FT1000(9000) Operator Training-iLT

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FT1000/FT9000
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Operator Training Manual
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HISKY Medical
Contents
• Presentation of the Device
• Power On and Off
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• Detection Functions
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• System Interface
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• Detection Procedure
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• Ultrasound Positioning
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• Fibrosis Detection
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• Measurement Results
• Other Functions N
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• User Management
• Case Management
• Troubleshooting
System Configuration
Fibrosis
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scanning
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Monitor
probe
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Imaging
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probe
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Main unit
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Foot switch
Front View
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Socket of fibrosis
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scanning probe
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Socket of
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probe
Side View
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Main power switch
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Rear View
USB port USB port
for service for user
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Power
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output port Internet
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for printer port
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Power
Fuse
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input port
Earthing Foot switch

terminal port
Control Panel
System on/off
button
Menu Select Encoder
Usually do not need to adjust, just
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use the default parameters.
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Function Keys
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Most functions can be realized by
these keys.
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N TGC Adjustment Slider
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Keep it as parabolic shape, which
can meet the demand of most of
detection, no need to adjust.
Fibrosis Scanning Probe-Connect
Align two red dots and push in
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
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1. Connect or disconnect the probe only when the system is switched off or
under freeze mode.
2. When connect or disconnect the probe, please firstly place the probe into the
corresponding probe holder in order to protect probes against falling down.
Fibrosis Scanning Probe-Disconnect
Warning: It is required to pull the unlocking
mechanism on the plug to unlock the probe.
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Unlocking
解锁装置
mechanism
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Pull the unlocking mechanism in the direction indicated in the picture to
unlock the locking pin and disconnect the plug from the socket.
Image-guided Probe-Connect & Disconnect
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Release the locking switch, insert the
Turn the locking switch 90°
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probe connector, turn the locking switch
anticlockwise and pull out the plug.
90° clockwise.
1. Connect or disconnect the probe only when the system is switched off or under freeze
mode.
2. When connect or disconnect the probe, please firstly place the probe into the
corresponding probe holder in order to protect probes against falling down.
Footswitch-Connect & Disconnect
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Connect:
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Keep the pins aligned and push
into the port. N
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Disconnect:
Pull the unlocking mechanism
and disconnect the plug from
the socket.
Contents
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• Other Functions
• User Management
• Case Management
• Troubleshooting
Power On
• Please read the safety regulations in the user manual carefully before use.
• Turn off the system immediately and contact our customer service department
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or local distributor if any abnormality is found.
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• The protective earthing terminal must be connected with the earthing
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protection mechanism of power supply. Please make sure that the earthing
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protection of power supply functions normally.
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Power Off
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Contents
• Presentation of Device
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• User Management
• Case Management
• Troubleshooting
System Interface
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Test mode Patient Function Name of doctor
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information keys & department
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System Interface-Imaging Mode
Test time
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Imaging
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scanning
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Function
keys
List of scanned images
System Interface-Fibrosis Scanning Mode
Pressure indicator bar

E mode
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M mode A mode
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UAP result Stiffness result
Display Modes
A mode
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Echo signal acquired by sensor at a single time point and
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displayed in waveform pattern.
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M mode
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A collection of A mode echo signal in a period of time.
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E mode (Elastogram)
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Graphic presentation of the propagation of shear wave as a

function of time and depth.
Pressure Indicator Bar
The area between the green inverted triangle and

