and installation requirements contained in the service

documentation require strict adherence.
If you should require additional information, please contact the qualified people
specified by the manufacturer.

Error messages and status indicators The system displays warnings and error messages as well as information about
current system status on the screen. It gives information on how to proceed in
each situation.


The error messages displayed by the system are self-explanatory. If the
problems are still unresolved following a system restart, please call Siemens
Customer Service.

 After system restart additional subsequent error messages might be

displayed. Please confirm these error messages.

Display elements ◾ Message boxes

Error messages and warnings are displayed in corresponding message boxes
(pop-ups) that appear on the screen, classification see
( Page 73 Application program).
If error messages with error codes are displayed, inform customer service.
◾ syngo status bar
Information about system status appears on the lower edge of each task card.
( Page 99 Layout of the Examination task card)
◾ Info bar
Information regarding exam status appears in the Examination task card
above the generator control field. ( Page 99 Layout of the Examination task
card)

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 2 Safety

◾ Protocol control
The status of a projection view (modifications and exposure progress) is
displayed by symbols in the protocol control of the Examination task card.
( Page 99 Control area)

Temperature monitoring As soon as the MAMMOMAT Inspiration is turned on, internal temperature
monitoring for the X-ray tube unit and detector is active.
The info bar indicates if the temperature of the X-ray tube unit or detector is too
high. In this case, wait until the message disappears. Then continue with the
exposure.

2.1.3 General safety information

Patient data
 CAUTION

Patient data are merged.

Examination data may be assigned to the wrong patient!
◆ Before confirming the message, make sure that the patient is one and
the same.

 CAUTION

Automatic deletion of archived patient data when database gets filled up.
Loss of patient data!
◆ Make sure that "archive" flag is set for transfer to authorized DICOM
archive nodes only.

 CAUTION

Inadequate patient positioning

Incorrect diagnosis due to unsuitable exposure control or image
processing. Injury to patient.
◆ The basis for patient safety and an appropriate image quality is the
correct positioning of the breast and the use of sufficient type of
compression plate and force. Please carefully read the recommendations
described in the manual. Educated and trained persons only are allowed
to use medical equipment.

Do not use auto transfer rule with "Sent" flag and auto deletion rule with

 "Sent" flag in combination, your data might be lost if both functionalities

start in parallel! Always crosscheck if the data chosen for auto deletion is
actually stored on the receiving system, before confirming auto deletion.

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 Safety 2

Documentation
 CAUTION

The syngo-specific data storage on the local hard disk does not fulfill the
requirements for long-term archival.
Loss of data due to unsuitable storage medium!
◆ Promptly archive data on external storage suitable for long time
archiving, e.g. PACS or CD-R/DVD-R for medical use. It is recommended
to use auto-transfer rules.
◆ Don’t delete data from database before the archive request is
successfully finished and committed.

 CAUTION

Loss of diagnostic information due to data compression.

Unnecessary radiation exposure if repeat of exposure is necessary!
◆ If lossy compression is selected for image transfer, the image quality at
the diagnostic workstation may be decreased. Lossless compression is
recommended for diagnostic purpose.
◆ Transfer images with lossless compression to a long-term-archive.

 Application of lossy compression is indicated in the image text except if “No

Text” is switched on.

 CAUTION

Scaled or cropped image on printed films if format is smaller than detector

size.
Faulty diagnosis or incorrect treatment possible!
◆ Use film sizes equal or larger than detector size. Printing in original size
is recommended.

 CAUTION

If you flip an image, all graphic elements you have entered (comment
texts, drawing elements, shutters, pixel lenses) will be removed from the
image.
Loss of data due to incorrect handling!
◆ Always flip an image before you add the required graphic elements.
◆ After flipping insert a note of the changed image position in the image.

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 2 Safety

 CAUTION

Sending data through the network with the attributes AC, SC signifies
secure data transfer. Flags AC/SC signal receipt and storage of data on hard
disk on the receiver side. However, the prescribed conditions with regard to
long-term archival are not fulfilled by this. Objects identified as
"committed" (confirmed) can be deleted by the user.
Risk of data loss in the prescribed archiving period due to erroneous/
incorrect interpretation of the AC/SC marks!
◆ Observe the regulatory requirements regarding the archiving procedure.

 CAUTION

Systems that do not use storage commitment only report back to the
sending system when the data has been fully received (flags A and S). A
user or an auto-delete mechanism at the sending system might
subsequently delete the sent data. However, this response does not imply
that the data has already been stored at the receiving system.
Risk of data loss!
◆ Observe the regulatory requirements regarding long-term archiving.

Images that meet the criteria for automatic deletion will be deleted even if
they have the Prot (protected) status.

 Images having the R (received) status will not be deleted by automatic

deletion. These images must be deleted manually.
Images having the P (printed) status will not be deleted by automatic
deletion. These images must be deleted manually.

2.2 Personal safety

2.2.1 Radiation safety

Safety of the personnel Although the MAMMOMAT Inspiration complies with the manufacturing
standards for medical X-ray equipment, radiation protection is largely dependent
on the behavior of the operating personnel.

 CAUTION

Danger from scattered X-ray radiation outside the radiation-protected area.

Personnel are exposed to unnecessary X-ray radiation!
◆ Always remain at the acquisition workstation in the radiation-protected
area during irradiation.

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 Safety 2

 CAUTION

Unsuitable dose level selected.

Unnecessary radiation due to repetition of exposure!
◆ The recommended settings are preset in "normal" dose level by factory
default. Before use of other dose levels, the user has to ensure that
image quality and dose meets dedicated needs (e.g. standard operating
procedure from responsible organization).

Radiation-protection regulations The following regulations must be observed:

◾ Radiation may be released only by authorized operators or persons with
proper authorization to apply ionized radiation.
◾ During exposure, the operator or other person shall stand behind the
radiation shield. If the exposure is to be released using the separate manual
control switch, the adjacent room must be protected from radiation
accordingly with an additional radiation shield or radiation-proof window.
◾ If the radiation shield is not used, the operator has to wear radiation
protection clothing with a 0.25 mm lead layer or similar clothing.
◾ Wear a film badge or pen dosimeter for monitoring of the personal radiation
exposure.

Radiation-protection areas
m
5
1,

(1) (2)

45

(3)
(4)

(1) Patient
(2) Low-radiation area
(3) Radiation shield
(4) Radiation-protection area

Patient safety Before exposure is released, it is the operator's duty to check that the exposure
parameters set at the workstation are the ones intended and that they have not
changed, while attending to the patient. If this is not done, the patient can be
exposed to unnecessarily high radiation.

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 2 Safety

The (FD) flat detector object table including the detector function as a beam
stopper. The face shield prevents the patient's head from coming into the beam
path.

(1)

(2)

(1) Face shield

(2) Beam path

 CAUTION

Leakage current when touching patient and electrical interfaces

simultaneously.
Injury to patient or operator due to increased touch current!
◆ Don't touch electrical interfaces (e.g. biopsy jack) during patient
positioning.

2.2.2 Mechanical safety

Risk of collision and crushing During the examination process and when positioning the patient operating
personnel and patient may grasp only the handles intended for this purpose.
It lies in the responsibility of the operating personnel to exclude all dangers for
the patient or third parties before system movements are initiated. This is
especially important when using the single-touch function and during the stereo
exposure procedure.

During upward, downward and pivoting system movements, avoid collisions

between:

 ◾ the object table and patient, user, third parties

◾ object table and system components
◾ swivel arm and patient, user

Possible danger areas are marked in the following figures by arrows.

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 Safety 2

Danger areas on stand

Danger area for operating personnel

Danger area for patients

Danger area – rotation

 CAUTION

Risk of collision and crushing during movement of the swivel arm.

Injury to patients or other persons!
◆ Ensure that there is a minimum distance of 50 cm between the swivel
arm and the surroundings.

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 2 Safety

 CAUTION

Moving the swivel arm using the single-touch function.

Injury to patients or other persons!
◆ Before activating the single-touch function, make sure that patient,
operators or others can be at no risk due to these movements.
◆ Before activating the single-touch function, remove all objects that could
lead to risk of collision.

 CAUTION

Unintended system movements due to malfunction of motion control or

switches.
Injury to patient or operator!
◆ Be aware of the location of emergency stop switches at the system and
the emergency shutdown switch in the room. The activation of
emergency stop switches or shutting down the system using the power
off or emergency shutdown switches will stop all movements and
radiation. The system will stay in a safe state.

Danger areas at the magnification

table (option)

Danger area for operating personnel

Risk of stumbling The operating personnel must be aware of that certain components of the
workstation or cables pose a risk of stumbling.

Mobile installations If MAMMOMAT Inspiration is used in a bus, the proper transport safeguards have
to be in place prior to transport.

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 Safety 2

(1)

 Ensure that the collimator cover (1) is positioned during transport of the
MAMMOMAT Inspiration and afterwards removed.

 CAUTION

Equipment falls over during transportation.

Injury to person!
◆ In case the stand needs to be transported, please turn the tube head to
180° position and move down the object table to the lowest position.

2.3 Equipment safety

2.3.1 Functional and safety checks

If a malfunction is discovered in the functional and safety check, the
MAMMOMAT Inspiration must be taken out of service until a service technician
from Siemens or a technician trained by Siemens has removed the malfunction
on site.

Daily checks

Prior to the examination

 CAUTION

Broken covers, applied parts or radiation shield.

Injury to patient or operator!
◆ Daily visual inspection of external parts for damages.

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 2 Safety

 CAUTION

Malfunction of the system control due to long operating time without self
test.
Injury to patient or operator!
◆ Restart the system at least once within 24 hours in order to run a full self
test every working day.

Basic system
1 Check the basic system for visible damages.
Displays and indicator lamps
2 Visually inspect all displays and indicator lamps on the stand.

 CAUTION

Danger in case of mismatch between size of detector field and X-ray

field.
Incorrect diagnosis!
◆ Check that the light field matches the compression plate used.

 CAUTION

Danger of compression plate tearing or breaking during compression.

Injury from sharp edges possible!
◆ Examine the compression plates, especially the side close to the chest
wall, for excessive wear before every use.
◆ Replace the compression plate if it is excessively worn or has visible
cracks.

Compression plates
3 The compression plates should only be used if they show no visible damages.
This is the only way to guarantee perfect functioning and minimize possible
risks for the patient.
Motorized movements
4 Make sure that the motorized movements run smoothly and normally.
Height adjustment and rotation
5 Check that height adjustment and rotation of the swivel-arm system are
blocked when the displayed compression force is ≥ 30 N (3 kg).
Movement of the swivel arm
6 Make sure that, during swivel arm movement with the single-touch functions,
neither the patient nor others are placed at risk or parts are found in the
swivel range.
Emergency release
7 Ensure that the emergency release works when pressed firmly.

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 Safety 2

Compression is then mechanically unlocked, compression plate can be

pushed up.

 When operating the emergency release, securely hold the compression

plate with the other hand.

During the examination

Radiation indicator lamp When the system is ready for exposure the radiation indicator on the keypad is
green. It may only light yellow when the exposure-release button is depressed.
Should the radiation indicator light up yellow without this button being
depressed, you must immediately switch the MAMMOMAT Inspiration off and
notify the Siemens Customer Service. Exception: During system startup the
radiation indicator will briefly light up yellow to check the LEDs.

 Observe radiation safety regulations.

Restart the system The system should be switched off after each working day ( Page 51 Starting
the system from the off state) and restarted on the next working day
( Page 72 Switching off).

Monthly checks

Emergency STOP button ◆ Check that the emergency STOP button is functioning correctly.
After pressing the emergency STOP switch, all motorized movements have to
be blocked.

 In the case of malfunctions switch off the power supply to the system and
notify the Siemens Customer Service.

Checking the field light 1 Mount the compression plate.

2 Place a sheet of white paper on the object table.
3 Lower the compression plate.
4 Switch on the light field.
5 Check whether the edges of the light field are coincident with the inside
edges of the compression plate (tolerance 1 cm).

Checking the automatic exposure 1 Select a kV value.

control (AEC)
2 Activate AEC mode.
3 Take an exposure with no object in the beam path.
The mAs values displayed should be smaller than 20 mAs.
4 Place a lead cover over the object table.
5 Take an exposure with the same generator setting.
A warning will be displayed.

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 2 Safety

Annual maintenance To maintain the safety and reliability of the unit, maintenance must be
performed every 24 months. If you have not concluded a maintenance
contract, please advise the Siemens Customer Service department.
For further information, see ( Page 20 Information on the maintenance plan
for checking the system).

2.3.2 Cleaning, disinfection

Before cleaning and disinfecting, the device has to be switched off.
However, when cleaning the parts which come into contact with the patients
during exam, it is not necessary to turn off the system.
These parts are:
◾ Compression plates
◾ Biopsy unit
◾ Object Table
◾ Patient support hand rest and
◾ Face shield

Cleaning All parts of the unit which come into contact with the patient must be cleaned
prior to examination. The plastic trays can be removed from the holder to
simplify cleaning.

 The compression plate can become contaminated or opaque. Therefore, the

patient's breast to be examined must be free of cosmetics (e.g. perfume).

 CAUTION

Use of unsuitable cleaning or disinfection agents

Damage of equipment
◆ Wipe off the system with a damp, non-fluffing, non-woven cloth or
cotton cloth (100 %).
◆ Moisten the cloth only with water or a lukewarm, diluted, aqueous
solution using a household cleanser without abrasives.
◆ Use biocompatible and non-inflammable cleaning and disinfection
agents (see list of recommended agents).
◆ Do not allow cleaning liquids to seep into the openings of the system.
◆ Disinfection wipes are recommended for disinfection.

 CAUTION

Using unapproved cleaning agents can accelerate the aging process of

plastics or leave residues.
Damage of equipment!
◆ Observe the instructions of the manufacturer for cleaning and
disinfection.

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 Cleaning agents shall not penetrate into the equipment.

Never wipe the surface of the MoodLight Plexiglas cover (option) with a dry
cloth. Improper cleaning procedures can damage the surface of the
MoodLight Plexiglas.

 Wipe off the system with a damp, lint-free, non-woven cloth or sponge.
Moisten the cloth only with water or a lukewarm, diluted, aqueous solution
using a household cleanser without abrasives.
For thorough cleaning, always a non-abrasive cleaning agent, such as
antistatic plastic cleaner and care product.

Disinfection As a general rule, no disinfectants sprays shall be used, since the spray mist may
penetrate into the equipment which means the safety of the equipment can no
longer be assured (damage to electronic components, formation of flammable
air solvent vapor mixtures).

 Disinfection wipes are recommended for cleaning and disinfection.

Anesthetics and skin disinfectants used during biopsies can damage or

discolor the plastic parts of the compression plates.

 Equipment damage due to anesthetics or disinfectants!

If such substances get onto the compression plates, wipe these off
immediately with a moist cloth.

Comply with the entries in the following table when disinfecting and sterilizing
mammography accessories:

Disinfection

Compression plate not permitted alcohol-based products

petroleum-based products
products containing hydrogen peroxide
phenols and their derivates have visible influ-
ence on the paddle surface

permitted disinfectants with quaternary ammonium

compounds
disinfectants without alcohol and hydrogen
peroxide for all compression troughs

Compression holder not permitted chlorine-containing products

organic acids containing products

permitted disinfectants with quaternary ammonium

compounds

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 2 Safety

Disinfection

Standard needle holder not permitted alcohol-based products

Special needle holder for dedicated biopsy sys- products containing hydrogen peroxide
tems
permitted disinfectants with quaternary ammonium
compounds

Magnification table, faceshield, covers such as not permitted no known restrictions on disinfectants
the detector cover
permitted 30% H2O2 hydrogen peroxide (except AHP's -
accelerated hydrogen peroxide, such as Oxi-
vir1 and Optim 1)
disinfectants with alcohol
disinfectants with quaternary ammonium
compounds

 The safety datasheets of the manufacturer provide detailed information on

the composition of the disinfectants.


Standard accessories manufactured by Siemens do not to be necessary to
sterilize, but accessories by suppliers e.g. bushings need to follow
manufacturer's guidance.

 Please note that the operating elements (particularly grooves and narrow
gaps) must also be disinfected.


Please note that disinfectants based on substituted phenols and chlorine-
splitting compounds have a slightly corrosive effect and therefore are not
recommended generally.

2.3.3 Disposal
Laws and directives can contain special regulations regarding the disposal of this
product or its components (including packaging materials).


Observe the relevant laws and directives for the disposal of the materials
used. You can obtain further information about this from the Siemens
Customer Service.

Materials used
Radiation Protection Material

Lead in the protective glass

Lead in the grid

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 Safety 2

Other Metal

In the X-ray tube assembly (single- Beryllium

tank)
Nickel
Molybdenum
Tungsten

In the detector Selen

In the collimator Molybdenum

Rhodium

Transformer Oil, type Shell 4655

Oil in the tube unit (single-tank)

Plastics

Epoxy resin on circuit boards

Insulating material (PVC) of the cables

Coating - polystyrene (PS-FR)

Electrolytic capacitors

Capacitors in the circuit board electronics

Batteries

Lithium batteries on CBS and rotary encoder

Mechanical dangers in disposal Please note that hazards may occur during disassembly and disposal of the unit.

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 System overview 3

3 System overview

3.1 System description

3.1.1 Range of application

The MAMMOMAT Inspiration is a Full Field Digital Mammography (FFDM)
system with FD (Flat Detector) based on aSe (amorphous selenium).
The MAMMOMAT Inspiration is used by medical specialist personnel for digital
mammography examinations, i.e. for diagnostic imaging.
A diagnosis workstation complying with the applicable regional requirements
(for example display) must be used for diagnostic work on the image data
acquired with the MAMMOMAT Inspiration.

3.1.2 Automatic modes for optimized exposures

The MAMMOMAT Inspiration has special automatic functions that help optimize
exposure parameters and therefore provide excellent image quality.

Optimized compression OPCOMP® The “optimized compression” (OPCOMP®) function determines the correct
compression force to be exerted on the breast based on individual features of
the breast. This provides optimal comfort for the patient as well as optimal
image quality.

AEC mode (Automatic Exposure The AEC automatic exposure control is available for standard exposures,
Control) magnification and spot examinations.
Principle of operation: A brief "AEC exposure" is taken before the actual
exposure. Using the pixel values (dynamic measurement over the entire breast
or in a limited area), the optimal parameters for the following exposure are
calculated and programmed into the system.

Automatic exposure system - OPDOSE With the automatic OPDOSE function, optimized exposure parameters for kV
and anode/filter combination are calculated based on the current compression
force and thickness. The larger the breast, the more high-energy radiation is
used. Dose and exposure time can be kept to a minimum in this way.
When using OPDOSE, it should be ensured that compression is carried out at
least up to the optimized OPCOMP compression to determine the optimized
exposure parameters.

3.2 Overview of total system

The MAMMOMAT Inspiration comprises the following system components:
◾ MAMMOMAT Inspiration X-ray stand
Stand column with integrated generator, swivel arm, compression unit, flat
detector object table, 2 foot switches
◾ MAMMOMAT Inspiration imaging workstation
Operating console with radiation shield (option), PC, flat-screen monitor,
keyboard, mouse, control box

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 3 System overview

ST OP

The MAMMOMAT Inspiration system

3.3 X-ray stand - Design and functionality

The X-ray exposure of the patient's compressed breast takes place on the X-ray
stand.

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 System overview 3

(1)

(2)
(9)
(3)
(4)
(2)
(5)

(6)

(7)

(10)
(8)

(1) Swivel arm with X-ray tube unit and collimator (integrated)
(2) Swivel-arm operation keys (on both sides) to adjust the height and angle
of the swivel arm and to turn on the field light
(3) Compression emergency unlocking device
(4) Compression/decompression control knobs (on both sides)
(5) Compression unit
(6) Object Table
(7) Patient support handles (on both sides)
(8) Stand display, digital
(9) Emergency STOP button
(10) Foot switches (2 switches; figure shows one foot switch)

3.3.1 X-ray tube unit and collimator

X-ray tube The X-ray tube used in the MAMMOMAT Inspiration is a Mo/W X-ray tube with a
rotating molybdenum/tungsten anode and four focal spots.

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 3 System overview

Collimator unit The collimator unit consists of the following components:

◾ Rotating filter disc with molybdenum and rhodium filters and mirror.
◾ Collimator
◾ Object lighting lamp

Filter disc The filter disc has three filters and one mirror.
The filter disc is positioned in the beam path with the mirror. When the exposure
button is pressed, the selected filter is inserted into the beam path.
Mo/W tube: Filter disc with three filters; 30 µm molybdenum, 25 µm rhodium
and 50 µm rhodium.

Object lighting The object lighting serves as a radiation-field indicator. It is turned on manually
using the swivel-arm operation keys or automatically by actuating the
compression foot switch.
( Page 40 Operation of swivel arm)

3.3.2 Display and control elements on the X-ray stand

Emergency STOP button

◾ Pressing (in an emergency): All system movements and X-ray radiation are
stopped.
◾ Turning clockwise (when situation has been rectified): Unit drives and X-ray
radiation are enabled again.

Operation of swivel arm

(1)
(4)
(2) (5)

(3)

(6)

(1) Raise swivel arm (height adjustment)

(2) Turn swivel arm counterclockwise (angle adjustment)
(3) Lower swivel arm (height adjustment)
(4) Turn swivel arm clockwise (angle adjustment)
(5) Single-touch button
Press briefly: Press automatic movement to the preset angle position for the
next projection view.
Briefly again (during movement): Movement stops.
Press the single-touch button again to resume movement.
Press for a long time: Transfer angle position to the opposite side.
(6) Field light On; Off automatic (automatic On when the foot switch
compression pedal is activated)

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 System overview 3

The rotation of the swivel arm stops automatically at -90°, 0°, +90° for
manual movement.

