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syngo MR Systems with DOTGO Turnover Workbook

syngo MR Systems with DOTGO Turnover Workbook

SIEMENS SIEMENS MAGNETOM Skyra TimeDot System O Welcome User Services www.usa.siemens.com/education syngo® MR Systems with DotGO™ Technology Turnover Workbook Answers for life. syngo® MR Systems with DOTGo Technology | Turnover Workbook 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 syngo® MR Systems with DOTGo Technology | Turnover Workbook I Contact Information Summary Welcome to Siemens Healthcare Discover. Try. Buy. on webShop Siemens Healthcare is dedicated to helping you Do you want to “Discover. Try. Buy.” options, get the most out of your investment throughout accessories, and clinical education to make the most the entire product life cycle and beyond. Our goal of yourimaging equipment? Discover images, case is to enable you to take technology further, studies,and video demonstrations with the latest profitability higher, and patient care to the next clinicalapplications. Try advanced applications level. Find the information, resources, and tools utilizingfree software trials. Buy applications, coils, you need to get the most out of your recent clinicaleducation, and accessories, conveniently at investment and stay up-to-date. Visit any time. Visit www.usa.siemens.com/webShop today! www.usa.siemens.com/Welcome2Healthcare. Clinical Training and Siemens Training Centers Continuing Education Siemens Clinical Education Training Center – TDC2 Siemens Customer Care Center: 110 MacAlyson Court Call 1-800-888-7436 Cary, NC 27511 • Troubleshooting assistance • Immediate assistance for software applications and workflow issues • For Tech Support press option 2 / for applications support, press option 3 • Press the * key or enter the last six digits of your Functional Location Number • Press 7 for ultrasound Functional Location Number ____________________ Clinical Education Offerings: Serial Number ________________________________ Call 1-888-221-8010 (follow the prompts) IP Address System _____________________________ • Classroom Training (Offerings, Registration& Scheduling) Educational Symposia IP Address PACS _______________________________ • • On-site Training • Printed Self-studies • Virtual Education (Offerings & Registration) • Workshops & Fellowships Visit www.usa.siemens.com/clinicaleducation for more information regarding the current Siemens Clinical Training and Continuing Education portfolio. 3 syngo® MR Systems with DOTGo Technology | Turnover Workbook II Contents I Contact Information Summary ............................................................................................... 3 II Contents .............................................................................................................................. 4 III Course Agenda .................................................................................................................... 7 Session 1 ........................................................................................................................... 7 Session 2 ........................................................................................................................... 7 Session 3 ........................................................................................................................... 7 Session 4 ........................................................................................................................... 8 Session 5 ........................................................................................................................... 8 IV Course Objectives ................................................................................................................ 9 1 System Introduction............................................................................................................ 10 1.1 System Start (System On)............................................................................................ 10 1.2 System Shutdown (System Off)................................................................................... 10 2 Table Controls..................................................................................................................... 11 3 Mouse and Keyboard........................................................................................................... 12 3.1 Mouse........................................................................................................................ 12 3.2 Keyboard.................................................................................................................... 12 3.3 Shortcuts ................................................................................................................... 12 4 Patient Table....................................................................................................................... 13 4.1 Table Weight Limit ..................................................................................................... 13 4.2 Table ......................................................................................................................... 13 4.3 Coil Sockets ................................................................................................................ 13 4.4 Table Connections ...................................................................................................... 13 5 Dockable Patient Table - Optional ........................................................................................ 14 5.1 Pedals ........................................................................................................................ 14 5.2 Side Rails.................................................................................................................... 14 5.3 Guiding Wheel............................................................................................................ 14 5.4 Undocking Table......................................................................................................... 15 5.5 Docking Table............................................................................................................. 15 5.6 Patient Table Safety .................................................................................................... 16 5.7 Dockable Patient Table Safety...................................................................................... 16 6 Quench Safety .................................................................................................................... 18 6.1 Magnet Stop Switch.................................................................................................... 18 7 Patient Safety ..................................................................................................................... 19 7.1 Screening form........................................................................................................... 19 7.2 Electrically Conducting Objects ................................................................................... 19 7.3 Patient Monitoring...................................................................................................... 19 7.4 Localized Regions of High RF and bore wall contact...................................................... 19 7.5 Hearing Protection...................................................................................................... 19 8 Quality Control (QA) ........................................................................................................... 20 8.1 Performing Quality Assurance ..................................................................................... 20 4 syngo® MR Systems with DOTGo Technology | Turnover Workbook 9 Intercom ............................................................................................................................ 21 9.1 Intercom Control Panel ............................................................................................... 21 9.2 Recording and editing voice outputs............................................................................ 21 9.3 Exam UI Configuration – Voice Output......................................................................... 22 10 Patient Registration .......................................................................................................... 23 10.1 Scheduler > Registration from Patient Browser........................................................... 23 10.2 Manual Registration.................................................................................................. 