Stenosis Analysis - Control Room (VD1xx - VD2xx)

Stenosis Analysis – Control Room (VD1xx-VD2xx) Job Aid Advanced Therapies - Application Software VD1xx to VD2xx. **There is an additional job aid available on PEPconnect to determine SW version of the system. Stenosis Analysis only works with XA datasets – Dyna3D or DynaCT. No CT or MRI images can be used within this workflow. 1. Perform a 3D spin or load a previously acquired XA dataset into the 4D taskcard. 2. If a previous dataset is imported and being used, 2D3D or 3D3D Registration will need to be performed first. 2D3D or 3D3D Registration is not required to plan the workflow, however, it will be required when the dataset and planning information is being used the day of the procedure. There is an additional Job Aid for 2D3D and 3D3D Registration on PEPconnect. 3. Open Workflow menu. New Patient Review and Processing 4. Select Stenosis Analysis. Select syngo 4D application X Select the 4D application you want to work with 1 Aneurysm Analysis Aortic Valve Guidance Cong. Heart Disease Guidance · CTO Guidance . EP Planning Embolization Guidance · EVAR Guidance Needle Guidance Stenosis Analysis OK Cancel SIEMENS Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Healthineers Job Aid Effective Date: 07/07/2020 | HOOD05162003101314 Job Aid | Stenosis Analysis – Control Room Effective Date: 07/07/2020 | HOOD05162003101314 5. Stenosis Analysis workflow has four steps: a. Auto Check Volume – this step will be grayed out unless an incorrect dataset was loaded. A message will display asking for a Dyna3D or DynaCT dataset to be loaded. b. Mark Vessel – Allows user to mark the vessel segment of interest. c. Analyze Stenosis – Optional step to perform a detailed analysis of the vessel stenosis. d. Simulate Stent – Manipulate and/or analyze the volume, place a virtual stent overlay graphic, and show on 3D Overlay (Show Live on 3D). Stenosis Analysis X Stenosis Analysis X Stenosis Analysis Auto Check Volume Auto Check Volume Auto Check Volume Mark Vessel Mark Vessel Mark Vessel Mark vessel by setting two or more Analyze Stenosis Analyze Stenosis seed points. Simulate Stent Select 'Calculate'. Verify analysis results. If necessary, switch between auto and Adjust virtual stent dimensions and manual reference mode. position. Activate overlay. Show Object ... 3D Objects Show Object . ... Seed Points M 3D Objects E Centerline1 E Seed Points Bifurcation Centerline1 Proximal and Distal ... Bifurcation Cutting Plane1 Reference Plane 1+1 81.0 mm Show Volume Data in VRT Analyze Stenosis Simulate Stent Simulate Stent 6. Mark Vessel – Using left mouse clicks, mark a minimum of two (seed) points (proximal to distal – in the direction of blood flow is recommended) in the affected vessel through the stenosis. To scroll through MPR while Mark Vessel is active, hold down the SHIFT key while using left mouse button to scroll; if mouse has a middle wheel, SHIFT key is not needed to scroll. Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 SIEMENS Job Aid Effective Date: 07/07/2020 | HOOD05162003101314 Page 2 of 9 Healthineers Job Aid | Stenosis Analysis – Control Room Effective Date: 07/07/2020 | HOOD05162003101314 It is recommended to use an MPR view for accuracy of seed point placement IBT_STENOSIS_ANALYS ... H St Jan Genk IBT_STENOSIS_ANALYS ... 01 AXIOM-Artis OM-Artis 20.05.26-06:39:00-STD Stenosis Measurement, P. *1/1/1950 VA21C 021001 Stenosis Measurement, P ... 