3D DynaCT Turnover Workbook

SIEMENS Tipe Ortest Table] 20 Co| Trois Meature X-Ray Artis Artis zoog zeego 7:47:17 am TE-V5M 46Hz 7.0MHZ 120mm TEE Type | Onest Table 20 General Pwr= - 3dB MI=0.3 Lens Temp=36.4ºC 6u Mity 65dB S1/ 0/1/4 Gain= - 3dB A=1 store inprogress 70bpm User Services www.usa.siemens.com/education 3D DynaCT Turnover Workbook Answers for life. User Services. Driven by More. More: Our philosophy for a lifelong improvement through continuing education and consulting. Working closely with you, we develop your personalized education and consulting strategy and support you and your staff with our comprehensive User Services to help gain: • More: Routine Confidence • More: Clinical Expertise • More: Superior Performance More: Personalized training, education, and consulting services from Siemens Healthcare Customer Services. For your leading edge in medical care. User Services. Driven by More. 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Clinical Training and Siemens Training Centers Continuing Education Siemens Clinical Education Training Center – TDC2 Siemens Customer Care Center: 110 MacAlyson Court Call 1-800-888-7436 Cary, NC 27511 • Troubleshooting assistance • Immediate assistance for software applications and workflow issues • For Tech Support press option 2 / for applications support, press option 3 • Press the * key or enter the last six digits of your Functional Location Number • Press 7 for ultrasound Functional Location Number ____________________ Clinical Education Offerings: Serial Number ________________________________ Call 1-888-221-8010 (follow the prompts) IP Address System _____________________________ • Classroom Training (Offerings, Registration& Scheduling) Educational Symposia IP Address PACS _______________________________ • • On-site Training • Printed Self-studies • Virtual Education (Offerings & Registration) • Workshops & Fellowships Visit www.usa.siemens.com/clinicaleducation for more information regarding the current Siemens Clinical Training and Continuing Education portfolio. 3 II Contents I Contact Information Summary ............................................................................................... 3 II Contents .............................................................................................................................. 4 III Course Agenda .................................................................................................................... 5 Basic 3D ............................................................................................................................ 5 Session Two ....................................................................................................................... 5 Session Three..................................................................................................................... 5 IV Course Objectives ................................................................................................................ 6 1 Basic 3D ............................................................................................................................... 7 1.1 Objectives .................................................................................................................... 7 1.2 Set system up. Select the appropriate Exam Program. ................................................... 7 1.3 Basic Manipulation and Documentation......................................................................... 8 2 Intermediate 3D.................................................................................................................. 12 2.1 Objectives .................................................................................................................. 12 2.2 Intermediate Post-Processing ...................................................................................... 12 3 Advanced 3D ...................................................................................................................... 16 3.1 Objectives .................................................................................................................. 16 3.2 Embo Guidance .......................................................................................................... 