 Field light is not switched on automatically when each button is pressed.

The single-touch function: In addition to the preset angle position, any
angle can be set using the Rotate swivel arm counterclockwise/Rotate swivel
arm clockwise buttons.

 CAUTION

Moving the swivel arm using the single-touch function.

Injury to patients or other persons!
◆ Before activating the single-touch function, make sure that patient,
operators or others can be at no risk due to these movements.
◆ Before activating the single-touch function, remove all objects that could
lead to risk of collision.

 CAUTION

Unintended radiation release with the exposure button.

Unnecessary radiation exposure!
◆ Note that unintentionally pressing the exposure button can release
radiation while the system indicates it's ready for exposure.

3.3.3 Compression/Decompression
Control knobs Compression/decompression is driven by a motor. With the control knobs it is
possible to adjust compression/decompression manually.
◾ Turning knob downward: manually compress
◾ Turning knob upward: manually decompress

 You can also control compression and decompression using the foot
switches. ( Page 43 Foot switch)

In the event of a power failure or if an error message is displayed (foot switch for
decompression does not work), release the patient as follows:

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 3 System overview

Emergency release

(1)

(1)

(3)

(2) (2)

1 Forcefully press the emergency release button (1) with one hand, and keep
the button pressed.
2 Place the other hand under the compression plate (2) and press it upward.
The patient's breast can be removed from the compression plate.
3 First remove the hand from the emergency release button, and then remove
the hand from the compression plate.
Make sure the compression plate does not fall on the detector.
If the emergency release button is blocked, proceed as follows:

(1) (1)

(3)

(2)

4 Forcefully press the emergency release button (1) with one hand, and press
against the compression holder (3) with the other.
The emergency release button is released.
5 Keep the emergency release button pressed.
6 At the same time, place your hand under the compression plate (2) and press
it upward.
The patient's breast can be removed from the compression plate.
7 First remove the hand from the emergency release button, and then remove
the hand from the compression plate.
Make sure the compression plate does not fall on the detector.

 The system is automatically reset upon pressing the emergency unlocking

device. Confirm the error message on the AWS monitor.

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 System overview 3

Stand display The stand display is located at the base of the X-ray stand.

(1) (2) (3)

0 219 0
- mm N (5)
Fletcher Mae (4)
X-ray stand display

(1) Projection angle

Current angle of the swing arm in [°]
Rotation range: +180° to -180°.
(2) Thickness of the compressed object in [mm]
(3) Compression
Compression force (F), expressed in N [Newtons]
The actual compression force is displayed during compression.
Status display when using OPCOMP: optimum compression attained, the
force indicator flashes.
(4) Patient name
Display of the registered patient
(5) Blocked movements:
As soon as the (P) is displayed the table movements are blocked.

3.3.4 Foot switch

Motorized compress/decompression and the swivel arm height adjustment are
controlled by the two mirrored foot switches. It is recommended that the foot
switches be placed on each side of the X-ray stand.

 Make sure that the foot switch is positioned sot that the foot switch pedals
for compression (3, 4) point to the center in each case.

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 3 System overview

(1) (2) (3) (4)

(1) Raise swivel arm (height adjustment)
(2) Lower swivel arm (height adjustment)
(3) Raise compression plate (decompression)
(4) Lower compression plate (compression)

 Object illumination switches on automatically when the foot-switch pedal is

activated.

3.3.5 Object tables

Flat-panel detector object table (FD)

Flat-panel detector object table (FD)

The detector in the object table is 24 x 30 cm.

Magnification table (option)

Magnification table

The magnification table is used for magnification exposures. The magnification

factor is 1.5 and 1.8. Upon mounting the magnification table, the grid is
automatically moved out of the radiation path and the focal size is changed.

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 System overview 3

The system recognizes whether or not the magnification table is installed.

 For example, if you want to start a magnification exposure without having

the magnification table installed, a corresponding warning is displayed on
the workstation.

 Only one magnification table can be configured.

Compression plates

(2)

(1)
Example: Compression plate 24x30H

You will find a complete list of the available compression plates in the
( Page 182 List of compatible components)

The plastic inserts in the compression plates can be re-ordered if there are
cracks or scratches on the plate.

 The plastic trays can be removed from the holder to simplify cleaning.
To remove the exchangeable plastic trays, slightly lift the two latches (1) on
both sides and pull the plastic tray (2) out of the holder.

 The size of the radiation field depends on the selected compression plate.

Spot Plus compression plate (Option) The Spot Plus compression plate is used for spot filming, where the spot of the
lesion is positioned in the center of the Spot compression plate. The collimator
format is 18 x 24 cm.

Example: Spot Plus compression plate

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 3 System overview

Shifting Paddle compression plate The Shifting Paddle compression plate can be used for 18 cm x 24 cm
(Option) exposures. The compression plate can be moved to the left or right by means of
a handle.

Example: Shifting Paddle compression plate

Functionality 1 Move the compression plate by actuating the handle until the plate is in the
right position.
The compression plate locks in position.
A green display (1) lights up in the small window.
The AEC segmentation follows the position of the plate.
The position of the collimator is controlled by the position of the tube head
(greater than +20°/less than -20° - corresponds to lateral compression plate
position).
The collimator automatically adjusts the radiation field size to the size of the
compression plate. For a CC view, the shifting paddle should be positioned in
the detector center. For MLO/ML/LM views, the paddle must be positioned at
the top (cranial).
2 Check that the illuminated field size matches the compression plate used.

 CAUTION

Incorrect beam collimation when using shifting paddle.

Unnecessary radiation exposure!
◆ As the beam collimation is related to the projection view when using
the shifting paddle, check that the illuminated field size matches the
position of compression plate before exposure.

2D biopsy compression plate (Option) The 2D biopsy compression plate is used for performing biopsies or for marking
the breast without biopsy unit. The coordinates (numbers and letters) are used
for guidance to signal in which hole the biopsy or marking is to take place. The
breast should remain compressed throughout the biopsy phase.
If the 2D biopsy compression plate is used in the examination, the X/Y
coordinates may not always be visible in the images. For smaller objects place a
skin marker (lead ball) (3) into the center of the compression plate.

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1 2 3 4 5 6 7 8 9 (1)
A A (2)
B B
C
(3)
C
D D
E E

(1) Marks for the X-coordinate with numbers (1 - 9)

(2) Marks for the Y-coordinate with letters (A - E)
(3) Skin marking (lead ball)

Create procedures and the corresponding projection views for the 2D biopsy
images.

 Do not perform a 2D biopsy if the coordinates of the compression plates are

not visible in the image.


The 2D biopsy compression plate does not allow for measurements to
determine the depth of a lesion inside the breast. The depth of the lesion
must be determined from previous images.

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3.4 Acquisition workstation - Design and function

(1)

(2)

(3) ST OP

(4)
(5)
(6)

(7)

(8)

(1) Radiation shield (option)

(2) Monitors
(3) Control box
(4) Operating console
(5) Keyboard (on keyboard shelf)
(6) Mouse
(7) Workstation with DVD drive
(8) Foot switch

Examinations using the MAMMOMAT Inspiration system are controlled at the

acquisition workstation.

3.4.1 TFT monitor

For information about the TFT monitor, see supplied documentation for the
monitor.

When the main switch on the back of the RX360 monitor is used to turn off
the monitor, the image displayed on the RX360 monitor is shifted to the

 second monitor. Even after the RX360 monitor is turned back on, the image
is not moved back. This RX360 monitor will still display a black screen. The
second monitor displays the contents of both monitors overlapping. Please
restart the system to correct this behavior.

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3.4.2 Control box

(1) STOP

(2) (5)

(3) (6)

(4)
(1) Emergency STOP
All system movements and X-ray radiation are stopped.
(2) Not used
(3) Raise compression plate (decompression)
Press the button. Decompression begins (to 130 mm).
(4) Start radiation (exposure button)
The button lights up yellow during irradiation (radiation display).
System readiness: Button flashes green
Exposure readiness: Button lights up solid green.
(5) System OFF
(6) System ON
When the system is ready for operation, the button lights up green.

 CAUTION

Unintended radiation release with the exposure button.

Unnecessary radiation exposure!
◆ Note that unintentionally pressing the exposure button can release
radiation while the system indicates it's ready for exposure.

3.4.3 Radiation release

In addition to the radiation release at the control box, you can also use a hand
switch or a foot switch.

With hand switch (option) The hand switch is plugged into the control box.

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(1)

(1) Release button

Releasing radiation

1 Press the button to release the exposure.

The exposure is released.
2 Hold down the button until the acoustic signal ends.

 Please note that the operating staff always has to be located behind the
radiation shield when releasing radiation with the hand switch.

With foot switch (Option) The foot switch is plugged into the control box.

Foot pedal

Releasing radiation ◆ Keep the foot pedal pressed during radiation release.

 Please note that the operating staff always has to be located behind the
radiation shield when releasing radiation with the foot switch.

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4 Operation

4.1 Unit

4.1.1 Preparations before start

( Page 32 Cleaning)

4.1.2 Switching on/start-up

The MAMMOMAT Inspiration system is started from the switched off mode.
The X-ray stand and the workstation with TFT monitor at the acquisition
workstation are switched on and off by separate corresponding switches:

(1)
ST OP

ST OP

(2)
(3)

(1) TFT monitor on/off switch

(2) Workstation on/off switch
(3) X-ray stand on switch (on the control box)

Starting the system from the off state If the MAMMOMAT Inspiration has been switched off at the main power switch,
you have to restart the entire system.

 Note that the MAMMOMAT Inspiration detector requires approx. 15 minutes

to warm up before images can be generated.

1 Switch the main power switch in the room on.

2 Press the startup button on the control box to activate the MAMMOMAT
Inspiration.
The internal monitoring system automatically performs a functional check of
the MAMMOMAT Inspiration.
3 Switch on the workstation and the monitor at the acquisition workstation.
The workstation will boot up.

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4 Log in at the workstation.

 Activate the single-touch functionality by rotating the swivel arm once in

+90° and then in -90° angle.

 A login with user name and password is necessary if user administration has
set up access protection, see Option Security Package.

The on and off switching functions for the mammography system can be


configured by Siemens Customer Service:
To switch the system on, it is sufficient to press the system ON button on
the control box. This button switches on the MAMMOMAT Inspiration and
the AWS PC. The AWS PC does not have to be switched on separately.


Please note in the event the AWS is restarted and the message appears
indicating that the connection to the detector has been interrupted during
startup, confirm with OK.

4.1.3 Calibration
The detector settings can be changed by external influences (e.g. temperature
fluctuations, humidity, vibrations). For this reason, a regular calibration of the
detector is required.

Type of calibration Your MAMMOMAT Inspiration offers a large number of different types of
examinations. To ensure the optimal detector settings for each type in all cases,
the following different types of calibrations are performed:

Type of calibration Special features

Contact none

Magnification without magnification table

If the difference between the detector temperature and the calibration

 temperature reaches 7°C or more, allow the MAMMOMAT Inspiration to

warm up for at least 30 minutes in order to ensure optimal results in the
image quality test.

Calibration intervals As a rule, the detector should be calibrated every 3 months.

The calibration should also be performed if the constant room temperature
deviates by more than 7 °C from the temperature at the last calibration.

 Note that the MAMMOMAT Inspiration requires approx. 5 minutes after start
up before the calibration can be started.

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 Calibration is performed without a compression plate.

Contact The Contact calibration method is used for standard mammography exposures.

Magnification After the calibration for magnification has been activated, it may take up to 10
minutes before the system is ready for calibration. The user receives the
message "Detector is busy. Please wait." After the message has disappeared from
the info bar, the magnification calibration can be performed.

Biopsy unit (option) Accuracy of the stereotactic biopsy unit, see Biopsy unit

Tomosynthesis (option) Accuracy of tomosynthesis, see Tomosynthesis Option

Preparations

Removing the face shield The face shield must be removed prior to starting calibration.
◆ Bend the sides of the face shield slightly to the outside to withdraw it from
the holder.

Preparing the swivel arm Before you begin calibration, you have to set the swivel arm up for the
calibration.
1 Install the 40 mm Plexiglass plate on the swivel arm so that the entire image
area is covered.
2 Remove the compression plate.

Performing a calibration Calibration images are generated with constant exposure parameters in the
course of the calibration. You can evaluate the quality of each individual
exposure and determine which calibration images are to be used for the
detector calibration and which are rejected.

 Detector calibration is carried out for all 3 anode/filter combinations

(Mo/Mo, Mo/Rh, W/Rh).

It is recommended to reject images which show sharp white lines at the

 edges or artifacts due to dirt particles or obstructions. Images of the

detector areas represented as homogeneous, rectangular patterns in the
image are normal.

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(1) Image appropriate for calibration

(2) Image inappropriate for calibration

Starting the calibration 1 Select Patient > Detector calibration from the main menu of the
Examination task card.
The Service Patient is automatically registered.
The Calibration subtask card is displayed.

(1) Next required step

(2) Area for selection of type of calibration
(3) Date of the last calibration for the respective type of calibration
(if a “!” appears, the calibration is overdue)
2 Click on the type of calibration you want to perform.

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
When the calibration subtask is selected, the exposure parameters are
automatically correctly set and displayed in the generator control field for
each anode/filter combination. ( Page 102 Generator control field)

3 Click on Start Calibration.

Calibration images When calibration is started, the Calibration subtask card for the type of
calibration selected changes. The projection view to be acquired is shown in the
Images subtask card.

The number of projection views to be acquired for the respective calibration

mode (Contact, Magnification) differs. The number of projection images to be
acquired is displayed in the Images subtask card.

1 The first projection view will automatically be activated when Start

Calibration is selected.

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2 Press the exposure button on the control box.

Radiation is released and the first calibration image is taken.
After the exposure is complete, the finished image is displayed in the image
area.
3 Click Accept if the exposure is suitable for calibration.
The detector is re-calibrated on the basis of the calibration image.
– or –
Click Reject if the exposure is not suitable.
The calibration image is rejected and a new exposure is added.
4 Accept all other calibration images still displayed in the Images subtask card.
The number of accepted and rejected exposures is counted in the Calibration
subtask card.

Ending the calibration As soon as you have calibrated the detector using a sufficient number of suitable
exposures (recommendation: 15 images), then the calibration process is ended.
The following message window appears:

◆ Confirm the message window by clicking Yes to start calibration calculation.

Calculation successful The following message window appears when the calculation is successful:

1 Confirm the message window with OK.

The calibration closes automatically.
2 Remove the 40 mm Plexiglass plate.

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
A small rectangular structure can be seen on the calibration images in the
upper right corner of the detector. This has no effect on calibration and
image quality of the clinical exposures.

 Wait ten minutes after calibration is completed before embarking on the

patient examination.

Calculation unsuccessful The following warning window appears when the calculation is unsuccessful:

This message means that several non-functioning pixels were found during the
calibration. This requires a system check by a Siemens service technician.
◆ Call a Siemens service technician or a technician trained by Siemens.

Until the analysis by the service technician, clinical operation may continue
if:

 ◾ the daily checks run without errors

◾ there are no visible artifacts
◾ the quality authorities have no objections

Check calibration results You can select and evaluate the calibration results. The results of all calibration
types can be found in the service menu.
The system generates a result in a log file for each individual calibration type:
◾ for calibration type CONTACT
◾ for calibration type MAGNIFICATION
◾ for calibration type TOMOSYNTHESIS
1 Select Options > Service > Local Service (without password).
2 Select Acquisition System > Detector > Detector Calibration.
The Log file of last calibration window is displayed.

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Calibration mode CONTACT 1 The results for the CONTACT calibration mode can be found under * Mode
CONTACT.
Only one evaluation is displayed at a time.
2 Scroll to the end of the CONTACT calibration type.
The end of the CONTACT calibration type is where the MAGNIFICATION
calibration type begins, entry * Mode MAG.

3 At the end of the CONTACT calibration mode check the message:

“Acceptance test passed”: This message means the calibration was
performed successfully.
Or

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“Acceptance test failed”: This message means that several non-functioning

pixels were found during the calibration. This requires a system check by a
Siemens service technician.

If the system includes a magnification table or the Tomosynthesis option, then

the MAGNIFICATION and TOMOSYNTHESIS calibration modes can be checked in
the same way as the CONTACT calibration mode.

Calibration mode MAGNIFICATION ◆ The results for the MAGNIFICATION calibration mode can be found under *
Mode MAG.

Calibration mode TOMOSYNTHESIS ◆ The results for the TOMOSYNTHESIS calibration mode can be found under *
Mode TOMO.

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4.1.4 Basic operation

Safety during the examination
 WARNING

Parts of the body may be jammed and crushed by motor-driven system

movements.
Injury to patient or operator!
◆ Ensure that the patient is positioned correctly. Pay attention to the
potential collision and crush points on the system. ( Page 26 Risk of
collision and crushing)

 WARNING

Parts of the body may be jammed and crushed by motor-driven system

movements.
Risk of injury due to moving system parts.
◆ Ensure that the patient is positioned correctly. Pay attention to the
potential collision and crush points on the system.
◆ In an emergency, immediately press one of the red emergency-stop
switches located on the X-ray stand and the control box .
◆ Before activating the single-touch function, make sure that patient,
operators or others can be at no risk due to these movements.

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 CAUTION

Incorrectly registered patient data can cause incorrect examination results.

Faulty diagnosis or unnecessary radiation exposure if repeat exposure
is necessary!
◆ Before every examination, ensure that the patient in question is really
assigned to the patient data and examination procedure currently
loaded in the system.

Examination workflow How to perform an examination:

At the acquisition workstation 1 Register and load the patient into the Examination task card with the
required examination data.
( Page 105 Performing an examination)
2 Activate of the first projection view or, upon opening the examination, the
first projection view is activated.
( Page 111 Making an exposure)

At the X-ray stand 1 Install a compression plate corresponding to the examination.

( Page 62 Compression plate)
2 Attach the face shield, if necessary.
( Page 62 Face shield)
3 Adjust swivel arm to the desired projection angle.
( Page 64 Adjusting the projection angle)
4 Adjust the swivel arm to the correct height.
( Page 64 Adjusting the projection angle)
5 Position the breast to be examined on the object table according to the view
selected on the acquisition workstation.
6 Lower the compression plate using the compression control knob or foot
switch.
The compression force and the compressed thickness of the breast are shown
on the stand display.
7 Make sure that the breast is correctly compressed.
Using the field light, check that no skin folds have formed during
compression. The nipple should be represented in profile, whenever possible.
8 Make sure that only the breast to be examined is inside the radiation field.

At the acquisition workstation 1 Check the preset exposure parameters. Adapt the examination settings, if
necessary.
( Page 106 Selecting different examination settings)
2 Release an exposure. To do this, press and hold the exposure button on the
control box until the acoustic signal ends.

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 The radiation indicator may light only when the exposure button is
operated. Observe radiation protective measures.

3 Make sure the breast is decompressed, automatically or manually,

immediately after exposure.
4 Check image quality. Repeat image processing if necessary.
( Page 115 Repeating image processing)

At the X-ray stand or acquisition 1 Repeat steps “Adjust swivel arm to the desired projection angle.” ( Page 61 At
workstation the X-ray stand) to “Check image quality. Repeat image processing if
necessary.” ( Page 61 At the acquisition workstation) until you have acquired
all projections.
2 Finish the examination.
( Page 128 Finishing an examination)

At the reporting station ◆ Report the diagnosis at the reporting station.

4.1.5 Compression plate

Mounting the compression plate 1 Insert the guide of the compression plate into the receiver on the
compression unit.
The compression plate automatically locks in position.
The compression plate is encoded.
The collimator automatically adjusts the radiation field size to the size of the
compression plate.
2 Check that the illuminated field size matches the compression plate used.

 For optimum exposure and lowest possible radiation exposure, select the
size of compression plate as small as possible.

Removing the compression plate

◆ Press the release button on the compression-plate receiver and pull the
compression plate out.

4.1.6 Face shield

The face shield prevents the patient's head from coming into the beam path.

Installing the face shield ◆ Push the face shield into the holder.

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Removing the face shield The face shield must be removed when using the magnification table.
◆ Bend the sides of the face shield slightly to the outside to withdraw it from
the holder.

4.1.7 Angle and height adjustment

Setting the projection angle and the height of the swivel arm are motorized.
The movements are controlled with the swivel-arm operation keys. These are
located on both sides of the swivel arm and the compression unit.
( Page 40 Operation of swivel arm)
The height can also be set using the foot switch. ( Page 43 Foot switch)

Information about swivel-arm

 WARNING
movements
Danger from motor-driven system movements.
Injury from jamming of or collision with patient possible.
◆ When adjusting the height of the swivel arm, ensure that no patient
body parts are within the danger areas. ( Page 25 Radiation-protection
areas)
◆ When rotating the swivel arm, ensure that the patient remains at a safe
distance from the X-ray stand. Special care must be taken for patients in
wheelchairs.

The rotation and height adjustment are always locked when the

 compression force is around 30 N (3kg) or more. The locking of the system

is indicated by the sign (P) next to the compression force in the X-ray stand
display.

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 CAUTION

Instable compression force results in premature release of swivel arm

movement.
Injury to patient!
◆ Check compression force on a regular basis as described in quality
control manual (mechanical tests).

 Note that the swivel arm always returns to the 0° position as soon as the
single-touch button is pressed at the end of an examination.

Adjusting the projection angle The swivel arm can be rotated isocentrically between +180° (clockwise) and
-180° (counterclockwise).