23 11 Patient Browser ................................................................................................................ 24 11.1 Quick Search ............................................................................................................ 24 11.2 Patient Search .......................................................................................................... 24 11.3 Work Status .............................................................................................................. 24 11.4 Edit Correct Patient Information ................................................................................ 25 11.5 Sorting Patient Data.................................................................................................. 25 11.6 Study Split - Offline................................................................................................... 26 11.7 Importing Patient Data.............................................................................................. 27 11.8 Deleting Patient Information ..................................................................................... 27 11.9 Protecting Patient Data ............................................................................................. 27 12 Exam Task Card................................................................................................................. 28 12.1 Objectives ................................................................................................................ 28 12.2 Exam Task Card Navigation ....................................................................................... 29 12.3 Measurement Queue ............................................................................................... 30 12.4 Exam Task Card - Measurement Queue Icons ............................................................. 32 12.5 Exam Task Strategy ................................................................................................... 34 12.6 Exam Task Card - Decisions........................................................................................ 35 12.7 Exam Task Card - Icons ............................................................................................. 39 13 Dot Cockpit....................................................................................................................... 48 13.1 Objectives ............................................................................................................... 48 13.2 Dot Cockpit ............................................................................................................. 48 13.3 Structogram ........................................................................................................... 51 13.4 Explorer ................................................................................................................. 52 13.5 Program Editor ........................................................................................................ 56 14 Dot Engines ...................................................................................................................... 58 14.1 Brain Dot Engine (standard) ...................................................................................... 58 14.2 Optional Dot Engines: ............................................................................................... 58 15 Viewing Task Card............................................................................................................. 59 15.1 Manually Load Images ............................................................................................. 59 15.2 Scrolling Through Images.......................................................................................... 59 15.3 Dog ears in image segment....................................................................................... 59 15.4 View – Screen layouts .............................................................................................. 60 15.5 View – Image subtask card ....................................................................................... 62 15.6 View – Tools Subtask Card......................................................................................... 63 15.7 Windowing images ................................................................................................... 64 15.8 View – Patient Subtask Card...................................................................................... 64 5 syngo® MR Systems with DOTGo Technology | Turnover Workbook 15.9 View – Evaluation Subtask Card................................................................................. 65 15.10 View – Exam Subtask Card ...................................................................................... 66 15.11 Rotating and flipping an Image................................................................................ 67 15.12 Save New series...................................................................................................... 67 15.13 Image Text Information........................................................................................... 67 16 Filming Task Card.............................................................................................................. 68 16.1 Steps for Filming....................................................................................................... 68 16.2 Filming Properties..................................................................................................... 69 16.3 Copies ..................................................................................................................... 69 16.4 Camera .................................................................................................................... 69 17 Archiving.......................................................................................................................... 70 17.1 Export or Archive Patient Data................................................................................... 70 17.2 Eject from & Eject finalized........................................................................................ 70 17.3 Sending to a Network Node....................................................................................... 71 18 3D Task Card..................................................................................................................... 72 18.1 Load images into 3D Task Card .................................................................................. 72 18.2 3D Task Icons............................................................................................................ 72 18.3 Type Subtask Card..................................................................................................... 73 18.4 Orientation Subtask Card .......................................................................................... 73 18.5 Settings Subtask Card ............................................................................................... 74 18.6 Lower Icons.............................................................................................................. 74 18.7 3D Task Card – MIP .................................................................................................. 75 18.8 MPR – Workflow ....................................................................................................... 76 Appendix A: Additional Dot Engines ........................................................................................................ 79 Appendix B: Image Text Information ....................................................................................................... 88 Appendix C: MRI Acronyms .................................................................................................................... 100 Appendix D: Sequences and Abbreviations............................................................................................ 