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Symbia Evo Turnover Workbook

Workbook to acccompany Symbia Evo system turnover

SIEMENS User Services www.usa.siemens.com/education Symbia Evo Turnover Workbook Answers for life. User Services. Driven by More. More: Our philosophy for a lifelong improvement through continuing education and consulting. Working closely with you, we develop your personalized education and consulting strategy and support you and your staff with our comprehensive User Services to help gain: • More: Routine Confidence • More: Clinical Expertise • More: Superior Performance More: Personalized training, education, and consulting services from Siemens Healthcare Customer Services. For your leading edge in medical care. User Services. Driven by More. More: Personalized More: More: Superior Clinical Performance More: Routine Expertise Confidence 2 I Contact Information Summary Welcome to Siemens Healthcare Clinical Education Offerings: Siemens Healthcare is dedicated to helping you Call 1-888-221-8010 (follow the prompts) • get the most out of your investment throughout Classroom Training the entire product life cycle and beyond. Our goal (Offerings, Registration & Scheduling) • is to enable you to take technology further, Educational Symposia • profitability higher, and patient care to the next On-site Training • level. Find the information, resources, and tools Printed Self-studies • you need to get the most out of your recent Virtual Education (Offerings & Registration) • investment and stay up-to-date. Visit Workshops & Fellowships www.usa.siemens.com/Welcome2Healthcare. 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 Day One............................................................................................................................. 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 ....................................................................................................................... 10 1.3 Detectors ................................................................................................................... 11 1.4 Hand Control.............................................................................................................. 14 1.5 Patient Bed, Pallet and Rear Bed .................................................................................. 15 1.6 Patient Positioning Monitor (PPM) ............................................................................... 19 2 Changing the Collimators .................................................................................................... 30 2.1 Collimator Changing Options ...................................................................................... 30 2.2 Collimators................................................................................................................. 31 3 Quality Control and Assurance............................................................................................. 44 3.1 Symbia Evo QC Schedule............................................................................................. 44 3.2 Daily System Shutdown and Startup ............................................................................ 44 3.3 QC Procedures ............................................................................................................ 46 3.4 Daily QC - Manual....................................................................................................... 46 3.5 Daily QC - Automatic................................................................................................... 49 3.6 Weekly QC.................................................................................................................. 50 3.7 Monthly QC................................................................................................................ 52 4 Overview of Acquisition Console: MI Workplace Command Module ....................................... 59 4.1 Areas of Command Module ........................................................................................ 59 5 Anatomy of a Workflow....................................................................................................... 61 5.1 Workflow Navigator .................................................................................................... 61 6 Acquisition Workflows......................................................................................................... 63 6.1 Acquisition Types ....................................................................................................... 63 6.2 Acquisition Tab........................................................................................................... 63 6.3 Analyzer Tab............................................................................................................... 66 6.4 Display Analysis Tab.................................................................................................... 66 7 Modifying and Saving Workflow Templates .......................................................................... 67 7.1 Save Workflow Template ............................................................................................. 67 7.2 Save Workflow Template As......................................................................................... 67 8 Patient Setup and Positioning.............................................................................................. 68 8.1 Manually Registering a New Patient ............................................................................ 68 4 8.2 Registering an Existing Patient ................................................................................... 68 8.3 Registering a Patient from the HIS/RIS.......................................................................... 68 8.4 Positioning Patient for Exams ...................................................................................... 69 8.5 SPECT Acquisition Setup ............................................................................................. 70 8.6 Performing the SPECT Acquisition ............................................................................... 70 8.7 Perform SPECT Reconstruction..................................................................................... 70 9 Processing Workflows.......................................................................................................... 71 9.1 Quality Control Activity ............................................................................................... 71 9.2 Auto Recon Activity..................................................................................................... 75 9.3 Advanced Reconstruction Options ............................................................................... 75 10 Organ Specific Processing.................................................................................................. 76 10.1 Gastrointestinal Processing ....................................................................................... 76 10.2 Hepatobiliary Processing .......................................................................................... 77 10.3 Planar Gated (MUGA) Processing ............................................................................... 77 10.4 Lung Processing........................................................................................................ 78 10.5 Renal Processing....................................................................................................... 79 10.6 Series Calculator....................................................................................................... 80 10.7 Flexible Display......................................................................................................... 84 10.8 Saving JPEG and AVI files........................................................................................... 86 10.9 Dual Monitor Support ............................................................................................... 87 11 syngo Patient Browser....................................................................................................... 88 11.1 Accessing the Patient Browser................................................................................... 88 11.2 Patient Databases ..................................................................................................... 88 12 Exercises and Knowledge Checks ....................................................................................... 92 11.1 Patient Gantry .......................................................................................................... 