Biograph mCT and mCT Flow (VG70) Turnover Workbook

Biograph mCT and mCT Flow (VG70) Turnover Workbook SIEMENS Healthineers www.usa.siemens.com/education I. Contact Information Summary Welcome to Siemens Healthineers Siemens Training Center Siemens Healthineers is dedicated to helping you get the Siemens Clinical Education most out of your investment throughout the entire product Training Center – TDC2 life cycle and beyond. Our goal is to enable you to take 110 Mac Alyson Court technology further, profitability higher, and patient care to Cary, NC 27511 the next level. Find the information, resources, and tools you need to get the most out of your recent investment and stay up-to-date. Visit www.usa.siemens.com/Welcome2Healthcare. Clinical Training and Continuing Education Customer Care Center - Clinical Application Support: Call 1-800-888-7436 Troubleshooting assistance • Immediate assistance for software • applications and workflow issues Please provide the Functional Location Number when calling for assistance. Clinical Education Offerings: Call 1-888-221-8010 (follow the prompts) Classroom Training (Offerings, Registration • & Scheduling) Educational Symposia • 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. 2 II. Contents I. Contact Information Summary.....................................................................................................................................2 II. Contents .............................................................................................................................................................................3 III Course Agenda .................................................................................................................................................................4 IV Course Objectives ............................................................................................................................................................ 5 1. Day One - System Overview...........................................................................................................................................6 1.1 System Overview: Objectives................................................................................................................................6 1.2 Overview of Your Biograph mCT .........................................................................................................................6 1.3 Display Panels .........................................................................................................................................................8 1.4 Patient Table ............................................................................................................................................................9 1.5 Universal Physiological Measurement Module (UPMM)...........................................................................10 1.6 Workstations ..........................................................................................................................................................10 1.7 Daily System Maintenance ................................................................................................................................. 13 2. Day Two - Using Your System......................................................................................................................................26 2.1 Using Your System: Objectives...........................................................................................................................26 2.2 Patient Browser.....................................................................................................................................................27 2.3 Registering a Patient............................................................................................................................................29 2.4 Positioning the Patients for Exams ..................................................................................................................32 2.5 Table Motion Modes ............................................................................................................................................34 2.6 Patient Acquisition...............................................................................................................................................36 2.6 Viewing Images .....................................................................................................................................................59 2.7 Viewing and Fusing Patient Data Using 3D Task Card................................................................................61 2.8 Data Archiving, Retrieving, and Transfer ........................................................................................................... 3. Day Three - Reviewing Concepts from Day Two ....................................................................................................63 3.1 Reviewing Concepts from Day Two: Objectives.............................................................................................63 3.2 TrueD Basic ............................................................................................................................................................63 3.3 Exercises.................................................................................................................................................................. 75 3 III Course Agenda Overview* Day Two Topics Day Three Topics This 32-hour training program occurs Daily Restart and QC Review • Daily System Startup and QC review • over a five-day period. Further details Patient Browser Orientation • Acquisition and Processing Review • on location and specific times are • Reconstruction Review included in your registration Patient Positioning and Laser • confirmation. Positioning Review • Image Evaluation Patient Acquisition Protocols • Image Quantitation • Day One Topics Patient Registration • Creating JPEG and AVI Files • • Component Layout CT Acquisition Hardware Day Four Topics • • System Control Orientation CT Scan Acquisition and CT Task Card • • Acquisition Review PHS Orientation/Homing PET Exam Task Card Overview • • • Emergency Stops CT and PET Reconstruction Reconstruction Review • • • PET•CT Acquisition Setup and Run Image evaluation Review • Radiation Lights • • Troubleshooting • System Safety Step and Shoot Acquisition • Continuous Bed Motion Acquisition • Contacting Customer Care Center • System Restart Monitoring the PET Acquistion • Daily CT Quality Control Procedures • Enabling the PET Cine Tool • Daily PET Quality Control Procedures • Reconstruction of PET Images • System Shutdown and Cleanup • From the Examination Task Card • PET Examination Configuration • From the syngo MI Workplace • Problem Steps Recorder Viewing Images • • • Viewing Task Card • 3D Task Card Database Maintenance • • Exporting and Importing • Sending • Deleting Help manuals • * The information contained in this workbook is condensed. For more detailed information and safety precautions, please consult your operator’s manual. 4 IV Course Objectives Course Overview: The purpose of this training session is to provide you with the skills and knowledge to operate your system. Learning Materials The following instructional materials are referenced throughout this training session: System Owner Manual: Provides the necessary knowledge and expertise to accurately and safely operate the system. Training Workbook: Supports the System Owner Manual through “big picture concepts,” examples, stories, interactive exercises and references to online documentation. This book is yours to keep so you can write in the book. Job Aids: These documents provide quick reference tips to aid customers in “just-in-time” learning opportunities. Upon completion of this course, you will be able to: Correctly perform startup and shutdown procedures • Identify the key hardware features of the Biograph® mCT. • Describe the key features of the syngo® interface on the acquisition workstation • Learn how to correctly perform the quality control procedures for the scanner • Correctly perform a patient registration • Utilize the Examination task card to perform a patient acquisition • Know the steps to take when performing a reconstruction of the raw data • List the steps needed in order to archive patient data • Know the procedures to maintain the patient database • Reference troubleshooting step by step to solve common issues and problems • 5 Turnover Workbook | Biograph mCT VG70 1. Day One - System Overview 1.1 System Overview: Objectives Notes After this session, you will be able to: Know the component layout • Learn the functions and location of the system controls • Know how to operate and handle the PHS (Patient Handling System) • Know the location of the emergency stops • Know the location and function of the radiation lights • Gain knowledge of system safety • Perform the restart of your system • Perform the daily CT quality control procedures • Perform the daily PET quality control procedures • Perform the system shutdown and cleanup • 1.2 Overview of Your Biograph mCT Gantry Components and Controls (1) (1) (4) -(5) (2) . (3) 1. Emergency stop buttons 2. Operator control panels 3. Laser light markers 4. Communication system 5. Display panel 6 Turnover Workbook | Biograph mCT VG70 Below are two possible gantry variations, depending on your system. Notes (2) (3) (12) (4) (14) (9) (9) STOP (15) (7) (8) (10) (11) (13) (5) (6) 9 * * (1) (2) 8 (3) STOP (4) 6 (5) (15) (10) (11) (12) (13) (14) 1. Switch on/off laser light markers 2. Move table up 3. Set display for horizontal table position to zero 4. Move table out 5. Retract and lower patient table 6. Move table down 7. Move table in 8. Set Table Begin/End position (Note that the tilt CT Gantry function of this button is disabled in Biograph.) 9. Increase speed of table movement 10. Move table to predefined position A 11. Move table to predefined position B 12. Move table from offset laser position into CT field of view 13. Interrupt scan 14. Start scan (encircling ring: green = ready to scan; yellow = radiation warning) 15. Stop Scan (E Stop) 7 Turnover Workbook | Biograph mCT VG70 1.3 Display Panels Notes CT Examination Display (1) (2)‘ 300.0 -2000.0 1. Tube voltage (in kV) 2. Tube current (in mA) 3. Scan time (topograms or sequences)/rotation time (spirals) 200 mA 300.0 -2000.0 (1) (2) 1. Table height 2. Relative horizontal table position 3. Gantry tilt (always 0.0 in Biograph) 8 Turnover Workbook | Biograph mCT VG70 PET Examination Display Notes 127.0 -694.5 (2) (3) (4) S 9255 P 477 R 129 T 347 (5) 6 1 3 149 s / 509 s 1. Singles rate (in kilocounts per second) 2. Prompts rate (in kilocounts per second) 3. Randoms rate (in kilocounts per second) 4. Trues rate (in kilocounts per second) 5. Current bed number (n / n) 6. Elapsed time / Total time 1.4 Patient Table Weight limit: 227.2 kg or 500 lb • Standard maximum co-scan range • with pallet extensions: 203 cm (79.92”) With TrueV Option: 198 cm (77.9’’) • 9 Turnover Workbook | Biograph mCT VG70 1.5 Universal Physiological Measurement Module (UPMM) Notes (1) (2) (3) (4) (5) Connection point for PET and CT cardiac gating and receptacle for the EKG electrodes and a push button for changing the ECG measurement mode. 1. Hinged lid – close when the UPMM is not in use 2. Lead selector push button 3. ECG lead cable connector 4. Respiratory trigger connector 5. External trigger connector 1.6 Workstations Equipment Name Function syngo Acquisition Workplace User system console for data (ICS) acquisition and processing. Monitors Dual syngo Acquisition Work- place monitors. Control box Provides operator control from outside the examination room. Molecular Acquisition Recon- Embedded computer for PET struction System (MARS) data acquisition, PET image reconstruction, storage of PET row data (List mode), replay of List mode into sinograms, and control of PET Gantry. CT Image Reconstruction Sys- Embedded computer for CT tem (IRS) image reconstruction. 