105 Appendix E: Bandwith Conversion Chart Siemens to GE.................................................................................................................... 107 6 syngo ® MR Systems with DOTGo Technology | Turnover Workbook III Course Agenda Session 1 Introduction to MR System • RF Coils • Patient Table • System and Table Controls • System Start-Up and Shutdown Software Navigation – syngo Introduction MR Overview of Task cards MR Safety Scan Volunteer Studies Session 2 Scan Volunteer Studies Explanation of Dot Concept Demonstration of Brain Dot Engine Overview of Patient Browser Image and Data Transfer and Archiving Phoenix Imaging Principles: Parameter Cards Auto/Manual Shim Building and Saving Protocols Postprocessing Session 3 Scan Volunteer Studies Implementing Additional Dot Engines (Option) Auto/Manual Shim Building and Saving Protocols Postprocessing 7 syngo® MR Systems with DOTGo Technology | Turnover Workbook Session 4 Scan Volunteer Studies Implementing Additional Dot Engines (Option) Care Bolus & Timing Bolus Overview Subtraction Postprocessing Session 5 Scan Volunteer Studies Review: Questions and Answers Technologists & Education Specialist Complete Training forms and Checklist 8 syngo® MR Systems with DOTGo Technology | Turnover Workbook IV Course Objectives Upon completing this course, you will be able to: Notes • Correctly perform startup and shutdown procedures • Be familiar with the table controls • Identify and acknowledge MR safety procedures • Know how to perform system QA • Describe the key features of the syngo interface of the MR Scanner • Correctly perform a patient registration • Utilize the exam task card to perform a patient procedure • Identify task cards including their functions • Perform post processing in 3D Task card • List the steps in order to archive patient data 9 syngo® MR Systems with DOTGo Technology | Turnover Workbook 1 System Introduction 1.1 System Start (System On) Notes • Turn the key switch to the right • Press the SYSTEM ON button • SYSTEM ON LED lights up and the MR System is switched on • Note: Do not perform preliminary examination steps at the MR System during start-up. (e.g., moving the patient table, connecting coils) SIEMENS System On System Off 1.2 System Shutdown (System Off) • Prior to shutting down the system, the patient table should be in the home position (e.g., Table should be up and out) • If the user is logged on, the system must be shut down using • System > End Session • Select > Shutdown System • Note: The screen will go blank. Then you may hit the System Off • Note: Otherwise, data may be lost. 10 syngo® MR Systems with DOTGo Technology | Turnover Workbook 2 Table Controls Notes • Large jog wheel turn right – moves patient table up and into magnet bore • Large jog wheel turn left – moves patient table down and out of magnet bore • Press large jog wheel – moves patient table to center position (1) (1) Table Up/Inward button (2) (2) Jog wheel, Center Position button (3) Home Position button -(3) (4) Table Down/Outward button (4) • Turn small jog wheel – Navigate through icons • Press small jog wheel – confirms selection • Outer control unit – is for patient comfort Confirm patient data Displays the patient data of the registered patient Table overview Displays the current table point patient orientation Physio data Displays the physiological data of the patient Table lock/Table unlock Activatesi Deactivates the table lock function for interventional examination (toggle icon) Start prepared measurement. during the med- the dispu Displays further information (e.g. undocking of the Info dockable patient table) X Close patient comfort Confirms the patient comfort settings 11 syngo® MR Systems with DOTGo Technology | Turnover Workbook 3 Mouse and Keyboard 3.1 Mouse Notes • Three button mouse • Left mouse – Select objects or starting applications • Right mouse – calls up context (pop-up) menus • Middle mouse – window and center images 3.2 Keyboard • Quick access to frequently performed operations and Applications • Cannot be used as a numeric keypad Window Center +/- Window Width +/- Auto Window Sudy +/- Send to Scrolling Node 1 Senes +1. - Conect - Mark Scrolling Image +/- Copy to Fim Sheet Patent Registration Browser 3.3 Shortcuts • Enter commands quickly with key combinations Ctrl, Alt or Windows plus another key • All functions can be executed by pressing the Alt key and the underlined letter key shown in the drown-down menu • Operates the program without using the mouse F1 - syngo MR Online Help Ctrl + I - Import data F5 - Examination task card Ctrl + L - Open Local Job Status F6 - Viewing task card Ctrl + P - Expose film task F7 - Filming task card Ctrl + S - Save (only 3D task card) F8 - 3D task card Ctrl + V -Paste Alt + F4 - Closes Open Window Ctrl + W - Save window values Ctrl + Tab - Switch active task card / page through stack of cards Ctrl + X - Cut Ctrl + Shift + Tab - Switch active task Ctrl + C - Copy card backwards / page through stack of cards backwards Ctrl + F - Remove a filter (Patient Browser) F12 - Start measurement 12 syngo® MR Systems with DOTGo Technology | Turnover Workbook 4 Patient Table 4.1 Table Weight Limit Notes • 550 lbs 4.2 Table • Table comprised of several sockets and connections • Tabletop can be moved horizontally into the magnet bore • When moved completely out of the magnet, the tabletop can also be moved vertically 4.3 Coil Sockets • Coil sockets are located at the head and foot end of the patient table 4.4 Table Connections • Connections are located at the foot end of the patient table • Note: Vacuum cushion is optional (2) (5) (1) ( 1) (2) (3) (4) (3) (1) Headphones (4) (2) Vacuum cushion (6) (3) Squeeze bulb (4) Placeholder [Intended for future use] (1) Tabletop (2) Head end Slide Connect Coil Plugs (3) Table Stop button (4) Handle at the foot end Direct Connect Coil Plugs OO Slide Connect Coil Plugs OC (5) Pull-out handle (6) Emergency release 13 syngo® MR Systems with DOTGo Technology | Turnover Workbook 5 Dockable Patient Table - Optional Dockable patient table can be completely removed from the magnet and enables Notes transport of immobile patients. 5.1 Pedals • If table is removed from the system, the pedals can be used to raise and lower the table manually (2) (3) (1) Guiding wheel is lifted/deactivated (2) Guiding wheel is lowered/activated (3) Table is braked Left Pedal - Undock Right Pedal - Dock 5.2 Side Rails • Raise side rails to secure patients during transport • Lower side rails and use as an arm rest to perform patient injections. • Note: If side rails are lowered the patient table stop is activated and cannot be moved 5.3 Guiding Wheel • Neutral position – Activates fifth wheel for better maneuverability (e.g., guiding wheel) • Fifth wheel functions as center point of rotation (e.g., turns in place) • Navigate curves while moving forward and backwards • Upright position – De-activates fifth wheel and moves patient table laterally 14 syngo® MR Systems with DOTGo Technology | Turnover Workbook 5.4 Undocking Table Notes • Tabletop is in Home Position (e.g., table must be out and up) • Depress left pedal to undock table • Table is released from the system and can be moved in any direction 5.5 Docking Table • Position table so docking nose is located in the docking station and table is positioned at the end stop of the docking station • Display shows if the table is positioned correctly and completely in the docking station • Depress right pedal down fully to lock the table to the MR system • Display shows when the table is docked (5) (4) (1) Side rails (2) Docking station (3) Lateral pedal (4) Emergency undocking handle (5) Pedals Docking Station • Table Weight Limit - 550 lbs 15 syngo® MR Systems with DOTGo Technology | Turnover Workbook 5.6 Patient Table Safety Notes • Stop Table Movement – Press Table Stop button to stop table movement • Reset Table Stop – Turn Table Stop button clockwise until released and simultaneously press Table Up and Table Down button • Patient Table Emergency Release – MR measurement is terminated and the table loses the referenced position. • Pull the handle to release table electronics, and then pull the tabletop out of the magnet. • Resetting Emergency Release • Move Emergency release back to original position while shifting the tabletop slightly in any direction until it audibly locks into position. • Reset Table – simultaneously press Table Up and down button • Press Home Position button – patient table is operational + 5.7 Dockable Patient Table Safety • Stop Table Movement – Press Table Stop button to stop table movement • Reset table stop – Turn Table Stop button clockwise until it releases. Simultaneously press Table Up and down button. • Patient Table Emergency Table Release – MR measurement is terminated and the table loses the referenced position. • Pull the handle to release table electronics, and then pull the tabletop out of the magnet. • Resetting Emergency Release • Move Emergency release back to original position while shifting the tabletop slightly in any direction until it audibly locks into position. • Reset Table – simultaneously press Table Up and down button • Press Home Position button – patient table is operational 16 syngo® MR Systems with DOTGo Technology | Turnover Workbook Notes • Undocking Table Only in case of emergency • If undocking the table using the pedals doesn’t work, use the emergency undocking handle at the foot end of the table (e.g., between