Biograph™ TrueD Lite Online Training

Welcome to the BiographTM TrueD Lite Online Training. In this training you will learn the basics about the features and functions of the syngo TrueD Lite Application. The topics covered in this module will include: Process of loading the images Viewing the images Manipulation of images Using the Rotating MIP image Creating parallel and radial ranges Saving, printing, exporting and closing images Use of the TrueD cardiac layout and cine   Upon successful completion of this course you will be able to: Understand the tools and options used to view and manipulate images   Load and register the patient data    Save, film, print, export and close images Define the purpose of the TrueD Lite Application and its functions Zoom and realign the images into cardiac orientation Understand and define the TrueD 4D cine feature Congratulations. You have completed the Biograph TrueD Lite online training. Listed below are the key points that have been presented. Take time to review the material before you proceed to the final quiz. Download and print a copy of the Course Review. Overview of the TrueD Lite User Interface The TrueD Lite is a medical diagnostic application for viewing, manipulating and providing 3-D visualization The application is available in the Biograph syngo MI Acquisition Workplace and the optional MI Workplace You can launch the TrueD application automatically and manually TrueD Lite enables you to review image data before sending it to the physician’s reading workstation or PACs. Image Registration In the TrueD Lite application you use the Image Registration to align images from different modalities in one time-point. The Reference series is fixed and the Model series is transformed to align. The following tools are available to register images: ​Volume Registration Tab: This allows you to select the data set to register Automatic Registration: This will automatically register the Model Series to the Reference series Visual Alignment: This gives you the ability to translate or rotate the model image to align it to the reference image using increment buttons Landmark Registration: This is another rigid method that you can use to align your reference and model images ​Viewing images The TrueD Lite application provides you with several tools in the common control area that assist you in viewing images in TrueD. The following tools are available to view images and are not self explanatory: Zoom/Pan mode to zoom and pan the image Layout Gallery to view the images and to see the layout formats The Sphere VOI is the only option in the TrueD Lite application to draw a VOI of a predetermined diameter The Pixel Lens tool gives you the ability to interrogate the pixels in an image Manipulation Images  Navigation: Dog Ear Control, Parallel Shift, Reference Lines, Rotate MIP Images, Stripe Layout Scroll Bar and Orientation Cube, Blending CT & MR with PET or SPECT Images Windowing: Visualization Tab, Mouse, PET & SPECT Windowing Bars ​ Creating Parallel Ranges & Radial Ranges Configuring Output Series Parameters Creating Parallel Ranges Automatically Creating MIP Ranges Saving, Filming, Printing & Closing the images After viewing and loading the images you have also the following options in the TrueD Lite application: ​To save an image as a new series and automatically load it to the Viewing task card To export display areas or individual images  To copy the currently displayed images to the syngo Filming task card To print the images  To close the current patient    Cardiac Layout & 4D Cine Display You can zoom and realign cardiac images as well as cine gated anatomical and functional images simultaneously. The syngo TrueD Lite is a medical diagnostic application for viewing, manipulating, and providing 3D visualization of medical images from multiple imaging modalities. The application supports functional data, such as PET or SPECT as well as anatomical data sets, such as CT or MR. You can view the images in a number of output formats including MIP and volume rendering (VRT). The application is available on the Biograph syngo MI Acquisition Workplace. Learn more about the TrueD Lite version Learn more about the TrueD Lite version Base ImageHotspotsText BlocksImage FileButtons for printing images, exporting images, loading images to Viewing task card, saving images, and closing the patient.View and layout controlsImage segment display area  Subtask cards (Volume Registration, Visualization, MIP, Quantification, Report)  Time-point icons   Learn more about the Launch and Loading of the Tru Learn more about the Launch and Loading of the TrueD Lite version Slide NumberText BlocksCalloutsAudio ScriptImage File1TrueD Lite can be launched in two ways. You can set up your protocols to automatically launch the application after the study is acquired and processed. You can also choose to launch the application manually.  Automatic Launch - TrueD  After selecting the current patient and the current recon job go to the Auto-Tasking subtask Card.   In the Auto Display field select TrueD in the drop-down menu.    