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CT syngo 3D Task Card - Basic Postprocessing

This web-based training will provide all clinical and imaging professionals an overview of the most common types of image postprocessing. Prerequisite scan parameters will be reviewed, and the basics of Multiplanar Reconstruction (MPR), Maximum Intensity Projection (MIP), Volume Rendered Technique (VRT) and Surface Shaded Display (SSD) will be discussed.

Upon completion of this course, participants will be able to:
  • Explain the pre-requisites for 3D postprocessing
  • Identify the common types of postprocessing techniques
  • Describe the features of basic postprocessing tools

syngo 3D Task Card – Basic Postprocessing   This web-based training will provide all clinical and imaging professionals an overview of the most common types of image postprocessing.  Prerequisite scan parameters will be reviewed, and the basics of Multiplanar Reconstruction (MPR), Maximum Intensity Projection (MIP), Volume Rendered Technique (VRT) and Surface Shaded Display (SSD) will be discussed. Objectives   Describe the features of basic postprocessing tools   Explain the prerequisites for 3D postprocessing   Identify the common types of postprocessing techniques Upon completion of this course, participants will be able to: Select Next to continue. Evolution of 3D Post Processing Technical advancements in CT increase amount of data gathered Modern computing power can process information more quickly 3D now routine part of patient exam Basic 3D tools improve workflow and enhance axial data Cross-sectional CT Image Properties Pixel/Voxel Volume Isotropic Resolution Post Processing Prerequisites Quality source data is necessary Garbage in --> garbage out Most prerequisites are the same, regardless of how data is post processed Multi-Planar Reconstruction/Reformations (MPR) Most common post processing tool Not *technically*  three-dimensional MPR Ranges Create a series of images along a defined plane Parallel Ranges Curved Ranges Change slice thickness, incrementation   Optimizing MPRs Slice Thickness Image incrementation/overlap Kernel or Algorithm Maximum Intensity Projection (MIP) Volume images that display the highest densities within a structure  Renders images in any projection or view, including X, Y, Z axis or interactive rotation. Contrast-filled blood vessels, which have high density, are shown very clearly while other tissues appear gray. Used most commonly for display of contrast-filled vascular structures. Maximum Intensity Projection (MIP) Volume images that display the highest densities within a structure Good for contrast filled vessels in CTAs Superimposes dense vessels and bones Visualize superimposed anatomy in a volume MIP Slab of data from the volume Thickness of slab can be adjusted Can create a range of MIP slabs to cover entire volume MIP Pros and Cons Pros: Accurate representation of CTA vasculature Reproducible results with different operators Cost and Time savings  Cons:    May misrepresent anatomic spatial relationship Without bone removal software - can require extensive editing    Surface Shaded Display Oldest type of post-processing Create a sub-volume of data based on a range (threshold) of densities Surface is generated Bone works well - high density voxels easy to segment compared to other anatomy Surface Shaded Display (SSD) Bone threshold typically >150 HU Changing threshold includes different anatomy   Surface Shaded Display - SSD Pros and Cons Pros: Very basic and easy to use post-processing option Cons: Not suitable for all anatomy Pathology can be obscured if wrong thresholding is applied Best only for smooth/soft kernels Volume Rendered Technique  (VRT) Renders entire volume of data - not just surface Each voxel in the volume is evaluated and classified VRT images can have transparency - can "see through" structures Volume Rendered Technique  (VRT) Renders entire volume of data - not just surface Displays transparency and opacity Window/level interactively adjust densities Bone removal not always necessary Volume Rendered Technique  (VRT) Pros: Able to see through surfaces Able to vary opacities/transparencies Better image quality than SSD Applicable to all types of anatomy Cons: Needs processing/graphics power Variable opacity may distort results VOI Clipbox and Punch Mode Manual volume editing Include or exclude anatomy Good for "cleaning up" non-essential parts of the image VOI Clipbox  Activate icon Adjust sides of box to include desired anatomy Deactivate icon to finish editing Anatomy may be rotated to edit in other planes   Activate icon Draw around anatomy in one motion or series of shorter segments Double click mouse to end drawing Select "Remove Inside" or "Keep Inside" Deactive icon to finsih editing Anatomy may be rotated to edit in other planes     Create a series of images as a 3D structure is rotated around an axis Define number of images and angulation between them Click the link below to view a step by step instruction on how to create 3d Radial Ranges. Bone Removal Separate bone from contrasted vessel Edit to refine what is included or excluded Follow the step-by-step instructions on how to perform a 3D Bone Removal over the next several pages. Surface Shaded Display (SSD) Click icon to create SSD volume Right click SSD icon to access SSD Definition properties Enter desired threshold/range of voxel densities Bone is usually > 150 HU Anything outside of range will not be displayed All remaining voxels will be shaded the same SSD cannot be windowed/leveled   Volume Rendered Technique  (VRT) Middle mouse to window/level VRT appearance Access VRT gallery with right-click on VRT icon Pixel Picture + Element Two-dimensional Smallest structure comprising an image Combined in X and Y to form a matrix Voxel Volume + Pixel Three dimensional cube of data Volume Element          Image 1                                                           Image 2                                               Image 3    Isotropic Resolution Early systems limited to thick reconstructions Produced images with asymmetric voxels Modern scanners routinely generate thin images Isotropic voxels are equal in all planes   Volume Building Axial images acquired Slices compiled Volume generated Image Reconstruction Parameters 30 - 50% image overlap Standard or smooth kernel or algorithm High resolution only for MPRs     Image Scanning Parameters Spiral Acquisition Thin Images FoV (Field of View) X/Y Coordinates Gantry Tilt Table Height Patient Orientation Multi-Planar Reconstruction/Reformations (MPR) Modern scanners acquire full volumes as opposed to only slices Volume can be reformatted into arbitrary planes Coronal Sagittal Paraxial/Oblique Curved Radiography includes more than one projection - why should CT be different?     