Navigator Placement (Numaris X) Step by Step

Navigator Placement (Numaris X) Before starting the measurement it is best to coach the patient for proper breathing:  Steady consistent breathing for the entire acquisition.  Be careful of the patient falling asleep, as breathing can become too shallow for navigator triggering to work properly.  The sequences should be planned off of a Non-Breath-hold localizer(Free-Breathing). This will ensure that the liver is at a similar location when the patientt is breathing freely. Types of Abdominal Navigators  There are 2 different types:  Liver Dome scout  Phase scout  They are both located on the same page Physio > PACE > Trigger 1:04 min 4 Auto @2 @ 1.0x1.0x5.0 mm 9 1.00 Routine Contrast Resolution Geometry System Physio Inline Sequence Signal Cardiac PACE Resp. Control Breath-hold Off Breath-hold Trigger  Once trigger is selected more parameters will be shown Signal Cardiac PACE Resp. Control Trigger Scout Mode Acquisition Window 1200 ¢ ms Scout Type Liver Dome Scout Scout TR 150 + m Accept Window + 2.0 - m Trigger Pulse 1 + Position Accept Window Automatic Concatenations 2 + Store Profile Images v 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 | Navigator Placement (Numaris X) Effective Date 04/22/2020 | HOOD 05162003081789  Select Drop down for Scout Type to choose which type of navigator will be used Scout Type  The options to choose: Liver Dome Scout or Phase Scout Scout Type Liver Dome Scout Liver Dome Scout Phase Scout Liver Dome Scout  It is best to have a free breathing localizer for positioning  The Liver Dome Scout will show up as a rectangle on the image as seen below  Optimal Positioning o On Coronal FB localizer find the highest point of the dome of the liver o Place the ‘circle’ or center of the navigator on the dome of the liver abd 2020.03.26-15:39:22-STD-1.3.12.2.1107.5.99.3 2020.03.26-15:39:22-STD-1.3.12.2.1107.5.99.3 2020.03.26-15:39:22-STD-1.3.12.2/107.5.99.3 2 IMA 1 FRM 14/43 3 IMA 1 FRM 8/33 1 IMA 1 FRM 1/23 R A TP H26 TP O SPA30.4 SP-H30:3 SP R35.0 GOV 400*400 FOV 304*360 FOV 430*430 2 MAGNINORMDIS2D Cor 1223 02 MAGNINORM/SHFIL/DIS2D Tra P2 MAGN/NORMOIS2D Sag> Tra(3) 683 283 C 702 12_haste_cor_mbh 12_haste_fs_tra_mbh localzer_bh 313 o Right Click on the coronal image and select Perpendicular. The box should be- come solid if done correctly. On the axial image, move the solid box to the center of patient’s body in the AP direction. H abd Copy Image Position 2020.03.26-15:39:22-STD-1.3.12.2.1107.5.99.3 2020.03.26-15:39:22-STD-1.3.12.2.1107.5.99.3 2020.03.26-15:39:22-STD-1.3.12 2.107.5.99.3 2 IMA 1 FRM 14/43 3 IMA 1 FRM &/33 1 IMA 1 FRM 4/23 OOD Clear All Segments Perpendicular Orthogonal RA Find Localizer Align Parallel O Align FoV 10cm Repeat Step A Repeat & Open Step TP F 20 TP H26 SPA30.4 SR.H80.3 SP R14.0 Shift to Image Plane GOV 400*400 FOV 304-360 430*430 IMPRIRESA 2 MAGNINORMOIS20 Cor Tra AAhead_scol 1223 Copy Parameters _haste_cor_mbh D2 MAGNINORM/SH/FIL/DIS20 683 12_haste_fs_tra_mbh 283 p2 MAGNINORM/DIS20 ag.Tra(3) 598 518 localizer_bh c 254 THATTHEY Create Snapshot 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 4 Job Aid | Navigator Placement (Numaris X) Effective Date 04/22/2020 | HOOD 05162003081789 Phase Scout  There are 2 options when using Phase Scout: Position Navigator Automatic Trigger Pulse Manual Automatic  When using Automatic, the scanner will choose the location of the navigator with no user interaction. This is also the default when you choose Phase Scout. Position Navigator Automatic  When using Manual, the user is responsable for the correct placement of the navigator. Position Navigator Manual  It is best to have a free breathing localizer for positioning.  Optimal Positioning: o Using the FB Loc Axial, find the image with largest amount of the liver o The navigator is to be placed only in liver tissue away from the common bile duct (CBD) and blood vessels. H A HL abd abd abd 2020.03.26-15:39:22-STD-1.3.12.2.1107.5.99.3 2020.03.26-15:39:22-STD-1.3.12.2.1107.5.99.3 2020.03.26-15:39:22-STD-1.3.12.2.1107.5.99.3 2 IMA 1 FRM 14/43 3 IMA1 FRM 8/33 1 IMA 1 FRM 4/23 A F TP F20 TP H26 PO SP A30.4 SR.H30.3 SP R14.0 GOV 400*400 FoV 304*360 OV 430.430 Cor 2 MAGN/NORM/DIS2D 02 MAGNINORM/SH/FIL/DIS2D Sag>Tra(3) 1223 12_haste_is_tra_mbh PZ MAGN/NORM/DIS2D localizer_bh C 598 12_haste_cor_mbh C 254 o Right Click on the axial image and select perpendicular. The box should become solid if done correctly. Copy Image Position abd al 2020.03.26-15:39:22-STD-1.3.12.2.1107.5.99.3 020.03.26-15:39:22-STD-1.3.12.2.1107.5.99.3 020.03.26-15:39:22-STO-1.3.12.2/ 107.5.99.3 DO0 Clear All Segments IMA 1 FRM 20/43 IMA 1 FRM 9/33 IMA 1 FRM 3/23 Perpendicular Orthogonal RA Find Localizer Align Parallel A Align FoV Repeat Step 10cm Repeat & Open Step UP F 20 TP H26 TP O Shift to Image Plane 00-400 SP.H7.4.3 SP R35.0 SMPRIRES/ FOV 304*360 FoV 430*430 AAhead_Scol Copy Parameters Tra 716 Sag> Tra(3) P2 MAGN/NORMDIS20 p2 MAGNINORM/SH/FIUDIS20 12_haste_Is_ra_mbh C 290 p2 MAGN/NORM/DIS2D C 702 localizer_bh ETE Create Snapshot 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 4 Job Aid | Navigator Placement (Numaris X) Effective Date 04/22/2020 | HOOD 05162003081789 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 4 of 4