TrueD Lite can be launched in two ways. You can set up your protocols to automatically launch the application after the study is acquired and processed. You can also choose to launch the application manually. In this section, we are going to explore these 2 methods for launching the application. To automatically launch TrueD Lite for the current patient and selected recon job, go to the Auto-Tasking subtask card. In the Auto Display field, select TrueD in the drop-down menu. When the reconstruction is complete, the series will automatically load into the application. You can also save the protocol with the Auto Display to TrueD checked. 2Manual Launch From the menu bar in the upper left corner, select Applications and select TrueD in the drop-down menu.   Open the Patient Browser and double-click to select the desired Study or Series. CalloutsMenu barStudy or Series DataTrueD Lite can also be launched manually after you have ended the study. From the menu bar in the upper left corner, select Applications and select TrueD in the drop-down menu. Open the patient browser and double-click to select the Study or Series you would like to load into the application. The TrueD Lite application provides you with several tools in the common control area that assist you in viewing images in TrueD. Some of these tools are self-explanatory and others require more detailed instruction. Click the tabs below to learn more about the options for viewing images. Learn more about Viewing Images Learn more about Viewing Images Slide NumberText BlocksCalloutsAudio ScriptImage File1Common Tools In the common control area, there are 15 buttons. Each one performs a different task. Show/Hide Reference Lines to show or hide the reference cross lines on the images. Zoom/Pan to zoom or pan the image. Change image segment view to coronal.  Change image segment view to sagittal. Change image segment view to axial.  Display Layout Gallery to change the layout format. CT Presets (7-10): ​a) Window Presets A, B, C can be configured to commonly used CT windows. b) Window 1/Window 2 toggle: Allows toggling with no preset window applied. In the common control area, there are 15 buttons. Each one performs a different task. The Show/Hide Reference Lines button will show or hide the reference cross lines on the images. The Zoom/Pan tool allows you to zoom or pan the image. With buttons 3 to 5 you can change the image segment view to coronal to sagittal or to axial. The button Display Layout Gallery allows you to change the layout format. Next are the CT Preset windows which are numbered 7 through 10. CT Window Presets A, B and C can be set up in the TrueD configuration, and they will allow you easy selection of commonly used CT windows 10. With the CT Window 1 and Window 2 Toggle button you can toggle between CT Windows 1 and 2 with no preset window applied. 2Common Tools Sphere VOI (Volume of Interest) button creates a sphere VOI at the current reference line crosshair. Enable/Disable Pixel Lens button is used to exam pixel quantification data. Enable/Disable Correlated Cursors button provides two or more cursors to be used during evaluation. Link/Unlink button is not used in TrueD Lite. Data Units button allows you to select SPECT or PET image data units, such as SUV (Standard Uptake Value) or Becquerels/cc. The Sphere (Volume of Interest) VOI button creates a sphere VOI at the current reference line crosshair. You can use the Enable/Disable Pixel Lens button to exam pixel quantification data. The Enable/Disable Correlated Cursors button provides you two or more cursors to be used during evaluation. Link/Unlink button is not used in TrueD Lite. The Data Units button allows you to select SPECT or PET image data units, such as SUV (Standard Uptake Value) or Becquerels (bek-er-rels) per cubic centimeter.3Zoom/Pan mode To enter Zoom/Pan mode, click the Zoom/Pan button in the Common Tools. ​Move your cursor over to the image segment. Move the cursor to the center of the image and the Pan cursor appears. Use the left mouse button to pan the image. When you want to zoom in or out on the image, move the cursor to the periphery of the image until you see the cursor change to the zoom mode. Click the left mouse button and drag the image up and down to increase or decrease the zoom. To reset the zoom to the original setting, click the Home Zoom/Pan button on the Visualization Tab. CalloutsZoom/Pan buttonTo enter Zoom/Pan mode, click the Zoom/Pan button in the Common Tools. Move your cursor over to the image segment. Move the cursor to the center of the image and the Pan cursor appears. Use the left mouse button to pan the image. When you want to zoom in or out on the image, move the cursor to the periphery of the image until you see the cursor change to the zoom mode. Click the left mouse button and drag the image up and down to increase or decrease the zoom. To reset the zoom to the original setting, click the Home Zoom/Pan button on the Visualization Tab. 4Layout Gallery By clicking on the Layout Gallery button, you will see the layout formats that are available to you for the types of datasets that you have selected. The number of image segments displayed in the syngo TrueD task card is indicated in layout nomenclature by a row/column number designation.   Layouts include: Non-fused images, which are displayed in separate segments Fused images, which are displayed as overlaid images  ​Note: You can create custom layouts as well. CalloutsLayout Gallery buttonBy clicking on the Layout Gallery button, you will see the layout formats that are available to you for the types of datasets that you have selected. The number of image segments displayed in the syngo TrueD task card is indicated in layout nomenclature by a row/column number designation.  