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Symbia E Turnover Workbook

Workbook to accompany Symbia E System Turnover

SIEMENS MEMENS X SIEMENS ....... Symbia SIEMENS User Services www.usa.siemens.com/education Symbia E Turnover Workbook Answers for life. User Services. Driven by More. More: Our philosophy for a lifelong improvement through continuing education and consulting. Working closely with you, we develop your personalized education and consulting strategy and support you and your staff with our comprehensive User Services to help gain: • More: Routine Confidence • More: Clinical Expertise • More: Superior Performance More: Personalized training, education, and consulting services from Siemens Healthcare Customer Services. For your leading edge in medical care. User Services. Driven by More. More: Personalized More: More: Superior Clinical Performance More: Routine Expertise Confidence 2 I Contact Information Summary Welcome to Siemens Healthcare Discover. Try. Buy. on webShop Siemens Healthcare is dedicated to helping you Do you want to “Discover. Try. Buy.” options, get the most out of your investment throughout accessories, and clinical education to make the most the entire product life cycle and beyond. Our goal of yourimaging equipment? Discover images, case is to enable you to take technology further, studies,and video demonstrations with the latest profitability higher, and patient care to the next clinicalapplications. Try advanced applications level. Find the information, resources, and tools utilizingfree software trials. Buy applications, coils, you need to get the most out of your recent clinicaleducation, and accessories, conveniently at investment and stay up-to-date. Visit any time. Visit www.usa.siemens.com/webShop today! www.usa.siemens.com/Welcome2Healthcare. Clinical Training and Siemens Training Centers Continuing Education Siemens Clinical Education Training Center – TDC2 Siemens Customer Care Center: 110 MacAlyson Court Call 1-800-888-7436 Cary, NC 27511 • Troubleshooting assistance • Immediate assistance for software applications and workflow issues • For Tech Support press option 2 / for applications support, press option 3 • Press the * key or enter the last six digits of your Functional Location Number • Press 7 for ultrasound Functional Location Number ____________________ Clinical Education Offerings: Serial Number ________________________________ Call 1-888-221-8010 (follow the prompts) IP Address System _____________________________ • Classroom Training (Offerings, Registration& Scheduling) Educational Symposia IP Address PACS _______________________________ • • On-site Training • Printed Self-studies • Virtual Education (Offerings & Registration) • Workshops & Fellowships Visit www.usa.siemens.com/clinicaleducation for more information regarding the current Siemens Clinical Training and Continuing Education portfolio. 3 II Contents I I Contact Information Summary ............................................................................................... 3 II Contents .............................................................................................................................. 4 III Course Agenda .................................................................................................................... 6 Day One ............................................................................................................................ 6 Day Two............................................................................................................................. 6 Day Three .......................................................................................................................... 6 Day Four ............................................................................................................................ 6 IV Course Objectives ................................................................................................................ 7 I Symbia E Overview ................................................................................................................ 8 1.1 Objectives .................................................................................................................... 8 1.2 Dual Head System......................................................................................................... 8 1.3 Single Head System ...................................................................................................... 8 1.4 Tower Assembly............................................................................................................ 9 1.5 Power Switches and Buttons ......................................................................................... 9 1.6 Gantry ....................................................................................................................... 10 1.7 Camera Detectors ....................................................................................................... 10 1.8 Light Rails .................................................................................................................. 11 1.9 Patient Bed and Pallet ................................................................................................. 12 1.10 Rear Bed and Safety Rail............................................................................................ 13 1.11 Hand Control............................................................................................................ 14 1.12 Setting Gurney and Wheelchair Height ................................................................... 14 1.13 Patient Bed Accessories............................................................................................. 15 1.14 Cleaning................................................................................................................... 15 1.15 Patient Positioning Monitor (PPM) ............................................................................. 15 1.16 Homing the System .................................................................................................. 16 1.17 Touch Pad Test.......................................................................................................... 16 2 Quality Control ................................................................................................................... 17 2.1 Sources for Quality Control and Calibrations ................................................................ 18 2.2. Daily Quality Control.................................................................................................. 19 2.3 Monthly QC................................................................................................................ 21 2.4 Quality Control for New Collimator or Collimator Damage ............................................ 26 3 Overview of MI Apps Workstation........................................................................................ 27 3.1 Objectives .................................................................................................................. 27 3.2 Overview of MI Apps Workstation................................................................................ 27 3.3 Acquisition Workflows Overview.................................................................................. 30 3.4. Patient Setup and Positioning..................................................................................... 35 3.5. Processing Workflows ................................................................................................ 37 4 Organ Specific Processing.................................................................................................... 43 4.1. Organ Specific Processing .......................................................................................... 43 4.2. Flexible Display.......................................................................................................... 52 4 5 Patient Browser .................................................................................................................. 55 5.1 Accessing the Patient Browser..................................................................................... 55 5.2 Patient Databases ....................................................................................................... 55 6 Exercises ............................................................................................................................ 59 6.1. Patient Gantry Exercises............................................................................................. 59 6.2 Quality Control Exercises............................................................................................. 59 6.3 Patient Registration Exercises ...................................................................................... 60 6.4 Workflows Exercises.................................................................................................... 60 6.5 Patient Browser Exercises ............................................................................................ 60 5 SIEMENS III Course Agenda Day One Overview of Symbia E Quality Control Day Two Overview of MI Apps Workstation Acquisition Workflows Overview Patient Setup and Positioning Processing Workflows Image Processing Parameter Groups Day Three Organ Specific Processing Flexible Display Patient Browser Day Four Troubleshooting 6 SIEMENS 900 90º 76º 76º X IV Course Objectives Upon completion of this course, you will be able to: • Describe the function of the Symbia E components • Demonstrate the operation of the gantry • Demonstrate the operation of the Patient Handling System (PHS) • Demonstrate the operation of the Patient Positioning Monitor (PPM) • Demonstrate the steps in changing the collimators • Describe the workflow of the daily, weekly and monthly QC procedures • Demonstrate the system daily startup and shutdown • Demonstrate restart of additional workstations • Demonstrate the steps for the NM Daily Quality Control • Demonstrate the steps for the Weekly Quality Control • Demonstrate the steps for the Monthly Quality Control. • Describe the function of the MI Apps Workstation. • Describe the layout of the Command Module. • Demonstrate the steps in patient selection and launching a workflow. • Demonstrate how to modify a workflow template and save it. • Demonstrate how to setup and position a patient. • Describe the purpose and demonstrate the use of the processing workflows. • Describe the purpose and demonstrate the use of the organ specific workflows. • Demonstrate the basic operation of the Flexible Display activity • Demonstrate the steps for saving JPEG and AVI files • Demonstrate how to use dual monitors(if applicable) 7 Turnover Workbook | Symbia E I Symbia E Overview 1.1 Objectives Notes By the end of this section, the user will be able to: • Identify the gantry controls of the Symbia E system. • Demonstrate the use of the PHS. • Demonstrate how to change collimators. • Describe the safety features of the Symbia E system. • State the purpose of the MI Workstations. 