How to Enable and Use DirectDensity

How to Enable and Use DirectDensity CT for Radiation Oncology Workflow Siemens’ DirectDensity1 enables the reconstruction of CT image datasets that display relative electron density information. CT acquisitions can now be patient-optimized for both dose and image quality in that individualized kV settings can be used without the need for additional cal- ibration curves for treatment planning. DirectDensity enables personalization and standardiza- tion in CT imaging for therapy planning, all in a familiar, routine workflow. 1. Build a DirectDensity Validation Protocol o Select the desired default or customized (if available) protocol o On the Scan Tab: 1. Enable CARE Dose4D 2. Set CARE kV to Semi and ensure the kV is set to 120kV RT_Abdomen_IR (Adult) DIRECT DENSITY 0000000 Total mAs: O Topogram Abdomen RT CARE Dose4D M CARE KV Semi Slice 4.0 mm - Acq. 16 x 1.2 mm Pitch 0.6 2 Eff. mAs kV 120 - Direction Craniocaudal Organ characteristic: Abdomen CTDIvol (32cm): mGy DLP: mGy*cm Scan time 19.13 s Scan start Start button Rotation time 1.0 s Delay 2 s Language German API None Load Hold Recon Recon Routine Scan Recon Auto Tasking o On the Recon Tab 1. For the first (already available) reconstruction job, ensure that the kernel/algorithm is the desired routinely-used kernel/algorithm 2. Add a second (new) reconstruction job by clicking the next available radio button  All of the parameters from the first (already available) reconstruction will be duplicated. Change only the kernel/algorithm of this second recon job:  If SAFIRE/ADMIRE is disabled, select the E30 (DirectDensity) kernel  If SAFIRE/ADMIRE is enabled, select the F30 (DirectDensity) algorithm 1 ) DirectDensity™ reconstruction is designed for use in Radiation Therapy Planning (RTP) only. DirectDensity™ SIEMENS reconstruction is not intended to be used for diagnostic imaging. Healthineers Job Aid | How to Enable and Use DirectDensity Effective Date: 07/31/2018 | Quality HOOD05162002923957 DIRECT DENSITY 0000000 Total mAs: O Recon job 2 3 4 5 7 Series description Abdomen 4.0 E30s 00 Slice 40 mm Recon job type o Axial + 3D ADMIRE Recon region: Narrow Wide . Kernel E30s medium smoMAR None 1 2 3 5 6 8 FAST Series description Abdomen 4.0 F30s 3 Window Abdomen Recon job Slice 4.0 mm Recon job type o Axial + 3D ADMIRE ( Strength 3 Recon region: Narrow . /Vide o HD FoV FoV 500 mm :: mi Algorithm F30s medium smc- iMAR None Center X 0 mm FAST Window Abdomen Begin position .459.0 mm: Overview Center Y 0 mm E End position 659.0 mm Mirroring None Comme Extended CT scale HD FOV FoV 500 mm == Image order Craniocaudal Routine Scan Recon Auto Task Center X 0 mm Increment 4.0 mm Overview Center Y 0 mm No. of images 51ª Mirroring None Comments Extended CT scale Routine Scan Recon Auto Tasking No checkup performed so far. Select Setup/Checkup. 03-Jul-2018 13: o NOTE: The first reconstruction job with the conventional kernel/algorithm should be used for contouring. These images will have optimized image quality due to the automatically-selected kV value for that patient. The second reconstruction job – with DirectDensity – should be used for the dose calculation. 2. Validate DirectDensity Data/Acquisition for Treatment Planning Curves o Scan the desired electron density phantom (Gammex, CIRS, etc.) using Semi and 120kV o Add a reconstruction Patient Applications Transfer Scroll Evaluation Options System Help Density_Gammex 2 Examination job and enable Density_Gammex_2 04/26/17, 0, 1D Density_Gammex_? 04/26/17 DirectDensity by 16:08:14.14 Density_Gammex_ 22 IMA 11 SPI 7 choosing either the E30 SP 21.0 1 Min/Max -100 /76 Viewing kernel or the F30 Mean/SD. 0.0 /27.4 algorithm Min/Max: 682 /760 Mean/SD: 721 4/15.1 o Utilize the ROI 3 Min/Max: -561 /-405 3D measurement tool in 3 Mean/SD: -487.8 /28.8 5 Min/Max. - 91 /70 5 Mean/SD. 0.9 /29.2 6 Min/Max: -60 -6 Mean/SD: 1.3 /28.0 the Viewing Task Card Min/Max: -187 /6 7 Mean/SD: -107.5 /29.1 Tools |Image | View to obtain CT values from both datasets o Enter the CT values of 1.0cm both datasets into the Patient | Eval TPS kV 80 eff.mAs 350 TI 1.0 GT 0.0 SL 5.0/20x0.6/p0.55 300 0/0 E30s S129C0 21 M 5x5 -7772 120 Siemens Healthineers Services Page 2 of 4 © Siemens Healthcare GmbH, 2017 Job Aid | How to Enable and Use DirectDensity Effective Date: 07/31/2018 | Quality HOOD05162002923957 o NOTE: Additional scans can be acquired in the same manner, using Semi and other available kV settings (e.g. 70kV, 80kV, 100kV, 140kV,) for further validation of the DirectDensity numbers, 3. Implement DirectDensity into the Scanning Routine o After comparing and validating the resulting HU and relative electron density values using the DirectDensity kernel/algorithm: 1. Change CARE kV from Semi to On and re-save the protocol.  CARE kV will automatically select the most appropriate kV setting going forward based on the individual patient size and the clinical needs of the scan, as prescribed in the CARE kV slider bar. DIRECT DENSITY 0000000 Total mAs: O CARE Dose4D M CARE KV On Slice 4.0 mm Acq. 16x1.2mm Pitch 0.6 Eff. mAs KV Direction Craniocaudal Organ characteristic: Abdomen CTDIvol (32cm): mGy DLP: mGy*cm Scan time 19.13 Scan start Start button Rotation time 1.0 s Delay Language German API None Routine Scan Recon Auto Tasking Siemens Healthineers Services Page 3 of 4 © Siemens Healthcare GmbH, 2017 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 expres s 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 ………………………………………………………… Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Telephone: +49 9131 84-0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2017