10 Turnover Workbook | Biograph mCT VG70 syngo Acquisition Workplace Notes Controls: 1. Scan acquisition 2. Reconstruction 3. Registration 4. Scheduling 5. Protocol selection 6. Standard evaluation applications 7. Data transfer Image Reconstruction System (IRS) Calculates the images for each CT slice and passes the data to the syngo Acquisition Workplace. syngo MI Workplace Satellite console used for image viewing, fusing, filming, archiving and 3D reconstruction. Molecular Acquisition Reconstruction System (MARS) Embedded computer for PET data acquisition, PET image reconstruction, storage of PET raw data (list mode), replay of list mode into sinograms, and control of PET Gantry. 11 Turnover Workbook | Biograph mCT VG70 System Control Box and E-Stop Notes (4) (5) (6) SIEMENS (7) (8) + (9) (3) (10) (2) STOP (11) (12) (13) WARNING This X-ray unit may be dengerou to potions ant operaror unless safe (1) exposure factore, operating acuciare and maintenance schedules ere observed I (14) (15) (16) 1. Start 2. Hold 3. Hear Patient 4. Gantry loudspeaker volume (hearing patient) 5. Loudspeaker 6. Loudspeaker volume (speaking to patient) 7. Status LED – indicates system off 8. Status LED – indicates computers only on 9. Status LED – indicates system on 10. Call Patient 11. Emergency stop (E-Stop) 12. Microphone 13. Move 14. Step in 15. Unload 16. Step out 12 Turnover Workbook | Biograph mCT VG70 Notes 1.7 Daily System Maintenance What When Restart computers Daily at startup CT Checkup Daily at startup CT Quality Daily at startup or after extended power off CT Constancy Monthly PET Daily Quality Check (with phantom) Daily at startup (prior to scanning patients), after extended power off, or after remote access service pro- cedures. Note: Perform a PET Full Setup and Time Alignment if the daily PET Quality Check fails. PET Partial Setup Weekly or automatically after 7 days PET Full Setup and Time Alignment Quarterly or automatically after 90 days QualityGuard Daily, performed overnight Archive patient data Daily Clear Scheduler Daily Clear local, network, and film queues Four times daily Call service When PET Full Setup or Time Alignment fails or When CT Quality test results are out of tolerance Scanner Cross Calibration When Ge-68 PET phantoms are replaced. You may access the cross calibration worksheet by selecting Options > PET Cross Calibration. NEMA Testing If required System Preventive Maintenance and Inspection Every 6 months System Cleanup and Shutdown Once a week Restarting the System Computers 1. Exit all examinations and applications. Ensure that the PET and CT gantries are powered on. 2. On the syngo MI Workplace menu (if applicable), select System > End. Select Shutdown System. Click Yes. 3. On the syngo Acquisition Workplace menu, select System > End. Select Restart System. Click Yes. 4. When the Checkup window appears on the syngo Acquisition Workplace screen, turn on the power to the syngo MI Workplace. 5. The system is ready for scanning when the disk icons in the lower right corner of the syngo Acquisition Workplace screen are visible and show the space remaining on each computer disk. 73%) 26% 6. Proceed with the Biograph daily quality control procedures. 13 Turnover Workbook | Biograph mCT VG70 Running CT Checkup Notes When all the computers are started, the Examination task card is displayed on the syngo Acquisition Workplace console. At this point, you should perform the checkup on the CT. The Checkup dialog box is automatically displayed. But if it is not, you can access it by selecting Setup > Checkup from the syngo menu. Checkup For best image quality please run checkup procedure. Please leave the scan room. The table will move out of the gantry. X-rays will be produced during the checkup procedure. Click on Checkup to start procedure. Click on Cancel to skip procedure. Time since last successful checkup: 05:42 Checkup Cancel Help 1. Click the Checkup button. The system checkup is started. 2. Press the Start button on the control box when you are prompted to do so. After a successful checkup, the system displays “Automatic checkup completed,” and automatically closes the dialog and displays the user interface with the task cards. 14 Turnover Workbook | Biograph mCT VG70 CT Daily Quality Notes Positioning the CT Quality Phantom 1. Using the gantry controls, set the patient table at the height where it was set for normalization. (Normalization is performed by a service engineer at installation.) 2. Remove the patient head holder if it is attached to the patient table. 3. Slide the L-shaped phantom bracket into the receptacle at the end of the pallet nearest the gantry (the same receptacle used for the head holder), and screw the bracket down tight. 4. Attach the quality assurance phantom set securely to the phantom bracket. 5. Turn on the laser light markers. 6. Move the table forward until the etchings on the quality assurance (water) phantom are aligned with the lasers. This might require adjusting the height of the phantom using the manual adjustment on the phantom holder. 7. When the phantom is completely aligned, run the quality test. Performing CT Daily Quality Measurements 1. You must perform calibration (checkup) before you start quality measurement. 2. Position the phantom. 3. Select Setup > Quality. 4. Click OK to the Quality Daily dialog. 5. Press the Start button on the control box. 6. After all measurements have been performed and evaluated, the test result is output in the Quality dialog box. 7. Click on the OK button to terminate the Quality/Daily measurement. 8. Call your service representative if the test results are out of tolerance. 15 Turnover Workbook | Biograph mCT VG70 PET Quality Check Notes You can configure your system to automatically perform PET Quality Check (QC) one of two ways. • QualityGuard offers an automatic, phantomless QC option • Auto QC with Phantom offers an automized, traditional approach to QC. Note: Full Setup is required to run every 90 days. The PET Quality Check Results window and QualityGaurd Report will notify you how many days until the next Full Setup is required. After a full setup is run, QualityGuard must be run within 24 hours in order to determine the correct ratio between the LSO energy peaks and the 511kV energy peaks. Positioning the Phantom 1. Remove the patient head holder if it is attached to the patient table. 2. Slide the L-shaped phantom bracket into the receptacle at the end of the pallet nearest the gantry (the same receptacle used for the head holder), and screw the bracket down tight. 3. Attach the semi-circular phantom adapter securely to the bracket. 4. Slide the PET uniform phantom into the phantom adapter. 5. Align the phantom in the CT field of view using the positioning lasers. Y Alignment VN X, Z Alignment AX - + FRONT Laser REAR Laser Outside CT FOV nside CT FOV 16 Turnover Workbook | Biograph mCT VG70 Notes 6. The rear laser inside the CT field of view should line up with the center reference mark on the phantom as shown in the photograph above. 17 Turnover Workbook | Biograph mCT VG70 Quality Check Procedure Notes 1. Prior to performing the PET Quality Check, the underlying settings can be configured by navigating to Options > Configuration > PET QC Configuration. PET QC Configuration 2. On the Phantom tab, you can evaluate the Phantom Volume, Assay Date and Time, and Cross Calibration. PET QC Configuration x Phantom Automatic QC Phantom Volume 8407 (Cc) Isotope Ge-68 Assay Activity 1.52 mCi Assay Time 16:56:38 Assay Date 18-Oct-17 Cross Calibration 1 OK Apply Cancel Help 3. Under the Automatic QC tab, you can configure the system to automatically perform QC and set the dates and times. Note: Quality Guard is an optional feature. PET QC Configuration Phantom Automatic Qc QualityGuard Auto QC with Phantom QC Schedule Day Mon Wed Thu Fri Sat Sun Auto QC Start 13:30:30 Auto QC End 21:30:30 OK Apply Cancel Help 18 Turnover Workbook | Biograph mCT VG70 To manually perform the PET Daily Quality: Notes 1. Navigate to the main menu and select Setup > PET Quality Check PET Quality Check Days until next Full Setup: 89 Days until next Partial Setup: 6 Phantom QC Only Partial Setup Full Setup OTime Alignment Start View Close Help 2. Select the desired QC option(s) Note: Full Setup will automatically include Time Alignment 3. Select Start 4. When the PET Quality Check procedure is complete, the results display in the PET Quality Check Results window. PET Quality Check PET Quality Check Perform and Monitor QC Configure QC Perform and Monitor QC Configure QC Gathering system information .. Quality Check procedure initiated. Quality Check procedure initi ated ... Moving the bed to PET-FOV ... Moving the bed to PET-FOV. The bed is at PET-FOV. The bed is at PET-FOV. Gantry Checkis being performed .. Gantry Check is being performed .. Gantry Check completed successfully Gantry Check completed successfully Setting energy thresholdis on ACS ... Setting energy thresholds on ACS ... Energy thresholds set successfully Energy thresholds set successfuly. Configuring ACS. Configuring ACS ... Configured ACS successfully. Configured ACS successfuly. PET Acquisiti on is in progress .. PET Acquisition is in progress ... PET Acquisition completed successfuly. ACS is unconfigured successfully. Deleting sinogrem fi les from ACS ... Successfuly deleted si nogram files from ACS. PET Image Reconstruction in progress Acquisition Progress Information FRS Progress Information Sinogram Acquisition in progress ... Image reconstruction is in progress .. Trues 412900 Randoms 154864 Singles 10094212 Est Time 8min 1sec Total Time Remaining: 14min 21sec Total Time Remaining: 9min 55sec Stet Cancel Help Start Cancel Heb 19 Turnover Workbook | Biograph mCT VG70 Quality Check Results Notes When the PET Quality Check procedure is complete, the results are displayed in the Report section of the dialog. 1. To inspect the sinogram, click View Sinogram. 2. To print the System Quality Report, click View/Print Report. 3. The System Quality Report is saved in the folder H:\SiteData\DailyQC. If the ECF is within the typical range of your system type, the system quality result is PASS and a green checkmark is displayed. If this is successful, click Save & Close. If the ECF is out of range, the system quality result is FAIL and you will see a red X box. If the system quality result is fail, check the phantom placement and repeat the acquisition. If the problem persists, contact your service representative. CT Calibration CT scanner calibration guarantees optimum image quality. CT calibration occurs automatically as part of the checkup procedure performed after system startup. To calibrate the CT: 1. Select Setup > Calibration from the main menu. The calibration dialog is displayed. 