Moving to the projection angle The projection angle for each projection view is already preset in the
workstation configuration. ( Page 131 Examination configuration)
1 Briefly press the single-touch button.
The swivel arm automatically moves to the preset angle position for the next
projection view.
The angle position is displayed on the stand display.
2 Press any keypad to stop movement.
The rotation movement stops in the current angle position.
3 Press the single-touch button again to resume movement.

 For safety reasons, the rotation movement automatically stops at ± 90°.

Additional functions of the single-touch button:

◾ The set projection angle can be changed at any time using the setting buttons
for rotation movement.
◾ If the projection angle has been changed, then it will be transferred for
exposure of the opposite side. The changed projection angle for the opposite
side is moved to automatically.
◾ Preset projection angle in the range from - 90° to + 90° can be moved to.
◾ Customer service has to release the single-touch function upon installation.
◾ The single-touch function has to be activated per working day. Move the
swivel arm with the setting buttons for rotation movements to between - 90°
and + 90°. The single-touch function is then active for 24 hours after this.

Trimming the projection angle If necessary, the projection angle can be trimmed by actuating the rotation
movement buttons again for desired adjustment.

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1 Press and hold the Turn swivel arm counterclockwise or clockwise.

2 Release the button when you reach the desired angle position.
The rotation movement stops in the current angle position.
The angle position is displayed on the stand display.

For safety reasons, the rotation movement automatically stops at 0° and ±

 90°. To resume movement, release the button briefly and press it again.
Rotation automatically stops when the system end position of ± 180° is
reached.

Adjusting the height of the swivel The swivel arm can be adjusted to a height between 69 cm and 150 cm above
arm the floor relative to the 0° angle position.

Adjusting height with the operation

keys

1 Press and hold the Raise or Lower swivel arm button.

2 Release the button when you reach the desired height.
The movement stops at the current swivel-arm height.

Adjusting height with the foot switch The pedals for adjusting the height are marked with an X-ray tube icon.

Height-adjustment icon on every foot switch

1 Press and hold the corresponding pedal for raise or lower the swivel arm.
2 Release the pedal when you reach the desired height.
The movement stops at the current swivel-arm height.

For safety reasons the swivel arm automatically stops moving downward

 when it reaches 82 cm from floor level. To resume movement, release the

foot switch briefly and then press it again. The swivel arm stops
automatically when it reaches a position 69 cm above the floor.

4.1.8 Compression/Decompression
Compression and decompression are driven by a motor controlled with the foot
switch or the control knobs on the compression unit. The compression speed
will automatically decrease when the compression plate comes in contact with
the breast and the compression force is more than 10 N (1 kg).

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Information about compression/

 CAUTION
decompression
Danger from unintentional activation of the compression foot switch.
Patient injury due to crushing possible!
◆ Move the foot switches outside the reach of the patient and personnel
as soon as the patient's breast is compressed.

 CAUTION

Unsuitable compression settings lead to poor image quality.

Faulty diagnosis or unnecessary radiation exposure if repeat exposure
is necessary!
◆ Whenever possible, use the automatic OPCOMP function to ensure
optimal compression and therefore optimal image quality.
◆ Ensure that the breast remains compressed during the entire exposure.

 CAUTION

Motion artefacts in the image due to low compression force.

Decreased image quality!
◆ Make sure that the compression force is high enough to keep the object
in place for the whole scan procedure.


Motor-driven decompression is not possible during a power failure. In this
case you have to activate the emergency compression release and push the
compression plate up by hand. ( Page 41 Compression/Decompression)

 The maximum compression force applied by the motor is preset in the range
between 50 N and 200 N (approx. 5 kg - 20 kg) at the workstation.

 If the projection view is selected during the breast compression, an error

message appears. Close the error message and continue as normal.

Compression using foot switch The compression/decompression pedals are marked with a compression/
decompression icon.

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Compression/decompression icon on every foot switch

1 Press and hold the corresponding pedal to lower (compression) or raise

(decompression) the compression plate.
Object lighting automatically turns on during compression.
2 Release the pedal when you reach the desired compression force.
The movement of the compression plate stops at the current height.
The compression force and compressed thickness are indicated on the stand
display.

Optimized compression OPCOMP® The automatic “optimized compression” OPCOMP® mode is activated at the
workstation. Compression of the breast until the optimal compression force is
achieved is controlled with the foot switch or control knob.

Information about OPCOMP® ◾ It is important that you trust OPCOMP® when you learn to use it. If OPCOMP®
is used correctly, you achieve unchanging and correct compression
examination for examination.
◾ Some breasts may require 200 N (20 kg) for correct compression. If this is
more force than is permitted in the clinic, a maximum compression force for
the exposure technique concerned can be set at the workstation by service.
◾ The “optimized compression” is intended as a recommendation for the
operator. Additional force up to the preset value can be applied by pressing
the foot switch again. If the preset maximum compression force is less than
the “optimized compression” value, the preset maximum force applies.
◾ OPCOMP® optimized compression is always combined with the OPDOSE
procedure. OPCOMP® can only be switched off in the Advanced dialog box.
This setting remains for the entire examination.
◾ Patients with implants, or patients who recently had breast surgery, must not
be exposed to the “optimized compression”.
Use instead the foot switch in the normal way, or the control knobs for
manual compression, to adjust proper compression force on the breast.
◾ OPCOMP® optimized compression works with all compression plates. For the
24 cm x 30 cm Flex compression plates, the compression thickness and force
are displayed incorrectly.

Step-by-step procedure 1 Check the generator control field at the workstation to ensure that OPCOMP®
is switched on. ( Page 103 Advanced dialog box)
2 Set the object table to the correct height and the correct angle for each
patient.
3 Position the breast on the object table.

 Correct positioning is indispensable for OPCOMP®.

4 Lower the compression plate onto the breast.

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5 Precompress the breast to 20 - 40 N (2 - 4 kg). It is recommended that this

pre-compression be carried out gradually by applying “pumping” technique on
the foot switch, in order to maintain correct positioning of the breast and to
avoid skin folds.
6 Perform optimized compression by pressing and holding the foot switch until
OPCOMP® interrupts the compression and the stand display signals that
optimal compression has been achieved. ( Page 43 Stand display)

Compression using control knob The control knobs for compression/decompression are located on both sides of
the compression unit.
1 Turn the knob downward (compression) or upward (decompression).
2 Release the control knob when you reach the desired compression force.
The movement of the compression plate stops at the current height. As soon
as compression begins, the compression plate moves down more slowly.
The compression force and compressed thickness are indicated on the stand
display.

Automatic decompression When automatic decompression is active, the compression plate lifts up approx.
13 cm after each exposure.
Automatic decompression is already preset by the selection of the examination
procedure at the workstation. If necessary, it can be manually activated or
deactivated. ( Page 103 Advanced dialog box)

 Early termination of an exposure also triggers automatic decompression.

Decompression during a power If motor-driven decompression is not possible, you must actuate the emergency
failure unlocking device at the head of the compression unit.

1 Firmly press the compression emergency unlocking device.

Compression is mechanically unlocked.
2 Push the compression plate up by hand.

 The system is automatically reset upon pressing the emergency unlocking

device. Acknowledge the error message.

4.1.9 Object lighting

Object lighting serves as a radiation-field display for correctly positioning the
breast. It is normally automatically switched on when the compression foot
switch is pressed.

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 CAUTION

If the breast is positioned improperly, other body parts may also be in the
radiation field.
Unnecessary patient radiation exposure possible!
◆ Position the patient with the aid of the object lighting so that only the
breast being examined is located in the radiation field.
◆ Make sure that no area of the breast is in the X-ray shadow.

Manually switching on object lighting Object lighting can be switched on manually at any time using the swivel-arm
operation keys.
◆ Press the object lighting key.

Switching off object lighting Object lighting is automatically switched off after a certain time (determined at
the installation of the system, normally 20 seconds).
Object lighting also switches off when an exposure is started (if the exposure is
completed before the preset time has elapsed).

4.1.10 Magnification table (Option)

 Using the magnification table obtains a 1.5x or 1.8x magnification of the

object.

(1)

(2) (3)

(1) Magnification table

(2) Handles
(3) Object Table

 Use a magnification compression plate or a spotview magnification

compression plate for selective spotview.

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 If using spot compression plate please mount also face shield.

For acquisitions of magnification views the compression plates for magnification

must be used, e.g. magnification compression plate (16 cm x 20 cm), spot
compression plate (9 cm x 9 cm).

Mounting the magnification table 1 Grasp the handles of the magnification table.
2 Press the bars on the handles of the magnification table and place the
magnification table on the object table.
The magnification table locks into place.

Removing the magnification table ◆ Press the bars on the handles of the magnification table and pull the
magnification table away from the object table at the same time.

Taking a magnified exposure To perform a magnified exposure, you will need

◾ a magnification table and
◾ a corresponding compression plate (magnification plate/spotfilm)

 Spotfilms can be made with a compression plate (magnification plate/

spotfilm). The image must be labeled accordingly, e.g., R-sCC.

The compression plate holder will automatically move to the corresponding

position once the magnification table has been mounted. The grid is
automatically moved out of the beam path.
The system automatically loads the detector data for the magnified exposures
after the installation of the magnification table and the compression plate
(message appears on the Info bar). The system is now ready for a magnified
exposure.

When the magnification table is used for the first time on a work day, it may

 take approx. two minutes for all required detector data to be loaded. The
waiting time will be shorter for all following examinations on the same
work day.

Check the exposure parameters in the generator control field.

(1) Grid position Out (setting in the dialog window Extended)

(2) Small Focus

 Create procedures and the corresponding projection views, as well as image

processing parameters, if applicable, for the magnified images.

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If an exposure is possible, but the projection view does not match the system
status (e.g., magnification table and magnification compression plate installed,
but projection view for standard exposure), this projection view will be shown in
the Images subtask card.
As soon as the exposure is performed, the display of the exposure will be
followed by a projection view such as L-mCC (correct), with the corresponding
projection view (L-mCC).

When taking exposures with the magnification table, make sure to use the

 right compression plate for magnification or magnification spotfilm. The

image will only be correctly collimated with the proper compression plates
and the accurate display of the compression thickness.

Please note that large markings are displayed as projection designations in

the exposure.

 The size of the markings depends on the image size:

◾ Markings on large exposures (18 cm x 24 cm, 24 cm x 30 cm) are
displayed larger than markings on spot exposures (9 cm x 9 cm).


In examinations using a magnification table and low compression pressure,
the spot paddle compression plate is easily visible on the exposure at the
edge of the chest wall side.


Specimen projection views cannot be acquired using the magnification
table. Perform a normal magnification projection view with a manual
exposure.

4.1.11 Biopsy (Option)

Work sequence of an examination 1 Register the patient.
with the 2D biopsy compression plate
Select the corresponding procedure and projection view.
Activate the exposure.
Automatic decompression must be switched off. For this purpose, open the
dialog window Extended and set Auto-Decompression to Off.
2 Attach the 2D biopsy compression plate.
3 Set the height of the swivel arm, and the projection angle if applicable.
4 Position the breast. The lesion must be located in the area of the holes.
Compress the breast.
5 Take the exposure. The image is displayed on the monitor. Check whether
the lesion is located within a hole. If not, you may need to re-position the
breast.
6 Using the coordinates on the monitor (numbers and letters), determine the
hole in which the lesion is located.
7 Switch on object lighting.

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8 Insert the biopsy needle into the selected hole.

The depth must be estimated based on the previous images.
9 Perform the biopsy, repeatedly if necessary.
10 If a lesion was marked, make lateral control images with standard
compression plates if necessary.
11 End the examination.

 CAUTION

Blood or dirt enters the collimator.

Damage of collimator!
◆ When performing biopsy in the 180 degree position, make sure that
no blood or dirt enters the collimator (e.g. cover the radiation
window during puncture).

 A 2-D-biopsy shall not be performed if the coordinates of the compression

plates are not visible in the image.

 CAUTION

Danger due to unintended decompression.

Risk of injury during decompression!
◆ Make sure automatic decompression is deactivated during a biopsy
examination.

 CAUTION

Unintended decompression during procedure.

Repetition of examination necessary!
◆ Move the foot switches outside the reach of the patient and personnel
as soon as the patient's breast is compressed.

4.1.12 Switching off

The system should be switched off after each working day. Before you switch off
the MAMMOMAT Inspiration, the examination has to be closed and the
workstation has to be shut down properly to avoid possible loss of data.

 CAUTION

Examination interrupted.
Unnecessary radiation exposure if repeat exposure is necessary!
◆ Make sure that the switch off button on the control box is not pressed
during the examination.

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Shutting down workstation 1 Select the End Session dialog window at the workstation with Options > End
Session.
For details, see ( Page 78 Exiting the program).
2 Click Shutdown System.
The workstation is shut down.

Switch the system off

◆ Press the off button on the control box.

The switch-off function for the mammography system can be configured by

Siemens Customer Service.

 To switch off, the workstation must be shut down:

In the main menu, select Options > End Session and press the System OFF
button on the control box.

4.2 Workstation

4.2.1 Application program

After logging in, the user interface of the program appears on your screen. It is
subdivided into the following areas:

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(1)

(2)

(3)

(4)

(5)
(6)

(1) Menu bar

(2) Task cards
(3) Control area with subtask cards
(4) Image area
(5) Generator control field
(6) Status bar

 The workstation is only suitable for image acquisition and not as a reporting
station or long-term archive.


The AWS monitor does not show the images in original size. Use the
postprocessing tool to measure the dimensions. ( Page 119 Post-
processing examination images)

 CAUTION

Misinterpreted image dimensions.

Incorrect diagnosis!
◆ The AWS monitor does not show the images in original size. Use the
postprocessing tool to measure the dimensions.

Task cards The arrangement of the task cards reflects routine operation in the hospital or
practice and their layout supports the examination procedure, for example:
◾ You can perform the examination in the Examination task card.
◾ You can view the results and process them in the Viewing task card.

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Call-up with the help of tabs

◆ Click on the tab on the right-hand side of the screen to activate a task card.

Calling up using the function keys You can also switch to each task card using the function keys.
1 Press the F5 key to switch to the Examination task card.
2 Press the F6 key to switch to the Viewing task card.

Setting the screen saver The screen saver is automatically enabled during system installation. Use the
Screen Saver configuration (Options > Configuration) to configure the inactivity
period (time-out) before activation.

 This option is only available if access protection is set up, see Option
Security Package.

◆ Double-click on this icon to display the Screen Saver configuration window.

The time-out for the screen saver should not be set too small.
For example, selecting a time-out of 0 seconds can result in the following:
The screen remains dark.
The screen saver can no longer be changed.
The workstation is locked.
The screen saver can only be reset by reinstalling the system.

4.2.2 High-resolution monitor (3MP monitor)

In addition to the color monitor with normal resolution, you can connect a high-
resolution monitor to the workstation. This allows you the option of showing
two different task cards at the same time.
The images are shown at high resolution on this monitor.
The 3MP monitor can be used in portrait and landscape format. This must be
considered and configured during the installation.

 Even with the high-resolution monitor, the workstation is only suitable for
image acquisition and not as a reporting station or long-term archive.

Layout The display remains unchanged on both monitors except for the Examination
task card.
On the Examination task card on the left screen, the image section is on the
right and the control section is at the bottom.

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After logging in, the Examination task card interface appears on your high-
resolution screen. It is subdivided into the following areas:

(1)

(2)

(3)
(4)

(5)
(1) Menu bar
(2) Examination task card
(3) Image and workspace of the task card
(4) Control area
(5) Information window
In the information window, you are guided step by step through the
examination.
You can go all the way back to the first instruction step by step using the
Previous screen button. You can scroll forwards to the last instruction step
by step with the Next button.

Functionality Invoking the functions does not change.

The dialog windows Patient list and Patient registration are displayed on the
screen on which they are invoked. If you invoke a window that has already been
opened (e.g. the Patient Browser) again on the other screen, then the
respective window will be transferred to the other screen.
The help windows and the messages windows are always displayed on the
monitor with normal resolution.

4.2.3 System messages

Different types of system messages can appear on the workstation monitor. The
type of message is identified by a corresponding symbol (top left):

Information messages support the user in continuing the

examination procedure or the database search.

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Warnings request from the user special attention before con-

tinuing the relevant procedure.

Error messages refer to an abnormal operating situation.

Question messages require from the operator the confirmation

of a step that was initiated by the system or the operator.

 Acknowledge the displayed error message. The affected components are

reset automatically and the examination can be continued.

4.2.4 Status bar

The status bar at the bottom edge of the window shows you messages and
instructions and contains the storage capacity icons.

(1) (2) (3)

It is subdivided into three columns:

(1) The first column displays examination-specific information.

(2) The second column displays warnings and messages.
(3) If functions are being executed in the background you will see the
application as an icon in the third column, next to the storage capacity
icons.

Action history The actions executed by the program are automatically logged together with
information about whether each step was successfully terminated or whether an
error occurred. You can query a list of the last entries in the history at any time.
◆ Click on the task bar with the left mouse button to list the last commands and
program actions.


You can determine the number of entries in the log in the History Size
dialog box that you call up by clicking the status bar with the right mouse
button.

Resource check Your system monitors the memory usage and the storage capacity of the main
database, the scheduler database and the exchange board (virtual memory).

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Main database and scheduler

By the storage capacity icon you can see how much space has already been
taken up in the local database. If the filled capacity rises above a configurable
limit (default 95 %), the icon changes color from green to red.
If you move the mouse pointer to this icon, the percentage of storage capacity
already taken up is displayed.
Archive the patient and examination data in time and delete them in the Patient
Browser to ensure that sufficient capacity is always available.

Virtual memory
 CAUTION

Insufficient memory or disk space may lead to system instability or

blocking.
Risk of data loss. The system is not available in emergency cases under
certain circumstances!
◆ Observe the warning symbols for the storage capacity and make sure
that sufficient storage space is available.

The flashing storage capacity icon in the status bar indicates that the virtual
memory is already full.
The message Resource Monitor is displayed.

4.2.5 Exiting the program

Before you switch the workstation or the MAMMOMAT Inspiration off, the
workstation must be shut down using the dialog box End Session. This properly
shuts down all programs that are running.

Safety information about exiting the

 CAUTION
program
Danger from switching off the computer from standby mode or before it
has completely shut down.
Data errors, data loss, system blocking or system damage possible!
◆ Shut the system down completely before you switch off the computer.

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End Session dialog box In the End Session dialog box, you have various ways of ending your session
and shutting down your system.
◆ Call up Options > End Session... in the main menu.
The End Session dialog box is displayed.

Locking the computer ◆ Click on Lock Computer to restrict access to your computer.
The computer can only be used after the password has been entered.

Logging off ◆ Click on Log Off <user name> to exit the program.
The computer ends the individual program parts one after the other and saves
the last settings.

 Only available if access protection is set up, see Option Security Package.

Other users 1 Click Log In Different User... if you want to log in to the already started
system.
2 Enter the user name and the password.
Dialog boxes and patient data are hidden corresponding to your
authorization.

 Only available if user management is activated.

Shutdown ◆ Click on Shutdown System..., if you want to close the system or switch it off.
The system shuts down.
You can now switch the computer off with the on/off switch.

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5 Patient data management

 For additional information regarding patient data, see the syngo VI10A
Online Help.

5.1 Connection of a virtual machine to the AWS

(depends on license)
◆ Click this button.
If configured an RIS or PACS application will open.

 The user is aware that he is not allowed to use the Virtual Client for any
other applications.

5.2 Multiple connected RIS

The AWS lets you configure two or more RIS connections.
◆ Click on the Update Worklist from SIMRIS button on the screen.
The RIS connection no. 1 becomes active in the Patient Browser.

5.3 Displaying rejected images

The list of rejected images is created in your local database. Here you can find
out at any time which rejected images of patients are available.
◆ Click on the Manage repeated/rejected images button on the tool bar.
The WH AWS Management of Repeated/Rejected Images dialog is
displayed.

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 It might be necessary to deselect Complete time frame to display the

complete list.


If an image was repeated/rejected and the operator was changed during the
examination, the WH AWS Management of Repeated/Rejected Images
dialog will display the last operator name.

 Rejected tomo images will be not displayed in the list but the are taken into
account for the statistical analysis.

5.3.1 Deleting rejected images

1 Select a rejected image that you want to delete.
2 Click on Delete.
The WH AWS dialog box is displayed.

3 Click Yes.
The rejected image is deleted from the list.
– or –
Click on No.
The rejected image is not deleted from the list.

5.3.2 Deleting all rejected images

You have the option of deleting all rejected images from the list.
◆ Click on Delete all.
All existing images are deleted.
All statistics are not deleted.

 Please note that the "Automatic Delete" function cannot be used with
rejected images.

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5.3.3 Displaying rejected images

1 Select a rejected image that you want to view.
2 Click on View image.
The selected image is displayed in the dialog box.

3 Click on OK.
The View Image dialog box closes.

5.3.4 Restoring rejected images

1 Select a rejected image that you want to restore.
2 Click on Undo discard.
The WH AWS dialog box is displayed.

3 Click Yes.

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The selected image is restored.

– or –
Click on No.
The selected image remains rejected.


If the patient and examination data are no longer located in the local
database, you must check the name of the patient when restoring a
rejected image.

5.3.5 Print list of rejected images

◆ Click on Print list....
The list of rejected images is sent to the printer as soon as a paper printer is
connected.