92 12.2 Quality Control ......................................................................................................... 92 12.3 Patient Registration .................................................................................................. 93 12.4 Workflows ................................................................................................................ 93 12.5 syngo Patient Browser............................................................................................... 93 5 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 6 IV Course Objectives Upon completion of this course, you will be able to: • Describe the function of the Symbia Evo 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 1 Getting Started Notes 9 1 2 7 3 4 8 11 13 5 10 9 12 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 (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. 8 Turnover Workbook | Symbia Evo 1.1.1.2 Gantry Power Switches Location Notes At the bottom of the gantry’s left side are the electrical power switches. 1 1.1.1.3 Main System Power Switch 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. 9 Turnover Workbook | Symbia Evo 1.2 Gantry Notes The gantry has a circular frame that supports the detectors and collimators, with a ring (center opening) for feet or head first patient entry 1.2.1 Gantry Components 6 2 5 3 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) 1.2.2 Emergency Stop Buttons 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. 10 Turnover Workbook | Symbia Evo Restart button above one of the gantry’s Emergency Stop buttons. Check that Notes 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) 1.3 Detectors 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. 11 Turnover Workbook | Symbia Evo 1.3.2 Orientation Dots Notes 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 (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) Touch Pads on Detectors (2) A touch pad covers three sides of the detector’s yoke. 12 Turnover Workbook | Symbia Evo 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 3 1 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 13 Turnover Workbook | Symbia Evo 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. ( 1 - 1 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. 1 10 (2 11 3 1 12 4 (13 5 O 14 6 15 2 16 (17 8 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 14 Turnover Workbook | Symbia Evo 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 1 2 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 1 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. 15 Turnover Workbook | Symbia Evo 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. 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 Y OCCUR UTION SURFACE A 16 Turnover Workbook | Symbia Evo 1.5.6 AutoQC Source Holder (Optional) Notes The Automated Quality Control (AutoQC) option allows unattended automated verifications and calibrations. The device is installed on the underside of the patient bed and contains: • a .5 mCi Co-57 point source, • a 10 mCi Gd-153 line source, • and a slotted shield for the line source. These automatically extend and retract for the following uses: • intrinsic tuning and intrinsic flood verification/calibration, • extrinsic sweep verification activity, • and detector alignment calibration. (1) Line Source Holder (2) Point Source Holder (3) Lead Cap 2 3 1.5.7 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). 17 Turnover Workbook | Symbia Evo 1.5.8 Patient Bed Travel Ranges Notes Patient bed positioning is shown on the PPM. 2 1 1 0.0 kcts/s 2 0.0 kcts/s 0.0 cm 31. 0.0 cm 3 95% 100% 0.0' 180.0' 0.0 cm 0.0 cm 1.23 1.23 319 123 KoV 123 KoV 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. 18 Turnover Workbook | Symbia Evo 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 5 6 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.) 19 Turnover Workbook | Symbia Evo Notes 1 Version syngo MI Applications VB10A 2 12.0.1.12 3 4 5 Restart Shutdown Touch Pad Test 6 X 7 D 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. 20 Turnover Workbook | Symbia Evo 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. 1 STENEN'S 2 1 U.U KGTE 2 0.0 kcts/s 22.0 cm 136.1 cm 95 % 100 % .6.0 .96.0 34.4 cm 34.4 cm 1.00 1.00 140 Key 140 KeV 3+0 HiResPar HiResPar 3 View 1/2 00:39 C X 4 13 5 6 7 9 10 11 (12 CO (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 21 Turnover Workbook | Symbia Evo 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 Waming Q 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. 2 3 4 Repeat 1/4 View 13/32 Phase 1/1 Cycle 1/3 00:39 5 6 7 (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. 22 Turnover Workbook | Symbia Evo 1.6.10 Patient Bed Information Fields Notes SIEMENS 1 0.0 kcts/s 2 0:0 kcts's 22.0 cm 2- 136.1 cm 95 % 100 % (1) Bed Height (2) Bed Index In/Out Position 1.6.11 Persistence Image Buttons and Information Fields SIEMENS 0.0 kotsys 1 0.0 kets/s 22.0 cm 2 136.1 cm 2 3 (4 95 % 100 % -96.09 34.4 cm 34.4 cm 1.00 5 6 1.00 140 KeV 140 KeV HiResPAL HiResPar View 1/2 00:39 C X 10:42 (1) Count Rate Per Second (2) Persistence Image (3) Persistence Level (4) Persistence Window Level (5) Persistence Value Controls (6) Persistence Window Level Controls 23 Turnover Workbook | Symbia Evo 1.6.12 Gantry and Detector Information Fields Notes SIEMENS 1 0.0 kots.s 2 0.0 kots/s 22.0 cm 136.1 em 95 % 100 % 1 -6.0" -96,0º 2 34.4 cm 34.4 cm 3 1.00 1.00 (4) 160 KeV 140 KeV HiResPar HiResPar View 1/2 00-39 C X (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 2 @ -130.50 49,50 36. 1 cm 18.0 cm 6 36.1 cm 2 0.0 cm 136.1 cm 0.0 cm =C 0.00 ₡ 0.0º 0.0º 5 1.00 1.00 140 KeV 140 KeV LEAP LEAP 3 .135º 1 4050 4 - X 09:01 (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 24 Turnover Workbook | Symbia Evo 1.6.13.2 90°, 76°, or Gurney Configuration Notes SIEMENS 1 90.00 1 2 90.00 45.00 -45.00 22.0 cm 2 35.3 cm 35.3 cm 12 136.1 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 90. 76ª 76º 3 4 X (1) Detector Reconfiguration Selections (2) Reconfiguration Tab (3) Proceed Button (4) Cancel Button 25 Turnover Workbook | Symbia Evo 1.6.14.2 Reconfiguration Screen with IQ·SPECT Collimators Installed Notes 1 4 IQ-SPECT 2 3 5 6 X Configuration completed. 13:57 (1) IQ•SPECT Icon (2) 180° Configuration Button (3) IQ•SPECT Configuration Button (4) Reconfiguration Tab (5) Proceed Button (6) Cancel Button 1.6.14.3 Detector Reconfiguration Buttons 180 Configuration with Outer Room Left Outer Room Right Gurney +90 and -90º Configuration Configuration Configuration IQ-SPECT 90º 90º IQ SPECT 180º Configuration 90% Supine 90º Prone Configuration Configuration 76º 76º 76" Supine Configuration 76" Prone Configuration 26 Turnover Workbook | Symbia Evo 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 8 10 9 3 5 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 27 Turnover Workbook | Symbia Evo 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 1 2 1 SPECT Q 1.00 (4) 2 (3 C X 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 1.6.17 Collimator Change Screen The collimator change screen displays the collimators available for selection. 1 SMARTZOOM 2) SMARTZOOM MELP Pinhole 4 3 JHR HE 5 LEHR SMARTZOOM Remove 6 X 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 28 Turnover Workbook | Symbia Evo 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. 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 29 Turnover Workbook | Symbia Evo 2 Changing the Collimators 2.1 Collimator Changing Options Notes There are 3 different types of collimator changing options that may come with your system, depending they types of collimators and options that you have purchased. 2.1.1 Integrated Collimator Changer (ICC) The Integrated Collimator Changer (ICC) is a collimator change server that is permanently mounted under the patient bed. The ICC holds two pairs of collimators and is intended to store most frequently used collimators. It does not store high energy, extra-high energy, or pinhole collimators. 3 .. 2 1 2 (1) Integrated Collimator Changer with Handles (2) Drawer opened. (3) Collimator clamp raised for collimator removal. 2.1.2 Automatic Collimator Changer (ACC) The automated collimator changer (ACC) is an option and requires the ICC. The ACC is attached to the ICC and automates the opening and closing of drawers when performing collimator changes. ACC supports the same collimators as the ICC. It is similar in design to the ICC for collimator changing, and uses the same PPM screens, but does not have the collimator drawer handles as with the ICC. 30 Turnover Workbook | Symbia Evo 2.1.3 Collimator Cart Notes 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 5 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 2.2 Collimators 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. 