Symbia Evo Excel Turnover Workbook

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Visit www.usa.siemens.com/education for more information regarding the current Clinical Training and Siemens Clinical Training and Continuing Continuing Education Education portfolio. Siemens Customer Care Center: Call 1-800-888-7436 Siemens Training Centers • Troubleshooting assistance Immediate assistance for software Siemens Clinical Education • applications and workflow issues Training Center – TDC2 • For Tech Support press option 2 / for 110 MacAlyson Court applications support, press option 3 Cary, NC 27511 • Press the * key or enter the last six digits of your Functional Location Number Functional Location Number ____________________ Serial Number ________________________________ IP Address System _____________________________ IP Address PACS _______________________________ 3 II Contents I Contact Information Summary ............................................................................................... 3 II Contents .............................................................................................................................. 4 III Course Agenda .................................................................................................................... 6 Image Quality Essentials .................................................................................................... 6 Image Quality Factors ......................................................................................................... 6 Image Quality Troubleshooting and Review.......................................................................... 6 Wrap-up and Feedback ....................................................................................................... 6 IV Course Objectives ................................................................................................................ 7 1 Getting Started ..................................................................................................................... 8 1.1 System Power............................................................................................................... 8 1.2 Gantry ......................................................................................................................... 9 1.3 Detectors ................................................................................................................... 11 1.4 Hand Control.............................................................................................................. 13 1.5 Patient Bed, Pallet and Rear Bed .................................................................................. 14 1.6 Patient Positioning Monitor (PPM) ............................................................................... 18 2 Changing the Collimators.................................................................................................... 29 2.1 Collimator .................................................................................................................. 29 2.2 Changing the Collimator ............................................................................................. 30 3 Quality Control and Assurance............................................................................................. 36 3.1 Symbia Evo Excel QC Schedule .................................................................................... 36 3.2 Daily System Shutdown and Startup ............................................................................ 36 3.3 QC Procedures ............................................................................................................ 38 3.4 Daily NM QC............................................................................................................... 38 3.5 Weekly QC.................................................................................................................. 40 3.6 Monthly QC................................................................................................................ 40 4 Overview of Acquisition Console: MI Workplace Command Module ....................................... 45 4.1 Areas of Command Module ........................................................................................ 45 5 Anatomy of a Workflow....................................................................................................... 47 5.1 Workflow Navigator .................................................................................................... 47 6 Acquisition Workflows......................................................................................................... 49 6.1 Acquisition Types ....................................................................................................... 49 6.2 Acquisition Tab........................................................................................................... 49 6.3 Analyzer Tab............................................................................................................... 52 6.4 Display Analysis Tab.................................................................................................... 52 7 Modifying and Saving Workflow Templates .......................................................................... 53 7.1 Save Workflow Template ............................................................................................. 53 7.2 Save Workflow Template As......................................................................................... 53 8 Patient Setup and Positioning.............................................................................................. 54 8.1 Manually Registering a New Patient ............................................................................ 54 8.2 Registering an Existing Patient ................................................................................... 54 4 8.3 Registering a Patient from the HIS/RIS.......................................................................... 54 8.4 Positioning Patient for Exams ...................................................................................... 55 8.5 SPECT Acquisition Setup ............................................................................................. 56 8.6 Performing the SPECT Acquisition ............................................................................... 56 8.7 Perform SPECT Reconstruction..................................................................................... 56 9 Processing Workflows.......................................................................................................... 57 9.1 Quality Control Activity ............................................................................................... 57 9.2 Auto Recon Activity..................................................................................................... 61 9.3 Advanced Reconstruction Options ............................................................................... 61 10 Organ Specific Processing.................................................................................................. 62 10.1 Gastrointestinal Processing ....................................................................................... 62 10.2 Hepatobiliary Processing .......................................................................................... 63 10.3 Planar Gated (MUGA) Processing ............................................................................... 63 10.4 Lung Processing........................................................................................................ 64 10.5 Renal Processing....................................................................................................... 65 10.6 Series Calculator....................................................................................................... 66 10.7 Flexible Display......................................................................................................... 70 10.8 Saving JPEG and AVI files........................................................................................... 72 10.9 Dual Monitor Support ............................................................................................... 73 11 syngo Patient Browser ...................................................................................................... 74 11.1 Accessing the Patient Browser................................................................................... 74 11.2 Patient Databases ..................................................................................................... 74 12 Exercises and Knowledge Checks ....................................................................................... 78 12.1 Patient Gantry .......................................................................................................... 78 12.2 Quality Control ......................................................................................................... 78 12.3 Patient Registration .................................................................................................. 79 12.4 Workflows ................................................................................................................ 79 12.5 syngo Patient Browser............................................................................................... 79 5 SIEMENS III Course Agenda Day One Overview of System (Power, Gantry, Detectors, Patient Bed, Hand Control) Changing the Collimators Quality Control and Assurance Overview of Acquisition Console Anatomy of the Workflow Day Two Acquisition Workflows Modifying and Saving Workflow Templates Patient Setup and Positioning Processing Workflows Day Three Organ Specific Processing syngo Patient Browser Exercises and Knowledge Checks Day Four Review Q&A 6 IV Course Objectives Upon completion of this course, you will be able to: • Describe the function of the Symbia Evo Excel components • Demonstrate the operation of the gantry • Demonstrate the operation of the Patient Bed • 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 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 set up 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 use of the Volumetric Analysis activity • Demonstrate the basic operation of the Flexible Display activity • Demonstrate the steps for saving JPEG and AVI files • Demonstrate how to use dual monitors 7 Turnover Workbook | Symbia Evo Excel 1 Getting Started Notes 9 1 ) (2) 3 11) 13 4 8 12 5 9 6 (1) Emergency Stop Button (2) Hand Control (3) Gantry (4) Rear Bed (5) Siemens Nuclear Acquisition Controller (SNAC) (6) Power Switches (7) Patient Positioning Monitor (PPM) (8) Touch Pads Bed Handle (9) Detectors (10) Integrated Source Holder (retracted) (11) Pallet (12) Patient Bed (13) Pallet Handle 1.1 System Power 1.1.1 Power Switches Power switches provide electrical power to system components. Some switches control power to individual components, while others control power to a group of components. Most switches will remain in the On position during normal use. The Symbia system’s power switches are found in or on: • Gantry • Workplace systems • Workplace UPS 1.1.1.1 Main Power Switch The main power switch controls electrical power for the system, and disconnects the system from the facility’s power supply when switched off. 1.1.1.2 Gantry Power Switches Location At the bottom of the gantry’s left side are the electrical power switches. 