For example, an image segment with 2 rows and 3 columns would be described as a “2 by 3” layout. Layouts include Non-Fused, Fused, and Combined categories, which determine how to handle images from multiple modalities.  Non-fused images are displayed in separate segments and fused images are displayed as overlaid images.  Besides the layouts provided, you can create custom layouts as well. 5Sphere VOI The Sphere VOI is the only option in the TrueD Lite application to draw a VOI of a predetermined diameter for analysis.  Triangulate the area on the image where evaluation is desired. Click on the Sphere VOI button. Move your mouse over to the image and click and drag to create a VOI. When you release the mouse button, the SUV and Hounsfield units will display. CalloutsSphere VOI buttonSUV and Hounsfield units The sphere VOI is the only option in the TrueD Lite application to draw a VOI of a predetermined diameter for analysis. To use this tool, first triangulate the area on the image where evaluation is desired. Next, click on the Sphere VOI button. Move your mouse over to the image and click and drag to create a VOI. When you release the mouse button, the SUV and Hounsfield units will display.6Pixel Lens You can interrogate the pixels in an image and get measurements correlated to a particular dataset SUV or Becquerels/cc for PET or SPECT Hounsfield units for CT images Fused images will show both displays To use the pixel lens tool, click the Pixel Lens button in the Common Tools area. With the mouse, move the cursor over the areas of the image where you would like to interrogate. Correlated Cursors Replication of cursor movements White cursor = main cursor Yellow cursors = replicated cursors Available when examining registered images in a single time-point using a non-fused layout. ​To enable correlated cursors, click the correlated cursors button   The Pixel Lens tool gives you the ability to interrogate the pixels in an image and get measurements correlated to a particular dataset. For instance, you will get SUV or Becquerels (bek-ker-els) per cc (cubic cm) for physiological images (PET or SPECT) and Hounsfield units for CT images. If you have fused images, you will see both displays. To use the pixel lens tool, click the Pixel Lens button in the Common Tools area. With the mouse, move the cursor over the areas of the image where you would like to interrogate. With correlated cursors enabled, the cursor movements are replicated so that any point on any segment pointed to by the main (white) cursor is also shown by the replicated (yellow) cursors in the other segment. Correlated cursors are available when examining registered images in a single time-point using a non-fused layout. To enable correlated cursors, click the correlated cursors button. After viewing and loading the images you have also the following options in the TrueD Lite application: To save an image as a new series and automatically load it to the Viewing task card To export display areas or individual images  To copy the currently displayed images to the syngo Filming task card To print the images  To close the current patient  Click the tabs below to learn more about Saving, Filming, Printing & Closing Images.   Learn more Learn more about Saving, Filming, Printing & Closing Images Base ImageHotspotsText BlocksImage FileSave and Load to Viewing button To save an image as a new series and automatically load it to the Viewing task card, perform the following steps: Select the image segment.  Click the Save and Load to Viewing button. Another way is to select the image segment and then pull down the Patient menu item and select Save and Load to Viewing. Close Patient button Use the Close Patient button to close the current patient. It is also possible to  pull down the Patient menu item and select Close Patient.Export Button To export display areas or individual images as bitmap, jpeg or emf files, perform the following steps: Select the image(s) to export. Click the Export Image button, or pull down the Patient menu item and select Export Image. The Export Image dialog box appears. In the dialog box enter the file name and specify the destination folder for the images. Click the Export button. .     Print button Click the Print button to print the currently displayed images. A standard Print dialog box appears, allowing you to choose on which printer to print the images.  Copy to Film Sheet button To copy the currently displayed images to the syngo Filming task card, perform the following steps: Display the images to be copied. Click the Copy to Film Sheet button. Another option is to pull down the Patient menu item and select Copy to Film Sheet.  The images will be then be transferred to the Filming task card. Save Image button You can save the image displayed in the selected segment as a new series. Then you can open the image in the syngo Viewing task card for later evaluation. To save the current image perform the following steps: Select the segment that you would like to save. Click the Save Image button. You can also pull down the Patient menu and select Save. This image is saved as a Collection series in the database. . The TrueD Lite application provides you with several tools to manipulate the images in the TrueD Lite application such as: Navigation Windowing Blending Rotating the MIP image Click the tabs below to learn more about the options for viewing images.   