pedals) • Tabletop in Home Position • Release Brake • Pull emergency undocking handle to undock table • Remove table from system. • Note: Use Emergency undocking handle only when tabletop is in the Home position (out and up) • Reset emergency undocking handle • Push emergency undocking handle back into original position • Position table with the docking nose in the docking station up to the end stop • Press the right pedal down fully to lock the table to the MR System • Display shows when the table is docked accordingly. Dockable Patient Table Emergency Release Button 17 syngo® MR Systems with DOTGo Technology | Turnover Workbook 6 Quench Safety 6.1 Magnet Stop Switch Notes • Triggers a controlled magnet quench • Shuts down magnetic field • Note: Magnet stop should only be used in cases of emergency where there is a life threatening accident involving attracted metal parts or fire. • MR System electronics are not disconnected. • Two separate MR System Magnet Stop (Quench) Buttons • Individual Quench Button • Alarm box Quench Button • Magnet Stop (Quench Button) switch has been pressed; an alarm is triggered on the alarm box. • Note: WARNING LED lights up and alarm signal sounds • Note: Siemens Service must be called following a quench. The magnet must only be put back into operation by Siemens Service personnel. 10 Magnet Stop Switch Magnet Stop Switch (Alarm (Individual Quench Button) Box Quench Button) 18 syngo® MR Systems with DOTGo Technology | Turnover Workbook 7 Patient Safety 7.1 Screening form Notes • A screening form for patients, personnel and non-personnel for MRI examinations and entry into the MRI environment must be completed • A comprehensive screening form should be filled out and a verbal interview performed to verify information on the form. • Check MR Safety guidelines for implants and prostheses prior to scanning the patient or entering the magnet room 7.2 Electrically Conducting Objects • Patient should remove all electrically conducting objects, (e.g., jewelry, piercings) • Patient should remove all clothing that has electrically conducting material, for example: bras, metallic appliqués or woven metallic yarns. • Note: It is recommended that patient’s are changed into a gown or scrubs. • Eyeliners and tattoos may contain ingredients causing artifacts or skin irritations during MR exams. Remove makeup prior to the MR examination. • Patients should seek medical attention in case of discomfort during or following the MR Exam. 7.3 Patient Monitoring • Routine Monitoring – All patients should receive routine monitoring • Mandatory monitoring – Sedated and physically unstable patients is required. • Note: Medical supervision is mandatory when the MR system is scanning in the First level Controlled Operating Mode. 7.4 Localized Regions of High RF and bore wall contact • Prevent potential localized regions of high RF by ensuring the patient is positioned with proper distance to magnet tunnel and between parts of body • A minimum distance of 5 mm is maintained between patient and tunnel covering. • Note: Ensure distance by using positioning aids, (e.g., blankets made of linen, cotton, paper, or dry material that is permeable to air). Sufficient ventilation is also recommended. • Instruct the patient of possible stimulation during the MR examination, such as twitching muscles and tingling sensations. 7.5 Hearing Protection • Appropriate hearing protection that lowers noise to at least 99 dB • Headphones are not classified as hearing protection. Headphones should only be used in combination with ear plugs for communication purposes • Provide anesthetized or unconscious patients with hearing protection. All patients and personnel in MR examination room should receive hearing protection. Note: For detailed system safety instructions consult the Operator Manual. 19 syngo® MR Systems with DOTGo Technology | Turnover Workbook 8 Quality Control (QA) • The quality measurement is performed with the quality measurement program. Notes The program checks the signal-to-noise ratio for all RF coils. In addition, it checks the artifact behavior for the Body coil. • Phantoms are used for quality measurements 8.1 Performing Quality Assurance • Select Options > Service > Customer QA ation Scroll System Add-On Options Help from menu File Browser. Adjustments SAR Information Stimulation Info. Auto Expose Maintenance Configuration Local Service. Service Remote Service. Event Log Customer QA Problem Steps Recorder. syngo Remote Assist. • Quality Assurance dialog Siemens Med Service Software - Microsoft Internet Explorer provided by Siemens Medical Solutions window opens Quality Assurance Help EXIT Customer Quality Assurance - Head Matrix Customer QA 10Ch Breast F Sen 10Ch Breast H Sen Coil Check Done 16Ch Al Breast feet Rap 16Ch Al Breast head Rap 16Ch Breast F Sen 16Ch Breast H Sen 2Ch Breast feet Sen 2Ch Breast head Sen 32Ch Head 4Ch Breast head Sen 4Ch Flex Large 4Ch Flex Small 7Ch BI Breast feet Inv 7Ch BI Breast head Inv 7Ch Breast feet Inv 7Ch Breast head Inv 8Ch Breast head Sen Body & Body Matrix + Head Matrix Neck Matrix Spine Matrix TxRx 15Ch Knee QED Update • Go to the selection list and select the head coil for the quality measurement. • Activate the control box Coil Check and click Go • Workflow dialog window opens Siemens Med Service Software - Microsoft Internet Explorer provided by Siemens .. .. [D][x] showing the positioning for the Workflow Popup phantom in head coil Position the Head Matrix, the phantom holder 14 and the plastic bottle 1900 ml in the center of measurement field, as shown in the picture below • Once the quality measurement is finished, a message appears • Done – QA is completed and parameters correspond to specifications • Not OK – parameters are out of it at least 10 minutes to avoid motion specification. Check position of Light marker position phantom and repeat QA More detailed information can be found in Operating Instructions Section Quality Assuranc measurement. Note: If the repeated QA measurement does not provide satisfactory results: Notify Siemens Service. 20 syngo® MR Systems with DOTGo Technology | Turnover Workbook 9 Intercom The intercom allows personnel and patients to communicate during the Notes examination. 9.1 Intercom Control Panel • Patient Table Stop • Play music or automatic voice outputs in examination room via the loudspeaker or the headphones. (5) -(1) (6) (4) (7) (3) (2) (1) Table Stop button – stops table movement and measurement immediately (2) Talk button – speak to patient (3) Reset Patient Alert button – silences alarm (4) Listen button – listen to patient (5) Physio Signal button – switches transmission of physiological signals on/off (6) Audio Connection – connect iPod, MP3 Players, etc (7) Reset Stop button – releases table stop 9.2 Recording and editing voice outputs • Patient cannot be registered • Select Queue > Voice Output > Organize • Organize Voice Output dialog window – Select language for new instructions • Select > New • Edit Label dialog window opens > Enter a label > OK • Record a new voice output – Intercom is selected • Select Record button in Organize Voice Output dialog window. • Record Voice dialog window opens > To start recording > Click Record button . . • Record new instructions via intercom microphone • End recording – select stop button 21 syngo® MR Systems with DOTGo Technology | Turnover Workbook 9.3 Exam UI Configuration – Voice Output Notes • Options > Configuration > Patient Comfort > Voice Output • Select primary language • Playback Volume slider – increases/decreases volume of voice output in examination room • Test selection list – determines voice output for testing • Record Volume slider – increases/decreases voice output volume ExamUI Configuration - Voice Output X Voice Output Patient Primary Language: English (United States) Playback Volume: Test @ Hold breath (inhaled). Record Volume: OK Apply Cancel Help 22 syngo® MR Systems with DOTGo Technology | Turnover Workbook 10 Patient Registration 10.1 Scheduler > Registration from Patient Browser Notes • Open > Patient Browser • Select > Scheduler – Contains Pre-Registered Patients and Patients scheduled by a HIS/RIS System • Select > Patient’s name or study • Select > Registration icon or Double left mouse click on Patient Study • Note: If the patient’s name is seen in the Scheduler update manually by Main menu > View > Update Worklist Local Database ABDOMEN 1_ abdomen upp Scheduler BRAN 1 DVD-ROM Abdorion 2 CD-R BRAIN 3 BRAIN 2 10.2 Manual Registration • Main Menu > Patient > Register • Complete all Bold Fields (e.g., Patient Registration PATIENT PROCEDURE Mandatory input) Last name Accession No Select > Exam Button First name Request ID • Title Requested Patient ID procedure(s) • Patient