Release Notes

Persyst 15 Release Notes

About Persyst 15 Features and Updates

Persyst 15 includes significant enhancements to change the way you work.

The new Neonatal Seizure Detector demonstrates the latest cutting-edge technology you would expect from Persyst, leveraging deep learning and AI. The Neonatal Seizure Detector operates on reduced electrode arrays (double distance), commonly used in neonate recordings, down to as few as three electrodes. It is FDA cleared, and specifically for use with neonates.

Building on our multi-modal neuroimaging capabilities, Persyst 15 includes new intracranial EEG (iEEG) analysis tools, making review and planning for the next surgical phase more efficient, including the ability to quickly localize in the patient’s head volume and export to DICOM the 3D positions of the intracranial EEG electrodes.

The EEG Electrical Source Imaging capability has a dynamic 3D Viewer for visualizing ESI results in the patient’s head volume.

Finally, the Spike Review feature, which allows users to compare customized spike selections according to morphology and topography and analyze propagation maps, now also allows users to sort spikes by similarity.

New Neonatal Seizure Detector

Our newest AI-based detector trained on a large set of neonatal records reviewed by expert EEG readers identifies seizures with similar accuracy as expert human readers.

• Persyst can be configured to prompt the user to select an MMX file and seizure engine to use at the beginning of each study. By default, Persyst always uses the same MMX file.

New Intracranial Electrode Localization

Persyst 15 significantly builds on and improves Persyst’s utility for overcoming the unique challenges of analyzing intracranial EEG (iEEG) datasets. Foremost among these is a new intracranial electrode localization application with the following functionality:

• Automatically align pre- and post-implant CT and/or MR imaging.
• An alignment viewer allows for the manual inspection and adjustment of the alignment based on anatomical landmarks.
• Semi-automatically localize iEEG electrodes in the patient’s head volume with minimal user intervention.
• Quickly and easily visualize the location of the iEEG electrodes with millimeter resolution in the patient’s head volume using pre- and post-implant imaging.
• The 3D positions of user-defined electrode groups can be exported in DICOM format.

Intracranial Trending Tools

In addition to intracranial electrode localization, Persyst 15 has improved tools for generating patient-specific iEEG montages and new tools for automatically creating corresponding iEEG trends.

• The creation of iEEG montages can be created based on a subset of channels from an existing iEEG montage.
• Trend panels are automatically created based on the hardware groups in the patient-specific iEEG montages. These trends facilitate seizure finding and onset analysis.
• Users can choose colors for iEEG waveforms to distinguish between individual electrodes or electrode groups.

EEG Electrical Source Imaging (ESI)

Persyst 15 includes a state-of-the-art, easy-to-operate electrical source imaging (ESI) functionality for estimating the neural generators of interictal discharges with the following improvements:

• The MRI Viewer for ESI Results allows users to interactively visualize ESI results in the patient’s MRI, including dynamic thresholding of ESI results, the ability to overlay and compare ESI results across clusters and time points, the ability to export ESI volumes in DICOM format.
• The ESI study list is user-friendly and includes a Study Details menu item that includes the study metadata.
• The study segments that were uploaded for a given study are also reported in the Study Details for traceability purposes.
• Users can copy/paste text from the ESI study list.
• Multiple patients can be selected and deleted at a time.
• Special characters are handled.
• The total patient count is displayed at the bottom of the list.
• There is a streamlined approach to uploading ESI studies and downloading results.
• ESI is meant for studies that have already been recorded; there is a warning if a user tries to upload a live recording.
• Error messages are in plain language.

Enhanced Spike Review

The updated Spike Review now allows users to sort spikes within a cluster by similarity, amplitude, or perception. Users can create and compare customized spike selections against the cluster average and more, using waveform overlays and propagation maps for assessing morphology and goodness of fit. Spike Review is optimized for use with Persyst ESI. Customized spike groups can also be easily exported. Persyst 15 includes significant enhancements to change the way you work.

