Biograph™ Routine Workflows Online Training

Welcome to the MI PET Routine Workflows Online Training. This course will provide an overview of the syngo MI Acquisition. The topics covered in this module will include patient registration, study selection, positioning the patient, acquiring the scan, reconstructing the data, and auto tasking. The information in this training supports the Biograph Vision™, Biograph™ mCT, and Biograph Horizon™.   Upon successful completion of this course, you will be able to: Understand how to perform the steps of patient registration and selecting a study Illustrate the steps for positioning a patient Explain the procedure for acquiring a scan Describe the functions of reconstruction and auto tasking Congratulations. You have completed the Biograph™ Routine Workflows Online Training. Listed below are the key points that have been presented course. Take time to review the material before you proceed to the final quiz.  Understand how to perform the steps of patient registration and define the study New Patient Registration Select Patient > Register from the main menu Fill in all  the entries marked in bold Additional entries are optional and depend on the site’s requirements Accessing an Existing Patient Select Patient > Register from the main menu Enter the Patient’s last name within the patient registration window Click the Search button at the bottom of the window Within the Patient Search window, click on the desired patient name Click OK Defining the Study Access the Patient Registration dialog Choose a protocol from the Study drop-down menu - or – Press the Exam button to choose a study from the Patient Model Dialog Patient Model Dialog Choose Adult or Child Select the body image or icons of interest to choose the protocol Choose Replace or Append Protocol If Appending a protocol, select Cut or Keep the topogram Select how to show reference lines Select Patient Position Select API Language Click OK to confirm entries Illustrate the steps for positioning a patient Preparing the Table Patient may require one or more of the following positioning accessories: Head Holder, Foot Extender, Knee Support, Velcro Straps, RTP Pallet Preparing the Patient Patient removes all jewelry, glasses, prosthetics, etc. Position patient in the table using any necessary accessories Position arms for lung, thorax, and abdomen scans Ensure region of interest is in the center of the measuring field Make sure patient is comfortable and immobilized Make sure IVs and patient leads are long enough to prevent getting caught anywhere Using the Positioning Laser Light Markers Move the table vertically to the appropriate height Move the patient horizontally into the gantry Use the gantry button to turn on the laser markers Center the patient in the FOV Instruct the patient to remain still Technologist should observe the patient Explain the procedure for acquiring a scan Acquisition Modes include Whole Body, Dynamic, Cardiac Gated, Respiratory Gated, and Dual Gated Procedural Steps Ensure the laser is positioned at the start of the imaging region Check topogram parameters for accuracy on the Routine subtask card If necessary, adjust the parameters on the Scan subtask card Click the Load button Press the Start button on the Control Box Describe the functions of auto tasking and reconstruction Auto Tasking Provides the ability to perform certain jobs automatically, including sending data to another application, filming, or transferring to another node Reconstruction Algorithms can be used to manipulate the quality of the acquired images Select the link below to view/print the review material before proceeding to the final quiz.   Before you can scan a patient, you must register the patient.​ A patient can be registered in one of the following ways: A new patient with all the required data - or - Accessing an existing patient ​For Hospitals operating with HIS/RIS, the patient data is entered at reception. The Patient Browser can also be used to search for the patient in the Scheduler database.    Accessing an Existing Patient Learn about accessing an existing patient. Element HTML Select Patient > Register Within the Patient Registration window, enter the patient's last name Click the Search button at the bottom of the window Within the Patient Search window, click on the desired patient Click OK   Sound File Audio ScriptTo register an existing patient to be scanned, complete the following steps: First Select Patient > then Register from the menu The system will display the Patient Registration window. Next, enter the patient's last name.   Next, click on the Search button. The system displays the Patient Search window. Select the desired patient from the list. And click the OK button. Defining a Study Learn about defining a study. Element HTML Access the Patient Registration dialog Choose a protocol from the Study drop-down menu - or - Press the Exam button to choose a study from the Patient Model Dialog   Sound File Audio ScriptTo define a study, choose the study from the dropdown menu on the right-side of the Patient Registration dialog. You can also press the Exam button and enter the study from the patient model dialog. Registering a New Patient Learn about registering a new patient. Select Patient, then Register from the main menu The entries marked in bold are required: Last Name Patient ID Date of Birth (DOB) Sex Weight Additional entries are optional and will depend on the site's requirements.   