16 3.3 Identify vessel ............................................................................................................ 17 3.4 iGuide Toolbox ........................................................................................................... 20 3.5 3D/3D Fusion.............................................................................................................. 22 3.6 Virtual Stent............................................................................................................... 24 3.6 PBV ............................................................................................................................ 25 3.7 Stent Follow up .......................................................................................................... 26 4 Angio Tab Card ................................................................................................................... 27 4.1 Objective.................................................................................................................... 27 4.2 iFlow.......................................................................................................................... 27 4 EMENS SIEMENS Artis zee III Course Agenda Basic 3D Acquiring Images Basic Manipulation Selection of Presets Window/Level Zoom/Pan Image Rotation Bookmarking MIP/MPR Slice Thickness Document Images on PACS Storing Individual Images Creating Radial Ranges/MPR Ranges Intermediate 3D High Contrast and DynaCT Intermediate Post-Processing Custom MPR Presets Adjustment of Reference Lines iPilot Application iGuide Application Advanced 3D Perform EmboGuidance Utilize iGuide Tool Box Perform 3D/3D Fusion Perform Virtual Stent Perform PBV Perform Stent Follow Up Angio Tab Card Perform iFlow Application 5 REMENS SIEMENS + IV Course Objectives Course Overview: The 3D Turnover Workbook will provide the experienced user with the skills and knowledge to use and perform the applications and functions of the syngo Workplace. Upon completion of this course, you will be able to: • Properly Set system up • Understand Basic Manipulation and Documentation • Optimize Intermediate Post-Processing • Perform Advanced 3D Applications • Describe Angio Tab Card 6 Turnover Workbook | 3D DynaCT 1 Basic 3D 1.1 Objectives Notes After completing this section, the technologist will be able to: • Acquire images • Perform basic manipulation (selection of presets, window/leveling, zoom/pan, image rotation, bookmarking, MIP/MPR, Slice Thickness) • Document images on PACS (storing individual images, creating radial ranges/ MPR Ranges) 1.2 Set system up. Select the appropriate Exam Program. 1.2.1 Program selection (DSA/DR/DCT) Settings Exam Image InSpace InSpace3D Body WP A ... DOS FL Angio DR Overview B 3 f/s 10 p/s 5sDR Body SM RDMP 5sDSA Body x 2 REF 5sDR Body Care ID REF 888 • DSA • DR (3D bone/ Needle Guidance) • DSA H (3D Angios/ CT with or without contrast) • DR H (CT with or without contrast) • AVG: Aortic Valve Guide • PBV: Stroke (With Contrast) • DynaCT Card (With contrast) • Large Volume Portrait or Landscape (Zeego only, With or without contrast) 1.2.2 Isocenter • Press down on the C-arm joystick and deflect toward the table (C-arm moves to AP) • Press down on the C-arm joystick and deflect toward the table (C-arm moves to Lateral) • Press down on the C-arm joystick and deflect toward the table (C-arm moves to Start Position ) • Press down on the C-arm joystick and deflect toward the table (C-arm performs Test Spin) 7 Turnover Workbook | 3D DynaCT 1.2.3 Fluoro to set technique and end setup Notes O 1.2.4 Set Injection 1.2.5 Perform acquisition from footswitch or hand switch 1.2.6 Auto Transfer (Manual Transfer- Post Processing, Image, send to 3D) 1.3 Basic Manipulation and Documentation 1.3.1 High Contrast Subtracted • Selection of modality preset. (Identify the Preset Icon and choose appropriate preset). • Window/Level. (Use the Middle mouse button. Up/Down the Screen for brightness and Right/Left on the screen for Contrast.) Window center! Brightness + Window width! Window width! Contrast - Contrast + Window centerl Brightness - 8 Turnover Workbook | 3D DynaCT Notes • Pan/Zoom. (Identify and use either the Icon on the screen or hold down the shift key on the keyboard) • Image Rotation. (Identify the Rotate Icon and use the Left mouse