• Enhanced Averaging. Users can now specify the number of spikes used for the rough average, providing more control over data analysis.
• Sort by Similarity. Users can now sort spikes by Similarity, making it easier to identify and categorize relevant spikes.
• Improved Handling. Spike Review can now efficiently handle records with a high number of spikes, exceeding 6,000, ensuring smoother data analysis.
• Streamlined Selection. Updated the spike selection feature to allow the selection of spikes across multiple pages, improving data management and analysis.
• Spike Review now has montages for 10-10 and 10-20 recordings with sub-temporal electrodes

Trending

Persyst 15 includes new default trend panels to enhance the out-of-the-box user experience.

• Trend panels can now be grouped for easier use.  If no trend panels are assigned to groups, all panels will appear at the top level of the list, simplifying the organization of trend data.  The panel grouping is stored in the MMX along with the trend panels themselves, improving data management and organization.  The new default Trend Panel Hierarchy includes:

• A new linear transformation instrument that enables lab values to be converted to a standard normal range. This allows various lab value types, such as sodium, potassium, chloride, blood urea nitrogen, and creatinine, to be plotted on a single graph.
• ECG channel selection for the Heart Rate Trend: A set of common ECG channel names has been added for the heart rate channel, making it easier for the heart rate trend to auto-configure.
• Extended Time Trend: Added the 1st and 99th  percentiles to the list of available choices in the Time Trend, providing a more comprehensive view of trends.
• A confirmation dialogue has been added to prevent accidental trend deletion.
• Baseline Setting: Implemented code to prevent users from setting a baseline in areas where trends have not been calculated, ensuring more accurate trend analysis.
• Line Width Customization: Users can now set the line width for trend panels, providing flexibility in trend visualization.
• The default range for Z Axis slider used on Versus Baseline Trends has been expanded to ±12.
• The Y-Axis range now has a slider for easy upper and lower trend limits adjustment.
• Enhanced data processing continuity, even after program interruptions.
• There is now the option to disable Artifact Reduction calculation on specific recordings.

User Interface and Features

• Persyst 15 has new icons throughout the program for a fresh and user-friendly design.
• Added an indicator on the Electrode Signal Quality trend panel to show “bad” electrodes marked by Persyst.
• Montage handling has been updated to show renamed montages in the correct location.
• There is now the option to change the channel label font based on the master control settings.
• Minor UI changes were made for longer channel lists display.

Persyst Database and Data Handling

• More controls and enhancements have been added for reindexing the Persyst Database including for more rapid searching of new comments.
• There is the ability to automatically close records in the monitoring view when acquisition stops.
• Records indexed with UNC paths can now be found when opened via a mapped drive.
• The Persyst Version can now be returned from PSCLI.
• Updated logging to log events from different processes to log files.
• Patient metadata can now be edited in the Persyst format (lay/dat), making it easier to add missing fields, such as date of birth or Patient ID.
• There is now a warning for debug-level logging settings to prevent performance degradation.

This release includes even more features and improvements. You can find the full list here.

Persyst 14d Release Notes

About Persyst 14d Features and Updates

Persyst 14d includes several new important capabilities.  Persyst Spike Review has been enhanced, allowing users to interactively assess and compare individual spikes and customized spikes groups against each other and the cluster average using waveform overlays and voltage maps on the fly. Additional capabilities include a new Data API that enables access to record information, annotations, and raw and artifact-reduced data, a new License Manager that allows IT groups to automatically receive licenses, improving their workflow, as well as over a hundred minor enhancements and fixes.