8 Turnover Workbook | Symbia Evo Excel 1.1.1.3 Main System Power Switch Notes The system has a main system power switch located in the recessed area at the left side of the gantry’s bottom and individual power switches for specific areas of the system. The main system power switch controls electrical power for entire gantry and its accessories, disconnecting the system from the facility’s power supply when switched off. 1.2 Gantry Patient-friendly integrated gantry design with 30% larger bore, a 101.2 x 78.3 cm (39.8 x 30.8 in) opening for greater patient comfort regardless of size. 1.2.1 Gantry Components 6 1 2 5 3 6 4 (1) Hand Control (2) Gantry (3) Siemens Nuclear Acquisition Controller (SNAC) (4) Power Switches (5) Touch Pads (6) Detectors (7) Patient Positioning Monitor (PPM) 9 Turnover Workbook | Symbia Evo Excel 1.2.2 Emergency Stop Buttons Notes Red Emergency Stop buttons are located on each side of the gantry. The buttons light when pressed. (1) Top down view of gantry with Emergency Stop Buttons located on 1 each side of Gantry. Restart button above one of the gantry’s Emergency Stop buttons. Check that the Emergency Stop buttons light when pressed as part of the daily quality control procedure. (1) Restart Button 2 (2) Emergency Stop Button To restore motion, press the green Restart button next to one of the gantry’s Emergency Stop buttons. Check that the Emergency Stop buttons light when pressed as part of the daily quality control procedure. 1.2.2.1 Remote Emergency Stop (Usually placed next to Acquisition Workstation) 10 Turnover Workbook | Symbia Evo Excel 1.3 Detectors Notes The NM detectors can be rotated around the gantry and rotated around their yokes at various angles. The detectors have an automatic infrared body-contour feature that allows for automatic body contoured (noncircular) acquisitions and prevent patient collisions. Infrared light rails reside on either side of the detectors. Additionally, look-ahead sensors view the patient’s contour prior to entering the field of view for whole body acquisitions. 1.3.1 SNAC The SNAC controls the movements of the system during an acquisition, communicating between the system and the workplace. It receives power from the gantry and is located beneath the rear bed. 1.3.2 Orientation Dots Orientation dots appear on each side of a detector (one white/unfilled and the other gray/filled). The gantry also has dots on each side. These dots work as reference points when moving the detectors using the hand control. Dots also appear on the hand control to indicate towards which dot (direction) a detector will move when a motion button is pressed. SIEMENS 1 . - (1) Orientation Dot 1.3.3 Touch Pads There are four touch pads that halt all system motion when contact occurs. One touch pad covers each detector’s collimator. The other two touch pads cover three sides of the area behind each detector’s yoke. 1 2 E (1) Touch Pads on Detectors (2) A touch pad covers three sides of the detector’s yoke. 11 Turnover Workbook | Symbia Evo Excel 1.3.4 Infrared Body Contour System (Light Rails) Notes The infrared Body-Contour System has the following features and functionality: • One pair of light rails per detector, between which an infrared beam passes, creating a light curtain across the surface of the detector • Assists in adjusting the relative positions of the detector(s) and patient during precision movements • Assists non-circular SPECT and autocontoured whole body studies The look-ahead sensors have the following features and functionality: • Light rails detect body contours for detector radius adjustments while the patient bed is traveling out of the gantry • Used to prevent possible collisions with Detector 1 • Located at each corner of Detector 1 nearest the gantry (4) 3 2 3 1 - 4 (1) Automatic Infrared Body-Contour System (Light Rails) for automatically adjusting detector position, patient bed position and detector orbit, thus avoiding contact with collimator touch pad surface (2) Detector Look-Ahead Sensor (only on Detector 1) for detecting raised body parts, especially the feet (3) Yoke Look-Ahead Sensors for detecting raised body parts, especially the knees (4) Gantry Sensors (physical contact sensor) for detecting raised body parts, especially the toes 12 Turnover Workbook | Symbia Evo Excel 1.4 Hand Control Notes The hand control is used to manually communicate with the system. It can control gantry, patient bed and detector movements, as well as initiate acquisitions and programmed positioning. SIEMENS To better understand the hand control and system motions, use the gantry icon , detector numbers (1 and 2), and the white O and gray orientation dots on the hand control as a reference for the motion’s direction. The detector number, appearing on the fronts of the detectors, and the white and gray orientation dots, appearing on the detectors and the gantry, help in identifying the relationship between system orientation and the hand control. 10 11 3 1 12 4 13 5 O 14 6 15 7 2 16 8 17 9 18 (1) Rotate Detector 1 Counterclockwise (10) Rotate Detector 1 Clockwise (2) Detector 1 Towards White (11) Detector 1 Outward Orientation Dot (12) Detector 1 Gray Orientation Dot (3) Detector 1 White Orientation Dot (13) Detector 1 Towards Gray (4) Detector 1 Inward Orientation Dot (5) Rotate Gantry Ring (14) Rotate Gantry Ring Clockwise Counterclockwise (15) Detector 2 Inward (6) Detector 2 Towards White (16) Detector 2 Gray Orientation Dot Orientation Dot (17) Detector 2 Towards Gray (7) Detector 2 White Orientation Dot Orientation Dot (8) Detector 2 Outward (18) Rotate Detector 2 (9) Rotate Detector 2 Clockwise Counterclockwise 13 Turnover Workbook | Symbia Evo Excel 1.5 Patient Bed, Pallet and Rear Bed Notes The patient bed supports the pallet and bed index, and raises them to go between the detectors and through the gantry’s ring. The rear bed and bed index support the pallet when it extends through the gantry’s ring. 7 3 (8) 6 4 5 (1) Rear Bed (2) Foot End (3) Pallet with Pad (4) Pallet Release Button (on side of bed) (5) Patient Bed Handles (beneath bed) (6) ECG Connection (at base of patient bed) 1.5.1 Patient Bed Handles Recessed patient bed handles are located on each side of the patient bed to provide a hand grip when pivoting the patient bed. (1) Patient Bed Handle Bed Handle 1.5.2 Pallet The pallet is the surface that the patient lies on during an acquisition. It moves horizontally, and can be moved using the hand control. 1.5.3 Pallet Pad The pallet pad is attached to the pallet and provides patient comfort. The pad can be removed for cleaning or quality control procedures. 14 Turnover Workbook | Symbia Evo Excel 1.5.4 Pallet Handle Notes The pallet handle is not used for routine patient positioning.It is located on both sides of the patient bed. It is used to remove the pallet from the gantry’s ring in an emergency. In an emergency situation, pressing the Pallet Release button will release the pallet and enable you to move the pallet with its handle. 1 2 (1) Pallet Handle (2) Pallet Release Button 1.5.5 Integrated Source Holder The integrated source holder is a retractable rod built into the foot end of the patient bed. It is manually pulled out of the patient bed for quality assurance procedures and pushed back in when complete. A point source vial is inserted into the end of the integrated source holder, enabling source positioning for peaking, tuning and intrinsic verifications and calibrations. The integrated source holder can be retracted by pushing it back into the patient bed. (1) Hinge enables holder to be lifted up if detector is accidentally raised. (2) Integrated Source Holder 1 2 AUTION SURFACE A MAY OCCUR 1.5.6 Rear Bed The rear bed provides additional support for the pallet as it passes through the gantry’s ring. As the patient bed moves up and down, so does the rear bed. However, once the patient bed and rear bed reach a certain downward position, only the patient bed will continue its downward motion (unless the pallet is extended, in which case both rear bed and patient bed stop). 15 Turnover Workbook | Symbia Evo Excel 1.5.7 Patient Bed Travel Ranges Notes Patient bed positioning is shown on the PPM. 2) 1 7 0.0 kcts/s 2 0.0 kcts/s 0.0 cm 4. 0.0 cm 3 95% 100% 0.0" 180.0 0.0 cm 0.0 cm 1.23 1.23 123 KoV 123 KcV * LEHR LEHR C X 18:12 (1) PPM Tab (2) Bed Height (3) Bed Position 7 : ..... 4 6 ................. 1 2 3 5 (1) -77.9 cm - End of Pallet Travel in SPECT Study Position (2) 0.0 cm - Center of Gantry (3) 84.5 cm - End of the SPECT FOV (4) SPECT Field of View (5) 123.2 cm - Beginning of SPECT FOV (6) 136.1 cm - Fully Retracted Pallet (7) The PPM’s Bed In/Out Position (for example, 136.1 cm) shows the pallet position when it is fully retracted The bed height position shows the pallet distance in cm to the gantry’s center of rotation. The bed in/out position shows the patient bed position from the center of the gantry ring. The pallet fully retracted measures 136.1 cm. The pallet fully extended measures - 77.0 cm. 16 Turnover Workbook | Symbia Evo Excel 1.5.8 Rotating the Patient Bed Notes The patient bed can be rotated away from the gantry to allow for wheelchair and gurney imaging. Patient bed rotated stopped at 90° The patient bed cannot be rotated when the bed height is between 49.5 cm to 55.5 cm. The bed height is displayed on the Patient Positioning Monitor. To rotate the bed, perform the following steps: 1. Remove any objects from the path of motion around the patient bed. 2. Turn and hold the patient bed handle downwards, towards the floor. 3. Gently push the head end of the patient bed, in the predetermined direction of travel. The patient bed will rotate around the base of the bed. Be aware of the pinch points that are exposed while the bed rotates. 4. You can lock the patient bed’s position in either a 70° or 90°position. To lock at 70°, gently release the bed handle after bed motion has begun and slowly push the bed until its internal locking mechanism engages at 70°. OR To lock the bed at 90°, continue holding the patient bed’s handle downwards until rotation stops at 90. Release the handle once the bed is at 90°. 17 Turnover Workbook | Symbia Evo Excel 1.6 Patient Positioning Monitor (PPM) Notes The PPM is mounted on an arm (boom) extending from the top of the gantry. The arm can be moved to either side of the gantry with the PPM swiveling left or right, and tilting forward or backward. (1) PPM Arm (2) PPM (3) PPM Monitor Buttons 1 SIEMENS 2 3 M 2 3 4 8 (1) Decrease Volume (2) Increase Volume (3) Display e.media / PPM (4) Left Arrow (submenu selection - Service use only) (5) Display Menu (Service use only) (6) Right Arrow (submenu selection - Service use only) (7) Power On / Off (8) Power On / Off Light Emitting Diode (LED) - (A blue LED indicates power on; an amber LED indicates power-save mode.) 18 Turnover Workbook | Symbia Evo Excel Notes 1 Version syngo MI Applications VB10A 2 12.0.1.12 3 4 5 Restart utdown ouch Pad Test 6 X 7 09:51 (1) PPM Tab (2) Camera Info Tab (3) Reconfiguration Tab (4) ECG Tab (5) Offset Zoom / FOV Limit Tab (6) Collimator Change Tab (7) Setup Tab 1.6.1 PPM Tab Pressing this tab displays the screen containing status information for the patient bed, persistence images and fields containing information to assist in positioning the patient for an acquisition. 1.6.2 Camera Info Tab Pressing this tab displays the screen containing camera, detector, patient bed settings and also displays acquisition status. 1.6.3 Reconfiguration Tab Pressing this tab displays the screen containing available detector configurations for selection. 1.6.4 ECG Tab Pressing this tab displays the screen displaying ECG output, and contains settings for monitoring the patient. 