QISS

SIEMENS Healthineers QISS Version 2020.07 Template Effective Date: 27 MAY 2019 | HOOD05162003010284 Effective Date: 10 SEP 2020 | HOOD05162003113049 Unrestricted © Siemens Healthineers, 2020 Effective 1/18/21 | HOOD05162003145296 QISS – SIEMENS Healthineers Table of Contents General 3 Programs 5 Examination 8 Effective 1/18/21 | HOOD05162003145296 Effective Date: 10 SEP 2020 | HOOD05162003113049 Unrestricted © Siemens Healthineers, 2020 General SIEMENS Healthineers QISS stands for Quiescent Interval Single Shot. QISS ontrast enhanced Angiography QISS provides: • an “easy-to-handle approach for imaging peripheral arteries with little requirement for further adjustments” 1 . Cor Tra 2 • non-CE peripheral MRA for patients with renal insufficiencies at comparable accuracy to contrast enhanced MRA 2 . The images on the right are comparison between QISS non contrast peripheral angiography (left) and Contrast Enhanced peripheral angiography (right). A Effective 1/18/21 | HOOD05162003145296 1 Knobloch-ClinRadiol-69-4854 Effective Date: 10 SEP 2020 | HOOD05162003113049 2 Hodnett-AmJRoentgenol-197 (6)-1466 Unrestricted © Siemens Healthineers, 2020 General SIEMENS Healthineers This technique is 2D ECG gated and acquires one axial slice per heartbeat. The image contrast is then generated using an in-plane ECG saturation pulse to suppress the background tissue. This tracking saturation pulse is used to suppress venous Arterial Flow signal prior to the quiescent inflow period. TD Fat sat k space center Sequence TrueFISP Saturation of venous inflow Saturation of imaging slice Quiescent interval Signal acquisition Effective 1/18/21 | HOOD05162003145296 Effective Date: 10 SEP 2020 | HOOD05162003113049 Unrestricted © Siemens Healthineers, 2020 Programs SIEMENS Healthineers In the Dot Cockpit, you can find the relevant Dot Cockpit - Main O x Explorer Program Editor Browse Import Export Edit Simulate programs in the Siemens tree: X SIEMENS Siemens tree > Peripheral Angiography > Angio Dot Test Bolus 4 steps Care Bolus 4 steps Engine pelvis male > tmj › shoulder > elbow hand > hip > knee ankle › foot > whole body oncology › whole body diffusion peripheral angiography Angio Dot Engine Test Bolus 4 steps Care Bolus 4 steps angiography QISS QISS_library NATIVE_SPACE legs TOF legs angiography ce › spectroscopy > intervention › System › radiotherapy Effective 1/18/21 | HOOD05162003145296 Effective Date: 10 SEP 2020 | HOOD05162003113049 Unrestricted © Siemens Healthineers, 2020 Programs SIEMENS Healthineers Select QISS to see the different examination Dot Cockpit - Main Explorer Pro Program Editor Browse Import Export Edit Simulate protocols of the program in detail. X SIEMENS peripheral angiography >> angiography » QISS Dot QISS Angio Patient View V QISS › pelvis male PERU positioning >tmj Generic Views FastView 00:33 › shoulder › elbow qiss_trufi_tra_ecg 06:08 O QISS hand hip knee ankle › foot whole body oncology › whole body diffusion peripheral angiography Angio Dot Engine Test Bolus 4 steps Care Bolus 4 steps angiography QISS QISS_library NATIVE_SPACE legs TOF legs angiography ce spectroscopy › Intervention › System radiotherapy Effective 1/18/21 | HOOD05162003145296 Effective Date: 10 SEP 2020 | HOOD05162003113049 Unrestricted © Siemens Healthineers, 2020 Programs SIEMENS Healthineers In addition, you can find the examination protocols Dot Cockpit - Main Explorer Program Editor Browse Import Export Edit Simulate of the QISS library: SIEMENS ... >> peripheral angiography >> angiography > QISS_library RR interval > 800 ms qiss_trufi_tra_ecg 00:46 pelvis male tmj qiss_flash_tra_ecg_bh 01:40 ›shoulder qiss_trufi_tra_highres_ecg 01:40 elbow RR interval < 800 ms › hand hip qiss_trufi_tra_fast_hr_ecg 00:39 > knee qiss_flash_tra_fast_hr_ecg_bh 01:21 ankle › foot qiss_trufi_tra_fast_hr_highres_ecg 01:22 whole body oncology › whole body diffusion peripheral angiography Angio Dot Engine Test Bolus 4 steps Care Bolus 4 steps angiography QISS QISS_library NATIVE_SPACE legs TOF legs angiography ce › spectroscopy › Intervention › System › radiotherapy Effective 1/18/21 | HOOD05162003145296 Effective Date: 10 SEP 2020 | HOOD05162003113049 Unrestricted © Siemens Healthineers, 2020 Examination SIEMENS Healthineers The QISS program provides guidance for SIEMENS x Healthineers MR ViewlGo positioning of the ECG – the PERU should be QISS ISO PERU positioning placed over the patients shoulder (not over the 2 FastView 00:33 3 X qiss trufi_tra_ecg 06:08 chest / abdomen), next to the patient's head to avoid gradient interferences to the ECG and susceptibility