Confirmation window Date of birth [M/d/yyyy] • Select > Study Sex Male Female Other Patient positi Age Years • Program – field is completed Height ft in Institution name Weight Ibs OZ Met once protocol is selected Additional info 1. Performing physician • Study comment (optional): Details ... . Operator NOTIMITISNI Place comment on every HOSPITAL reconstructed image; (e.g., Referring physician Requesting physician left knee) Admission ID Body part examined – field Preregister Search Cancel Help • is completed once protocol is SO IR 100 selected atient Confirmation MEDICAL INFORMATION PATIENT SAFETY • Laterality – Right, Left, or Both Name Brain Dot Engine Contrast Allergie • Select Confirm: Accepts data Position Head First - Supine Height 5'3" Pregnancy Status entered and completes Weight 124.00 Medical Alerts registration First Level Mode SAR Special Needs irst Level Mode Study head Brain Dot Engine Togram B. head B- Brain Dot Engine -program - clinical libraries Study Description head Brain Dot Engine advanced applications libraries B- programs Study Comment B- library E. c-Spine Body part examined Et-spine Head B- I-spine m wdhole enine Laterality Unpaired Confirm Cancel Help 23 syngo® MR Systems with DOTGo Technology | Turnover Workbook 11 Patient Browser 11.1 Quick Search Notes • Open > Patient Browser • Select > Local Database • Type first letter of patient’s last name on keyboard (Example: S for Smith) • Continue typing first letter until the patient’s name is displayed 11.2 Patient Search • Search remote DICOM nodes for existing patient studies, series, images or report documents (structured reports and results). Import the required data into the local database for evaluation via the network transfer. • Patient and examination data can only be retrieved from workstations that have corresponding remote nodes configured as query/retrieve providers. • Main Menu > Patient > Patient Search Selected 11.3 Work Status • Indicates process or editing stage the patient and examination have reached. • Capital Letter – indicates that all data has been processed • Lower Case Letter – indicates some of the data has been processed. • Abbreviation consists of seven parts – r/com/p/a/e/s/h • Received: 1st part shows if patient images have been imported into the local database via the network (received) • (…/R/…)All patient images imported • (…/r/…) Only partial patient images were imported • (…/ /…) No patient images were imported • Workflow: 2nd part shows how far the examination and edits have progressed (e.g., Verified and Read can only be checked by the physician) • (…/com/…) Study has been completed • (…/verf/…) Images and examination data have already been verified • (…/rea/…) Images have already been read • Printed: 3rd part shows if patient have been printed or exposed on film • (…/P/…) All patient image printed • (…/p/…) Only part of the patient images printed • (…/ /…) No patient images printed. • Archived: 4th part shows if data has been archived to local storage media • (.../A/...) Data has been archived completely • (.../AC/...) Data has been archived and committed • (.../AV/...) Data has been archived and checked • (.../A?/...) Archiving and checking data is pending • (.../Af/...) Archiving and checking data has failed • (.../a/...) Part of the data has been archived • (.../ /...) No data has been archived • Exported: 5th part shows if images have been exported • (.../E/...) All data exported • (.../e/...) Part of the data has been exported • (.../ /...) None of the data has been exported 24 syngo ® MR Systems with DOTGo Technology | Turnover Workbook Notes • Sent: 6th part shows the status of patient images • (.../S/...) Data has been sent completely • (.../SC/...) Data has been sent and committed • (.../SV/...) Data has been sent and checked • (.../S?/...) Sending and checking data is pending • (.../Sf/...) Sending and checking data has failed • (.../s/...) Part of the data has been sent • (.../ /...) No data has been sent • History available: 7th part if patient data was modified • (.../H/...) history available • (.../ /...) no history available 11.4 Edit Correct Patient Information • Correct patient data in local database • Open > Patient Browser • Select > Patient, Study, Series or images (Instances) to modify • Note: Patient data in all task cards must be closed and un-protected • Select Edit > Correct from Main Menu or Correct icon from toolbar • Fields that can be modified; e.g., tabs located down middle of screen are Patient, Hospital, Study, Series, Instance (images) • Select > OK to accept changes to patient data • Once changes are accepted an H is displayed in patient work status. (e.g., H is for history). 11.5 Sorting Patient Data • Image data can be sorted on the Patient, study, series and instance (Image) levels. • Sort data – select item to the left of what needs to be sorted. • Open > Patient Browser > Main Menu > Sort > (pull down change depending on area selected) • Select > Local Database: sorts Patient folders • Patient Name – Alphabetical • DB Date and Time – Date and time acquired • Patient ID • Patient Latest Exam Date • Work Status – Printed, Archived, Sent • Reverse Order – Combine with selections above to reverse sorting order • Select > Patient folders: sorts Study folders • Study Description – Alphabetically • Study Date and Time – Date and Time study acquired • Work Status – Printed, Archived, Sent, Workflow • Reverse Order – Combine with selections above to reverse sorting order • Select > Study folder: sorts series folders • Series Number – Numerically • Series Description – Alphabetically • Series Date and Time – Date and Time study acquired • Modality – (e.g., MR and CT images loaded in Patient Browser) • Performing Physician • Work Status – Printed, Archived, Sent, Workflow • Reverse Order – Combine with selections above to reverse sorting 25 syngo® MR Systems with DOTGo Technology | Turnover Workbook • Select > Series folder: sorts Instances (Images) Notes • Instance Number – Numerically • Instance Date and Time – Date and Time study acquired • Slice Position • Modality Specific Data • Anatomical • Triggered • Chronological • Instance Oriented • Echo Time (TE) • Repetition Time (TR) • Inversion Time (TI) • Trigger Time (TT) • Main Orientation (MO) • Acquisition Time TA) • MR Slice Position (SP) • Time After Start (TD) • B_Value (BV) • Work Status – Printed, Archived, Sent 11.6 Study Split - Offline • Split patient studies after patient exam is completed into separate patient folders with different accession numbers • Patient data in all task cards must be closed and un-protected. • Open > Patient Browser • Applications > Study Split or Study Split Icon • Series can be copied or moved • Hover mouse over stamps to enlarge for viewing • Multiple selections Study Split - Dale, Test STUDIES • Move series – Drag & Drop Accession No. N.A. N.A. • Copy series – Ctrl Drag & Drop Requested Procedure TRIO HEAD TRIO HEAD Requested procedures provided Study Description TRIO^HEAD TRIO^HEAD • localizer SERIES from scheduler or manual input (1)localizer (2)csi_se_30 b)csi_nd EN • Add Study – Select > (+) (3)svs_se_30 button • Accession numbers populated from scheduler OK Cancel Help 26 syngo® MR Systems with DOTGo Technology | Turnover Workbook 11.7 Importing Patient Data Notes • Import selected or entire patient examinations, studies, series, images (instances) from a CD or DVD • Open > Patient Browser • Select > CD_R or DVD_R drive • Select > Patient, Study, Series or Instances to import back to Local Database • Select > Import icon on toolbar or Main Menu > Transfer > Import • Select > Local Job Status icon to check import status ? 