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 31 Turnover Workbook | Symbia Evo 2.3.1 ACC/ICC Procedure Notes 2.3.1.1 Collimator Removal 1. Dock patient bed 2. PPM -> Press Collimator Change tab 3. Collimator Change screen 7 SMARTZOOM 1 SMARTZOOM MELP Pinhole UHR HE 2 LEHR SMARTZOOM 4- Remove 6 3 5 13:57 (1) Collimators installed on the detectors (2) Available collimators (3) Home button (4) Remove button (5) Proceed button (6) Collimator Change Tab (7) IQ•SPECT Icon 4. Press Remove button 5. Press Proceed button 6. System reconfigures for ACC/ICC. While the detectors are in motion, PPM text message reads: Please wait 32 Turnover Workbook | Symbia Evo System Preparing for Drawer Opening Notes 7. Bottom detector rises to collimator drawer height and its collimator clamp rises. PPM Text: Open collimator drawer (number). SIEMENS X Open collimator drawer 4. 8. 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 (1) Contact Area 33 Turnover Workbook | Symbia Evo 9. PMM Text: Close collimator drawer (number) Notes SIEMENS X Close collimator cart drawer 4. 10. Slide and close collimator drawer until the beep sound. PPM Text: Please wait. 11. Second detector moves into position. 12. Repeat steps 7-10 for second collimator. 13. Collimator removal procedure is complete. 2.3.1.2 Collimator Installation 1. Press the Home button 2. Press the Proceed button 3. PPM -> Press Collimator Change tab HELP LEAP UHR LEHS (2) LEHR Remove 4 3 X 11:54 (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 34 Turnover Workbook | Symbia Evo 4. PPM -> Press the desired collimator selection button. PPM Text: Press PROCEED Notes to change collimators or press CANCEL to exit. 5. Press Proceed button. 6. If collimators are on ACC/ICC: PPM Text: Please wait, while detectors are in motion. 7. If collimators are on collimator cart, please proceed to step 8 in Collimator Cart Installation procedure. 8. Bottom detector rises to collimator drawer’s height and collimator clamp rises. PPM Text: Open collimator drawer. 9. 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 10. PPM Text: Close collimator drawer (number) 11. Slide and close collimator drawer until the beep sound. PPM Text: Please wait. 12. Second detector moves into position 13. Repeat step 8-10 for second 14. Proceed to Touch Pad Test. 2.3.2 ACC Procedure?? 2.3.2.1 Collimator Removal 1. Dock patient bed 2. PPM -> Press Collimator Change tab 3. Collimator Change screen SMARTZOOM 1 SMARTZOOM MELP Pinhole UHR HE 2 LEHR SMARTZOOM 4 Remove 6 3 5 X 13:57 (1) Collimators installed on the detectors (2) Available collimators (3) Home button (4) Remove button (5) Proceed button (6) Collimator Change Tab (7) IQ•SPECT Icon 35 Turnover Workbook | Symbia Evo 4. Press Remove button Notes 5. Press Proceed button 6. System reconfigures for ACC/ICC. While the detectors are in motion, PPM text message reads: Please wait SIEMENS X Please wait System Preparing for Drawer Opening 7. Bottom detector rises to collimator drawer height and its collimator clamp rises. PPM Text: Open collimator drawer (number). SIEMENS x Open collimator drawer 4 8. System will automatically remove the collimators from both detectors. 9. Collimator removal procedure is complete. 36 Turnover Workbook | Symbia Evo 2.3.2.2 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 Remove 4 X 11:54 (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. If collimators are on ACC/ICC: PPM Text -> Please wait, while detectors are in motion. 7. If collimators are on collimator cart, please proceed to step 8 on Collimator Cart Installation procedure. 8. Chosen collimators will automatically be installed on both collimators. 9. Proceed to Touch Pad Test. 37 Turnover Workbook | Symbia Evo 2.3.3 Collimator Cart Procedure Notes 2.3.3.1 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) Patient Bed Docking Connector (2) Collimator Cart Guide on patient bed (3) Collimator Cart Leg 3 (1) Collimator Cart Connector (2) Collimator cart leg inserted into patient bed’s Collimator Cart Guide 2 38 Turnover Workbook | Symbia Evo 2.3.3.2 Collimator Removal Notes 1. Dock patient bed 2. PPM -> Press Collimator Change tab 3. Collimator Change screen SMARTZOOM 1 SMARTZOOM MELP Pinhole UHR HE LEHR SMARTZOOM 4 Remove 6 3- 5 X 13:57 (1) Collimators installed on the detectors (2) Available collimators (3) Home button (4) Remove button (5) Proceed button (6) Collimator Change Tab (7) IQ•SPECT Icon 4. Press Remove button 5. Press Proceed button 6. System reconfigures for collimator cart. 7. If here is an ACC/ICC present, let this lower to the floor before the collimator cart is docked. 8. If there is no ACC/ICC present or if the ACC/ICC is lowered, PPM Text: Dock the collimator cart. SIEMENS X Dock the collimator cart. 39 Turnover Workbook | Symbia Evo 9. Dock the appropriate collimator cart with empty drawers. Notes 10. PPM Text: Please wait System Preparing for Drawer Opening 11. Bottom detector rises to collimator drawer’s height and collimator clamp rises. 12. PPM Text: Open collimator drawer (number) SIEMENS X Open collimator drawer 4. 13. 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. 1 40 Turnover Workbook | Symbia Evo 14. PMM Text: Close collimator drawer (number) Notes SIEMENS X Close collimator cart drawer 4. 15. Slide and close collimator drawer until you hear the audible beep. PPM Text: Please wait. 16. Second detector moves into position. 17. Repeat steps 13-15 for second collimator. 18. Patient bed lowers to lock drawers. 19. System undocks collimator car 20. PPM Text: Undock the collimator cart. Remove collimator cart to safe storage. 21. Collimator removal is complete. 41 Turnover Workbook | Symbia Evo 2.3.3.3 Collimator Installation Notes 1. Press the Home button 2. Press the Proceed button 3. PPM -> Press Collimator Change tab HELP LEAP UHR LEHS 2 LEHR Remove 4 3 X 11:54 (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. If ACC/ICC is present, it will be lowered to the floor. 7. If ACC/ICC is not present or if the ACC/ICC is lowered, PPM Text: Dock the collimator cart. 8. Dock the collimator cart with appropriate collimators. 9. PPM Text: Please wait. System Preparing for Drawer Opening 10. Bottom detector rises to collimator drawer height and collimator clamp rises. 11. PPM Text: Open collimator drawer (number) 12. 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. 13. Collimator clamp lowers and second detector is moved into position. Collimator clamp is raised. 14. Repeat steps 11 and 12. 15. PPM Text: Close collimator drawer (number) 16. Close the collimator drawer. Audible beep sounds. 17. PPM Text: Please wait. 18. Patient bed lowers to lock drawers. 19. System undocks collimator cart 20. PPM Text: Undock the collimator cart. Remove collimator cart to safe storage. 21. Proceed to Touch Pad Test. 42 Turnover Workbook | Symbia Evo 2.3.4 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 1 2 Collimator Tenciono Gantry Touch Pad Gentry Touch Pad X Press PROCEED to confirm the successful Touch Pad Test. 3. Press Proceed 4. Press Home 43 Turnover Workbook | Symbia Evo 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 QC Schedule Performed Quality Control Procedure Source Daily Intrinsic Verification, or 35 pCi of Tc99m, or Extrinsic Verification or Extrinsic Co-57 sheet source Sweep AutoQC source Weekly Intrinsic Verification with Tune 35 pCi of Tc99m AutoQC source Monthly Intrinsic Calibration with Tune 95 pCi of Tc99m AutoQC source Monthly Multiple Head Registration 1-2 mCi of Tc99m per source (MHR) 1903 (Match sources within 20% of Head Alignment Verification each other for Tc99m only) [Calibration if needed] AutoQC source Every 6 months or per Regu- Perform a leak test of the auto Gd-153 line source and Co-57 latory/License requirements mated quality control device point source sources. 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) 190ª (Match sources within 20% of erence of Low Energy Parallel Hole collimator Head Alignment Calibration each other for Tc99m only) AutoQC source 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) 44 Turnover Workbook | Symbia Evo 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 2.3.4 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 45 Turnover Workbook | Symbia Evo 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 Otherwise, the QC procedures can be performed automatically by using the internal AutoQC device with: • An internal point source, or • An internal line source 3.4 Daily QC - Manual 3.4.1 Symbia Evo Daily QC Flow Chart Daily NM QC Auto QC7 Yes No Intrinsic or Extrinsic? Intrinsic or Extrinsic? Int. Ext Int. Ext Cof Button Gd 3ª Line COM Source Source Point Sheet NM Intrinsic NM Extrinsic NM Intrinsic NM Extrinsic Verification Sweep Verification Verification Auto Auto Manual Manual 3.4.2 Intrinsic Verification An intrinsic verification uses a point source, flooding uncollimated detectors to verify the detectors’ corrected performance. 