issues • Use a cushion to avoid direct contact of the PERU and the patient's skin. 2 06:41 For correct positioning take a look at the GO Cancel Guidance picture. Position the patient feet first and supine. For this examination it may be useful to position the PERU next to the patient's head (as shown in the picture). • To suppress patient movements, position the This can help to reduce gradient interferences or artifacts in the vicinity of the PERU transmitter unit. patient as comfortably as possible using RESP 0 - suitable positioning aids. O ng for slice Effective 1/18/21 | HOOD05162003145296 Effective Date: 10 SEP 2020 | HOOD05162003113049 Unrestricted © Siemens Healthineers, 2020 Examination SIEMENS Healthineers Some hints for attaching the ECG electrodes: • The electrodes must be positioned and attached with care to ensure a sufficient and consistent ECG signal. • Discuss the breath holding and respective commands with the patient. • Ensure satisfactory contact between the electrodes and the patient's skin. • Thoroughly clean the patient's skin with a dry cloth or NUPREP ECG & EEG Abrasive Skin Prepping Gel . • If the patient is hirsute, shave the location where the electrodes shall be attached. • Dry the skin carefully. • Check the signal at the display above the magnet bore. • If the signal received is not satisfactory and consistent, vary the location of the electrodes. Use new electrodes every single time. • If one of the leads does not provide a sufficient signal, change to a single ECG lead in the Physiological Display dialog window. Effective 1/18/21 | HOOD05162003145296 Effective Date: 10 SEP 2020 | HOOD05162003113049 Unrestricted © Siemens Healthineers, 2020 Examination SIEMENS Healthineers The QISS protocol contains an add-in enabling the user SIEMENS Healthineers Mc. . OISS RD. . 121978 M 12345 X MR View&GO to interact and select the number of steps wanted for QISS ISO ℮ / . + + X PERU positioning Set’n’Go protocols (maximum 10, due to GSP technical FastView 00:33 | 3 %% qss_truf tra_ecg limitations). • The steps which should be measured using breath- hold can be selected by clicking on the small grey bar and dragging – breath-hold steps will turn blue. Step 2 - FastView If not preferred to apply any breath-hold commands 2 00:33 Display at all, click on the speaker button on the Go Cancel 46 sec 4 Auto @ 2 @@ 0.5-0.5x3.0 mm? $ 1.00 QISS Parameters schematically displayed patient. Adapt the number of steps to be measured according to the patient's height and select the range of voice • As there is no auto-timing, to change the time per Number of Steps 8 breath hold, change the “concatenations per step” RESP Auto Breath-Hold Commands at the User Interface. Concatenations per Step 4 + Breath-hold Duration: 4 x 11.5s • Once the measurement is started, all steps will run consecutively and are in-line composed eventually. O Stimu com waiting for slice positioning. Effective 1/18/21 | HOOD05162003145296 Effective Date: 10 SEP 2020 | HOOD05162003113049 Unrestricted © Siemens Healthineers, 2020 Examination SIEMENS Healthineers Further hints for the examination: • Please try to avoid loops of the cables and attach each electrode from head direction. If necessary, pull the cables through the neckline of the patient’s shirt. • Position the necessary coils on the patient. • Typically, the peripheral angio coil for the extremities and one or more body coils and the spine coil for the abdominal region are used. Center the light localizer to max. 1/2 FoV above the feet. • • There is a decision point for the patients’ heart rate – the only difference is the iPAT factor (p3 for short RR intervals < 800ms; p2 for longer RR intervals > 800ms); this reduces the readout time for faster heart rates, so that data acquisition is still within a single heartbeat. • However even if the heart rate varies, for example and the next R-wave comes along whilst we are still acquiring during the readout, it doesn’t matter from an imaging perspective, it just means that the next heart beat is skipped, so the overall acquisition time will be longer e.g. if only every second heartbeat is acquired, then 100 heartbeats to acquire 50 slices, instead of 50 which are needed. Effective 1/18/21 | HOOD05162003145296 Effective Date: 10 SEP 2020 | HOOD05162003113049 Unrestricted © Siemens Healthineers, 2020 SIEMENS Healthineers 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 Telephone: +49 9131 84-0 siemens.com/healthineers Effective 1/18/21 | HOOD05162003145296 Effective Date: 10 SEP 2020 | HOOD05162003113049 Unrestricted © Siemens Healthineers, 2020