button) • Bookmarking. (Identify the Icon and differentiate Save vs Load Bookmark. Left Mouse button to Load, Right mouse button to Save) • Saving individual images or radial ranges. (Identify the “Save As” Icon for individual images. Identify Radial Ranges on the Tools tab card for Radial Ranges. In Radial Ranges, differentiate between predefined ranges (Load Settings) or creating custom ranges by defining First/Last frame. Identify and discuss “Output”) • Identifying images on browser. (Identify “Refresh” on the Browser and find the images that you named in previous step). • Transfer to PACS. (Identify the appropriate PACS node on the “Transfer” menu.) 9 Turnover Workbook | 3D DynaCT 1.3.2 Soft Tissue Notes • Selection of modality preset. (Identify the Preset Icon and choose appropriate preset.) • Window/Level. (Use the Middle mouse button. Up/Down the Screen for brightness and Right/Left on the screen for Contrast) Window center! Brightness + Window width! Window wid th! Contrast - Contrast + Window center' Brightness - • Pan/Zoom. (Identify and use either the Icon on the screen or hold down the shift key on the keyboard) • Changing slice thickness. (Perform a Right mouse click on either the Sagittal, Coronal or Axial images and choose “Slice Properties”) 10 Turnover Workbook | 3D DynaCT Notes • MIP vs. MPR. (Identify Icons and compare image quality on these 2 settings.) MPR, MIP Thin or MinIP Thin icon Type | Orient | Table| 20 Type |Orient Table 2D MPR MIP • Creation of MPR Ranges. (Identify the Icon and create MPR ranges with/without planning lines, OR Use a predefined setting under “Load Settings”. Identify and discuss Slice Thickness, Image Spacing and Output.) • Identifying images on the browser. (Identify “Refresh” on the Browser and find the images that you named in previous step.) • Transfer to PACS. (Identify the appropriate PACS node on the “Transfer” menu.) 11 Turnover Workbook | 3D DynaCT 2 Intermediate 3D 2.1 Objectives Notes After completing this section, the technologist will be able to: • Perform High Contrast and DynaCT Intermediate Post-Processing • Use of custom MPR presets • Adjustment of reference lines • Perform iPilot • Perform iGuide 2.2 Intermediate Post-Processing 2.2.1 High Contrast Subtracted • Primary/Secondary Reconstructions - • VOI Punching • Vessel Measurements Clip Tools Measure |X-Ray XYZ ABC • Clip Planes • Creating custom modality presets 12 Turnover Workbook | 3D DynaCT 2.2.2 DynaCT Notes • Use of custom MPR presets • Adjustment of reference line - Goedgui 2.2.3 iPilot Live Live vs. Dynamic • Adjust to patient 13 Turnover Workbook | 3D DynaCT 2.3 iGuide Notes (3D/3D Fusion when CT or MR images are imported) • Launch program ( Step 1: Define Path Presspoint warpath by selecting target and REGALAR THE NOSA 1 11/11/2000 M Bone Nat Fill HU Auto JaSpace301 The Queen Elizabeth Hospital FA3C. AXIOM-Artis 6/29/2012 12:40:01 Step 2 Check Views Step 3 Progress Needle Close Suspend Help • Identify lesion/target • Identify skin surface • Confirm target/skin on other projections and adjust if needed • Go to “Step 2” Check views. Are all C arms BLUE ? iGuide Needle Guidance X Stop 1: Defino Path Step 2 Check Views Please check Progression Views. They can be adjusted by rotating the volume in the upper left and lower left VRT view 14 Turnover Workbook | 3D DynaCT Notes • Go to Step 3 and deflect C arm joystick within 30 seconds. C arm will go to Bullseye View. iGuide Needle Guidance x Step 1: Define Path Step 2. Check Views Step 3: Progress Needle Activate stand movement to reach Bull's Eye View Adjust table until overlaid graphics are aligned Check patient position by performing an overlay Align needle to Bull's Eye View Use Progression Views to check needle progress Decide if Control Scan is needed -7ª, 0º 83º. 0º -7º, 30* LAO/RAO, CRAN/CAUD 100% 3D Overlay 0% Close Suspend Help • Adjust table to align graphics General graphics (Artis without laser positioner) Laser graphics (Artis with laser positioner) Position not adjusted Position adjusted • Introduce the needle in the Bullseye View and Check the Needle Progress using Progression Views 1 and 2 iQuide, Liver Biopsy Needle Guidance X 7/24/1968 Step1: Define Path 7/24/2008 Step2: Define Views Step3: Progress Needle Move C-Arm to Bull's Eye View Adjust table until Target/Entry