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syngo Application Software VE20: syngo EVAR Guidance Job Aid

This PDF Job Aid will demonstrate the workflow for performing syngo EVAR Guidance on syngo Application Software VE20. 

SIEMENS Healthineers syngo Application Software VE20 syngo EVAR Guidance 10 cm Effective date: 05.29.2020 | HOOD05162003097073 Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 Unrestricted © Siemens Healthcare, 2020 syngo EVAR Guidance SIEMENS Healthineers Table of Contents Introduction 3 3D Sharing Q O Browser Images Somings Clase Im Snapsho 30) Poi Interars Fxport 1 C HPR HFS syngo EVAR Guidance workflow overview 4 syngo EVAR Guidance workflow steps 5 Load the planning volume to 3D Sharing 9 Select the syngo EVAR Guidance workflow 11 RAH 10 cm VRT LAO 34 / CRAN 31 W 315 730 2 Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo EVAR Guidance SIEMENS Healthineers Introduction Livo A 3D Sharing The syngo EVAR Guidance application provides the ability to safely plan and perform endovascular procedures under fluoroscopic or Application Control angiographic image guidance. Application EVAR Cadence @ Add or delete vessel centerlines, if necessary LLLLI Create Vessel T .. Define Landmarks Teck Bockmarks Layouts syngo EVAR Guidance can be performed using a previous CTA volume Overlay Show Vessel Coler of the same patient. Aortic Vessels L Rcnal R Rana R IIAE ...... Using syngo 3D Roadmap, the live image can be overlaid to the 3D image including the vessel tree. The vessel tree and the ring markers (landmarks) can be projected to the live image. Introduction 3 Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo EVAR Guidance SIEMENS Healthineers Workflow Overview 1 2 3 Planning: Registration: Overlay: Create the Vessel Tree: Segment all • Using syngo 3D Roadmap overlay the • • Select the Overlay workflow step. important vessels of the vessel tree. The Use syngo 3D registration to register the 3D vessel centerlines, vessel contours, and • Vessel Tree can be later used for navigation planning volume (CTA) with the examination landmarks with live X-ray. when overlaid with live X-ray (during the patient so that it can be used for overlay. • You may adjust the C-arm position Overlay workflow step). according to the image display. • Define Landmarks: The system creates a • You may adjust the volume view according vessel mesh based on the vessels segmented to the C-arm position. in the Create Vessel Tree workflow step. Then, based on the mesh, important landmarks (ostia and landing zones) are created. Workflow 4 overview Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo EVAR Guidance SIEMENS Healthineers Workflow Load the 3D volume: • Load the 3D volume (CTA volume) to the 3D Sharing segment (see pages 9 and 10). Start EVAR Guidance: Application EVAR Guidance X Close Object List • Select the EVAR Guidance workflow from the Workflow Header or from the Application Control window Application X (see pages 11 and 12). Detecting Aorta. Cancel • The vessel tree (aorta, the iliacs, and the renal arteries) is automatically detected in the Create Vessel Tree Create Vessel T ... workflow step. Create Vessel Tree • Select the Add Vessel icon. Create Vessel T ... Define Landmarks Tools Bookmarks Layouts • If the aorta vessel has already been defined: you can use 1-click segmentation to define a vessel. Overlay • Click into the most distal end of the branching vessel. The vessel segmentation occurs Add Massal Edit Vessel Undo Redo automatically. Show Vessel Color • If the aorta vessel has not been defined: you must first create the aorta vessel using 2-click Aortic Vessels V Aorta segmentation. L Iliac • Place a point at the most proximal end of the aorta and a second point at the most distal end of R Renal R Iliac the aorta. You can then use one click segmentation as described above to define a vessel. • To edit a vessel select the Edit Vessel icon. ....... • Click the vessel segment to edit. Workflow 5 Steps Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo EVAR Guidance SIEMENS Healthineers Workflow Define Landmarks: Landmarks, for example Ostium markers and Landing zones are automatically defined by the software. Define Landmarks Check and edit the landmarks for EVAR Guidance: Tools Bookmarks Layouts Overlay • Select Define Landmarks in the workflow