19 Turnover Workbook | Symbia Evo Excel 1.6.5 Offset Zoom/FOV Limit Tab Notes Pressing this tab displays the screen containing persistence images and settings to set the position and zoom factor of the images within the persistence displays. It is also used for IQ•SPECT setup. 1.6.6 Collimator Change Tab Pressing this tab displays the screen containing available collimators. 1.6.7 Setup Tab Pressing this tab displays the screen containing controls for camera operations including shutdown and restart. 1.6.8 Function Buttons and Information Fields These buttons run along the bottom of the screen. Pressing a button initiates an action. The information fields display system status or study information. STEIVIENS 1 U.U KCISTS 2 0.0 kcts/s 22.0 cm 4, 136.1 cm 95 % 100 % -6.00 .96.0ª 34.4 cm 34.4 cm 1.00 1.00 140 KeV 140 KeV HiResPar HiResPar View 1 / 2 3 00:39 C X 4 09:51 13 5 6 8 9 10 11 12 (1) System Status Icons Area (2) Detector Number (3) Acquisition Progress Area (4) Text Message Area (5) Start / Resume Button (6) Pause Button (7) Stop Button (8) Home Button (9) Auto retract Detectors Button (10) Clear Button (11) Proceed Button (12) Cancel Button (13) Workplace Time Area 20 Turnover Workbook | Symbia Evo Excel 1.6.8.1 System Status Icons Notes Displayed across the top of the PPM when error conditions or system status changes occur. System Status Icons High Rate Warning Low Rate Warning Lost Lead Warning IQ SPECT Configuration QC SP Specialty Pallet Start/Resume AutoQC Source Attached Acquisition Exposed 1.6.9 Acquisition Progress Area This area displays the acquisition state in terms of cycles, repeats, phases, views, and scans. The acquisition progress area displays dynamically updating status bars which fill with color to indicate the progression of the acquisition, with units of measure indicated for the type of acquisition being performed. 1 2 3 4 Repeat 1/4 View 13/32 Phase 1/1 Cycle 1/3 00:39 5 6 (1) Repeats - This area displays the acquisition’s progress state as Repeat/Repeats (only for dynamic tomo). (2) Views - This area displays the acquisition’s progress state as View/Views (not for gated planar). (3) Phases - This area displays the acquisition’s progress state as Phase/Phases (only for dynamic and dynamic tomo). (4) Cycles - This area displays the acquisition’s progress state as Cycle/Cycles (only for dynamic tomo). (5) Acquisition Elapsed Time - This area displays the amount of time that has passed during the acquisition by shading the status bar. (6) Status Bar - This area displays the acquisition’s progress by shading the bar. (7) Remaining Acquisition Time - This area displays the amount of time remaining to complete the acquisition by displaying the amount of unshaded bar. 21 Turnover Workbook | Symbia Evo Excel 1.6.10 Patient Bed Information Fields Notes SIEMENS 1 0.0 kcts/s 2 0.0 kcts/s 22.0 cm 136.1 cm 95 % 100 % (1) Bed Height (2) Bed Index In/Out Position 1.6.11 Persistence Image Buttons and Information Fields SIEMENS 1 0.0 kcts/s 1 2 0.0 kcts/s 22.0 cm 2 4 136.1 cm 2 4 (W) 95 % 100 % -6.0º -96.0º 34.4 cm 34.4 cm 1.00 5 6 1.00 140 KeV 140 KeV HiResPar HiResPar View 1/2 00:39 C X (1) Count Rate Per Second (2) Persistence Image (3) Persistence Level (4) Persistence Window Level (5) Persistence Value Controls (6) Persistence Window Level Controls 22 Turnover Workbook | Symbia Evo Excel 1.6.12 Gantry and Detector Information Fields Notes SIEMENS 1 0.0 kcts/s 2 0.0 kcts/ 22.0 cm 136.1 cm 95 % 100 % -6.0º -96.00 (2) 34.4 cm 34.4 cm 1.00 1.00 140 KeV 140 KeV 5 HiResPar HiResPar View 1 / 2 00:39 ¢ C X 09:01 (1) Gantry Rotation Angle (2) Detector In or Out (3) Zoom Factor (4) Energy Window (5) Collimator Type 1.6.13 Camera Information Screens The camera information screen contains system, detectors, and patient bed’s settings, as well as acquisition status. 1.6.13.1 180° Configuration SIEMENS 1 N -130.5º 49.5º 36.1 cm 18.0 cm 6 36.1 cm 1 0.0 cm 136.1 cm 0.0 cm (2) 0.00 ₡ 0.0º 0.0º 5 1.00 1.00 140 KeV 1ª LEAP LEAP 3 135 | 405º (4) - X 59:01 (1) Detector 1 Towards White or Gray Orientation Dot (2) Detector Angle (3) Detector 1 Rotation Angle (4) Acquisition Status (5) Detector Tilt (6) Camera Info Tab 23 Turnover Workbook | Symbia Evo Excel 1.6.13.2 90°, 76°, or Gurney Configuration Notes SIEMENS 1 90.00 1 2 90.00 45.00 -45.0º 35.3 cm 22.0 cm 35.3 cm 136.1 cm (1) Configuration (2) Camera Information Tab 1.6.14 Reconfiguration Screen The Reconfiguration screen displays the available detector configurations for selection. 1.6.14.1 Reconfiguration Screen SIEMENS 1 2 90º 90º 76º 76º 3 4 X 09:05 (1) Detector Reconfiguration Selections (2) Reconfiguration Tab (3) Proceed Button (4) Cancel Button 1.6.14.2 Detector Reconfiguration Buttons 180 Configuration with +90 and -90º Outer Room Left Configuration Outer Room Right Configuration Gurney Configuration 90º 90º 180º Configuration 90" Supine 90º Prone Configuration Configuration 76º 76º 76º Supine Configuration 76º Prone Configuration 24 Turnover Workbook | Symbia Evo Excel 1.6.15 Integrated ECG Screen Notes The Integrated ECG Screen displays information from the internal or external integrated ECG gate. When used with the internal ECG gate, an ECG wave and heart rate are displayed. When used with the external ECG gate, only heart rate, in beats per minute (BPM), is displayed. The Integrated ECG Screen contains settings used to monitor the patient when an integrated ECG gate is present. ECG alarms alert the user when the patient’s heart rate rises or falls past set limits. 1 80 BPM 3PM 100 2 4 6 Do 8 (10) 9 3 5 7 X 18: 12 (1) ECG Display (2) Wave Height Increase (3) Wave Height Decrease (4) Integrated ECG Device Selection (5) External ECG R-Wave Trigger Device Selection (6) Audible Alarm On (7) Audible Alarm Off (8) Audible Alarm Lower Limit (9) Audible Alarm Upper Limit (10) ECG Tab 25 Turnover Workbook | Symbia Evo Excel 1.6.16 Offset Zoom / FOV Limit Notes The Offset Zoom / FOV Limit screen displays a persistence screen, and settings for the position and zoom factor of the image within the persistence display. SIEMENS 2 1 SPECT Q .00 4 2 3 C X D 11:42 (1) Persistence Images (2) SPECT FOV Zoom Factor (3) FOV Offset Controls with X and Y axis settings (4) Offset Zoom / FOV Limit Tab 1.6.16.1 FOV Offset Controls y 1 X (1) FOV Offset Control Up - Moves the zoom box in 0.0 0.0 an upward direction, four pixels at a time. As the Up button is pressed, the value shown for the Y Axis Setting on the PPM changes. 2 4 (2) FOV Offset Control Left - Moves the zoom box left, four pixels at a time. As the Left button is pressed, the value shown for X Axis Setting on the 3 5 PPM changes. (3) FOV Offset Control Reset - Using this control resets the image (no offset applied) and the zoom box X and Y Axis Setting values on the PPM to 0. (4) FOV Offset Control Right - Moves the zoom box right, four pixels at a time. As the Right button is pressed, the value shown for X Axis Setting on the PPM changes. (5) FOV Offset Control Down - Moves the zoom box in a downward direction, four pixels at a time. As the Down button is pressed, the value shown for the Y Axis Setting on the PPM changes. 26 Turnover Workbook | Symbia Evo Excel 1.6.17 Collimator Change Screen Notes The collimator change screen displays the collimators available for selection. LEHR 1 LEHR MELP Pinhole 3 2 HR HE (4 Remove 5 LEHR D 13:57 (1) Collimator Name - This area lists the name of the collimator installed. (2) Collimator Selection Buttons - Pressing a button selects a collimator for the collimator change sequence. (3) Collimator Scroll Controls - Pressing the forward or backward button scrolls and displays those collimators available for installation. (4) Collimator Remove Button - Pressing this button signals the system to remove a collimator. (5) Collimator Change Tab 27 Turnover Workbook | Symbia Evo Excel 1.6.18 Setup Screen Notes The setup screen displays the controls for preparing the system for acquisition, including homing the system, performing the touch pad test, automatically retracting the detectors, and shutting down or restarting the SNAC. 1-Version syngo MI Applications VB10A 12.0.1.12 2 3 4 5 6 7 8 Restart Shutdown Touch Pad Test 9 10- 09:51 (1) System Version - This area displays the current revision of acquisition controller application. (2) Restart Button - Pressing this button restarts the SNAC system. (3) Shutdown - Pressing this button shuts down the SNAC system. (4) Home Button - Pressing this button begins the system homing process. (5) Retract Detectors Button - Pressing this button retracts the detectors away from the center of the gantry. (6) Touch Pad Test Button - Pressing this button displays the Touch Pad Screen for testing the detectors and yokes’ touch pads. (7) Proceed Button - Pressing this button, when enabled, begins or continues a selected process. (8) Cancel Button - Pressing this button, when enabled, cancels a selected process. (9) Setup Tab (10) Text Message Area 28 Turnover Workbook | Symbia Evo Excel 2 Changing the Collimators 2.1 Collimator Notes The collimators come in sets of two, one for each detector (except for pinhole). Collimator thickness and construction vary. Various acquisitions require or restrict the use of certain collimators. 2 (1) Collimator with Touch Pad (2) Collimator Clamp 1 2.1.1 Collimator and Cart Components The collimator cart provides storage and transportation, and enables installation and removal of collimators. There are four collimator drawers for storage. A pinhole collimator can be stored in the second drawer. Each drawer is numbered on the side of the collimator cart. 1 6 2 7 3 4 (1) Pinhole Collimator (2) Collimator Cart Drawer Numbering (3) Collimator in drawer which slides in and out (4) Collimator cart leg slides into patient bed guide for docking (5) Collimator Cart Connector (6) Collimator Cart Handle (7) Collimator Cart Drawer Handle 29 Turnover Workbook | Symbia Evo Excel 2.2 Changing the Collimator Notes 2.2.1 Docking Collimator Cart To connect the collimator cart to the Symbia system, a collimator cart leg is inserted into the patient bed’s Collimator Cart Guide, found on the front of the patient bed. When the leg is fully inserted, the cart connects to the Patient Bed Docking Connector, which then confirms successful docking. 1 ) 2 3 (1) Patient Bed Docking Connector (2) Collimator Cart Guide on patient bed (3) Collimator Cart Leg 2 (1) Collimator Cart Connector (2) Collimator cart leg inserted into patient bed’s Collimator Cart Guide 30 Turnover Workbook | Symbia Evo Excel 2.2.2 Collimator Removal Notes 2.2.2.1 Removing a Collimator from the Collimator Cart 1. Dock patient bed 2. PPM -> Press Collimator Change tab 3. Collimator Change screen SIEMENS LEAP LEAP MELP UHE LEHR 2 LEAP 4 Remove (6 3 5 X 08:47 (1) Collimators installed on the detectors (2) Available collimators (3) Home button (4) Remove button (5) Proceed button (6) Collimator Change Tab 4. Press Remove button 5. Press Proceed button 6. The PPM displays the system motion screen with the text message, Please wait, while the detectors are in motion. SIEMENS X 31 Turnover Workbook | Symbia Evo Excel 7. If the collimator cart must be docked, the PPM displays the dock collimator cart Notes screen with the text message, Dock the collimator cart. SIEMENS X Dock the collimator cart . 8. Dock the appropriate collimator cart with empty drawers. 9. PPM Text: Please wait 2.2.2.2 System Preparing for Drawer Opening 10. Bottom detector rises to collimator drawer’s height and collimator clamp rises. 11. PPM Text: Open collimator drawer (number) SIEMENS X Oben collimator drawer 4. 