Learn more about Navigating Images Learn more about Navigating Images Slide NumberText BlocksCalloutsAudio ScriptImage File1There are several ways to navigate through the images:  Dog Ear Control Parallel Shift  Reference Lines  Rotate MIP Images Stripe Layout Scroll Bar Orientation Cube Blending CT & MR with PET or SPECT Images Dog Ear Controls The Dog Ear Controls allow you to scroll through the image slices using left mouse clicks.  Click to view the next slice ("behind" the current one). Click to view the previous slice ("in front" of the current one). There are several ways to navigate through the images. The Dog Ear Control, the Parallel Shift, the Reference Lines, the Rotate MIP Images, the Stripe Layout Scroll Bar, the Orientation Cube Blending CT & MR with PET or SPECT Images. The Dog Ear Control allows you to scroll through the image slices using left mouse clicks. In this image, you are shown where to click to view the previous and next slices. 2Parallel Shift To access the Smart Menu, move your cursor to an image segment. Press and hold the right mouse button until it displays. Drag the mouse over to the Parallel Shift. You will see the cursor turn into the Parallel Shift cursor.  To shift through the images, move the pointer over the segment. Click to drag up or down using the left mouse button. The segment will page through the images relative to the length of the pointer movement. CalloutsParallel Shift Parallel Shift cursorYou can also use a tool called Parallel Shift to navigate through the images. This tool can be accessed through the Smart Menu. To access the Smart Menu, move your cursor to an image segment then press and hold the right mouse button until it displays. Drag the mouse over to the Parallel Shift. You will see the cursor turn into the Parallel Shift cursor.  To shift through the images, move the pointer over the segment, then click to drag up or down using the left mouse button. The segment will page through the images relative to the length of the pointer movement. 3Reference Lines You can use the reference lines to step through the images in the orientation views.  Option: Drag the intersection point (or cross-hairs) to move both reference lines together. Option: Drag the desired reference line with the cursor. Click on a desired position in an orientation segment to place the intersection at that point. All the segments will triangulate to that position. Each reference line is color-coded as well as the border of the images. Blue corresponds to trans-axial, red corresponds to sagittal and green corresponds to coronal.CalloutsTransaxial Reference Line (blue)Sagittal Reference Line (red)Coronal Reference Line (green)To use the reference lines to step through the images in the orientation views drag the intersection point (or cross-hairs) to move both reference lines together. It is also possible to drag the desired reference line with the cursor. Lastly, you can click on a desired position in an orientation segment to place the intersection at that point. All the segments will triangulate to that position. Each reference line is color coded as well as the border of the images. Blue corresponds to trans-axial, red corresponds to sagittal and green corresponds to coronal(ca-ro-nul).4Rotate the MIP Image  Click on a pick point in the MIP image. The image planes intersecting with the pick point are displayed in the MPR views. 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.  CalloutsRotate MIP Image Scroll BarWith 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. In a Stripe layout, you can use the scroll bar at the bottom of the task card to navigate through the displayed image slices. 5Orientation Cube The following positions are labeled: A displays the front view going from Anterior to Posterior, P indicates the rear view going from Posterior to Anterior, L indicates the left view going from Left to Right, R indicates the right view going from Right to Left, H indicates the top view going from Head to Feet; towards posterior, a check mark is displayed below the H. F indicates the bottom view going from Feet to Head. ​Blending CT & MR with PET or SPECT Images To blend the fused images, toggling between the anatomical images to the functional images, use the blend bar located below the common tools. CalloutsOrientation CubeBlend barTo indicate the orientation and slice positions of the image you are viewing click on the Orientation cubes. You can see the Orientation cubes on each image segment. The following positions are labeled: A displays the front view going from Anterior to Posterior,P indicates the rear view going from Posterior to Anterior,L indicates the left view going from Left to Right, R indicates the right view going from Right to Left,H indicates the top view going from Head to Feet; Towards posterior, a check mark is displayed below the H. Lastly,  F indicates the bottom view going from Feet to Head. You can blend the fused images, toggling between the anatomical images to the functional images. To do this, use the blend bar located below the common tools. Learn more about Windowing Learn more about Windowing Slide NumberText BlocksCalloutsAudio ScriptImage File1Visualization Tab The Visualization Tab has the following options: Select CT window level presets from the drop-down menu. ​Select PET or SPECT color LUTs (look up tables) from the drop-down menu. If you have a fused image, the Fused LUT drop-down menu allows you to select an LUT for the PET or SPECT dataset. ​Use the Masking tool for PET or SPECT images. To change the top and bottom values use the slider end handles or spin boxes. You can change the center point of the threshold by sliding the middle handle. The Home Zoom/Pan button returns the image to the default.  