1/1/1950 CT 12/30/2002 12/30/2002 11:44:46 AM 11:44:46 AM 3D Review and Processing Stenosis Analysis X Auto Check Volume Identify Vessel Adjust view. Select 'Mark Vessel' function. Define vessel by marking two O O or more seed points. Start calculation. cm O 85 SL 6.0 410 MPR Thick 416 0/0 IBT_STENOSIS_ANALYS. St Jan Genk IBT_STENOSIS_ANALYS ... 01 AXIOM-Artis Analyze Stenosis Stenosis Measurement, P ... VA21C 021001 Stenosis Measurement, P ... Simulate Stent *1/1/1950 * 1/1/1950 CT 12/30/2002 12/30/2002 11:44:46 AM 11:44:46 AM -O olume Opacity Image | Tools |Meas ... |X-Ray Slice Thickness (mm) 6.0 R O 1 cm B LLLLLLLLLL F A Injector not armed. Only manual inje .. MPR.T 419 VRT 2003 1517 7. Select the Calculate icon. Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 SIEMENS Job Aid Effective Date: 07/07/2020 | HOOD05162003101314 Page 3 of 9 Healthineers Job Aid | Stenosis Analysis – Control Room Effective Date: 07/07/2020 | HOOD05162003101314 8. Analyze Stenosis -- user can view detailed results of affected vessel. Stenosis Analysis X ADV DCT STENOSIS RH St Jan Genk ADV DCT STENOSIS StJan Genk AXIOM-Artis 01 Stenosis Measurement, VA21C 02100112002B Stenosis Measurement, ... VA21C 021001120028 *1/171950 *1/1/1950 Auto Check Volume CT 12/30/2002 CT 12/30/2002 11:44:46 AM 11:44:46 AM Mark Vessel Analyze Stenosis Verify analysis results. If necessary, switch between auto and AFR 1.6 mm manual reference mode. 4.0 mm Show Object ... 3D Objects . MouriD: 23 mm Seed Points SL 2.0 Thick MPR LAO 57 / CRAN 59 Centerline1 ADV_DCT_STENOSIS HAL Atvan Cons 111 Bifurcation Stenosis Measurement, 01 VA21C 021001 20028 "1/1/1950 CT Proximal and Distal 12/30/2002 11:44:46 AM Cutting Plane1 Reference Plane OF CATAN 90 768 Analysis Results Vessel Segment Analysis Min. D Max D 40 mm Length: 13.2 mm Area Area Mean.A 6.5 mm2 %MLD Min A: 1.3 mm2 %MLA 27.0 % Max A 11.0 mm2 Min.Diameter Reference Mean.D 2.5 mm Ref D: Min, D 0.6 mm Ref .A Max. D: 3.6 mm Simulate Stent 80 mm • Upper Left – MPR view – user can scroll through this image. • Upper Right – Curved MPR view – user can left click and drag to move the dots along the pink center line. o Red dot = MPR min/max diameter and area of stenosis plane. o Green dot = Manual Reference diameter, Reference Area (estimated healthy vessel size). User can choose between Auto or Manual Reference. o Blue dot = Proximal plane (end point) o Yellow dot = Distal plane (end point) • Lower Left – VRT with graphics • Lower Right – Analysis Results Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 SIEMENS Job Aid Effective Date: 07/07/2020 | HOOD05162003101314 Page 4 of 9 Healthineers Job Aid | Stenosis Analysis – Control Room Effective Date: 07/07/2020 | HOOD05162003101314 9. Auto Reference vs. Manual Reference Selection Can be changed in Analyze Stenosis or Simulate Stent step. Selecting the icon turns on Manual Reference. Stenosis Analysis Stenosis Analysis X Stenosis Analysis X X Auto Check Volume Auto Check Volume Auto Check Volume Mark Veccel Mark Vessel Mark Vessel Analyze Stenosis Analyze Stanacic Analyze Stenosis Verify analysis results. Simulate Stent ?HE Simulate Stent If necessary, switch between auto and Adjust virtual stent dimensions and Adjust virtual stent dimensions and manual reference mode. position. position. Activate overlay. Activate overlay. Show Object ... ] 3D Objects Show Object Show Object ... Seed Points 3D Objects 3D Objects E Centerline1 Seed Points Seed Points Bifurcation Centerline1 Centerline Proximal and Distal Bifurcation Proximal and Distal ... Cutting Plane1 Reference Plane +1 81.0 mm 14 : 17.0 mm < 3 Show Volume Data in VRT Show Volume Data in VRT Simulate Stent Auto Reference Active Auto Reference Active Manual Reference Active icon is gray icon is gray icon is white – – – BT_STENOCIO_ANALYS ... BT_STENGSS ANALYS ... BT_STENOSIS ANALYS ... 