New Spike Review capabilities

• Persyst Spike Review allows for detailed review of individual spikes within a cluster and includes new logic that differentiates between Selected spikes and Confirmed spikes. Selected spikes can be assessed using waveform overlays and voltage maps on the fly. Confirmed spikes are further flagged for inclusion in the FinalReport, as ESI candidates in Persyst ESI and included in the Export Spikes function. Selected and Confirmed groups can also be compared against one another.
• At the Overview level, spike clusters can be sorted by count, average amplitude, average perception or electrode.
• Within a spike cluster, individual spikes can be sorted by time, amplitude or perception with an additional option to show Confirmed spikes first.
• Within a spike cluster there are voltage and propagation map comparison displays with controls. The top half of the display shows a voltage or propagation map for the Confirmed spikes in the cluster.  The bottom half of the display shows the voltage or propagation map for the currently Selected spike(s) for comparison.
• Within these same controls, the user can see the average of the spike waveform, a comparison of the average waveform to any currently Selected waveforms, and an option to see the average waveform over each of the individually Confirmed waveforms. Spike Review now shows spikes in a multi-record study even if one segment had no spikes detected.
• Manually annotated spikes now appear in Spike Review and FinalReport and cluster according to how they are named, even if the record is not processed by Persyst.

New Persyst License Manager

• Persyst now has a license server at license.persyst.com enabling systems to automatically request and obtain updated licenses.
• Administrative rights are no longer required to install licenses.
• The Created Date is now included in the Persyst license information so the software always uses the most recent license file.
• When a license is not valid, Persyst now displays detailed information about why.
• The Persyst license registration now only shows the licensed components.
• The first implementation of the new Persyst licensing server will only download new license files but not apply them.

New Persyst Data API

• Persyst has a new Data API that supports access to record information, annotations, raw and artifact-reduced data. For example, this will allow researchers to test different detectors and OEM partners to show Persyst Artifact Reduced EEG in their own proprietary review software.

Persyst EEG Viewer

• Keyboard commands were added to scroll channels and EEG vertically.
• Users now have the ability to confirm and reject spikes from the right-click menu in Persyst. Rejected spikes can also now be restored. Rejecting a spike hides it from the Comment List and Spike Review. Confirming a spike, marks it for inclusion in the Spike Review Final Report.
• Montages can now be organized into groups to make finding and selecting relevant montages easier.
• A right-click in waveforms and trends now shows the context menu when the mouse button is released.
• An issue was fixed so that when the video window is open, placed cursors are not lost.
• Page duration controls now work when using multiple monitors with different orientations.
• An issue was fixed with the EEG Paging controls where the left arrow key jumped back in the record to a time point beyond the visible EEG duration.
• Hotkeys are no longer functional when the focus is in a text field

Multi-Record Capability

• Persyst allows opening multiple records from the same multi-record ID even when record grouping is turned off. Users can select the desired segments and click open.
• Multi-record support has been extended to Insight II.

Intracranial EEG Analysis and Trending

• Channels can now be added to intracranial EEG montages via the EEG reader interface and are also available for trending.

Trends, Processing and Notifications

• Synchronization between the visual (on-screen) seizure notifications and the audible seizure notification has been improved.
• The Seizure Probability trend results are now finalized when the record is stopped and done processing. This fixes an issue where the probability results changed if the record was closed, other records opened, and then first record opened again.
• When trends are being calculated, Persyst now saves a copy of the trending montage and recorded montage with the original recording. This ensures trends are displayed properly if the montage changes during the recording, or if the trending montage is not available on a subsequent review station.
• The notification condition for Event Density trends is now numeric rather than boolean to increase options for further trending and calculations of measurements, such as seizure burden.
• When creating a new notification, there is now the option to display the Numeric Value for that notification.
• The bad electrode detector now uses impedance measurements to automatically exclude open channels in the recording. Excluded channels are not used in the Artifact Reduction calculation.
• Features using impedance measurements now use the most recent measurement, reflecting the most up to date signal quality.
• If an EEG record was processed with a version of Persyst that is newer than the version on a workstation where it is later reviewed, for example, the user will be notified.
• A user may begin post-processing of an EEG study with an Advanced Review license 10 minutes after the study is completed (in case the study is merely paused). If post-processing is initiated within those first 10 minutes, Persyst generates a message that it is monitoring trends.
• Replicated trends now maintain their location (no longer drop to the bottom of the page), after other trends are subsequently deleted.
• The performance of Persyst has improved when auto-paging through an EEG with long trend time duration.
• Trend panels can now be organized into groups to make finding and selecting relevant panels easier.
• Persyst no longer makes any changes to the original record when exiting Modify Template mode.
• The study data now includes both the hostname of the computer where the study was acquired (created) and the hostname where the study was last processed (trends created).
• Persyst now allows disabling of Instrument Caching.