2. To start the calibration, press the Start button on the control box. The system will be calibrated immediately. Clearing the Scheduler When the scheduler contains too many completed or idle jobs, overall system performance may be degraded. To avoid this situation, you should clear the Scheduler at the end of each work day. 1. Access the Patient Browser (Patient > Browser). 2. Click on the Scheduler icon. 3. From the main menu, select Edit > Clear Scheduler. Clearing Network, Local, and Film Queues To clear the network or local job status: 1. Access the Patient Browser by selecting Patient > Browser. 2. Select Transfer > Network Job Status or Local Job Status. 3. Click Clear to clear all jobs. 20 Turnover Workbook | Biograph mCT VG70 To clear the film queue: Notes 1. Select Patient > Film Task Status in any task card or in the Patient Browser by selecting Patient > Browser. 2. Click Clear to clear all jobs. System Cleanup and Shutdown Recommended to be performed once a week on the syngo Acquisition Workplace for optimum performance. To perform system cleanup and shutdown: 1. Exit all examinations and applications. Make sure the system is in an idle state and that there are no active processes (e.g., acquisition, display and analysis, image transfer, archiving, etc.). 2. Remove all media from drives on the syngo Acquisition Workplace and syngo MI Workplace computers. 3. Shut down the syngo MI Workplace computer, if present: On the syngo MI Workplace console, select System > End. Select Shutdown System. End Session X Log Off ... Shutdown System .. Restart System. Restart Application .. Standby .. Cancel Help 21 Turnover Workbook | Biograph mCT VG70 A confirmation dialog is displayed. Click Yes. Notes Shut Down System X Do you really want to shut down the system? Yes No Help ............................................ 4. On the syngo Acquisition Workplace console, select System > Run > System Cleanup and Shutdown. The system displays the syngo countdown screen for several seconds, after which the following window is displayed. System Clean Up and Shutdown The system clean up may take a few hours. After clean up the system will automatically shut down. You may stop the system cleanup at any time by using the "Cancel" button. The system will then shut down Remember to turn off the power for the complete system at the control box button and then proceed with the normal start up procedure. Start Cancel 5. Click Start to begin system cleanup and shutdown. 6. When cleanup is complete, the CT scanner, syngo Acquisition Workplace, IRS and MARS will shut down. Note: Keep in mind that if this procedure is run at the end of the day, Auto QC and or Quality Check scheduled overnight will not run. 7. After turning off the scanner, wait 5 minutes before proceeding to the next step. 8. Turn on power to the CT scanner and computers by pressing the System On button on the rear of the control box. 22 Turnover Workbook | Biograph mCT VG70 9. The system is ready for scanning when the disk icons in the lower right corner of the Notes syngo Acquisition Workplace screen are visible and show the space remaining on each computer disk. 26% 10. Proceed with quality control procedures. Scanner Cross Calibration Please follow the user manual for this procedure. PET Examination Configuration Go to Options > Configuration and double-click on PET Examination in the new pop window that comes up. Dose Units Tab From the pull-down menu, select how dose units are displayed on the Routine subtask card: • mCI - millicuries • μCI - microcuries • MBq – megabecquerels Pharmaceuticals Tab To add a new pharmaceutical, click Add, then enter the name in the Pharmaceutical field. Next, select the Associated isotope, and click Add. • Delete - removes the selected pharmaceutical. • OK - closes the panel and applies the settings. • Apply - applies the settings and keeps the panel open. PET Recon Job Priority PET Recon job is prioritized for the current patient - select to always move the current patient to the top of the reconstruction queue. Recon jobs already in progress will be interrupted until the current patient Recon is complete. Unselect to process Recon jobs in the order they were queued. • OK - closes the panel and apply the settings. • Apply - applies the settings and keeps the panel open. • Default - resets to unselected. • Cancel - closes the panel without making any changes. Export Series Types Tab Select the series type to export when using the Export tool. See Managing Data for more information. • OK - closes the panel and apply the settings. • Apply - applies the settings and keeps the panel open. • Default - resets to unselected. • Cancel - closes the panel without making any changes. 23 Turnover Workbook | Biograph mCT VG70 Notes Image Statistics Tab Select the data series to display when creating an Image Statistics series. • OK - closes the panel and apply the settings. • Apply - applies the settings and keeps the panel open. • Default - resets to unselected. • Cancel - closes the panel without making any changes. Changing the Time and Date To change the date, time, or time zone on the syngo Acquisition Workplace (ICS): 1. Verify that the system is in an idle state and that there are no active processes running. 2. On the syngo Acquisition Workplace, select Options > Configuration. 3. Double-click the Date and Time icon. 4. The Date and Time Properties window will be displayed. 12 Somaris/5 - Configuration Panel X File cm3 DynEva CT Examination Respiratory Scan Protocol Volume CT ImageText Gating Manager Editor Regional and Date and Language Time Date and Time Properties ? X SE Date & Time |Time Zone | Date Time August 2007 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 |11: 38:39 Current time zone: Eastern Standard Time OK Cancel Apply 5. On the Date & Time Tab, adjust the current local time. 6. Restart the ICS system by selecting System > End. Select Restart System. Click Yes. Restarting the ICS updates the date and time on the MARS computer. All computers will synchronize with the new time information. If the MARS finishes restarting before the syngo Acquisition Workplace, it may take about five minutes for the time to synchronize with the syngo Acquisition Workplace console. Restarting the IES updates the date and time on the IES computer. 7. Repeat steps 1 - 6 for the syngo MI Workplace (IES). 24 Turnover Workbook | Biograph mCT VG70 Image Statistics Notes Types of PET Image Statistics and what types of studies generate them: PET Reconstruction Statistics Non-gated routine protocols • Non-gated list mode protocols • Cardiac gated protocols • Respiratory gated protocols • PET Cardiac Gating Statistics Cardiac Gated Protocols • Respiratory Gating Statistics Respiratory Gated Protocols • PET Count Rate Curve (Single Bed Step and Shoot Protocols Only) Non-gated listmode protocols • Cardiac gated protocols • 25 Turnover Workbook | Biograph mCT VG70 2. Day Two - Using Your System Notes 2.1 Using Your System: Objectives After the end of this session, you will be able to: • Know the layout and how to use the Patient Browser • Register a patient • Position a patient using the lasers • Select the proper protocol for your patient exam • Know how to change parameters in the protocol • Acquire the topogram • Acquire the spiral CT exam • Acquire the PET exam • Understand the reconstruction parameters for CT and PET • Have a basic understanding of the Viewing task card • Have a basic understanding of the Filming task card • Know how to display and fuse data using the 3D task card • Know the procedures for archiving, retrieving and transferring data. 26 Turnover Workbook | Biograph mCT VG70 2.2 Patient Browser Notes Accessing the Patient Browser The Patient Browser displays all the patient and examination data stored in each database or external archive medium. To access the patient browser, select Patient > Browser from the menu. The system displays the browser. 3 Patient Browser (1) Basent Applications Transfer Edt PET Yew Filter Evelystion Sort Options Help (2) (3) 15021 Dose Report (4) 1601] Raw Data Local Datobaco PETHoadNock (AI 607| FET Raw Data (5) Scheduler CD_DVD (6 ) UM_VG40_CUT_45 profs cxhammvalichition SoJok desgestion PLE Hna Nock kaart) mosaic .. ~ Instance Typo |inssasco De and .. |inconce Comment (7) [ORIGINAL] [P1 23-Oct-20 2 12 23:18 PET Scan 2 Count Rate [ORIGINAL][PI 23-Oct-2012 12:16:11 PET Scan 2 Bed 1 Sind rom [ORIGINAL][PI 33-001-20:12: 12:16:01 PET Scan 2- Picco 1 [ORIGINAL)(P101-Jas 19. 0 00:00.00 PET Normalization CLUTORE FILES ON (8) (9) (10) (1) - Browser main menu (2) - Browser Toolbar (3) - Navigation area (4) - Local database access (5) - Patient scheduler access (6) - External media access (7) - Data list (8) - Patient folders (9) - Exam folder (10) - Data series 27 Turnover Workbook | Biograph mCT VG70 Patient Databases Notes The types of databases are symbolized on the left-hand side of the navigation area. Click an icon to see its contents displayed in the content area of the browser. Local Database: Basically, the system stores all patient and examination data in a large local database. Scheduler: This database contains all patients who have been preregistered. The content switches to a special list and displays all patients scheduled. Local Archive: This icon represents the selected external drive CD or DVD (disk currently inserted in that drive). Selecting Data in the Patient Browser To select data in the Patient Browser: 1. Scroll through the list of patients in your local database or an attached device with the scroll bar. 11111 dok 40352 (/a// / OPEN Local Database Franklin, James Thorax Thorax PETCT1 CT Spiral 5.0 840s /// / OPEN 11/17 / OPEN Scheduler Pearson, Ellen Raw Data // / OPEN 11/17 / OPEN CD_RW_READ Powers, Richard Thorax ThoraxPETCT1 Topogram TUS " OPEN 11 / OPEN Sony_MOD Quality Assurance Patient (state) ¿ OPEN Reference Images 2. When you find the patient you are looking for, click on the patient entry. Doe, John The system displays all the studies associated with that patient. 3. Click on the study entry you desire. Thorax ThoraxPETC The system displays all the scan series associated with that study. 4. To access a scan series, double-click on the desired series icon. CT Spiral 5.0 B40s 28 Turnover Workbook | Biograph mCT VG70 2.3 Registering a Patient Entering a New Patient To enter a new patient: 1. Select Patient > Register from the menu. The system displays the Patient Registration dialog (below). atient Registration X PROCEDURE PATIENT Last name Patient Accession No 1011121314 First name My Requested E.PET PETCT_Cardiac_Gated (AdL Patient ID 12345 procedure(s) Date of birth 9/12/1970 [M/d/yyyy] Sex · Male Female Other Study PETPETCT_Cardiac_Gated (Acv] Age 40 Years Weight 175.00 [b] Institution name Hospital HOSPITAL Referring physician Dr. Good Health 1. Performing physician Dr. P.E.T. Diagnostics Admitting diagnosis Chest pain Ward East 1. Operator Diagnostician NOLIMITISNI Admission ID 6789 Preregister Exam Search Cancel Emergency Help SO_IR 100 2. Fill in the required fields (displayed in bold). The system requires the patient’s last name, first name, ID (which can be automatically assigned by the system), date of birth, sex and weight to generate Standard Uptake Values (SUVs). All but the last field are necessary to meet DICOM requirements. 3. Enter or select the Hospital and Physician/Operator information. 