1.2 Dual Head System (5) ( 2 ) ( L ) (6) (10) (3) (8) (11) ( 4 ) (9) (12) (13) (14) (15) (16) 1.3 Single Head System (5) (2) (6) (10) '7) (3) (12) (8) (9) (11) (4) (13) (14) (15) ( 16 ) 1. Emergency Stop Button 9. Pallet 2. Hand Control 10. Patient Bed Posts 3. Gantry 11. Pallet Handle 4. Rear Bed 12. C-Frame 5. Patient Positioning Monitor (PPM) 13. Patient Bed (Optional) 14. Ruler 6. Detectors 15. Pallet Release Button 7. Infrared Body Contour System 16. Foot Pedal and Docking Pin 8. Touch Pads 8 Turnover Workbook | Symbia E 1.4 Tower Assembly Notes • The tower assembly provides electrical power to the gantry, detector(s), and patient bed. This includes the Siemens Nuclear Acquisition Controller (SNAC) computer and syngo MI workplace, their monitors, keyboards, and mice, and the e.media option DVD/CD player. (1) 1. SNAC Monitor 2. Tower Assembly 3. Power Switches (2) - (3) 1.5 Power Switches and Buttons MAIN INPUT CAUTION MOTION COMPUTER N (2) CAUTION: TO REDUCE THE RISK OF ELECTRICAL SHOCK DO NOT REMOVE COVERIST OR BACKIST NO LASER. SERVICEABLE BAITS (3) INSIDE REFER SERVICING TO QUALIFIED SERVICE PERSONNEL 0 (4) (5 ECG CUMERA 1. Main Input Switch 2. Motion Switch 3. Computer Switch 4. ECG Switch 5. Camera Switch 9 Turnover Workbook | Symbia E Notes 1.6 Gantry • The gantry is a circular frame that supports the detector(s) and collimator(s) with a center opening for feet-first or head-first patient entry. The gantry’s detectors provides a field of view of 53.3 cm (21 in) x 38.7 cm (15.25 in). (1) (2) SIEMENS ... ... ( 3) (4) (5) ( 6 ) CNE 1. Patient Positioning Monitor (PPM) (optional) 2. Emergency Stop Button 3. Hand Control 4. Gantry Ring 5. Rear Bed 6. Patient Bed Pallet 1.7 Camera Detectors 3 2 1. C-Frame Touch 1 Pad MEDIUM LE 2. Collimator Touch Pad 3. Light Rails 3 10 Turnover Workbook | Symbia E 1.8 Light Rails Notes (2) (2) (1) (2) 1. Look-Ahead Sensors 2. Infrared Body Contour System 11 Turnover Workbook | Symbia E 1.9 Patient Bed and Pallet Notes (1) (1) (2) (7) (3) (5) (8) (4) (6) (9) (10) (9) 1. Patient Bed Posts 2. Foot End 3. Patient Bed Pallet 4. Brain Position Latch 5. Pallet Handle 6. Head End 7. Ruler 8. Pallet Release Button 9. Patient Bed Pedals, Docking Pins, and ECG Connections 10. Pallet is retracted out in brain position. Weight limit: 180 kg or 400 lbs WARNING: Do not exceed weight limit! Patient injury or system damage can result. 12 Turnover Workbook | Symbia E 1.10 Rear Bed and Safety Rail Notes (1) (2) (4) (5)-" (6) (3) 1. Rear bed moves up or down to match pallet height. 2. Rear bed lifts back out of the gantry’s ring. 3. Pallet rolls on top of rear bed for support. 4. Rear Bed 5. Hinge for Lifting Up Rear Bed 6. Pallet (1) (2) 1. Safety Rail 2. Integrated Source Holder 13 Turnover Workbook | Symbia E 1.11 Hand Control Notes (2) 1. Acquisition Start Stop Button 2. Clear PPM Button 3. Auto Height Buttons for Wheelchair or Gurney Heights PPLI 4. Patient Bed Pallet In and Out of Gantry Buttons, Patient Bed Up and Down Buttons 5. Detector 1 and 2 In and Out (Towards and Away) from Gantry Buttons. 6. Rotate Gantry Detectors Counterclockwise or (4) Clockwise Buttons 7. Move Gantry Left or Right Buttons are enabled for a Dual Detector System Detector 2 In or Out and Move Gantry Left or Right buttons are disabled for a single detector system. 6 1.12 Gurney and Wheelchair Height Lell Right To move the patient bed to using the Wheelchair or Gurney buttons, perform the following steps: 1. Slide the pallet’s brain position latch back towards the handle. 2. Fully retract the pallet. 3. Press and hold the desired Auto Height button. (2) 1. Wheelchair 4. Press and hold the A (Bed Up) button until motion begins. 2. Gurney A. Bed Up Release the buttons once motion begins. Ded 5. After the system completes the sequence, load or unload the patient onto or off of thepallet. 14 Turnover Workbook | Symbia E 1.13 Patient Bed Accessories Notes • Head Holder • Wholebody Armrests • Body Wraps • Cardiac Armrest 1.14 Cleaning • Do not pour liquids on system. • Spray cleaning solution on to cloth and wipe where necessary. • Touch Pads: Use caution and avoid scrubbing detectors and touch pad surfaces. • Disinfection: Lightly wipe with bleach, alcohol or other germicides • Do not use abrasive cleansers or organic solvents. 1.15 Patient Positioning Monitor (PPM) • The PPM has a graphical interface displaying system interaction and through which the user can change the collimators and view acquisition information. It enables the user to move between screens by touching a screen tab. • There are two styles of PPMs: (1) (2) (3) .. ..... (4) : : : : : 1. PPM Arm 3. PPM Monitor Buttons 2. PPM 4. Tower Assembly (1) (2) (3) 1. PPM Arm 3. PPM Monitor Buttons 2. PPM 15 Turnover Workbook | Symbia E Notes 1.16 Homing the System • Purpose: Homing is repositioning the detector(s) to their start position for collimator changing or patient acquisition. • When homing the system, the patient bed can be docked at the gantry or in the storage position. If the system has electrical power turn off and then turned on again, the system should be homed. • PPM 1. Press the Home button. 2. Press the Proceed button to begin the homing process. • As the system is moving through the homing process, the message “Homing, Please wait.” appears until homing is complete. 1.17 Touch Pad Test • The touch pads stop all system motion when contact is made. There are touch pads on the system with one on each collimator and one on each C-frame. • To test the touch pads, perform the following steps. 1. From the PPM, press the Setup tab. The Setup screen displays. 2. Press the Touch Pad Test buttons. 16 Turnover Workbook | Symbia E 2 Quality Control Performed Quality Control Procedure Notes • Peaking • Fine Tuning if peaking value is larger than +3.0%, then re-peak.(Note: This Daily value becomes +2.0% for a Symbia system, E series with c.clear.) • Daily Intrinsic Flood QC • Daily Touch Pad Test • Peak • Tune • Peak • MHR/COR for each collimator used for Monthly tomo • NCO Calibration (dual-detector variable angle systems) • Monthly Intrinsic Flood ≥ 200 million counts • Peak • Tune If Collimator Damage • Monthly Intrinsic Flood ≥ 200 million Occurs counts • Monthly Extrinsic Flood for the damaged collimator. Calibration Sequence — The proper sequencing of calibrations is as follows: 1. MHR/COR 2. NCO (Dual-Detector variable-angle systems) with collimator sets used in 90° and 76° configuration 3. Intrinsic Flood (Daily/Monthly) 4. Extrinsic Flood (if collimator damage occurs) Point Source Strength Calibration Activity (MBq) Activity (μCi) Peaking 0.55-0.75 35 Tuning 0.55-0.75 35 MHR/COR 33.0-40.0 900-1100 NCO 33.0-40.0 900-1100 Intrincic Flood 0.55-0.75 35 17 Turnover Workbook | Symbia E 2.1 Sources for Quality Control and Calibrations Notes Point Source and Preparation • One 35 µCi Tc99m point source in vial is required for peaking, tuning and intrinsic floods. • Three to five 900 to 1100 µCi Tc99m point sources in vials are required for MHR/COR and NCO calibrations. To Prepare: 1. Place a small piece of cotton (approximately 3 mm in diameter) into the vial. 2. Check the table to ensure that the point source’s activity is correct. 3. Place drops of Technetium on the cotton. Sheet Source and Holder • One top fillable sheet source phantom or one Co57 sheet source is required for extrinsic flood calibrations. Installing the Sheet Source Holder • The sheet source holder accessory supports and positions a sheet source for quality assurance testing. Hooks on the bottom of the sheet source holder attach to loops fasteners on the patient bed pallet. Rubber pegs on top of the sheet source holder help hold the sheet source on the holder. The sheet source can be either a top filled, uniform Tc99m phantom sheet source or a Co57 sheet source. 2 1. Hook and Loop 2 Fasteners 2. Rubber pegs N provide grip for sheet source. 1 18 Turnover Workbook | Symbia E 2.2. Daily Quality Control Notes 2.2.1. System Daily Shutdown and Startup Shutdown • syngo MI Workplace: 1. Ensure all workflows and data are saved, suspended or completed. 2. Command Module: Options -> End Sessions 3. Select Shutdown System 4. Yes to confirm shutdown. • PPM 1. Setup tab 2. Shutdown 3. Proceed 4. Confirm syngo MI Workplace is shutdown. Startup • syngo MI Workplace: 1. Turn on the syngo MI Workplace by pressing the power button to turn it on. 2. Ctrl, Alt and Delete keys to display log on. 3. Username: esoft Password: esoft and click OK • PPM 1. Confirm that the message OK to Shutdown appears 2. On the tower assembly, flip the computer power switch down (off) to shut down the SNAC computer. 3. Wait 1 minute and flip the computer power switch up (on). 4. If touch pad test has not been performed in the last 24 hours, press the Setup tab on the PPM. 5. Press the Touch Pad Test button to perform the collimator and C-frame touch pad test. 6. Press the Proceed button. 7. Gently touch each detector’s collimator and C-frame touch pads by hand. 8. Press the Proceed button. 9. Press the Home button to home the Symbia system. 10. Press the Proceed button. Home Complete appears when finished. Reset Emergency Stop 1. Above the emergency stop button and hand control holder on the gantry’s side, press the green Restart button. 2. The light inside the red emergency stop button goes out indicating the button is reset. 3. The syngo MI Workplace starts to power up. 2.2.2. Restarting the Additional Workstations (Processing, Reading Workstations) 1. Exit/Complete running all workflows and applications. 2. On the syngo MI Workplace menu: System -> End, Restart and Yes. 3. To log on: Ctrl, Alt, Delete keys. 4. Username and password: esoft 19 Turnover Workbook | Symbia E 2.2.3. Peaking and Tuning Notes Peaking the System 1. Remove the collimator(s). 2. Fully retract the detector(s). 3. Rotate the gantry so detector 1 is at 0°, and detector 2 is at 180°. For a single detector system, detector 1 is at 0°. 