32 Turnover Workbook | Symbia Evo Excel 12. Slide collimator drawer open and stop before collimator clamp. Make contact Notes and hold until detector movement begins and beep is heard. PPM Text -> Please wait. 13. PMM Text: Close collimator drawer (number) SIEMENS X 14. Slide and close collimator drawer until you hear the audible beep. PPM Text: Please wait. 15. Second detector moves into position. 16. Repeat steps 13-15 for second collimator. 17. Patient bed lowers to lock drawers. 18. System undocks collimator cart 19. PPM Text: Undock the collimator cart. Remove collimator cart to safe storage. SIEMENS X ndock the collimator cart. 20. Collimator removal is complete. 33 Turnover Workbook | Symbia Evo Excel 2.2.3 Collimator Installation Notes 1. Press the Home button 2. Press the Proceed button 3. PPM -> Press Collimator Change tab MELP LEAP UHR LEHS (2) LEHR 4 emove 3 X (1) The not available symbols and blank collimator-name fields indicate that no collimators are installed. (2) Available collimators (3) Proceed button (4) Collimator Change Tab 4. PPM -> Press the desired collimator selection button. PPM Text: Press PROCEED to change collimators or press CANCEL to exit. 5. Press Proceed button. 6. PPM Text: Dock the collimator cart. 7. Dock the collimator cart with appropriate collimators. 8. PPM Text: Please wait. 2.2.3.1 System Preparing for Drawer Opening 9. Bottom detector rises to collimator drawer height and collimator clamp rises. 10. PPM Text: Open collimator drawer (number) 11. Slide collimator drawer open and stop before collimator clamp. Make contact and hold until detector movement begins and beep is heard. PPM Text -> Please wait. 12. Collimator clamp lowers and second detector is moved into position. Collimator clamp is raised. 13. Repeat steps 10 and 11. 14. PPM Text: Close collimator drawer (number) 15. Close the collimator drawer. Audible beep sounds. 16. PPM Text: Please wait. 17. Patient bed lowers to lock drawers. 18. System undocks collimator cart 19. PPM Text: Undock the collimator cart. Remove collimator cart to safe storage. 20. Proceed to Touch Pad Test. 34 Turnover Workbook | Symbia Evo Excel 2.2.4 Touch Pad Test Notes 1. When the Touch Pad screen appears, press the 4 touch pads by hand. SIEMENS 2 Collimator Touch Pad Collimator Touch Pad Gantry Touch Pad Gantry Touch Pad X Press CANCEL to ignore the Touch Pad Test. 2. Confirmation clicking sounds and dimmed squares show with each successful contact. SIEMENS 2 nek pad Gentry Touch Pads Gentry Teach Paid X Press PROCEED to confirm the successful Touch Pad Test. 3. Press Proceed 4. Press Home 35 Turnover Workbook | Symbia Evo Excel 3 Quality Control and Assurance *Acquisition of a bar phantom is not required by Siemens, but can be done at the Notes discretion of the user. It is subject to state or federal requirements set forth in the user’s radioactive materials license. 3.1 Symbia Evo Excel QC Schedule Performed Quality Control Procedure Source Daily Intrinsic Verification 35 #Ci of Tc99m or or Extrinsic Verification Co-57 sheet source Weekly Intrinsic Verification with Tune 35 uCi of Tc99m Monthly Intrinsic Calibration with Tune 35 uCi of Tc99m Monthly Multiple Head Registration 1-2 mCi of Tc99m per source (MHR) 180º (Match sources within 20% of Head Alignment Verification each other for Tc99m only) (Calibration if needed) If the collimator is damaged Intrinsic Calibration, and See source strengths above. or replaced. Extrinsic Calibration for collima- tor MHR for collimator Head Alignment Calibration for collimator Significant change to Head Multiple Head Registration 1-2 mCi of Tc99m per source Alignment values for the ref- (MHR) 180º (Match sources within 20% of erence of Low Energy Parallel Hole collimator Head Alignment Calibration each other for Tc99m only) 3.2 Daily System Shutdown and Startup Before starting your daily QC, you need to recycle power to your system. 3.2.1 Shutdown 1. Ensure all workflows and data are saved, suspended, or completed 2. From the acquisition console: Options -> End Session 3. Select Shutdown System button 4. Yes to confirm shutdown. This will shutdown acquisition console, and its applications. 3.2.1.1 Turning off the Acquisition Console’s UPS 5. If a UPS is present, wait until the acquisition console is powered off. Press and hold the acquisition console’s UPS OFF (O) button until the UPS powers off. (The on and off buttons may be the same button on your UPS or they may be separate buttons) 36 Turnover Workbook | Symbia Evo Excel 3.2.1.2 Shutting Down the SNAC Notes 6. Go to PPM -> Setup tab 7. Shutdown 8. Proceed 3.2.2 Startup 3.2.2.1 Logging on to Acquisition Console 1. If a UPS is present, turn acquisition console’s UPS button ON (I). If UPS is not present, press the power button on the acquisition console to turn it on. (The on and off buttons may be the same button on your UPS or they may be separate buttons) 2. Open the esoft user icon that appears on the Windows screen. 3. User name: esoft and press ENTER key. 4. Password is esoft and press the ENTER key. 3.2.2.2 Resetting the SNAC 5. When PPM Text reads OK to Shut Down, flip the SNAC power switch Off (down) to turn off SNAC computer. 6. Wait 60 seconds, and flip the SNAC power switch On (Up) to turn on the SNAC computer. 7. PPM -> Press Setup Tab 8. Continue with Touch Pad Test 3.2.3 Touch Pad Test If collimators are installed on both detectors, press the Touch Pad Test button on the PPM, and then the Proceed button to initiate the touch pad test. See 2.2.4 in this manual on performing the Touch Pad Test. If collimators are not installed, move to the Homing the System section below. 3.2.4 Homing the System 1. PPM -> Setup tab. 2. Press HOME button 3. Press PROCEED button 4. System will proceed with homing 37 Turnover Workbook | Symbia Evo Excel 3.3 QC Procedures Notes The QC procedures can be performed by: • Inserting a point source in an integrated point source holder • Using a sheet source, or • Using a phantom 3.4 Daily NM QC 3.4.1 Intrinsic Verification An intrinsic verification uses a point source, flooding uncollimated detectors to verify the detectors’ corrected performance. 3.4.1.1 Setup 1. Home the system and remove collimators 2. Prepare 35 uCi point source 3. On workstation, highlight current QC patient 4. Double click the Intrinsic Verification workflow 5. Cover the Detector 2 surface with a protective material to avoid contamination 6. Extend point source holder and place point source in, cap end in 7. Count rate should be between 15 kcts/sec and 50 kcts/sec. 3.4.1.2 Tuning the System 8. Tuning the system is only necessary on a weekly basis. If you do not need to tune, Skip to Next Activity and go to step 11 9. On the first Tuning activity for Detector 1, select Start Tuning and Peaking. The system automatically configures the gantry and patient bed for the acquisition. 10. On the second Tuning activity for Detector 2, select Start Tuning and Peaking. The system automatically configures the gantry and patient bed for the acquisition. 11. When completed, a message appears for each activity above of success or failure. If it fails, repeat Tuning and Peaking for each head. If repeated failures, place a Service Call. 3.4.1.3 Peaking and Verification Acquisition 12. Adjust table height to center the source so count rates are similar between heads. 13. If you skipped the tuning activity, go to the Static Acquisition activity of the workflow and select the Analyzer tab. Click Begin Peaking, to peak the system. 14. If peak shift is >± 3%, you must exit the workflow, restart the workflow and Tune the system. Perform steps 8 and 9. 15. Go to the Acquisition tab, enter the date in series information and click Prepare Acquisition and Start to acquire the flood. 38 Turnover Workbook | Symbia Evo Excel 3.4.1.4 Review the Results Notes 16. On the Flood Calculation Activity, visually inspect the flood and make sure the flood is uniform. Review the values. If the values are within limits, accept and save the values. Reject unacceptable values. These values are used for service trending purposes only. Uniformity CFOV UFOV Integrated 5% 6% Differential 2.5% 3% 17. Make appropriate selections in the Hard Copy activity. 18. Complete the workflow. 19. Remove source and retract the source holder, remove the protective cover, and attach the collimators. 3.4.2 Extrinsic Verification An extrinsic verification uses a sheet source, flooding collimated detectors to verify the detectors’ corrected performance. An extrinsic verification may be performed instead of an intrinsic verification to verify the detector’s performance. However, intrinsic verification with tuning should be performed at least once per week. 3.4.2.1 Setup 1. Home the system 2. Install the appropriate collimators 3. Attach the sheet source holder (See users manual for more detailed instructions) 4. Center the sheet source within the defined source area 5. On workstation, highlight current QC patient 6. Double click the Extrinsic Verification workflow 3.4.2.2 Acquisition 7. Go to the Acquisition tab and enter the date in the series information field. 8. Click Prepare Acquisition 9. Start to acquire the flood. A warning message indicating system motion is displayed. The system automatically lowers the patient bed, rotates Detector 1 to 0°, and adjusts the patient bed’s height and in/out position so that the sheet source is in the detector’s FOV. The system acquires a corrected 10 million count flood for Detector 1. Upon completion, the system automatically retracts the pallet, rotates Detector 2 to 0°, moves the pallet back in, and acquires 10 million counts on Detector 2. Upon completion, the workflow proceeds to the Flood Calculation activity. 39 Turnover Workbook | Symbia Evo Excel 3.4.2.3 Review the Results Notes 10. On the Flood Calculation activity, visually inspect the flood and make sure the flood is uniform. Review the values. If the values are within limits, accept and save the values. Reject unacceptable values. These values are used for service trending purposes only. Uniformity CFOV UFOV Integrated 5% 6% Differential 3.5% 4% 11. Make appropriate selections in the Hard Copy activity for save screens and hard copies. 12. Complete the workflow. 13. Remove the source and the source holder and reattach the pallet pad. Home the system. 3.5 Weekly QC 3.5.1 Intrinsic Verification with Tune Follow the steps for the acquisition of Intrinsic Verification under Daily QC. Tuning must be performed during this procedure. 3.6 Monthly QC 3.6.1 Intrinsic Calibration Procedure An intrinsic calibration uses a point source, flooding uncollimated detectors to verify the detectors’ corrected performance. 3.6.1.1 Setup 1. Home the system 2. System will automatically remove the collimators 3. On workstation, highlight current QC patient 4. Double click the Intrinsic Calibration workflow 5. Ensure that nothing is obstructing the motion of the detector heads 6. Extend the source holder and insert the point source 7. Make sure the count rate is between 15 kcts/sec and 50 kcts/sec. 3.6.1.2 Tuning and Peaking and Intrinsic Calibration Acquisition 8. Click on the Tuning activity of the workflow and click the Start Tuning/Peaking button to peak Detector 1. 9. When detector 1 is finished, the workflow will move to the next activity. 10. Click the second the Tuning activity and click Start Tuning/Peaking button to peak Detector 2. 11. When the tuning of Detector 2 is complete, click on the first Static Acquisition activity. 12. Click Prepare Acquisition and then the Start button. 40 Turnover Workbook | Symbia Evo Excel 3.6.1.3 Review the Results of the Intrinsic Calibration Notes 13. 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. 