4. Select the study you wish to perform. For PET and CT acquisition, always use a protocol with PET•CT in the name. Other protocol names correspond to CT acquisitions only. Notes 29 Turnover Workbook | Biograph mCT VG70 Accessing an Existing Patient 1. Select Patient > Register from the menu. The system displays the Patient Registration dialog. Patient Registration X PROCEDURE PATIENT Last name Frankdin Accession No First name Requested Patient ID procedure(s) Date of birth [dd-MMM-yyyy] Sex Male Female Other Study Age Years INSTITUTION Weight Institution name HOSPITAL Referring physician 1. Performing physician Admitting diagnosis Ward 1. Operator Admission ID Preregister Exam Search Cancel Emergency Help Patient Registration 2. Enter the patient’s last name, if known. 3. Click on the Search button. The system displays the Patient Search window as shown below. Patient Search Last Name First Name Patient ID Date of Birth Location Frankdin James 34092 07-May 1962 Local 03.03.14-13:41:54-STD- 03.03.14-13:41: ... 18-Nov-1958 Local Lathrop 234567 13-Mar-1974 Local TempPET 01-Jan-2001 Local _TempPET 01-Jan-2001 Local -- OK Cancel Help Search completed 5 Patients found. 4. Highlight the desired patient and click OK. Notes 30 Turnover Workbook | Biograph mCT VG70 Defining a Study 1. Access the Patient Registration dialog and enter the information as required. 2. Choose a PET·CT protocol, for example, PETCT_AC_WholeBody (Adult). Patient Registration PROCEDURE Ixl PATIENT Last name Franklin Accession No First name Requested Patient ID procedure(s) Date of birth [dd-MMM-yyyy] Sex Male Female Other Study Age Years INSTITUTION Weight [b] Institution name HOSPITAL Referring physician 1. Performing physician Admitting diagnosis Ward 1. Operator Admission ID Preregister Exam Search Cancel Emergency Help Patient Registration 3. Select Exam. The Patient Model dialog is displayed. Patient Model Dialog 6 Adult Protocol ( Replace @ Child C Append Tardi Topogram & Cut @ Keep Auto reference lines None PET API Language English OK Cancel 4. Select the correct position for the patient. 5. Confirm your entries with OK. Notes 31 Turnover Workbook | Biograph mCT VG70 Saving the Protocols Notes 1. Select Edit > Save Scan Protocol from the main menu whenever you want to save scan protocols during the examination. 2. When saving protocols, only the following characters and numbers are valid in protocol names: • 0123456789_ • ABCDEFGHIJKLMNOPQRSTUVWXYZ • abcdefghijklmnopqrstuvwxyz Spaces are not permitted in protocol names. 2.4 Positioning the Patients for Exams Preparing the Patient Table 1. Lower the patient table until the patient can easily sit down on it or be placed on it. 2. Use any positioning accessories that might be necessary. This includes the use of a head holder (to be used only for the head of the patient), foot extender (to be used only for the feet of the patient), positioning mat, RTP pallet and towels, sheets, or immobilizing straps for securing the patient. Preparing the Patient 1. Remove (or have the patient remove) jewelry, glasses, prostheses, etc., from the body region to be examined. 2. Now position the patient on the table using the necessary accessories. Positioning the patient with the arms up for lung, thorax, and abdomen scans, when he/she can tolerate it, will reduce beam hardening and scatter artifacts in the CT, reduce the potential for CT field-of-view truncation artifacts, and improve the quality of the PET images. Setting the Table Height 1. Move the table to the appropriate height by using the vertical motion buttons on the gantry control panel. 2. You can achieve the optimum setting by using the lateral positioning laser marker (see below). Make sure that the laser is marking the center of the measuring field, including the patient and the table. * Moving the Patient Toward the Gantry 1. Using the table positioning buttons on the gantry control panel, move the table with the patient toward the gantry. 2. Before starting the examination, make sure that table movement toward the gantry opening is not obstructed and that the patient cannot be injured by a movement of the table or gantry. 32 Turnover Workbook | Biograph mCT VG70 Using the Positioning Laser Light Markers Notes The laser light markers are laser beams that emanate from three points in the gantry opening. These points are marked. The laser beams fan out so that you see lines as a mark or a cross at the intersection of the beams. 1. Switch on the light markers. 2. With the keys for horizontal table, adjust the longitudinal direction of the table such that the starting point for scanning is marked by the offset laser. 3. With the keys for vertical motion of the patient table, you can adjust the height of the patient table using the vertical laser so that the examination region is in the center of the scan field. 4. Switch the laser markers off again. From now on, the patient must lie still. 5. You can apply the predefined position keys to move the patient table into scanning position. 6. Check the patient position and make sure they are correctly entered in the protocol. Also, observe the patient to make sure they are in no danger of collision with the gantry. Monitoring the Patient As long as the table or scanning unit is moving during scanning, the patient must always be visible and the intercom system must be switched on to hear the patient. Stopping the System In critical situations, press an E-Stop push button to stop all system movements immediately and to shut down radiation. 33 Turnover Workbook | Biograph mCT VG70 2.5 Table Motion Modes Notes Step and Shoot Mode With step-and-shoot bed motion mode, the bed is moved sequentially in equal distances determined by the PET axial field of view (FOV). After acquiring the topogram, beds are indicated visually in the PET Planning Window by rectangular boxes within the scan range. The axial position of the scan range is adjusted by dragging the circle in the center of the scan range up or down. The number of beds is typically defined by the protocol, but can be redefined after the topogram is acquired by dragging the scan range lines in the PET Planning window. When Match CT Range is selected on the Routine subtask card, syngo automatically snaps the line to the closest integer number of PET beds (consecutive full fields of view), and the CT field of view automatically snaps to full PET beds. The duration for each bed is defined on the Routine subtask card. In the following figure, seven equally spaced beds are shown: Patient, My Hospital 12345 Biograph64 *09-Dec-1970. M. 41Y MI.PETICT 2013A 17-Oct-2012 H-SP 13:00:53.3 1-2 1 IMA 1 A TOP 1 SP -601.0 (1) R (2) 10cm kv 120 mA 35 TI 10.4 GT 0.0 1024 0/0 TensLumen 1d 350 (1) – Topogram (2) - Step-and-shoot bed reference boxes 34 Turnover Workbook | Biograph mCT VG70 Continuous Bed Motion – CBM Notes CBM requires an optional license With CBM, the bed is moved continuously through the PET axial field of view (FOV). After acquiring the topogram, the scan range is indicated visually in the PET Planning window by a rectangular box. The axial position of the scan range is adjusted by dragging the circle in the center of the scan range up or down. The scan range is typically defined by the protocol, but can be redefined after acquiring the topogram by dragging the scan range reference lines in the PET Planning window. Up to four Ranges can be defined on the Routine subtask card, each with a different Distance, Duration, and Speed. When Match CT Range is selected on the Routine subtask card, syngo automatically adjusts the CT field of view to match the PET field of view. In the following figure, four Ranges are shown, each with a different Distance, Duration, and Speed. PETCT #/B10556/ 1097364873098,54-56-4-3322 01-Jan-1959, F. 58Y Biograph40 MI.PET/CT 2012A #15693757 H-SP 09-Mar-2012 (1) 15:23:39.20 TOP 1 SP 160.0 (2) (3) R 10cm KV 120 mA 30 TI 12.1 GT 0.0 1536 0AD T80fU32P0 1c (1) - Scan range reference bar (2) - Topogram (3) - Scan range reference lines 35 Turnover Workbook | Biograph mCT VG70 Maximum Patient Clearance Mode Notes The maximum patient clearance mode provides more space in the gantry bore for the patient or additional accessories necessary for positioning. With maximum patient clearance mode, the vertical table movement allows you to lower the patient table to the lowest limit possible: 298 mm. In this mode, you have extended vertical movement with limited horizontal movement. To Enable, perform the following Steps 1. Select the desired protocol from the Patient Model Dialog. 2. Select Move Out from the Table: Position drop-down menu on the Routine subtask card and follow the prompts to move the patient table away from the gantry. 3. Select the RTP PHS mode on button within the Topogram or CT Routine subtask card. Manual Table Begin/End Positioning You can manually set the table begin and end positions at the scanner using the Table Position Setpoint or Gantry Position Rocker buttons on the gantry. Gantry Position Rocker Buttons Table Position Setpoint 2.6 Patient Acquisition Topogram Acquisition 1. Position the patient on the table. 2. Align the patient in the CT field of view using the laser light marker. The laser should be positioned at the start of the imaging region. 3. Check the topogram parameters on the Routine subtask card of the Examination card. PETCT_Whole Body (Adult) Patient, My 12345 Total mAs: Topogram mA 35 - CT WB KV 120 Pause Scan time 10.4 s PET WB 8 Slice 0.6 mm Topogram length Tube position . Top Bottom Lateral Comments Table: Position Height Load Recor -600.0 ] 100.0 Craniocaudal Routine Scan Auto Tasking 36 Turnover Workbook | Biograph mCT VG70 4. Check the topogram length and tube position. Notes • “Top” provides anterior view of patient. • “Bottom” provides posterior view of patient. • “Lateral” provides lateral view of patient. If you want to adjust the topogram parameters, click on the Scan subtask card. PETCT_WholeBody (Adult) Patient, My 12345 Total mAs Topogram Slice 0.6 mm CT WB mA 35 Longth 1024 mm -- Pause Direction Craniocaudal KV 120 PET WB 4 Tube position . Top Bottom .Lateral Scan time 10.4 5 Scan start Start button Language English Delay 2s= API None Kernel T80f sharp Window Topogram Body Load Hoe ecor Routine Scan Auto Tasking 5. To set up automatic viewing, filming, or transfer, set parameters on the Auto Tasking subtask card. PETCT_Whole Body (Adult) Patient, My 12345 Total mAS: Topogram Series description Topogrem 0.6 T80f CT WB Pause Auto filming Auto viewing PET WB Auto transfer Auto Requested procedure Auto Auto AUTO Body part examined Abdomen Load Reco Routine| Scan Auto Tasking 6. To load the topogram as defined, click Load. The system prompts you to press the Move button on the control box. 37 Turnover Workbook | Biograph mCT VG70 7. Press and hold the Move button on the control box until the table stops moving and Notes the Press START prompt is displayed. 