4. Fully extend the integrated source holder from its storage position on the rear bed. 5. Prepare the point source as previously described. 6. Insert the capped end of the vial into the integrated source holder, and ensure that the cotton tip with the activity is approximately centered above the detector. 7. For a dual detector system, raise or lower the rear bed (by lowering the patient bed) until the source is centered between the detectors. For a single detector system, set the rear bed (by lowering the patient bed) to 3.8 cm or lower. 8. On the syngo MI Workplace, select the Daily QC Patient and open the Daily QC Workflow 9. Go to the static acquisition activity and select the Analyzer Tab, select the isotope, and select the Begin Peaking button. 10. Peak status will read PEAKED if successful and NOT PEAKED if unsuccessful. Tuning the Detectors 1. Set up the source as previously described. 2. Peak the system for 99mTc. 3. From the syngo MI Applications Command Module, double click the Tuning workflow template and examine the Tuning page. 4. Select the Tuning activity. 5. From the Detector Selection pull-down menu, select Detector 1. 6. Select the Basic User tab. 7. Click the Start Peaking/Tuning button to begin the tuning process. 8. When Detector 1 tuning is complete, repeat steps 6 and 7 for Detector 2 in the Detector Selection pull down menu. 2.2.4. Daily Intrinsic Flood Uniformity and Verification • Purpose: The daily intrinsic flood is performed to check uniformity of the system prior to clinical use. This flood does not update the calibration database. Setup 1. Obtain a point source of approximately 35 µCis. 2. Remove the collimators. 3. Place the point source into the integrated point source holder. 4. Ensure that the count rate is below 75k counts/second. 5. Select the Daily Flood patient and select the Daily Intrinsic Flood QC workflow. (10 million counts) 6. Review the parameters. Acquisition 1. Click the Prepare Acquisition button to load the parameters onto the system. 2. Click the Start button to start the acquisition. 20 Turnover Workbook | Symbia E Review the Results Notes 1. Select the Intrinsic Calculation Activity, visually inspect the flood and make sure the flood is uniform. Review the values. If the values are not within the limits, check setup and background radiation. Otherwise the detector may require tuning or an intrinsic calibration. Uniformity CFOV UFOV Integrated 5% 6% Differential 2.5% 3% 2. Make appropriate selections in the Hard Copy activity for save screens and hard copies. 3. Complete the workflow. 4. Remove the source. 2.2.5 Touch Pad Tests • After replacing the collimators, the touch pad test needs to be performed. See section 1.17 for steps to perform the touch pad tests. 2.3 Monthly QC 2.3.1. Peak, Tune and Peak the Detectors See section 2.2.3 for details on peaking and tuning the detectors. 2.3.2. Multiple Head Registration (MHR)/Center of Rotation (COR) and Non Circular Orbit (NCO) Calibrations • Purpose: The MHR and COR corrects for any camera motion deviations when acquiring a tomo acquisition. MHR is for a dual head system and COR is for a single head system. The NCO calibration corrects for any deviations in a noncircular orbit acquisition. Schedule To minimize the amount of time required to perform these calibrations, below is a suggested schedule. 1. 180º MHR 2. NCO Calibration 3. 90º MHR 4. 76º MHR (Optional) • The NCO calibration should be performed for every collimator that used for 90º or 76º configurations. Setup for Patient Bed MHRs • Sources 1. Prepare 1-2 mCi Tc99m point sources. a. 3 Point Sources: medium-energy, high-energy, and high-sensitivity collimators. b. 5 Point Sources: high-resolution, low-energy all-purpose, fanbeam, and ultra-high-resolution collimators. 21 Turnover Workbook | Symbia E • Camera Notes 1. Home the system and remove the pad. 2. Reconfigure the detectors for 180 degree configuration. 3. Rotate the heads so detector 1 is at +90º. 4. Mount the MHR phantom on top of the pallet and fasten (For more information on this, see the operator’s manual for your system) 5. Use MHR Phantom instructional screening to place point sources in the appropriate configuration. 6. Move the pallet in so the sources are in the FOV. 7. Set the bed height to -8.0 cm, ensuring that the sources are centered. 8. For 180º configuration, set the radius for rotation 20.5 degrees. 9. Ensure that nothing is obstructing the motion of the detector heads. • Workstation 1. In the patient database, highlight current Calibration Patient. 2. Select the appropriate workflow for the acquisition being performed: • MHR COR 180 Calibration • MHR COR 90 Calibration • MHR COR 76 Calibration • Single Head COR Calibration 3. Review the camera parameters • Stop Conditions: • Select 50,000 counts as the First View by Counts stop condition for 5 points. (50,000 is the default.) • Select 30,000 counts as the First View by Counts stop condition for 3 points. • Camera Parameters • Select Tc99m-NMG as the Camera Preset. (99mTc is the default.) 22 Turnover Workbook | Symbia E Setup for Rear Bed MHRs Notes • Sources 1. Prepare 1-2 mCi Tc99m point sources. a. 3 Point Sources: medium-energy, high-energy, and high-sensitivity collimators. b. 5 Point Sources: high-resolution, low-energy all-purpose, fanbeam, and ultra-high-resolution collimators. • Camera 1. Home the system and remove the pad. 2. Reconfigure the detectors for 180 degree configuration. 3. Rotate the heads so detector 1 is at +90º. 4. Move the pallet into the brain position. 5. Position the source holder and mount the phantom on the rear bed. a. Flip-up the small hinged door at the front of the rear bed; this will expose the integrated source holder. b. Extend the integrated source holder fully from its storage position. c. Grasp the phantom and with the open end, slide around the integrated source holder and front edge of the rear bed until contact with the rollers is made, then lower the phantom onto the integrated source holder. 6. Push the integrated source holder inward until motion stops. 7. Use MHR Phantom instructional screening to place point sources in the appropriate configuration. 23 Turnover Workbook | Symbia E • Workstation Notes 1. In the patient database, highlight current Calibration Patient. 2. Select the appropriate workflow for the acquisition being performed: • MHR COR 180 Calibration • MHR COR 90 Calibration • MHR COR 76 Calibration • Single Head COR Calibration 3. Review the camera parameters • Stop Conditions: • Select 50,000 counts as the First View by Counts stop condition for 5 points. • (50,000 is the default.) • Select 30,000 counts as the First View by Counts stop condition for 3 points. • Camera Parameters • Select Tc99m-NMG as the Camera Preset. (99mTc is the default.) Acquisition 1. Prepare and Start Review the Results • Displaying the MHR/COR/NCO Results • 5 point sources – Head Alignment Activity • 3 point sources – MHR Processing Activity • NCO – NCO Processing Activity • Acceptable Values • If the MHR/COR or NCO calibration on the system yields the following values, use the system as normal. Note that the following figures are valid for high- resolution or ultra-high resolution collimators. If an MHR/COR or NCO acquisition is performed using high-energy or medium-energy collimators, these values can be slightly (50%) higher. • Head Alignment Calibration Results (Parallel Hole Collimators) • |Center of Rotation| ≤ 10 mm • offset of detector center relative to the system’s center of rotation • |Axial Shift| ≤ 5 mm • axial offset of detectors relative to each other • |Back Projection Angle| ≤ 0.8 degrees • -angular offset of detectors relative to each other • System Resolution At 20 cm – varies per collimator • -estimated planar system resolution at 20 cm (non-NEMA) • Head Alignment Calibration Results (Fanbeam Collimators) • |Center of Rotation| ≤ 10 mm • |Axial Shift| ≤ 5 mm • |Back Projection Angle| ≤ 0.5 degrees • |Principal Ray| ≤ 8mm • Focal Length = factory calibrated values • NCO Calibration Results • PHS Angle Between - 2.0 degrees and +2.0 degrees • RMS PHS Angle ≤ 0.5 degrees • Gantry Angle Between -1.0 degrees and +1.0 degrees • RMS Gantry Angle ≤ 0.5 degrees 24 Turnover Workbook | Symbia E 1. Make appropriate selections in the Hard Copy activity. Notes 2. Complete the workflow. 3. Remove the MHR phantom, replace the pad and home the system. 2.3.3. Intrinsic Flood Calibration • Purpose: This weekly 200 million count flood is used to update the calibration flood database. Setup: • Sources 1. Obtain a point source of approximately 35 µCis. • Camera 1. Remove the collimators. 2. Place the point source into the integrated point source holder. 3. Ensure that the count rate is below 75k counts/second. • Workstation 1. Highlight the calibration patient in the MI Apps database. 2. Double click the Monthly Intrinsic Flood Calibration workflow. (200 million counts) 3. Review the parameters. • Acquisition 1. Click the Prepare Acquisition button to load the parameters onto the system. 2. Click the Start button to start the acquisition. Review the Results 1. Review the monthly intrinsic calibration processing results, including the uncorrected floods and uniformity values. The intrinsic calibration flood should be reviewed for major uniformity defects consistent with crystal damage, defect, or detector malfunction. Mild variations in uniformity may occur with a properly functioning detector and will be removed by the uniformity correction. Uniformity values may be used as a guide to distinguish between acceptable and unacceptable levels of uniformity. In general, uniformity calibrations can compensate for values up to 10%, however If integral uniformity exceeds 7%, contact your Siemens Customer Service Representative. 2. If the results of the calibration flood are acceptable, click the Accept These Calibrations and Make Them Current button. 25 Turnover Workbook | Symbia E 2.4 Quality Control for New Collimator or Collimator Damage Notes Extrinsic Flood Calibration • Purpose: This weekly 200 million count flood is used to update the calibration flood database for each collimator used. This only needs to be done if there is a new collimator added or if collimator damage occurs. An intrinsic calibration should be performed within ten days prior to the extrinsic flood calibration. Setup: • Sources 1. Use a uniform top filled phantom or Tc99m or Cobalt sheet source. 2. Install sheet source holder and place source on holder. • Camera 1. Configure the detectors to 180 degrees and rotate the gantry so that detector 1 is at 0 degrees. 