the red inverted triangle in the pressure indicator
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bar is the moderate pressure area, and the area
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within the blue box is the best pressure area.
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Pressure When the probe contacts the skin, as the probe
too low
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pressure gradually increases, the pressure slider
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Moderate moves from left to right, and the color of pressure
indicator bar changes from pink to green and then
pressure
Nto red, which means that the pressure changes
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Pressure
too high from low pressure to moderate pressure and then
to high pressure respectively.
Contents
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• Other Functions
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• User Management
• Case Management
• Troubleshooting
1/4 New Patient
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2/4 Ultrasound Positioning
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3/4 Fibrosis Scanning
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Conditions for Successful Measurement
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Successful measurement needs to
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meet the following three conditions:
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•At least 10 valid measurements.
•Success rate above 60%.
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•IQR/med less than 33%.
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4/4 Report Printing and Saving
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4.1 Print Examination Report
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After measurement, click “up” or “down” to review the measurement results, select a good image,
then click “Report” (Print) on the screen or control panel to print out the Examination Report.
4.2 Save Examination Report
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After report is generated, click “Save” icon to save the report in the USB disk
that has been connected with the device.
Contents
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• Other Functions
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• User Management
• Case Management
• Troubleshooting
How to hold the image-guided probe?
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Patient Positioning
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1. Patient lies in a supine position with
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right arm lifted above the head, to
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fully expand the intercostal space.
2. Keep breathing steadily, and no For patients with narrow intercostal space:
speak during detection. 1.Lying down position, the body bent left to C-
3. Detect on the right lobe of the liver shape.
between the ribs. 2.Do not move the hip, and put the right leg on
the left leg.
Ultrasound Positioning-Image of Liver
1. Liver capsule
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2. Vessels
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❸ 3. Gallbladder
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❷
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• Identify the liver
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when you see the
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❶ liver capsule.
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Ultrasound Positioning-Correct Image
Suitable Location:
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Within the fibrosis scanning area, it is
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homogeneous liver parenchyma, no cyst,
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big blood vessels, ribs, or other non- liver
tissues.
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❶
N 1.Firstly, look for the liver capsule to
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make sure liver area is scanned;
2. Avoid the major vessels if possible;
3.Avoid the edge of liver.
Ultrasound Positioning-Incorrect (1)
1 2
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1. Near field region is highlighted
and blurred.
Scanned a bean-like object.
2. Vaguely see the liver capsule
when moving the probe.
-> Probe position is too high, -> Probe position is too low,
scanned the lungs. scanned the kidney
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Major vessels
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Bile duct
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There are several black shadows in There are major vessels, bile duct
the image. or other non-liver tissues.
-> Probe direction is incorrect, -> Probe position needs to be adjusted; you
scanned the ribs. can move the probe along the intercostal
space, to avoid non-liver tissues.
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1. Keep the probe still and can see a clear movement of liver.
2. Under some certain moments, most of the near field area is blurred
(usually the left half).
The scanning position of liver is greatly influenced by breathing of patient.
Consider to change another intercostal space or let the patient keep breathing
steadily or hold the breath.
Ultrasound Positioning-Mark Detecting
Location
• After choosing a good detecting location, make a mark with coupling
agent or grease pencil in the center position of the probe as the fibrosis
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detecting location.
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Red Mark
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Contents
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• User Management
• Case Management
• Troubleshooting
How to hold the fibrosis scanning probe?
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Five Criterions
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Tips: 1. The patient should keep a steady breath.
2. For patients with narrow intercostal space, body bent left to C-shape.
3. When the patient’s breathing influence the detection seriously, you may ask
the patient to hold his breath for 15s every time, and detect 3 times during
each breath holding.
M Mode & A Mode-Correct (1)
Subcutaneous tissue, echo amplitude of A mode
is big; the image of M mode shows tissue with
high brightness.
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Liver tissue, echo amplitude of A mode is
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smaller than subcutaneous tissue and it’s
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relatively uniform, with no big ups and downs
at different depths. After the probe is stable, the
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signal of A mode becomes stable. The image of
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M mode shows dark tissue in a big range of
depth, with no big difference in brightness.
N When the probe is stationary, the tissue shows
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a layered form.
Tissues beneath the liver, performance of A-

mode echo amplitude and M mode is unlike the
liver tissue.
M Mode & A Mode-Correct (2)
Subcutaneous tissues, echo amplitude of A
mode is big; the image of M mode shows tissue
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with high brightness.
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Liver tissue, echo amplitude of A mode is
smaller than subcutaneous tissue and it’s
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relatively uniform, with no big ups and downs
at different depths. After the probe is stable, the
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signal of A mode becomes stable. The image of
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M mode shows dark tissue in a big range of
N depth, with no big difference in brightness.
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When the probe is stationary, the tissue shows
a layered form.
M Mode & A Mode-Incorrect (1)
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The image of M Mode shows wave-like
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layers.
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Possible causes:
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2.Patient’s breath may not stable.
3.The probe may not be perpendicular to
the skin.
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The image of M mode shows no uniform
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brightness at different depth;
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Echo amplitude of A mode is big at
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different depth.
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Possible causes:
There are non-liver tissues in the
examination path.
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The image of M mode becomes darker
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as the depth increases;
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Echo amplitude of A mode becomes
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smaller as the depth increases.
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Possible causes:
The probe contacts a rib or the edge of a
rib.
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The image of M mode becomes
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heightened suddenly and attenuated as the
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depth increases.
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A mode becomes heightened suddenly and
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Possible causes:
There is gas in the examination path.
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The image of M mode shows no stable
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layers.
A mode is not stable and the echo
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amplitude becomes greater.
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Possible causes:
The detection position may be improper.
E Mode
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Notes
• Generally, the liver is located in 2.5cm down from the skin surface. Locate the probe
between 7th to 9th intercostal space on the right lobe of the probe along the midaxillary
line for measurement. The thickness, specific location and shape of liver will be
different to different patients.
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• To improve the success rate of detection, better to perform imaging scanning to find
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the best detecting position before fibrosis detection.
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• When the detecting effect is not good on the imaging scanning position (poor image
quality or big relative deviation), consider to slightly move the position and direction of
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the probe. If the adjustment is ineffective, switch to imaging mode to reselect the
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detection position.
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• It’s better to make detection at the same position and same angle. Please press
[Clear] button to clear the current records when you intend to change the detecting
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position or angle.
• Causes for high measurement results:
• The detecting area is near the edge of the liver.
• Probe edge is close to the ribs.
Contents
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• Other Functions
• User Management
• Case Management
• Troubleshooting
Median and IQR
Median
1. Sort the valid measurements in an ascending order (from M1 to M10).
2. Median Q2 divides the ordered data set into two halves.
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M1 M2 M3 M4 M5 M6 M7 M8 M9 M10
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25% of 25% of 25% of 25% of
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Q0 readings Q1 reading readings Q3 readings Q4
(minimum) s Q2 (maximum)
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(median)
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IQR = Q3-Q1
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IQR (Inter Quartile Range)
1. Divide the data set in four quartiles Q1 to Q4
Q1 : Median of Q0-Q2 IQR = Q3-Q1
Q3 : Median of Q2-Q4
2. IQR contains 50 % of measurements around the median Q2
Understanding of Readings
1st reading Actual Measurement Value