46 Turnover Workbook | Symbia Evo 3.4.2.1 Setup Notes 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. 3.4.2.2 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. 3.4.2.3 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. 3.4.2.4 Review the Results 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. 47 Turnover Workbook | Symbia Evo 3.4.3 Extrinsic Verification - Manual Notes 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. 3.4.3.1 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 3.4.3.2 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. 3.4.3.3 Review the Results 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. 48 Turnover Workbook | Symbia Evo 3.5 Daily QC - Automatic Notes 3.5.1 Scheduling AutoQC 1. Command Module -> Options -> Configuration Menu -> MI Acquisition Settings 2. Adjust dates and time for AutoQC scheduled completion 3. Click OK 3.5.2 Intrinsic Verification (Quick Flood) – Auto QC An intrinsic verification uses a point source, flooding uncollimated detectors to verify the detectors’ corrected performance. 3.5.2.1 Setup 1. On workstation, highlight current QC patient 2. Double click the Intrinsic Verification Auto workflow 3. Enter date on the series information tab 4. Ensure that nothing is obstructing the motion of the detector heads 3.5.2.2 Acquisition 5. Return to AutoQC activity and click Start 3.5.2.3 Review the Results 6. On the Flood Calculation Activity, visually inspect the flood and make sure it 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% 7. Make appropriate selections in the Hard Copy activity 8. Complete the workflow 9. Attach the collimators 3.5.3 Extrinsic Sweep Verification — AutoQC An automatic daily extrinsic sweep verification uses a gadolinium line source over collimated detectors to verify extrinsic detector performance. 3.5.3.1 Setup 1. Ensure desired collimators are on the detectors (HRES, LEAP or SMARTZOOM) 2. On workstation, highlight current QC patient 3. Double click the Extrinsic Sweep Verification workflow 4. Enter tomorrow’s date on the series information tab of the Tomo Acquisition activity 5. Ensure that nothing is obstructing the motion of the detector heads 49 Turnover Workbook | Symbia Evo 3.5.3.2 Acquisition Notes 6. Return to AutoQC activity and press Start. The system homes itself, aligning the detectors and patient bed. The Gd153 line source will extract and get a count rate to determine the proper start time. 3.5.3.3 Review the Results 7. (Typically done the following morning) 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% SMARTZOOM collimator floods will have a different appearance than those from a parallel hole collimator. See Users Manual for example of differences. 8. Make appropriate selections in the Hard Copy activity 9. Complete the workflow 3.6 Weekly QC 3.6.1 Symbia Evo Weekly Flow Chart Performed Quality Control Procedure Source Daily Intrinsic Verification, or 35 pCi of Tc99m, or Extrinsic Verification or Extrinsic Co-57 sheet source Sweep AutoQC source Weekly Intrinsic Verification with Tune 35 pCi of Tc99m AutoQC source Monthly Intrinsic Calibration with Tune 95 pCi of Tc99m AutoQC source 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] AutoQC source Every 6 months or per Regu- Perform a leak test of the auto Gd-153 line source and Co-57 latory License requirements mated quality control device point source sources. 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 mef- (MHR) 190 (Match sources within 20% of erence of Low Energy Parallel each other for Tc99m only) Hole collimator Head Alignment Calibration AutoQC source 50 Turnover Workbook | Symbia Evo 3.6.2 Weekly QC - Manual Notes 3.6.2.1 Intrinsic Verification with Tune - Manual Follow the steps for the acquisition of Intrinsic Verification - Manual under Daily QC. Tuning must be performed during this procedure. 3.6.3 Weekly QC - Automatic An intrinsic verification uses a point source, flooding uncollimated detectors to verify the detectors’ corrected performance. 3.6.3.1 Setup 1. Home the system 2. System will automatically remove the collimators 3. On workstation, highlight current QC patient 4. Double click the Intrinsic Verification Auto workflow 5. Enter date on the series information tab for both the Tomo Acquisition and Static Acquisition activities 6. Ensure that nothing is obstructing the motion of the detector heads 3.6.3.2 Acquisition 7. Click the Start button on the AutoQC activity. The detectors will be tuned and an intrinsic verification is performed according to the AutoQC schedule. 3.6.3.3 Review the Results 8. On the first Flood Calculation activity, visually inspect the Intrinsic Verification and make sure the flood is uniform. Review the values. If the values are within limits, accept and save the values. Reject unacceptable values. Uniformity CFOV UFOV Integrated 5% 6% Differential 2.5% 3% 9. Go to the second Flood Calculation activity, visually inspect the Extrinsic Sweep Verification and make sure the flood is uniform. Review the values. If the values are within limits, accept and save the values. Reject unacceptable values. Uniformity CFOV UFOV Integrated 5% 6% Differential 3.5% 4% 51 Turnover Workbook | Symbia Evo 3.7 Monthly QC Notes 3.7.1Symbia Evo Monthly QC Chart Monthly QC Auto QC Productivity Package? Yes No Monthly QC Suite: Intrinsic Calibration Performs: Performs: Tuning Tuning Int. Calibration Int. Calibration Int. Verification Int. Verification MHR Ext. Sweep MHR/COR 180º Config: Performed on most commonly used low energy collimator 3.7.2 Monthly QC - Manual 3.7.2.1 Intrinsic Calibration with Tune - Manual Performs an intrinsic calibration and Intrinsic Verification using a 35μCi Tc99m point source 3.7.2.1.1 Setup 1. Remove objects that will interfere with gantry and PHS motion and home the system 2. Remove the collimators 3. Cover the Detector 2 surface with a protective material to avoid contamination 4. Extend point source holder and place point source in, cap end in 5. On workstation, highlight current QC patient 6. Double click the Intrinsic Calibration workflow 7. Extend the integrated source holder and insert the point source. 8. Count rate should be between 15 kcts/sec and 50 kcts/sec. 52 Turnover Workbook | Symbia Evo 3.7.2.1.2 Tuning the System Notes 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 fails, repeat Tuning and Peaking for each head. 3.7.2.1.3 Acquisition of Intrinsic Calibration 12. Click on the Static Acquisition activity, enter the date on series information tab, and click the Prepare Acquisition and Start button to acquire the 200 Million Count Matrix Correction Flood. The system automatically positions the point source. 3.7.2.1.4 Review the Results of Intrinsic Calibration 13. On the Flood Calculation activity, visually inspect the intrinsic calibration flood making sure the flood is uniform. Review the values, then click the button Accept These Calibrations and Make them Current to save. 14. If unacceptable, click Reject These Calibrations. If Calibration Integral Uniformity exceeds 7%, call service; system can be used with values up to 10%. Uniformity CFOV UFOV Integrated 5% 6% Differential 2.5% 3% 3.7.2.1.5 Acquisition of Intrinsic Verification 15. Go to the second Static Acquisition activity, enter the date on series information tab, and click the Start button to acquire the 10 Million Count Flood. 16. Make appropriate selections in the Hard Copy activity. 17. Complete the workflow. 18. Retract the source holder and remove the protective cover. 19. Attach the collimators, home the system, and perform touch pad test. 53 Turnover Workbook | Symbia Evo 3.7.2.2 Multiple Head Registration (MHR), Center of Rotation (COR) – Manual Notes 3.7.2.2.1 Setup 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. You may only need to do the 180º configuration MHR/COR for the most used low energy collimator. You will need to compare the new values to last performed MHR/COR. If the recent calibration is <0.5 pixels (2 mm) in x-shift/ center of rotation and y-shift/axial shift and <0.1º in the back projection angle, then you can skip the MHR/COR for the remaining collimators and configurations. If the values fall outside of the acceptable range, you will need to perform the MHR/COR for all the collimators and configurations. 1. Prepare five 1-2 mCi Tc99m point sources. 