8. The Start button on the control box will be lit and flashing. Press the Start button on the control box to begin the topogram. A radiation warning alarm sounds as the topogram is acquired. Setting the Scan Range for Step and Shoot (1) (2) Applications PET Edit nsort Setup ape Option System Hop Patient, My Ha spaal 17346 "DO Dvr-1970, VL 21Yr M PETICT 20124 1 MAI TOP I SP -201.0 (5) - ₩ 120 GTOE 1024 0/ TROY UOPO 14 M - 10242 PETCT_WholeBody_Dynamic (Adult) Patient, My Topogram Isotope F 18 Pharm Fluorodecrygluco CT WB Dos0 10.00 Pause Date 31-Aug-2012 Time 09 32:21 PET WB Dyn Scan range D Maxch CT Range Bed Duration Pass : 2 Pas Range Begin Table Postion Load -1337 0 -1275 -1650.0 Roubne Sca Recon (3) (4) (1) Drag to define the center of the scan range. (2) Drag the rectangular box to define scan range. (3) If applicable, drag the slider to select the Pass. In this example, 2 passes are defined. (4) Define the Duration for each bed for each Pass. 38 Turnover Workbook | Biograph mCT VG70 (5) Observe the number of and position of beds. Beds are shown as rectangles with rounded corners. Each bed has a corresponding number on the Routine subtask card. Setting the Scan Range for Continuous Bed Motion (CBM) Note: Continuous Bed Motion is a an optional license that can be purchased (1) (2) Edit issert Mow Setup lege Options Setem Bet (5) OT00 M -10242 PETCT_CBM_WholeBody (Adult) Patient, My Topogram lestope Go-68 Phorm. Solution CT WB Dose 10:00 ma Pause Date 20-Aug-2012 Time 14 33:43 PET WB Scan range : Match CT Range Scan duration Es 107 Range Distance Duration Speed (rys) 1 304.5 31 10 110.5 23 5 114 5 3345 24 10 Range: Begin End Table Position Load -15215 -858.0 -1650.0 Routine Scan Recon (3) (4) In continuous bed motion, you may create up to 4 individual regions by selecting the check box next to the range on the routine subtask card in the PET chronicle. Additional ranges can be set for faster scanning in that region or even respiratory gating in a region if you have purchased that option. (1) Drag to define the center of the scan range. (2) Drag to define scan range. (3) Click the box to add a new Range. (4) Define the scan Speed. (5) Color coded PET CBM regions correspond to the color coded Ranges on the Routine subtask card. Notes 39 Turnover Workbook | Biograph mCT VG70 Match CT Range Match CT Slice Location Behavior of PET CT Planning Checked Checked CT range will snap to an integral number of PET beds. The PET image slice location and thickness will be matched to the CT. Unchecked Checked CT range is not restricted to integral number of beds. The CT and PET scan range will be independ- ently defined. The PET image slice location and thickness will be matched to the CT for the planned PET scan range. Checked Unchecked The CT range will snap to an integral number of PET beds. The PET image slice location and thick- ness will be native PET, independent of CT slice location and thickness. Unchecked Unchecked CT range is not restricted to integral number of beds. The PET image slice Location and thickness will be native PET, independent of CT slice location and thickness. For example, this configuration is necessary when using multiple CT reconstructions for the attenuation correction of PET images. Acquiring the CT Scan 1. Verify the routine CT parameters displayed on the Routine subtask card. PETCT_WholeBody (Adult) Patient, My 12345 Total mAs: 364 Topogram Eff. MAs 39 CARE Dose4D CT WB ky 120 CTDIvol [32cm): 2.88 mGy DLP: 230.9 mGy cm Pause Scan time 26.63 5 Delay PET WB 2 5 Slice - 5.0 mm Acq. 16 x 1.2 mm No. of images 264 Comments RH Range: Begin End Table: Position Height Load Hold Recon Recon -7265 30 -1516.5 -1650.0 100.0 Craniocaudal Routine Scan Recon Auto Tasking Notes 40 Turnover Workbook | Biograph mCT VG70 2. Click to the Scan subtask card to verify the CT scan parameters. PETCT Whole Body (Adult) Patient, My 12345 Total mAs: 364 Topogram 5.0 mm + Acq. 16x 1.2 mm CT WB RT CARE DOS84D MI CARE KV Off Slice Pitch 0.8 Pause Eff. MAS 39 kV 20 Direction Craniocaudal PET WB Organ characteristic: Abdomen CTDIvol (32cm]: 2.88 mGy DLP: 230.9 mGy*cm Scan time 26.63 s:| Scan start Start button Rotation time 0.55 Delay 2s =| Language English API None Load Hold Recor Routine Scan Recon Auto Tasking 3. Click on the Recon subtask card to verify the CT reconstruction parameters. Wholebody (Adul:) Patient, One 15.03.11-00:31:12-STC Total mAs: 1361 Tepogram Pscon job Sonos description [CT lung 30 970 CT WB Recon jobtype - Andal ADMIRE kemel B/Overstap MAR PLT WD FAST ~ Window Topogram Body Begin position -12240 mm End position HD FOV FOV 200 mm Image order Craniocaudal Center X 0mn 0 mm Ovenlow Comments Extended CT scale Recon Routine Scan Recon Auto Tasking Notes 41 Turnover Workbook | Biograph mCT VG70 4. If desired, select the option to perform the CT scan using an extended 78 cm field of view (FoV). The extended FoV (HD-FoV) CT data are used for enhanced PET attenuation correction. To enable the extended FoV feature, select the HD FoV or Extended FoV check box on the CT Recon subtask card. CT images acquired using the extended 78 cm FoV are overlaid with a circle indicating the extended FoV. HD FoV M Fov Center X 5. If metallic objects are present within the patient’s body, you have the option to reconstruct the CT scan data using metal artifact reduction for a number of medical devices (e.g., a pacemaker, hip implants, et cetera). To do so, click the iMAR option button on the CT Recon subtask card to bring up the Artifact correction menu, and then select a matching item from the list, when available. Cardiac (Adult) test 123 Total mAs: 503 Topogram Recon job 2 34 5 Series description AC CT Cardiac CT Cardiac Slice 3.0 mm .] Advanced reconstruction options Pause ADMIRE Kernel B30f medium smo iMAR Artifact correction Pacemaker PET Cardiac FAST M Window Abdomen None Neuro coils Dental fillings Spine implants Shoulder implants HD FOV FOV 780 mm Image order Pacemaker Center ) 0 mm Thoracic coils Hip implants Overview Center 0 mm No Extremity implants Mirroring None Comments Load Hold Extended CT scale Recon Routine Scan Recon Auto Tasking 6. You can define up to eight (8) different reconstruction jobs with different parameters for each protocol to be executed. Each reconstruction job can be automatically post-processed. To switch between reconstruction jobs, click the radio buttons (1, 2, 3, ... 8) on the Recon subtask card. 7. Enter a unique Series description for each CT reconstruction job so that it is easily identifiable. Recon job 1 2 3 4 5 6 7 8 Series description AC CT Cardiac 8. To set up automatic CT reconstruction, post processing, viewing, filming, or transfer, set parameters on the Auto Tasking subtask card. Notes 42 Turnover Workbook | Biograph mCT VG60 PETCT_Whole Body (Adult) Patient, My 12345 Total mAs: 364 Topogram Recon job . 234567 Series description AC CT WB 5.0 HD_FoV CT WB Auto recon Pause Auto filming II every 1 image Auto viewing No of filmed images 0 PET WB Auto postprocessing None Auto reference ines Auto transfer None Requested procedure [PET PETCT_WholeBody None None Body part examined Abdomen Load Hold Recon Recon Routine Scan Recon Auto Tasking 9. Click the Load button 10. If you have selected extended FOV, the following warning is displayed. Click the Cancel button to cancel loading. Scan Controller X The recon job running during measurement, or a recon job starting after measurement (auto recon) contains extended Field of View. Reconstruction with an extended Field of View can lead to image artifacts Load Cancel Notes 43 Turnover Workbook | Biograph mCT VG60 11. Click Load to continue. The system then prompts you to Press MOVE to position the table for the CT scan. PETCT_AC_WholeBody (Adult) Franklin, James 08.08.27-10:25:48-DST-' Total mAs: 380 Topogram Eff. mAs AC_CT_Body Press MOVE KV 120 CTDIvol 3.32 mGy Pause Scan time 13.64 s Delay 2 PET Acq Slice 5.0 mm Acq. 32 x 1.2 mm No. of images 263 Comments Range: Begin End Table: Position Height Load Cancel 1010.0 221.5 10.0 138.0 Recor Craniocaudal Move Routine Scan Recon Auto Tasking 12. Press and hold the Move button on the control box until the table stops moving and the Press START prompt is displayed. Notes 44 Turnover Workbook | Biograph mCT VG70 13. The Start button on the control box will be lit and flashing. Press the Start button on the control box to start the CT scan. PETCT_AC_WholeBody (Adult) Franklin, James 50 mAs 120 kV 13.64 s 5.0 mm / 0.8 Topogram Eff. MÁS 50 AC_CT_Body Press START 120 CTDIvol 3.32 mGy Paus Scan time 13.64 s Delay ET Acq 25; Slice 5.0 mm Acq. 32 x 1.2 mm No. of images 263 Comments Range: Begin End Table: Position Height 1047.0 - Craniocaudal Load Cancel 1010.0 | 221.5 138.0 Recon Routine Scan Recon Auto Tasking A radiation warning alarm sounds as the CT is acquired. Notes 45 Turnover Workbook | Biograph mCT VG70 Examination | Vie wing (1) (2) (3) Pvient, My CT WID PETWE Aun Tasking (1) Topogram display (2)CT reconstruction display (3)Reconstruction progress bar CT reconstruction jobs are executed depending on how the reconstruction and auto tasking parameters are set. Notes 46 Turnover Workbook | Biograph mCT VG70 Identifying a CT Scan for PET AC When performing a PET∙CT protocol, CT Recon job 1 is most commonly used for attenuation correction for the PET scan. However, in circumstances such as those listed below, you will need to manually select the appropriate CT scan data to use for the PET attenuation correction. • When you append a PET or PET∙CT protocol to a CT or PET∙CT protocol • When you place multiple CT protocols prior to the PET acquisition • When you delete the CT scan from a PET∙CT protocol • Optional: When you use the Merge Multiple CTs tool to combine multiple CT reconstructions for attenuation correction • Optional: When you use a split filter for dual energy CT attenuation correction for PET In each of these cases, you must: 1. Select the PET scan in the Chronicle on the Examination task card. 2. Select the PET Recon subtask card. 3. Select the CT reconstruction(s) to be used for the PET attenuation correction from the Attenuation correction CT drop-down menu. Notes 47 Turnover Workbook | Biograph mCT VG70 Acquiring the PET Scan – CBM 1. Fill in the appropriate information for the radiopharmaceutical, dose, scan duration, and the scan speed per zone. 1PETCT_WB_RespWaveform_Gated M_2-17-11_1 886.0 mm 717 sec 7.99 mCi Topogram Isotope F-18 Pharm. Fluorodeoxyglucose CT Lung Dose 7.99 mCi Residual Dose Pause Date 2/17/2011 Time 10:14:00 AM A PET Lung Scan range _ Match CT Range 2 Scan duration 717 Range |Distance Duration (s)| Speed (mm/'S) 1 368 182 1.5 150 150 368 386 Range: Begin End Table: Position Height Scan direction Hold Recon -832 0 -1718.0 511.5 213.0 Craniocaudal Routine Scan Recon Auto Tasking 2. Click the Residual Dose button to edit the residual dose, if applicable. Wholebody (Adult) Patient, One 849.3 mm 180 sec 9 mC Topogram Recon job 1 2 3 4 5 6 7 8 Series description PET WB CT WB Recon range (bed) Begin End 6 Attenuation correction CT Pause Output Image type Corrected AC CT WB 5.0 B30f (1-1) Scatter Correction ET WB Recon method TrueX+TOF (ultraHD-PET) Relative Iterations 2 Backprojection Registration Matrices terative+TOF Default Image size 200 TrueX (HD-PET) TrueX+TOF (ultraHD-PET) Backprojection+TOF Match CT slice location Filter Gaussian FWHM (mm) 5.0 Save mu-map image Offset (mm) x 0.00 Y 0.00 Cardiac MAR Volume Scaling Load Hold Comments Recon Routine Scan Recon Auto Tasking Notes 48 Turnover Workbook | Biograph mCT VG70 Scatter correction options are also available on the Recon subtask card from the Scatter Correction drop-down menu. The default setting applies Relative scaling, which is suitable for most examinations. However, depending on the PET isotope used for the PET scan, other options are made available for selection. When listed, you may choose None to turn scatter correction off, wherein images will