01 G20.05.20 05:38:00 STD 20.05.26-03.30.00-STD Stenosis Mesobrement 7. 78.21C 021601 1:1/1950 Ster os5 Measurement P 12/90/2002 12/20/2002 Review and Processing Stenosis Analysis x 1.0 mm Auto Chack Volume Identify Vessel Identity Vessel Analyze Stenosis Analyze Stenosis Verry analysis fesuts 1.7 mm Verty analysiscuts r necessary, satch hatesen auto and necessary, suiten between auto and marua reference mace. manual retroenon maar Show Offer" Show Object 2D Objects 3D Gbjects Saed Points Seed Foirts Mean.D: 1.4 mm Camarins Centerline Proximal weed Dietal Froxmal :nd Dista Cutting Flare Cutting Plane Reference Flane Hetcrente Plane Aute Reference Plane Furto Rafa arca Plans 0.0.2 BT_STENOSIS_ANALYS .. Simulate Stent BT_STENOSIS_ANALYS ... Stenosis Measuremen; F .. Stenosis Measurement, P .... Simulate Stent "1/1/1853 1/121850 CI CI 12/30-2002 12/31/2002 11:44:46 AM delume Opacity 11:44:45 AM clurie Opacity nage | Tools |Meas | X Ray Image Tools |Meas ... | X Ray Clip Clip 378RAN SO Clip Plane Clip Plane Analysis Results Analysis Results Vessel Segment Analysis Ves581 Segmert Analysis Lowith Lerg:1 more Area MeanA Mcan A 5.0 62.9 MIn.A. 1.3 819 Max A 12.8 Min. Ciameter Mr Dareter Mean.D Mcan.C: MrI. U. nectar act anred. Ony manual ne ... Reference jertornatamed Orly marta inje MEX D Max. 11 Auto Reference Manual Reference Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 SIEMENS Job Aid Effective Date: 07/07/2020 | HOOD05162003101314 Page 5 of 9 Healthineers Job Aid | Stenosis Analysis – Control Room Effective Date: 07/07/2020 | HOOD05162003101314 10. Create a Snapshot to save Analysis results. Results will be saved to Local Database. Patient Applications Show Mode View O Browser ... Num . Close Patient Save image Define save properties Save snapshot selected segment Save snapshots all segments Export to file. Copy Image to Sensis Refine Volume Interactive Reconstruction .. Patient Browser X Patient Transfer Edit View Filter Sort Private Applications Options Help ? - O gz ? Local Database IBT STENOSIS Ar STENOSIS_AN/ [970] Scheduler IBT Bone Remova [6] Stenosis Measurement, Pre R////// / RecycleBin IBT_ANEURYSM_ DVD-R 20.05.26-06:39:00- 111/11 / 2D_Image_Collecti B DSA CO2, CO2 R////// / Q.zen CS_02_RC/ R////// / Q.zen_CSL_02_Sc R////// / Patient name IBT STENOSIS ANALYSIS Date of birth 1/1/1950 Patient ID 01 Study description STENOSIS ANALYSIS Study date 7/4/2001 Modality SC 5 4 1 3 2 1 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 SIEMENS Job Aid Effective Date: 07/07/2020 | HOOD05162003101314 Page 6 of 9 Healthineers Job Aid | Stenosis Analysis – Control Room Effective Date: 07/07/2020 | HOOD05162003101314 11. Simulate Stent – this step allows user to overlay a virtual stent with 3D Overlay. Stent length is displayed and can be adjusted. Additionally, the virtual stent can be moved proximal and distal within the vessel. To adjust virtual stent diameter, user can adjust Manual Reference point to vary stent diameter with a left click and drag of the green manual reference