step. + Select the Next Landmark icon to progress the view to next landmark. Next Add Save Distance • Landmark Landmark Angulation Measure • You can hide or show landmarks by clicking the check marks in the Landmark list or via the Object Show Landmark Adjust Color R Renal List. Infrarenal Landing Zone V R Renal Ostium VSL 5 C Manipulating landmarks: VSL 5 Landing Zone • To reposition an ostia, grab the center of the ostia and move it. VSL_5 Ostium • When moving it along the mesh, ostia orientation will snap to the mesh. • When moving it outside of the mesh, then the last orientation will be retained. Centerline Surface • To reorient or resize an ostia, select it and grab a handle at an end of the ostia. • Reposition the handle to resize or reorient the ostia. • To reposition a landing zone, grab the center or anywhere on the ring of the landing zone and move it. • Landing zones can only be moved along the centerline. Workflow 6 Steps Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo EVAR Guidance SIEMENS Healthineers Workflow Define Landmarks: Adding a landmark: Define Landmarks< Tools Bookmarks Layouts • Click the Add Landmark icon. Overlay • Click the landmark position on a centerline within the vessel. + Landmar Add Save Distance Landmark Angulation Measure ... • If you click into the aorta or external iliac centerline, a landing zone is created. Show Landmark Adjust Color R Renal C • If you click on the vessel mesh, a ring marker is created and snaps to the mesh. Infrarenal Landing Zone • If you click outside of the vessel, a general ring marker is created. R Renal Ostium + VSL_5 C • If the vessel is identified as an aorta or external iliac, a landing zone is created which is VSL 5 Landing Zone VSL_5 Ostium perpendicular to the centerline of the vessel at the point on the centerline closest to the click. • If necessary, you can move the landing zone along the centerline in both directions. Centerline Surface • You can change the name, hide, or show landmarks in the Landmark list or via the Object List. • To delete a landmark, mark the landmark in the image segment, press the right mouse button and select Delete in the context menu. Planning Select the Overlay workflow step Overlay Perform syngo 3D Registration: • Select the syngo 3D Registration icon. • Select 3D/3D Registration (syngo 3D Fusion) or select 2D/3D registration (syngo (2D/3D Fusion). Workflow 7 Steps Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo EVAR Guidance SIEMENS Healthineers Workflow Overlay: • Select the checkboxes to show or hide items. Overlay the live image on 3D Create Vessel T .. • Select the Live on 3D icon in the workflow header in the Segment Menu or in the Define Landmarks Tools Bookmarks Layouts Overlay Application Control dialog box. Show Landmark Adjust Color • To adjust 2D/3D blending, drag the slider. R Renal C V Infrarenal Landing Zone R Renal Ostium VSL_5 C • To select another frame from the scene, press the ← or → key on the keyboard. VSL_5 Landing Zone • To invert the grayscale of the 2D image, click the Invert 2D icon. VSL_5 Ostium Overlay the vessel tree to the Live image: Vessel Visualization Contour • Select the Objects on Live icon. • The 3D objects are projected to the perspective of the C-arm position. They are Centerline Planning Volume displayed in the Live segment. Hide all Live on 3D Objects on 3D objects Live Registra. 3D • 3D image follows the C-arm position. 3D • Adjust the C-arm position to the 3D image. Workflow 8 Steps Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo EVAR Guidance SIEMENS Healthineers Load the planning volume 1 3D Sharing = Source Browser Images Settings Menu Close Im ... Save Bo ... Snapsho ... 30 Polyli ... Export t ... Parallel . Viewing Review loaded or acquired volumes. Review and Proxcreating New acquisitions will replace existing volumes. Bookma ... Layouts Undock If you are using a pre-procedure 3D volume for planning, Image Directory 3D Sharing ? X import the data to the patient browser before starting Send To SelectAll Deselect .. Multiple All Scenes + 3D 3D REF/ Bookmarks Key Images Custom Overlay. 2 December 16, 2013. CT VOL Load the planning volume to the 3D Sharing segment AN ANLUME If the patient is the currently registered examination: 1. Open the Image Directory in 3D Sharing. 