3.6.1.4 Intrinsic Verification Acquisition 14. Click the second Static Acquisition activity and click the Start button. At 10 million count flood will be acquired on both detectors simultaneously. 3.6.1.5 Review the Results of the Intrinsic Verification 15. Review the daily intrinsic verification flood results, including corrected floods and uniformity values. Values for a 10 million count verification flood should meet the following uniformity values. If not, check the setup and background radiation. Otherwise, the detector may require tuning or a new intrinsic calibration required. Uniformity CFOV UFOV Integrated 5% 6% Differential 2.5% 3% 16. If results are acceptable, click Accept These Verifications button. If not acceptable, click Reject These Verifications button. 17. Complete the workflow. 3.6.2 Extrinsic Calibration Procedure The extrinsic calibration is performed for new collimators or if minor collimator damage is suspected. It uses a sheet source to flood collimated detectors and generate an extrinsic uniformity correction matrix. If an intrinsic flood was acquired in the ten days prior to the extrinsic calibration flood, this calibration will also generate a collimator correction matrix representing the uniformity of the collimator separate from the detector. This matrix will be combined with a subsequent intrinsic calibration flood to provide an updated extrinsic uniformity correction matrix. An intrinsic calibration should be performed within ten days prior to the extrinsic flood calibration. 3.6.2.1 Setup 1. Home the system. 2. Install the collimators on the detectors. 3. Remove the pallet pad. 4. Install the sheet source holder (See Operators Manual for detailed instructions) 5. Center the sheet source on the sheet source holder. 6. Select the QC patient and launch the Extrinsic Calibration workflow. 41 Turnover Workbook | Symbia Evo Excel 3.6.2.2 Extrinsic Calibration Acquisition Notes 7. Click Start button Note: For collimators only used for planar imaging, the Stop on Counts condition may be reduced from the default of 120 million to 30 million. 3.6.2.3 Review the Extrinsic Calibration Results and Save 8. The uniformity values should be <10%. The extrinsic calibration flood should be reviewed for major defects consistent with collimator damage. For medium and high energy floods, the collimator septa will be visible in the uncorrected flood image. 9. If the results are acceptable, click the Accept These Calibrations and Make Them Current button. 10. If the results are not acceptable, click the Reject These Verifications button. 3.6.2.4 Extrinsic Verification Acquisition 11. From the Static Acquisition activity, click the Start button. 12. System acquires 10 million count flood for Detector 1. 13. The system reconfigure and acquire 10 million count flood for Detector 2 3.6.2.5 Review Extrinsic Verification Results and Save 14. Review the extrinsic verification processing results, including the corrected flood and quality values. Check that no significant defects have appeared since the previous day’s flood. 15. If the results are acceptable, click the Accept These Calibrations and Make Them Current button. 16. If the results are not acceptable, click the Reject These Verifications button. 3.6.3 Multiple Head Registrations (MHR)/ Center of Rotation (COR) Calibrations MHR/COR calibrations are performed for each collimator and configuration used clinically. The calibration aligns the detector to the gantry’s center of rotation and to one another. 42 Turnover Workbook | Symbia Evo Excel 3.6.3.1 Setup and Acquisition Notes 1. Retract the pallet and remove pad. 2. Mount MHR phantom and insert the 1-2 mCi Tc99m point sources (See Operators Manual for more detailed instructions) a. 3 point sources for MELP and HE collimators b. 5 point sources for LEHR, UHR, LEAP, FB, LPHR and all other collimators SIEMENS MHR Phantom O O *AO Source Location Extra High Energy Collimator UHR, HRES, LEAP, LPHR & Fan Beam Collimator SMARTZOOM Collimator All Others Use mild detergent to clean. Do not use alcohol based cleaners 3. Home the system. 4. Configure the system for the collimators to be used. Parallel Hole Collimators Fanbeam Collimators Configure Detec- 180º * 90º * 76º * 180º tors Bed In / Out - 39.5 cm - 39.5 cm - 39.5 cm 136.1 cm Bed Up / Down 9 cm 9 cm 9 cm - 1.5 cm Radius 22 cm 22 cm 22 cm 16 cm + 0.5 cm Done automatically. 5. On workstation, highlight current QC patient 6. Double click the desired MHR/COR workflow. 7. Select the Tomo Acquisiiton activity, and click the Series Information tab. 8. In the Series Description field, type the name of the collimator and the date of the calibration in the name. 9. Click the Start button 3.6.3.2 Review the Results and Save 10. On the Head Alignment Processing activity, visually inspect the MHR COR Calibration Results. Review the values. If the values do not meet system specifications, they will be displayed in red. a. If this occurs, click the Reject These Calibrations and Use Existing Set button, review point source placement, and repeat calibration b. If acceptable, click the button Accept These Calibrations and Make them Current to save the values 43 Turnover Workbook | Symbia Evo Excel Head Alignment Calibration Results (Parallel Hole Collimators) Notes • |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 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 11. Make appropriate selections in the Hard Copy activity. 12. Complete the workflow. 13. Repeat these steps for all collimators and configurations. 44 Turnover Workbook | Symbia Evo Excel 4 Overview of Acquisition Console: MI Workplace Command Module 4.1 Areas of Command Module Notes Study Name ALL Show A · Local Study Date ALL @ Network Category Al System Up Time: 12 Mins Database, Local Find 18 studies found on the system. Study dates (at datos) Inage Space Available 75400 MB Auto Fiber sddy IW Patient Horne Patort D Study Nome | Study Date |# Series |Database Locator Bone. 3 Phase 0127:18 Bone Scan 4/23/2002 Local Database Sone, Lumbar Tomo 673 Bone Scan 4/22/1993 Local Database Bone. Spine Torno 2 E.CAM Bone Scan 11/30/1989 Local Database Bone, WB and Statics Cardiac Detector 81156 Bone Scan 4/19/2002 Detector Brain, ktolintencial 12345 Brain Scon Local Database 5/19/2003 Sico Local Database ase Bon Centering Convergen AD AO Cardiac 1. Myo Pert Duet MBI Duet MET Myocardial Pect 2/1/2001 Local Database Cardi ac 2, Myo Perf Myocardial Pert 1/25/2001 Local Database Cardrac 3. Dual Study Cd Duet Myoview 1/9/2001 Local Database Cardi ac 3. Dual Study Cod. Duet Myoview Myocardial Pert al Pert. Display Example Cardiac 4, Stress & Rest 124-58-5106 1/2/2001 Local Database Example ot Perf 3/25/2002 Local Database Dynamic Cardioc 4, Stress & Rest 124-58-5106 Duet Myoview 1 o Pert 3/25/2002 Local Database Cardiac 5, Myo Perf Abno al Pert 1/8/2001 Local Database 2 Cardiac 7. Profilo Tc TI 12162212 o Pert 2/2 1/2001 Local Database Example Cardoc, Cardiac Motion 123456 lol Pert 2/23/2000 Local Database Dcample Example WB and St Cardioc. Shurt COL91362794 Equilibrium Gate 1/7/2002 Local Database Gated Stade (DH) First Pass COL91620666 First Pass 12/17/2001 Local Database AD Fusion 1. PETICT WB FU 1 Siemens PET Philipps CT @/18/2002 Local Database Fusion 1. PETICT WB FU 1 8/6/2002 Fusion 6. MRIPET Head FU 6 Local Database Brain 8/15/2002 Local Database Example Example Exarrole Fusion Desplay. WB PET e soft Fusion Di -4/5/2001 Local Database Band T Wholebo WholeBo halbladder 1. GBEF Dyn Perrose 0333443 GEEF 2/22/2001 Local Database Gallbladder 2, GBEF Dyn ECAM 5/17/2000 Local Decabose 012533 Garbladder EF 4/1/2002 Catbladder, Dyn & Static Local Database Calium, 2 WB & 1 Tomo Galbladder EF 2429453 Turnor Imaging 5/17/2000 Local Database Extririsic Ful Gastric Emp, Static A/P 520730 Gastric Emptying 11/23/2001 Local Database Verfication Dot Regen Sice Gastric, Dynamic Single Is Perrose 7051808 Gastric Emptying 2/20/2001 Local Database Gated Bloodpool, TOMO 12345 Equilibrium Gate 2/20/2001 Local Database ung. Aerosol 22085481U0MM Lung Veralation 2/16/2001 Local Database Long. VIQ 381201STM Lung WO Scan 2/22/2000 Local Database ntrinsic letrinsic Irensic Kidess VM Data, AX Coronaries 42711 4/22/1997 Local Database da bead on Service LC Category All Workplace SYNGO26 Work Status: All Launch Suspend Complete 3 (1) MI Applications Patient Browser (2) Workflow Template Browser (3) Workflow Manager 4.1.1 Patient Browser Area Patient Browser Patient Register List Patients List Studies List Series Search Study Name: ALL Show All Refresh Study Date: ALL System Up Time: 12 Mins Database: Local Find Summary 48 studies found on the system .. Study dates: (all dates) Image Space Available 75460 MB Information Patient Name Patient ID Study Name Study Date # Series Database Location Bone, 3 Phase 012718 Bone Scan 4/23/2002 3 Local Database Bone, Lumbar Tomo 673 Bone Scan 4/22/1993 Local Database Column Bone, Spine Tomo 2 E.CAM Bone Scan 11/30/1989 Local Database Bone, WB and Statics 81156 Bone Scan 4/19/2002 Headings Local Database 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 JOSHOOOONON- Cardiac, Shunt COL91362794 Equilibrium Gate .. 1/7/2002 8 Local Database First Pass COL91620666 First Pass 12/17/2001 1 Local Database Fusion 1, PET/CT WB FU 1 Siemens PET 9/18/2002 1 Local Database Fusion 1, PET/CT WB FU 1 Philipps CT 8/6/2002 Local Database Fusion 6, MR/PET Head FU 6 Brain 8/15/2002 Local Database Fusion Display, WB PET . e soft Fusion Di .. 4/5/2001 Local Database Gallbladder 1, GBEF Dyn ... Penrose 0333443 GBEF 2/22/2001 Local Database Gallbladder 2, GBEF Dyn ... ECAM Gallbladder EF 4/1/2002 Local Database Gallbladder, Dyn & Static 912533 Gallbladder EF 5/17/2000 2 Local Database Gallium, 2 WB & 1 Tomo 2429453 Tumor Imaging 5/17/2000 3 Local Database 45 Turnover Workbook | Symbia Evo Excel 4.1.2 Workflow Template Browser Notes . Local Refresh Category: All Local or Workflows Network Auto Filter Category Phase Bon. Cardiac Detector Detector Slice Centering Convergen ... AO AO Auto Filter Workflow Display Example Example Example Template Dynamic Gated Tom. AD AO AO List Example Example Example Example Gated Static (DH) Tomo (DH) WB and St. AO AO AO Example Example Example Extrinsic Calibration WB and T ... Wholebo ... WholeBo ... Calibration Extrinsic Extrinsic Service Verification Dot Regen Full General Slice ... 