The Home Windowing button returns the windowing levels to default. ​Home Orientation brings the orientation of your images back to default. ​You can use the Volume Punch tool to cut out areas of your CT image. One of the methods for windowing images is to use the Visualization tab. In this tab, you can select CT window level presets from the drop-down menu. You can also select PET or SPECT color LUTs (look up tables) from the drop-down menu. If you have a fused image, the Fused LUT drop-down menu allows you to select an LUT for the PET or SPECT dataset. You can use the Masking tool for PET or SPECT images. To change the top and bottom values use the slider end handles or spin boxes. You can change the center point of the threshold by sliding the middle handle. The Home Zoom/Pan button returns the image to the default. The Home Windowing button returns the windowing levels to default. The Volume Punch tool can be used to cut out areas of your CT image. Home Orientation brings the orientation of your images back to default.2The Mouse To adjust brightness, click and drag up or down using the center mouse button in the display segment on either side of the image. To adjust contrast, click and drag right or left using the center mouse button in the display segment below the image.   To adjust the CT or MR image windowing for Fused MPR images, 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. CalloutsCenter mouse buttonAdjustments of CT or MR image windowing for Fused MPR images  Adjustments of the PET or SPECT image windowingYou can also window images with the mouse. To adjust brightness, click and drag up or down using the center mouse button in the display segment on either side of the image. To adjust contrast, click and drag right or left using the center mouse button in the display segment below the image.  To adjust the CT or MR image windowing for Fused MPR images, 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. 3PET & SPECT Windowing Bars PET and SPECT windowing bars are available for adjusting window levels.  To adjust maximum window intensity (contrast), click and drag the upper handle. To adjust minimum window intensity (contrast), click and drag the lower handle. To see a double windowing bar load both attenuation-corrected (AC) and non-attenuation-corrected (NAC) images. CalloutsAdjust minimum window intensityAdjust center window intensityAdjust maximum window intensityAC Windowing BarNAC Windowing BarPET and SPECT windowing bars are available for adjusting window levels. This image is a depiction of a single PET or SPECT series windowing bar. To adjust maximum window intensity (contrast), click and drag the upper handle. To adjust minimum window intensity (contrast), click and drag the lower handle. You will see a double windowing bar when you load both attenuation-corrected and non-attenuation-corrected images You can create parallel and radial ranges using the TrueD Lite application to send to another workstation or a PACS system. It is also possible to create an output series from the currently displayed time-points. This allows you to load different 3-D orientation images as 2-D images in PACS.   Click the tabs below to learn more about creating parallel and radial ranges.   Learn more about creating parallel & radial ranges Learn more about creating parallel & radial ranges Slide NumberText BlocksCalloutsAudio ScriptImage File1Configuring Output Series Parameters In order to create these slices automatically, you can set up your TrueD configuration to create the ranges you want. Perform the following steps: Go to the Examination Task Card. Click on the Options menu and select Configuration. From the Configuration panel, double click on the TrueD icon. CalloutsConfiguration panelTrueD iconIn order to create these slices automatically, you can set up your TrueD configuration to create the ranges you want. To do this, go to the Examination Task Card. Click on the Options menu and select Configuration. From the Configuration panel, double click on the TrueD icon.2Configuring Output Series Parameters After selecting the TrueD icon the TrueD configuration window opens and you will see some tabs along the top. Click on the Documentation tab. Select the modality Type. Select the Orientation of the ranges. Click in the checkbox, if you want to resample the functional images to match the slices of the anatomical images of your fused ranges. Select the slice distance of the ranges. Click the Apply button. Click the OK button. When the TrueD configuration window opens, you will see some tabs along the top. Click on the Documentation tab. Next, select the modality Type. Select the Orientation of the ranges Then click in the checkbox if you want to resample the functional images to match the slices of the anatomical images of your fused ranges. Select the slice distance of the ranges. Lastly, click the Apply button and then click the OK button. 