This page will discuss some guidelines on how to position your patient for optimal image quality. Some of the topics include: Preparing the Table Preparing the Patient Using the Positioning Laser Light Markers   Preparing the Table Learn about preparing the table. Element HTMLOnce the table is in position, the patient may require one or more positioning accessories. Some examples include: Head Holder Foot Extender Knee Support Velcro Straps RTP Pallet (optional) 54321 Sound File Audio ScriptTo position the patient, lower the patient table until the patient can easily sit down on it or be placed on it. Use any positioning accessories that might be necessary. Positioning accessories may include 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), knee support, Velcro straps and the RTP pallet which is an optional item. Preparing the Patient Learn about preparing the patient. Element HTMLTo prepare the patient for the examination: Patient should remove jewelry, glasses, prosthetics, etc. Position patient in the table using any necessary accessories Position arms up for lung, thorax, and abdomen scans. This will: Reduces beam hardening and scatter artifacts Reduces CT FOV truncation artifacts Improves PET IQ ​Ensure region of interest is as near to the center of the measuring field as possible Avoids image artifacts on subsequent reconstructions Make sure patient is comfortable and immobilized Avoids motion artifacts Avoids poor attenuation correction Make sure IVs and patient leads are long enough and can't get caught anywhere Sound File Audio ScriptTo prepare the patient, remove or have the patient remove any jewelry, glasses, prosthetics, etc., from the body region that will be examined. Position the patient on the table using the necessary accessories. For lung, thorax and abdomen scans, position with the arms up if possible. This 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. When positioning the patient, ensure that the object of interest is as close to the center of the measuring field as possible. It is very important to make sure that the patient is comfortable and immobilized if needed. You need to limit the patient’s motion as much as possible between the CT and the PET scan to avoid motion artifacts. Motion artifacts can result in poor attenuation correction. Make sure that IVs and patient leads are long enough to avoid tensile stress when the table is moved. Also, make sure that the tubes and leads can’t get caught anywhere. Using the Laser Light Markers Learn about using the laser light markers. Element HTMLTo use the positioning laser light markers: Move the table vertically to the appropriate height Move the patient horizontally into the gantry Use the gantry button to turn on the laser markers Center the patient in the FOV Instruct the patient to remain still Technologist should observe the patient Sound File Audio ScriptWhen the patient is positioned, move the table to the appropriate height by using the vertical motion buttons and move the patient horizontally into the gantry. The laser markers are laser beams that emanate from 3 points in the gantry opening.  Turn on the laser markers using the button on the gantry.  Use the lasers to center the patient in the field of view. From this point forward, the patient must remain still and the technologist should observe the patient at all times throughout the scan. Acquisition Modes include: Whole Body ​Additional Optional Modes include: Dynamic Cardiac Gated Respiratory Gated Dual Gated   Biograph scanners support either of the table motion modes listed below: Step-and-Shoot Continuous Bed Motion ​For PET-CT exams, the system groups the acquired data with either of these methods to allow PET and CT alignment. Step-and-Shoot Learn about step-and-shoot. Element HTMLStep and Shoot Planning Window Drag to define the center of the scan range Drag the rectangular box to define scan range If applicable, drag the slider to select the Pass In this example, 2 passes are defined Define the duration for each bed for each pass Observe the number and position of beds. Beds are shown as rectangles with rounded corners. Each bed has a corresponding number on the Routine subtask card.  (1)(2)(1) Topogram (2) Step-and-shoot bed reference boxes Sound File Audio ScriptWith the step-and-shoot bed motion mode, the bed is moved sequentially in equal distances that are determined by the PET axial field of view (or 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 can be adjusted by dragging the circle in the center of the scan range up or down. If more or less coverage is needed, the rectangular box can be extended or minimized at the top or bottom to define the length of the scan range. The image shown here is of a dynamic acquisition allowing for more than one pass. Drag the slider to select the pass. In this example, 2 passes are defined. The duration for each bed and each pass can be defined. Continuous Bed Motion (CBM) Learn about continuous bed motion (CBM). Element HTMLContinuous Bed Motion (CBM) Drag and define the center of the scan range Drag to define scan range(s) Click the box to add a new Range Define the scan speed Color coded PET CBM regions correspond to the color coded Ranges on the Routine subtask card (1) Scan Range Reference Bar (2) Topogram (3) Scan Range Reference Lines(1)(2)(3) Sound File Audio ScriptThe scanner supports the optional Continuous Bed Motion acquisition also known as FlowMotion. In this mode, four ranges can be defined by checking the boxes to the left of the scan range column. The speed can be defined for each range in the speed column. The duration value will change based on the distance divided by the speed. Each range is defined by color codes shown on the routine subtask card.  To acquire the PET scan: Fill in the appropriate information for the radiopharmaceutical, dose, scan length, and duration on the Routine subtask card For Step-and-Shoot protocols: Press the Configure duration per bed button to set the duration of each bed or use the syngo defaults For Continuous Bed Motion exams: Adjust the range(s) and speed as desired Verify or adjust the parameters in the Routine, Scan, Recon, and Auto Tasking subtask cards Select the Load button Select the Move button on the Control Box Press the Start button on the Control Box   Monitoring the PET Acquisition Learn about monitoring the PET Acquisition. Element HTMLTo access PET Acquisition Monitor (PAM): Select Option from the menu Select PET Monitor The PET Acquisition Monitor displays: Statistical Data Trigger Signal Rate Gantry Status File System Status on Remote Acquisition and Reconstruction Computers   Sound File Audio ScriptYou can monitor the PET acquisition by selecting the Options menu from the menu bar and then choosing PET Monitor. The PET Acquisition Monitor window will be displayed. It displays statistical data, the trigger signal rate, gantry status, and the file system status on remote acquisition and reconstruction computers. A reconstruction job defines a set of reconstruction parameters that the system uses for image reconstruction.  