Coronal Sagittal Paraxial Curved Multi-Planar Reconstruction/Reformations (MPR) Coronal - a plane dividing the anterior and posterior Sagittal - a plane dividing the left and the right Paraxial/Oblique - a straight plane off the X, Y or Z axis Curved - a plane along a curved or irregular axis Thicker images typically result in stairstep artifacts Thin source images deliver best post processed images Image Incrementation Spiral scanning allows for image overlap Eliminates data gaps Reduces partial volume artifacts Kernel - Algorithm Controlled noise Important for high contrast structures  - bone, lung Higher kernel = more noise Soft tissue and bone reconstructions for many studies Kernel recons require raw data Window/level setting for soft tissue and bone Changing window/level does NOT change kernel 3D Parallel Ranges allow volumetric data (usually presented as Axial slice image data) to be reformatted into other anatomic planes or projections (such as Coronal, Sagittal and/or Oblique   1      From the Patient Browser, load an appropriate data set into the 3D Task Card. Use thin-sliced data with a 50% overlap for best results. 2 To create a Coronal, Sagittal or Oblique range, use the existing Axial data as a planning base. Click in the Axial segment to make it active (displayed with a bold border).   3 Enable Parallel Ranges by clicking the Parallel Ranges icon. 4 Define the desired image thickness and distance between images. 5 Using the mouse, move the outermost lines to define the desired first and last slice positions. 6 Click Start on the dialogue box. A preview of the images created will populate in segment 4.   7 If the resulting images are satisfactory, click Save As to save images as a new series to the Patient Browser. 3D Curved Ranges allow volumetric data to be reformatted as a series of images that follow the path of a curved or tortuous object, like a vessel or other structure.   1         From the Patient Browser, load an appropriate data set into the 3D Task Card. Use thin-sliced data with a 50% overlap for best results. 2 To create a Coronal, Sagittal or Oblique range, use the existing Axial data as a planning base. Click in the Axial segment to make it active (active segments will be displayed with a bold border).   3 Enable Curved Ranges by clicking the Curved Ranges icon 4 Define the desired image thickness and distance between images. 5 Use the mouse to draw the desired path through the anatomy of interest, as one continuous line, or a series of smaller connected segments. You can scroll through the image stack and click in other images if the anatomy is not displayed on one slice. Double-click to end the drawing. 6 Click Start on the dialogue box. A preview of the images created will populate in segment 4.   7 If the resulting images are satisfactory, click Save As to save images as a new series to the Patient Browser. 3D Radial Ranges allow for the creation of rotating images – typically spins or tumbles – for the purpose of better visualizing a volumetric data set. 1     3D Radial Ranges allows for the creation of rotating images – typically spins or tumbles – for the purpose of better visualizing a volumetric data set. 2 To create a spin of the data set, use the existing Axial data as a planning base. Click in the Axial segment to make it active (active segments will be displayed with a bold border).   3    Enable Radial Ranges by clicking the Radial Ranges icon. 4 Define the desired image thickness and angle between images. 5 Use the mouse to draw the desired path through the anatomy of interest, as one continuous line, or a series of smaller connected segments. Scroll through the image stack and click in other images if the anatomy is not displayed on one slice. Double-click to end the drawing. 6 Click Start on the dialogue box. A preview of the images created will populate in segment 4.   7 If the resulting images are satisfactory, click Save As to save images as a newseries to the Patient Browser. The syngo 3D Bone Removal function provides a set of algorithms that you can use for CT datasets. With this function you can create an edited version of the volume by masking out bones. After you have identified structures in the volume as bone, you can choose different approaches to visualize or hide the bones in the dataset. Step 1: 1. Open the Patient Browser by selecting Patient > Browser from the upper left hand corner menu. 2. Select Local Database, which will display all of the patient examinations currently available on the system. 3. Find the desired patient and single-click on the patient name, highlighting it in blue. 4. Single-click on the desired study series (preferably a series of thinly-sliced images with overlap). Single click the series to highlight it in blue. 5. Load the series into the 3D application by selecting Applications > 3D > MPR from the upper left hand corner menu.     2 Select the Bone Removal icon on the Settings palette. 3    Select Region: Click the icon that corresponds to the body part scanned: Body – body (thorax, abdomen, pelvis, extremities) Head – head and neck CTAs Fracture – Used to separate two opposing joints for evaluation of fractures Once you select the body region, the software will automatically begin the segmentation. Refine: Once the segmentation is complete, the Step 2 dialogue box opens. Here you can refine the bone mask To use, click on the Set Marker icon. By setting markers in the images you are able to: remove bone fragments that are not removed in the automatic segmentation redisplay vessels, plaques and stents which were removed by the automatic Click on the desired anatomy to include or exclude it 5 Finish In the Finish tab card, you can control the visualization of segment volume and save the results and the bone mask The Display Mode offers four display options: Bone – the bone mask is inverted. The bone is shown and any non-bone tissue is hidden Highlight – Displays the Bone Region in color inside the VRT Transparent Non Bone – The bone mask is used to remove the bone from the volume that is displayed Both – the bone mask is NOT used; the whole volume is displayed as it was < >The Opacity slide bar allows you to set the opacity of the segmented anatomy when viewing in the composite mode Use the Save icon to save your work in the current state Close the Bone Removal tool when done   6 The resulting data set can be displayed as a VRT or a volume MIP. You can then create radial ranges or other images for transfer and archival to PACS or external media.

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