Video

• During high-speed EEG review, video sync is no longer lost when using the spacebar to start and stop playback.
• Video can once again be played from a mapped drive.
• The maximum audio playback speed is now increased to 500x to allow for high-speed audio review.
• Video directional zoom is now available in the video player by hovering the mouse over the video.
• The video player context menu (right-click) allows the user to show or hide the toolbar and status bar.

Comments

• An issue was fixed to that comments are no longer duplicated during live monitoring.
• The Comment List now has the option to display fractional event times if the seconds resolution is set to at least 1 decimal place in General Preferences.
• An issue was fixed so that when editing a comment’s text via a double click, the comment will no longer move in time.
• Context-sensitive help options for pages in preferences has been improved.
• When creating a range in Persyst a flag appears on the second cursor indicating the duration of the range which dynamically updates as you drag the cursor.

Persyst Command Line Interface (PSCLI) and Archiving

• Clearing and reprocessing trends can now be done from the command line interface.
• Including Artifact Reduction (AR) when archiving records no longer requires a research license.
• The command line capability to export to CSV has been restored.
• When archiving using an XML file for Options, filter settings are now correctly applied.
• The ability to deidentify the study date now also works in EDF archiving.
• The Persyst Archive Tool now allows using the same name for the file if the archive is being saved to a different folder.
• Video file handling has been improved when archiving.
• Path length warnings are now only displayed when writing to CD.

Persyst Database and Data Reader

• The Persyst Database has been added to the help file and there is now a help link from the database.
• Records with different numbers of EEG channels will no longer be grouped together.
• The Persyst Database service was updated to correctly handle commas vs periods for different language conventions.
• EEG record types are correctly sorted in the Persyst Database Preferences Record Type list when resorting the list order.
• The Record Type list is now shown in alphabetical order by default. The order can still be adjusted manually, as before.
• Channel labels with multiple hyphens in the label are now handled better.
• The Persyst Locator service better handles data files that cannot be opened.
• Support was added for the MED (new MEF) data format.

Install and Setup

• Support for the installation of Persyst on Windows 7 is ongoing.
• All Persyst projects that use .Net are harmonized to version 4.7.2
• Redundant libraries were removed from the installer that are now included with Windows
• The DeploySettingsTool now updates the default workspace for Persyst.
• The license registration form was redesigned and simplified.

This release includes even more features and improvements. You can find the full list here.

Persyst 14c Release Notes

About Persyst 14c Features and Updates

Persyst 14c adds numerous capabilities that improve workflow and efficiency for review and monitoring of EEG. A new multi-record capability allows the user to review multiple recordings as if they were a single study. This is particularly important for systems where the recording increment is less than 24 hours, but it can be used to see continuous trends and EEG over multiple days. Persyst 14c also includes a new intracranial EEG montage generator replacing the tedious process of building bipolar montages, and providing new types of montages that allow for faster and easier review of high channel counts. Persyst 14c also adds the ability to ratchet notifications to better track EEG progression over time. Persyst 14c includes a sophisticated integration for Persyst ESI (EEG Electrical Source Imaging), with improved support for user marked spikes and the ability synchronize ESI Patient lists and studies across multiple Persyst workstations.

New multi-record capability

• Combines multi-records into 24 hour or entire patient stay views.
• EEG, Video and Trends are all continuous.
• Play through multiple physical records at high speed or move through Trends at high speed without having to wait to close and open subsequent records.
• Review spikes and seizures for 24 hours or for an entire patient stay.
• Compare the EEG from today with the EEG from two days ago just by changing the time point.

New intracranial EEG montage generator

• Ability to semi-automatically generate bipolar and referential montages for intracranial EEG data.
• Space saving overlapped montage option for faster and easier review of high channel counts.
• Montages are patient specific and can be applied across other data from the same patient.