dot. Stenosis Analysis X ADV_DCT_STENOSIS St Jan Gonk ADV_DCT_STENOSIS of Auto Check Volume Stenosis Measurement, AXIOM APA VA23C 02100120028 Stenosis Measurement VA21C 021001 20628 *1/1/1950 1/1/1950 CT Mark Vessel 12/30/2002 11.46:46 AM 12/30/2002 11:44:46 AM Analyze Stenosis Simulate Stent Adjust virtual stent dimensions and position. Activate overlay. Show Object 3D Objects Seed Points Thick MPR LAD 57 /CRAN 5 Centerline1 ADV_DCT_STENOSIS Stenosis Measurement, 1C 021001 20028 -1/1/1950 Bifurcation CI 12:40/2002 11:44:46 AM *1 81.0 mm> Show Volume Data in VRT Analysis Results MPR Mn D Vessel Segment Analysis Mas D Length: 132 mm Area Area Mean A 6.5 mm2 %6MLD Min.A %MLA 49.1 1.3 mm2 Max A 11.0 mm2 Virtual Stent Mean.D 3.7 mm Min. D 3.5 mm Max D 3.8 mm Length 110 mm IST STELOSS ALLA G ... 20.05 26-06:39:00-STD G20.05.26-06.29:00 STD Stenocis Measurement it ... Stenosis Acasuremero P 171/1357 CT CT 12/30/2002 12/30/2002 Review and Processing Stenosis Analysis X Auto Check Volume oujuMex' Identify Vessel Identify Vessel Analyze Stenosis Analyze Stenosis Simulate Stent Simulate Stent Just virtual stert cimensure and Adjust virtual stent dimensions and position position Activate overlay Activate cvclay Show Object Show Object 3D Objects Seed Poi-ks Canterlina Proximal and Dietal .. Protina are Distal .. Shev: Volume Ders in VAT 5304 / CPAN 60 BT_STENOSIS_ANALYS BT_STENOSIS_ANALYS .. Stenosis Measurement, F .. Stenas's Measurement, P ... *1/1/1950 *121/1950 CT 12/31/2002 12/90/2002 1:44:45 AM 1 1:44:45 AM voume Opacity Volume Opacity Image Tools Meas X-Ray Image Tools |Moas ... | X-Ray Slice Thickness (mm) 0.2 Slice Thickness (mm) 02 OCEANSO Analysis Results Analysis Results Vessel Segment Analysis Vessel Segment Analyss Length 11.5 mm Area Mean A: Mein A Mn A SILA 13 mm3 Max A 12.8 mm A LA Reference Reference Length: Ref.A. Length Undersized Correct sizing Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 SIEMENS Job Aid Effective Date: 07/07/2020 | HOOD05162003101314 Page 7 of 9 Healthineers Job Aid | Stenosis Analysis – Control Room Effective Date: 07/07/2020 | HOOD05162003101314 12. Create a Snapshot (see Step 8) to save Simulate Stent results. Results will be saved to Local Database. 13. Enable 3D Overlay to overlay LIVE image onto 3D volume. BT_STENOSIS_ANALYS ... HPR St Jan Genk AXIOM-AI C 20.05.26-06:39:00-STD Examination Stenosis Measurement, P .. VA21C 021001 1/1/1950 3D 12/30/2002 Review and Processing Stenosis Analysis × 11:44:46 AM Auto Check Volume Identify Vessel Analyze Stenosis PostProc Simulate Stent Adjust virtual stent dimensions and position. Activate overlay. Show Object 3D Objects Seed Points Centerline Proximal and Distal Quant -100 mm > Show Volume Data in VRT PA Filming O. Volume Opacity 0.80 Image Tools Meas X-Rav Overlay X Blending 4D more PHE VRT W LAO 30 / CRAN 2 C 520 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 SIEMENS Job Aid Effective Date: 07/07/2020 | HOOD05162003101314 Page 8 of 9 Healthineers Job Aid | Stenosis Analysis – Control Room Effective Date: 07/07/2020 | HOOD05162003101314 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. Pl ease 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 auth ority. 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 Phone: +49 9131 84-0 siemens-healthineers.com Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 SIEMENS Job Aid Effective Date: 07/07/2020 | HOOD05162003101314 Page 9 of 9 Healthineers