1 1 4.1.3 Workflow Manager Refresh Category Workstation Launch Suspend Category: All Workplace: SYNGO26 Work Status: All Stage: All Launch Suspen omplete 4.1.4. Launching a Workflow 2 Select Category Study Name ALL Show All Study Date ALL ategory Al System Up Time: 12 Mins Database: Local Find 48 studies found on the system. Study datos (al datos) Image Space Avariable 75460 MB Auto Filler Patient Name |Patort D | Study Nome Study Date |# Series | Database Locator Bone: 3 Phase 012718 Bone Scan 4/23/2002 Local Database Bone, Lumbar Tomo 673 Bone Scan Bone, Spine Torno 2 E CAM 4/22/1993 Local Database 11/30/1989 Bons, WB and Statics Bone Scan Local Database Bone Scan 4/19/2002 Cardiac Brain, Ictalfintencial 81156 Local Database Centering Convergen 12345 Brain Scan 5/19/2003 Local Database Slice Cardiac 1, Myo Perf Duet MBI Myocardial Pert 2/1/2001 Local Database AD 1. Highlight Mancendial Bent 1/25/2001 ardrac 3. Dual Study Ofd . Duet Myoview Myocardial Pert 1/9/2001 Local Database Example Cardi ac 4, Stress & Rest 124:58-5106 Myocardial Pert 3/25/2002 Local Database Dynamic Gated Tom Patient Cardiac 4, Stress & Rest 124-58-5100 A Cardiac 5, Myo Perf Abno Myocardial Pert Local Database Cardiac 7, Profile Tc TI Duet Myoview 12162212 Myocardial Pert 3/25/2002 Myocardial Pert 1/8/2001 2/21/2001 Local Database Local Database Cardiac, Cardiac Motion 123456 Myocardial Pert 2/23/2000 Local Database Example Example Cardiac, Shurt COL91362794 Equilibrium Gato 1/7/2002 Local Database Stade (DH) Stade (DH) Tomo (DH) 0 and St 3. Double First Pass COL01620606 Fusion 1, PET/CT WB First Pass 12/17/2001 Local Destabase FU_1 @/18/2002 Fusion 1. PETICT WB FUI Siemens PET Fusion 6. MRIPET Head Philipps CT Local Database Local Database ConDroon Click FU 6 8/15/2002 Fusion Desplay. WB PET Local Database Example Example Gallbladder 1, GBEF Dyn e soft Fusion Di Local Database VB and T Wholebo Penrose 0333443 GBEF Gallbladder 2. GBEF Dyn 2/22/2001 Gatbladder, Dyn & Static ECAM Goibladder EF 912533 Galbladder EF 4/1/2002 Local Database Workflow Local Database 5/17/2000 Gallium, 2 WB & 1 Tomo 2429453 Tumor Imaging 5/17/2000 Local Database Local Database Gastric Emp, Stabc A/P 520730 Gastric Emptying Service Venticomo 11/23/2001 Local Database Gastric, Dynamic Single Is. Perrose 7051008 Gastric Emptying Gated Bloodpool, TOMO 12345 Equilibrium Gate 2/20/2001 2/20/2001 Local Database Local Database Lung. Aerosol 22085-48 1UJoIM Lung Veralation 2/16/2001 Local Database Lung. VIQ 381201STM Lung WQ Scan 2/22/2000 Local Database Intrinsic MM Data, AX Coronanes 42711 4/22/1997 Local Database Colbracion LC Category All Workplace SYNGO26 Work Status All Launch Suspend Compliant Stage Al 1. Highlight the patient from Patient Browser 2. In the Workflow Template Browser Category > Select Category 3. Double click the workflow desired 46 Turnover Workbook | Symbia Evo Excel 5 Anatomy of a Workflow A workflow template contains a sequence of syngo MI applications activities. Each Notes activity performs a particular procedure (acquisition, processing, display, motion correction, etc.). # Common Workflow Data Configuration #1 Selector A workflow that contains Activity #2 acquisition, processing Data (two in this example). Selector displaying, and hard copy Acquisition Activity in one workflow. Activity Common Workflow Processing Processing eccochigeige Activity Configuration #2 Activity A workflow that contains processing, displaying. and hard copy in one workflow. Processing Flexible Activity Display Activity Flexible Display Hard Copy Activity Activity Canakte Hard Copy Activity 5.1 Workflow Navigator 5.1.1 Activity States Complete: The checkmark indicates the activity is complete. Data has successfully passed through the activity. Error: The caution sign indicates an error. Data has not successfully passed through the activity. Click on the activity to disclose the error message Active: The start symbol. This is the current activity which contains the data. Data may be currently Processing or Acquiring. Stopped: The stop symbol. This is the current activity which has your data when the workflow Navigator was paused. Manual Interaction Needed (MIN): This activity requires the user to perform a manual interaction before continuing. 47 Turnover Workbook | Symbia Evo Excel 5.1.2 Workflow Navigator Controls Notes Pause and Play: The automation with the controls above the activities. Complete: The proper way to close a workflow. Once you Complete, all data requested is saved to the patient database. Complete Suspend: Saves the data to the hard disk on the PC so that Suspend you can resume at any time to complete it. Setup: Automates tasks for data post completion. The Setup function allows for the following automatically: • Saves selected data to the database. • Prints specified outputs defined in the Hardcopy activity. • Sends selected data to another DICOM node. • Archives selected data to a configured archive device. • Uses Modality Performed Procedure Steps. • Starts (link) another workflow with the currently selected patient 48 Turnover Workbook | Symbia Evo Excel 6 Acquisition Workflows 6.1 Acquisition Types Notes • Static • Dynamic • Whole Body • Tomo • Gated Planar • Gated Tomo • Dynamic Tomo 6.2 Acquisition Tab The acquisition tab displays the patient information, the acquisition displays for both detector 1 and detector 2, camera controls and the sub tabs. Acquisition Analyzer Display/Analysis Acquisition Analyzer Display/Analy Patient Bone, 3 Phase & WB Acquisition Display Detector 1: Detector 2 Study Bone Scan Patient Bone, 3 Phase & WE Series Study Bone Scan Series Summary Series Information Camera Parameters Stop Conditions Name Description Summary Series Information Camera Parameters Stop Condition Patient Name Bone, 3 Phase & WB Patient ID Symbia T Name Description Study Name Bone Scan Patient Name Bone, 3 Phase & WB Series Name Patient ID Symbia T Series Study Name Bone Scan Technologist Series Name Reading Physician KCounts: kCourts: Referring Physician temaining: 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 Supino 64 X 64 1.0 Both Detectors Prepare Acquisition = 6.2.1 Summary Sub Tab Used to review the acquisition parameters. 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 Referring Physician Organ Matrix Size 64 X 64 Zoom 1.00 Camera Preset Detectors Both Detectors Orientation Head In Patient Position Supine Phase Parameters 49 Turnover Workbook | Symbia Evo Excel 6.2.2 Series Information Sub Tab Notes Series name is required. The rest of the fields are optional. Summary Series Information Camera Parameters Stop Conditi < Series: Bone Flow Technologist JD Reading Physician: Referring Physician Organ: Skeletal Radiopharmaceutical Dose: Isotope: 25.0 mCi 99m Technetium Pharmaceutical MDP Interventional Drug Interventional Drug: Injection Time (hh:mm:ss): 0 0 Inject Dose (mg): 0 6.2.3 Camera Parameters Sub Tab 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 Callbrations ~ Apply Uniformity Correction Orientation Body Position: Supine 50 Turnover Workbook | Symbia Evo Excel 6.2.4 Stop Conditions Sub Tab Notes 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 El First View by Counts Counts Time or Counts Count Density Manual Time: sec Counts Kcts Any Window Group View Control Detector 1: Ant Detector 2: Post .AddView. Insert View 6.2.5 Gate Allows you to select gated parameters. Camera Parameters Gate |Stop Conditions Framing Beat Window · Number of Frames: Selected Window: 1 8 Center: 72 Time per Frame: Width (%): 20 imsec Autocenter Primary Window . Average of . Forward 10 Beats . Forward/Backward by Thirds Peak Bin of 10 Beats Autotracking PVC Reject PVC Beats Beats To Reject Post PVC: 1 PVC Threshold (msec) 300 Beat Histogram 100 80 60 40 Beats 20 O 0 20 40 60 80 100 140 180 220 Beats/Min 1 Window Beats/Min /Raaf Save Curve 51 Turnover Workbook | Symbia Evo Excel 6.2.6 Acquire with Statics Sub Tab Notes Allows you to modify stop conditions for the statics acquired during a dynamic study, modify views, and change matrix size. Camera Parameters |Stop ConditionIs |Static 2. Static Tab Camera Parameters|Stop Conditions |Static Stop Conditions Appears Stop Conditions Time Start Time (mm:ss): o msec Duration: 20 min Acquire with R-Wave Gate 22:00 Acquire with Statics 1. Check Acquire StopTime: with Statics Phase Parameters Camera Parameters No Pause or Delay Static Matrix Size: 64 X 64 Pause Before Phase Number of Frames: 1 View Names Detector 1 Detector 2 Anterior Posterior View Control Add View sert View Update View Delete View View| Start Time Duration Stop Time |Detector Detector 2 2:00 20 min 22: 00 Anterior Posterio 6.3 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: eak Shifts (%) Tc99m-NMG Detector 1 Dead Time (%) | Peak Status | 1 |2 New Preset Name: Detector 2 NOT PEAK , Save Preset Begin Peaking Pause Between Peaks Window Number Takev) Width (9%) Shift (9%) Photopeak Parent Window Center (kev): Window Width (% ) Window Shift ( 9% ) Window Group A 99m Technetium Window Group B Window Group C Window Group D Window Group E Counts Window Group F 0 150 200 250 300 350 400 450 500 550 600 650 . Detector 1 Detector 2 6.4 Display Analysis Tab Used to review images. 52 Turnover Workbook | Symbia Evo Excel 7 Modifying and Saving Workflow Templates 7.1 Save 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 Save Workflow Template ... OK Save Workflow Template As 7.2 Save Workflow Template As 1. Template > Save Workflow Template As (to create a new template) Template Workflow Activities ow Workflow Save Workflow Template. Workflow Characteristics Save Workflow Template As .. Enter New Workflow Name Workdow Name New Woodlow Enter New Description (Optional) Norknow Description This workflow acquife Static acqastions Select Category Select Icon nert Type: Lymphatic Mammary Parathyroid Pulmonary - Renal Saivary gland Soknic Testicular Q Thyroid Tumor Urecentc Vesical Calibration Join Coincidence Dispuy Dynamic Dynamic Tomo Good QGaned Tema CC Click OK to Save OK Cancel 2. Enter the name, description, category, and appropriate icon and click OK. 3. To modify the category list, Configure is found in this category drop down. 4. Select this option and Add, Remove or Reorder the category list as desired. 53 Turnover Workbook | Symbia Evo Excel 8 Patient Setup and Positioning 8.1 Manually Registering a New Patient Notes 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 X PROCEDURE ATIENT Last name Accession No First name Request ID Title Suffix Requested procedure(s) ther Patient Name(s) Other Patient ID(s) Ethnic Group Study list Step 2 Military Rank Patient ID Date of Birth Delete Sex Male Female Other Study Age Years Study comment Height [ft'in'] Weight [b] Address Patient position Additional info Institution name Details 1. Performing physician warren moore, md 2. Performing physician HOSPITAL Referring physician NOLIMITISN Operator Requesting physician 2. Operator Admitting diagnosis Ward Step 3 Admission ID Preregist Exam Search Cancel Emergency Help 8.2 Registering an Existing Patient 1. Open Patient Browser from Command Module: (See Patient Browser section) 2. Patient > Browser 3. Click the Local Database icon in the tree 4. Highlight the patient 5. Patient > Register 8.3 Registering a Patient from the HIS/RIS 1. Open up the Patient Browser (See Patient Browser section) 2. Highlight Scheduler icon 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 54 Turnover Workbook | Symbia Evo Excel 8.4 Positioning Patient for Exams Notes 1. From the PPM, press the Reconfiguration tab SIEMENS (2) (1 ) 90º 90º 76º 76º (3 X 09:05 2. Choose detector configuration > 3. Press Proceed 4. Raise or lower the patient table to patient access height OR Press the Wheelchair Height button twice to automatically lower table Press the Gurney Height button to automatically raise the table. (1) 1) (4) (2) (4) (2) V (3) (3) (5) (6) 0 (6) 7 5. Select the patient and launch the workflow on the MI Workplace and start the acquisition 55 Turnover Workbook | Symbia Evo Excel 8.5 SPECT Acquisition Setup Notes For SPECT acquisition setup, perform the following steps. 1. When the workflow appears, click the appropriate SPECT acquisition activity. 2. Review the Summary tab information. If the information is correct, and no changes are made, skip to the next section. If incorrect, select the appropriate tab, and then enter the required information. 3. If information is not correct or needs to be entered, click the Series Information tab, and then enter the required information. 4. Click the Prepare Acquisition button. 8.6 Performing the SPECT Acquisition To start the SPECT acquisition, perform the following steps. 1. Click the Start button. 2. When the SPECT acquisition activity is completed, click the Quality Control activity to check the studies for motion. 3. Click the Reconstruction activity. 8.7 Perform SPECT Reconstruction After the SPECT acquisition is complete, the SPECT data is reconstructed automatically. 