11.8 Deleting Patient Information • When deleting patient information, patient data in all task cards must be closed and un-protected. Deletion may occur at any level: Patient, Study, Series or Instance (Image) • Select > information to be deleted • Right mouse click > Delete or Main Menu > Edit > Delete • Delete Confirmation window opens • Select Yes – continue and delete information • Select No – cancels operation 11.9 Protecting Patient Data • Patient information can be protected from unintentional deletion • Protect Patient, Study, Series or Instances – Right mouse > Protect or Main Menu > Edit > Protect • Remove patient protection – Right mouse > Remove Protection 27 syngo® MR Systems with DOTGo Technology | Turnover Workbook 12 Exam Task Card 12.1 Objectives Notes Provide the MR user with the knowledge and ability to navigate and run Protocols with and without Dot Engines in the Exam Task Card. At the completion of this section of the course the MR participant will be able to Identify the Exam Task card layout using a Dot Engines and Non Dot Engines • Identify the workflow for the Dot Engines currently available and how to • navigate and run a protocol within the Exam Task card Identify the Dot Engines Guidance Views and the minimized parameter card • Identify the Details View and the various parameters cards in the Exam Task • Card Open and use the various icons within the Position Toolbar and the Table • Positioning window Open the Inline Display and explain when to use the Scan Breath-hold and Stop/ • Continue buttons Open the Physiological Display and identify when to modify the triggering • features available Identify the location of parameters on the parameter cards and be able to briefly • summarize their meaning 28 syngo® MR Systems with DOTGo Technology | Turnover Workbook 12.2 Exam Task Card Navigation Notes • GSP (Graphic Slice Positioning) – Scan and load reference images into the GSP segments to display intersection or projection of planned slices or slabs. The display used for these objects shows their position and orientation with respect to the reference images when the sequence is open in the queue. • Stamp Segments – 12 stamp segments are shown below the large GSP image segments. The stamp segments assist in orientating during examinations to manage the acquired series. Note: Must be in Maestro UI viewing format to see stamp segments • Main Menu > View > Maestro UI • GSP Stamp Segments x SIEMENS AHeat_Scout 00:34 . Brain Dot Engine 2 M_se_sag_320 program 03 37 . cinkal Rvaries haben intensive (BLADE) _the_a_512 advanced applications ioraries 04 22 epod_dit_Sscan_Jrace_92 01:50 11_se_tra_320 / wgect contrast agent · whole-spine 11__la_320 02:25 f1_se_cor_320 . breast . abdomen Stim-NM SAR-MM Pregarstion of mesuremert system failed. • Queue – Measurement queue Note: In order to modify parameters, graphically position slices, FoV and • saturation bands, sequences must be located in the measurement queue Queue Patient View test 10/8/1980 Dot Brain X V MHead_Scout Exam Strategy Standard 00: 19 Standard 11_se_sag_320 03:07 Decisions Resolution focus Speed focus 12_tse_tra_512 03:37 contrast agent Motion-insensitive (BLADE) 12_tirm_tra_dark-fluid 320 3 04:32 ep2d_diff_3scan_trace_p2 3 01:50 11_se tra 320 3 02:25 Inject contrast agent H1_se_tra 320 02:25 11_se_cor_320 02:24 2 20:39 Strategy • Patient View – Select an examination strategy, and if a contrast agent is to be administered. The pending protocols in the measurement queue are updated based on these selections 29 syngo® MR Systems with DOTGo Technology | Turnover Workbook 12.3 Measurement Queue Notes Tim, Buktu 1/1/1980 Dot X 1 ! 11_02d_sag_p2_3mm 2 11_12d_tra_4mm 6 11_112d_tra_4mm 8. 11_02d_sag_2mm 5 _ 11_se_sag 04:54 9 9 Y T 5- 6 7- 11_12d_sag 01:25 7 % 11_tinn_sag_dark-fluid_p2 09:16 8 7 11_tirm_tra_dark-fluid_p2 04:56 11_22d_tra 01:19 CO 2 29:22 1. Canceled or skipped 6. Series icon measurement 7. Selected protocol 2. Completed measurement 8. Display of measurement time of 3. Measurement in progress the protocol 4. Open protocol 9. Display of the remaining overall 5. Element not yet executed in measurement time queue Inline Capability to edit protocol name • 7 t1_f12d_sag 01:25 2 [1_02d_sag_p2_] 03:15 3 . 11_firm_sag_dark-fluid_p2 04:38 30 syngo® MR Systems with DOTGo Technology | Turnover Workbook Drag & Drop Multi-Selection support Notes • 1 % M_Ise_r_tra_p2 04:31 @ Copy [1_(se__tra_p2 04:31 Trash Bin • FORMI Multi-selection • Supported for Cut, Copy, Paste, Move, Remove, and Append • Drag and Drop • Multi-selection support • Creating Copy References • Simplified Creation of multiple Copy References • Select Source and Targe steps via multi-select • Step Context Menu – Create Copy References will show “Create Copy • Reference” Dialog window Select according Copy Reference Group • Close Dialog via “OK” Button • Inline Capability to edit protocol names • Copy Parameters ? X Step 4 - 11_space_sag_p2_iso_1.0 Center of slice groups and satu Slices and saturation regions Slices and Adjustment volume Slices Saturation regions Measurement parameters Adjustment volume 2 X_ 11_112d_sag_p2_3mm Append Insert Table position 3 11_tirm_sag_dark-fluid Create Copy References .. Navigators Everything 4 @ 11_tse_sag_2mm_p2 1; Cut Ctrl+X 5 4. 11_112d_sag_2mm Copy Ctrl+C Copy phase encoding direction Delete Del Clear All Shift+Del Ignore measurements gnore last step 31 syngo® MR Systems with DOTGo Technology | Turnover Workbook 12.4 Exam Task Card - Measurement Queue Icons Notes Dot – Opens Patient View of a Dot Engine examination Dot Syringe – Opens the Apply Contrast Agent dialog window Open – Opens selected protocol Scan – Duplicates the open protocol and runs the sequence. The original protocol remains open and this process can be repeated multiple times × Cancel – Closes the open protocol without saving any changes Apply – Runs the open protocol Stop – Stops the measurement Pause – Pauses the measurement Note: Measurement cannot be paused during data • acquisition and resumed Continue – Reconvenes the measurement if a pause was placed between protocols Note: Sequences cannot be paused and continued during • data acquisition Skip – Aborts the measurement Working Man – Denotes planning of protocol is necessary Protocol must be opened and further user interaction is needed 32 syngo® MR Systems with DOTGo Technology | Turnover Workbook Flagman – Pauses the measurement and waits for user to start Notes the exam. Can be selected for a single measurement or multiple measurements Copy Reference – Selected parameters have been copied and stored in the protocol. The number displayed indicates the reference 3 sequence Series icon – During the measurement one series of images were generated and reconstructed Note: Images can be pulled into the GSP segments or the • stamp segments Multiple Series icon – During the measurement more than one series of images were generated and reconstructed Manual Voice Instructions Automatic Voice Instructions Inline Function - Image inline functionality is selected for this protocol (e.g., inline subtraction, ADC map, Etc.) AutoAlign - Indicates successful computation of AutoAlign references + Scope Marker A Image Comment View omStandard 1 7 11_f12d_sag mr. Comment 1 01:25 ME Image Comment 2 % t1_f12d_sag_p2_3mm Comment 2 03:15 .- Body Part ._ Study Part Body Part View 1 7 11_f12d_sag ·~ Head 01:25 2 7 11_f12d_sag_p2_3mm ~ Aorta 03:15 MPPS View 1 % 11_f12d_sag 01:25 2 7 11_f12d_sag_p2_3mm .... 1 03:15 33 syngo® MR Systems with DOTGo Technology | Turnover Workbook 12.5 Exam Task Strategy Notes • Exam Strategy – Strategies are defined in the Dot Engine Step. Strategies are defined in Dot Engine Step • Used to adapt examination based on patient capabilities • Strategies –list of optional protocols stored in Dot Cockpit User tree • Only available in Dot Engine Protocols • Siemens standard 4 Exam Strategy’s • Standard • Resolution focus • Speed focus • Motion Insensitive • Customer can build more than 4 Exam Strategies • 34 syngo® MR Systems with DOTGo Technology | Turnover Workbook 12.6 Exam Task Card - Decisions Notes • Patient Context Decisions – Contrast Agent Patient context decisions are initially in the Patient View of the Dot Engine • Step. For example, should contrast be used for a patient? Contrast Agent Selected • Post contrast agent protocols moved to measurement queue • test 1/1/1980 Dot Dot Engine X V Standard AAHead_Scout 00:17 Exam Strategy 11_112d_sag 01:25 Decisions 12_tse_tra_p2 01:26 contrast agent with contrast agent 12_tirm_tra_dark-fluid 04:32 TOP ep2d_diff_3scan_trace_p2 33 01:38 6 t1_ f12d tra 3 01:19 inject contrast agent 11_12d_tr 3 01:19 9 11_f12d_c 01:19 0% E 13:15 Without Contrast Agent Selected • Post contrast agent protocols are removed from the measurement • queue test 1/1/1980 Dot Dot Engine X V AAHead_Scout Exam Strategy Standard 00:17 11_f12d_sag 01:25 Decisions 12_tse_tra_p2 01:26 contrast agent without contrast agent 12_tirm_tra_dark-fluid 3 04:32 TOF W / N ep2d_diff_3scan_trace_p2 01:38 6 11_112d_tra 3 01:19 10:37 35 syngo® MR Systems with DOTGo Technology | Turnover Workbook Notes • Exam Task Card - Exam Paused Exam Paused – Contrast agent administration • Exam paused 1? X Step 1 - inject contrast agent Patient has contrast agent (Vol.: 0.00) Agent name Catalog ... Volume 0.00 ml Total dose ml Active ingredient Dilution Concentration mg/ml Timing Continue Close Patient has contrast agent - default selection • Select Syringe Icon • Agent name: Type in amount and brand of contrast • All subsequent sequences • Contrast agent comment displayed on all images reconstructed • Sequences marked with syringe by sequence name in measurement • Smith, Sue 3/4/1955 Dot x 12 t1_f12d_sag t2_tse_tra_p2 4 t2_tirm_tra_dark-fluid 10 3 15 ep2d_diff_3scan_trace_p2 t1_f12d_tra contrast agent 8 11_f12d_tra