5.3.6 Displaying the status of rejected images

1 Click Show analysis.
The WH AWS Repeat/Reject Analysis dialog is displayed.

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(1) Number of rejected images in a time period

(2) Percentage
of all exposures
of rejected/restored images
of rejected images
of restored images
(3) Reasons for rejected images
List can be sorted by reasons, percentage, etc.
(4) Display of existing users
(5) Selection list of existing users
(6) Result display for selected user

 If only one user exists, the bottom part of the dialog box can be ignored.

2 Click Print statistics....

The contents of the WH AWS Repeat/Reject Analysis dialog are sent to the
printer.
3 Click on Export analysis...

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The Export repeat/reject analysis ... dialog is displayed.

Enter the file name and path.
The contents of the WH AWS Repeat/Reject Analysis dialog are saved. In
addition, information such as hospital, address, SW version, etc. is saved.
4 Click on Reset.
All statistics are deleted.
All images are not deleted.
5 Click on Update.
The WH AWS Repeat/Reject Analysis dialog is updated.
6 Click on Close.
The WH AWS Repeat/Reject Analysis dialog is closed.

5.4 Reenter the examination

The stored studies are filed in your local database. You can resume an
examination here at any time, e.g. if you want to:
◾ continue an interrupted examination
◾ process and project view anew or
◾ add a new project view.

5.4.1 Continuing interrupted examination

The examination had to be interrupted, because the patient felt faint or for a
similar reason. You can continue the examination on the same day or later.
1 Select in the local database the study of the patient the patient data of which
you want to load again in the Examination task card.

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
You cannot resume a study if the study is open in the Viewer at the same
time.
First close the study in the Viewer.

2 Click the Reenter examination button in the tool bar.

The selected study is loaded in the Examination task card.

3 Double click in the Images subtask card on the outstanding image to release
the operating console for the examination.

4 Click on this button to close the patient.

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If the patient cannot be loaded in the scheduler with a double click in the


Examination task card, or if a resumption of the patient is not possible
(since the MPPS status is DONE), then the examination can be started via
Patient Registration > Examination. The corresponding procedure must
appear in the Examination task card.

If comments are stored in a new series and the patient is closed, this patient


cannot be opened again in the Examination task card. Reenter the
examination is not possible. Reenter the examination is only possible if a
study only consists of 2 series. Comments, remarks, etc. are only saved
upon resuming newly acquired images.

5.4.2 Repeating image processing

1 Select the study of the patient in the local database.
2 Click the Reenter examination button in the tool bar.
The selected study is loaded in the Examination task card.
3 With the right mouse button, click on the image affected in the Images
subtask card.
You can correct the exposures, change the image attributes, restore images,
reject/restore images, or reprocess.
For a detailed description of the entries, see ( Page 115 Repeating image
processing).
4 Select the entry, e.g. Reprocess... .

5.4.3 Correcting projection views

The procedure to apply if you wish to resume an examination and correct the
projection views is as follows:
1 Select the Correct item.
The Correct projection view dialog box is displayed.

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2 First, define the special settings for the projection views (1) required.
3 Then click in the area of the available PVs (2) on the projection view you
want.

5.4.4 Adding a projection view

1 Select the study of the patient in the local database.
2 Click the Reenter examination button in the tool bar.
The selected study is loaded in the Examination task card.
3 With the right mouse button, click on an arbitrary projection view in the
Images subtask card.
4 Select Add in the displayed popup menu.
The Modified Views window is displayed.
5 Select the desired projection view, ( Page 94 List of abbreviations in
mammography).
6 Click on OK.
The new projection view is added at the end of the projection sequence on
the Images subtask card.

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7 Double click in the Images subtask card on the outstanding image to release
the operating console for the examination.
8 Take the corresponding exposure.

5.4.5 KOS function

The KOS (Key Object Selection) function must be activated in the Service menu
by Siemens Customer Service. The KOS Information button then appears in the
Patient Browser.
After an examination the stored studies are filed in a local database. If you
resume an examination and then close the examination, the modified or
corrected patient data are stored in the database again.
Using the KOS function, make sure that
◾ only the modified patient data is available
◾ no invalid patient data can be sent/used
◾ the administration of the patient data is managed automatically.
The KOS function only manages patient data that are modified using the
following functions in the case of the resumption of an examination:
◾ Correct projection views
◾ Reject + Repeat projection views

 Note that the KOS function cannot be used for examinations with the
biopsy unit and Tomosynthesis Option.

1 Close the patient.

The modified patient images are sent to a local database.
This database contains only the current patient images.The invalid patient
images are moved automatically.
A new series, the KOS series, is inserted into the study concerned in the
Patient Browser.
This KOS series can be administered from the corresponding archives or PACS
systems in accordance with the IHE mammography workflow.

(1) KOS Information button

(2) KOS Series
2 Click the KOS Information button.

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The system automatically creates a KOS Information object. This object

contains all of the information relating to the modified projection view.
Correct KOS information for project view

Reject + Repeat KOS Information for project view

5.5 Description of autodelete function

The autodelete function consists of 3-steps:
◾ checking disk usage
◾ deleting studies after checking image flags and expiration period
◾ re-checking disk usage

5.5.1 Checking disk usage

Resource monitor displays actual fill level of different HDD partitions. First two
lines are important for autodeletion:
◾ line 1 stays for patient data database part (name, birthday etc) -> partition D:
◾ line 2 stays for image database part -> partition E:

Figure 1: Resource Monitor

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The circle or also called pie-diagram shows the fill level of highest value of
partition D: or E: (1-st and 2-nd line of resource monitor window).

Figure 2: Acquisition System

There are two values to define for autodeletion:

◾ database fill level
◾ image age
Autodeletion task starts only once during startup when database fill level (2-nd
line of resource monitor window) is above defined value (an image age is not
considered in this step).
In current example case, the circle/pie diagramm shows 40% (highest value of
two first lines of resource monitor window). The autodeletion will not start due
do the database fill level behind specified (40% vs. 80%); image age is not
considered for starting autodeletion.
If the actual fill level reaches or exceeds the user defined fill level limit, a dialog is
presented to the user asking to confirm autodeletion. If the user acknowledges
the dialog, the autodelete process goes on with the image and expiration check,
otherwise the autodelete process is interrupted and the system startup
continues.
If the fill level limit is set to 0, the autodelete function is disabled.

5.5.2 Deleting studies after checking image flags and expiration

period
When database fill level exceedes the defined fill level the autodelete taks will
start. In this step an image is deleted if all the processed images belonging to its
parent study fulfill the autodelete conditions.
In this case the complete study is deleted.
In all other cases the study and all its images remain in the database. In other
words the deletion is performed on study level.
Following autodelele conditions apply:
1 Examination image pairs
Examination image pairs are deleted if they have one of the flags:
◾ Archived (“A” in Patient Browser) or
◾ Archived-Verified (“AV” in Patient Browser) or
◾ Archived-Committed (“AC” in Patient Browser) or

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◾ Printed (“P” in Patient Browser) depending on the autodelete

configuration setting on the service interface (see Figure 1, where this
value is NO)
◾ and all the images are older than the image expiration period (see Figure 2,
where this value is 30 days)
◾ and the hierarchy (Patient-Study-Series-Image) does not have the Protect
flag (“Prot” in Patient Browser).
2 Imported images (does not work in System Version VB21x and VB30x)
◾ Imported images are deleted if they have the Received flag (“R” in Patient
Browser) and
◾ all the images are older than the image expiration period (see Figure 2,
where this value is 30 days) and
◾ the hierarchy (Patient-Study-Series-Image) does not have the Protect flag
(“Prot” in Patient Browser).
3 Calibration images
Calibration images and image pairs are deleted if they are older than the
image expiration period (see Figure 2, where this value is 30 days) and they
do not have the Protect flag (“Prot” in Patient Browser).

5.5.3 Re-checking disk usage

After finishing the delete phase the disk’s fill level is checked once again. If the
fill level limit is still reached, the user is informed about this via a pop-up
message also displaying proposal for possible solutions.
1 If the fill level of the general local database rises above a configurable limit
(default is 95%, see Figure 1), the storage capacity icon’s color is changed
from green to red. In this case the patient and examination data have to be
archived and deleted to regain sufficient disk capacity. One of the possibilities
is autodeletion, but please note, that it will only free up the necessary
amount of disk space if the above autodelete conditions are fulfilled.
2 After deleting (either automatically or manually) series/studies containing
transferred images, the transferred image files will only be removed from the
hard disk (partition ‘E’), if the corresponding transfer jobs (see job control list
in the Network Job Status dialog, Figure 3) are also deleted. The number of
completed transfer jobs which should be appear maximally in the job control
list is configurable (maximum: 15, default: 5). Exceeding this limit, the oldest
completed job will be removed from the list. Failed jobs are not counted as
completed and are not deleted automatically, therefore the corresponding
image files will not be deleted either.

Figure 3: Network Job Status

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3 From the autodelete point of view a flag is only set - and therefore will be
considered during the autodeletion checks - if it is set on the processed image
of an image pair. It means for example that if only a raw image has the
protect flag but all other autodelete conditions are fulfilled in a study, the
corresponding study will be deleted.
4 If the Patient Browser shows lower case flags (i.e. “a”, “p”, “r”), this indicates
that not all images of a patient have the corresponding flag.
Following cases are possible:
◾ A series has lower case flags if not all images in that series have the
corresponding flag (e.g. only 3 images out of 4 have the Archived flag).
◾ A study has lower case flags if not all its series have the corresponding
upper case flag (e.g. in case of 2 series only one has “A” or both have “a”).
◾ A patient has lower case flags if not all its studies have the corresponding
upper case flag (e.g. in case of 2 studies only one has “A” or both have “a”).
5 If all the studies of a patient are deleted, the patient will be deleted as well.
6 The default value of the autodelete configuration setting of printed images is
NO (see Figure 2), i.e. printed images are not deleted automatically per
default.
7 Rejected/discarded images are not deleted automatically.

5.6 List of abbreviations in mammography

Abbreviations Definition

Default Setups CC Cranio Caudal

MLO Medio Lateral Oblique
LMO Latero Medial Oblique
LM Latero Medial
ML Medio Lateral
AT Axillary Tail
FB From Below (Caudocranial)
SIO Superolateral-to-inferomedial oblique
CV Cleavage View
rm rolled medially
rl rolled laterally
tan Tangential
XCC Exaggerated Cranio Caudal
XCCL Exaggerated Cranio Caudal (Lateral)
XCCM Exaggerated Cranio Caudal (Medial)

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Abbreviations Definition

Implant displaced MLOid Medio Lateral Oblique Implant displaced

- id
CCid Cranio Caudal Implant displaced
MLid Medio Lateral Implant displaced
LMid Latero Medial Implant displaced
XCCid Exaggerated Cranio Caudal Implant displaced
XCCMid Exaggerated Cranio Caudal Medial Implant displaced
FBid From Below Implant displaced
SIOid Superolateral-to-inferomedial oblique Implant displaced
LMOid Latero Medial Oblique Implant displaced

Spot - s sMLO Spot Medio Lateral Oblique

sCC Spot Cranio Caudal
sML Spot Medio Lateral
sLM Spot Latero Medial
sXCC Spot Exaggerated Cranio Caudal
sXCCL Spot Exaggerated Cranio Caudal Lateral
sCCM Spot Exaggerated Cranio Caudal Medial
sFB Spot From Below
sSIO Spot Superolateral-to-inferomedial oblique
sLMO Spot Latero Medial Oblique

Magnification msMLO Magnification Spot Medio Lateral Oblique

Spot - ms
msCC Magnification Spot Cranio Caudal
msML Magnification Spot Medio Lateral
msLM Magnification Spot Latero Medial
msXCC1 Magnification Spot Exaggerated Cranio Caudal
msXCCL Magnification Spot Exaggerated Cranio Caudal Lateral
msXCCM Magnification Spot Exaggerated Cranio Caudal Medial
msFB Magnification Spot From Below
msSIO Magnification Spot Superolateral-to-inferomedial Oblique
msLMO Magnification Spot Latero Medial Oblique

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Abbreviations Definition

Magnification - m mMLO Magnification Medio Lateral Oblique

mCC Magnification Cranio Caudal
mML Magnification Medio Lateral
mLM Magnification Latero Medial
mXCC1 Magnification Exaggerated Cranio Caudal
mXCCL Magnification Exaggerated Cranio Caudal Lateral
mCCM Magnification Exaggerated Cranio Caudal Medial
mFB Magnification From Below
mSIO Magnification superolateral-to-inferomedial Oblique

Rolled medial - rm MLMO Magnification Latero Medial Oblique

MLOrm Medio Lateral Oblique rolled medial
CCrm Cranio Caudal rolled medial
MLrm Medio Lateral rolled medial
LMrm Latero Medial rolled medial
XCCrm Exaggerated Cranio Caudal rolled medial
XCCLrm Exaggerated Cranio Caudal Lateral rolled medial
XCCMrm Exaggerated Cranio Caudal Medial rolled medial
FBrm From Below rolled medial
SIOrm Superolateral-to-inferomedial Oblique rolled medial
LMOrm Latero Medial Oblique rolled medial

Rolled laterally - rl MLOrl Medio Lateral Oblique rolled lateral

CCrl Cranio Caudal rolled laterally
MLrl Medio Lateral rolled laterally
LMrl Latero Medial rolled laterally
XCCrl Exaggerated Cranio Caudal rolled laterally
XCCLrl Exaggerated Cranio Caudal Lateral rolled laterally
XCCMrl Exaggerated Cranio Caudal Medial rolled laterally
FBrl From Below rolled laterally
SIOrl Superolateral-to-inferomedial Oblique rolled laterally
LMOrl Latero Medial Oblique rolled laterally

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Abbreviations Definition

Tangential - tan MLOtan Medio Lateral Oblique Tangential

CCtan Cranio Caudal Tangential
MLtan Medio Lateral Tangential
LMtan Latero Medial Tangential
XCCtan Exaggerated Cranio Caudal Tangential
XCCLtan Exaggerated Cranio Caudal Lateral Tangential
XCCMtan Exaggerated Cranio Caudal Medial Tangential
FBtan From Below Tangential
SIOtan Superolateral-to-inferomedial Tangential
LMOtan Latero Medial Oblique Tangential

General explana- M* Medio*/-Medial

tion of themost
L* Latero*/-Lateral
frequent abbrevi-
ations O* .-oblique
r* .-rolled
X* Exaggerated
m* Magnification
s* Spot
id Implant displaced

1 not available on this system

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6 Examination

6.1 Examination task card

In the Examination task card you can control the image acquisition and have
the current examination images displayed.

6.1.1 Layout of the Examination task card

The Examination task card is divided into different functional areas:
(1)

(2)

(3)

(4)

(5)
(6)

(1) Menu bar

(2) Task cards
(3) Control area with subtask cards
(4) Image area
(5) Generator control field
(6) Status bar

Menu bar Select the different functions which are relevant in the course of the
examination using the menu bar. These are displayed as menu items when you
click on the desired menu.

Control area The following data is displayed within the control area:
◾ Information about the current patient
◾ Examination settings

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◾ Protocol control
– Projection views
– Status of projection views

Patient data

The patient folder with the last name and first name of the registered patient is
displayed in the upper part of the control area.

Procedures

You see the procedure selected for the current examination displayed in the
lower part of the control area.

Projection views The projection views and the order of their exposure are displayed as buttons in
the Images subtask card.

(1) First projection view

(2) Second projection view
(3) Last projection view

 It is not possible to select several images simultaneously in the

Examination task card.

Status The status of a projection view (modifications, exposure progress) is identified

by corresponding symbols in the protocol control.

Icon Definition Icon Definition

Projection view according to default, expo- Image finally acquired

sure scheduled

Projection view changed, exposure sched- Exposure interrupted

uled

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Icon Definition Icon Definition

Projection view according to default, magni- Image rejected

fication exposure scheduled

Projection view changed, magnification Image released for repetition

exposure scheduled

Projection view selected for exposure, wait- Repeated image finally acquired
ing for system to be ready for exposure

Repeat/reject image Image released for rejection/repetition

Projection view according to default, Projection view selected for exposure, sys-
Implant exposure scheduled tem is ready

Projection view according to default, Spot Projection view acquired, image transmis-
exposure scheduled sion runs

Projection view according to default, Prime Projection view acquired, image processing
Mode* exposure scheduled ongoing

Projection view according to default, 2D Radiation is released

Tomo Implant* exposure scheduled
CAUTION: X-ray radiation!

Projection view according to default, Prime Projection view selected for exposure, sys-
and Tomo* exposure scheduled tem is ready.
NOTE: Some prerequisites have not been ful-
filled (e.g., magnification exposure without
magnification table), exposure is possible.

Projection view according to default, Tomo Projection view selected for exposure, sys-
Implant* exposure scheduled tem is not ready.
NOTE: Some prerequisites have not been ful-
filled (e.g., compression plate not installed),
exposure not possible.

Projection view according to default, 2D Problem with the MAMMOMAT Inspiration

Tomo* exposure scheduled (e.g., no connection), exposure not possible.

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Icon Definition Icon Definition

Projection according to default, specimen

exposure scheduled

* optional

 If the red or yellow icons light up, your intervention or appropriate safety
measures are required.

Subtask cards for examination A stack with subtask cards with which you can control the examination is
settings located in the central part of the control area. Here you also select the
acquisition method, the operating program and the exposure technique with in
each case preset exposure parameters.

(1) Open patient subtask card

(2) Acquisition subtask card
(3) Post processing subtask card
(4) Close patient subtask card

Image area The X-ray images of the current examination are displayed in the image area.
After every single acquisition the display in the image area is updated. According
to the set layout, the last image (layout 1:1) is displayed or the last images
(layout 2:1, 4:1, etc.) are displayed.

Generator control field The currently selected exposure parameters appear in the generator control field
(the first settings displayed are those configured for the selected exposure
procedure, the acquisition mode and the exposure technique).
( Page 102 Subtask cards for examination settings)

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If you want to use parameters other than the preset parameters, set them in the
generator control field before beginning the exposure.

Settings

(1) Display and selection of exposure mode (manual, AEC, OPDOSE)

(2) Display and selection of compression thickness range (OPDOSE only)
(3) Display and selection of +/- kV
(4) Display and selection of +/- mAs (only manual)
(5) Display and selection of anode/filter combination
(6) Overview of current detail parameter settings in Advanced dialog box
(7) Display of currently set focus
small focus
large focus
(8) Display of current compression thickness
Value is displayed if compression is over 30 N.
(9) Button to call up Advanced dialog box to change detail parameters

 If the compression is below 30 N (could be the case by implants) the

manual mode (with manual settings) have to be used.

Advanced dialog box After clicking the Adv. button on the screen, the Advanced dialog box is
displayed. Detail parameters preset for the currently set exposure technique can
be changed in the Options fields here. The standby mode of the exposure
technique determines which options are available.
(2) (3) (4) (5) (6)

(1)

(1) Overview of current settings of the detail parameters (same as generator

control field)
(a) (b) (c) (a) Option On or Active
(b) Option Off or Not active
(c) Option not available (dependent on the exposure mode)
(2) Position grid within/outside the beam
(a) Option On - within the beam
(a) (b) (c)
(b) Option Off - outside the beam

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(c) Option AUTO - without grid and with PRIME algorithm if licensed
(3) Automatic decompression On/Off
On: if unit should automatically decompress following the exposure
(4) Optimized compression (OPCOMP) On/Off
(5) AEC-Segmentation On/Off (measurement range for automatic exposure
control)
On: for dynamic measurement of pixel values over the entire breast
Off: to limit to small, predetermined measurement area
(6) Dose level
(a) Low - dose level low
(a) (b) (c) (d) (e)
(b) Medium low - reduced dose level
(c) Normal - standard dose level
(d) Medium high - elevated dose level
(e) High - high dose level

 CAUTION

Unsuitable dose level selected.

Incorrect diagnosis or unnecessary radiation!
◆ The normal dose level is preselected by default as it is recommended. If
an adjustment of dose level is necessary anyway, change the dose level
in an appropriable balance of image quality and patient dose.

Status bar System messages indicating the current state of the system or error messages
are displayed in the lower area of the Examination task card.

Info bar You will find help for your examination as well as information about the
exposure parameters used in the individual exposures on the info bar.

Information texts Information texts advise you of the current state of the exposure and give
instructions about the continuing procedure.

(1) Information text

(2) Scroll bar to scroll through previously displayed information texts

Exposure parameters used After irradiation is completed, the exposure parameters used are displayed for
your information. As soon as the completed image appears in the image area,
these data are hidden again.

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(1) Radiation parameters (kV, mAs, anode/filter combination, dose value)

(2) Angle of rotation of the swivel arm
(3) Compression parameter (thickness, compression force)

6.2 Performing an examination

6.2.1 Registering the patient

You must register the patient before the examination. The data that you enter
during registration are transferred for the pending examination. The new
images are inserted in a newly created study.

 Registration information, syngo VI10A Online Help.

Registration in the Examination task You can also select Patient Registration directly from the Examination task
card card in the Open Patient subtask card, e.g., if you want to examine the next
patient after an examination is complete.

1 Select a different Operator.

 You can change the Operator in the Open patient subtask card during an
examination.

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2 Click on the button.

The Patient Registration window appears.
3 Enter the required examination data.
4 Click the Exam button.
You are back in the Examination task card.
Selection lists of the available examination procedures and of the assigned
projection series are displayed in the Open Patient subtask card.

6.2.2 Selecting different examination settings

When a patient is registered, default standard exposure parameters are loaded,
e.g., the examination procedure, projection views and their sequence. If these
settings are appropriate for your examination, you can start the exposure at the
MAMMOMAT Inspiration immediately.

 You can find more information on the default procedure, and projection
sequences in ( Page 132 Configuring procedures).