New ratcheting notifications for Trends

• Notification thresholds can adjust dynamically, alerting for progressive changes in patient trends.

Persyst EEG Electrical Source Imaging (ESI)

• Persyst now integrates ESI as a service into one seamless workflow all from the Persyst software platform.
• Persyst ESI leverages the clinically validated ESI data processing pipeline from Epilog, as described in the literature.
• Users can mark their own spikes in the EEG record, or select subsets of Persyst detected spikes for ESI.
• Validated on standard 10-20 EEG arrays; scales up to 256 channels.
• No additional hardware or expertise needed.
• Upload EEG and MRI data directly to a secure cloud server from Persyst.
• All data are automatically anonymized prior to upload; no PHI leaves the local network.
• ESI results for clinical interpretation in PDF form within 48 hours.
• Ability to download the ESI results in the patient’s MRI for viewing in a MRI viewer of your choice.
• ESI methodology utilizes Current Density Reconstruction (CDR) sLORETA
• Patient specific, 3-dimensional Finite Difference Models (FDM), the highest resolution possible, are built from the patient’s own MRI and model six different tissue types, including air, white matter, gray matter, CSF, skull and scalp.

Standalone Persyst Database Program

• Ability to search by comment field text for specific records.
• Records can now grouped by day as well as by patient.
• Choose whether days are always 24 hours from the beginning of the patient’s recordings, or start at a particular time of day.
• An entire patient stay, multiple days, a single day or a single recording can now be opened and reviewed as if they were a single record.
• Ability to show the total count of studies indexed, group studies by time period and limit the number of records displayed.
• Multi-record studies can be expanded to the level of time period, or collapsed into nodes, representing the whole study.
• The Persyst Database now updates dynamically, including when new file pathways are added.
• Ability to index OEM comments along with Persyst comments.
• Patient History now added as an optional field in the Persyst Database.
• Improved controls for adding custom fields to the database study list, including preventing duplicate fields.
• Added a database field for Study Name and the ability to create named filters based on any of the available fields.
• The Persyst Database is now limited to a single instance to avoid confusion.
• View options for sorting, filtering or searching are preserved in the Persyst Database between subsequent file openings via the “Open” button.
• Improved handling of start times when the decimal is changed to a comma.
• Japanese and Korean path names are no longer truncated.

Enhancements to EEG Review, Analysis and Video

• Added ability to manually mark spikes directly into a record, including an in an unprocessed study.
• Artifact Reduction (AR) now works with 10-10 montages.
• The default impedance threshold is now 35kOhm for more accurate results.
• The number of recorded channels is now reported based on impedance.
• The Montage editor can now add Physiological Monitoring channels.
• The Average Reference is now saved in all cases.
• Improved memory handling and paging speed of records with high sampling rate and/or high number of channels.
• Improved stability of the Persyst window and video playback with multi-record studies.
• Improved sensitivity handling when working with multiple displays.
• New scroll bar feature now indicates what has been reviewed.
• More user-friendly notification configuration.
• Added video support for EDF+ records.
• Added support for dual video.
• Improved video synchronization for fast forward and reverse.

Spike Review

• Improved memory and overall performance of Spike Review.
• Spike Review now allows for sorting spikes by amplitude and by the number of visible spikes (high, medium, low) rather than total spikes.
• EEG display settings are now retained in Spike Review.
• Preferred montages are now easier to find in Spike Review.
• Spike Review now always displays the correct montage.

Persyst Command Line Interface (PSCLI) and Archiving

• The Persyst Command Line Interface (PSCLI) is now available in all versions of Persyst.
• Added the ability for the user to specify in PSCLI whether Artifact Reduction (AR) is on or off.
• PSCLI now processes records chronologically to improve handling of multi-segment records.
• Batch processing is now enabled for all Advanced Review licenses.
• Batch archiving can now be specified to a particular folder and the file format can now be specified.
• Expanded options for the Archive function, including:
  • Impedance measurements are now preserved .
  • Non-integer sampling rates can now be rounded off to allow export to EDF.
  • Improvements made to video archiving, including to EDF.
  • Archiving records with more than 256 channels to EDF is now possible.