2. Move the patient bed in so that the source is in the field of view. Make sure the source is covering the entire FOV. 3. Set the detector distance at approximately 10 cm from source. 4. Do not exceed a count rate of 75k counts/second for either detector. • Workstation 1. Highlight the calibration patient in the MI Apps database. 2. Double click the Monthly Extrinsic Flood Calibration workflow. (120 million counts) 3. Review the parameters 26 Turnover Workbook | Symbia E 3 Overview of MI Apps Workstation 3.1 Objectives Notes By the end of this section, the user will be able to: • Describe the purpose of the Command Module. • Demonstrate how to launch a workflow. • Navigate how to modify a workflow and save the workflow after modifications. • Demonstrate how to set up a study and position the patient for the exam. • Navigate how to register a patient manually, through the HIS/RIS or an existing patient. • Describe the user interface of an acquisition workflow. • Describe the user interface of a processing workflow. 3.2 Overview of MI Apps Workstation 3.2.1. MI Workplace Command Module Areas of Command Module Study Name ALL Show All · Local Study Date ALL Network MI Apps Category All System Up Time: 12 Mins Database, Local Find 48 studies found on the system .. Study dates (all dates) Inage Space Available 75400 MB Alto Fiber Patient Name Patort D Study Name Study Date |# Series |Database Locator Bow. 3 Phase 0127 18 Bone Scan 4/23/2002 Local Database Bone, Lumbar Tomo 673 Bone Scan 4/22/1993 Bone. Spine Torno 2 E CAM Bone Scan 11/30/1989 Local Database Local Database Bone, WB and Statics 81156 Bone Scan 4/19/2002 3 5/19/2003 Local Database Cardiac Detector Detector Brain, Ictalfintencial 12345 Brain Scan Local Database nase Bon Sice AD Centering Convergen Cardiac 1, Myo Perf Duet MBI Myocardial Pert 2/1/2001 Local Database Cardiac 2, Myo Perf Duet MBI Myocardial Pert 1/25/2001 Local Database Cardiac 3, Dual Study Ofd. Duet Myoview Myocardial Pert 1/9/2001 Local Database Cardiac 3, Das ChaY Local Database Cardiac 4, S ocal Database Cardioc 4, 9 Cardioc 5. M 1. MI Apps Patient Browser Jocel Database 2. Workflow ocol Database Cardioc 7. P local Database Fo Cardioc, Car local Database Template Cardiac, Shi ocal Database First Pass COLD1620606 First Pass 12/17/2001 Local Database Fusion 1. PETICT WB FU 1 Siemens PET Local Database Browser Fusion 1. PETICT WB FU 1 Philipps CT 8/6/2002 Local Database Fusion 6. MRIPET Head FU-6 Brain 8/15/2002 Local Database Examp Fusion Display. WB PET e soft Fusion Di 4/5/2001 Local Database NB and Galbladder 1, GBEF Dyn Penrose 0333443 GEEF 2/22/2001 Local Database Gallbladder 2, GBEF Dyn ECAM Gaïbladder EF 4/1/2002 912533 Local Database Galbladder, Dyn & Static 2429453 Gallbladder EF 5/17/2000 Local Database Galium, 2 WB & 1 Tomo Tumor Imaging 5/17/2000 Local Database Extinsic Local Database Service Extrinsic Gastric Emp, Static A/P Mification Dot Regen Gastric, Dynamic Single Is : Perrose 7051808 Gastric Emptying 520730 Gastric Emptying 11/23/2001 2/20/2001 Local Database Gated Bloodpool, TOMO 12345 Equilibrium Gate: 2/20/2001 Local Database Lung. Aerosol 22085-481UOM 381201STM Lung Veralation 2/16/2001 Local Database Lung, WQ 2/22/2000 Intrinsic Intrinsic Intrinsic Kiness MM Data, AX Coronanes 42711 Lung WO Scan Local Database 4/23/1997 Local Database Colbracon Service . Verification ONA LC 100 Category :All Workplace SYNGO26 Work Status: All Stage: Al Launch Suspend Complete 3. Workflow Manager 1. MI Apps Patient Browser 2. Workflow Template Browser 3. Workflow Manager 27 Turnover Workbook | Symbia E • MI Apps Patient Browser Notes Patient Patient Patient Study Series Browser Register Level Level Level Search Study Name: ALL Show All Refresh Study Date: ALL System Up Time: 12 Mins Database: Local Find 48 studies found on the system .. Study dates: (all dates) Image Space Available : 75460 MB Summary Patient Name Patient ID Study Name Study Date # Series Database Locatior Information Bone, 3 Phase 012718 Bone Scan 4/23/2002 3 Local Database Bone, Lumbar Tomo 673 Bone Scan 4/22/1993 Local Database Bone, Spine Tomo 2 E.CAM Bone Scan 11/30/1989 2 Local Database Column Bone, WB and Statics 81156 Bone Scan 4/19/2002 Local Database Headings Brain, Ictal/Interictal 12345 Brain Scan 5/19/2003 Local Database Cardiac 1, Myo Perf Duet MIBI Myocardial Perf ... 2/1/2001 Local Database Cardiac 2, Myo Perf Duet MIBI Myocardial Perf ... 1/25/2001 Local Database Cardiac 3, Dual Study Old ... Duet Myoview Myocardial Perf ... 1/9/2001 Local Database Cardiac 3, Dual Study Old ... Duet Myoview Myocardial Perf .. 1/2/2001 Local Database Cardiac 4, Stress & Rest ... 124-58-5106 Myocardial Perf ... 3/25/2002 Local Database Cardiac 4, Stress & Rest ... 124-58-5106 Myocardial Perf .. 3/25/2002 Local Database Cardiac 5, Myo Perf Abno ... Duet Myoview Myocardial Perf .. 1/8/2001 Local Database Cardiac 7, Profile Tc TI 12162212 Myocardial Perf ... 2/21/2001 Local Database Cardiac, Cardiac Motion 123456 Myocardial Perf .. 2/23/2000 Local Database Cardiac, Shunt COL91362794 Equilibrium Gate ... 1/7/2002 Local Database First Pass COL91 OONOONE Local Database Fusion 1, PET/CT WB FU 1 MI Apps Patient Browser Area Local Database Fusion 1, PET/CT WB FU 1 Local Database Fusion 6, MR/PET Head FU 6 8/15/2002 2 Local Database Fusion Display, WB PET ... Brain e.soft Fusion Di ... 4/5/2001 Local Database Gallbladder 1, GBEF Dyn ... Penrose 0333443 GBEF 2/22/2001 1 Local Database Gallbladder 2, GBEF Dyn ... ECAM Gallbladder EF 4/1/2002 1 Local Database Gallbladder, Dyn & Static 912533 Gallbladder EF 5/17/2000 Local Database Gallium, 2 WB & 1 Tomo 2429453 Tumor Imaging 5/17/2000 3 Local Database Gastric Emp, Static A/P 520730 Gastric Emptying 11/23/2001 1 Local Database Gastric, Dynamic Single Is ... Penrose 7051808 Gastric Emptying 2/20/2001 1 Local Database Gated Bloodpool, TOMO 12345 Equilibrium Gate ... 2/20/2001 2/20/2001 Local Database Lung, Aerosol 22085481UofM Lung Ventilation ... 2/16/2001 2/16/2001 Local Database Lung, V/Q 381201STM Lung V/Q Scan 2/23/2000 Local Database MM Data, AX Coronaries 42711 4/23/1997 Local Database ONN • Workflow Template Browser Refresh Node Category Selection · Local Network Category: All Auto Filter Auto Filter K Cardiac Detector Detector Phase Bon Slice Centering Convergen ... AO AO Display Example Example Example AD Dynamic Dynamic Gated Tom. AO AO AD Examph Workflow Template Browser Area Examp WB and Extrinsic Extrinsic Full General Service Verification Dot Regen Slice ... 1 Intrinsic Intrinsic Intrinsic Calibration Service Verification Kitless LC 180 28 Turnover Workbook | Symbia E Notes • Workflow Manager Category Filter Workplace Filter Filter Lauch Workflow Complete Workflow Refresh Category All Workplace SYNGO26 Work Status: AN Launch Complete Stage: All Work Status Filter Stage Filter Filter Suspend Workflow View PPM • Command Module -> Utilities -> View PPM 3.2.2. Workflow Navigator #1 Common Workflow Data Configuration #1 Selector #2 A workflow that contains Activity acquisition, processing Data (two in this example). Selector displaying, and hard copy Acquisition Activity in one workflow. Activity Common Workflow Processing Processing Configuration #2 Regcostruction Activity Activity A workflow that contains processing, displaying. and hard copy in one workflow. Processing Flexible Activity Display Activity land Copy Flexible Display Hard Copy Activity Activity Canalte Hard Copy Activity Play Button Asgestion Pause Button Suspend Suspend Button Complete Super Setup 29 Turnover Workbook | Symbia E 3.2.3. Launching a Workflow Notes Study Name ALL Show All O Local Study Date ALL togory AL 2. Select System Up Time: 12 Mins Database, Local Find Category 48 studies found on the system .. Study dates (all datos) Inage Space Availabi 75460 MB Auto Finee Patient Name El Pasort D 1 Study Nom ato @ Locator B.3 Ph 4/23/2002 e, Lumbar Tomo 012718 673 Bone Scan 4/22/1993 Local Database cevi. Spine Torno 2 E.CAM Bone Scan 11/30/1989 81156 Local Database Bone Scan 4/19/2002 Detector on, WB and Stancs Local Database rain, Italintencial 12345 Brain Scan 5/19/2003 2/1/2001 Local Database Sice Centering Convergen 3. Double cardiac 1, Myo Perf Duet MBI Myocardial Pect Local Database Cardi ac 2, Myo Perf Duet MBI Myocardial Pert 1/25/2001 Local Database Cardiac 3; Dual Study Old Duet Myoutew Myocardial Pert 1/9/2001 click Cardiac 3, Dual Study Ofd: Duet Myoview Myocardial Perf 1/2/2001 Local D Local Database Example Example Example Cardiac 4, Stress & Rest 124-58-5100 Myocardial Pert 3/25/2002 Local Database Dynamic Gered Tom workflow Cardiac 4, Stress & Rest 124-58-5100 Myocardial Pert 3/25/2002 Local Database Cardiac 5, Myo Perf Abeo Duet Myoview Myocardial Pert 1/8/2001 Local Database Cardioc 7, Profile Te TI 12162212 Myocardial Pert 2/21/2001 Local Database Cardioc; Cardiac Motion 123456 2/23/2000 Local Database Example Cardiac, Shurt COL91362794 Myocardial Pert Example Example Example Equilibrium Gate 1/7/2002 Local Database Gated Stade (DH) Tomo (DH) WB and St. COL91620606 First Pass 12/17/2001 AD irot Pass Local Database usion 1, PETICT WB FU 1 Siemons PET Q'18/2002 Local Database usion 1; PETICT WB FUI Philipps CT 8/6/2002 Local Database 1. Select usion 6. MR/PET Head FU-6 Brain 8/15/2002 6 and T Wholebo usion Desplay, WB PET e soft Fusion Di 4/5/2001 Local Database Local Database WholeBo -glibladder 1. GBEF Dyn. Perrose 033:3443 GEEF 2/22/2001 Patient Fallbladder 2, GBEF Dyn. ECAM 4/1/2002 Local Database Local Database Fatbladder, Dyn & Static 912533 Gorbladder EF Local Database -album, 2 WB & 1 Tomo 2429453 Gallbladder EF 5/17/2000 Exgingic Extrinsic Ful astric Emp, Static A/P 520730 Turnor Imaging 5/17/2000 Local Dacabase Gastric Emptying 11/23/2001 Local Database Service Verification Dot Regon astric, Dynamic Single Is. Penrose 7051808 Gastric Emptying 2/20/2001 ated Bloodpool, TOMO 12345 2/20/2001 Local Database Equilibrium Gate Local Database ung Aerosol 22085-481UOM Lung Veralation 2/16/2001 Local Database ung. VIQ M Data, AX Coronanes 381201STM 2/22/2000 Local Database Intrinsic Intrinsic Intrinsic Kitess 42711 Lung WO Scan 4/23/1997 Local Database Catbracon Service Verification LC 180 Category All Workplace SYNGO26 Work Status: All Stap Al Launch Suspend Complete 1. Highlight the patient from Patient Browser 2. In the Workflow Template Browser -> Select Category 3. Double click the workflow desired 3.3 Acquisition Workflows Overview 3.3.1. Acquisition Types • Static • Dynamic • Whole Body • Tomo • Gated Planar • Gated Tomo • Dynamic Tomo 30 Turnover Workbook | Symbia E Acquisition Tab Notes • Summary Tab • Used to review the acquisition parameters Acquisition Analyzer Display/Analysis Patient Bone, 3 Phase & WB Acquisition Display Detector 1: Detector 2 : Study: Bone Scan Series: Summary Series Information |Camera Parameters|Stop Conditions Name Description Patient Name Bone, 3 Phase & WB Patient ID Symbia T Study Name Bone Scan Series Name Series Technologist Reading Physician KCounts: KCounts: Referring Physician Remaining: Organ Elapsed Matrix Size 64 X 64 Zoom 1.00 Camera Preset Detectors Both Detectors Phase Frame Orientation Head In Patient Position Supine Phase Parameters Camera Parameters Supine 64 X 64 1.0 Both Detectors Prepare Acquisition • Series Information Tab • Series name is required. The rest of the fields are optional. Summary Series Information |Camera Parameters |Stop Conditi_1 | Series: Bone Flow Technologist JD Reading Physician Referring Physician: Organ: Skeletal Radiopharmaceutical Dose: sotope: 25.0 mCi 99m Technetium Pharmaceutical: MDP Interventional Drug Interventional Drug: Injection Time (hh:mm:ss): 0 0 0 Inject Dose (mg): 0 31 Turnover Workbook | Symbia E • Camera Parameters Notes • Allows you to select matrix size, zoom, camera preset, detectors, apply uniformity correction, orientation and body position. Summary Series Information |Camera Parameters|Stop Conditi Camera Parameters Matrix Size: 64 X 64 Zoom: 1.00 Camera Preset. Tc99m-NMG Detectors: Both Detectors Calibrations Apply Uniformity Correction Orientation Body Position : Supine • Stop Conditions • Allows you to modify the stop conditions, label the view and determine number of views. Summary |Series Information|Camera Parameters|Stop Conditions Stop Conditions Stops on both detectors. Detector 1 Detector 2 Use the same parameters for Detector 2. Time First View by Counts Counts >Time or Counts O Count Density Manual Time: 5 min Counts: 750 Kcts Any Window Group View Control Detector 1: Anterior Detector 2: Posterior Add View Insert View Update View Delete View View Detector 1 Stop On | Detector 2 Stop On | Orientation Corr. 1. Anterior 5 min Posterior 750 K ... Head Out Yes 2. Rt. Later ... 5 min ... Lt. Lateral 750 K ... Head Out Yes 32 Turnover Workbook | Symbia E Notes • Gate • Allows you to select gated parameters Camera Parameters Gate Stop Conditions Framing Beat Window · Number of Frames Selected Window. 8 Center: 72 Time per Frame: Width (%): 20 0 msec Autocenter Primary Window * Average of · Forward 10 Beats Forward / Backward by Thirds Peak Bin of Beats Autotracking PVC Reject PVC Beats Beats To Reject Post PVC: 1 PVC Threshold (msec): 300 Beat Histogram 100 80 60 40 20 Beats O 0 20 40 60 80 100 140 180 220 Beats/Min . 1 Window Beats/Min ms/Beat Save Curve • Acquire with Statics • Select Acquire with Statics on the Stop Conditions tab. A Static tab will appear. Camera Parameters |Stop Condition Static Stop Conditions 2. Static Tab Appears Time 0 msec Acquire with R-Wave Gate Acquire with Statics 1. Check Acquire with Statics Phase Parameters No Pause or Delay Pause Before Phase Number of Frames: 1 Phase Control Add Phase Insert Phase Update Phase Delete Phase Phase| Pause| Time / Frame # of Frames Off 1 sec 60 33 Turnover Workbook | Symbia E • Allows you to modify stop conditions for the statics acquired during a Notes dynamic study, modify views, and change matrix size. Camera Parameters |Stop Conditions|Static Stop Conditions Start Time (mm:ss): 0 Duration: 20 min StopTime: 22:00 Camera Parameters Static Matrix Size: 64 X 64 View Names Detector 1 Detector 2 Anterior Posterior View Control Add View Insert View Update View Delete View View Start Time Duration Stop Time Detector 1 Detector 2 2:00 20 min 22 :00 Anterior Posterior Analyzer Tab • Verify the selection of the correct isotope, or make changes to this selection. Also, shows verification that the isotope is peaked. Acquisition |Analyzer | Display/Analysis Camera Presets Detector Status Select Existing Preset: Peak Shifts (%) Tc99m-NMG Dead Time (%) | Peak Status 12 |3 |4 5 6 7 8 New Preset Name: Detector PT PEAK. Detector NOT PEAK .. Save Preset Begin Peaking Pause Between Peaks Window Number Center (kev) Width (% ) 15 Shift (%) Type Parent hotopeak WL Window Center (keV) Window Width ( % ) Window Shift (% ) : Window Group A 99m Technetium 12000 Window Group B 11000 10000 Window Group C 7000 Window Group D 6000 - Window Group E Counts 3000- Window Group F 1000 - 100 150 200 250 300 400 450 500 550 600 650 key 350 . Detector 1 Detector 2 be added to the current list of presets, for recalling at anytime. Display Analysis Tab • Used to review images 34 Turnover Workbook | Symbia E 3.3.2. Modifying and Saving a Workflow Template Notes 1. Review the parameters in the current workflow template 2. Make appropriate modifications 3. Template -> Save Workflow Template (to overwrite the current template) -> OK Template | Workflow Activities H Save Workflow Template OK Save Workflow Template As ... 4. Template -> Save Workflow Template As (to create a new template) Template | Workflow Activities H New Workflow Workflow Characteristics Save Workflow Template ... Enter New Workflow Name Workflow Name New Workflow Save Workflow Template As ... Enter New Description (Optional) Workflow Description: This worldlow acquires static acquisitions Select Category Category Select Icon ment Type: Lymphatic Mammary Workflow Icon: Parathyroid Pulmonary Renal Salivary gland New Old Skeletal Splenic Testicular 9 Thyroid Tumor Ureteric Vesical Calibration Coincidence Display Dynamic Dynamic Tomo Gated Q|Gated Tomo CO Click OK OM to Save Cancel 5. Enter the name, description, category and appropriate icon and click OK. 3.4. Patient Setup and Positioning 3.4.1. Manually Registering a New Patient 1. From Command Module -> Patient -> Register. 2. Fill in the following mandatory fields: Last Name, Patient ID, Date of Birth, Sex, and Study. (optional). All other fields are optional. 3. Click the Exam button. Patient Registration PROCEDURE PATIENT Last name Accession No Request ID Title Sufix Requested Other Patient Name(s) procedure(s) Other Patient ID(s) Ethnic Group Study list Military Rank Patient ID Date of Birth [M/d/yyyy] Sex . Male Female Other Study Age Years Study comme Height [ft'in"] Weight [b] Address Patient position INSTITUTION Additional info Institution name Details. 1. Performing physician warren moore, md 2. Performing physician HOSPITAL Referring physician Requesting physician . Operator Admitting diagnosis Ward Admission ID Preregister Exam Search Cancel Emergency Help 35 Turnover Workbook | Symbia E 3.4.2. Registering a Patient from HIS/RIS Notes 1. Open Patient Browser from Command Module: Patient -> Browser. 2. Highlight the Scheduler in the tree. 3. Pull down View -> Update Worklist. 4. Highlight the Patient at either the Patient or Study Level. 5. Double left click to load patient into Local Database. 3.4.3. Manually Registering a Existing Patient 1. Open Patient Browser from Command Module: Patient -> Browser 2. Click the Local Database icon in the tree. 3. Highlight the patient name. 4. Pull down Patient -> Register. 5. Select Study from pull down menu. Click Exam. 3.4.4. Positioning the Patients for Exams 1. From the PPM, press the Reconfiguration tab. 2. Choose detector configuration -> Proceed. Select Configuration Select Reconfiguration Tab 90º 76º Proceed X 14:27 3. To stop all system motions, press emergency stop button on gantry or any button on hand control. 4. Raise or lower the patient table to patient access height. 5. Select the patient and launch the workflow on the MI Workplace, and start the acquisition. (see section 3.2.3 for details in launching workflow) 36 Turnover Workbook | Symbia E 3.5. Processing Workflows Notes 3.5.1. Quality Control Activity (Motion Correction) • Used on the following data types: • Cardiac Gated Tomo • Cardiac Non-Gated Tomo • Dynamic • Tomo • Dynamic Tomo Cardiac Gated Tomo and Non-Gated Tomo Correction 1. Select the Quality Control Activity in the workflow 2. Pull down Series -> Select appropriate series 3. Select Beat Normalize if desired 4. Click and drag red horizontal line to the center of the heart. 5. Click the Cine button to view image for motion. 6. If motion correction is needed, click Motion Correct Series button. Settings Correction 2. Select Series Series: Stress Mibi-Gated [Corrected Before Sinogram After Sinogram % % 33 4. Click and drag red Linogram Linogram line to center heart 100 6 5. Click the Cine button to view motion 250 3. Apply Beat Normalize (Optional) Beats 10 20 30 40 50 60 70 80 90 100 120 140 160 180 200 220 Beats /Min Beat Normalize Beat Histogram: . Beats/Min Beats vs. Projections Unapply Correction ms/Beat HR vs. Projections 6. Click Motion Correct Series button Isotope: A Motion Correct Series ... Revert to Origina 37 Turnover Workbook | Symbia E 7. Drag the red ROI over the heart, centering the box over the heart. Resize and Notes reposition if needed. 8. Review cine, sinogram and linogram in the After section. 9. Click OK Motion Correction Automatic |Manual Automatic Correction Use All Projections Isotope : Shift all projections Apply X Shift 7. Center red ROI over Apply Y Shift heart. Head Misregistration Before 100 33 224.99 264.99 304.99 344.99 384.99 X Moll On Sinogram Linogram 224.99 264.99 304.99 344.99 384.99 Y MOLIOn After % 100 33 4.99 264.99 304.99 344.99 384.99 X Motion Sinogram Linogram 224.99 264.99 304.99 344.99 384.99 Y Motion 8. Click to Review Cine 9. Click OK 10. If satisfied, continue with processing 11. If not satisfied, click Revert to Original button. 12. Repeat steps 2-9 on additional series if required. 38 Turnover Workbook | Symbia E Dynamic Correction Notes 1. Select the Quality Control activity in the workflow. 2. Pull down Series-> Select appropriate series 3. Click Motion Correct Series AI Settings Correction 2. Select series Series : Renal Mag 3 Before After Renal Mag 3 20 Sum Sum 100 Quality Control Tools Unapply Correction 3. Select Motion Detector: Motion Correct Series .... Isotope: A Revert to Origina 4. Choose Correction Mode (Single or Multiframe) 5. Click the Cross Tool to change position of the red cross lines. 6. You can use the Shift tools to make adjustments to the position. The cursor changes to a hand. 7. Click inside the desired frame(s) and drag to shift the frame(s). 8. Review the cine and summed data to make sure the motion correction is acceptable. 