If different examination settings are required, call up a suitable procedure, the

desired operating program and the exposure technique from the selection lists
in the Open patient and Acquisition subtask cards.

Procedures You can select the procedure and sequence of the assigned projection views in
the Open patient subtask card.


You can set which procedures are available to you for examinations and
which procedure is the default in the configuration.
( Page 132 Configuring procedures)

1 Select the Procedure required for your examination from the selection list.
The projection sequence preset for the procedure is displayed in the PV
sequence selection list.
If the patient was requested from the RIS, the reason for the requested
procedure is shown as well.
2 If necessary select a different projection sequence in the PV sequence
selection list.
3 Select ON from the selection list Display Markers:
The projection view will then be saved with the image ("burned in").
The size of the burned-in markers will be scaled to the size of the image. The
markers should be placed relative to a corner.
The markings in the image are retained when repeating image processing.

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 After a Req. Reason(s) is specified in the RIS, it also displays in the Open
patient subtask card.

 CAUTION

Breast tissue might be covered by software marker for view and

laterality.
Repeated image!
◆ Awareness of marker position. Marker function can be switched on
and off.

Automatic functions In the lower area of the Open patient subtask card select the automatic
functions to be performed during the examination, if necessary.
◆ Activate the desired functions using the check boxes.
◾ Auto Filming: Completed images are automatically copied to the Filming
task card.
◾ Auto Expose: The images collected in the Filming task card are
automatically forwarded to the printer as soon as a printer has been
configured.

 Make sure that all images are sent to the printer if the Auto-expose function
is activated.

Details on configuration of the automatic functions, see ( Page 132 Configuring

procedures).

Acquisition The corresponding acquisition mode and IPPG for the selected procedure are
shown in the Acquisition subtask card.
Examples:

Procedure: Bilateral Mammogram

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Procedure: Implant Bilateral

The corresponding IPPG for each procedure is shown as standard.

◆ If required, select a different IPPG from the IPPG selection list.

 New IPPGs can only be created by the local application specialist.

 CAUTION

Selection of inadequate image processing parameters.

Reduced image quality!
◆ Make sure correct image processing parameter set is used.

6.2.3 Settings in the generator control field

The default exposure parameters in the selected procedure, operating program
and subprogram are displayed in the generator control field.

Settings You can change individual exposure parameters for the current examination, if
necessary.

 CAUTION

Changing the exposure parameters can lead to unsuitable mAs, kV and

anode/filter combinations.
Faulty diagnosis or unnecessary radiation exposure if repeat exposure
is necessary!
◆ Observe the recommended exposure parameters when you change
settings manually.

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 If possible, use the automatic modes AEC or OPDOSE to ensure that the
exposure parameters are optimized.

◆ If necessary, change the settings for exposure mode, kV, mAs, and anode/filter
combination. ( Page 102 Generator control field)
Manual mode: The maximum mAs value that can be set depends on the set kV
value. If the mAs value is further increased for a specific kV value, then the kV
value is reduced to reach the mAs value.

kV 23 24 25 26 27 28 29 30 31 32 33 34 35

Maximum 560 560 500 500 500 500 450 450 400 400 400 400 360
mAs

Exposure parameters for implant For acquisition mode “Implant” manual exposure parameters are provided by the
exposures system. Note that these figures are just suggested guideline values for the
exposure.
◆ It may be necessary to adjust the exposures depending on the nature of the
breast or implant concerned.

Thickness (mm) Anode/filter kV mAs

combination

20 WRh 25 50

30 WRh 26 70

40 WRh 26 90

50 WRh 27 110

60 WRh 28 120

70 WRh 29 130

80 WRh 30 140

90 WRh 30 160

100 WRh 31 180


First, take an exposure with the recommended parameters. Depending on
the image impression, the parameters for further exposures may need to be
adjusted.

Detail parameters Depending on the procedure, detail parameters such as Automatic

decompression can be set in the Advanced dialog box.

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 CAUTION

Unsuitable compression settings lead to poor image quality.

Faulty diagnosis or unnecessary radiation exposure if repeat exposure
is necessary!
◆ Whenever possible, use the automatic OPCOMP function to ensure
optimal compression and therefore optimal image quality.
◆ Ensure that the breast remains compressed during the entire exposure.

1 Click on Adv. to call up the Advanced dialog box to change detail

parameters.
2 If necessary, change the settings for grid position, automatic decompression,
OPCOMP, AEC segmenting and dose.
( Page 103 Advanced dialog box)


If you switch on AEC segmenting in the Advanced dialog box, you can
check the position of the AEC region in the image after the exposure. To do
this, select Tools > AEC region.

6.2.4 Modifying projection views

In the protocol control (Images subtask card) you have the possibility of
modifying for the current examination the projection views preset in the
selected procedure as well as their number and sequence.

Modifying the projection view 1 With the right mouse button, click on the Images subtask card of the
projection view you want to modify.
2 Select Modify in the displayed popup menu.
The Modified Views window is opened.

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 The selection list can be configured in the Procedure Handling

Configuration. ( Page 132 Configuring procedures)

3 Select the desired Acquisition mode.

4 If necessary define special settings for the wanted projection view in the
upper window area.
The list of the projection views (lower box area) is restricted to the views that
fulfill the selected criteria.
5 Select the desired projection view and confirm by clicking OK.
The modified projection view is displayed on the Images subtask card with a
corresponding symbol. ( Page 99 Control area)

Adding a projection view 1 With the right mouse button, click on an arbitrary projection view in the
Images subtask card.
2 Select Add in the displayed popup menu.
The Modified Views window is opened.
3 Select the desired projection view and confirm by clicking OK.
The new projection view is added at the end of the projection sequence on the
Images subtask card.

Inserting a projection view 1 With the right mouse button, click on the Images subtask card of the
projection view in front of which you want to insert an additional projection
view.
2 Select Insert in the displayed popup menu.
The Modified Views window is opened.
3 Select the desired projection view and confirm by clicking OK.
On the Images subtask card, the new projection view is inserted in sequence in
front of the originally selected projection view.

Deleting a projection view 1 With the right mouse button, click on the Images subtask card of the
projection view you want to delete.
2 Select Delete in the displayed popup menu.
The projection view is removed from the Images subtask card.

6.2.5 Making an exposure

Safety ◆ Observe the safety and operating instructions for operating the MAMMOMAT
Inspiration.
( Page 15 Safety) and ( Page 51 Operation)

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 CAUTION

Incorrectly registered patient data can cause incorrect examination

results.
Faulty diagnosis or unnecessary radiation exposure if repeat
exposure is necessary!
◆ Before every examination, ensure that the patient in question is really
assigned to the patient data and examination procedure currently
loaded in the system.

Starting the projection series The projection views to be performed are displayed as buttons in sequence on
the Images subtask card.
1 In the Images subtask card, double-click on the first projection view to release
the exposure.


Possible setting: automatic activation of the first exposure when the patient
record is opened, Options > Auto Enable First PV. ( Page 132 Configuring
procedures)

2 Position the swivel arm of the MAMMOMAT Inspiration corresponding to the

first intended projection view.
3 Position the breast to be examined on the object table according to the view
selected on the acquisition workstation.

 Wait until the system is ready (green light stops blinking) before making the
exposure.

4 Press and hold the exposure button on the control box as long as the signal is
audible.
The button will light up yellow during the exposure.
Radiation is released and the first examination image is taken.
After the exposure is complete, the finished image is displayed in the image
area.

 CAUTION

Incorrect patient data entered.

Incorrect diagnosis!
◆ Patient data in an active study can't be rearranged. Before registering
patient and starting examination make sure that data match
examined patient.

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 CAUTION

Incorrectly registered patient data.

Unnecessary radiation exposure or incorrect diagnosis!
◆ Before every examination, ensure that the patient in question is really
assigned to the patient data and examination procedure currently
loaded in the system.


If a non-recoverable error occurs during the exposure, the maximum ADG
value could be estimated at < 3 mGy for AEC Mode (90 mm breast
thickness).

If, after an exposure, the image appears black, reprocess the raw data, set
the correct IPPGs, or click on the Reenter examination screen button.

 Some parts of images may be black for acquisitions of large breasts where
the edge of the breast can no longer be recognized.
Process the raw data again, select the MagSpot IP parameter set and click
Reenter examination.

Start with different view You can also begin a projection series with a projection view other than the one
displayed first.

 Observe the correct side and positioning of the breast to be examined

according to the revised first projection view.

◆ Double-click on the projection view with which you want to begin.

The selected projection view will be placed before all other remaining
projection views.
The exposure is initiated with the exposure button on the control box.
The order of the remaining projection views remains unchanged.

Continuing the projection series The exposure of the other projection views is automatically released.

The next projection view to be performed is selected for exposure in the Images
subtask card.
1 Position the swivel arm of the MAMMOMAT Inspiration corresponding to the
intended projection view.
2 Position the breast to be examined on the object table according to the
intended projection view.
3 Press the exposure button on the control box.
Radiation is released and the next examination image is taken.
After the exposure is complete, the finished image is displayed in the image
area.
You can monitor the progress of the current examination on the Images subtask
card. After the last exposure, all screen buttons show the images you have taken
as thumbnails.

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Cancelling the exposure Exposure of a projection view can be cancelled as long as no radiation has been
released.
1 Right-click on the projection view selected for exposure in the Images subtask
card.
A pop-up menu is displayed.
2 Select the Disable exposure item.
3 Click Yes in the dialog box displayed.
The continuation of the projection series is canceled.
All remaining projection views remain in the Images subtask card. They can
now be processed or you can restart.

6.2.6 Correcting projection views

The exposures displayed in the image area must correspond to the planned
projection views. If there is a discrepancy, a subsequent correction will be
necessary.
The Correct function can only be used in the open examination.

 CAUTION

If the incorrect breast side or a different view is exposed than intended, the
image is saved under an incorrect projection view.
Faulty diagnosis or incorrect treatment possible!
◆ Check that the image is assigned to the correct projection view and
correct it, if necessary.

1 Right-click the relevant image in the Images subtask card.

A popup menu is displayed.
2 Select the Correct... item.
The Correct projection view dialog box is displayed.

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3 Select the correct projection view in the New projection view selection list
and click on OK.
A dialog box is displayed.
4 Click on Yes to make the change.
The image is reconstructed and displayed in the changed view.

6.2.7 Repeating image processing

If the quality of an image is unsatisfactory, repeat the image processing with
different parameters. This can be done without irradiating again.

 CAUTION

Quality of an image is unsatisfactory (for example due to noise or motion

artifacts).
Incorrect diagnosis possible.
◆ Always use multiple projection views for diagnosis.
◆ Repeat the exposure if motion artifacts occur.

1 Right-click the relevant image in the Images subtask card.

A popup menu is displayed.
2 Select Reprocess....
The Reprocessing of the image dialog box is displayed.

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3 Select a new parameter in the New IP Set name selection list.

4 Select a new parameter in the New image processing paramter selection
list.
5 If necessary deactivate the Display Markers function using the checkbox, if
the marking overlaps the breast tissue.
The selected projection view in the acquired image is displayed.

 CAUTION

Markers might overlap breast tissue.

Incorrect diagnosis!
◆ If necessary deactivate the Display Markers function using the
checkbox, if the marking overlaps the breast tissue.

6 Click on OK.
A dialog box appears prompting you to confirm the change.

7 Click on Yes to make the change.

The exposure data are reconstructed with the altered parameters.
The new image is displayed.

6.2.8 Repeating an image

If reprocessing does not result in noticeably higher image quality, you should
repeat the process.
1 Right-click the relevant image in the Images subtask card.
A popup menu is displayed.

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2 Select the Repeat item.

The Repeat image dialog box is displayed.

3 Select the reasons that caused you to repeat the image.

4 Click on OK.
A new image appears in the Images subtask card.

5 Double-click on the projection view to release the exposure.

6.2.9 Rejecting/repeating an image

If the image quality still is not sufficiently improved by reprocessing, you should
reject it (e.g., in cases of noise or motion artifacts).
1 Right-click the relevant image in the Images subtask card.
A pop-up menu is displayed.
2 Select the Reject + Repeat image item.
The Reject + Repeat image dialog is displayed.

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3 Select the reasons that caused you to reject/repeat the image.

4 Click on OK.
The image appears crossed out in the Images subtask card.
An image with the same projection view appears on the end of the projection
series in the Images subtask card. The rejected image is deleted.

 Rejected images are deleted. You can view them in the WH AWS
Management of Repeated/Rejected Images dialog box.

 Rejecting/repeating images are not supported for stereotatic biopsy and

quality control procedures.

5 Double-click on the projection view to release the exposure.

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Restoring the image display

◆ Select the image and click on Undo reject.

The image is restored and now visible in the Patient Browser.

6.2.10 Enquiring exposure data of an image

The projection view and the exposure parameters used are stored as image
attributes with the examination images. You can call up this information
individually for all images displayed in the Images subtask card.
1 Right-click on the required image in the Images subtask card.
A pop-up menu is displayed.
2 Select the Image Attributes... item.
The Image attributes dialog box is displayed.

3 Click on Close.
The Image attributes dialog box is closed.

6.3 Post-processing examination images

You can process the examination images directly in the Examination task card.
Appropriate tools are available in the Post processing subtask card or the main
menu. These post-processing tools correspond to those in the Viewing task
card.

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 You can find detailed information about the individual tools for image
processing and evaluation in the syngo VI10A Online Help.

6.3.1 Activating/deactivating tools

Some tools need only be activated once to be applied.
If you no longer require the activated tool, you can deactivate it again. This
helps you to avoid drawing graphic objects by accidentally clicking on an image.
1 To switch on a tool, select it from the menu or click on the relevant button.
The corresponding button is active.
The menu item for the tool is provided with a check mark.
2 To deactivate the tool, reselect it from the menu or click on the activated
button.

6.3.2 Division of the image area

By dividing the image area, you can define the number and size of the segments
in the image area.
Switch to a large format display with just a few images on the screen if you want
to see diagnostic details. Select a small format display to obtain an overview.

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◆ To view a large-format image, select View > a 1:1 in the main menu.
The current layout is now marked with a checkmark.
You can set the following layout sizes: a 1:1, b 2:1, c 4:1, d 9:1, e 16:1

6.3.3 Scrolling
You will usually have taken more images of a patient than can be displayed in
the image area of the Examination task card. All the images that cannot be
displayed due to lack of space are placed in the background.
The Examination task card provides you with several alternative ways of
scrolling through the taken images:
◾ By using the Scroll menu
◾ By using the scroll bar to the right of the image area.

6.3.4 Zooming and panning images

You can zoom in on sections of images that you are particularly interested in
(zooming). If the enlarged image then no longer fits in the segment, you can
pan it until the relevant area is in the center of the segment again.

Doubled image size

◆ In the main menu select Image > Magnify by 2.0 or click the button.
The image is displayed in twice its size.

Half image size

◆ Select Image > Minify by 0.5 or click the button.

The image is displayed at 50 % its original size.

Adjustable zoom factor

1 Select Image > Zoom Factor or click the button.

The Zoom Image dialog box is opened.
2 Enter a zoom factor and confirm with OK.
The image is displayed zoomed in/out.

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Zooming of point

1 Select Image > Zoom From Point or click the button.

2 Click the position in the image that you want to zoom.
The selected image position is displayed centered and zoomed in the image
segment center.

Zooming with the mouse The left mouse key is used to select or deselect images and objects. However,
you can also switch over the function of the left mouse button to perform
zooming and panning.
1 Select Image > Zoom/Pan.
2 Position the mouse pointer in the outer area of the image.
The cursor changes shape.
3 Drag the mouse cursor up/down with the left mouse button pressed.
The image is zoomed in/out.
As soon as you release the mouse button, the new zoom factor is applied to
all the selected images or the selected scope of action.
4 Deselect Image > Zoom/Pan again.
The left mouse button is available for selecting images again.

Panning images After zooming, portions of the images may be outside the visible image
segment. Therefore always pan the image so that the region of diagnostic
interest is in the center of the image segment again before storing.
1 Select Image > Zoom/Pan.
The function of the left mouse button is now switched from selection to
Zoom & Pan On.
2 Now place the mouse cursor in the inner area of the image.
3 To pan the content of the image, press and hold the left mouse button while
dragging the mouse upward, downward, to the left or to the right.
You can see the result of your mouse movements in the image on which the
mouse cursor is located immediately.

Restoring the image display ◆ Select Image > Home Zoom/Pan.

The original size with which the images were last stored in the database is
restored.

6.3.5 Magnifying glass

Instead of zooming/panning, you can temporarily display image segments in
maximum magnification in the segment. Two magnifying glass functions are
available for this:

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(1) Large magnifying glass (1/4 of image surface)

(2) Small magnifying glass (1/16 of image surface)

◆ Firstly, select the image in which you want to display in an enlarged image
section.

Large magnifying glass

1 Select Tools > Magnification > Large or click the button.

The mouse pointer changes into a rectangular magnification window.
2 Keep the left mouse button pressed and move the mouse pointer in the
segment.
The area at the mouse position is displayed magnified by a factor of 2.0.

Small magnifying glass

1 Select Tools > Magnification > Small or click the button.

The mouse pointer changes into a rectangular magnification window.
2 Keep the left mouse button pressed and move the mouse pointer in the
segment.
The area at the mouse position is displayed magnified by a factor of 2.0.

6.3.6 Pixel lens

With the pixel lens, you can display the average value of the gray scales of an
area of 5 × 5 pixels.
◆ Select Tools > Pixel Lense or click the button.
The cursor changes its shape.
The pixel value is displayed in the image at the mouse position.

6.3.7 Distance lines

You can measure the distance between two defined points in an image using a
distance line.

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1 Select Tools > Distance or click the button.

The cursor changes its shape.
2 Place the mouse cursor on the starting point of the distance line.
3 Keep the left mouse button pressed and draw a line.
4 Release the mouse button to finish the line.

6.3.8 Angle
With the Angle function, you can determine the angle enclosed between two
lines drawn in a clockwise direction. If the angle is larger than 180°, the program
subtracts 180° from the angle.
1 Select Tools > Angle or click the button.
The cursor changes its shape.
2 Set the mouse pointer on a starting point for the first side.
3 With the left mouse button pressed, draw a line to the end point of the first
side.
4 Draw the second side in the same way.
The measured angle is displayed while you are drawing it.

6.3.9 ROIs
You can designate questionable areas in images as Regions of Interest (ROIs)
and evaluate them. For this purpose, draw a frame around the relevant area.

Rectangular and circular ROIs

1 Select Tools > Circle or Tools > Rectangle or click the button.
The cursor changes its shape.
2 Click on the image and draw the ROI (a rectangle or circle) with the mouse
button kept pressed.
3 Release the mouse button as soon as the ROI has the desired size.
The gray-scale values inside the ROI are evaluated statistically and the result is
indicated on the edge line.

Freehand ROIs

1 Select Tools > Freehand ROI or click the button.

The cursor changes its shape.
2 Draw the ROI point by point by clicking the mouse button once at each
change of direction (polygon definition).
– or –
Keep the mouse button pressed and map the region of interest.
3 Double-click on the last corner point.
The ROI is closed.
The gray-scale values inside the ROI are evaluated statistically and the result is
indicated on the edge line.

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Saving graphics ◆ Select Patient > Save.

The images are saved with the graphics.

6.3.10 Image captions

You have the following possibilities of recording important information by
corresponding annotations in the image:
◾ Annotations (on image details)
Annotations are displayed at the image detail concerned and are anchored
there. They can be shown/hidden and deleted again like other graphic
objects.
◾ Image comment (for the total image)
Image comments are displayed and saved as image test. They can be shown/
hidden like the other image text.

Inserting an annotation

1 Select Tools > Annotate or click the button.

The cursor changes shape.
2 With the left mouse button, click on the position in the image at which you
want to insert the text.
The mouse pointer becomes a text cursor.
3 Enter your text.
4 Complete your text entry with the Enter key or click on the image outside the
text.
The text is displayed white with shading.

 Annotations can be moved.

Saving annotations ◆ Select Patient > Save from the main menu.
The images are saved with the annotation text.

 Take care that the saves notes are not located in the region of tissue of
diagnostic relevance.

 In the Reenter examination mode, comment texts for the newly acquired
images are saved.

Adding a comment

1 Select Edit > Comment or click the button.

A text input field is displayed.
2 Enter your text.
3 Complete the text entry by pressing the Enter key.

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The image comment is displayed on the lower image margin and saved
automatically.

 Comments cannot be moved.

 You can insert text input fields in all available images, even if the Comment
button is dimmed.

 In the Reenter examination mode, image comments for the newly

acquired images are saved.

 The inserted comments are DICOM-accessible.

Change window values ◆ Use the center mouse key to individually set the window values.

 Window values are not saved.

Deleting graphics and annotations You can delete graphic objects that you have drawn from the image using the
post-processing tools.
1 Disable the currently activated tool, if required.
2 Click on the graphic (line, ROI, annotation) which you want to delete.
Grab handles are displayed for the selected graphic object.
3 Press Del on the keyboard or select delete in the context menu (right mouse
button).
4 Select Save.
The images are saved without the deleted graphics or annotations.

 In the Reenter examination mode, images and comments are only deleted
for the newly acquired images.

6.3.11 Inverting images

Inverted gray-scale images are dark in bright image areas and bright in dark
image areas. The gray-scale assignment in the LUT (Look Up Table) is therefore
inverted.

Using inversion 1 Select the images that you want to invert.

2 Select the Image > Invert command in the main menu.
The selected images are displayed in inverted display.

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Restoring the starting image ◆ Select the Image > Invert command once again.
The selected images are displayed in inverted display.

6.4 Filming/printing examination images

You can film or print images of the current examination directly from the
Examination task card if a printer is configured.