be non- quantitative, or you may choose Absolute scaling which may be more suitable for low-count PET scans or myocardial perfusion scans. Otherwise, Absolute scaling is intended for use only by experienced users familiar with the potential effects on image quality and quantification. Scatter Correction Options Image Effect None When you select None, the system turns scatter correction off wherein images are non-quantitative. Relative Relative is the default scatter scale which is suitable for most examina- tions. When you select this scaling option, the system automatically includes prompt gamma correction (PGC) for appropriate isotopes.3) Absolute When you select Absolute scaling, the system may reduce the effects of very Low uptake or other scatter-related artifacts in PET images and myo- cardial perfusion images. Note: Absolute scaling should only be used by experi- enced users familiar with the potential effects on image quality and quantifi- cation or at the recommendation of Siemens. WB Relative Applies additional scatter correction to reconstructed images that contain halo artifacts. Note: WB Relative scaling is intended only for use in offline, static reconstructions. WB Absolute Applies additional scatter correction to reconstructed images that contain halo artifacts. Note: WB Absolute scaling is intended only for use in offline, static reconstructions. When scatter correction with relative scaling is used, prompt gamma correction (PGC) is automatically included for some isotopes. This is reflected in the list of available menu choices as shown below: Rb-82: Relative (includes PGC),Absolute and None • I-124: Relative (includes PGC), Absolute and None • Ga-68: Relative (includes PGC), Absolute and None • All other isotopes: None, Relative, and Absolute • Notes 49 Turnover Workbook | Biograph mCT VG70 3. Click on the Auto Tasking subtask card to set up automated tasks. PETCT_WholeBody (Adult) Patient, My 787.7 mm 240 sec 10 mCi Topogram Recon job 1 2 3 4 5 6 7 8 Series description PET WB CT WB RT Auto recon Pause Auto Display TrueD PET WB 00 Auto Cardiac Registration Auto transfer None Requested Procedure PET PETCT_WholeBo None Body part examined None Load Recor Routin Scan Recon Auto Tasking 4. Click on the Recon subtask card and set PET reconstruction parameters from the Recon method pull-down menu. PETCT Whole Body (Adult) Patient, My 787.7 mm 8 min 10 mC Topogram Isotope F-18 Pharm. Fluorodeoxyglucose CT WB Dose 10.00 mCi Pause Date 22-Oct-2012 Time 14:49:15 PET WB Press MOVE Scan range M Match CT Range No. of beds 8 Scan duration min Range: Begir End Table: Position Height Scan direction Load Cancel Recor -1515.5 -727.5 1533.0 100.0 Caudocranialv Routine Scan Recon Auto Tasking 5. Press and hold the Move button on the control box until the table stops moving and the Press START prompt is displayed. Notes 50 Turnover Workbook | Biograph mCT VG70 PETCT Whole Body (Adult) Patient, My 787.7 mm 8 min 10 mC Topogram Isotope F-18 Pharm Fluorodeoxyglucose IT WB Dose 10.00 mCi Pause Date 22-Oct-2012 Time 4:49:15 ET WB Press START Scan range M Match CT Range No. of beds Scan duration min Range: Begin End Table: Position Height Scan direction Load Cancel Recon -1515.5 -727.5 -2057.5 100.0 Caudocranial Routine Scan Recon Auto Tasking 6. The Start button on the control box will be lit and flashing. Press the Start button to begin the PET acquisition (unless you have selected to Auto Start the PET scan). Notes 51 Turnover Workbook | Biograph mCT VG70 Acquiring the PET Scan- Step and Shoot 1. Fill in the appropriate information for the radiopharmaceutical, dose, number of beds and scan duration on the Routine subtask card. 2. Click the Residual Dose button to edit the residual dose, if applicable. PETCT_WholeBody (Adult) Patient, My 787.7 mm 24 min 10 mCi Topogram Lisatooe F.18 Lvl Pharm Fluorodecolucose CT WB Dose 10.00 Residual Dose mc Pause Date 26-Oct-2012 15:12:18 PET WB Scanrange v Match CT Range No. of beds O Scan duration 3 min Range: Begin End Teble: Position Height Scan direction Recon -1454.0 -866.0 -600.0 100.0 Caudocranial Routine Scan Recon Auto Tasking 3. Click on the Recon subtask card and set PET reconstruction parameters from the Recon method pull-down menu. PETCT_WholeBody (Adult) Patient, My 787.7 mm 24 min 0 mCi Topogram Recon job 2 34 5 6 7 Series description PET WB Uncorrected CT WB Recon range [bed) Begin 1 End 2 Attenuation correction CT Pause Output Image type Corrected AC CT WB (1-1) PET WB Recon method Iterative Registration Matrices Iterations 2 Backprojecton Default Iterative Iterative+TOF Image size 200 TrueX (HD-PET) TrueX+TOF (ultraHD-PET) Scatter correction Backprojection+TOF Filter Gaussian FWHM (mm) 5.0 v Match CT slice location Save mu-map image Offset [mm] × 0.00 Y 0.00 Metal Artifact Reduction Load Comments Volume Scaling Recor Recon Routine Scan Recon |Auto Tasking Notes 52 Turnover Workbook | Biograph mCT VG70 Acquiring the PET Scan – CBM 1. Fill in the appropriate information for the radiopharmaceutical, dose, scan duration, and the scan speed per zone. 2. Click the Residual Dose button to edit the residual dose, if applicable. 1PETCT_WB_RespWaveform_Gated M_2-17-11_1 886.0 mm 717 sec 7.99 mCi Topogram sotope F. F-18 Pharm. Fluorodeoxyglucose CT Lung Dose 7.99 Residual Dose Pause Date 2/17/2011 Time 10.14:00 AM A PET Lung Scan range Match CT Range 2 Scan duration Range Distance Duration (s) | Speed (mm/s) 1 368 182 1.5 150 150 368 386 Range: Begin End Table: Position Height Scan direction Hold Repor Recor -832.0 -1718.0 511.5 213.0 CraniocaudalY Routine Scan Recon Auto Tasking 3. Click on the Recon subtask card and set PET reconstruction parameters from the Recon method pull-down menu. PETCT_WholeBody (Adult) Patient, My 787.7 mm 24 min 0 mCi Topogram Recon job 1 3 34 5 67 8 Series description PET WB Uncorrected EE CT WB Recon range [bed) Begin 1 End 2 Attenuation correction CT Pause Output Image type Corrected AC CT WB (1-1) PET WE Recon method Iterative Registration Matrices 2 Iterations 2 Backprojection Default Iterative Iterative+TOF Image size 200 TrueX (HD-PET) TrueX+TOF (ultraHD-PET) Scatter correction Filter Gaussian Backprojection+TOF FWHM (mm) 5.0 Match CT slice location Offset [mm] X 0.00 Y 0.00 Save mu-map image Metal Artifact Reduction Load Recor Comments Volume Scaling Routine Scan Recon Auto Tasking Notes 53 Turnover Workbook | Biograph mCT VG70 Monitoring PET Acquisition Notes To view the PET Acquisition Monitor, select Options > PET Monitor from the menu bar. Enabling PET Cine Tool 1. To enable the PET Cine tool go to Options > PET Cine Tool (This option is either checked on or off.) ET Edit Insert View Setup Image Options System Help Version. 872. 79399 License 52Y PET Acquisition Monitor Restart PET Components Life Card print number File Browser .. Maintenance Auto Expose Configuration. Event Log Entry PET Cine Display Service Notes 54 Turnover Workbook | Biograph mCT VG70 2. The PET Cine Tool will open up a new window as the PET beds are acquired and Notes processed building until the end of the study. See image below. x Select LUT. InvertGrayScale16 Fis 1 55 Turnover Workbook | Biograph mCT VG70 Identifying a CT Scan for PET Attenuation Correction When performing a PET·CT protocol, CT Recon job 1 is most commonly used for attenuation correction for the PET scan. However, in some circumstances, you will need or choose to manually select the appropriate CT scan data to use for the PET attenuation correction. 1. Select the PET scan in the Chronicle on the Examination task card. PETCT_WholeBody (Adult) Patient, My 787.7 mm 8 min 10 mCi Topogram Recon job 1 2 3 4 3 7 8 Series description PET WB CT WB Recon range (bed) Begin 1 End 8 Attenuation correction CT Pause Output Image type Corrected AC CT WB 5.0 HD_FoV (1 PET WB Recon method TrueX+TOF (ultraHD-PET) AC CT WB 50 HD FOV (1-1) CT WB 3.0 B30f (1-2) kerations 2 Subsets 21 CT lung 3.0 B7of (1-3) Image size 200 Zoom 1.0 Scatter correction Filter Gaussian FWHM (mm) 2.0 Match CT slice location Offset (mm) × 0.00 Y 0.00 F Save mu-map image Metal Artifact Reduction Comments Volume Scaling Load Hold Reco Recon Routine Scan Recon |Auto Tasking 2. Select the PET Recon subtask card. 3. Select the CT reconstruction(s) to be used for the PET attenuation correction from the Attenuation correction CT drop-down menu. Residual Radiopharmaceutical Dose To enter the residual dose or edit dose information for a completed acquisition: 1. Click the Residual Dose button on the PET Routine subtask card on the Examination task card. 2. Enter the dose information as required in the Radiopharmaceutical Dose window and click OK to accept. - M Interrupting the Scan If you want to interrupt the topogram, CT, or PET scan, and it is not an emergency, press the Hold ª button on the control box or gantry control panel, or click the Suspend button on the Examination task card.\ Suspend The scan is canceled, and the protocol moves to the next step. Notes 56 Turnover Workbook | Biograph mCT VG70 To restart the aborted protocol step (topogram, CT, or PET), right click on that step and select Repeat. Press Load. The scan will start over from the beginning. The patient should be in the same position on the patient table to repeat the scan and for proper attenuation correction. Ending the Exam When PET and CT acquisitions are completed, you can end the exam. All reconstruction jobs are queued and will continue to process. 1. Click the Close Patient button on the Examination task card. M or select Patient > Close Patient from the menu. Click OK to end the exam. Click Cancel to return to the exam. PETCT_WholeBody (Adult) Franklin, James 08.08.27-10:25:48-DST-' Total mAs: 1481 Topogram No. 34 PatientID 08.08.27-10:25:48 -... Total mAs 1481 CT WB Date 27-Aug-2008 15-Jun-1965 Pause Patient nome Franklin, James Scon protocol nome PETCT_AC_Whol ... PET WB Load Hold Recon Recon OK Cancel 2. A confirmation dialog displays Chronicle Do you want to close the current patient ? Yes No 3. Click Yes to close the exam. Click No to cancel. Notes 57 Turnover Workbook | Biograph mCT VG70 Reconstruction Notes From the Examination: To create an additional PET or CT reconstruction job: 1. Select the protocol entry in the chronicle for the Pause acquisition series that you want to reconstruct ThinSliceSpi 2. Select a new recon job (1 through 8) on the Recon Recon job 1 2 3 4 5 6 7 8 subtask card for either CT or PET 3. Change the description of the new reconstruction job so that it is unique 4. Change the reconstruction parameters as needed on the Recon and Auto Tasking subtask cards 5. Click on the Recon button to start reconstruction of the selected series 6. To delete the reconstruction job, click the reconstruction job icon in the chronicle 7. Choose Edit > Delete > Yes DET Arn Add Recon Job Delete Recon Job Copy Recon Range Replace Recon Range From the syngo MI Workplace 1. Select Patient > Browser to open the Patient Browser 2. Select the patient raw data series that you want to reconstruct 3. Select Patient > Reconstruction or double-click the PET or CT raw data series to load it into the Recon task card 4. Set the parameters for the reconstruction job or jobs 5. Click Recon to reconstruct images Patient Browser Patient Applications Transfer Edit PET View Filter Evaluation Sort Options Help SIM ? PET PETCT_Whol [6] PET WB Uncorrected PET PETCT_Whol [4] PET WB Local Database_ Patient, My PET PETCT_Whol [8] PET WB - VS Scheduler [602] PET Raw Data [2] AC CTWB 5.0 HD_FoV [601] Raw Data [1] Topogram 0.6 T80f Patient name Patient, My Study description PET PETCT WholeBody (Adult) Study date 22 Oct. 2012 Modabty PT hstanc ... Istance Type |Instance Date and ... ~ Instance Comment [ORIGINAL] [PI24-Oct-2012 13:21:33 AC CTWB 5.0 HD FoV [ORIGINAL] [PI24-Oct-2012 13:21:33 AC CTWB 5.0 HD_FOV [ORIGINAL] [PI24-Oct-2012 13:21:33 AC CTWB 5.0 HD FoV [ORIGINAL TF124-Oct-2012 13 21:33 AC CTWB 50 HD FOU [ORIGINAL] [PI24-Oct-2012 13:21:33 AC CTWB 5.0 HD FOV [ORIGINAL] [PI24-Oct-2012 13:21:33 AC CTWB 5.0 HD_FoV 58 Turnover Workbook | Biograph mCT VG70 2.6 Viewing Images Notes Viewing Task Card The tool palettes are located beside the image display area of the Viewing task card. They are arranged as a stack of tab cards. Tools | Image | View Patient | Eval KR Loading and Displaying Images 1. Choose the Patient > Browser menu item on the Viewing task card 2. To load a single data object, double-click the object (for example, a series) in the navigation area or in the content area of the Patient Browser 3. To load several data objects into the Viewing task card: Press [Ctrl] and click on the images, series, studies, or patients you want to load • Drag and drop them into the Viewing task card window • 4. To select images, do the following: To select ... Do this a single image Click on the image. The segment is marked by a blue dotted border. one or several images [Ctrl] click the desired images. all succeeding images of the series Select the starting seg- ment and choose Edit > Select On Succeeding. an entire series Select one image within each desired series and choose Edit > Select Ser- ies. Setting the Window Levels (Windowing) 1. Move the mouse pointer onto the image 2. Press and hold the center mouse button 3. Move the mouse up/down to change the window center 4. Move the mouse right/left to change the window width 59 Turnover Workbook | Biograph mCT VG70 Zooming/Panning an Image Notes 1. Select the Viewing task card. 2. Click on the Image card in the card stack. 3. Click on the Zoom/Pan button on the Image card. Make sure no other button on the Image card is selected. 4. To pan, move the mouse pointer onto the image, and press and hold the left mouse button. The cursor changes as shown below. Move the mouse to pan. 5. To pan, move the mouse pointer onto the image, and press and hold the left mouse button. The cursor changes as shown below. Move the mouse to pan. Saving an Image 1. Select the images or series that you want to save. 2. Select Patient > Save As. 3. To save a new series, enter a designation in the dialog box displayed next to Save images in new series and click OK. A new series is stored in the local database when stored for the first time. 4. To append images to a data set, select Append images to series, select the series name, and click OK. Save As X Patient Au1_6 Study Thorax^ThoraxPETCT1 Series CT Spiral 5.0 B40s Images 1 . Save images in new series 605 New Series · Append images to series 2, CT Spiral 5.0 B40s OK Cancel Help 60 Turnover Workbook | Biograph mCT VG70 2.7 Viewing and Fusing Patient Data Using 3D Task Card Notes Loading the CT Images 1. On the syngo Acquisition Workplace or syngo MI Workplace, click on the 3D task card. 2. Open the Patient Browser (select Patient > Browser) and highlight the CT images you want to load. Patient Browser Patient Applications Transfer Edit View Eiter Evaluation Sort Options Heb ( OPEN jobunique PET WB ***** / OPEN Mukesh PET Raw Data ** ( OPEN Local Database_ Mukesh 1 PET PETCT_AC_ AC CT Schedule Froid / OPEN asit / OPEN MUKESH122 PETPETCT_AC_ Raw Data Foi / OPEN a CD-Writer Mukesh2 Topogram 0.6 T8Os stoJ / OPEN JJEJE J INFILOC MOD.Dicom Mukeshg4 $(){J ( OPEN NORM ** )el/ OPEN SCATFRAC 11JIJ / OPEN Patient name Mukesh 1 Date of birth 29-Dec-2004 h 29-Dec-2004 Patient ID 05.12.29-14:49:16-STD-1.3.12.2.1107.5.1.4.54434 04-Jan-2006 Study description PET PETCT_AStudy date 04-Jan-2006 Modality CT mag ... - Image Type |Slice Width Sice Po ... KV KV MAS Gantry Tilt |Kemel FoV |Image Comm ... |Mark Status Work Status ky ky MAS SP SPI 50 .70.5 120.00 50 0.00 [B19h] 700 50 -73.5 0.00 SPI 120.0050 [B190] 700 SPI 50 -76.5 120.0050 0.00 [B190 700 50 .79.5 120.0050 0.00 SP B190) 700 rest's 5.0 SPI -82.5 120.0050 0.00 [B190] 700 50 SPI -85.5 120.0050 0.00 [B190 700 50 -88.5 0.00 SP 120.0050 [B190] 700 50 -91.5 120.0050 0.00 [B190] 700 ------- Current Filter: Off 3. Load the image series by double-clicking on it or dragging onto the 3D task card. 4. To change the window center, place the mouse on an image and press the middle mouse button while moving the mouse up or down. Loading the PET Images 1. Open the Patient Browser (select Patient > Browser) and highlight the processed PET images (PET WB) to fuse with the CT images Patient Browser Patient Applications Transfer Edit View Eiter Evaluation Sort Options Heb + Neck /Carotids Cervical CA, demo Local Database Head Neck CA, de_ Thorax Thorax [606] PET WB Scheduler MSKCC lng ca1 [607] CT Spiral 50 B40s CD_RW_READ UT LIVER CA Date of birth do Patient ID pt0001.0302.upmc Modality PT . 10 11 12 14 Querying database Current Filter: Off 2. Click the 3D Fusion button in the Patient Browser toolbar. 61 Turnover Workbook | Biograph mCT VG70 Adjusting the CT/PET Balance Ratio 1. From the 3D task card menu, select Type > Fusion Definition. The system displays the Fusion Definition dialog. Fusion Definition X CT Mixing Ratio PT (1) 400% 50% 509 100% (3) Color Lookup Table Gray Scale (8 Bit ) Hot Body (8 Bit) SUV (2) Window Value (4) C 40 W 300 B 0.0003 T 0.0103: Close Advanced >> Help (1) Alpha Blending Ratio Slider (2) CT Window (3) Color Table Selectors (4) PET Threshold 2. To adjust the CT image: • Slide the Mixing Ratio slider at the top all the way to the left • Manipulate the color range and max/min using the purple slider on the left and the bars that define it, or type values into the (C)enter and (W)indow fields and press [Return] Fusion Definition CT Mixing Ralio PT 100% 100% 0% 100% Color Lookup Tablo Grey Scale (8 Biq - Hor Body ( BIC) Window Valle C W B 0.0009 T 0.01092 Advanced >> Help 3. When you are satisfied with the CT image, move the Mixing Ratio slider over to the right so that you see 100% PET image. 4. Use the controls on the right side of the Fusion Definition dialog to adjust this image in the same way. Notes 62 Turnover Workbook | Biograph mCT VG70 3. Day Three - Reviewing Concepts from Day Two Notes 3.1 Reviewing Concepts from Day Two: Objectives After the end of this session, you will be able to: Know how to use the techniques involved with image evaluation and quantification Know the steps in creating and saving JPEGs and AVI files 3.2 TrueD Basic TrueD Basic is the version available on the MI Acquisition Workplace. Loading Images Note: You can only load a single time-point on an MI Acquisition workplace. 1. Select the Patient > Browser menu item. 2. To select a patient folder, study, or series, click its icon. 3. To select multiple studies or series, press the Ctrl key as you click each icon. 4. Drag and drop the selected icon(s) from the Patient Browser window onto the TrueD task card. (If using dual monitors, drag and drop the icon(s) onto the TrueD task card on the right monitor.) Automatic Rigid Registration Volume Registration Data Sets Prior 1, Current Custom 1 (1) auto Automatic Registration (2) (3) - (4) (1) Selects Automatic Rigid Registration mode (2) Performs automatic registration according to current selection in Data Sets drop- down list (3) Registers all currently loaded time-points (4) Cancels the automatic registration operation 63 Turnover Workbook | Biograph mCT VG70 Image Display Functions in Common Control Area Notes (3) (1) (4) (2) ( 5 ) (6) (9) (7) A (10) ( 11 ) (14) ( 12) (15) x: (xx/yy) (1) Show/hide reference lines (2) Enable/disable Zoom/Pan image mode (3) Change image segment view to coronal (4) Change image segment view to sagittal (5) Change image segment view to axial (6) Display the Layout Gallery, to change the layout format (7) CT window level preset A (8) CT window level preset B (9) CT window level preset C (10) Select CT window level extension presets to the currently selected CT window level preset; toggles between Window 1, Window 2; no preset window applied (11) Sphere VOI: Create a sphere VOI at the current reference line crosshair (12) Enable/disable the Pixel Lens to examine pixel quantification data (13) Enable/disable correlated cursors in image segments (14) Link/unlink image display parameters and Paging Registration between segments in different time-points (15) Display menu for selecting PET or SPECT image data units Blowing Up a Single Image To toggle between Blow Up and normal image view, double-click on the image segment. 64 Turnover Workbook | Biograph mCT VG70 Scrolling Images Notes Dog Ears 1. To view the next slice (“behind” the current one), click here. 2. To view the previous slice (“in front of” the current one), click here. (1) (2) Parallel Shift 1. To enter Parallel Shift mode, press and hold the right mouse button until the Smart Select menu is displayed, then select parallel shift. 2. To shift through the images, move the pointer over the segment, then click and drag up and down using the left mouse button. The segment will page through the images relative to the length of your pointer movement. Using Reference Lines 1. Drag the intersection point (cross-hairs) to move both reference lines together. 2. Drag the desired reference line with the cursor. 3. Click at a desired position in an orientation segment to put the intersection there. Using the Rotating MIP Image With a rotating MIP image displayed, click on a pick point in the MIP image. The image planes intersecting with the pick point are displayed in the MPR views. Using the Stripe Layout Scroll Bar In a Stripe layout, you can use the scroll bar at the bottom of the task card to navigate through the displayed image slices. 65 Turnover Workbook | Biograph mCT VG70 Zoom/Pan Mode Notes 1. To enter Zoom/Pan mode, click the Zoom/Pan button in the layout control area. 2. To zoom in and out, move the pointer to an area outside the image, then click and drag up and down using the left mouse button. The pointer is hidden as you zoom. 3. To pan the image within the segment, move the pointerover the image, then click and drag the image. 4. To home zoom/pan, click the Home Zoom/Pan button. Blending CT or MR with PET or SPECT Images Follow-up 2 50 % PET 50 % CT (1) (1) Blend bar for currently selected time-point. 66 Turnover Workbook | Biograph mCT VG70 Windowing Notes Visualization Subtask Card Visualization CT W/L Presets (1) Lung PET LUT (2) Invert Grayscale (16 Bit) Fused LUT (3) Hot Body (16 Bit) Masking (4) 0.0000 H 15.7968 (5) (6) (8) (7) (9) (1) Select a CT window level preset (2) Select a PET or SPECT color LUT (3) Select a PET or SPECT color LUT when fused with CT or MR (4) Mask tools for PET and SPECT images: Change top/bottom values using slider end handles or spin boxes; change center point of threshold range using slider middle handle (5) Home Zoom/Pan: Return image zoom/pan to default (6) 6Home Windowing: Return windowing to default (7) Volume Punch tool (9) Home Orientation: Return orientation views to defaults Windowing with the Mouse To adjust brightness, click and drag up and down using the middle mouse button in • the display segment on either side of the image To adjust brightness, click and drag up and down using the middle mouse button in • the display segment on either side of the image To adjust the CT or MR image windowing, click and drag in the left half of the • segment To adjust the PET or SPECT image windowing, click and • drag in the right half of the segment 67 Turnover Workbook | Biograph mCT VG70 PET and SPECT Windowing Bars Notes (1) (2) (3) (1) To adjust maximum window intensity (contrast), click and drag the upper handle (2) To adjust center window intensity (brightness), click and drag the center handle (3) To adjust minimum window intensity (contrast), click and drag the lower handle Note that separate AC and NAC windowing bars are available, as shown below, when both image types are loaded. 