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Corridor4DM: MI Processing Screen How to Verify Auto-Processed Results

This document will aid the user in the verification of the left ventricle (LV) surfaces in generating contours, LV orientation, and basal limits.

 

Corridor 4DM: MI Processing Screen How to Verify Auto-Processed Results MI SPECT and SPECT/CT Description: This document will aid the user in the verification of the 4DM SPECT surface generator algorithm which accurately identifies the left ventricle (LV) surfaces in generat- ing contours, LV orientation, and basal limits. MI Processing Screen (SPECT only): The MI Processing screen replaces the Surf QA and Pmap QA screens as of version 2013. MI Pro- cessing allows users to verify the left ventricular surfaces and the location of the valve plane, when in QA mode. When minor adjustments are made to the HLA valve and VLA basal plane limits, the perfusion and function values immediately update. Be sure to click Save before quit- ting the application to save any changes. SPECT DE SPECT Tomo QA 4DM SPECT, 001, 004-001, 1D GS/R (Ischemic2) 52 yo Male 09 Mar 2007 15:36:19 Perfusion ED Pert ES Perfusio 16 Fr. Supine, FBP Te 99m Sestamité Images EDV: 99 ml (52 mim') esv: 31 mi (17 mim) Tomo QA EF: 60% Mass: 148 g. CO: 1.0 livin O) O ugVot: 55 ml, 10:- Fun - Quant V2-GSRDITONCM Wall Mollo Contractil MI Processing ED HLA ES HLA ED VLA ES VLA Gstress T 09 Mar 2007 15:37:05 Images Ung. Supire, FBP Tc-99m Sestamib UCVOE SE IL TI: 1.29 555:16 505:18 V2-GSRDICNCM 06.4 +/- 10.1 (104.7) % Images + Quant 66.7 +/- 11.0 (84.8) % 66.2 +/- 16.8 (104.7) % Func + Quant MIJ-HLA Mid-VLA BORESTIC IFBPI 09 Mar 2007 14:04:53 ting. Supire, FBP Tc-99m Tetrafosmin UgVok 45 ml, TO: - SRS: D V2-GSRDICNCM Dyssynchrony O 75.7 +4-9.6 (93.0) % O O 32.0 +/- 12.2 (103.0) % 71.1 -4. 135 (91.1) % 77.A +1. 12.5 (103,6) % MPI Summary Mid-HLA Mid-VIA Auto [ Une Figure 1: MI Processing Screen SIEMENS Healthineers Effective Date: 05/18/2018 | HOOD05162002675255 siemens.com/healthineers Job Aid | 4DM: MI Processing Screen Effective Date: 05/18/2018 | HOOD05162002675255 Perform Three Main Visual Checks: 1. Verify Contours  Verify the white 4DM contours properly track the inner and outer surfaces of the my- ocardium while excluding extra-cardiac activity.  Confirm the contours track properly for all datasets. ED emic2) GStr Frame: Ung Filter: None Ungated 15 21 28 28 33 28 28 20 In 33 ED HLA ES HLA ED VLA ES VLA Figure 2: Contour icon highlighted in orange. 2. Verify LV Orientation and Centering Check the orientation (tilt) of the study. Apex should be pointed to 12 o’clock for HLA views and to 3 o’clock in the VLA views. LV slices for all patient images should be cen- tered, tilted, and oriented symmetrically between all datasets. 33 28 28 33 ED HLA ES HLA ED VLA ES VLA Figure 3: Example of apex orientation for HLA and VLA views. Siemens Healthineers Services Page 2 of 5 © Siemens Healthcare GmbH, 2017 Job Aid | 4DM: MI Processing Screen Effective Date: 05/18/2018 | HOOD05162002675255 3. Verify Basal Limits for all Datasets The basal limits should be positioned at the base of the LV. If adjustments are necessary, click and drag the limit using the screen handle. The values are immediately updated on the screen. 33 28 28 33 ED HLA ES HLA ED VLA ES VLA Figure 4: Example of how basal limit can be adjusted. How to Verify Proper Placement of HLA and VLA Limits HLA: 4DM calculates Polar Map perfusion estimates such as defect extent, severity, and polar map displays from the placement of the valve plane limit on the HLA slice viewports. 