2. Number of sources needed: Three Point Source Collimators: a. Medium Energy Low Penetration (ME) b. High Energy (HE) Five Point Source Collimators a. High Resolution (LEHR) b. Ultra High Resolution (UHR) c. Low Energy All Purpose (LEAP) d. Fanbeam (FB) e. SMARTZoom f. Low Penetration High Resolution (LPHR) g. All Others 3. Mount the MHR phantom on top of the pallet and fasten. (For more information on this, see the operator’s manual for you system.) 4. Use MHR phantom instructional screening to place point sources in the appropriate configuration for your collimator. SIEMENS MHR Phantom * * O 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 54 Turnover Workbook | Symbia Evo 5. Home the system Notes 6. Configure the system for the collimator being used using the table below. Parallel Hole Collimators Fanbeam Collima- SMARTZOOM tors Collimators Configure 180º * 90º 76ª * 180º IQ.SPECT * Detectors Bed In / Out - 39.5 cm - 39.5 cm 39.5 cm 136.1 cm -41.0 cm Bed Up / Down 9 cm 9 cm 9 cm 1.5 cm 15.6 cm Radius 22 cm 22 cm 22 cm 16 cm + 0.5 cm 28 cm * Done automatically. 3.7.2.2.2 Start MHR/COR Calibration Workflow 7. On workstation, highlight current QC patient. 8. Double click the MHR/COR 180 Calibration 5 points workflow. 9. Enter date on the series information tab. 10. Ensure that nothing is obstructing the motion of the detector heads. 3.7.2.2.3 Acquisition 11. Click the Prepare Acquisition and Start buttons. The system automatically configures the gantry and patient bed for the acquisition. 3.7.2.2.4 Review the Results and Save 12. 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 Head Alignment Calibration Results (Parallel Hole Collimators) • |Center of Rotation| < 10 mm • offset of detector center relative to the system’s center of rotation • |Axial Shift| < 5 mm - axial offset of detectors relative to each other • |Back Projection Angle| < 0.8 degrees • angular offset of detectors relative to each other 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 55 Turnover Workbook | Symbia Evo Head Alignment Calibration Results (SMARTZoom Collimators) Notes The tolerances for the head alignment processing results for SMARTZOOM collimators are different from all other collimators because of the new IQ•SPECT reconstruction algorithm • Center of Rotation < ± 20.0 mm • Axial Shift < ± 5.0 mm Back Projection Angle < ± 2.0 degrees • Principal Ray X and Y < ± 10.0 mm • Principal Ray Angle X and Y < ± 5.0 degrees • Long Focal Length X = 4480 mm to 6268 mm • Long Focal Length Y = 4703 mm to 5837 mm • Short Focal Length X = 482 mm to 590 mm • Short Focal Length Y = 472 mm to 604 mm 13. Make appropriate selections in the Hard Copy activity. 14. Complete the workflow. 15. Remove the MHR phantom and replace the pad and home the system. 3.7.3 Monthly QC – Automatic 3.7.3.1 AutoQC Monthly QC Suite This procedure should be used if you have the AutoQC Productivity package. It performs the Intrinsic Calibration, Intrinsic Verification, MHR, and Extrinsic Sweep Verification. 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. You may only need to do the 180º configuration MHR/COR for the most used low energy collimator. You will need to compare the new values to last performed MHR/COR. If the recent calibration is <0.5 pixels (2 mm) in x-shift/ center of rotation and y-shift/axial shift and <0.1º in the back projection angle, then you can skip the MHR/COR for the remaining collimators and configurations. If the values fall outside of the acceptable range, you will need to perform the MHR/COR for all the collimators and configurations. 3.7.3.1.1 Setup 1. On workstation, highlight current QC patient. 2. Double click the Monthly QC Suite workflow. 3. Enter today’s date on the series information tab for the Intrinsic Calibration activity. 4. Enter today’s date on the series information tab for the Intrinsic Verification activity. 5. Enter today’s date on the series information tab for the Head Alignment activity. 6. Enter tomorrow’s date on the series information tab for the Extrinsic Sweep activity. 7. Ensure that nothing is obstructing the motion of the detector heads. 56 Turnover Workbook | Symbia Evo 3.7.3.1.2 Start the Workflow Notes 8. Click the Start button in the AutoQC activity. 3.7.3.1.3 Review the Results and Save 9. (Typically done the following day) Click on the Head Alignment Processing activity. Review the head alignment calibration results. If the values are within limits, click the button Accept These Calibrations and Make Them Current to save the values. MHR/COR Results Head Alignment Calibration Results (Parallel Hole Collimators) • Center of Rotation <10 mm • offset of detector center relative to the system’s center of rotation • Axial Shift <5 mm • axial offset of detectors relative to each other • Back Projection Angle <0.8 degrees • angular offset of detectors relative to each other 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 Head Alignment Calibration Results (SMARTZOOM Collimators) The tolerances for the head alignment processing results for SMARTZOOM collimators are different from all other collimators because of the new IQ•SPECT reconstruction algorithm. • Center of Rotation < ± 20.0 mm • Axial Shift < ± 5.0 mm • Back Projection Angle < ± 2.0 degrees • Principal Ray X and Y < ± 10.0 mm • Principal Ray Angle X and Y < ± 5.0 degrees • Long Focal Length X = 4480 mm to 6268 mm • Long Focal Length Y = 4703 mm to 5837 mm • Short Focal Length X = 482 mm to 590 mm • Short Focal Length Y = 472 mm to 604 mm 10. If the values are not within the limits, click the button Reject These Calibrations and Use Existing Set. Neither the calibration database nor the internal quality monitors are updated. 57 Turnover Workbook | Symbia Evo Intrinsic Verification Results Notes 11. On first Flood Calculation Activity, visually inspect the intrinsic verification flood and make sure the flood is uniform. Review the values. If the values are within limits, click the button Accept These Calibrations and Make them Current to save the values. Uniformity CFOV UFOV Integrated 5% 6% Differential 2.5% 3% 12. If the values are not within the limits, click the button Reject These Calibrations. Neither the calibration database nor the internal quality monitors are updated. Extrinsic Sweep Verification Results 13. Go to the second Flood Calculation activity, visually inspect the Extrinsic Sweep Verification and make sure the flood is uniform. Review the values. If the values are within limits, accept and save the values. Reject unacceptable values. Uniformity CFOV UFOV Integrated 5% 6% Differential 3.5% 4% 14. If the values are not within the limits, click the button Reject These Calibrations. Intrinsic Calibration Results 15. To review intrinsic Calibration Flood, go to Flexible Display activity and visually inspect the savescreen image and uniformity values. If the Calibration’s Integral Uniformity exceeds 7%, call service; system can be used with values up to 10% 16. Make appropriate selections in the Hard Copy activity 17. Complete the workflow. 58 Turnover Workbook | Symbia Evo 4 Overview of Acquisition Console: MI Workplace Command Module 4.1 Areas of Command Module Notes Study Name ALL Show Al O Local Study Date ALL Category Al MIAMI Up Time: 12 Mins Database Local Find 13 studies found on the system. Study daer's call datos] Page Space Avalacie /75460 MB sddy Pan ert Name Peert D Fourty Date La Senes | Database Loginor a Jon, 3 Phane 012/18 Bono Scan 4723/2002 X one, Lumbar Tomo 673 Elone Scan 4/22/1993 Local Dacicase Local Decabase Jon, Spine Tomo 2 ECAM Bone Scan 11/30/1909 Local Database lone, WB and Statics 81156 Bone Scan 4/10/2002 Local Database Cardiac Detector Detector Iran, ksalfreenctal 12345 Ban Scan Local Dicacase ase Bon Sace Centering : Convergen AO Cerdiac 1; Myo Per Dust ME Myocardial Pert 2/1/3001 Local Dicabase Cord ac 2. Myo Perf Myocardial Port 1/25/2001 Local Dicabase cardi ac 3, Dual Study Old Duet Mywww erd &< 3. Duel Study Old Local Ducat-ase Dust Myoview Myocardial Perf 1/9/2001 Example Cord ac 4, Saress & Prent 124-58-5108 1/2/2001 Local Decat-ast 1 Pe 3/25/2000 Local Database Good Tom ardac 4. Stress & Rest 124.58-5106 3/25/2002 Local Durabase Ferdac 5, Myo Perf Abnio Duet Myowew Pert 1/9/2001 Local Database 2 Cardi ac 7, Profile Te TI 12162212 Pe Exangle Cordac, Card ac Mcbon 123456 Port 2/21/2001 Local Decabase COL$1362794 2/23/22000 Local Database Cordiac. Shure 1/7/2002 Local Defabase WB and St. in Pays COL91620006 Finkt Pass union 1. PETICT WD FU 1 Semens PET 12/17/2001 Local Database 8/15/2002 Local Database Fusion 1. PETICT WE FU 1 Palipps CT 8/06/2002 uvon D. MOPET Head FU 6 Bean 8/15/2002 Example Usion Display. WB PET e son Fusion Di 4/5/2001 Local Database