t1_f12d_cor 36 syngo® MR Systems with DOTGo Technology | Turnover Workbook Notes • Patient Clinical Decisions - Made during the examination For example: Is there a find in the images? • Clinical decision is represented by a Decision Step, an optional program • step located in the measurement queue (e.g., SWI For “Seizure”) Prompted by a decision in order to continue • Beat_MM_25.05 5/25/1972 Dot Dot Engine X Exam Strategy Standard localizer 02:53 t1-pre 02:53 Seizure 4 X SWI 02:53 TI-pUST 11:32 • Guidance View – Images and text are displayed to guide the user. Slices/slabs • FoV • Saturation band placement • 37 syngo® MR Systems with DOTGo Technology | Turnover Workbook Parameter View– Minimized list of parameters the user can modify for Notes • the current patient examination Interactive slider – Modify parameters by moving the interactive slide • Left mouse click in the parameter box • Select the interactive slider > Depress left mouse and move slider right • or left • Note: Interactive slider only available in a Dot engine protocol TA: 3:07 PM: REF Voxel size: 0.7x0.7x5.0mm Rel. SNR: 1.00 : se Guidance Parameters Slices are aligned by AutoAlign. Note that if you change slice positions manually, it might be impossible to reproduce these exact slice positions for subsequent protocols and follow-up examinations. Sagittal slices are aligned with the mid-sagittal plane as defined by the symmetry of the skull. (The interhemispheric fissure is not used for the alignment of the mid-sagittal plane because it might shift due to mass effects.) No AutoAlign result. Please check alignment and FOV and press apply. Guidance View TA: 3:07 PM: REF Voxel size: 0.7x0.7x5.0mm Rel. SNR: 1.00 se Guidance Parameters Slices 20 FoV read 230 m Slice thickness 5.0 mm FoV phase 100.0 % TR 550.0 : ms Concatenations 0 % No AutoAlign result. Please check alignment and FOV and press apply Parameter View Details View – Access standard syngo parameter cards Slice/Slabs • FoV • Saturation band placement • 38 syngo® MR Systems with DOTGo Technology | Turnover Workbook 12.7 Exam Task Card - Icons Notes Position Toolbar Inline Display Table Positioning Physiological Display Program Card/Dot Cockpit SAR Information 31 % Details View 12.7.1 Position Toolbar Icon Position Toolbar X 0 0 × O non to by Modify Graphics Depress left mouse button on a reference image • Provides values relative to isocenter and original landmark • Zoom/Pan + Modify Graphics Zoom and/or pan a reference image • 39 syngo® MR Systems with DOTGo Technology | Turnover Workbook Create Slice (Slab) Group Notes Creates a new slice or slab after left mouse clicking on a reference image • Create a slice group in a particular plane > Depress left mouse > Move mouse • and draw slice group > Release left mouse button Yellow icon – Icon is selectable; enough TR to create new slice groups • Gray icon – Icon is not selectable; not enough TR to create new slice groups • Increase TR to add additional slices • Create Regular Sat Create a Saturation region • Create a sat band in a particular plane > Depress left mouse > Move mouse and • draw sat band > Release left mouse button Yellow icon – Icon is selectable, enough TR to create new sat bands • Gray icon – Icon is not selectable, not enough TR to create new sat bands • Increase TR in routine parameter cards to add sat bands • Create Slice (Slab) Group (Three Points) Create a slice or slab group by defining three points • May be created on same image, multiple images and orientations • Delete Delete a selected object (yellow) • Right mouse click > Select > Delete • Press Delete on keyboard • Line Mode Displays slices in line mode, shows center of each slice • Box Mode Displays slices in box mode, shows volume each slice encompasses • Package Mode Displays first, middle and last slice position • Ability to see through slices so anatomy is visualized • Selectable with Line or Box mode • Extend Thickness Graphically change slice thicknesses • Depress left mouse on diamonds of slices or sat bands > Drag mouse to • extend group > Release left mouse Default selection when system is powered on • Extend Slices (Slabs) Graphically increase/decrease number of slices or slabs • Depress left mouse on diamonds of slices or sat bands > Drag mouse to • extend group > Release left mouse 40 syngo® MR Systems with DOTGo Technology | Turnover Workbook Extend Distance Notes Graphically increases/decreases distance factor • Depress left mouse on diamonds of slices or sat bands > Drag mouse to • extend group > Release left mouse Extend Slice Oversampling Graphically modify oversampling in slice direction for 3D sequences only • Extend Phase Oversampling on/off Graphically modify Phase Oversampling (PhaseOS) • Depress left mouse on boxes of slices or FoV in phase encoding direction > • Drag mouse to extend PhaseOS > Release left mouse Reference Lines On/Off Shows slice position lines in reference images (e.g., active segment) • Correlates slice positions displayed (Sagittal, Coronal, Axial) in active segments • to visualize there relation spatially to each another Example – Axial slice locations shown on a Coronal image • Coils On/Off Graphically activates or deactivates display of array coil elements on reference • images Displays elements turned on or off in relationship to the anatomy • Adjust Volume Visually see adjust volume; (e.g., shim volume) • Green box displayed on image showing FoV • Activate or Deactivate display of adjust volume box independent of FoV and • slices Image Text On/Off Turns text on or off the reference images • • Note: Patient name still displayed in program control area 41 syngo® MR Systems with DOTGo Technology | Turnover Workbook 12.7.2 Inline Display Icon Notes Scan Breath-hold button (or) F12 Starts PACE breath-hold sequence • Note: Select > Scan Breath-hold button again if multiple concatenations are • programmed Stop & Continue Scan next protocol button (or) F12 Starts Care Bolus sequence • 12.7.3 Table Positioning Icon Table Positioning X Warning: Current position Inform the patient about [mm] remote table movement Move table by Monitor the patient during remote table movement. 0 [mm] Close Help Current Position Displays current table position in millimeters • 42 syngo® MR Systems with DOTGo Technology | Turnover Workbook Move Table By Notes Enter distance in millimeters to move table to a new position • Move to Center button Moves table to isocenter based on original landmark • Table moved during examination workflow • First button click – Moves table to last scan position • Next click – Moves table to zero table position • • Move in / Move Out arrow buttons Moves table by selected value entered towards patient’s head or feet • Move to Home Moves Table to the home position out of bore and up • Note: Table moved to home and lowered, landmark is lost • Stop Movement Stops table movement if in motion • Ventilation of magnet opening Switches tunnel ventilation on/off and sets the ventilation to different levels • Lighting of magnet opening Switches tunnel lighting on/off and sets the brightness to different levels • 12.7.4 Physiological Display Icon PULSE ECG I : 1000 ms ECG II ECG III PULSE RESP Ext. Signal Extll.Signal Note: Window position is fixed to the left of the screen and cannot be moved • Battery Level – Status of battery charge • Signal Mode – ECG1, ECG11, ECG111, Pulse, Resp, Ext. Signal, Ext. 1 Signal • Shows Controls – Will open up another window with Dsiplay,Trigger, Statistics • 43 syngo® MR Systems with DOTGo Technology | Turnover Workbook Display Rate Icons- Fast Speed, Medium Speed, Slow Speeds Notes • Display Scan Bars • Display- One Signal, Two Signals, All ECG • Trigger – VCG Stndard, ECG I, ECGII • Statistic – Reset • Display: One Signal Trigger. VCG standarc Statistic: Reset 12.7.5 Program Card/Dot Cockpit Icon Displays the Program Card or the Dot Cockpit • Split button is extended via the arrow for accessing • both options 12.7.6 Program Card Icon Tree Selection Highlighting Criteria Tim, Buktu 1/1/1980 Dot P100%am Card × V SIEMENS Q 11_1120_s Sagittol 1 X_ 11_121_$89_02_3mm 03: 15 nead [35] 2 %- H_trm_sag_dark-luid_p2 04:30 Brain Dot Engine [8] 1_12d_sag > clinical libraries [10] 01:25 % H_tse_sag_2mm_p2_180mm 04:44 advanced applications Ibranes 1_nad_sag_p2_3mm 03:15 programs [4] library [14] Show/Hide koxalizer 04.38 T1 [11] Program T2 H tse sag_2mm_p2_180mm 04:44 PD+12 Card H_112d_sag_2mm 04:50 epi_di_perf_bold 04:54 Sow SWI transverse BLADE E 12:37 32ch head- head > Brain Dol Engine > program Brain . Neuro Patient View Standard Resolution focus Speed focus AAHead_Scout 00:19 AAHead Scout 00:19 AAHead_Scout 00:19 @ AutoAlign Scout o AutoAlign Scout AutoAlign Scout t1_se_sag_320 03:07 t1_space_sag_p2_iso 05:34 t1_12d_sag 