3Creating Parallel Ranges Automatically To automatically create parallel ranges, perform the following steps: Load the images that you would like to use into the TrueD Lite application. Pull down the Image menu and select Create Ranges. The ranges will be automatically created and saved into the database. To automatically create parallel ranges using the configuration settings, load the images that you would like to use into the TrueD Lite application. Pull down the Image  menu and select Create Ranges. The ranges will be automatically created and saved into the database. 4Creating MIP Ranges To create MIP Ranges perform the following steps: Click on the transaxial image segment. Click on the Type menu and select MIP. Click on the Image menu and select Create MIP Ranges. You have the ability to create MIP or Radial Ranges in TrueD Lite as well. To do this, click on the transaxial image segment. Click on the Type menu and select MIP.Click on the Image menu and select Create MIP Ranges. Your ranges will be created and saved to your database. Image Registration is the process of aligning images from different series. You can use this function to align images from different modalities in one time-point:  Reference series is fixed: Anatomical image (CT and MR) Model series is transformed to align series: Physiological image (PET and SPECT) Note: Patient motion can cause artefacts and improper attenuation correction which can affect quantification and outcomes. Learn more about Image Registration Learn more about Image Registration Slide NumberText BlocksCalloutsAudio ScriptImage File1Volume Registration Tab    To select the data set to register click on the Data Sets options. The Result drop-down list allows you to select the registration matrix to load, or enter a name for the new matrix. To revert to the last saved matrix registration you can use the Home Registration button. The Save button allows you to save the current registration in the Result drop-down list. To save all unsaved registrations click on the Save All button. Using the Delete Registration button you can delete the currently selected matrix in the Result drop-down list. CalloutsSelect Data Sets Result drop-down listHome Registration buttonSave buttonSave All buttonDelete Registration buttonAt the top of the Volume Registration Tab you can find the Data Sets options that allow you to select the data set to register. In the TrueD Lite version, you only have one time-point, so this is not used. To select the data set to register click on the Data Sets options The Result drop-down list allows you to select the registration matrix to load, or enter a name for the new matrix To revert to the last saved matrix registration you can use the Home Registration button. The Save button allows you to save the current registration in the Result drop-down list. The Delete Registration button deletes the currently selected matrix in the Result drop- down list. 2Automatic Registration Automatic Registration will automatically register the Model Series to the Reference series. It uses a rigid registration mode to accomplish this. You can automatically register the model with the reference image by using the Automatic Registration button. You can perform the registration according to the current drop-down list in the Data Sets field by clicking on the Data Set button.  The Register All button registers all currently loaded time-points. The Cancel button cancels the automatic registration operation. CalloutsAutomatic Registration buttonData Set buttonRegister All buttonCancel button​Automatic Registration will automatically register the Model Series to the Reference series. It uses a rigid registration mode to accomplish this. The Automatic Registration button automatically registers the model with the reference image. The first button in the Automatic Registration list is the Data Set button. This button performs the registration according to the current drop down list in the Data Sets field. The Register All button registers all currently loaded time-points and the Cancel button cancels the automatic registration operation.3Visual Alignment  The Visual Alignment tool gives you the ability to translate or rotate the model image to align it to the reference image using increment buttons.   Shift the long axis direction using the arrows labeled here. The rotate around axis arrows allow you to rotate the image. Each of these arrows offers a gross adjustment and a fine adjustment to the image position. You can also use the visual alignment to pan and rotate the model image over the reference image. To pan the model image relative to the reference image, move the mouse over the image until the pan cursor appears. Click and drag using the left mouse button. To rotate the model image, move the mouse to either side of the image (but still in the segment) until the rotate cursor appears. Click and drag using the left mouse button.  