Up to 8 reconstruction jobs can be executed at once If more than eight jobs are required, you must delete one reconstruction job before defining an additional role To Delete a Reconstruction Job: Select the reconstruction job icon in the Chronicle Choose Edit > Delete Recon Job from the main menu - or -  Right-click on the Reconstruction Job icon and choose Delete Recon Job Confirm the deletion by clicking Yes   CT Reconstruction Learn about CT reconstruction options. Element HTMLThe reconstruction subtask card includes the following CT reconstruction settings: Kernel Window Image Order Field of View (FoV) Mirroring Extended CT scale Comments Sound File Audio ScriptA kernel is a reconstruction algorithm that can be used to manipulate the quality of your images. The window selection will allow you to select a predefined brightness and contrast that is specific to the organ that is being studied. Image order selects the slices to be displayed craniocaudal (pronounced “cray-knee-o-cau-dal”) or caudocranial (pronounced “cau-do-cray-knee-al”). The increment specifies the reconstruction spacing and the number of images that will be produced. The size of the field of view can be selected. HD FOV provides an extended FOV. Mirroring provides the opportunity to mirror images vertically or horizontally. Extended CT scale extends the windowing scale so the higher Hounsfield units of metal can be better visualized. Lastly, comments can be added to the images in the comment selection. Please note: some of the entries depicted here are optional and may not appear on your scanner. PET Reconstruction Learn about PET reconstruction options. Element HTMLOn the PET reconstruction subtask card, you can perform the following tasks: Select how many reconstruction jobs Enter a series description name  Select the range of the reconstruction Output the image type as corrected or uncorrected Select the algorithm Select the number of iterations and subsets Sound File Audio ScriptOn the PET reconstruction subtask card, you can select how many reconstruction jobs you would like to produce, and enter a series description name for each of the jobs.  You can also select the range of the reconstruction by the number of beds and choose to output the image type as corrected or uncorrected. The Recon method option has the ability to select the algorithm and the number of iterations and subsets. Auto Tasking can be used to set up automated tasks for PET reconstruction, postprocessing, and transferring images.  The Auto Task setting can determine the default parameters for the following elements: Recon Job Radio Button Series Description Auto Recon Auto Display Auto Cardiac Registration Image Order Auto Transfer Requested Procedure Body Part Examined Send to Taskflow for Processing Data Role   CT Auto Tasking Learn about CT auto tasking. Element HTML Sound File Audio ScriptThe image shown here depicts the CT Spiral Auto Tasking subtask cards. Here you can select options that allow you to autofilm and auto view. CT Spiral Auto Tasking also has options that allow you to automatically reconstruct the data and send it to a post processing application. You can select to automatically transfer to other nodes as well. PET Auto Tasking Learn about PET auto tasking. Element HTML Sound File Audio ScriptThe below image shows an example of a typical PET Auto Tasking Subtask Card. It gives you the option to automatically reconstruct the data and display it in a selected application. The Auto Cardiac Registration can also be selected if that option is available. Using this feature, it is also possible to send the data to other nodes. Please note that the learning material is for training purposes only!   For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training.   The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions.   Note:  Some functions shown in this material are optional and might not be part of your system.   Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country.  Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information.   The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages.   All names and data of patients, parameters and configuration dependent designations are fictional and examples only.   All rights, including rights created by patent grant or registration of a utility model or design, are reserved.   Copyright © Siemens Healthcare GmbH 2019 Please proceed to the assessment. ​ Procedural Steps Ensure the laser is positioned at the start of the imaging region Check topogram parameters for accuracy on the Routine subtask card If necessary, adjust parameters on the Scan subtask card Click the Load button Press the Start button on the Control Box   To acquire the CT scan: Verify the routine CT parameters that are defined on the CT Routine subtask card Verify the CT scan parameters on the Scan subtask card Verify the CT reconstruction parameters on the Recon subtask card Review the Auto Tasking subtask card if needed Click the Load button Select the Move button on the control box When prompted, Press the Start button on the Control Box   From the Patient Model Dialog, the following information can be entered: Choose Adult or Child Select the body image or icons of interest to choose the protocol Choose Replace or Append Protocol If Appending a protocol, select to Cut or Keep the topogram Optional: Select how to show reference lines Select patient position Select API Language Click OK to confirm the entries