9. Click the OK button to accept the changes. Motion Correction Manual Manual Correction Results Detector. single Frame Mode 4. Choose correction Isotope: 5. Cross Tool Multiframe Mode 6. Shift Tools to make adjustments in position 20 Sum 10% 0 8. Click to cine images X Shift: 0.00 Y Shift : 0.00 9. Click OK to accept the changes. OK 39 Turnover Workbook | Symbia E Tomo Correction Notes 1. Select the Quality Control activity in the workflow. 2. Pull down Series -> Select appropriate series 3. Click Motion Correct Series. Settings Correction 2. Select the series Series: Chest Before Sinogram After Sinogram 100 Pelvis 100 100 0 Linogram Linogram % 100 Sum Sum % Quality Control Tools Unapply Correction 3 . Click to motion correct series Motion Correct Series ... Isotope: A Revert to Original 4. Choose Correction Mode (Single or Multiframe) 5. Click the Cross Tool to change position of the red cross lines. 6. You can use the Verticle Shift tool to make adjustments to the position. The cursor changes to a hand. 7. Click inside the desired frame(s) and drag to shift the frame(s). 8. Review the cine and summed data to make sure the motion correction is acceptable. 9. Click the OK button to accept the changes. Motion Correction Manual Manual Correction Results Single Frame Mode 4. Choose correction Isotope: Multiframe Mode move 6. Vertical Shift Tool to 5. Cross Tool make adjustments in Linogram 52 100 Sum 100 8. Click to cine images 0.00 Y Shift: 0.00 9. Click OK to accept the changes. OK 40 Turnover Workbook | Symbia E 3.5.2. AutoRecon Activity Notes 1. Select the AutoRecon Activity in the workflow 2. Go to the Settings Tab 3. Make necessary adjustments to the Reconstruction Settings. 4. Make necessary adjustments to the Filter Settings. 5. Click to apply settings Bone - WB Tomo. @ cam - Bone Scan. 3/171 Workflow Activities Help Settings Reconstruction 6. Click the Reconstruction Bone Scan - Abdomen - Isotope A 3/17/2003 Tab Anterior Transverse Sagitta Coronal 71 7. Click and drag red lines to adjust range Quality Control Scrollable Views Display Zoom: Auto Recon Bone Scan - Thorax- Isotope A 3/17/2003 Transverse Sagitta Coronal 68 exible Displa ~ Scrollable Views Display Zoom: Non-AC - Isotope A Transverse Hard Copy Coronal 100 ~ Scrollable Views 4th Tomo for Non -A.C - Isotope A Display Zoom: Transverse Sagitt Coronal ~ Scrollable Views Display Zoom: 6. Click the Reconstruction tab 7. Click and drag the limits to adjust the range. 41 Turnover Workbook | Symbia E 3.5.3 Flash 3D Notes • Flash 3D is a statistically based iterative reconstruction method based on OSEM, where the distance-dependent collimator blurring is accurately modeled in all 3 dimensions. Adjusting Settings to Improve Image Quality Image is... Possible Solution Ensure Flash 3D is selected Decrease FWHM filter (guideline: roughly 2 * pixel size) Check image quality with 0 mm. Too Smooth Increase iterations. Usually more than 6 - 8. Increase subsets. Check number of subsets, and change to next valid value. Check for any workflow connection changes Increase FWHM (in particular for Tl201 rest studies) Too noisy, or sharp Decrease subsets Decrease iterations Check for motion, and correct if needed 42 Turnover Workbook | Symbia E 4 Organ Specific Processing 4.1. Organ Specific Processing Notes 4.1.1. Gastrointestinal Processing 1. Select the Gastrointestinal Activity in the workflow Gastric Emptin- Normal dyn- normal w/ solids, 12345678 - Gastric Emptying- Solids. 2/20/2001 File Gastrointestinal View Template Workflow Activities Help AI 3. Check ROI ngs ROI and placement (ric empting [Results] 2/21/2014 51 2. Click Cine button Switch to Cine Mode sotope: 99m Technetium ROI Create ROI Using: bom Technet! Emptying Curves Composite Image 80 m Techneti 600 % 100 500 400 Tit 300 Tempty-! Thalt Hard Copy 200 100 Counts per sec C 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 Minutes 4. Click the ROI Too Fr:1 1179K 64x64 to redraw ROI if needed. Treshold Results Summary Parameter 99m Technetium .......... Bkgd Correction on Emptying 41 % Decay Correction Emptying begin (TO) 3 mins Complete Suspen ROI Tool ... Geometric Mean Emptying end 60 mins T 1/2 68 mins Composite Frame Range TO -> T 1/2 65 mins First Frame: 1 Setup Last Frame: 20 The cine mode allows for cinematic viewing of a series in a single pane. Isotope: 99m Techn 6. Drag Tfit to gym Techneti .. ...... 99 m Techneti . Empt end of empty 5. Drag to start of empty 400 Tfit 300 Tempt-A Thalf 200 100 Counts per 0 5 10 15 20 7. Drag to position for % emptying 60 65 70 75 80 85 2. Review results 3. See Settings tab to review or modify parameters for this activity. 43 Turnover Workbook | Symbia E 4.1.2. Hepatobiliary Processing Notes 1. Select the Gastrointestinal Activity in the workflow Gallbladder 1 GBEF Dynamic, ECAM - GBEF. 2/22/2001 File Gastrointestinal View Template Workflow Activities Help AI Settings ROI Pan GallBladder [Results] 2/21/2014 Data Selector % 3. Check for ROI placement HARPE 2 . Click the Cine icon 5. Drag to adjust Start 6 . Drag to adjust End RO Create ROI Using: Warm Technet ... -darm Techneti.] Ejection Fraction Curves Composite Image 4500 flexible Display 4000 % Start 100 3500 3000 2500 2000 Hard Copy 1500 End 1000 Min Counts per sec 500 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 Minutes 4. Click to Fr.1 17002K 64x64 redraw the ROI ROI Results Summary Threshold : 25 Parameter 99m Technetium Bkgd Correction Decay Correction On Ejection Fraction 85 % EF interval begin 2 mins ROI Tool EF interval end 35 mins nplete T Max 2 mins Composite Frame Range T Min 35 mins First Frame: Setup Last Frame: 40 es the image position within the frame. Ctrl-click to center the image. 2. Review results 3. See Settings tab to review or modify parameters for this activity. 4.1.3. Planar Gated (MUGA) Processing 1. Select the Gated Bloodpool Activity and on the Processing tab of the workflow. Settings Processing > ils Fitting Results 1. Click the Gated Bloodpool Data Selector LAO- Gated [Results] 2/21/2014 activity and the Processing Tab Ventricular ROI flexible Display Duration : 31 msec Duration : 31 msec 5. Cine to check RO Hard Copy 2 2 All Fram Background ROI 2. Center LV in green box Cancel Fr:11 260K 64X64 11 262K64x64 Edit ROI 3. Click to determine LV center 6. Use to modify ROIs 4. Click in center of LV Setup Determine LV center ... ROI Tool ... ROI TOOL ... 2. Review results on Results and Fitting Results tabs. 3. See Settings tab to review or modify parameters for this activity. 44 Turnover Workbook | Symbia E 4.1.4. Lung Processing Notes 1. Select the Lung Processing Activity and on the ROI tab of the workflow AI 2. Review ROI A placement Settings ROI Regional Analysis Washout Analysis Perfusion Series Feritilazon/Se Perfusion Lung 2/24/2014 DTPA Aerosol Ventilation 2/24/2014 % 9% 100 Perfusion RPO Perfusion LA Perf Rt lat LILat All Images [ All Images Per POST SHANT Postaeroso grosOL 106 Threshold Adjust Frame Threshold : Adjust Frame X Shift: ................ ........ ........ 0 X Shift: ............................................ 0 ............ ........ ....... Y Shift: 0 Y Shift: 0 ROI Tool . Angle: 0 Angle: ROI Tool 3. Click to modify ROIs Registration 4. Click to adjust registration of the ventilation scan 2. See Regional Analysis tab to review or modify results for this activity. 3. See Settings tab to review or modify parameters for this activity. 45 Turnover Workbook | Symbia E 4.1.5. Renal Processing Notes • There are many parameters that can be modified on the Settings tab. There are several tabs on the Settings tab that may be selected. The tabs displayed depend upon which renal method has been selected. 1. Select the Renal Processing Activity and on the ROI tab of the workflow Renal MAG 3. Symbia T - Renal Scan. 1/26/2006 File Renal Processing View Template Workflow Activities Help AI . Review ROI as |Display ROIS placements Results Aort 5. Click to view results Quality Control 3. Use sliders to edit thresholds Processing Fri1 1752K 256X258 151 294K 256X251 Flexible Display Threshold : dit Threshold ..... ROITOOL Composite Image First Frame: 60 First Frame: 4. User ROI Last Frame: 70 Last Frame: 30 Tool to redraw ROI Setup Renal MAG 3. Symbia T - Renal Scan, 1/26/2006 File Renal Processing View Template Workflow Activities Help AI Settings Display ROls Results Kidney Aorta Data Selector Kidney Processing Fr:1 1752K 256x256 Fr.1 294K 256x256 Table of Patient Parameters Parameters Values Renal Protocol Generic (None) Counts / Second Flexible Displa Kidney Depth Method Standard Patient Name Renal MAG 3 Patient ID Symbia T 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 35 38 Sex Other Age 0.07 Reference BSA 1.73 m2 Hard Copy Split Uptake Interval ( ... 2.0 - 3.0 Radiopharmaceutical 10.0 mCi 99m Technetium MAG3 Method Adult Flow Hematocrit 0,00 Table of Result Summary Parameters | Left Right Total Split Function (%) 46.9 53.1 Kidney Counts (cpm) 57001 64629 121630 Renal Retention 0.182 0.248 Time of Max (min) 2.501 3.001 Time of 1/2 Max (min) 7.634 9.990 Time from Max to 1/2 M ... 5.134 6.989 Counts/Second 25 30 35 40 45 50 Setup FOALRAWLSEVA thess Levels 0% (0) -> 8% (187) 46 Turnover Workbook | Symbia E 4.1.6. Thyroid Processing Notes 1. Select the Thyroid Processing Activity. Thyroid 1123 Uptake Syringe, H46545 - Thyroid Scan, 12/18/2008 6 X File Thyroid Processing View Template Workflow Activities Help AI A Settings ROIs Result Series: CAPSULE 3. Select series Data Selector CAPSULE 12/18/2008 % 100 2. Select ROI Tab . Click Results tab to review results Processing 3. If necessary, you can drag/drop correct images into the fields below. Flexible Display CAPSULE 134K Duration:60sec Thyroid Image Empty Syringe Antecubital 4. Review RO placement 5. Redraw ROls, if needed, using ROI Tools Ant 24 HR 50K Duration:511 sec 256x256 Pix:0.7mm 123-lodine 256X256 Plc0.7mm 123-lodine Ihres Threshold : Edit Threshold : Edit ROI Threshold Setup ROI Tool .. ROI Tool .. ROITOOL ROI Tool .. Brightness Levels: 0% (0) -> 91% (202) Thyroid 1123 Uptake Syringe, H46545 - Thyroid Scan, 12/18/2008 Eile Thyroid Processing View Template Workflow Activities Help AI A Settings ROIS Result Data Selector Thyroid Imag 100 Result Statistics Total Total Right Left Right/Left Uptake Rate (%) : 12.5 8.8 3,6 24 Thyroid Uptake Rate/Pixel (%/Pixel) : 3.1e-00 3.5e-00 2.30-00 1.5 Vert. Length (cm) : Hor. Length (cm) : Area (cm2) : 22.8 14.0 8.8 1.6 Volume (cm3) : Weight (g): Pixel Size (mm) : 0.7 Right Total Count (KCounts) : 5.1 Bkgd. 12.4 0.4 Number of Pixels : 2494 255 Ruler Location Calibration Information Isotope : 123 lodine Injected dose (Kcpm): 59,6 Full Syringe Activity (Kcpm): 59.6 Ant 24 HR 50K Duration:511 sec 256x256 Plc0.7 mm 123-lodine Empty Syringe Activity (Kcpm): how Regions ~ Smooth Restore Antecubital Activity (Kcpm): Suspen Setup ick to display the Result tab. 2. See Settings tab to review or modify parameters for this activity 47 Turnover Workbook | Symbia E 4.1.8. Pixon® Processing (Optional Purchase) Notes • Clinical value: The Planar Processing activity uses the patented Pixon® Method to enhance the quality of planar images as though they were obtained with higher counts. This enables you to produce planar images of comparable quality to those obtained using your current protocols from raw images acquired using either lower than standard acquisition time and/or lower than standard radiopharmaceutical dosage. Alternatively, you may elect to maintain the counts and enhance image quality, or both reduce counts and enhance image quality. Display Input Series Statics Statics Statics [EPP-Complete] 2/24/2014 Statics 4/19/2002 % 30 % 100 100 PLAT 601 K Duration : 146 se 256X256 Pix:2.4mm 99m LAT 4 68 K Duration : 146 sec 256X256 Pix:2.4 mm 99 m 100 100 100 % RLAT 601K Duration: 146sec 256x256 Pix 2.4mm 99m Technetium arameters Auto RAO 9ook Duration:161 sec Technetium Po Boek Duration : 1 61 sec 256X256 Pix:2.4 mm 99m 100 100 00 100 PO 813 k Duration : 170 sec LA0 801 k Duration : 1 70 se Technetumm 99m of 8 frames processed. 