CalloutsVisual Alignment IconFine adjustmentsGross adjustmentsRotate around axisShift Long Axis directionThe Visual Alignment tool gives you the ability to translate or rotate the model image to align it to the reference image using increment buttons. Shift the long axis direction using the arrows labeled here. The rotate around axis arrows allow you to rotate the image. Each of these arrows offers a gross adjustment and a fine adjustment to the image position. You can also use the visual alignment to pan and rotate the model image over the reference image. To pan the model image relative to the reference image, move the mouse over the image until the pan cursor appears, then click and drag using the left mouse button. To rotate the model image, move the mouse to either side of the image (but still in the segment) until the rotate cursor appears, then click and drag using the left mouse button. 4Landmark Registration  Landmark registration is another rigid method that you can use to align your reference and model images.  To place landmarks on the image select the Landmark Registration button. Landmark Registration List lists all of the landmarks added to the image.  Add New Landmark button adds a new landmark to the registration crosshair intersection. To go to the landmark selected in the landmark list select the Go To Selected Landmark button. Update Landmark button updates the selected landmark with the current registration coordinates. Delete Selected Landmark button deletes the landmark selected in the landmark list.   To delete all landmarks on the image select the Delete All Landmarks button.  CalloutsLandmark Registration button  Add New Landmark button Go To Selected Landmark buttonUpdate Landmark button Delete Selected Landmark buttonDelete All Landmarks buttonLandmark Registration ListLandmark registration is another rigid method that you can use to align your reference and model images. This image depicts the features shown on the Volume Registration tab. The Landmark Registration button allows you to place landmarks on the image and the Landmark Registration List lists all of the landmarks added to the image.  The Add New Landmark button adds a new landmark to the registration crosshair intersection   The Go To Selected Landmark button goes to the landmark selected in the landmark list.  The Update Landmark button updates the selected landmark with the current registration coordinates. The Delete Selected Landmark button deletes the landmark selected in the landmark list.  The Delete All Landmarks Button deletes all landmarks on the image. 5To use landmark registration, perform the following steps: Click on the Landmark Registration button on the Volume Registration window. ​Click on an area within the patient image where you would like to create a landmark.   Select the Add New Landmark button on the Volume Registration window. This will add the landmark to the list. You will have to add a minimum of three landmarks for the registration initiation. The limit is 100. Once you have created all the landmarks, click the Save Registration button. CalloutsLandmark Registration buttonAdd New Landmark buttonLandmark listSave Registration buttonTo use the landmark registration, the first step is to click on the Landmark Registration button on the Volume Registration window. For the next step, click on an area within the patient image where you would like to create a landmark.  Click the Add New Landmark button on the Volume Registration window. This will add the landmark to the list. You will have to add a minimum of three landmarks for the registration initiation. The limit is 100. Once you have created all the landmarks, click the Save Registration button. In the TrueD Lite application you can zoom and realign cardiac images as well as cine gated anatomical and functional images simultaneously. TrueD Lite will automatically realign and zoom a cardiac study. When a cardiac study is loaded, it defaults to the standard transverse, sagittal and coronal layout that you need for whole-body images. With the Cine display in TrueD Lite, you can navigate to other gates, or play the cine sequence of gates, using the Cine Control. The 4D Cine Control is displayed automatically any time a gated series is loaded. Click the tabs below to learn more about the TrueD Lite Cardiac Layout and 4D Cine Display. .   Learn more about TrueD Cardiac Layout Learn more about TrueD Cardiac Layout Base ImageHotspotsText BlocksImage FilePatient Axis button to autozoom the heartCardiac Axis View button - This autozooms the heart and orients it in the standard cardiac orientation of short axis, vertical long axis and horizontal long axis.Orthogonal view Learn more about the Cardiac 4D Cine Display Learn more about the Cardiac 4D Cine Display Base ImageHotspotsText BlocksImage FilePlay forwardNext gatePrevious gateSlider for stepping through gates interactively 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 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. The information in this material contains general technical descriptions of specifications and options as well as standard and optional features that do not always have to be present in individual cases. Certain products, product related claims or functionalities described in the material (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