56 Turnover Workbook | Symbia Evo Excel 9 Processing Workflows 9.1 Quality Control Activity Notes Used on the following data types: • Cardiac Gated Tomo • Cardiac Non-Gated Tomo • Dynamic • Tomo • Dynamic Tomo 9.1.1 Cardiac Gated Tomo and Non-Gated Tomo Correction Settings| Correction 2. Select Series Series: Stress Mibi-Gated [Corrected] Before Sinogram After Sinogram % % % 100 100 4. Click and drag red Linggram line to center heart 1001 5. Click the Cine button to view motion 250 200 Sum Sum 150 100 100 Beats . Apply Beat Normalize (Optional) 50 6 10 20 30 40 50 60 70 80 90 100 120 140 160 180 200 20 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 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 7. Center the red ROI over the heart. Resize and reposition if needed 8. Review cine sonogram and linogram in the After section 9. Click OK 57 Turnover Workbook | Symbia Evo Excel Motion Correction Notes Automatic Manual Automatic Correction Use All Projections Isotope Shift all projections Apply X Shift 7. Center red ROI over Apply Y Shift Head Misregistration Before 100 100 224.99 264.99 304.99 344.99 384.99 33 X Motion Sinogram Linogram 4.99 264.99 304.99 344.99 384.99 Y Motion After 100 % 33 224.99 264.99 304.99 344.99 384.99 X Motion Inogram Sinogram -5 224.99 264.99 304.99 344.99 384.99 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 9.1.2 Dynamic Correction 1. Select the Quality Control Activity in the workflow 2. Pull down Series > Select appropriate series 3. Select Motion Correct Series button O AI Settings Correction 2. Select series Series : Renal Mag 3 Before After Renal Mag 3 20 Sum 100 100 Quality Control Tools Unapply Correction 3. Select Motion Detector: Motion Correct Series Isotope: A Revert to Original 58 Turnover Workbook | Symbia Evo Excel 4. Choose for Single Frame Mode or Multiframe Mode Notes 5. Select the Cross Tool 6. Use the Shift Tools to adjust the position 7. Click the Cine Tool to check the images 8. Click OK to save the changes 9.1.3 Tomo Corrections 1. Select the Quality Control Activity in the workflow 2. Pull down Series > Select appropriate series 3. Click Motion Correct Series button Settings Correction 2. Select the series -Series: Chest Before Sinogram After Sinogram Pelvis 100 % % 100 100 Linogram Linogram Sum 100 Quality Control Tools Unapply Correction 3. Click to motion correct series Isotope: A Motion Correct Series ... Revert to Original 59 Turnover Workbook | Symbia Evo Excel 4. Choose for Single Frame Mode or Multiframe Mode Notes 5. Select the Cross Tool 6. Use the Vertical Shift Tool to adjust the position 7. Click the Cine Tool to check the images 8. Click OK to save the changes Motion Correction Manual Manual Correction Results Single Frame Mode 4. Choose correction Isotope: A Multiframe Mode mode 6. Vertical Shift Tool to 5. Cross Tool make adjustments in 6 79 Linogram % 52 Sum % 100 7. Click to cine images X Shift 0.00 Y Shift: 0.00 8. Click OK to accept the changes. OK 60 Turnover Workbook | Symbia Evo Excel 9.2 Auto Recon 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 6. Click the Reconstruction tab 7. Click and drag the limits to adjust the range Bone - WB Tomo. e.cam - Bone Scan. 3/17/2003 -6 X Template Settings Reconstruction skingtCent 6. Click the Reconstruction Bone Scan - Abdomen- Isotope A 3/17/2003 Tab Transverse Data Selector Sagittal Coronal 71 7. Click and drag red lines to adjust range Quality Control Scrollable Views 1-19 Display Zoom: utoRecon Bone Scan - Thorax - Isotope A 3/17/2003 Transverse Sagittal Coronal % Flexible Displa Scrollable Views Display Zoom: 3rd Tomo for Non-A.C - Isotope A Transverse Sagittal Scrollable Views 4th Tomo for Non-AC- Isotope A Transverse Display Zoom: - Sagittal Coronal Complet Buspen Scrollable Views Setup Display Zoom: - 9.3 Advanced Reconstruction Options The Advanced reconstruction options require a specific license 9.3.1 Flash 3D 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. 9.2.1.1 Adjusting Settings to Improve Image Quality Image is Possible Solution Too smooth Ensure Flash 3D is selected Decrease FWHM filter (guideline: roughly 2 pixel size). Check image quality with 0 mm. 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 Too noisy, or sharp Increase FWHM (in particular for TI201 rest studies) Decrease subsets Decrease iterations Check for motion, and correct if needed 61 Turnover Workbook | Symbia Evo Excel 10 Organ Specific Processing 10.1 Gastrointestinal Processing Notes 1. Select the Gastrointestinal activity in the workflow Gastric Emptin- Normal dyn- normal w/ solids, 12345678 - Gastric Emptying- Solids, 2/20/2001 EX File Gastrointestinal View Template Workflow Activities Help AI 3. Check ROI nigs ROI and placement ric empting [Results] 2/21/2014 Data Selector 105 51 Quality Control 0 2. Click Cine button Gastrointestinal Switch to Cine Mode sotope: 99m Technetium ROI Create ROI Using: tien Technet Emptying Curves Composite Image Flexible Display 600 % 500 100 400 300 Hard Copy 200 100 Counts per sec 0 35 40 45 50 55 60 85 70 75 80 85 4. Click the ROI Tool Fr:1 1179K 64X64 o redraw ROI if to redraw no reshold Results Summary Paramet 99m Technetium Bkgd Correction Decay Correction On Emptying begin (TO) 3 mins 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 .Com Technet ... Bom Technet. Empt end of empty 600 5. Drag to 500 start of empty 400 300 Termoty ha 200 100 Counts per 15 2 7. Drag to position for % emptying 60 65 70 75 80 95 2. Review results 3. See Settings tab to review or modify parameters for this activity 62 Turnover Workbook | Symbia Evo Excel 10.2 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 O AI Settings ROL Pan GallBladder [Results] 2/21/2014 Data Selector % 4 Quality Cor 3. Check for OI placement 2 . Click the Cine icon 5. Drag to adjust Start m 6 . Drag to adjust End RO Create ROI Using: Ejection Fraction Curves Composite Image Flexible Display % 100 End HoMin Counts per sec 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 Minutes 4. Click to 1.1 17002K 64X64 edraw the RO Threshold Results Summary Parameter 99m Technetium ..... 88 kad Correction Ejection Fraction 85 % Decay Correction EF interval begin 2 mins Complete ROI Tool EF interval end 35 mins T Max 2 mins Composite Frame Range T Min 35 mins First Frame: 1 Setup Last Frame: 40 Moves 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 10.3 Planar Gated (MUGA) Processing 1. Select the Gated Bloodpool activity on the Processing tab of the workflow 2. Review results on Results and Fitting Results tabs 3. See Settings tab to review or modify parameters for this activity AI A Settings (Processing > sults|Fitting Results 1. Click the Gated Bloodpool Para Selector Image & ROIs activity and the Processing Tab LAO-Gated [Results] 2/21/2014 % 100 ated Bloodpool Ventricular ROI Flexible Display Duration: 260K Duralot.7 260K 5. Cine to check ROI E All Frame Background ROI . Center LV in green box Cancel Fr:11 260K 64x64 Fr:1 262K 6 4X64 Edit ROI TI 6. Use to modify ROIs 3. Click to determine LV center 4. Click in center of LV Setup Determine LV center .. ROI Tool .. ROI Tool .. 63 Turnover Workbook | Symbia Evo Excel 10.4 Lung Processing Notes 1. Select the Lung Processing activity on the ROI tab of the workflow AI 2. Review RO A placement Settings ROI Regional Analysis Washout Analysis Perfusion Series Perfusion Lung 2/24/2014 DTPA Aerosol Ventilation 2/24/2014 % % % % 100 100 100 100 100 Pert Rtlat 29 [ All Images kg [ All Images ROT POST Post aerosol aerosol 10 % 100 0 Edit ROI Threshold : Adjust Frame Edit ROI Threshold : Adjust Frame ..................... ........ X Shift: ....................................... X Shift: 0 .................... ....... Y Shift: 0 Y Shift: 0 ROI Tool .. Angle: 0 Angle: 0 Ol 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 64 Turnover Workbook | Symbia Evo Excel 10.5 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 on the ROI tab of the workflow Renal MAG 3. Symbia T - Renal Scan, 1/26/2006 -5 X ile Renal Processing View Template Workflow Activities Help AI 2. Review ROI Display ROIS Results placements Krane Aorta 5. Click to view results 81 3. Use sliders to edit thresholds Processing Fr:1 1752K 256x256 Fr:1 294K 256X256 Flexible Display Edit ROI Threshold : Threshold : 31 ........... Hard Copy ROL Tool te Image Composite Image First Frame: 60 First Frame: 1 yser Ror Last Frame: 70 Last Frame: 30 redraw ROI Renal MAG 3. Symbia T - Renal Scan, 1/26/2006 Eile Renal Processing View Template Workflow Activities Help AI Settings Display ROls Results Kidney Aorta Data Selector 100 Kidney 1200 TMax R 1100 Quand Control 1000 TMa-L 900 800 TYL 700 600 Processing Fr:1 1752K 256x256 Fr:1 294K 256x256 500 Table of Patient Parameters 400 Parameters Values 300 Counts/Second Renal Protocol Generic (None) 200 Kidney Depth Method Standard Patient Name Renal MAG 3 100 Patient ID Symbia T Sex Other 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 3 Age 0,07 Minutes Reference BSA 1.73 m2 Split Uptake Interval ( ... 2.0 - 3.0 Radiopharmaceutical 10.0 mCi 99m Technetium MAG3 Flow Method Adult 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 Susper ess Levels: 0% (0) -> 8% (187) for is RUNNI 2. See Settings tab to review or modify parameters for this activity 65 Turnover Workbook | Symbia Evo Excel 10.6 Series Calculator Notes 10.6.1 Series Reformat The Series Reformat activity is used to perform the following for data manipulation: Bone 3 Phase & WB. Symbia T - Bone Scan, 11/15/2005 Eile SeriesReformat View Template Workflow Activities Help O AI 1. Select the desired 2. Click Resize to adjust pries Reformat matrix size matrix. Data Selector Select Series: Bone Statics TOOL ... Revert To Original Input 1: Entire Series Matrix Size: 128 Resize 100 100 100 Flexible Displ Duration: 300 sec 8x1 28 Pc4.8 mm Duration : 300 s 8 2 5K 128 x 1 28 Pbc 4. 8 mm Duration : 300sec 28x1 28 Px.4.8 mm Duration : 300sec 28x1 28 Pix4.8m Duration : 300 sec 128 P bc4.8 m Duration:300sec 28x1 28 P.4.8 mm Hard Copy 82 09 [ All Images All Detectors 66 Turnover Workbook | Symbia Evo Excel 10.6.2 Image Masking Notes To remove masking, click Revert to Original button 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 CO AI A Settings Series Reformat Data Selecto Select Series: Wholebody ROI Tool . Revert To Original Input 1 : Entire Series Matrix Size: 256 Resize 100 2. Select the ROI Tool Flexible Display 1. Select image 5758K Duration: 1701 88 56x 1 024 PC 2.4 m Setup DE All Detectors ROI Tool User Interaction Prompt ROI TOO Display Frames . 1x1 1x2 2x1 2x2 Select ROI 100 User Mask 3. Select ROI Tool used to draw 4. Draw mask ROI Color : RT ANTERIOR LT 5758K Duration:1701 sec 256x1024 Pix:2.4mm 99m Technetium Edit ROI 5. Select to Keep ROI Name : Inside or Outside Threshold User Mask Keep Outside Keep Inside Cance 67 Turnover Workbook | Symbia Evo Excel 10.6.3 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 DE MUGA 5 2 View, Symbia S - Equilibrium Gated Cardiac, 1/26/2006 File Series Filter View Template Workflow Activities Help AI Settings> Series Filter . Select Spatial or Select Series: LAO Temporal filter Revert Series Original Series 1 : Entire Series Series File 2. Select series uration: 599sec 64X64 Plot 3.6 mm 95 m Flexible Display Filter Applied: No Filte Filtered Series Complete Suspend Setup ilter Tool Wiener [S] Delete Save Test Specified Filter Filter Parameters Kernel 2. 