Median Value
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2nd reading
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(1st -2nd actual values)
3rd reading Median Value
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(1st-3rd actual values)
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4th reading Median Value
(1st-4th actual values)
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! FT starts calculating median value from 2nd shot,
so 2nd to 10th readings are median values, actual
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Median Value
10th reading (1st-10th actual values)
Final Stiffness Value
Measurement Results
Liver Stiffness Measurement (LSM, kPa)
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Degree of Liver Fibrosis
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Ultrasound Attenuation Parameter (UAP, dBm)
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Degree of Hepatic Steatosis
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Factors affecting LSM must be considered when interpreting results in clinical practice.
-Inflammation of liver (ALT level <5 x ULN), especially when ≤ F2
-Absence of extra-hepatic cholestasisN
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-Absence of liver edema, congestion (Elevated TBil)
-Absence of ongoing excessive alcohol intake
-Food intake (Patient should fast for at least 2 hours before measurement)
-BMI
-Narrow intercostal space
-Operator’s experience
Contents
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• User Management
• Case Management
• Troubleshooting
User Management
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Function
Enter user
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keys
management
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mode
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After login, the administrator can create, modify or delete any user.
Case Management (1/3)
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Enter the dates to search patient cases in search mode.

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N Double-click on a
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history medical
record to load
information.
Search mode
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Use the drop-down
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box to review
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Search mode
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Use the drop-down
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box to review
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different records.
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Contents
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• User Management
• Case Management
• Troubleshooting
No Display on Monitor
Before connection After connection
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N If LCD monitor cannot be displayed, please check
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1.Whether the power switch on display panel is
Power Display turned on.
Interface data cable 2.Whether the monitor power cable is connected.
3. Whether the display data cable is connected.
Trouble Cases in Imaging Mode
Trouble Solutions
No image output Check if it’s in freeze mode.
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Shows no probe Press [Probe] button to see if probe can be identified. If not, try to change the
probe socket.
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1. Check whether it’s connected to the socket with earth wire.
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Image
interference 2. Disconnect the printer power supply.
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(longitudinal 3. Find the source of interference within the grid (stop functioning of large
twill) equipment nearby).
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Buttons no respond; abnormal 1. Press [Probe] button, reload the probe.
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phenomenon of image display; 2. Repeatedly press the start / stop button, to see if the image can be
and other failures, switched between freeze mode and unfreeze mode.
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3. Stop scanning, click [Clear] on the screen, wait three seconds and restart
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not be solved the image module, and avoid repeated clicks.
4. When No.3 failed, click Exit and re-login.
5. When No. 4 failed, shut off the system and restart after one minute.
Trouble Cases in Fibrosis Scanning Mode
Problems Solutions
No ultrasound output in M mode 1. Continuously press twice the start / stop button to
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and A mode. restart testing.
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2. Press the [Mode] button to switch to image mode,
press the [Mode] button again to switch back to the
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fibrosis mode.
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3. Re-connect the probe in freeze mode
Foot switch does not work well or 1. Check whether the probe pressure is in moderate
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with no respond. zone.
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2. Check whether the probe tip is applied with coupling
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agent.
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3. Re-plug the foot switch.
The presence of pre-pressure 1. Slightly pull the black tip on the probe.
when no load on probe (pressure
indicator bar is pink or green).
Other Trouble Cases
Trouble Solutions
Trackball does not work well. 1. Connect wired mouse, see if it works.
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2. Open the trackball cover, remove the trackball, and put the
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trackball back after clearing the dust inside.
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Keyboard doesn’t work or input is 1. Check if the three small blue lights in the top right corner of the
abnormal. keyboard are on.
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2. Press the keyboard Caps Lock key, to see if the indicator will
change.
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Shortcuts is not working properly. 1. See whether individual button fails or all buttons fail.
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2. Click menu options on the screen to see if they are working
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properly.
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3. Check if it is in the correct operating mode.
Other Error 1. Logout, and then login.

2. If No.1 fails, turn off the system and power on again after one
minute.
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L

Earthing Foot switch

Pressure indicator bar

Graphic presentation of the propagation of shear wave as a

The area between the green inverted triangle and

Tissues beneath the liver, performance of A-

1st reading Actual Measurement Value

Enter the dates to search patient cases in search mode.

Other Error 1. Logout, and then login.

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