Band T. Wholebe WholeBlo Parrose 0333443 GEEF eltladder 2. GEEF Dyn ECAM 2/22/2001 Gaïbladder EF 4/1/2002 Local Ducatase oftladder. Dun & Subc 912539 Galbladder EF 5/17/2000 Local Ducat-ase alium: 2 WB & 1 Tomo 2426453 Ful lastric Emp, Static A/P 520730 Thenor ivaging 5/17/2000 Local Database Digic Perote 7051808 Gastric Emptying 11/23/2001 Local Darabiase Service Verfication Dor Repen Hatic, Dynamic Sieglo Is Gastric Emptying 2/20/2001 LOON Database jeted Bleozpost TOMO 12345 22085481U6MM Equibelum Gate 2/20/2001 Local Database ung. Aerosol Lung Ventlotion 2/16/2001 Local Database una WO 381201STM 43711 Lung VO Scan 2/20/2000 Local Decabase ntrinsic intrinsic Hidess VM Data AX Coronaries 4/25/1997 Local Database Jenbc.abon LC Cibogory Al Workplace SYN0025 Work States. All Launch Suspend Complet 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 Refresh Show A 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 D Study Name Study Date # Series Database Location Bone, 3 Phase 012718 Bone Scan 4/23/2002 4/23/2002 3 Local Database Bone, Lumbar Tomo 673 Bone Scan 4/22/1993 Local Database Bone, Spine Tomo 2 E.CAM Bone Scan 11/30/1989 Column Local Database Headings Bone, WB and Statics 81156 Bone Scan 4/19/2002 Local Database Brain, ktalinterictal 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 Ivyoview Myocardial Perf. 1/2/2001 Local Database Cardiac 4, Stress & Rest. 124-58-5106 Myocardial Perf. 3/25/2002 4 Local Database Cardiac 4, Stress & Rest ... 124-58-5106 Myocardial Perf. 3/25/2002 4 Local Database Cardiac 5, Myo Perf Abno ... Duet Myoview Myocardial Perf. 1/8/2001 A Local Database Cardiac 7, Profile To Tl 12162212 Myocardial Perf. 2/21/2001 17 Local Database Cardiac, Cardiac Motion 123456 123456 Myocardial Perf. 2/23/2000 2 Local Database Cardiac, Shunt COL91362794 Equilibrium Gate. 1/7/2002 Local Database First Pass COL91620666 First Pass 12/17/2001 Local Database Fusion 1, PETICT WB FU 1 Siemens PET 9/18/2002 Local Database Fusion 1, PETICT WB FU 1 Philipps CT 8/6/2002 1 Local Database Fusion 6, MR/PET Head FU 6 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 ECAM ECAM Gallbladder EF 4/1/2002 Local Database Gallbladder, Dyn & Static 912533 Gallbladder EF 5/17/2000 Local Database Gallium, 2 VVB & 1 Tomo 2429453 Tumor maging 5/17/2000 3, Local Database 59 Turnover Workbook | Symbia Evo 4.1.2 Workflow Template Browser Notes . tocar Refresh Local or Workflows Category: All Network Nuno F ber Category 3 Cardi ac Detector Phase Bon. Slice Cortoring Convorpen AD AD Auto Filter Workflow Display Example Example Template Dynamic Gated Tom AD AD List Exemple Example Example Example Gaed Stetc (DH] Tomo (CH) WWB and St AD Example Example Example W8 and T .. Calibration Extrinsic Extrinsic Full Gonora Service Verrication Doc Regen Sice 4.1.3 Workflow Manager Refresh Category Workstation Launch Suspend Category: All Vork Status: All Workplace: SYNGO26 Stage: All Suspen mplete 4.1.4. Launching a Workflow 2 Select Category ----- 012156 4/25/2001 - CAM 1. Highlight Patient 134.5a Stse PartAbra Out MyorWN 115456 221/0001 Cand ac Mogers 2/28/2000 3. Double L1 Whoiba Cmtriton Click Workflow wmc. Dyunic Sah 539150 --- LC Woinplace Sodiode 1. Highlight the patient from Patient Browser 2. In the Workflow Template Browser Category > Select Category 3. Double click the workflow desired 60 Turnover Workbook | Symbia Evo 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.). #1 Common Workflow Configuration #1 Ad hity #2 A workflow that contains acquisition. processing D two in this examplel. displaying, and hard copy Arquitition in one workflow. Activity Common Workflow Processing Processing Configuration #2 Activity Activity A workflow that contains processing, displaying. and hard copy in one workflow. Processing ible Activity Display Activity Flexible DEplay Hard Copy Activity Activity 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. 61 Turnover Workbook | Symbia Evo 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. Suspend: Saves the data to the hard disk on the PC so that Complete 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 62 Turnover Workbook | Symbia Evo 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 DisplayfAnalysis Patent Bone, 3 Phase & WB Acquisition Display Acquisition Analyzer Display/Analysis Decactos 1. Detector 2: Study Bone Scas Patient Bone, 3 Phase & WB Series Study Bone Scan Series Summary Series laformation Camera Paramasters Stop Conditions MarTre Description Summary Series Information Camera Parameters Stop Condition Patient Name Bone. 3 Phase & W3 Patent D Symbio T Name Description Study Name Bone Scan Patient Name Series Name Bone, 3 Phase & WB Patient ID Symbia T Study Name Bone Scan Sones Technologist Series Name Reading Physician KCounts KCourts Referring Physician umaring Elapsed Matrix Size 54 X 64 Zoom 1.00 Comono Preset DeCOCIOes Both Detectors Phase Frame Orientation Head In Patent Position Supine Phase Parametces Camera Parameters Supere 64X6 Both Detectores Prepare Acquisison 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 Camera Preset 1.00 Detectors Both Detectors Orientation Head In Patient Position Supine Phase Parameters 63 Turnover Workbook | Symbia Evo 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 4] Series: Bone Flow Technologist JD Reading Physician: Referring Physician Organ: Skeletal Radiopharmaceutical Dose: Isotope: 25.0 mCi 99m Technetium Pharmaceutical MDF Interventional Drug Imerventional Drug Injection Time (hh:mm:ss): D 0 hject Dose (mg): 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 64 Turnover Workbook | Symbia Evo 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 v Use the same parameters for Detector 2. Time First View by Counts Counts Time or Counts Count Density Manual Time: sec Counts 500 Kcts Any Window Group View Control Detector 1: Ant Detector 2: Post Add View Insert View 6.2.5 Gate Allows you to select gated parameters. Camera Paramotors| Gate |Stop Conditions Framing Beat Window · Number of Frames: Selected window 1 Center: 72 Time per Frame: Wicth (%) 20 o msec Autocenter Primary Window . Average of . Forward 10 Beats Forward/Backward by Thirds 0 Peak Bin of 10 Beats Autotracking PVC Reject PVC Beats Beats To Reject Post PVC. 1 PVC Threshold [msec) 200 Beat Histogram 100 81 20 Beats D 0 20 40 60 80 100 1.40 180 220 Beats/Min . 1 Window Beats/Min ms/Beat Save Curve 65 Turnover Workbook | Symbia Evo 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 Conditions |Static Camera Parameters|Stop Conditions |Static Stop Conditions 2. Static Tab Appears Stop Conditions Time Start Time (mm:ss): msec Duration 20 min Acquire with R-Wave Gate Acquire with Statics 1. Check Acquire StopTme 22 : 0 with Statics Phase Parameters Camera Parameters . No Pause or Delay Static Matrix Size: 64X 64 Pause Before Phase Number of Frames: 1 View Names Detector 1 Detector 2 Anterior Posterior View Control Add View Insert View Update View Delete View View Start Time Duration Stop Time Detector 1 Detector 2 2.00 20 mn 22 :00 Anterior Posterior 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 Peak Shifts ( % ) Tc99m-NMG Dead Time (9%) | Peak Status |1 2 New Preset Name: Detector 1 Detector 2 NOT TEAK Save Freset Begin Peeling Pause Between Peaks Windows Number | Center (kaV) width (96) Shift (%) Parent WL Window Center (keVx Window width (% ) Window Shift (% ) Window Group A 99m Technetium Window Group B Window Group C Window Group D Window Group E Counts Window Group F 100 150 200 250 300 350 400 850 500 950 800 E50 Detector 1 Detector 2 6.4 Display Analysis Tab Used to review images. 66 Turnover Workbook | Symbia Evo 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 New Workflow Workflow Characteristics IT Save Workflow Template ... Save Workflow Template AS ... Enter New Workflow Name Workflow Name Enter New Description (Optional) worddow Descripnon This workflow acquitestikc acquis Bors Select Category Select Icon vert Type Vanmery WodBowlcon Parathyroid DO RW Tumor Thetenc Vesical Conbrad on @ Coincidence Dynamic Torno 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. 67 Turnover Workbook | Symbia Evo 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 PROCEDURE ATIENT Last name Accession No Firstreme Request D Title Suffix procedure(a) Cher Patient Name[s] Othor Patient D(s) Ethnic Group Step 2 Military Rank Patient ID Date of Birth Dece Sex Male Female Other Study Yours Study comment Height Weight tal Address Patient position Additional info Institution narno 1. Performing physicien warren moore, md 2. Performing physicien HOSPITAL Referring physicion NOTIMITISN 1 Operator Requesting physicien 2. Operator Admitting dagnosis Ward Step 3 Admission ID 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 68 Turnover Workbook | Symbia Evo 8.4 Positioning Patient for Exams Notes 1. From the PPM, press the Reconfiguration tab SIEMENS (2) 1) 90º 90º 76º 76º (3) X 6 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) (6) (7) 5. Select the patient and launch the workflow on the MI Workplace and start the acquisition 69 Turnover Workbook | Symbia Evo 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. 