Using the Auto-Filming and Auto-Expose functions, the filming/printing
processes can be run automatically. ( Page 106 Selecting different
examination settings)

6.4.1 Transfer to the film sheet

In the first step, you decide which images you want to transfer to the film sheet.
1 First select the images you want to film/print.
2 Click on the button in the Post processing subtask card.
All selected images are transferred to the virtual film sheet in the Film Sheet
window.

6.4.2 Film preview

You can see how the film sheets will be populated with images of pending film
jobs in the Film Sheet window. From here, you can transfer the images
intended for filming or printing to the desired output device.

The scaling factor of an image is specified as approx. 104 % in the Filming


task card even if 100 % is specified in the configuration. This is because the
printed images are displayed using the same magnification as the earlier
analog images. The SOD/SID (source-object distance/source-image distance)
results in a magnification factor of approx. 104%.

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 CAUTION

Inconsistent magnification factor.

Misdiagnosis due to inaccurate measurements!
◆ Verify the consistence of the nominal magnification factor displayed on
the image and magnification factor on magnification table.

Calling up the film preview

◆ Click on the Film Preview button on the Post processing subtask card.
The Film Sheet window is opened.

 Details on the functions Automatic Filming/Automatic Exposure, see

( Page 106 Selecting different examination settings).

Ending film preview ◆ Click on the Close button.

6.5 Completing the examination

After completing your acquisitions, the last acquired image is displayed on the
monitor. You can now finish the examination of the current patient. If required,
you can then generate the billing documentation.

6.5.1 Finishing an examination

You discharge the current patient in the Close patient subtask card. You can
then register the next patient or further process the acquired image data in
other syngo applications.

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1 Click on the Open MPPS Dialog check box (if RIS is connected) if you want to
edit the billing documentation later on.
2 Click on the Open Scheduler check box if you want to examine the next
preregistered patient.
If required, the Auto Transfer function can be deselected for a current
examination in the Close Patient subtask card.
3 Deselect the Skip Auto-Transfer Rules check box.
The images will not automatically be sent to the configured nodes.
4 Select Examination > End of examination in the main menu or click the
button.
The comments are saved automatically when closing the patient.
The graphics, annotations and window values have to be saved manually.
The examination of the current patient is now finished.
The patient and examination data are deleted from the Examination task
card.

6.5.2 Procedure tracking with MPPS

If it is set up, your system creates the performance report, which is used for cost
accounting, etc., during registration of a patient. During examination and post-
processing of the examination results, the report is updated.
Provided the Open MPPS Dialog option has been activated, the Modality
Performed Procedure Step window is displayed automatically after the
examination is finished.

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Sending and completing a report 1 Check the performance report and add any missing entries.
If all data in the performance report is entered correctly, you may close the
report. Depending on operational requirements, you can pass the report on to
the HIS/RIS system.
2 Click the Save button to save your changes to the report.
The report has not yet been completed.
– or –
Click the Completed button to complete the report.
A message referring to this process is sent to the HIS/RIS system, if connected.
You cannot make any further changes to the performance report.

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7 Configuration

7.1 Examination configuration

The MAMMOMAT Inspiration system is delivered with examination procedures
and associated operating programs installed in the factory.

7.1.1 Configuration of the procedures

However, you can prepare the MAMMOMAT Inspiration system additionally for
your special requirements and examinations. Use the Procedure Handling
Configuration dialog box for this.
You can configure the following examination settings:
◾ Procedures: Modifying and managing the examination procedures stored in
the system; assignment of projection views.
( Page 132 Configuring procedures)
◾ Projection names: Changing the standard names of projection views and
projection angles.

7.1.2 Configuration of WH AWS transfer

If the auto-transfer function in the syngo configuration for archiving and
sending is activated, images are automatically transferred to specified
destination addresses at the end of an examination. In the WH AWS Transfer
Configuration configuration window, you can define the selection of image
material to be automatically sent to individual destination address.
( Page 144 Image selection for auto transfer destinations)

7.1.3 Starting configuration

Calling up the configuration window 1 Select Options > Configuration... in the menu bar.
The syngo configuration panel is opened.
2 Double-click on Procedure Handling Configuration.
The Procedure Handling Configuration window with the Procedures,
EXPOSURE Programs and Projection names tab cards is opened.

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Saving settings and closing the dialog You make your changes to the configuration of the system in the individual tab
box cards. You must confirm your changes before exiting a tab card.
1 Click on Apply, if you want to make further settings.
Your settings will be saved; the dialog box remains open.
2 Click on OK, once you have made all your settings.
Your settings will be saved; the dialog box is closed.

 The saved settings will be available when you call up the next examination.

3 Click Cancel if you want to cancel the configuration.

The dialog window is closed; no changes are saved.

7.1.4 Configuring procedures

When configuring examination procedures, you can assign projection views to
each procedure:
◾ You can create additional examination procedures and revise or delete
existing procedures with the Procedures tab card. Factory default Procedure
can not be deleted.
◾ You can determine the type and sequence of the projection views in the PVS
Dialog dialog box. Select the dialog box in the Procedures tab card with the
Modify PVS button. You can only change the projection views.

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
Changes to the procedure definitions become effective only on selection of
the next examination. Procedures that are used in a current examination
remain unaffected until the examination is ended.

List of available procedures The examination procedures currently stored in the system are listed in the left-
hand area of the Procedures tab card. The check marks in front of the entries
identify those procedures that are available for an examination (selectable via
the selection list Procedure in the Open patient subtask card).

 The procedures installed ex works cannot be changed. If necessary, you

must copy them and make your changes to the copy.

Creating procedure You can copy an already existing procedure and redesign it according to your
requirements, or you can create a procedure that has to be configured
completely from scratch.

1 Select a procedure from the list that comes close to your requirements.

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 If the checkmark is set, then the procedure is displayed in the Examination

task card.

2 Click on Copy.
A procedure named "Copy from..." is created in the list.
– or –
Click on New.
A procedure named *New appears in the list.
You edit the settings of the added examination procedure like those of an
already existing procedure.

 Name your procedure corresponding to the conventions of a possibly

connected HIS/RIS to facilitate error-free exchange of data with the HIS/RIS.

Defining defaults With the Set default button you determine which examination procedure is
preselected as default if no procedure is selected through the registration.
1 Select a procedure from the list.
2 Click Set default.
The selected procedure is identified in the list with the addition "(Default)".

Deleting procedures You can delete for more clarity user-defined procedures you no longer require.
1 Select a procedure to be deleted from the list.
2 Click on Delete.
The procedure is no longer available for future examinations.

Move procedure 1 Select a procedure from the list.

2 Drag the procedure to the desired position with the arrow buttons.

Procedure details You define the name, examination purpose and availability of the edited
procedures in the Procedure details area. In addition you can preset automatic
functions.

1 Overwrite the previous procedure name with a new name corresponding to

your procedure.

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2 Select the purpose of the examination in the selection list.

 The examination purpose is considered a filter criterion when images are

automatically sent.

3 In the selection list, define whether the procedure should be available only
under your login or generally (only selectable if the system is configured with
user management).

 The Procedure code is established for new procedures by the application

specialist.

4 Click on Show Procedure Code.

The application specialist sets up the corresponding Procedure code.

Default for Auto Decomp

◆ By default, the automatic decompression is always activated.

Default for OPCOMP

◆ By default, the optimized compression is always activated.

OPDOSE programs are always combined with OPCOMP® optimized
compression.

For exposure techniques used to examine patients with breast implants,

 OPCOMP must be switched off.

To switch off OPCOMP, go to the Advanced dialog box and click OPCOMP
Off.

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Default for layout The reconstructed images can be displayed in different layouts during the
examination. 1:1 representation is recommendable (one image in the image
area).

◆ Select the display that should be default in the Default Display Layout
selection list.

 The layout can still be modified during the examination.

 Please note that for Tomosynthesis Option always 1:1 layout will be used.

Setting for films

◆ Click on the wanted automatic film functions.

Autofilming: In the examination procedure automatic forwarding of images
from the Examination task card to the virtual film sheet is default.
Autoexpose: In the examination procedure automatic forwarding of the
images from the virtual film sheet to the camera/printer is default.

Default for IP Set

◆ The default IP Set is configured by Siemens application specialist.

Default for PV- collimation

◆ Select the desired automatic display of the marker:

◾ ON: The projection views used are included as markers in each projection
view.
◾ OFF: The projection views used are not included as markers in each
projection view.
◾ Except mag/spot: The projection views used are included as markers in
each projection view, except for exposures using a magnification table or
spot compression plate.

Details of the projection views In the course of an examination procedure different projection views are
acquired in a defined sequence. You can determine the composition and
sequence of the projection views in the PVS Dialog.
◆ Click on Modify PVS in the Procedure Handling Configuration dialog.
The PVS Dialog dialog box opens.

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Modifying projection views 1 Click on the Modify PVs tab into the foreground.

2 Select the Acquisition mode in the selection list.

Examples:

Acquisition mode Magnification

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Acquisistion mode Spot

The corresponding IPPG to each acquisition mode is assigned in the Service

menu by Siemens application specialist.

3 If necessary define special settings for the wanted projection views.

The list of the available projection views (lower box area) is restricted to the
PVs that fulfill the selected criteria.

4 Double click in the area of the available PVs (lower box area) on the projection
view you want.
The selected projection view is transferred to the current set of projection
views (lower box area).

 The projection views are transferred to the current set of projection views in
the order of their selection. You can still change the order later.

5 Double click in the area of the current PVs on the projection view to be
removed.
The selected projection view is removed from the current set of projection
views.

Modifying the sequence of projection You can change the order of the projection views to adapt it to your
views requirements.
1 Click on Modify PVS.
The PVS Dialog dialog box opens.
2 Click the Modify PV sequences tab into the foreground.

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The currently projection view orders that can be selected in this procedure are
listed in the Projection view sequences area.

3 Select the projection order to be modified in the list.

The projection views are displayed in the existing order in the Selected PV
sequences area on the Modify PV sequences tab card.

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4 In the Selected PV sequences area move a projection view (PV) with the
mouse to the required position in the projection view order.
– or –
Select a projection view.
5 Drag the projection view to the desired position with the mouse.
The selected projection view is moved by one step.

Saving projection views ◆ Click on Apply, if you want to make further settings.
Your settings will be saved; the PVS Dialog dialog box remains open.
– or –
Click on OK to accept the changes.
Your settings will be saved; the PVS Dialog dialog box closes.

Creating further projection view You can create further projection view orders and then revise their order.
orders
1 Click New, to make the projection views in a further projection view order
ready for the examination.
The new projection order is included in the list.

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2 If necessary, you can change the distribution of the projection views inside
the new projection view set details.

 The number of possible projection orders depends on the number of

selected projection views.

Defining the default projection views You can determine a projection order that should be used as default for the
order procedure.
1 Select the required projection order from the Projection view sequences list.
2 Click on Set default, to determine the selected order as default for the
examination.
The selected order is preset with the appropriate procedure for the
examination.

7.1.5 Viewing the exposure programs

The parameter for exposure technique that works with OPDOSE is allocated in
the factory according to standard.


In order to make changes in the EXPOSURE Programs, you have to select
Local Service > Acquisition System in the menu (using a service
password).

In the Procedure Handling Configuration dialog, click on the EXPOSURE

Programs tab card.

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(1) The window area (top left) lists the preset Acquisition Modes with the
original name.
(2) The window area (top right) contains a list of parameter for exposure
technique that works with OPDOSE with the original parameters.
(3) The window area (bottom left) contains the thickness independent
parameters.

7.1.6 Changing projection name

The original name of the projection views (PV) is allocated in the factory
according to DICOM standard. You can change the original names and adapt
them to your needs.
In the Procedure Handling Configuration dialog, click on the Projection
names tab card.

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(1) The window area (top left) lists the preset side designations of the PVs with
the original name and the modified name.
(2) The window area (top right) contains a list of angles for the single-touch
function with the original angles and the changed angles.
(3) The window area (bottom left) contains the item designation and available
projection views (PVs) with the original names and the changed names in
each case.
By placing a checkmark, you select which PV is to be displayed in the
Modifying projection views dialog window.

Changing side designation ◆ You change the designation for the side designations in the Modified name
input field.
The modified designation is marked in the original name column with an
asterisk.

Changing position designation 1 Mark the name you want to change in the list of the position designations.
The name to be changed appears on the right in the Modified name input
field.
2 You change the name in the Modified name input field.
The modified name is marked in the original name column with an asterisk.

Changing preset angles ◆ In the Preset angle input field, set the preset angle of the swivel arm for the
projection views.

Accepting the changes ◆ Click on OK to save your changes.

The dialog box closes.
– or –
Click on Apply to save your changes.

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The dialog box will stay open.


These changes are active only locally. When sending to DICOM nodes or into
an archive the original names are used, since these are filed in the standard.
Other names are not allowed.

Using original names ◆ Click on Reset.

All changed names are reset to the original names after confirming the
message.

If you want to reset only individual names to the original names, select

 these in the list and enter the original name in the Modified name input
field. To save the original names, proceed in the following as for entering a
modified name.

7.2 Transfer and archive configuration

7.2.1 Image selection for auto transfer destinations

In the syngo configuration for archiving and sending you define the rules
depending on the work status according to which examination images are
automatically preselected for archiving on CD or are sent via the network.
In the WH AWS Transfer Configuration dialog you define which image material
from the examination should be transmitted automatically to the individual
destination addresses. You differentiate in this case according to image type and
examination purpose of the images.

Opening the configuration dialog 1 Select Options > Configuration... in the menu bar.

2 Double-click on WH AWS Transfer Configuration.

The WH AWS Transfer Configuration dialog box opens.

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Destination address

◆ Select the destination address for which you want to specify the image
material to be sent in the Transfer destinations selection list.
The DICOM nodes configured in the Local Service are available for selection.

Image type

◆ Select the image type that should be sent to the selected destination address.
Single Images for processing only individual raw data (suitable for image
processing/CAD server); correspond to 2D images.
Single Images for presentation only single processed images (suitable for
reporting station, for example); correspond to 2D images.

Examination purpose

◆ If necessary you restrict the image material to the examination purpose that is
relevant for the selected destination address.
◾ Screening: Only image material acquired within the scope of a procedure
with a Screening examination purpose is sent.
◾ Diagnostic/Specimen/Stereo: Only the image material acquired within the
scope of procedures for diagnostics, preparations and the Stereo Mode (if
available) will be transmitted.
◾ Calibration/Biopsy Calibration/Phantom: Only the image material
acquired within the scope of procedures for Calibration/Biopsy Calibration
(if available) and Phantoms will be transmitted.

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If Auto-Transfer is enabled, the images are automatically sent to the

configured nodes.
Use the configured transfer rules by using Send to for sending the images
manually.
The following message will display if images do not meet these transfer


rules, e.g. Examination reason: "No images exported to...".
All transfer rules can be overridden and all images can be sent to all
configured nodes using the following method:
◾ Select Patient List.
◾ Select Patient/Studies/Series.
◾ Open Transfer > Skip Transfer Configuration for Next Export.
◾ Select Transfer > Send.

Configuring the data transfer The AWS only supports the following rule for automatic transfer:
◾ Work status: Completed
◾ Processing status: Don't care
◾ Objects: Images
Rules for automatic transfer and automatic deletion with the "sent” status
must not be used.

7.3 MoodLight configuration (option)

The optionally available MoodLightTM illuminated glass wall can be lit in various
different colors or set to change colors. You can use this to create a comfortable
and relaxing atmosphere for the patient in the exam room.
You can use MoodLight configuration to select from various predefined
individual colors and color changing programs. Alternatively, you can define a
new single color or create a color changing program from various colors with
harmonious color transitions.

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7.3.1 Calling up the configuration window

1 Select Options > Configuration... in the menu bar.
The syngo configuration panel is opened.
2 Double click on MoodLight.
The Light Shield V1.06 window is displayed.

7.3.2 Configuring colors

Predefined colors and color changing If single colors or color changing programs have already been defined and
programs saved, then these are saved in the system in corresponding files. These
MoodLight settings can be invoked at any time.

Load MoodLight setting 1 Click load.

The Load file dialog box is displayed.

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2 Select the file with the required MoodLight settings in the Existing files area.
3 Click on OK.
The MoodLight settings are read from the file.
The Load file dialog box is closed.

Activating the MoodLight settings ◆ Click on transmit in the Light Shield V1.06 window.
The illuminated glass wall is lit using the changed color settings.

New individual colors and color

changing programs

Defining a single color You can define a single color using the Microsoft palette.

Number of colors

◆ Set the number of different colors to "1" in the Light Shield V1.06 window.

Select color

1 Use the right mouse button to click on the color bar Color No. 1 in the Light
Shield V1.06 window.
The Color dialog window is displayed with the Microsoft color palette.

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2 Click on the required color in the Basic colors section or select Custom
colors.

You can define further colors in the right section of the window using the

 crosshairs in the color matrix (hue and saturation) and the slider
(brightness). Use the Add colors screen button to make the new color
available in the Custom colors area.

3 Click on OK.
The Color dialog box is closed.
The color bar Color No. 1 is displayed in the selected color.

Activating the MoodLight settings ◆ Click on transmit in the Light Shield V1.06 window.
The illuminated glass wall is lit using the changed color settings.

Saving the MoodLight settings If you also want to make the single color available for future use, then you have
to save it in the system.
1 Click on save in the Light Shield V1.06 window.
The Save file dialog box is displayed.

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2 Enter a suitable file name for your color setting and click on OK.
The MoodLight setting can now be loaded from the system at any time under
the entered file name. ( Page 147 Predefined colors and color changing
programs)

Creating a color changing program You create a color changing program by specifying the required colors first and
then specifying the duration of the color and the transfer to the next color.

Number of colors

◆ Set the number of required colors in the Light Shield V1.06.

The corresponding number of color bars will be displayed.

Select color 1 Use the right mouse button to click on the color bar Color No. 1 in the Light
Shield V1.06 window.
2 Select the required color from the Microsoft® color palette and confirm with
OK. ( Page 148 Defining a single color)
3 Define the other colors in the same way until all color bars appear in the
required colors.

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Enter the holding time During the holding time the illuminated panel is only lit in the respective color.

1 Click on the hold-time field under the color bar Color No. 1 with the right
mouse button.
The Please enter time dialog box is displayed.

2 Enter a holding time and confirm with OK.

3 Define the holding times for all other colors in the same way.

Entering the dimming time During the dimming time, the illuminated panel is lit in a continuous color
transition, in which the intensity of the previous color reduces while the
intensity of the next color increases.
1 Click on the dim-time field under the color bar Color No. 1 with the right
mouse button.
The Please enter time dialog box is displayed.

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2 Enter a dimming time and confirm with OK.

3 Define the dimming times for all other color transitions in the same way.

Activating the MoodLight settings 1 Click on transmit in the Light Shield V1.06 window.
The Transfer of data dialog box is displayed.

2 Click on Test.
The illuminated glass wall is briefly lit using the changed color settings.
3 Click on Read.
The changed color settings can be verified.
4 Click on Send.
The illuminated glass wall is lit using the changed color settings.

Saving the MoodLight settings If you also want to make the color changing program available for future use,
then you have to save it in the system.
1 Click on save in the Light Shield V1.06 window.
2 Save your color changing program using a suitable name in the Save file
dialog box. ( Page 148 Defining a single color)

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8 Technical description

8.1 Identification labels

 All labels displayed in the operator manuals are examples only and may
differ from the labels attached to the system and components.

8.1.1 X-ray stand labels

The labels shown below are attached permanently to the corresponding
locations of the following components of the X-ray stand.

(7) (1)
(6)

(5)
(2)

(3)

(4)

(1) Overall system

(2) Detector
(3) Object Table
(4) Power supply unit
(5) Compression unit and plate
(6) Collimator
(7) Single tank
Magnification table (not shown)

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Overall system labels

(1) Supplementary label

(2) Identification system label

(3) Power connection label

or

(4) Follow the instructions in the Operator Manual

(5) Transport label: When transporting the device standing up, the tube arm must be
lowered to the end stop.

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(6) Label for Brazil only

(7) Label for Saudi Arabia (Ministry of Health) only

(8) Label for Venezuela only

(9) Label for Korea only

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(10) Date of Manufacturing, for Example April 2005

(11) Label EAC countries for Russian federation, Kirgiztan, Kazakhstan, Armenia

Detector labels

(1) Supplementary label

(2) Identification label

(3) DHHS label

Object table labels

(1) - (3)
(1) Identification label

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(2) DHHS label

(3) Applied Part Type B

Collimator labels

(1) Supplementary label

(2) Identification label

(3) DHHS label

(4) SID label

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Single tank labels

(1) Supplementary label

(2) Identification label

(3) X-ray tube label

(4) DHHS label

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Compression plate label

(1)

(1) Identification label (example)

Magnification table labels

(1)
(1) Identification label

(2) DHHS label

Biopsy unit labels

(1)
(2)
(1) Label for emergency clutch - handle

(2) Label for emergency clutch - handle direction of rotation

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(1)

(1) Labels for biopsy unit

Identification label

Spare part label

8.1.2 Labels on the acquisition workstation

The labels shown below are attached permanently to the corresponding
locations of the following components of the acquisition workstation.