4DM de- faults to automatically select the mid-membranous septum for basal limit placement based on the 4DM normal databases. Upon visual inspection of the automatic placement, the user is able to adjust the basal limit to ensure proper placement by repositioning the limit if necessary. After modifications are made, the same adjustment needs to be made to all remaining datasets. Consistency with basal plane limits will improve accuracy of polar maps. Perfusion 30 Mid-HLA Figure 6: Example of proper HLA Figure 5: Corresponding polar basal limit at mid-membranous map based on proper HLA basal septum. limits. VLA: 4DM calculates functional estimates such as LVEF %, TID, and volume values from the placement of the basal limit on the VLA slice viewport. Again, 4DM will automatically place the basal limit but it is important for the user to visually inspect the placement. The basal limit should be located where the ventricular intensity drops to <50% of the mid ventricular intensity. It may be helpful to change the LUT to GQS Step 10 in order to better identify the 50% color dropping point. Siemens Healthineers Services Page 3 of 5 © Siemens Healthcare GmbH, 2017 Job Aid | 4DM: MI Processing Screen Effective Date: 05/18/2018 | HOOD05162002675255 30 32 Mid VLA Mid-VLA Figure 7: Example of proper VLA basal limit. Figure 8: Example of improper VLA basal limit. 50% MI Processing Screen (SPECT/CT) Verify the auto-processed 4DM results for both NC (non-corrected) and AC (attenuation correc- tion) datasets. By default, 4DM displays the NC (gated, stress, and rest) datasets and the steps below need to be completed to view the AC datasets. Repeat steps 1-3 above for both the NC and AC datasets. It is important to be consistent in the processing of both the NC and AC data. 1. Click the green drop down arrow icon next to the first NC dataset Stress [Recon - No AC] to view AC datasets in addition to the NC. 2. Click the Predefined dataset layout Str/Rst/AC Str/AC Rst. Dataset Selector Use these controls to prioritize datasets in the Image Display Window. Select a predefined dataset layout or manually drag an available dataset into the desired display panel. Predefined Dataset Layouts: Dataset Display Panels: Study 1 Dataset 1 Dataset 2 GStr/Str/Rst GStr/Rst STRESS IRNC_SA REST IRNC_SA Str/Rst 10-Aug-2004 10-Aug-2004 GStr 13:36:12 11:17:00 AC Str/AC Rst Str/Rst/AC Str/AC Rst Dataset 3 Dataset 4 Rst/AC Rst × STRESS IRAC_SA REST_IRAC_SA 10-Aug-2004 10-Aug-2004 13:36:12 11:17:00 Available Datasets: Series Date Time Gating Info. Corrections |Status Study 1 STRESS FBP_SA_1 10-Aug-2004 13:36:12 Gated FBP Processed STRESS FBP_SA 10-Aug-2004 13:36:12 Ungated FBP Processed STRESS IRAC_SA 10-Aug-2004 13:36:12 Ungated IR:AC Processed STRESS IRNC_SA 10-Aug-2004 13:36:12 Ungated IR Processed REST FBP_SA 10-Aug-2004 11:17:00 Ungated FBP Processed REST IRAC_SA 10-Aug-2004 11:17:00 Ungated IR:AC Processed REST IRNC_SA 10-Aug-2004 11:17:00 Ungated IR Processed Save Cancel 3. Click Save to keep the layout selected for current session. These steps will need to be re- peated for each session. Siemens Healthineers Services Page 4 of 5 © Siemens Healthcare GmbH, 2017 Job Aid | Insert Title of Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS 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 Func- tionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales repr e- sentative 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 2018 ………………………………………………………… Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Telephone: +49 9131 84-0 siemens.com/healthineers Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018

  • Corridor4DM: MI Processing Screen How to Verify Auto-Processed Results