Release Notes - Q3 2018

Release Notes - Q3 2018

Ikonopedia Users,

We are pleased to announce the release of a new software update.  This update includes a complete refactoring of the biopsy module along with the addition of a new “priors needed” feature.

Below is a short summary of the changes:

1. Biopsy Modality Update

Updates to the biopsy module include the addition of seven localization types, multiple new markers and clip choices, sentinel node lymphoscintigraphy, and rearrangement of the interface to match other modalities more closely.  (See details in section below)

2.  Priors Needed
This new feature helps to simplify the process of acquiring prior imaging by immediately updating the followup manager and automatically documenting the need for priors in the clinical report.  (See details in section below)

3.  Clinical Report Enhancement

In order to improve clarity for our referring physicians, we have made the following changes to the clinical report:
  • Changed “ CATEGORY ” section header to “ OVERALL ASSESSMENT CATEGORY ”. 
  • Removed the Term “BI-RADS-#” from the conclusion section — leaving it only in the new  OVERALL ASSESSMENT CATEGORY.

4.  Ultrasound Enhancement
Ability to say “ No Axillary Adenopathy ” is no longer dependent on selection of categories 1 and 2 (See details in section below)

See below for a full description of items 1,2 and 3 listed above

Biopsy Modality Update

The biopsy modality has been upgraded with the following changes: 

  1. Addition of lesion localization including seven localization methods
  2. Updated list of markers and clips.
  3. Addition of sentinel node lymphoscintigraphy
  4. Refactoring of post-procedure imaging including new gamma probe and tracer reporting.

Below is the main procedure screen that appears when a biopsy exam is selected in the worklist 

Interface changes

Several of the interface elements have been rearranged to accommodate new functionality and to improve the look-and-feel of the biopsy screen.

We have also moved the depth and CFN inputs to the location seen below.

Imaging Assist

We have added Tomosynthesis to the imaging assist choices.

Device Changes

We have added three new devices to the device section:
  • Localization
  • Skin Punch Biopsy
  • Sentinel Node Lymphoscintigraphy (labeled Sentinel below)

Localization Device

Selecting the lesion localization device will display seven new selectors to the left:

Each localization method is selectable and will offer additional properties when selected.  Wire localization is selected in the image above.

The lesion localization method selections are:

  • Single wire localization
  • Bracketing wire localization
  • MagSeed® magnetic seed
  • SaviScout® radar reflector
  • Iodine-125 radioactive seed
  • Faxitron® miniature radiofrequency (RFID) tag
  • Methylene and Toluidine blue dye localization

Note : Selected items will be displayed with an orange background as seen above.

Note : The  Marker Position button will change to  Localization Position and may have a few more options from which to choose depending on the localization method chosen.

Sentinel Lymph Node Device

Choosing this method displays additional information seen on the details page where you can document your tracer injection. 

General Usage:

1.  Create a location and make the following selections seen below:

2.  Select the Details tab and take note of the Sentinel-specific panel as seen below:

Note : You can also choose a specific location along with CFN and Depth if you will be injecting perilesional.

Skin Punch Biopsy

Skin punch biopsy is a new addition.  When you select this device, the needle-gauge list below it changes to punch size:

Cyst Aspiration (FNA)

Cyst aspiration has not changed in this release but as a quick reminder, here are steps for general usage:

General Usage

1.  Create a location and set the specific location.

2.  Make selections as seen below:

3.  Now, select the details tab and notice  fluid disposition and  fluid appearance choices now appear.

Post-Procedure Tab

We have also reorganized the post-procedure tab.  Below are a few highlights of features on this screen:

A new selector for post-procedure imaging type is now available.

We have added tracer uptake confirmation for Gamma Probe and Gamma Camera.  When you select Gamma Probe or Gamma Camera, the Tracer Uptake panel will appear on the right.

Post-imaging confirmation panel.   For localization and marker placement, this post-procedure confirmation panel will appear with a helpful hint about where the marker or localization device was placed.

Priors Needed 

You can now quickly select “needs priors” within our reporting modalities.  This will automatically add sentences in the clinical report and immediately update the followup manager.

On diagnostic reporting screens, the “Needs Priors” button is located near the top as seen below.

Screening Mammography Button Location

Updated Clinical Report

Report text is automatically added to the PRIOR EXAMS and RECOMMENDATIONS sections of the clinical report when the “Need Priors” button is selected.  Below is a report fragment to show the new text.

“Need Priors” in Followup Manager

A new followup notification will appear in the followup manager as in the example below.

Customize Patient Lay-Letters:  As a customizable option, we can update your patient lay-letters to explain the need for prior imaging.  Please contact Ikonopedia support at (214) 308-0248 or (888) 768-6869  

Ultrasound Enhancement

No Axillary Adenopathy ” can now be specified without first selecting a BI-RADS category .   In the current version, you must first select either BI-RADS 1 or 2 categories first before you can select  “No Axillary Adenopathy”.   This has been changed in this update.

Follow the steps below to make this selection:

1.  Select a location from the location list:

2.  Select the green negative button without first selecting a BI-RADS.

IMPORTANT NOTE:  The Negative buttons are only enabled if you select either BI-RADS 1 or 2 buttons or have NOT selected ANY BI-RADS buttons. 

In order to specify “No Axillary Adenopathy” in a laterality that has BI-RADS other than 1 or 2, you will need to add a new location of the same laterality without specifying a BI-RADS category to make the selection seen below.

3.  A dialog will appear where you can select “No Axillary Adenopathy”

NOTE : you can also select “No Change on Comparison in the same manner.

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