point are aligned Align needle to Bull's Eye View - Select Progression View - Move C-Arm to Progression View - Progress needle - Check needle path using the other Progression View 1240 x 960 RÃO 100/0" iGuide refers to current C-arm geometry Close Suspend Help • Perform control spin to confirm needle placement (optional) 15 Turnover Workbook | InSpace 3D and DynaCT 3 Advanced 3D 3.1 Objectives Notes After completing this section, the technologist will be able to: • Perform Embo Guidance • Utilize iGuide Toll Box • Perform 3D/3D Fusion • Perform Virtual Stent • Perform PBV • Perform Stent Follow Up 3.2 Embo Guidance • Launch program • Segmentation Embolization Guidance X Segmentation Mark the object to segment. Calculate segmentation. Review and/cr modify results H. Segmentation Overlay Opacity Identify Vessel Register Display Close Help • Mark the VOI interior + Segmentation Ouriay Cpecky 16 Turnover Workbook | 3D DynaCT Notes • Mark the VOI background A • Segmentation calculation A_DynaCT LIVER CHEMO, DYNA CT A.D RES/MIP 1082577 4/29/1953 0 LAO/RAO O DynaCT Nat Fill HU Normal [InSpace 3D] CRAN/CAUD Uni AXIOM Artis SL 0.49 A PX 0.49 Volume: 1.53 ml 512x51 2x388 [1 4 bit) W 2614 C 1193 • Modify results if needed 3.3 Identify vessel • Mark the vessel segment Embolization Guidance X H A_DynaCT LIVER CHEMO,DYNACT RES/MIP 1082577 4/29/1958 0 Segmentation DynaCT Nat Fill HU Normal [InSpace3D] RANICAUP (Identify Vessel > Uni AXIOM-Artis Mark the Vessel by selecting two 1/26/2010 11:22:06 i or more points. AX Then compute centerline or select next step (e.g. Display). Show segmentation overlay Place Seed Points SL 0.49 SP 0.40 PX 0.49 Volume: 1.53 ml W 2485 512x512x388 [14 bit] C 806 Register Display Close Help 17 Turnover Workbook | 3D DynaCT • Calculate Notes • Register (Only if a CT or MR is used. Use a Control scan and Fusion) Embolization Guidance x Segmentation Identify Vessel Register Load or acquire a DynaCT. i Review/modify registration. Select another step to accept. Windowing A: DynaCT Body Nat Fill HU Normal [InS B Both Volume Blending A B Register Manually Display Manual registration Close Help 18 Turnover Workbook | 3D DynaCT Notes • Display Options RESIMIP 6.0mm LADIRAO CRANICAUJO Type |Orient Table| 2D agedsul WY 1407 C 254 ... DCT LV,Liver TACE RESMIP 6.0mm 0000000002 1/1/2009 O LADIRAD Segmentation CTA_008-DR Nat FIT HU teamst In CRANICAUD Identify Vessel NMonal CancerCenter East AXIOM-Arts Register 4/9/2009 Display 16 1200 Use iPilot for Overlay. i To add or modify overlays, return to respective step. Show Vessel Segment ~3D Volume A B Vessel Overtey Segmentation Overlay Seed Points Bifurcations DE 3D Overlay Help Type |Orient | Table | 2C Boedsul Liver TACE 12 1/1/2009 0 LADIRAO Segmentation OR Nat Fa HU Normal Pn CRANICAUO nser Center East Identify Vessel Register Display Use iPilot for Overlay. To add or modify overlays, return to respective step Show Vessel Segment 1 3D Volume A B ~ Vessel Overlay Segmentation Overlay I Seed Points Bifurcations RA 3D Overlay 8 39 W 35 660 5.49 Live Close Helo RES/MIP 6.0mm LACRAO CRANICAUD Type | Orient | Table | 2D esedsu 0 Enghtmesg Segmentation Identify Vessel Register Display Use iPilot for Overlay. To add or modify overlays, return to respective step. Show Vessel Segment · Vessel Centerline · Vessel Outine Vessel Surface Show Vessel Branches Vessel Overlay Opacity 22 30 Overlay Close Help Boedsu Segmentation Identify Vessel Register Display Use iPilot for Overlay To add or modify overlays, return to respective step. Show Vessel Segment Vessel Centerline Vessel Outine Vessel Surface Show Vessel Branches Vessel Overlay Opacity 237 3D Overlay Help 19 Turnover Workbook | 3D DynaCT • Apply iPilot Live or Dynamic Notes Live Close Help • 2D/3D registration if patient moves 3.4 iGuide Toolbox • Launch Program • Linked points vs. lines • Select linked markers: lines or points iGuide Toolbox X Linked Marker Size Small Show on Live Screen Advanced Linked Contour Show on syngo WP Screen 20 Turnover Workbook | 3D DynaCT Notes • Lt click to mark anatomy on the MPR or VRT view • Double Lt click to end • Select “show on Live Screen or Show on Syngo XWP screen” Linked Contour Show on singo WP Screen • Select “linked Marker, Pointer, or Contour Linked Marker Linked Pointer × Linked Contour 21 Turnover Workbook | 3D DynaCT • Overlay is displayed on the Live or XWP monitor Notes 3.5 3D/3D Fusion • Importing and manipulate external data set (VOI punching, bone removal, bookmark, etc.) • Load two volumes • Perform DynaCT when CT or MR are already loaded • Load both volumes from the browser, use merge • Use open addition volume when CT or MR is already loaded and control volume is on in the browser. • Launch Program 22 Turnover Workbook | 3D DynaCT Notes • Manual vs. Automatic Registration 3D/3D Fusion X 3D/3D Fusion Volume Selection Volume Selection Registration Registration Relai stration Matrix |Default Registration Matrix Default Registration Mode Registration Mode auto auto Manual/Visual Registration Automatic Registration @ FL Fully automatic (pre-registration done by application) Pre-aligned (takes pre-registration of the user into account) Hint: It is recommended to register the two volumes roughly per Manual/Visual Registration before using this registration mode. Start Automatic Registration: Register| Help Close Help Close • Saving Registration • Display: iPilot Live vs. iPilot Dynamic Live Close Help 23 Turnover Workbook | 3D DynaCT 3.6 Virtual Stent Notes • Perform secondary reconstruction • Launch Program a • Perform segmentation. Choose Advanced Vessel Analysis X Vessel Analysis X Segmentation Analysis Select Method 1. Check Threshold 2. Select Analysis Method Threshold 2677 Use InSpace Table Ramp Close Help Identify aneurysm and vessel proximal and distal to aneurysm • Enable stent overlay AX Vessel Analysis X Segmentation Analysis Virtual Stent Overlay 1. Verify or adjust stent dimensions and position 2. Select iPilot for overlay. Display Stent Diameter 4.59 Volume Planes Length 4 Back STL-Export Close Help 24 Turnover Workbook | 3D DynaCT Adjust length/diameter of stent as needed Notes • aa EEE • iPilot Live 3.7 PBV • IV vs. IA • Injection protocols • Manual triggering start CM end CM start saline end saline veins visible 1 3 5 Scan Direction Scan Direction Rotate back Patient Patient Bolus Watching (<30s) patient 8s 5s Xs 8s .................................. Contrast Material Saline chaser 60ml@5ml/s 60ml@5ml/s 12s injection time 12s injection time Total scan time: 13s + Xs (Bolus Watching) + 8s ~30s • Loading of dataset (automatic) InSpace Reconstruction i Reconstruction in progress Cance • ROI MPR Tools Measure |X-Ray 3.8 Stent Follow up • Intravenous access • Injection protocols • Manual triggering ABC • Loading of dataset (automatic) 25 Turnover Workbook | 3D DynaCT Notes Mihate back 10 % Bolus watching mask run arterial 10 s rotate back contrast fill run Contrast injection 60 ml @ 5ml/s Saline cheser 60 ml @ 5 ml/s total program time appr. 30 s nSpace Reconstruction Reconstruction in progress. Cancel 26 Turnover Workbook | 3D DynaCT 4 Angio Tab Card 4.1 Objective Notes After completing this section, the technologist will be able to: • Perform iFlow 4.2 iFlow • Acquire DSA • Launch program • Mark POI/ROI 6.67 s 5.33s • Adjustment of beginning/end times • Store monitor/Transfer to PACS SIM 27 On account of certain regional limitations of sales rights and service availability, we cannot guarantee that all products included in this brochure are available through the Siemens sales organization worldwide. Availability and packaging may vary by country and is subject to change without prior notice. Some/All of the features and products described herein may not be available in the United States. The information in this document contains general technical descriptions of specifications Local Contact Information and options as well as standard and optional Siemens Medical Solutions USA, Inc. features which do not always have to be 51 Valley Stream Parkway present in individual cases. Malvern, PA 19355-1406 Siemens reserves the right to modify the USA design, packaging, specifications and options Telephone: +1-888-826-9702 described herein without prior notice. Please www.usa.siemens.com/healthcare contact your local Siemens sales representative for the most current information. Global Business Unit Note: Any technical data contained in this Siemens AG document may vary within defined tolerances. Medical Solutions Original images always lose a certain amount Imaging & Therapy Systems of detail when reproduced. 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