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(3)

(1)
(4)
ST OP

(2)

(1) Monitor
(2) Workstation
(3) Indication of radiation protection
(4) Control box

Monitor label

(1) Identification label (example)

Workstation label

(1)

(1) Identification label (example)

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Indication of radiation protection

label

(1) Load label for the monitor holders

(2) Follow the instructions in the Operator Manual

(3) Warning label indicating risk of crushing

(4) Equipotential bonding

Control Console Table

(1) Identification label

Control box labels

(1)

ST OP

(1) Warning label (only for USA)

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(2) Identification label

(3) DHHS label

(4) Manufacturer label

(5) Revision label

(6) Spare part label

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8.2 Curves and diagrams

8.2.1 Anode heating and cooling curves

P 40 Mo W

(1) Heat storage capacity

(2) Time
(3) Heating curves
(4) Cooling curve

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8.2.2 Heating and cooling curves of the X-ray tube assembly

(1) Heat storage capacity

(2) Time
(3) Heating curves
(4) Cooling curve

Room temperature: 20 °C
Average rotor power: 124 W

8.2.3 Emission curves

Focus 0.1 Mo Focal spot: small

Emission and filament heating

(1) Tube current

(2) Heating current
(3) Heating voltage

Focus 0.1 W Focal spot: small

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Emission and filament heating

(1) Tube current

(2) Heating current
(3) Heating voltage

Focus 0.3 Mo Focal spot: large

Emission and filament heating

(1) Tube current

(2) Heating current
(3) Heating voltage

Focus 0.3 W Focal spot: large

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Emission and filament heating

(1) Tube current

(2) Heating current
(3) Heating voltage

8.3 Technical specifications

The system may be used only in rooms intended for medical purposes.
The national regulations in force apply primarily. However, we strongly
recommend adherence to the standards described herein - provided they do not
contradict national regulations in effect - to ensure the safety of operators,
patients, and third parties.

8.3.1 General information

Power supply

Mains voltage 208 / 220 / 230 / 240 / 277 VAC, For USA/Canada only:
1P/N/PE
208 / 230 / 240 / 277 VAC, 1P/N/PE
208 / 220 / 230 / 240 / 277 / 400 VAC,
208 / 230 / 240 / 277 VAC, 2P/N/PE,
2P/N/PE,
50/60Hz
50/60 Hz

Permissible supply mains voltage fluc- ±10%

tuations

Mains fuses input side 32 A recommended: Type B/C (slow blow)

external fuse at 208...400 V under average load

Disconnection from the power supply The system can only be disconnected from the power supply by trained person-
nel or using corresponding means fitted during installation.

Connected power 7.5 kVA (momentary)

0.5 kVA (continual)

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Internal line impedance 208 VAC; 0.25 Ohms

220 VAC; 0.28 Ohms
230 VAC; 0.30 Ohms
240 VAC; 0.35 Ohms
277 VAC; 0.45 Ohms
400 VAC; 0.90 Ohms

Continuous output 60 exposures/per hour at 28 kV/100 mAs

Generator

High voltage waveform Multipulse (high frequency 500 kHz)

Tube voltage 23 kV to 35 kV, in steps of 1 kV

mAs range (at 25 kV and maximum Mo anode W anode

power)
2 mAs to 500 mAs manual mode 2 mAs to 630 mAs manual mode
5 mAs to 500 mAs AEC mode 5 mAs to 630 mAs AEC mode

Exposure times 10 ms to 4 s with large focus

60 ms to 6 s with small focus

kV accuracy ± 1 kV

mA accuracy ± 10 % (measured in the rectified high-voltage circuit)

mAs accuracy ± 10 % (measured in the rectified high-voltage circuit)

ESAK / AGD accuracy Mo anode W anode

Large focal spot < 20 % Large focal spot < 20 %
Small focal spot < 20 % Small focal spot < 40 % (23 - 28 kV), <
30 % (29 - 35 kV)

Power rating 5 kW (30 kV, 1 s, acc. to IEC 60601-2-45)

Voltage/current combination to reach 23 - 26 kV 190 mA

max. power:
27 kV 185 mA
28 kV 179 mA
29 kV 172 mA
30 kV 167 mA
31 kV 161 mA
32 kV 156 mA
33 kV 151 mA
34 kV 147 mA
35 kV 142 mA

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PC hardware / software

Workstation Intel Xeon W-2123 CPU, 4 cores, 3.6 GHz, 32 GB RAM

2 TB hard disc for image data

100,000 images (20 MB per image) or 1300 tomosynthesis scans (1.5 GB per
scan for 50 mm breast thickness)

Operating system Windows 10 operating system with syngo-based applications and proactive
virus protection (whitelisting)

Displays

19“ TFT color display Screen size 19“ (48 cm)

Image matrix 1280 x 1024

Maximum brightness, typical 350 cd/m2

Horizontal/vertical viewing angle 178º / 178º

Contrast ratio, typical 2000 : 1

3 MP 21“ TFT color display (Option) Screen size 21“ (53 cm)

Image matrix 1536 x 2048

Maximum brightness, typical 1100 cd/m2

Horizontal/vertical viewing angle 178º / 178º

Contrast ratio, typical 1500 : 1

Radiation shield

Dimensions 850 mm (W) x 1949 mm (H)

Lead equivalent 0.50 mm Pb Eq (for standard installation)

0.30 mm Pb Eq (for vehicle installation)

Detector

Image Receptor Overall Dimensions 35.92 cm (W) x 34.65 cm (D) x 4.5 cm (H)

Image Receptor Weight 9 kg (detector)

Imaging Area 23.94 cm x 30.46 cm

Pixel size 85 µm

Spatial resolution > 5.8 lp/mm at 28 kV for all F/T

MTF at Nyquist frequency 40 % or greater

DQE at 1 lp/mm 50 % at 20 mR X-ray exposure or greater

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DQE at Nyquist frequency 15 % at 7 mR X-ray exposure or greater

Linearity ≥ 99 % ; saturation dose: 5000 µGy

Ghosting < 3 % after 180 seconds

Bucky Factor Max. 2

Bucky table attenuation factor < 0.3 mm Al equivalent

Analog to Digital conversion 14 bit depth

Max. matrix size 2816 x 3584

Dead space at the chest wall Max. 5 mm

Time between x-ray exposures approx. 30 seconds depending on the application

Image non-uniformity Less than 5 % (AEC and 45 mm PMMA)

Anti-scatter grid Linear grid, 31 lines/cm

Grid Ratio 5:1

Focus-to-detector distance 65 cm

Max. symmetrical radiation field 24 cm x 30 cm

according to IEC 60806

Automatic exposure control

The AEC functions for all available kV-settings (23 kV to 35 kV).

At appropriate clinical kV, target/filter materials and variable object thickness (0 -
9 cm) the AEC shall be capable of maintaining digital value (pixel value) within
± 15 % of their averages.

Dose Five dose modes can be selected by the user on the workstation.

X-ray tube

X-ray tube (Mo/W) P40

Molybdenum/tungsten rotating anode tube with beryllium window.

Focus size Large: 0.3 (IEC 60336)

Small: 0.15 (IEC 60336)

Tube current (Mo/W) Molybden focal spot track maximum Wolfram focal spot track maximum
current; current;
Large focal spot: 150 mA at ≤ 24 kV Large focal spot: 190 mA at ≤ 26 kV
Small focal spot: 28 mA at 25 kV Small focal spot: 34 mA at 25 kV
Current range: 20 to 150 mA Current range: 20 to 190 mA

Nominal tube voltage 40 kV

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Max. power Mo W
large focus spot 3.7 kW 5 kW
small focus spot 0.7 kW 0.85 kW

Anode-filter combination Mo/W tube: Mo/30 µm Mo, Mo/25 µm Rh, W/50 µm Rh

Max. continuous heat dissipation of Ambient temperature 20-25 °C (500 W)

the tube assembly with fan IEC 60613

Heat storage capacity of tube assem- 1800 000 J (2 430 000 HU)
bly

Anode heat storage capacity 120 000 J (162 000 HU)

Tube unit weight 22 kg

Tube unit total filtration (Al balance) 1 mm Be (0.02 mm Al)

Envelope voltage IEC 60613 50 V

Envelope current IEC 60613 <1A

Anode input nominal power IEC 200 W

60613

Anode speed 8,800 rpm/147 Hz (±10%) A

Calculated, absorbed glandular dose

The dose value is a theoretically calculated value based on exposure and source
table data.

Exposure data ◾ Target/Filter combination

◾ kV value
◾ Thickness of compressed breast
◾ Focus (large or small)
◾ Distance between focus and skin

Source-table data ◾ Dose absorbed by the glandular for 50/50 % (glandular tissue/fatty tissue)

◾ Typical tube yield (air kerma) at 28 kV for the target/filter combination:

Mo/Mo large focus 0.10 mGy/mAs
Mo/Mo small focus 0.08 mGy/mAs
Mo/Rh large focus 0.08 mGy/mAs
Mo/Rh small focus 0.06 mGy/mAs
W/Rh large focus 0.03 mGy/mAs
W/Rh small focus 0.03 mGy/mAs

◾ Typical HVL values (half value layer, thickness of aluminum that reduces the
dose to 50 % at 28 kV)
W/Rh 50 μm 0.55 mm Al (typical value)

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
Users should be aware of that the dose value displayed is an estimated
value and the accuracy of all parameters in the calculation affects the
accuracy of displayed value.

System attenuation factor

Device attenuation factor with grid Mo/Mo Mo/Rh W/Rh

and detector cover
< 1,8 < 1,7 < 1,7

Object table < 0.3 mmAl (typical 0.14 mmAl)

(Al equivalent)

Magnification table < 0.3 mmAl (typical 0.10 mmAl without object table)
(Al equivalent)

Biopsy table < 0.3 mmAl (typical 0.10 mmAl without object table)
(Al equivalent)

Software and Data security

Network connection information Contact manufacturer for more detailed information (Medical IT-Network Secur-
ity Statement)

Image format See the “DICOM Conformance Statement”. The “DICOM Conformance State-
ment” is available on request from Siemens Healthcare or via the Siemens inter-
net homepage.

Supported user interface languages ◾ German

◾ English
◾ French
◾ Spanish
◾ Italian (not supported for syngo online help)

Classifications

Leakage technique factors* 40 kV and 8 mA, continual

Beam quality (HVL) > 0.25 mm Al at 25 kV

Protection against electrical shock Class I, Applied Part Type B (Object table and accessories), in accordance with
IEC 60601-1
Attention: To avoid the risk of electrical shock, a protective conductor must be
implemented when connecting this device to line power.

Mechanical stability of stand (system The device does not tilt over if, when used under normal conditions, it is tilted
not secured to the floor by bolting) horizontally up to an angle of 5° or if a force of 220 N is exerted at a distance of
1.50 m above the floor.
The device should only be transported horizontally or vertically, if the tube arm
has been placed in the lowest position.

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Degree of protection against ingress of Ordinary equipment (enclosed equipment without protection against ingress of
water water, protection class IPX0 (IEC60529).

Degree of safety of application in the Not applicable

presence of flammable anesthetic mix-
not intended for flammable gases (APG)
ture with air or nitrous oxygen

Operating mode Continuous operation with intermittent loading

Technique factors for testing the pri- 35 kV, maximum mAs

mary protective shielding (beam stop-
per)

Degree of contamination Class 2, according to IEC 60601-1

* The leakage radiation of the tube housing assembly and attached collimator
complies with the requirements of 21 CFR, part 1020.30(k).

8.3.2 Environmental conditions

 Information about disposal and environmental protection may be obtained

from Siemens Customer Service.


Further information about maintenance, disposal and environmental
protection and information on installation may be found in the Siemens
Customer Service technical documentation.

 Information concerning connections (power supply, door contact switch, X-

ray indicator, etc.) may be obtained from Siemens Customer Service.

 Note that the version of the workstation software (including image

processing) is displayed in the AWS help window.

Transport and storage

Ambient temperature -20 °C to +70 °C (MAMMOMAT Inspiration)

+10 °C to +40 °C (detector)

Max. temperature gradient Less than 10 °C per hour

Relative humidity 10 - 90 % (non-condensing)

Barometric pressure 700 - 1060 hPa

Operation

Ambient temperature +12° to +35 °C

Recommended ambient temperature +20° to +30 °C

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Max. temperature gradient 10 °C per hour

Relative humidity 30 - 75 % non-condensing

Barometric pressure 700 - 1060 hPa

Height ≤ 3000 m

Heat dissipation approx. 500 W

8.3.3 Mirror stand

79 79 117,5

110

65
max. 235
180˚ 180˚
193

69 - 150
65 34

92 78

Dimensions of the stand

Maximum height 2312 mm

Isocenter height 30 mm above the object table

Object table height 690 - 1500 (± 20) mm

Source Image Distance (SID) 65 cm

Rotation range of swivel-arm system +180° (clockwise),

-180° (counterclockwise)

Weight Max. 350 kg

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8.3.4 Acquisition workstation

Dimensions of the acquisition workstation

8.3.5 Tube assembly

Dimensions of the tube assembly/beam path

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Electrical connections

8.4 Notice concerning electromagnetic compatibility

(EMC)
Medical electrical equipment is subject to special precautions regarding EMC.
The systems must be installed and put into service according to the EMC
information provided in the accompanying documents.
Portable and mobile RF communications equipment can affect medical electrical
equipment.

Fixed equipment or system cabling that cannot be removed by the user is

 not listed. This cabling is part of the system and was considered in all EMC
measurements. Without this cabling the equipment or system would not
function.

Use of this equipment adjacent to or stacked with other equipment should

 be avoided because it could result in improper operation. If such use is

necessary, this equipment and the other equipment should be observed to
verify that they are operating normally.

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 CAUTION

Use of different accessories, converters and cables than those indicated or

use of devices emitting electromagnetic fields close to the system.
Increased emission or reduced interference immunity of the unit or
system possible!
◆ Only use accessories, converters and cables that are sold by the
manufacturer of the unit or system as replacement parts for internal
components.
◆ Avoid the usage of devices emitting electromagnetic fields (e.g. mobile
phones) close to the system.

- Control Box
In case of electrostatic discharge of high voltages (> 8 kV) at Control Box, the
Mammo Unit might switch off suddenly. Please restart the Mammo Unit for
recovery.
- Biopsy Handbox
In case of electrostatic discharge of high voltages (> 8 kV) at Biopsy Handbox, it
might freeze. Please disconnect and reconnect the coiled cable for recovery.

8.4.1 Guidelines and manufacturer's declaration - electromagnetic

emissions
The system is intended for use in an electromagnetic environment as specified
below. The customer or the user of the system should ensure that it is operated
in such an environment.
The emissions characteristics of this equipment make it suitable for use in
industrial areas and hospitals (CISPR 11 class A). If it is used in a residential
environment (for which CISPR 11 class B is normally required) this equipment
might not offer adequate protection to radio-frequency communication services.
The user might need to take mitigation measures, such as relocating or re-
orienting the equipment.

Interference emission Agreement Electromagnetic environment – Guidelines

measurements

RF emissions Group 1 The system uses RF energy exclusively for its internal func-
tion. Therefore, its RF emissions are very low and are not
according to CISPR 11
likely to cause any interference in nearby electronic equip-
ment.

RF emissions Class A The system is intended for use in all facilities other than
domestic establishments and for those directly connected
according to CISPR 11
to a public low-voltage power supply network which also
Harmonic emissions Class A supplies buildings used for domestic purposes.

according to IEC 61000-3-2 Components with input cur-

rent ≤ 16 A only

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Interference emission Agreement Electromagnetic environment – Guidelines

measurements

Voltage fluctuation/flicker Components with input cur-

emissions rent ≤ 16 A only
according to IEC 61000-3-3

8.4.2 Guidelines and manufacturer's declaration - electromagnetic

immunity
The system is intended for use in an electromagnetic environment as specified
below. The customer or the user of the system should ensure that it is operated
in such an environment.

Immunity tests IEC 60601 test level Compliance level Electromagnetic environment – Guidelines

Discharge of static ± 8 kV contact dis- ± 8 kV contact dis- Floors should be wood, concrete or ceramic
electricity (ESD) charge charge tile. If the floor is covered with synthetic mate-
rials, the relative humidity must be at least 30
IEC 61000-4-2 ± 15 kV air discharge ± 15 kV air discharge
%.

Electrical fast transi- ± 2 kV for power ± 2 kV for power The mains power quality should correspond to
ent/bursts cables cables that of a typical commercial or hospital envi-
ronment.
according to IEC ± 1 kV for input and ± 1 kV for input and
61000-4-4 output cables output cables

Surges ± 1 kV normal mode ± 1 kV normal mode The mains power quality should correspond to
voltage voltage that of a typical commercial or hospital envi-
according to IEC
ronment.
61000-4-5 ± 2 kV common mode ± 2 kV common mode
voltage voltage

Voltage dips, short < 5 % UT (> 95 % dip Not applicable The mains power quality should correspond to
interruptions and fluc- of the UT) for 0.5 that of a typical commercial or hospital envi-
tuations of the supply periods at 0°, 45°, ronment. If the user of the system requires
voltage 90°, 135°, 180°, 225°, continued operation during power mains inter-
270°, 315° ruptions, it is recommended that the system
according to IEC
be powered from an uninterruptible power
61000-4-11 < 5% UT (95% dip of
supply.
the UT) for 1 period
The stand has a nominal input current of more
70% UT (30% dip of
than 16 A per phase and is therfore excluded.
the UT) for 25 periods

< 5% UT (> 95% dip of < 5% UT (> 95% dip of

the UT) for 5 s the UT) for 5 s

Power frequency 30 A/m Not applicable No components sensitive on magnetic fields.

(50/60 Hz) magnetic
field
according to IEC
61000-4-8

Remark: UT is the a.c. line voltage prior to application of the test levels.

178 Operator Manual

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 Technical description 8

8.4.3 Guidelines and manufacturer's declaration - electromagnetic

immunity
The system is intended for use in an electromagnetic environment as specified
below. The customer or the user of the system should ensure that it is operated
in such an environment.

Immunity tests IEC 60601 test level Compliance level Electromagnetic environment – Guidelines

Portable and mobile RF telecommunications

equipment should not be used closer to any
part of the system (including cables) than the
recommended safe distance calculated with
the equation for transmission frequency.

Conducted RF inter- 3 Vrms 3 Vrms Recommended separation distance:

ference
150 kHz to 80 MHz Standby: d = 1.2 √P
according to IEC
150 kHz to 80 MHz
61000-4-6
For X-ray mode cer-
tain ISM frequencies
have been tested only
(dwell time > 60 s):
6.765 MHz
6.780 MHz
6.795 MHz
13.553 MHz
13.560 MHz
13.567 MHz
26.967 MHz
27.120 MHz
27.283 MHz
40.660 MHz
40.680 MHz
40.700 MHz

6 Vrms For all modes:

ISM bands between 6 Vrms
150 kHz to 80 MHz
ISM bands between
150 kHz to 80 MHz

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 8 Technical description

Immunity tests IEC 60601 test level Compliance level Electromagnetic environment – Guidelines

Radiated RF interfer- 3 V/m 3 V/m d = 1.2 √P for 80 MHz to 800 MHz

ence
80 MHz to 2.7 GHz Standby: d = 2.3 √P for 800 MHz to 2.7 GHz
according to IEC
80 MHz to 2.7 GHz
61000-4-3
For X-ray mode cer-
tain ISM frequencies
have been tested only
(dwell time > 60 s):
433.05 MHz
443.92 MHz
434.79 MHz
902.00 MHz
915.00 MHz
434.79 MHz
902.00 MHz
915.00 MHz
928.00 MHz
2400.00 MHz
2450.00 MHz
2500.00 MHz

9 V/m to 28 V/m in For all modes:

dedicated ISM fre-
9 V/m to 28 V/m in
quencies according to
defined ISM fre- quen-
Table 9 of IEC
cies according to
60601-1-2:2014
Table 9 of IEC
60601-1-2:2014

Where P is the maximum output power rating

of the transmitter in watts (W) according to
the transmitter manufacturer and d is the rec-
ommended separation distance in meters (m).
Field strengths of fixed RF transmitters, as
determined by an electromagnetic site surveya,
should be less than the compliance level in
each frequency rangeb.
Interference may occur in the vicinity of equip-
ment marked with the following symbol:

180 Operator Manual

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 Technical description 8

Immunity tests IEC 60601 test level Compliance level Electromagnetic environment – Guidelines

Remark 1: At 80 MHz and 800 MHz, the higher frequency range applies.

Remark 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and
reflection from structures, objects and people.

a Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile
radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy. To
be able to assess the electromagnetic environment with regard to the stationary transmitters, an electromagnetic site
study should be considered. If the measured field strength at the location where the system is used exceeds the applica-
ble RF compliance level specified above, the system should be observed to verify normal operation. Should unusual per-
formance features be observed, additional measures (such as change in orientation or change of site of the system) may
be necessary.

b Above the frequency range of 150 kHz to 80 MHz the field strength should be less than 3 V/m.

8.4.4 Recommended protective distances between portable and

mobile RF telecommunication devices and the system
The system is intended for use in an electromagnetic environment in which
radiated RF disturbances are controlled. The customer or the user of the system
can help prevent electromagnetic interference by maintaining a minimum
distance of 30 cm (12 inches) between portable and mobile RF communications
equipment (transmitters) and the system as recommended below, according to
the maximum output power of the communications equipment.

Nominal power of the Separation distance according to frequency of transmitter [m]

transmitter [W]
150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2.7 GHz
d = 1.2 √P d = 1.2 √P d = 2.3 √P

0.01 0.12 0.12 0.23

0.1 0.38 0.38 0.73

1 1.2 1.2 2.3

10 3.8 3.8 7.3

100 12 12 23

For transmitters rated at a maximum output power not listed above, the recommended separation distance d in meters
(m) can be estimated using the equation applicable to the frequency of the transmitter, where P is the maximum output
power rating of the transmitter in watts (W) according to the transmitter manufacturer.