1) (2) BX (1) AC windowing bar (2) NAC windowing bar Selecting a LUT from the Windowing Bar Menu Right-click on the windowing bar, then select the desired LUT from the menu. If you select the Extended Range menu item, the windowing slider displays and uses the extended range (that is, -50% to 400%). MIP Controls 68 Turnover Workbook | Biograph mCT VG70 MIP MIP PT AC, Friday, February 07, 2003 PT AC, Friday, February 07, 2003 (1) (12) (2) (13) (3) 10% (4) 2% 10%6 (5 ) (6) (20) (7) (8) (9) (10) (11) (14) (15) (16) (17) (18) (19) (1) Click pick-point in image to move reference lines in image (8) Step to previous frame segments to that anatomical point (9) Move interactively through frames (2) Indicates location of displayed axial MPR image slice (10) Step to next frame (3) VOI IDs: Click on ID to navigate to that VOI in image segments (11) Refresh MIP (enabled only if PET gated images are loaded) (4) Change frames/sec (12) Save AVI file of rotating MIP (5) Change rotation direction (13) Show/hide MIP graphics (6) Pause the rotation (14) Home Zoom/Pan (7) Start rotation (15) Home Windowing Notes 69 Turnover Workbook | Biograph mCT VG60 Quantification The Quantification subtask card is available only on a reading workplace. Quantification (1) (2) -(10) (11) |12) (14) (13) (15) [16) (17) 19) (18) 120] (21) Isc-Contour Threshold CT (22) 3.20 (23) (24) (1) VOI Ellipse (15) Delete VOI: Delete selected VOI (2) VOI Freehand (16)VOI Color: Change color of selected VOI (3) VOI Ellipsoid (17) VOI Analysis: Display comparison of quantification data for (4) VOI Iso-Contour Ellipse linked VOIs (5) VOI Iso-Contour Freehand (18) Copy VOI for Comparison: Copy selected VOI in one time-point to the other time-point (6) VOI Iso-Contour Ellipsoid (19) Copy Iso-Contour for Comparison: Copy selected iso-contour VOI (7) Show/Hide Bounding Graphics (for iso-contours) in one time-point to the other time-point while retaining the (8) Line: Measure distance in image same iso-contour area (9) Angle: Measure angle in image (20) Save Active VOIs (RT): Save VOIs in active time-point to DICOM RT (10) Annotation: Add comment to image (21) Save All VOIs (RT): Save VOIs in all time-points to DICOM RT (11) Show/Hide Graphics: Show/hide VOI quantification data and graphic (22) CT (and MR) Iso-Contour Threshold bar (12) VOI Copy to Prev: Copy the VOI to the previous image slice (23) PET (and SPECT) Iso-Contour Threshold bar (13) VOI Copy to Next: Copy the VOI to the next image slice (24) PET (and SPECT) minimum threshold as percent of maximum value (displays if data units are set to SUV or Bq/mL) ( 14) Group VOI: Group a VOI’s contours so that all contours can be moved together 70 Turnover Workbook | Biograph mCT VG70 Editing and Moving a Contour Notes 1. Click and drag a corner handle to resize that corner of the contour in any direction. 2. Click and drag a vertical handle to resize that side of the bounding box vertically. (1)- 3. Click and drag a horizontal handle to resize that side of the bounding box horizontally. 4. Click the bounding box edge (between the resize handles)to select/ deselect the VOI. OR Click and drag on a bounding box edge to move the contour without changing its shape. Registering Images Registration is the process of aligning images from different series. Registration is used for the following conditions: Within a time-point, when images from different modalities (for example, CT and • PET) are loaded Across time-points, when images for multiple time-points are loaded • Automatic Rigid Registration Volume Registration Data Sets Prive 1. Current Custom 1 (1) - P Automatic Registration (2) (3) (4) 1. Selects Automatic Rigid Registration mode 2. Performs automatic registration according to current selection in Data Sets drop- down list 3. Registers all currently loaded time-points 4. Cancels the automatic registration operation 71 Turnover Workbook | Biograph mCT VG70 Paging Rigid Registration Notes 1. Right-click the Link/Unlink button in the common control area. 2. In the Link Settings dialog box, select the Registration option. a. Registration link option rueD-Link Settings CT Window Level MR Window Level PET SUV Windowing Blend Rabo ¥ Registration - (1) OK Cancel Help 3. With at least two time-points loaded, make sure the Link/Unlink button is in the Unlink state (not depressed). 4. Page through the slices in a view in one time-point to align it with the view in the other time-point. 5. When you are satisfied with the alignment between the views in the two time-points, click the Link/Unlink button to link them. You can make and save as many paging registrations for the loaded time-points as you want. • To save the current paging registration, in the Volume Registration subtask card, enter a name for the registration in the Result list field and click the Save Registration button. • To apply a saved paging registration, select it from the Result list. 72 Turnover Workbook | Biograph mCT VG70 Image and Close Patient Buttons Notes (3) (5] Oh (2) (4) (6) (1) Print currently displayed images; an option in the TrueD Configuration window determines whether the print job is sent to a paper printer or to a DICOM printer (2) Copy currently selected image to the Filming task card (3) Save currently selected image as new series and load to Viewing task card (4) Export display area or selected segment to bitmap file (5) Save currently selected image as new series (6) Close the patient Saving JPEG and AVI files in TrueD To save a JPEG or bitmap file (1) (3) 15 TO (2) (4) [6] (1) Select the page or region that you would like to save as a JPEG or bitmap (2) Select the Export Image button (3) Select whether you want to create a segment or a screen image (4) Select the folder where you want the image to reside and select Save 73 Turnover Workbook | Biograph mCT VG70 To save an AVI file Notes (1) (E) (4) (5) (e) (11) 112) (12) (14) (15] (1) Open patient study and select the MIP task card (2) Select the Save AVI icon in the MIP tools (3) Select the folder location and Save 74 Turnover Workbook | Biograph mCT VG70 3.3 Exercises Notes Exercise 1: Patient Gantry 1. The maximum weight the PHS will hold is __________ lb 2. Match the labels on the following: (1) (4) -(5) (2) spoed -(3) (1) a. Laser light markers ____ (2) ____ b. Display panel (3) ____ c. Operator control panels (4) ____ d. Stop buttons (5) ____ e. Communication system 75 Turnover Workbook | Biograph mCT VG70 Exercise 2: Daily QC Notes 1. Perform the daily scanner QC from start to finish. 2. List the steps for completing your daily QC. a. __________________________________________________________________ b. __________________________________________________________________ c. __________________________________________________________________ d. __________________________________________________________________ e. __________________________________________________________________ f. __________________________________________________________________ g. __________________________________________________________________ 3. Which two QC procedures are recommended to be completed weekly? a. __________________________________________________________________ b. __________________________________________________________________ 76 Turnover Workbook | Biograph mCT VG70 Exercise 3: Patient Registration Notes 1. Register a patient to acquire a routine whole body acquisition. 2. Which 4 fields of information are required to register a patient? a. __________________________________________________________________ b. __________________________________________________________________ c. __________________________________________________________________ d. __________________________________________________________________ 77 Turnover Workbook | Biograph mCT VG70 Exercise 4: Acquisition Notes 1. Demonstrate how you would change the acquisition parameters on the CT study. 2. Demonstrate how you would change the acquisition parameters on the PET study. 3. Which task card in the Exam UI contains the CT and PET acquisition parameters? ________________________________________________________________ 4. If you get a warning message on the CT acquisition asking you to change the parameters, this means that the CT tube will ____________ under these conditions. Exercise 5: Reconstruction 1. On which task card will you find the reconstruction parameters? 78 Turnover Workbook | Biograph mCT VG70 Notes ____________________________________________________________________ 2. How many reconstruction jobs will the Exam UI allow you to do at one time? ____________________________________________________________________ 3. The extended field-of-view selection will allow you to reconstruct images up to cm. ________ ____________________________________________________________________ Exercise 6: Patient Browser 1. Match the icon with the name. 79 Turnover Workbook | Biograph mCT VG70 Notes 1. Scheduler 2. Local Database 3. Local Archive 2. Practice archiving patient data to your desired media. 3. Where can you see the status of jobs relating to sending data to another network node? ____________________________________________________________________ 4. What are 3 types of media to which you can archive patient data to? a. __________________________________________________________________ b. __________________________________________________________________ c. __________________________________________________________________ d. __________________________________________________________________ 80 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 and options as well as standard and optional features which do not always have to be present in individual cases. Local Contact Information Siemens Medical Solutions USA, Inc. Siemens reserves the right to modify the 40 Liberty Blvd. design, packaging, specifications and Malvern, PA 19355-9998 options described herein without prior USA notice. Please contact your local Telephone: +1-888-826-9702 Siemens sales representative for the siemens.com/healthcare most current information. Legal Manufacturer Note: Any technical data contained in Siemens Medical Solutions USA, Inc. this document may vary within defined Molecular Imaging tolerances. Original images always lose 2501 N. Barrington Road a certain amount of detail when Hoffman Estates, IL 60192 reproduced. USA Telephone: +1 847 304-7700 siemens.com/mi Siemens Healthcare Headquarters Siemens Healthcare GmbH Healthcare Sector Henkestr. 127 91052 Erlangen Germany Telephone: +49 9131 84-0 siemens.com/healthcare Published by Siemens Healthcare GmbH · Order No. HOOD05162002982678· Printed in USA · 02/2019 · ©Siemens Healthcare GmbH, 2019