70 Turnover Workbook | Symbia Evo 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 ottings |Correction 2. Select Series eries: Stress Mibi-Gated [Corrected) Before Sinogram el Sinogram 100 D 4. Click and drag red Linogram Linogram line to center heart 100 100 5. Click the Cine button to view motion 250 200- Sum Sum 100 100 3. Apply Beat Normalize (Optional Boots Baat Normaliza Boat Histogram . Boats Min Boats VE. Projections Unapply Correction ms.Best HR vs. Projections Click Motion Correct Series button Isotope: A Motion Correct Series .. Revort to Original 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 71 Turnover Workbook | Symbia Evo Motion Correction Notes Automatic Manual Automatic Correction Use Al Projections Shift all projections Isotope: Apply X Shift 7. Center red ROI over Apply Y Shift neart. Head Misregistration Before 100 100 224.99 254.99 304 99 344.99 394.99 X Motion 12 Sinogram inogram 221 99 254 99 304 99 344.99 334 9 Y Moton After 100 100 33 224 99 264.99 30499 344.99 394 99 X Motion 224.59 254.99 304.99 344.99 384.99 Y Motion 3. Click to Review Cine 9. Click OK COK 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 Sellings Correction 2. Select series Series: Renel Meg 3 Before After Rana Mag 3 Sum Sun 100 Quality Control Tools Unapply Correction 3. Select Motion Detector: 1 Isotope. A Motion Correct Series .. Revert to Original 72 Turnover Workbook | Symbia Evo 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 Sottings Correction 2. Select the series Series: Choat Before Ginogram After Sinogrem 100 POMS 100 100 Linogram Linogram Sum Sur 100 Quality Control Tools DUhapply Correction 3. Click to motion correct series Isotope: A Motion Correct Series ... Filevert to Original 73 Turnover Workbook | Symbia Evo 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 : Multiframe Mode 6. Vertical Shift Tool to 5. Cross Tool make adjustments in inogram % 52 100 Sum % 100 0 7. Click to cine images X Shift: 0.00 Y Shift 0.00 8. Click OK to accept the changes. OK 74 Turnover Workbook | Symbia Evo 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 ist Template Workflow Activities Help 6. Click the Reconstruction Settings Reconstruction Bone Scan - ADJunvorTECtope A 3/17/2003 Tab Anterior Transverse Sagmal Coronal Data Saloctor 21 7. Click and drag red lines to adjust range Qualky Com Scrollable views Display Zoom: Bone Scan - Thorax- Isotope A 9/17/2003 Transverse Saghe Coronal 68 Flanela Display ~ Scrollabla Views ra Tomo for Non-AC - Bctope A Display Zoom: Transverse Sagital Coronal 100 Scrollabla View 4th Tormo for Non-AC - Isotope A Display Zoom: !! Transverse Sagmel Coronel 100 - 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 75 Turnover Workbook | Symbia Evo 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 Eile Gastrointestinal View Template Workdow activities Help AI 3. Check ROI ROI and placement ic empling (Resulta) 2/21/2014 51 0 2. Click Cine button Gastrointestinal Switch to Cine Mode Isotope 98m Technetum ROE Creete ROI Using Emptying Curves Composite mage 600 600 100 400 300 200 100 Counte par tec 0 5 10 15 20 25 90 35 40 45 50 56 80 66 70 75 80 4. Click the ROI Tool to redraw ROI if needed Treshold: Results Summary Paramotor Ekgd Correction 99m Tochnotium Emptying 41 % Decay Correction On Emptying begin (TO) 3 mins ROITOOL Geomedic Mean Emptying end 60 mins T 12 68 mins Composite Frame Range TO-> T 1/2 65 mins First Frame: 1 Sctup Last Frame. The cine mode alkeys for cing evAng of a series in a single pane Isotope: 99m Techr Empf 6. Drag Tfit to end of empty 5. Drag to start of empty 400 Tit empty That 300 200 100 Courts per . Drag to position 0 5 10 15 20 for % emptying GD 85 70 75 80 85 2. Review results 3. See Settings tab to review or modify parameters for this activity 76 Turnover Workbook | Symbia Evo 10.2 Hepatobiliary Processing Notes 1. Select the Gastrointestinal activity in the workflow Gallbladder 1 GBEF Dynamic, ECAM - GBEF, 2/22/2001 Eile Gastrointestinal View Template Worklow activities Help AI Sottings ROI Pan CallBludde: [Resulta) 2/21/2014 Data Saloctor 3 . Check for ROI placement CH 2. Click the Cine icon 5. Drag to adjust Start 6. Drag to adjust End ohnetium RO Create ROI Using Ejection Fraction Curves Composite Image 100 Carte per 0 12 14 1@ 18 20 22 24 26 28 30 32 34 38 38 Ninubira 4. Click to edraw the ROI 25 Results Summary Paramotor 00m Tochnotium kgd Correction on Ejection Fraction 95 % Decay Correction EF interval begin 2 mins EF imtervel end 35 mins Complete ROIToCl - T Max 2 mins Composite Frame Range T Min 35 mins First Frame: 1 Schep Last Frame. 40 loves the image position within the treme. 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 O AI oftings Processing P. cults |Fitting Results 1. Click the Gated Bloodpool Data Selector Image & ROIs activity and the Processing Tab LAD-Gated [Results] 2/21/2014 % 100 Ventricular ROI 5. Cine to check ROI Hard Copy All Fram 100 2. Center LV in green box Cancel F1:11 200K.61234 Edit RO Use to modify ROIs 3. Click to determine LV center 4. Click in center of LV Schep Determine LY center ... ROI Tool ... RO Tool . 77 Turnover Workbook | Symbia Evo 10.4 Lung Processing Notes 1. Select the Lung Processing activity on the ROI tab of the workflow Al 2. Review RO placement Settings ROI Regional Analysis Washout Analysis Perfusion Series Perlosion Long 2/26/2014 DIPA ABresol VEMOSHe 100 Partisim LAD 110.31 E Alleges 8 2 All Images Post aerosol Fait ROI Threshold : Adjust Frame Threshold: Adjust Frame X Shift: O X Shift: ........... .--------- 0 Y Shit ROI Tool. Anglec Andle RCITOdl 3. Click to modify ROIs Registration . 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 78 Turnover Workbook | Symbia Evo 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, 1/25/2006 Eile Ronal Processing yow Template Workflow Activites Hop AI 2. Review ROI Display ROls Rosults placements Aorta 5. Click to view results . Use sliders to edit thresholds Procession Threshold : Threshold .......... Hard Capy FOL TO Composite Image First Frame: 60 First Freme: 4. User ROI Last Frame: 70 Lest Freme: 30 redraw RO Setup Body Renal MAG 3, Symbia T - Renal Scan, 1/25/2006 Eile Ronal Processing yjew Template Workflow Activites Hep AI Sottings Display ROls Results Kichay Aorta Data Saloctor Kidney OuSky Corti Processing Fr11752K 256-256 Fr.1 164K 258-058 Table of Patient Parameters Ferameters Values Renal Protocol Generic [None) Counts / Second Kidney Depth Method Standard Patient Neme Rienel MAG 3 Patient D Symbia T 10 12 14 16 18 20 22 24 25 Sex Other 0.07 Reference BSA 1.73 m2 FRAL RRHE BEV. Spit Uptake Interval ( ... 2.0-30 Radiopharmaceutical 10.0 mCi 99m Technetum MAG3 Flow Method Adut Hemato cric 0.00 Table of Result Summary Perometers Left Right Total Spit Function (as) 46.9 57001 53.1 Kidney Counts (cpm) 84829 121630 Renal Retention 0.182 0.248 Time of Max (min] 2.501 2001 Time of % Max [min] 7.634 Time from Max to J&M ... 5.124 Counts/Second ghtness Levels: 0% (01 -> 8% (187] 2. See Settings tab to review or modify parameters for this activity 79 Turnover Workbook | Symbia Evo 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, Symbis T - Bone Scan, 11/15/2005 Eile SeriesReformat Yjow Template Workflow Activities Help O AI 1. Select the desired 2. Click Resize to adjust nes Reformat matrix size matric. Data Saloctor doct Sonos: Bono Stabcs POITOOL .. Revert To Original Input 1: Entire Series Matrix Size: 128 Resize 100 100 100 100 Sales Freo ATLAT BOSK AUNT ARME UP EBAK Hard Copy Setup 80 Turnover Workbook | Symbia Evo 10.6.2 Image Masking Notes To remove masking, click Revert to Original button Hands-on Lab Computer MI Sim 1 Bone WB and Statics, ECAM - Bone Scan, 4/19/2002 File SeriesReformat View Template Worklow Activities Help O AI Settings Series Reformat Data Selector Select Senes: Wholebody Wholebook RO TOOL ... Revert To Original| Input 1: Entre Series Matrix Size: 258 Resize 2. Select the ROI Tool 1. Select image Hard Copy TROQUEBIER HT 256x1024 P. J.arm Betup ROI Tool User Interaction Prompt:7 ROI TO Display Frames . 