Remark 1: At 80 MHz and 800 MHz, the higher frequency range applies.

Remark 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and
reflection from structures, objects and people.

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 8 Technical description

8.4.5 Essential Performance of the system and its possible

degration in case of electromagnetical distorsions
The system was conscientiously tested for any influence of electromagnetical
distorsions. Even if during EMC testing no degration was determined, please be
aware that the essential perfomance of the system might be affected by
electromagnetical distorsions:
◾ Accuracy of loading factors
◾ Automatic control system / Automatic Exposure Control (AEC)
◾ Linearity of Air Kerma
◾ Reproducibility of X-ray radiation output
◾ Imaging Performance
◾ Missed tissue at chest wall
◾ Compression
Please regularily check dose, image homogeneity and compression unit as
described in Quality Control Manual. In case of suspicious system behaviour in
regards of applied dose, image artifacts or compression, please call service.

8.5 List of compatible components

 CAUTION

Use of unsuitable accessories.

Injury to persons or damage to equipment!
◆ Exclusively use accessories which are explicitly declared by the
manufacturer to be compatible with the mammography system.

The person connecting additional equipment to the medical device is

considered to be the system configurer and is therefore responsible for

 ensuring that the current system configuration complies with the relevant
standards (e.g. system standard IEC/EN 60601-ff and/or other applicable
standards).
In case of doubt, please consult your local contact person.

Please note that the dimensions for the compression plates in the following
table are given with a tolerance of ± 5 %.

8.5.1 Compatible components MAMMOMAT Inspiration

Description Image Size Material number Manufacturer

Object tables*

1.5 x magnification table* 10139851 Siemens Healthcare GmbH

1.8 x magnification table* 10502581 Siemens Healthcare GmbH

182 Operator Manual

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 Technical description 8

Description Image Size Material number Manufacturer

Compression plates*

18 cm x 24 cm high edge* 18 cm x 24 cm 10139952 Siemens Healthcare GmbH

18 cm x 24 cm low edge* 18 cm x 24 cm 10139950 Siemens Healthcare GmbH

24 cm x 30 cm high edge* 23 cm x 30 cm 10139954 Siemens Healthcare GmbH

24 cm x 30 cm low edge* 23 cm x 30 cm 10139964 Siemens Healthcare GmbH

18 cm x 24 cm flexible* 18 cm x 24 cm 10139956 Siemens Healthcare GmbH

24 cm x 30 cm flexible* 23 cm x 30 cm 10139958 Siemens Healthcare GmbH

9 cm x 9 cm Spot* 9 cm x 9 cm 10139960 Siemens Healthcare GmbH

9 cm x 9 cm Mag Spot* 12 cm x 12 cm 10139855 Siemens Healthcare GmbH

18 cm x 24 cm Spot Plus * 18 cm x 24 cm 10139966 Siemens Healthcare GmbH

8 cm x 20 cm Axilla* 8 cm x 20 cm 10139962 Siemens Healthcare GmbH

16 cm x 20 cm Mag* 16 cm x 20 cm 10139853 Siemens Healthcare GmbH

2D Biopsy Multihole* 16 cm x 20 cm 10139823 Siemens Healthcare GmbH

Shifting Paddle low edge* 18 cm x 24 cm 10139896 Siemens Healthcare GmbH

Shifting Paddle high edge* 18 cm x 24 cm 10501356 Siemens Healthcare GmbH

Tomo Paddle* 25 cm x 36 cm 10501363 Siemens Healthcare GmbH

6 cm x 6 cm Spot Focus* 9 cm x 9 cm 10762392 Siemens Healthcare GmbH

6 cm x 6 cm Mag Focus* 9 cm x 9 cm 10762391 Siemens Healthcare GmbH

Inserts for compression plates (cradles)*

18 cm x 24 cm high edge* 18 cm x 24 cm 10139942 Siemens Healthcare GmbH

18 cm x 24 cm low edge* 18 cm x 24 cm 10139940 Siemens Healthcare GmbH

23 cm x 30 cm high edge* 23 cm x 30 cm 10139944 Siemens Healthcare GmbH

23 cm x 30 cm low edge* 23 cm x 30 cm 10139974 Siemens Healthcare GmbH

18 cm x 24 cm flexible* 18 cm x 24 cm 10139946 Siemens Healthcare GmbH

6 cm x 6 cm Spot+ Mag Focus* 9 cm x 9 cm 10549874 Siemens Healthcare GmbH

24 cm x 30 cm flexible* 23 cm x 30 cm 10139948 Siemens Healthcare GmbH

9 cm x 9 cm Spot* 9 cm x 9 cm 10139970 Siemens Healthcare GmbH

9 cm x 9 cm Mag Spot* 9 cm x 9 cm 10139970 Siemens Healthcare GmbH

8 cm x 20 cm Axilla* 8 cm x 20 cm 10139972 Siemens Healthcare GmbH

16 cm x 20 cm Mag* 16 cm x 16 cm 10139943 Siemens Healthcare GmbH

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 8 Technical description

Description Image Size Material number Manufacturer

18 cm x 24 cm Spot Plus* 18 cm x 24 cm 10139967 Siemens Healthcare GmbH

2D Biopsy Multihole* 16 cm x 20 cm 10139824 Siemens Healthcare GmbH

Tomo Paddle high* 25 cm x 36 cm 10501366 Siemens Healthcare GmbH

Shifting Paddle high* 18 cm x 24 cm 10139942 Siemens Healthcare GmbH

Shifting Paddle low* 18 cm x 24 cm 10139940 Siemens Healthcare GmbH

Biopsy attachment with laser cross

Alphanumeric compression plate* 12 cm x 22 cm 10139696 Siemens Healthcare GmbH

Laser targeting device 10643088 Siemens Healthcare GmbH

Compression plate holder 10139772 Siemens Healthcare GmbH

Stereo biopsy unit*

Biopsy unit including hand box* 10501300 Siemens Healthcare GmbH

Compression plate with window includ- 7 cm x 11 cm 10501318 Siemens Healthcare GmbH

ing holder*

Additional insert with window 10501346 Siemens Healthcare GmbH

Additional insert without window 10501347 Siemens Healthcare GmbH

Hand switch for radiation release 1170609 Siemens Healthcare GmbH

Foot switch for radiation release 10139752 Siemens Healthcare GmbH

Foot switch with four paddles 10139755 Siemens Healthcare GmbH

19" color monitor 11171888 EIZO

3MP 21" color monitor 11171870 EIZO

Additional monitor holder for control 10549894 Siemens Healthcare GmbH

console

Control console with radiation shield 10549892 Siemens Healthcare GmbH

Object table* 10860592 Siemens Healthcare GmbH

Handles* 10140049 Siemens Healthcare GmbH

llluminated glass front pane (MoodLight) 10139890 Siemens Healthcare GmbH

* applied part in accordance with IEC 60601-1

184 Operator Manual

Print No. XPW7-330G.620.61.01.02
 Appendix 9

9 Appendix

9.1 Calibration form

 Record the calibrations on a copy of the appendix page and file it along with
the Operator manual.

Location: __________________________

Year

Month

Day

Time

Tempera-
ture

Performed
by

Comment:

Checked:

Date:

MAMMOMAT Inspiration | VB61 or higher 185

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 9 Appendix

186 Operator Manual

Print No. XPW7-330G.620.61.01.02
 Glossary 10

10 Glossary
AT Axillary Tail

CC Cranio Caudal

CCid Cranio Caudal Implant displaced

CCrl Cranio Caudal rolled laterally

CCrm Cranio Caudal rolled medial

CCtan Cranio Caudal Tangential

CV Cleavage View

FB From Below (Caudocranial)

FBid From Below Implant displaced

FBrl From Below rolled laterally

FBrm From Below rolled medial

FBtan From Below Tangential

id Implant displaced

L* Latero*/-Lateral

LM Latero Medial

LMid Latero Medial Implant displaced

LMO Latero Medial Oblique

LMOid Latero Medial Oblique Implant displaced

LMOrl Latero Medial Oblique rolled laterally

LMOrm Latero Medial Oblique rolled medial

LMOtan Latero Medial Oblique Tangential

LMrl Latero Medial rolled laterally

LMrm Latero Medial rolled medial

LMtan Latero Medial Tangential

m* Magnification

M* Medio*/-Medial

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 10 Glossary

mCC Magnification Cranio Caudal

mCCM Magnification Exaggerated Cranio Caudal Medial

mFB Magnification From Below

ML Medio Lateral

MLid Medio Lateral Implant displaced

mLM Magnification Latero Medial

MLMO Magnification Latero Medial Oblique

MLO Medio Lateral Oblique

MLOid Medio Lateral Oblique Implant displaced

MLOrl Medio Lateral Oblique rolled lateral

MLOrm Medio Lateral Oblique rolled medial

MLOtan Medio Lateral Oblique Tangential

MLrl Medio Lateral rolled laterally

MLrm Medio Lateral rolled medial

MLtan Medio Lateral Tangential

mML Magnification Medio Lateral

mMLO Magnification Medio Lateral Oblique

msCC Magnification Spot Cranio Caudal

msFB Magnification Spot From Below

mSIO Magnification superolateral-to-inferomedial Oblique

msLM Magnification Spot Latero Medial

msLMO Magnification Spot Latero Medial Oblique

msML Magnification Spot Medio Lateral

msMLO Magnification Spot Medio Lateral Oblique

msSIO Magnification Spot Superolateral-to-inferomedial Oblique

msXCC Magnification Spot Exaggerated Cranio Caudal

msXCCL Magnification Spot Exaggerated Cranio Caudal Lateral

msXCCM Magnification Spot Exaggerated Cranio Caudal Medial

mXCC Magnification Exaggerated Cranio Caudal

188 Operator Manual

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 Glossary 10

mXCCL Magnification Exaggerated Cranio Caudal Lateral

O* .-oblique

r* .-rolled

rl rolled laterally

rm rolled medially

s* Spot

sCC Spot Cranio Caudal

sCCM Spot Exaggerated Cranio Caudal Medial

sFB Spot From Below

SIO Superolateral-to-inferomedial oblique

SIOid Superolateral-to-inferomedial oblique Implant displaced

SIOrl Superolateral-to-inferomedial Oblique rolled laterally

SIOrm Superolateral-to-inferomedial Oblique rolled medial

SIOtan Superolateral-to-inferomedial Tangential

sLM Spot Latero Medial

sLMO Spot Latero Medial Oblique

sML Spot Medio Lateral

sMLO Spot Medio Lateral Oblique

sSIO Spot Superolateral-to-inferomedial oblique

sXCC Spot Exaggerated Cranio Caudal

sXCCL Spot Exaggerated Cranio Caudal Lateral

tan Tangential

X* Exaggerated

XCC Exaggerated Cranio Caudal

XCCid Exaggerated Cranio Caudal Implant displaced

XCCL Exaggerated Cranio Caudal (Lateral)

XCCLrl Exaggerated Cranio Caudal Lateral rolled laterally

XCCLrm Exaggerated Cranio Caudal Lateral rolled medial

XCCLtan Exaggerated Cranio Caudal Lateral Tangential

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 10 Glossary

XCCM Exaggerated Cranio Caudal (Medial)

XCCMid Exaggerated Cranio Caudal Medial Implant displaced

XCCMrl Exaggerated Cranio Caudal Medial rolled laterally

XCCMrm Exaggerated Cranio Caudal Medial rolled medial

XCCMtan Exaggerated Cranio Caudal Medial Tangential

XCCrl Exaggerated Cranio Caudal rolled laterally

XCCrm Exaggerated Cranio Caudal rolled medial

XCCtan Exaggerated Cranio Caudal Tangential

190 Operator Manual

Print No. XPW7-330G.620.61.01.02
 Index

1,2,3 … ending 56 Control box 49

intervals 52 labels 162
2D biopsy compression plate 46
magnification 53 Control knob
3MP monitor 75 method 53 compression 68
performing 53
Cooling curves 164
A preparations 53
X-ray tube assembly 165
Accessories type 52
Country-specific regulations 15
use 19 Calibration form
form 185 Crushing 26
Acquisition workstation
design and function 48 Captions Curves 164
dimensions 175 of images 125 CV 94
labels 160 CC 94
AEC mode 37 CCid 94 D
Angle 124 CCrl 94 Daily checks 29
Angle adjustment 63 CCrm 94 Data security 15, 17
Annual maintenance 32 technical specifications 172
CCtan 94
Anode cooling curves 164 Decompression 41, 65
CE marking 15
automatic 68
Anode heating curves 164 Checks 19 during a power failure 68
Application program 73 automatic exposure control 31 information 66
Archive daily 29
Detector
configuration 144 during the examination 31
labels 156
monthly 31
Archiving technical specifications 169
data security 17 Circular ROIs 124
Diagrams 164
Area of application 9 Classifications
Dimensions
technical specifications 172
AT 94 acquisition workstation 175
Cleaning 32, 32 mirror stand 174
Attenuation factor
technical specifications 172 Collimator tube assembly 175
labels 157 Disinfection 32, 33
Auto transfer destinations
image selection 144 Collimator unit 40 Display
Autodelete Collision 26 of rejected images 81
function 91 Colors Displays
Autodelete function 91 configuration 147 technical specifications 169

Automatic decompression 68 Compatible components 182 Disposal 34

Compression 41, 65 materials used 34
Automatic exposure control
information 66 mechanical dangers 35
technical specifications 170
OPCOMP 37 Distance line 123
Automatic exposure control (AEC)
using control knob 68 Documentation
checks 31
using foot switch 66 safety information 23
Automatic Exposure Control (AEC) 37
Compression plate Dose
Automatic exposure system 2D biopsy 46 technical specifications 171
OPDOSE 37 label 159
During the examination
Automatic modes mounting 62
checks 31
for optimized exposures 37 Shifting Paddle 46
Spot Plus 45
Available procedures 133
E
Compression plates 45
AWS 73
Electrical connections 176
connection of a virtual machine 81 Conditions of use 12
dimensions 175 Electromagnetic compatibility (EMC) 176,
Configuration
labels 160 182
colors 147
examination 131 EMC 176, 182
B MoodLight 146 Emergency release 42
of the procedures 131
Biopsy 10, 71 Emergency shutdown switch 17
of WH AWS transfer 131
Biopsy unit starting 131 Emergency STOP button 16, 40
labels 159 transfer and archive 144 Emission curves 165
Body region 11 Connection End Session
of a virtual machine to the AWS 81 dialog box 79
C Contraindications 12 Environmental conditions
Calibration 52 Control area 99 technical specifications 173

MAMMOMAT Inspiration | VB61 or higher 191

Print No. XPW7-330G.620.61.01.02
 Index

Equipment safety 29 Height of object 68

Error messages 21 of the swivel arm 65 LM 94
Examination Height adjustment 63 LMid 94
completing 128 Height with the foot switch 65 LMO 94
configuration 131 High-resolution monitor 75 LMOid 94
finishing 128
performing 105 LMOrl 94
I
resuming 86 LMOrm 94
safety 60 id 94
LMOtan 94
settings 106 Identification labels 153
task card 99 LMrl 94
Image
workflow 61 LMrm 94
captions 125
Examination settings exposure data 119 LMtan 94
subtask cards 102 inverting 126 Lock computer 79
Examination task card rejecting 117
Log-off 79
layout 99 repeating 116
zooming and panning 121
Explosion protection 16 M
Image area 102
Exposure 111 m* 94
magnified 70 Image processing
repeating 115 M* 94
Exposure data
Image selection Magnification calibration 53
of an image 119
for auto transfer destinations 144 Magnification table 44, 69
Exposure programs
Imagee labels 159
viewing 141
filming/printing 127 Magnified exposure 70
Exposures
automatic modes 37 Images Magnifying glass 122
post-processing 119 Maintenance
F Implants 17 annual 32
Face shield Info bar 104 Maintenance plan 20
installing 62 Installation 20 Materials used 34
FB 94 Installation site 15 mCC 94
FBid 94 Intended use 10 mCCM 94
FBrl 94 Introduction 9 Mechanical dangers
FBrm 94 Inverting in disposal 35
FBtan 94 images 126 Mechanical safety 26
Film preview 127 Menu bar 99
L Messages 76
Filming
images 127 L* 94 mFB 94
Flat-panel detector object table 44 Labels 153 Mirror stand
acquisition workstation 160 technical specifications 174
Foot switch 43
Biopsy unit 159
adjusting height 65 ML 94
collimator 157
compression 66
compression plate 159 MLid 94
radiation release 50
control box 162 mLM 94
Freehand ROIs 124 detector 156
MLMO 94
Functional checks 29 magnification table 159
monitor 161 MLO 94

G object table 156 MLOid 94

radiation protection 162 MLOrl 94
Generator
single tank 158
technical specifications 168 MLOrm 94
system 154
Generator control field 102 workstation 161 MLOtan 94
settings 108 X-ray stand 153 MLrl 94
Laws 15 MLrm 94
H
Layout MLtan 94
Hand switch of the Examination task card 99
mML 94
radiation release 49
Legally required tests 15
mMLO 94
Heating curves 164
Legend 4
X-ray tube assembly 165 Mobile installations 28
Lighting
Monitor 48

192 Operator Manual

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 Index

high-resolution 75 Parameters 9 Range of application 37

label 161 Patient Rectangular ROIs 124
Monthly checks 31 registration 105 Registration
MoodLight Patient data of the patient 105
configuration 146 safety information 22 Regulations 15
MPPS Patient data management 81 country-specific 15
procedure tracking 129 Patient group 11 Rejected images
msCC 94 Patient safety 25 displaying 81
msFB 94 PC hardware / software Rejecting
mSIO 94 technical specifications 169 an image 117

msLM 94 Personal safety 24 Repair 20

msLMO 94 Personnel Repeating

safety 24 an image 116
msML 94
image processing 115
msMLO 94 Physical functionality 12
Required documents 9
msSIO 94 Pixel lens 123
Resource check 77
msXCC 94 Post-processing 119
Restart the system 31
msXCCL 94 Power failure
decompression 68 Resuming the examination 86
msXCCM 94
Power supply RIS
Multiple connected RIS 81 multiple connected 81
technical specifications 167
mXCC 94 Risk
Preparations
mXCCL 94 before start 51 of collision and crushing 26
for calibration 53 of stumbling 28
N Printing rl 94
Names 9 images 127 rm 94
Procedure tracking ROIs 124
O with MPPS 129 Rrocessing
O* 94 Procedures repeating 115
configuration 131
Object lighting 68
configuring 132 S
Object table details 134
labels 156 s* 94
list 133
Object tables 44 Safety
Projection angle
during the examination 60
OFF 72 adjusting 64
general information 15
ON 51 Projection name protective measures 15
OPCOMP 67 changing 142
Safety checks 29
optimized compression 37 Projection views
sCC 94
procedure 67 correcting 114
default order 141 sCCM 94
OPDOSE
automatic exposure system 37 details 136 Screening 10
modifying 110, 137
Operation Scrolling 121
orders 140
of swivel arm 40 Settings
saving 140
technical specifications 173 in the generator control field 108
sequence 138
Operator Manual sFB 94
Protective measures 15
area of application 9
Shifting Paddle compression plate 46
parts 9
required documents 9 R Shutdown 79
structure 9 r* 94 Single tank
Optimized compression 67 Radiation protection labels 158
OPCOMP 37 label 162 SIO 94
procedure 67 Radiation release 49 SIOid 94
Overview 37 Radiation safety 24 SIOrl 94
system 37
Radiation shield SIOrm 94
technical specifications 169 SIOtan 94
P
Radiation-protection areas 25 Site 15
Panning
Radiation-protection regulations 25 sLM 94
images 121

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sLMO 94 technical specifications 173
sML 94 Tube assembly
sMLO 94 dimensions 175

Software 19 Type of calibration 52

Spot Plus compression plate 45

U
sSIO 94
Uninterruptable Power Supply (UPS) 18
Stand display 43
UPS 18
Start-up 51
Use of accessories 19
Starting
the system from the off state 51 User profile 12

Status
symbols 100 V
Status bar 77, 104 Virtual machine
connection to the AWS 81
Status indicators 21
Virtual memory 77
Stereotactic biopsy 10
Storage
W
technical specifications 173
WH AWS transfer
Stumbling
configuration 131
risk 28
Workflow
Subtask cards
examination 61
examination settings 102
Workstation 73
Switching off 72
label 161
Switching on 51
Swivel arm X
adjusting height 65
X-ray stand
operation 40
design and functionality 38
Swivel-arm movements labels 153
information 63
X-ray tube 39
sXCC 94 technical specifications 170
sXCCL 94 X-ray tube assembly
Symbols heating and cooling curves 165
status 100 X* 94
System XCC 94
labels 154
XCCid 94
overview 37
restart 31 XCCL 94

System description 37 XCCLrl 94

System messages 76 XCCLrm 94

System overview 37 XCCLtan 94

XCCM 94
T XCCMid 94
tan 94 XCCMrl 94
Task card XCCMrm 94
Examination 99 XCCMtan 94
Task cards 74 XCCrl 94
Technical description 153 XCCrm 94
Technical specifications 167 XCCtan 94
Tests 19
legally required 15 Z
TFT monitor 48 Zooming
Training 12 images 121
Transfer
configuration 144
Transport

194 Operator Manual

Print No. XPW7-330G.620.61.01.02
Siemens Healthineers Headquarters Legal Manufacturer
Siemens Healthcare GmbH Siemens Healthcare GmbH
Henkestr. 127 Henkestr. 127
91052 Erlangen 91052 Erlangen
Germany Germany
Phone: +49 9131 84-0
siemens-healthineers.com

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