10 2 032 0 04328 0.04328 0.12148 0.04328 4. Select filter 5. Make desired updates to filter parameters 6. Trial Filter to visually inspect. Size Wiener - 2D SNR 0.26 FWHM 0 mm Update Trial Filter 6ª Views 7. Select the desired 8. Click OK Boxcar Iterations: 3 Gaussian FWHM:6.00 Wiener FWHM.6.00 OK Cancel 2. See Settings tab to review or modify parameters for this activity 10.6.4 Static Merge 1. Select the study and double click the Static Merge Proc workflow. Up to 20 static series can be merged into one 68 Turnover Workbook | Symbia Evo Excel 10.6.5 Static Extract Notes Lung Aerosol, ECAM - Lung Scan, 2/16/2001 File Flexible Display View Template Workflow Activities Help O AI X Y Single Series Static Display Patient Name: Lung Aerosol Patient ID: ECAM DOB: 7/5/1962 Study Name: Lung Scan Arithmetic Study Date: 2/16/2001 x + Perfusion Lung [Concatenated] 2/24/2014 0% % % Arithmetic 0 0 0 0 Series Ant aerosol 198K Post aerosol 198K RAO Aerosol 198K LPO aerosol 198K Rt Lat Aerosol 150K Arithmetic Duration:203sec 128x128 Duration:203sec 128x128 Duration:268sec 128x128 Duration:268sec 128x128 Duration:315sec 128x128 % % % % % x4 100 100 100 100 100 Series Arithmetic x + 0 0 0 0 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 128x128 Duration:78sec 128x128 Duration:78sec 128×128 % % % % % 100 100 100 100 100 Flexible Dis O O O Perf Rt lat 316K Lt Lat 316K Duration:127 sec Perf RAO 316K128 Duration:127sec 128x128 128x128 % 100 Suspen 0 Perf POST 495K Duration:96sec 128x128 (8:0% T:100%) All Images 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: Statics perand 1 Series 1: Multiple Frame 100 100 Arithmetic Flexible Displ RLAT 601K LLAT 468K RAO 900K Duration: 1709 Duration:146sec Duration:146sec Duration:161 sec Juration: 161 se 256x256 Pbc2.4mm 256x256 Pbc2.4mm 256x256 Pbc2.4mm 56x 256 Pix : 2 .4 m Duration: 170 sec qam Technotium ors lam forhratimm 16x256 Px 2 . 4 m Qam Technotium Qam Technotium All Images All Detectors Hard Copy Select Series: Statics Operand 2 Series 1: Entire Series 100 RLAT 601K LLAT 468K Duration:146sec Duration:146sec Juration: 161 se Duration : 161 sec Duration: 170 sec 256x256 Poc2.4mm 256x256 Pic2.4mm 56 PDC 2. 4 mm 16x256 Pix : 2.4 mn 56x256 Pix: 2.4 mm Duration : 170se 56x 256 Pix 2 . 4 mm QQm Tochnotium Qam Tochnotium CHE | All Images All Detectors Operation: Extract [Multiple Frame] 3. Result will have the extracted images or phase Result Series 1 0 0 RAO 900K LPO 808K Duration: 170sec Duration:161 sec Duration:161 sec 256x256 Pix:2.4mm 256x256 Pic:2.4mm Qam Tochnotium Qam Tochnotium Setup BE DD E All Images 69 Turnover Workbook | Symbia Evo Excel 10.7 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. Results 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 ? ? AI Print Area Object Print Area Object A 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 70 Turnover Workbook | Symbia Evo Excel Below are examples of how different display objects are used. Notes ONADD AI Text - Display Image Display Slice - Display Ci Curve Display  AI DOU 2/21/1/148 / ? Carax 1,Me Pef.DuitMes BB AL Myocardial Recor 800000€ 12:39 00 PMV 8 mil mit 3/10001 9:42:54 AM Cune Diglay Carsac 1. Mai Por. Duet ines 71 Turnover Workbook | Symbia Evo Excel Text Notes Display me: Renal, MAG3 Abnormal 614 Print DOB: 8/26/1940 Study Name: Renal Scan Study Date: 12/1/2000 Display Result Summary Curve Parameters Total Split Function (%) 92.6 7.351 Display @chey Counts (cpm) 31635 2510.2 Time of Max onino 3.001 0 868 Time of % Maxemini 9.294 Series Display Multiple Frame and ROI Statistics  Patient Name: Renal, MAG3 Abnormal Patient ID: 614 DOB: 8/26/1940 Study Name: Renal Scan Study Date: 12/1/2000 Amel Scas 12/1/2000 1 DE 1 Scan: 12/1/2000 8 00 10 AM 730/2004 12:41:344 PM 10.8 Saving JPEG and AVI files 10.8.1 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 72 Turnover Workbook | Symbia Evo Excel 10.8.2 AVIs Notes 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 10.8.3 Recording Offline Files (This is often done to create CDs of JPG and AVI files) 1. Copy desired files to H:\Site Data\CDR_OFFLINE 2. From syngo browser, select Transfer>Local Job Status and clear 3. Insert a blank CD or DVD into the recording device 4. Transfer>Record Offline Files 10.9 Dual Monitor Support The dual monitor option aids in positioning workflows across two monitors. 10.9.4.1 Launching a Workflow on the Left Monitor To launch a workflow on the 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. 10.9.4.2 Launching a Workflow on the Right Monitor To launch a workflow on the 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. 73 Turnover Workbook | Symbia Evo Excel 11 syngo Patient Browser Notes Patient Browser Patient Applications Transfer Edit View Filter Evaluation Sort Options Help Local Database 4DM CaSc1 Myocardial Perfusic [1] 4DM-REST TC [FBP] R//// / / RITJAVI! ! Scheduler 4DM Ischemic2 [1] 4DM-GSTRESS TC [FBP] DVD-R 4DM MUGA2 [1] 4DM-CaScoringResults R///// / DVD-RW 4DM PET Abnormal [1] 4DM-GSTRESS TC [ACI] R///// / AMMONIA_1 [1] 4DM-REST TC [ACI] R/// // / Bone - WB Tomo [1] 4DM-Patinfo R/// / / / Bone 4 (complete), flow.po [1] 4DM-GSTRESS TC-Gated [FBP] Bone 5, 2 tomos [1000] REST TC[ACI] Patient Name Patient ID Date of Birth Sex Comm. Studies Series Mark Status 4DM CaSc1 DEMO 5/28/1944 M 1 18 - 4DM Ischemic2 DEMO 3/13/1954 M 10 4DM MUGA2 DEMO 2/13/1939 M 2 7 4DM PET Abnormal DEMO 9/12/1947 F 7 AMMONIA 1 Anonymou - O 1 8 Bone - WB Tomo e.cam 6/2/1955 M 1 4 Bone 4 (complete), flow.pool 45678912 1/1/1983 M 1 5 Bone 5, 2 tomos 56789123 1/1/1992 F 1 2 BONE EPP COMPARE Tc99m_DF 1/1/1965 M 1 2 Bone, WB and Statics ECAM 8/7/1943 F 2 BoneCompare HALFTIME TC99M M 1/1/1950 M 1 4 Brain ECD Child, Dyn SPEC Kitasato U 3/26/2007 M ECD brair 1 3 Brain Tomo 1, Scenium Neurolite 1/1/1932 1 Brain Tomo 2, Neurogam Tc99m NE 1/1/1942 F 2 6 Brain, DIAMOX Gen CT A( 6/3/1958 M 1 4 Cardiac 1, Normal ECAM 11/24/1926 M 1 -------------- Current Filter: Off 11.1 Accessing the Patient Browser 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 bar. The system displays the browser. 11.2 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. 11.2.1 Local Database 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. The Local Database is where the patient data and results of the examinations performed on the local workstation are stored. 74 Turnover Workbook | Symbia Evo Excel 11.2.2 Scheduler Notes The Scheduler contains the data on all pre-registered patients. 11.2.3 Archive Devices One or more DVD or CD devices may be connected to MI Apps workstation. 11.2.4 Correcting a Patient Name, ID Number, or Other Demographics 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 11.2.5 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 11.2.6 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 75 Turnover Workbook | Symbia Evo Excel 11.2.7 Manually Archiving Data Notes 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 11.2.8 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 Acquisition Console 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 11.2.9 Ejecting a CD or DVD 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) 11.2.10 Deleting the 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 cannot be restored. 76 Turnover Workbook | Symbia Evo Excel 11.2.11 MI Apps Cleanup Notes 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 MI APPS > MI APPS Cleanup Study Name: ALL Show All . Local Study Date: ALL Category Au 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. A Gastric Emptin- Normal, dyn- normal w/ solids 12345678 2/20/2001 Local D: Series Static Extractor Proc Extracts a singl Gastric Empting abnormal. dynamic-abn. w/ s ... 212 4/1 1/2008 Local D. Series Tomo Composite Proc Creates a stati .. Gastric Empty (4 hr), Pt 1 06514450 11/20/2009 Local D: Local D: Series Tomo Detector Extractor EXTRACTS D .. Gastric Emptying, Dual Isotope 30644173 7/6/2009 Local Di Local Di Series Tomo Extractor Det 2 EXTRACTS D .. GI Bleed (positive), 2 phase dynamic & statics 1000469630 2/21/2008 Local Di Local D: Series Tomo Extractor Proc Extracts a singl IQ SPECT good case2. Case #2 H0233973 1/25/2011 Local D. SITUS INVERSIS PROC This workflow w IQ SPECT SYMBIAT, symbiaT 0171544 Local D. SITUS INVERSIS REST ACQ ACQUIRES A . IQ SPECT, NICE CASE IQ SPECT, T6 H1151800 2/28/2011 Local D: SITUS INVERSUS gSTRESS ACQ ACQ SITUS IN .. 11.01.19-09:18 1/19/2011 Local D: Situs Inversus Proc v4_0 This worldflow w IQSPECT 2. T2 11.01.19-08:17 1/19/2011 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 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. 0102/2000 Local D. SMV 3 Phase Bone Display DISPLAYS A MI Apps Get Logs $/2001 Local D. SMV Cardiac Proc. processes a ga syngo MI Apps Clean Local Di SMV Lung Display LUNG DISPLA. Start MI Apps $/2009 Local D: SMV Slice display displays the S Set Program Access and Defaults 5/2008 Local D: SMV Wholebody Bone Displays a whol BS Win MIBG 3/15/2006 Local D. SMV Wholebody Masking MASK A WHO. Windows Catalog Symbia S 1/26/2006 Local D: Source Replenishment AQC Use this worldfl .. ir Win 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 Local D. STATIC DISPLAY. Multiple Static .. ECAM 2/22/2000 Local D. Static Display Displays static . ever eventvwr.msc ECAM 2/26/2002 Local Di Static Gastric Emptying Proc. Will generato th Paint ECAM 9/2/2003 Local D: STATIC GASTRIC PROC Processes up t. Symbia T 1/18/2008 Local D. Static Masking Will mask regio explorer.exe 269351859 11/8/2011 Local D. Static Merge Proc Merges 1 to 20 shutdown_at_twenty_hour bat Programs ory. All Workplace SYMBIA01 Launch Suspend Complete Documents Stage: All Settings Search Run ... Shut Down ... Windows XP Professional Adds a Normal Priority Workist Item Checkup not completed, system should not be used 114 12:46:45 2. Select Force Shutdown of High-Level Processes. 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 Ww Exit. 3. YES to continue with Cleanup Warning WARNING: This action may result in a loss of data. Are you sure that you want to do this? Yes 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 77 Turnover Workbook | Symbia Evo Excel 12 Exercises and Knowledge Checks 12.1 Patient Gantry 1. The maximum weight the PHS will hold is __________ lbs. 2. Match the labels on the following: 6 1 7 2 5 ) m 3 6) 4) Siemens Nuclear Acquisition Controller (SNAC) ______ Touch Pads ______ ______ Gantry Emergency stop buttons ______ Power Switches ______ Detectors ______ Patient Positioning Monitor (PPM) ______ 12.2 Quality Control 1. Perform the daily QC from start to finish. 2. List the steps needed to complete the Weekly QC: a. _____________________________________ b. _____________________________________ c. _____________________________________ 78 Turnover Workbook | Symbia Evo Excel 3. List the steps for Monthly Quality Control a. _____________________________________ b. _____________________________________ c. ______________________________________ d. ______________________________________ e. ______________________________________ f. _______________________________________ 12.3 Patient Registration 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. _______________________ 12.4 Workflows 1. Modify the acquisition parameters on a Renal Scan 2. Process a Renal Study 12.5 syngo Patient Browser 1. Match the icon with the name a. Scheduler b. Local Database c. Local Archive ________ ________ ________ 2. Practice archiving patient data to your desired media. 3. Where can you view the status of jobs relating to sending data to another network node? ____________________ 79 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 40 Liberty Blvd. design, packaging, specifications and options Malvern, PA 19355-9998 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-16117-P1-4A00 USA Printed in USA 10-2015 | All rights reserved Telephone: +1-888-826-9702 © 2015 Siemens Medical Solutions USA, Inc. www.usa.siemens.com/healthcare Siemens Healthcare Headquarters Siemens Healthcare GmbH Henkestraße 127 91052 Erlangen Germany Phone: +49 9131 84-0 siemens.com/healthcare www.siemens.com/healthcare