4.1.9. Series Calculator Series Reformat • The Series Reformat activity is used to perform the following for data manipulation. • Resize Matrix Bone 3 Phase & WB. Symbia T - Bone Scan, 11/15/2005 File SeriesReformat View Template Workflow Activities Help AI 1. Select the desired 2. Click Resize to adjust eries Reformat matrix size matrix. Data Selector Select Series: Bone Statics OTTOOl. Revert To Original Input 1: Entire Series Matrix Size: 128 Resize % % % % % 100 100 100 100 100 100 Series Reformat Flexible Display Duration : 300 sec k 128 x 1 28 Pix 4 . 8mm Duration :300 sec 128x1 28 Plc.4.8mm Duration : 300 sec Duration: 3003 236K 28X 1 28 Pix 4 . 8 mm Duration:300sec 128x1 28 Pix:4.8 m Duration : 300 set * * 28x1 28 Pix.4. 8 mm 28x1 28 Plex:4 . 8 mm Harpy Susper Setup | DE All Images| All Detectors 48 Turnover Workbook | Symbia E Notes • Image Masking Hands-on Lab Computer MI Sim 1 You are in Hands-on Lab Bone WB and Statics, ECAM - Bone Scan, 4/19/2002 File SeriesReformat View Template Workflow Activities Help AI Settings Series Reformat Data Selector Select Series : Wholebody ROITOOL ... Revert To Original Input 1 : Entire Series Matrix Size: 256 Resize % 100 Series Reformat 2 . Select the ROI Tool Flexible Displ 1. Select image RT ANTERIOR LE POSTEBIOR RT 99m 24 Pbc2.4 mm ration: 1701 sec 2.56 x 1 0 2 4 P / C 2 . 4 mm Suspen Setup MXGP CALI Detectors ROI Tool X ROI User Interaction Prompt: ROI Tool Display Frames . 1x1 = 1×2 2x1 2x2 Sum : Select ROI ROIs : 1100 User Mask 3. Select ROI Tool used to draw 4. Draw mask ROI Color 0 RT ANTERIOR LT 5758K Duration:1701 sec 256x1024 Pix2.4mm 99m Technetium Edit ROI ROI Name : 5. Select to Keep Inside or Outside Threshold User Mask Keep Outside Keep Inside Cancel 3. To remove masking, click Revert to Original button 49 Turnover Workbook | Symbia E Series Filter Notes 1. Click on Series Filter activity and Series Filter tab. Hands-on Lab Computer MI Sim 1 You are in Hands-on Lab MUGA 5 2 View, Symbia S - Equilibrium Gated Cardiac, 1/26/2006 File Series Filter View Template Workflow Activities Help AI A SettingsSeries Filter 3. Select Spatial or Temporal filter Select Series: LAO Revert Series Original Series 1 : Entire Series Series Filter 2. Select series 0 ration 3 953 4 K 64X6 Pirechnetium FLEXIBLE DISP Filter Applied: No Filter Filtered Series 1 100 ration : 598 sec 64X 13.5mm 99 m uspen Filter Tool Wiener [S] Delete Save Test Specified Filter Filter Parameters 100 Kernel 2. 0.04328 0.12148 0.04328 0.04328 034998 002328 4. Select filter Affe 5. Make desired updates to ter parameters 6. Trial Filter to visually inspect. Size Wiener - 2 SNR 0.26 FWHM Update Trial Filter Views 7. Select the desired filter 8. Click OK Boxcar Iterations:3 Gaussian FWHM:6.00 Wiener FWHM :6.00 SNR:0.26 OK Cancel 2. See Settings tab to review or modify parameters for this activity. 50 Turnover Workbook | Symbia E Static Merge Notes 1. Select the study and double click the Static Merge Proc workflow. Up to 20 static series can be merged into one. Lung Aerosol, ECAM - Lung Scan, 2/16/2001 Eile Flexible Display View Template Workflow Activities Help X O AI A X Y Single Series Static Display Patient Name: Lung Aerosol Patient ID: ECAM DOB : 7/5/1962 Study Name: Lung Scan Series Study Date: 2/16/2001 Arithmetic Perfusion Lung [Concatenated] 2/24/2014 * + % % % % Anthmetic * + Arithmetic Duration:203sec 128x128 Duration: 203sec 128X1 28 Duration. 288sec 128x1 28 turation : 268sec 128x1 28 % Du Duration 31 5sec 128x1 28 % % Series Arithmetic 0 Lt Lat Aerosol 151K RPO aerosol 198K LAO aerosol 198K Perfusion RPO 316K Perfusion LAO 316K Dicom Toolbox Duration:315sec 128x128 Duration:298sec 128x128 Duration:298sec 128x1 28 Duration:78sec 128x128 Duration:78sec 128x128 % % % % % 100 100 100 100 100 Pert Rtlat 21128x128 Lt Lat 31 6k. Duration:127 sec Duration. 79sec 128x1 28 Duration: 79sec 1 28x128 Duration g6sec 128x1 26 Suspend 0 Perf POST 495K Duration:96sec 128x128 Setup (B:0% T:100%) All Images Series Extract 1. Select the Series Extract activity " Bone WB and Statics, ECAM - Bone Scan, 4/19/2002 File Series Arithmetic View Template Workflow Activities Help C Process Workflow 1. Select the images or phase to 2. Click the Data Selector Settings Ari extract in Operand 1 Extract icon Select Series. Stalles perand 1 Series 1: Multiple Frame x+ Flexible Display RLAT 601K LLAT 468K RAO 900K Duration:146sec Duration:146sec Duration:161 sec Duration : 161 sec uration: 170sec Duration : 170se 256x256 Pix2.4mm 256x256 Pix2.4mm 256x256 Px. 2. 4 M 256x256 Pix2.4mn a6 256 Pix. 2.4m 56x2:56 PIX 2.4 mm QQm Technotium QQm Technotium QQm Technetium All Images All Detectors Select Seri perand 2 Series 1: Entire Serie 100 100 RLAT 601K LLAT 468K RAO 900K Duration: 146sec Duration:146sec Duration:161 sec Duration :161 sec 56x256 Pix: 2.4 mm Duration: 170sec 6x256 Px 2 .4 mm Duration:170sec 256x256 Pix2,4mm 256x256 Pix2.4mm 256x256 Pix:2,4mm QQm Tochnotium QQm Tochnotium QQm Tochnotium am Torhnassim aam torna mm | All Images All Detectors Operation: Extract [Multiple Frame 3. Result will have the extracted images or phase Result Series RAO 900K LPO 808K Duration:161 sec Duration:161 sec Duration:170sec 256x256 Pix2.4mm 256x256 Pix2,4mm QQm Tochnotium QQm Tochnotium am Torhnafilm 3 | All Images Setup 51 Turnover Workbook | Symbia E 4.2. Flexible Display Notes • The Flexible Display activity is used to arrange and display all data acquired and processed in the MI Apps application. The Flexible Display activity can contain one or more display pages (tabs) with each page displaying one or more display objects. esults Composite Curve Display Flow (Phase 1) Filling (Phase 2) Excretion (Phase 3) Tools X Patient Name: Renal Lasix Patient ID: Symbia DOB: 12/30/1981 Study Name: Renal Scan Study Date: 4/6/2006 Radiopharmaceutical 1: 0.0 MBq (0.00 mCi) Operator Name: Tools X] V? ? Print Area Object Print Area Object Results Composite, Series Display (#25) Renal Lasix, Symbia Renal Scan 4/6/2006 7:44:24 AM #1000 Renal [Results] 10/8/2013 1:45:44 PM ....................................................................................................................................................................................... Print Area Object Print Area Object 52 Turnover Workbook | Symbia E • Below are examples of how different display objects are used. Cardi ac L. 2. 2/1/2001 * D * AI Text - Display Cada 1. Me Pet. DuitMES Image BB AI 41 Gatad Sovss 31/0001 11 51 Display Cardac tino Put.Duit ME 3/40001 8 57 43 AM Slice FUI Display weil white 2/10001 9:42 54 AM Curve Display Carsac 1. Mya Por, Duit utes == : MAGS AL Text Patient Name: Renal, MAG3 Abnormal Display Patient ID: 614 DOB: 8/26/1940 ame: Renal, MAG3 Abnormal Study Name: Renal Scan D: 614 DOB: 8/26/1940 Study Date: 12/1/2000 Con Dispia Print Study Name: Renal Scan Study Date: 12/1/2000 Display Of Resa Summary 19300004 12 41 34 7M2 Curve Parameter Rich Total Split Function (%) 7.351 Display Kthey Counts (cpm) 3001 2510.2 34145 Time of Max (mnin) 0 868 Time of % Maxémini 0.859 Series Display Multiple Rosal Scas 12/1/02000 #06 10 AM 30/2004 12:41:34 PM Frame and ( Maj 3.112/9/2000 8 211:58 AM ROI Statistics Notes 53 Turnover Workbook | Symbia E 4.2.1. Saving Pages as JPEGS and AVI Files Notes JPEGs 1. Click the Flexible Display activity. 2. To save or print a page, click the menu (Flexible Display activity), and then select the Save Page As menu item. The Save page-name Print Area As window is displayed. 3. Select a save location. 4. Type a file name. 5. Select a file type (.jpg, .bmp, .emf). 6. Click the Save button. AVIs 1. From within the Flexible Display activity, right click anywhere in the cine control bar. 2. From the pop-up menu, select the Save Cine As AVI menu item. 3. From the Save As window, select a location to save the file in. 4. Type a file name. 5. Select a file type. By default, the .avi file extension is the only selection. 6. Click the Save button. 4.2.2. Dual Monitor Support • The dual monitor option aids in positioning workflows across two monitors. Launching a Workflow on Left Monitor 1. Select the patient data. 2. Double click on the desired workflow. • By default, all workflows will be launched on the left monitor, keeping the MI Apps Browser displayed on the right monitor. Launching a Workflow on Right Monitor 1. Select the patient data. 2. Hold down the Shift key. 3. Double click the desired workflow. When the Shift key is held down while launching a workflow, the workflow will be launched on the right monitor. • This feature is useful if there is a workflow on the left monitor, and a side-by- side comparison is desired. * Workflows designed to be displayed across both monitors will have a DM in the workflow name. Press the ALT key when double clicking the DM workflow to use the DM feature. 54 Turnover Workbook | Symbia E 5 Patient Browser 5.1 Accessing the Patient Browser Notes • The Patient Browser displays all the patient and examination data stored in each database or external archive medium. • To access the patient browser, select Patient > Browser from the menu. • The system displays the browser. 