This release includes even more features and improvements. You can find the full list here.

Persyst 14b Release Notes

About Persyst 14b Features and Updates

Persyst 14b introduces a powerful new set of features including a brand new Seizure Detector written from the ground up, new ways to quantify the extent of change in EEG over time, trending for heart rate and physiological data, and overall optimizations for ease of use, based on feedback from thousands of customers (Thank you!).

New Seizure Detector

• Higher sensitivity with 10x fewer false positives than the previous Seizure Detector at the same sensitivity level.
• Lower latency where Seizure notifications are raised more than a factor of two earlier than the previous detector.
• The ability to change the Seizure detection and Seizure notification thresholds (sensitivity) during active processing.
• Seizure detection sensitivity settings can be patient specific.

New Versus Baseline Trend

• Change over time displayed in terms of statistical variation, measured in Z-Scores, in the EEG data relative to baseline values.
• Baseline values can be user defined or automatic.
• Baseline Trends carry across multiple segments and files.

New Heart Rate Trend

• ECG signals obtained as part of the EEG recording.
• Continuous heart rate trends displayed alongside qEEG and seizure detection trends.
• Easy assessment of heart rate changes associated with events such as seizures.

Physiological Trends

• Enhanced ability to trend physiological data from multiple device inputs.
• View physiological trends alongside qEEG and seizure detection trends.
• Available with Moberg and Natus Neuroworks systems.
• Trend physiological data including:
  • Pressure (BP/PbtO2/CPP/ICP), measured in mm of Hg
  • Heart Rate (HR), measured in beats per minute
  • RR Interval (RR), measured in time (portions of seconds)
  • Pulse Oximetry (PR), measured in beats per minute
  • Temperature, measured in Celsius or Fahrenheit
  • Oxygen Saturation (SpO2/SaO2/ SvJO2/NIRS), measured as %
  • Perfusion, measured in ml/100g/min

Standalone Persyst Database Program

• Persyst Database is now standalone, independent of the Persyst application window.
• The Persyst Database window now also stays open when an EEG study is launched.
• Quickly open additional EEG studies as needed.
• Work across data formats as a Universal Reader.

Enhancements to EEG Review, Analysis and Video

• Added flexibility to the Montage Favorites.
• Option to quickly add multiple EEG System Montages to the Persyst Montages.
• Pan EEG waveforms by clicking and dragging.
• The “HFO display” no longer requires a research license.
• Overlay (butterfly plot) of all traces for all events now available for visualization alongside Voltage Plot of spikes.
• Search for and filter on comments in the comment list using any string of text.
• Persyst comments are now automatically saved to the OEM list.
• Optimized video performance for limited network bandwidth.
• Expanded video capability and options, including:
  • New controls within the video window for adjusting speed.
  • Adds ability to assign hotkeys for video controls.
  • Adds option to only clip video when archiving.
  • Adds ability to retain video player size and location when Persyst is closed and reopened.

Audible Notifications & Printing

• Simplified implementation of audible notifications.
• Improved sound notification so that it only plays once per event.
• Added automatic default of print dialog to print the current page.
• Added option to remove patient and file names from header of printed pages.

Installation, Logging & Diagnostics

• Persyst Diagnostic Service now provides a method of uploading log files automatically to Persyst to provide diagnostic data on how Persyst is running.
• Simplified installation process for shared settings.

Other features and improvements

• Improved installation process on various OEMs using the DeploySettings tool.
• Addressed an issue where the number of spikes in the comment list now reflects the level of sensitivity the user adjusted to in the EEG page.
• Spike Index Tool now has the option to only count spikes included in the Final Report in Spike Review.
• Increased efficiency of handling high sampling rate recordings.
• Optimized Trend performance now with caching always turned on
• Increased ease at which the user can distinguish Trend values by adding tick marks within the vertical scale.