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NATIVE TrueFISP Scanning Workflow with Respiratory Gating (E-line)

Job Aid for scanning workflow of NATIVE TrueFISP with ECG Triggering

NATIVE TrueFISP Scanning Workflow with Respiratory Gating (E-line) syngo E-Line Software NATIVE TrueFISP is a flow-dependent non-contrast enhanced technique for MRA studies of the renal arteries. Because of the challenges of breathing motion, cardiovascular motion, and flow- dependent signal, the NATIVE TrueFISP protocol provides the most optimal results when each of these challenges are compensated for using gating and triggering options. 1. Position the patient on the table preferably in the Head First - Supine position. Feet First positioning will yield more restrictive SAR calculations. TrueFISP pulse sequences are relatively high SAR sequences. (1) (2) (3) SIEMENS 2. Position the Respiratory Cushion (2) on the patient. a. Place and secure the Respiratory Cushion by wrapping the Respiratory Belt (3) around the patient b. Connect the hose (2) from the respiratory cushion into the PERU c. Place the PERU in the PERU Cushion (1) d. Ensure that a consistent respiratory signal is being acquired by checking the Physio- logical Display M RESP RF: 20 /min RP: 3000 ms 3. Position the coil. Landmark & center the patient at the area of the renal arteries. Be sure that the PERU device is not immediately over the area being scanned, as it can create image artifacts on the NATIVE TrueFISP images. Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Job Aid | NATIVE TrueFISP Scanning Workflow with Respiratory Gating (E-line) Effective Date: 06/09/2020 | HOOD05162003096950 4. Run the Transverse and Coronal localizers. a. Note: The coronal localizer should include at least one image that shows the right and left renal arteries 5. Open the “NATIVE_trufi3d tra_p2_resp_trig” sequence 6. Position the Acquisition slab over the Renal Arteries a. Note: Position imaging FOV, set upper border of FOV very close to origin of the vessel of interest. Do not include too much of the proximal aorta in the FOV as FOV is limited in the head to foot direction. ............................................................................................................................................................. 10 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 2 of 6 Job Aid | NATIVE TrueFISP Scanning Workflow with Respiratory Gating (E-line) Effective Date: 06/09/2020 | HOOD05162003096950 7. Position the Top Inversion Region, so that top of the Inversion Band corresponds to the top of the Acquisition slab a. This ensures that the Inversion region extends well below the Acquisition slab, so that inflowing venous blood will not be imaged ............................................................................................................. wwwwwwwwwww .... www. ............................................................................................................ ............................ ..................................... 8. Go to the Geometry>Inversion tab and add a second inversion region a. Note: The second inversion region helps suppress inflowing venous blood in the inferior vena cava b. First Inversion Pulse should be 1350 ms at 150 mm c. Second Inversion Pulse should be 800 ms at 100 mm TA: 2:52 PM: ISO PAT: 2 Voxel size: 1.3x1.3x1.1 mm Rel. SNR: 1.00 tfi Common Saturation Inversion Navigator Tim Planning Suite Graph. Sel. Inversion 2 + TI 800 ms Thickness 100 mm Position LO.O PO.0 H121.4 Orientation Transversal Thickness 100 150 Routine Contrast Resolution Geometry System Physio Inline Sequence Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 3 of 6 Job Aid | NATIVE TrueFISP Scanning Workflow with Respiratory Gating (E-line) Effective Date: 06/09/2020 | HOOD05162003096950 9. Position > Second Inversion Pulse inferior to the first inversion Pulse a. Align the top of the TI2 region even with the bottom of the TI1 region b. Note: This helps suppress venous signal from the Inferior Vena Cava (IVC) NTR Volunteer1. Skyra H NTR_Volunteert 3 IMA 22 125 8/7/2012 R TI1 100m 9.92 Tl = 1350ms @ 150mm TI2 TP O P2 M/NPRMDI82D NE CORA TI2 = 800ms @ 100mm loc_flash_oor FOV 400%:00 Ep cor ba 10. Go to the Physio>Signal1 tab > Capture the cycle TA: 1:31 PM: ISO PAT: 2 Voxel size: 1.1x1.1x0.9mm Rel. SNR: 1.00 tfi Routine Contrast Resolution Geometry System Physio Inline Sequence Signal1 Cardiac PACE 1st Signal/Mode Resp./Trig ... Average cycle 3000 + 3 ms Captured cycle not set- Acquisition window 1497 - ms 3.5 7 7.5[s] Threshold 20 . % Concatenations Trigger delay 0 _ ms Resp. phase Expira. TR 729.35 : ms Segments 56 11.Apply the sequences. 12. Load the 3D NATIVE TrueFISP Series to 3D Task Card and MIP Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 4 of 6 Job Aid | NATIVE TrueFISP Scanning Workflow with Respiratory Gating (E-line) Effective Date: 06/09/2020 | HOOD05162003096950 13. Imaging tips: a. If the patient is an abdominal breather, place the respiratory belt around abdomen. Or, if the patient is a thoracic breather, place the respiration belt around their chest b. The imaging volume can be prescribed as a coronal instead of axial. If changed to a coronal, then increase the phase FOV and add more phase oversampling. An ex- ample of Coronal imaging volume is illustrated below. The yellow box represents the coronal imaging volume, while the blue box represents the axial inversion vol- ume. Note, the upper edge of the inversion volume is planned at the level of the top of the kidneys. A second inversion pulse can be located inferior to the first in- version volume to suppress venous signal from IVC. Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 5 of 6 Job Aid | NATIVE TrueFISP Scanning Workflow with Respiratory Gating (E-line) Effective Date: 06/09/2020 | HOOD05162003096950 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 2020 Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84-0 siemens-healthineers.com Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 6 of 6