11| 2D ANDHER SAVE SREENS. Loca Deabaco CCF3. 5.2 Patient Databases • The types of databases are symbolized on the left-hand side of the navigation area. Click an icon to see its contents displayed in the content area of the browser. Types of Databases • The Local Database is where the patient data and results of the examinations performed on the local workstation are stored. • The Scheduler contains the data on all pre-registered patients. • One or more DVD or CD devices may be connected to MI Apps workstation. 55 Turnover Workbook | Symbia E Correcting a Patient Name, ID Number, or Other Demographics Notes • If incorrect patient information was entered when registering the patient, it can be corrected using the following steps: 1. Access the syngo Patient Browser. 2. Click the Local Database icon. 3. Click the patient/study/series to be corrected. 4. Edit -> Correct 5. Make the needed corrections -> Enter initials -> OK Rearranging a Patient Series • The following steps may be used if data is acquired under the wrong patient name (for example, if Mr. Doe’s Rest series is acquired under Mrs. Smith’s name). 1. Access the syngo Patient Browser. 2. Select the Rest series under Mrs. Smith’s name. 3. Edit -> Cut 4. Click the appropriate study name under Mr. Doe. 5. Edit -> Paste Manually Transferring Data • Patient data may be manually sent to another workstation using the following steps: 1. Access the syngo Patient Browser. 2. Click the Local Database icon. 3. Click the patient/study/series name to be sent. 4. Transfer -> Send to. 5. Select the destination workstation. 6. Send 7. To check the status of the transfer, click the Transfer menu, and then select Network Job Status. Manually Archiving Data • A patient, study, or series data may be manually copied to an archive device using the following steps. 1. Access the syngo Patient Browser. 2. Insert the media into the archival device. 3. Click the Local Database icon. 4. Click the patient/study/series to be copied to the CD or DVD. 5. Transfer -> Archive To (name of the destination device) 6. If required, label the medium. 7. To check the status, pull down Transfer -> Local Job Status. Retrieving Data from an Archival Device • Data may be retrieved from DVD or CD devices and copied into the local database by using the following steps. 1. Insert CD media in the CD-ROM, CD_RW or DVD drive (located in the e.cam/ICS Tower) 2. Access the syngo Patient Browser. 3. Click the CD_ROM, CD_RW, or DVD icon. 4. Select the patient, study, or series to be imported. 5. Transfer -> Import. 56 Turnover Workbook | Symbia E Ejecting a CD or DVD Notes • The CD or DVD media must be ejected using the following method, or database errors may occur. 1. Access the syngo Patient Browser. 2. Click the Transfer menu, and then select Eject from CD_RW (or DVD, depending on the media) Deleting Data • Patient, study, or series data may be deleted from the database by using the following steps. 1. Access the syngo Patient Browser. 2. Click the Local Database icon. 3. Click the patient, study, or series to be deleted. 4. Edit -> Delete 5. Yes Caution: Deleted data is gone when deleted can not be restored. MI Apps Cleanup • The MI APPS Cleanup activity is used when the system becomes unstable/locks up. When using the MI Apps Cleanup activity, all data in currently running activities is lost. 1. From the Windows Start menu, select APPS -> MI APPS -> MI APPS Cleanup. es Options System Help Study Name: ALL Show All · Local MI Apps Study Date: ALL Network Category: All System Up Time: 1 Hour 22 Mins Database: Local Find 104 patients found on the system. Study dates: (all dates) Image Space Available : 45174 MB Auto Filter Patient Name Patient ID Most Rece ... # Studies # Series Databas Template Name Template Desc. Gastric Emptin- Normal, dyn- normal w/ solids 12345678 2/20/2001 1 Local D: Series Static Extractor Proc Extracts a singl Gastric Empting abnormal, dynamic-abn. w/ s ... 212 4/11/2008 1 Local D: Series Tomo Composite Proc Creates a stati .. Gastric Empty (4 hr), Pt 1 06514450 11/20/2009 5 Local D: Series Tomo Detector Extractor EXTRACTS D .. Gastric Emptying, Dual Isotope 30644173 7/6/2009 1 Local D: Series Tomo Extractor Det 2 EXTRACTS D .. GI Bleed (positive), 2 phase dynamic & statics 1000469630 2/21/2008 2 Local D: Series Tomo Extractor Proc Extracts a singl IQ SPECT good case2, Case #2 H0233973 1/25/2011 22 Local D: IQ SPECT SYMBIAT, symbiaT SITUS INVERSIS PROC This workflow w 0171544 3/20/2012 10 Local D: SITUS INVERSIS REST ACQ ACQUIRES A .. IQ SPECT, NICE CASE H1151800 2/28/2011 32 Local D: SITUS INVERSUS gSTRESS ACQ ACQ SITUS IN .. IQ SPECT, T6 11.01.19-09:18: 1/19/2011 Local D: Situs Inversus Proc v4_0 This workflow w IQSPECT 2, T2 11.01.19-08:17: .. 1/19/2011 11 Local D: Slice Comparison Displays and c .. IQSPECT, SYMBIA S SYMBIA S 3/20/2012 Local D: SMARTZOOM NM CT FOV Calibr ... Acquires a NM Liver Hemangioma 110099 12/29/2006 2 Local D: SMARTZOOM NM CT FOV Verifi ... Acquires a NM Liver, Complete TC99m_SC 4/17/2003 Local D: SMV 1Det Spot Display Displays spot v. CAAM 2123/2000 2 Get Logs Local D: SMV 3 Phase Bone Display DISPLAYS A .. MI Apps $/2001 2 Local D: SMV Cardiac Proc. processes a ga 1 syngo MI Apps Cleanup 2003 Local D: SMV Lung Display LUNG DISPLA. Start MI Apps 3/2009 2 Local D; SMV Slice display displays the S ... Set Program Access and Defaults T5/2008 2 Local D: SMV Wholebody Bone Displays a whol MIBG 3/15/2006 3 Local D: SMV Wholebody Masking MASK A WHO. Windows Catalog Symbia S 1/26/2006 5 Local D: Source Replenishment AQC Use this workfl .. 6 Windows Explorer ECAM 4/1/2002 Local D: SPECT_CT Display Displays correc 100329 2/5/2008 Local D: STATIC CCK ACQ ACQUIRES 5 .. Windows Update Symbia T 11/17/2005 1 3. Local D: STATIC DISPLAY. Multiple Static .. ECAM 2/22/2000 Local D: Static Display Displays static . eventwwwr.msc ECAM 2/26/2002 Local D: Static Gastric Emptying Proc. Paint ECAM 9/2/2003 Local D: STATIC GASTRIC PROC Will generate th Processes up t. -- Symbia T 1/18/2008 3 17 Local D: Static Masking Will mask regio explorer.exe 269351859 11/8/2011 5 Local D: Static Merge Proc Merges 1 to 20. shutdown_at_twenty_hour.bat Programs gory: All Workplace: SYMBIAO Stage: All Launch Suspend Complet Documents tus: All 14/ 14 Settings Search Run ... Shut Down ... Windows XP Professional Adds a Normal Priority Worklist Item. neckup not completed , system should not be u 114 12.48.45 F 57 Turnover Workbook | Symbia E 2. Choose Force Shutdown of High Level Processes. Notes Clean Up X This application may be used to clean up processes if the system becomes unstable or if a workflow no longer responds to the user. WARNING: Using this application will cause data in running workflows to be lost. Use this application only after you have exited all the workflows that you can. Comment to be logged : Use this first: Force Shutdown of High-Level Processes Use this only if the previous button does not solve system instability . Force Shutdown of High-Level Processes and Low-Level Servers EXIT 3. YES to continue with Cleanup Warning X WARNING: This action may result in a loss of data. Are you sure that you want to do this? Yes NO 4. When cleanup is complete you will be prompted to copy log files if necessary, if not choose Cancel. 5. If this step was unsuccessful, repeat Step 2 but choose Force High level Processes and Low Level Servers. 58 Turnover Workbook | Symbia E 6 Exercises 6.1. Patient Gantry Exercises Notes 1. The maximum weight the PHS will hold is __________ lbs. 2. Match the labels on this image: (5) (1) ( 2 ) (6) (10) (7) (3) (12) (8) (9) (11) (4) (13) (14) (15) (16) C-Frame ________ Rear Bed ________ Gantry ________ Patient Bed Posts ________ Foot Pedal and Docking Pin ________ Patient Bed ________ Pallet ________ Pallet Handle ________ Touch Pads ________ Detectors Infrared Body Contour System ________ Patient Positioning Monitor (PPM) (Optional) ________ Emergency Stop Button ________ Ruler ________ Pallet Release Button ________ 6.2 Quality Control Exercises 1. Perform the daily QC from start to finish. 2. List the steps needed to complete weekly QC. 3. List the Monthly Quality Control Procedures. a. b. c. d. 59 Turnover Workbook | Symbia E 6.3 Patient Registration Exercises Notes 1. Demonstrate how to register a patient manually and through the scheduler to acquire a WB Bone Scan. 2. Which 4 fields of information are required to register a patient? a. b. c. d. 6.4 Workflows Exercises 1. Modify the acquisition parameters on a Renal Scan. 2. Process a Renal Study 6.5 Patient Browser Exercises 1. Match the icon with the name. a. Scheduler b. Local Database c. Local Archive 3. Practice archiving patient data to your desired media. 4. Where can you view the status of jobs relating to sending data to another network node? 60 On account of certain regional limitations of sales rights and service availability, we cannot guarantee that all products included in this brochure are available through the Siemens sales organization worldwide. Availability and packaging may vary by country and is subject to change without prior notice. Some/All of the features and products described herein may not be available in the United States. The information in this document contains general technical descriptions of specifications and options as well as standard and optional features which do not always have to be Local Contact Information present in individual cases. Siemens Medical Solutions USA, Inc. Siemens reserves the right to modify the 51 Valley Stream Parkway design, packaging, specifications and options Malvern, PA 19355-1406 described herein without prior notice. Please USA contact your local Siemens sales representative Telephone: +1-888-826-9702 for the most current information. www.usa.siemens.com/healthcare Note: Any technical data contained in this document may vary within defined tolerances. Global Business Unit Original images always lose a certain amount Siemens Medical Solutions USA, Inc. of detail when reproduced. Molecular Imaging 2501 N. Barrington Road Hoffman Estates, IL 60192-2061 Order No. A914CX-CS-141451-P1-4A00 USA Printed in USA 04-2014 | All rights reserved Telephone: +1-888-826-9702 © 2013 Siemens Medical Solutions USA, Inc. www.usa.siemens.com/healthcare Global Siemens Headquarters Global Siemens Healthcare Siemens AG Headquarters Wittelsbacherplatz 2 Siemens AG 80333 Muenchen Healthcare Sector Germany Henkestrasse 127 91052 Erlangen Germany Telephone: +49 9131 84-0 www.siemens.com/healthcare www.siemens.com/healthcare

  • Symbia E Turnover Workbook