5/2: BodyAngio 0.75 B261 5/2: 1.5mm 2. Select the exam data, when the 3D volume was created. Load the 9 planning Effective Date: 05.29.2020| HOOD05162003097073 volume Unrestricted © Siemens Healthcare GmbH, 2020 syngo EVAR Guidance SIEMENS Healthineers Load the planning volume 1 If the 3D volume data is not under the current examination, Live A Q 3D Sharing = CH Monu Closo I ... Savo Co ... Stapsho ... JU Pot/ll .. Iloract ... Export t ... Viowing FReview and Processing Review loaded or acquired volumes. New acquisitions will replace existing volumes. Axum for example if the data is from another hospital and not Patient Browser Local Date es1 2 (2) Test 1 (1) matched to the current patient: 3D Patient x Q More Fillere 2 Results ($ results, 1:44:33 AM) Series 1. Select the Patient Browser in 3D Sharing. Patient Study Description Study Date and Time| + Series Number Series Description Modalily Series Date and Time Series Aic + 3D Patient, Siemens Healthineers 5 BodyAngio 0.75 028f CT 12/16/2013 1:05:53 PM '11/11/1978, M 1.5mm CT 10/4/2018 5.03:56 PM 0020329995 950 3D Objects SEG 4/10/2019 9:37:51 PM 2. Double click on the required volume to open the 4/17/2019 12:59:57 AM CTA Herz 12/11/2015 2:22:52 PM Coronary^Diagnostic Coronary Catheterization 12/11/2015 7:48:26 AM 3D Patient, Siemens Healthineers "11/11/1978, M volume in 3D Sharing and confirm that the data is for 1234557 4/17/2019 1:41:02 AM 4/18/2019 11:20.04 PM 4/18/2019 7:53:09 PM the current patient. CT 12/16/2013 12:55:27 PM > 3D Patient, Siemens Healthineers Instances *11/11/1911, M 0020329995 > 3D Patient, Siemens Healthineers "1/1/1951, M 320 4 877 Selected dala correcled. Load the 10 planning Effective Date: 05.29.2020| HOOD05162003097073 volume Unrestricted © Siemens Healthcare GmbH, 2020 syngo EVAR Guidance SIEMENS Healthineers Select the EVAR Guidance workflow You select the EVAR Guidance workflow from the Application 3D Sharing Source Browser Images Settings Menu Close Im ... Save Bo ... Snapsho ... 30 Polyl ... Interacti ... Export t .. l'arallel .. Viewing Review and Processing Loading graphics .. R Bookma Layouts Control. Viewing HFS CT HFS Overlay Active Workflows TrueFusion EP Planning The Application control may be docked (fixed) in the workflow Embolization Guidance header or undocked. You can undock the application control EVAR Guidance R in the top right corner of the 3D Sharing segment. LLLLLLLLL 10 cm 10 cm A SL 0.8 330 SL 0.8 MPR W MPR W 330 LAO 90 / 0 C 60 0 /0 C 60 CT HFS CT HFS R 10 cm 10 cm A SL 0.8 Review> MPR 0 / CAUD 90 Select the 11 workflow Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo EVAR Guidance SIEMENS Healthineers Select the EVAR Guidance workflow 1. When the Application control is docked: Select the EVAR 2. When undocked: Select the EVAR Guidance in the Guidance workflow step in the Workflow Header. application workflow step in the Application Control. 3D Sharing Q Sctangs Menu Clec I .... Save Bo Searche ... 3D Polyl ... Imcractt Exportt .... Patalici III Viewing Live A Q Loading graphics .. parser mages Sezhpe 3D Sharing Scainge Monu Cozc m Saut Bo. Snapsho 30 PoML. Ilcrocs HFS CT TR Viewing HFS CT Overlay Artien Workflows TrueFusion EP Planning Application Control ? C Embolization Guidance Application EVAR Guidance Review and Processing Review and Processing R R Annurysm Analysis Aortic Valve Guidance volumes 10 cm Congerital Heart Disease Guidance GU LLLL CTO Guidance TrueFusion Okmarks Layouts EP Planning A 14 Embolization Guidance EVAR Guidance SL 0.8 330 SL 0.5 330 SL 0.8 Needle Guidance MPR MPR MPR LAO 90 / 0 Spine Gudance HFS CT CT HFS CT HEST CT Stenosis Analysis No bookmarks stored 10 cm SLLLLLLL 10 cm LA SLOB STEADD-3Q [‘Review? < Review> SL 0.5 MPR 0 / CAUD 90 Select the 12 workflow Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 SIEMENS Healthineers Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. The information in this material contains general technical descriptions of specifications and options as well as standard and optional features that do not always have to be present in individual cases. Certain products, product related claims or functionalities described in the material (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright © Siemens Healthcare GmbH, 2020 13 Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020

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