1x1 1x2 2x1 2x2 Sum: 1 User Mask 3. Select used to 4. Draw mask ROI Color : RT ANTERIOR LT 5758K Duration:1701sec 256x1024 Pix2.4mm 99m Technefur ROI Name 5. Select to Keep Inside or Outside Threshold : User Mask Keep Outside Keep Inside Cancel 81 Turnover Workbook | Symbia Evo 10.6.3 Series Filter Notes 1. Click on Series Filter activity and Series Filter tab Hands-on Lab Computer MI Sim 1 YOU O PY MUGA 5 2 View, Symbio S - Equilibrium Gated Cardiac, 1/26/2006 File Series Filter View Template Worldlow Activides Help Settings& Series Filter . Select Spatial or Select Series AO Revert Series Temporal filter Original Senes 1: Enore Senes 2. Select series Filter Applied No Filter tered Series 1 Completo Setup Wiener [5] Delete Save Test Specified Filter Filter Parameters Kernel 2 3 0.04328 0.12148 0.04328 4. Select filter 2 0.12148 034099 0.12148 3 0.04328 0.12148 0.04328 5. Make desired updates to filter parameters 6. Trial Filter to visually inspect. Size Wiener . 2D SNR 0.26 FIVHM ª mm Update Trial Fibor Views 7. Select the desired 8. Click OK Boxcar terations 3 Gaussian FWHM.6.00 Mener FWHM.8.00 SNR.0. 26 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 82 Turnover Workbook | Symbia Evo 10.6.5 Static Extract Notes Lung Aerosol, ECAM - Lung Scan, 2/16/2001 Eile Flexible Display View Template Worldlow Activities Heb x ? O AI X/Y Single Series Static Display Patient Name: Lung Aerosol Study Date: 2/16/2001 Patient ID: ECAM DOB: 7/5/1962 Study Name: Lung Scar Aifinile x + Perfusion Lung [Concatenated] 2/24/2014 % % 100 100 Affinatic * + 0 Seres Ant serozal 193% Post serpool 190-< LPO at13:cl 150K Asfineto Derbor:20386€ 128x128 Duritas:203sce 128x128 Durcharcadisoc 128x128 Durch wrc299sec 128x128 Duration:31 5sec 128x128 % % x + 100 100 100 100 100 Athnite x + O D D LI Let Acrecol 151k APO corocol 109% Porusion RIPO 316K Deratos:315sec 128x128 Duration:299sec 128x128 Duradi arc298ses 128x128 Duration:76sec 128x1:28 Duration78sec 128x1 28 % % % % 100 100 100 100 Flexible Drap 0 D Per RI bt 316k U Lat 316K Durator 127 sec Per RAD 115K DeraBan:12fast 120x12D 12001 3D Duratione I'Daux 121x120 uratiort Ibavc 12 De1 20 100 Compete O FOSPOST 455KC Durationci fico<< 123x128 (80%.1:100%] Select the Series Extract activity "Bone WB and Statics, ECAM - Bone 5can, 4/19/2002 Elle Series Arithmetic View Template Worknow Activiles Help x C Process Workflow 1. Select the images or phase to Click th Data Selector Settings Art extract in Operand 1 Extract icon erand 1 Series 1: Mutiple Frame 100 150 PLAT 601K ULAT 468K Dutation 146aut Durd crel 4fac Dumbon 161 aux 2568256 Px:2Am 250:258 Pbc2 4mm All Detecters Select Series Operand 2 Series 1: Entre Series FLAT 601K ULAT 488%< RWO HOUK Duktion 14058F Durad ont 4f se puntos4 TOser Curatore 17 0sec 3582256 Pte3 Imm 2568316Ptr24mm Con Taitnesim All Datacfare Operation Extract [Mutiple Frame] 3. Result will have the extracted Resu: Series 1 images or phase % 100 100 RAO 100K LPO 000K DUNIn 15199 256:256 Pix24mm 25%(258 Pbc2 4mm Qum Tertrefury Ectup 83 Turnover Workbook | Symbia Evo 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 low (Phase 1) Filling (Phase 2) Excretion (Phase 3) Paliand Narne: Renal Lasix Patient ID: Symbia DOB: 12/30/1981 ools X Study Nare: Remal Scam Study Data: 4/6/2008 Radispharmaceutical 1: 0.0 MBq (0.00 mCi) Operator Name: Took x IA Print Area Object Print Aroa Object OH A Resuts Composite, Series Display (25) Renal Lasix, Symbia Renal Scan 4/8/2006 7:44:24 AM #000 Rond Puts] 10/8/2012 1:45:44 PM Print Area Object. Print Area Object 84 Turnover Workbook | Symbia Evo Notes Below are examples of how different display objects are used. Text - Display Image Display Slice - C Display Curve Display  85 Turnover Workbook | Symbia Evo Text Notes Display Ronal, MAG33 Abnormal HID. 614 Print DOB: 8/26/1940 Study Name: Ronal Scan Study Date: 12/1/2000 Display Curve Parameters Tata Scht Function (%) 7.351 Display oday Counts ispm) 92 6 31433 2510 2 Time of Max ovino 3. 001 34145 laxemini 1.294 Series Display Multiple Frame and ROI Statistics  0ª Abnona Study Name: Study Dulac 12/1122:000 A 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 86 Turnover Workbook | Symbia Evo 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. 87 Turnover Workbook | Symbia Evo 11 syngo Patient Browser Notes Patient Browser Patient Applications Transfer Edit View Filter Evaluation Sort Options Help oca Database 4DM CaSc1 Myocardial Perfusi [1] 4DM-REST TC [FBP] Schedule 4DM Ischemic2 [1] 4DM-GSTRESS TC [F6P] DVD-R 4DM MUGA2 [1] 4DM-CaScoringResuts DVD-RW 4DM PET Abnormal [1] 4DM-GSTRESS TC [ACI] AMMONIA 1 [1] 4DM-REST TC [ACI] Bone - WB Tomo [1] 4DM-Pathto Bone 4 (complete], flowv.po [1] 4DM-GSTRESS TC-Gated [FBP] Bone 5, 2 tomos [1000) REST TCTACI Patient Name Patient ID Date of Birth Sex |Comm. Studies Series Mark Status 4DM CaSc1 DEMO 5/28/1944 M 4DM Ischemic2 DEMO 3/13/1954 M 4DM MUGA2 DEMO 2/13/1939 M 4DM PET Abnormal DEMO 9/12/1947 F AMMONIA 1 Anonymou - Bone - WB Tomo e.cam 6/2/1955 M Bone 4 (complete], flow.pool 45678912 1/1/1983 M Bone 5, 2 tomos 56789123 1/1/1992 F ------ - BONE EPP COMPARE Tcm DF 1/1/1965 M Bone, WB and Statics ECAM 8/7/1943 F BoneCompare HALFTIME TC99M_M 1/1/1950 M Brain ECD Child, Dyn SPEC Kitasato U 3/26/2007 M ECO brar Brain Tomo 1, Scenium Neurolite 1/1/1932 F Brain Tomo 2, Neurogam Tcsem_NE 1/1/1942 F Brain, DIAMOX Gen CT A( 6/3/1958 M Cardiac 1, Normal ECAM 11/24/1926 M ---------. ---------------- 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. 88 Turnover Workbook | Symbia Evo 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 89 Turnover Workbook | Symbia Evo 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. 90 Turnover Workbook | Symbia Evo 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 Bady Namo ALL O Local Study Date: ALL Nowork Category All System Up Time: 1 Hour 22 Mins Find Image Space Available 45174 MB Auto Fitur Pabest Name Most Roce a Stades | # Senes Dacabar a Teraplace Name Template Desc. A. Geetic Empas- Normal, den- nonnel ve solids 12345678 2/20/2001 Series Stati c Extractor Proc Extracts a sing Gastric Empang abnormal, dynamic-abin.vds .. 212 AM V2008 LocalD. 06514430 11/2002009 LocalD LocalD Series Tomo Composite Proc Sorios Tono Detector Extractor Cremes a stad. Goctic Empty (4 hr), Pt 1 EXTRACTS D .. Gestic Emptying, Dual isotope 30644173 T/0/2009 LocelD Series Tono Extractor Det 2 EXTRACTS D .. Gil Blood (positivo), 2 phase dynamic & stics 1000160880 2/2 12008 Sorios Tore Extractor Proc Extracts a sing IO SPECT goed cose2, Caso #2 IO SPECT SYMBIAT, symbiaT HO289973 1/25/2011 LocalD SITUS INVERSIS PROC 0171544 3/20/2012 LocalD. Thra workfor w IO SPECT, NICE CASE SITUS INVERSIS REST ACO ACQUIRES A IO SPECT.TB H1151800 2/28/2011 1/19/2011 Local D SITUS INVERSUS OSTRESS ACO ADO SITUSIN. IOSPECT 2. 12 1101.10-00 18 Local D Stai lmrsus Procv4 0 This worldfor W IOSPECT, SYMBIAS 1101 18-03 17 1/15/2011 LocalD. Stoa Comparison SYMBLA S Displays ande $20/2012 LocalD SMARTZOOMNM CT FOV Canbe. Acquises a NM Liver Horsangioma SMARTZOOMNM CT FOV Venn .. Acquises a Now Liver, Complice 110000 TCRAm SC 12/280008 LocalD LocalÉ SMV 1De Spel Display Displays spol v MM ACOS Gor Logs LocalD SMV 3 Phase Bone Display DISPLAYS A 12001 LocalD SMV Cardiac Proc LocalD SMV Lung Display LUNG DISPLA 13 SlatM Apas V2009 LocalD SMY Sice dispicy display's the S. 541 Picoran Access and Défauts 2008 LocalD SMV Whokbody Bono MEG 3/16/2006 LocalD SMV Wholebody Masking Displays a whol MASK A WHO. Windows CHalog SymbiaS 1/26/2000 LocalD Source Replonichment AOC Lise this work ECAM 4/1/2002 LocalD SPECT_CT Display Displays correc 100320 2/5/2008 LocalD STATIC CCK ACO Windows Update Symbie T 1 11703005 STATIC DISPLAY. ADQUIRES 5 Multiple Steht. ECAM LocalD 2/22/2000 LocalD Sanse Display Displaye thizic evertw rsc ECAM 226/2002 LocalD. Paint FCAM LocalCx STATIC GASTRIC PROC Smbist 268051050 110V/2011 LocalD Staoc Maslang Whilmask regio explorer ese LocalD Stotic Merge Proc Morpos 1 to 20. Shutdown_at_Monty_hour bat Eroprans pory Al Suspend Complete Documents lotus Ratings Seach Bun Shut Down 2. Select Force Shutdown of High-Level Processes. Clean Up 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 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 . NO 4. When cleanup is complete you will be prompted to copy log files if necessary, if not choose Cancel 5. If this step was unsuccessful, repeat Step 2 but choose Force High level Processes and Low Level Servers 91 Turnover Workbook | Symbia Evo 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 1 2 (5) 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. _____________________________________ 92 Turnover Workbook | Symbia Evo 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? ____________________ 93 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-16119-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

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