00:52 o Generic Views 2 o MPR Assignment o Generic Views 12_tse_tra_512 03:37 12_space_sag_p2_iso 04:40 2_haste_tra_p2 00:42 o Generic Views o MPR Assignment · Generic Views 12 tirm tra dark-fluid 320 04:32 12_space_da-il_sag_p2_iso 05:07 12 tirm tra dark-fluid_p2 01:50 Generic Views o MPR Assignment o Generic Views ep2d_diff_3scan_trace_p2 01:50 ep2d_diff_3scan_trace_p2 01:50 ep2d_diff_3scan_trace_p2 00:51 o Generic Views o Generic Views Generic Views MPR planning . MPR Planning t1_se_tra_320 02:25 t1_#2d_tra 01:11 o Generic Views Generic Views contrast agent contrast agent contrast agent with contrast agent with contrast agent with contrast agent inject contrast agent inject contrast agent inject contrast agent 11_se_tra_320 02:25 t1_space_sag_p2_iso 05:34 01:11 o Generic Views . MPR Assignm. t1_12d_tra o Generic Views 45 syngo® MR Systems with DOTGo Technology | Turnover Workbook 12.7.7 SAR Icon Notes Opens the SAR information dialog window • The fill level and percentages displayed on the icon indicate • to what degree the estimated highest SAR value of the measurement approximates the critical SAR limit (SAR Information Prediction) O 46 syngo® MR Systems with DOTGo Technology | Turnover Workbook SAR Information – Prediction Notes • SAR Information X Current operating mode: Normal mode (NM) Operating mode for the next measurement Normal mode First level Displayed values belong to the current patient! Whole Body 39 Exposed Body 26 [% ] 1961 Head [% ] o (2) Head Local [% ] O Torso Local 0 [% ] Legs Local 10 [% ] B1+ rms 26 (196 ] Calculation time: 14:09:40 (3) B1+ mms [AT] 1.8 71 Prediction Status Patient Protocol Current (1) SAR Operating Mode • (2) Show Relative SAR and B1 + root mean square (rms) values • (3) Shows detailed information about the item selected in area (2) • Normal mode or First Level • 12.7.8 Details View Icon TA: 1:26 PM: REF PAT: 2 Voxel size: 0.3x0.3x4.0mm Rel. SNR: 1.00 : tse Routine Contrast Resolution Geometry System Physio Inline Sequence Slice group 1 . FoV read 220 mm Slices 27 FoV phase 100.0 ; Dist. factor 30 % Slice thickness 4.0 - mm Position L8.7 P43.5 H27.0 TR 6000.0 - ms Orientation T > C5.3 > S-3.2 TE 99.0 ms Phase enc. dir. R >> L Averages AutoAlign Head > Brain Concatenations Phase oversampling 30 ; % Filter Prescan Normalize Coil elements HE1-4 Details View Access Standard syngo parameter cards. • 47 syngo® MR Systems with DOTGo Technology | Turnover Workbook 13 Dot Cockpit 13.1 Objectives Notes At the completion of this section of the course the MR participant will be able to: Identify the Dot Cockpit and how to access it • Describe the functions of the Explorer and Program Editor • Demonstrate how to use the search function • Identify the Structogram • Demonstrate the workflow of import and export • Identify the Step Properties of a protocol • Demonstrate Protocol Building • Demonstrate Dot Engine workflows • 13.2 Dot Cockpit A new tool to manage and expand the contents of exam database • How to open Dot Cockpit • Click the Dot Cockpit Icon in the toolbar of the View Image Tools Evalu • Exam Task Card 2 Segments 3 Segments Select View > Dot Cockpit Maestro UI • Cardio UI Tim Planning UI Spine Planning UI Image Text On Reference Lines On Protocol Table Position On Coil Positions On Adjust Volume On Graphics CSI Matrix Position Toolbar ... Inline Display ... Table Positioning. Physiologistlay Dot Cockpit ... 48 syngo® MR Systems with DOTGo Technology | Turnover Workbook Dot Cockpit - Explorer ? X Notes EXPLORER PROGRAM EDITOR Browse Import Export USER sweet head Q c-spine t-spine sweet I-spine head whole-spine c-spine TimCT whole-spine t-spine neck soft tissue I-spine thorax whole-spine heart TimCT whole-spine breast neck soft tissue abdomen thorax pelvis female heart pelvis male breast tmj abdomen shoulder pelvis female elbow pelvis male wrist tmj hand shoulder hip elbow knee wrist ankle hand lower extremity hip whole body oncology knee whole hodty diffusion It contains two different tasks: • Explorer: Organizing • directories and programs, as Explorer Program well as maintain the user Editor database Dot ockpit - Explorer EXPLORER PROGRAM EDITOR Import/Export, printing, • Browse Import Export create regions, user trees, etc SIEMENS general lesion Program Editor: Modify Q trauma • directories and programs neurodegeneration head epilepsy Brain Dot Engine ms Program steps and clinical libraries pituitary • general orbits sequence parameters lesion lac trauma uncooperative neurodegeneration vascular epilepsy ms pituitary orbits lac uncooperative vascular advanced applications libraries programs › library > c-spine t-spine All tasks in the Dot Cockpit support drag & drop to move and copy objects • It is also possible to drag steps or entire measurement programs into the • measurement queue (prerequisite: patient is registered) 49 syngo® MR Systems with DOTGo Technology | Turnover Workbook Move Notes • Dot Cockpit - Explorer EXPLORER PROGRAM EDITOR Browse Import Export USER gen lesid Move Q trauma neurodegeneration sweet epilepsy head ms Brain Dot Engine pituitary clinical libraries orbits general iac lesion uncooperative trauma vascular Explorer or Editor is open • To move an object from one place to another • Drag the object to the target position • An icon, as well as text dialog window “Move” will be performed if • you release the mouse button The current Drop position is indicated by an orange line • • Copy Dot Cockpit - Explorer EXPLORER PROGRAM EDITOR Browse Import Export USER USER > c-spine >> clinical libraries >> general Edit Q localizer 00:19 c-spine t2_tse_sag_384 03:11 c-spine Dot Engine clinical libraries 03:58 ms+-lesions t1 tirm_dark-fluid_sag_p2 myelo Copy general t2_tirm_sag_p2 03:51 uncooperative library t2_tse_fs-dixon_sag_p2 03:38 spine t1 tse_sag_384 04:53 Explorer or Editor is open • To Copy an object from one place to another • Drag the object to the target position while pressing the Ctrl Key • 50 syngo® MR Systems with DOTGo Technology | Turnover Workbook 13.3 Structogram Notes Dot Cockpit - Program Editor (Program Path = USER/head/Brain Dot Engine/program) 3 x EXPLORER Edit Simulate - Standard Q USER >> head >> Brain Dot Engine >> program Browse Search Default Column ac Brain o Patient View Standard Speed focus USER AAHead_Scout AAHead_Scout AutoAlign Scout AutoAlign Scout sweet 1_se_sag_320 03:07 11_112d_sag › head o Generic Views o Generic Views › c-spine 12 tse_tra 512 03:37 12 haste_tra p2 00:42 › t-spine o Generic Views 2 o Generic Views › I-spine 12_tirm_tra_dark-fluid_320 04:32 12_tirm_tra_dark-fluid_p2 01:50 › whole-spine › TimCT whole-spine Row ep2d_diff_3scan_trace_p2 01:50 ep2d_diff_3scan_trace_p2 00:5 thorax OCTIUTIC VIEWS t1_se_tra_320 02-25 11 /12d_tra 01:12 Generic Views o Generic Views TOF needed? yes Basic Decision TOF eded? select a program or library essels_head 00:27 Strategy OF_3D_multi-slab p5:24 Decision Pause Visualizes programs, including Dot Engines in a comprehensive way • Programs are displayed in a grid so that all steps are visible at once • All strategies • All Decisions • All Branches • Structogram is part of the Explorer as well as the Program Editor • Contstructed of rows and columns • Each strategy is represented as a column • Each step in the strategy is represented by a row • Each row is equivalent across the strategies • Dot Cockpit - Program Editor (Program Path = USER/head/Brain Dot Engine/program) EXPLORER Edit Simulate - Standard Q USER >> head >> Brain Dot Engine >> program Browse Search Default Brain . Neuro Patient View Strategy Speed focus USER AALHead Scout 00:19 AAHead_Scout 00:19 AutoAlign Scout AutoAlign Scout sweet 11_se_sag_320 03:07 11_112d_sag 00:52 head . Generic Views o Generic Views › c-spine 12_Use_tra_512 03:37 12_haste_tra_p2 › t-spine o Generic Views 2 . Generic Views › I-spine 12_tirm_tra_dark fluid_320 04:32 12_tirm_tra_dark-fluid_p2 01:50 whole-spine . Generic Views . Generic Views TimCT whole-spine ep2d_diff_3scan_trace_p2 01:50 ep2d_diff_3scan_trace_p2 00:51 neck soft tissue . Generic Views o Generic Views › thorax 11_se_tra_320 02:25 Decision 11_112d_tra . Generic Views o Generic View step TOF needed? %. [yes Basic Decisk select a program or library vessels_head 00:27 Branch Strategy Decision TOF_3D_multi-slab 05:24 Interaction Pause 51 syngo® MR Systems with DOTGo Technology | Turnover Workbook 13.4 Explorer Notes E Dot Cockpit - Explorer ? X EXPLORER PROGRAM EDITOR Browse Import Expor E: Q USER Brain Dot Engine clinical libraries Q advanced applications libraries programs sweet library head › c-spine › t-spine I-spine whole-spine TimCT whole-spine neck soft tissue thorax heart breast abdomen pelvis female pelvis male tmj shoulder elbow wrist hand hip knee ankle lower extremity whole body oncology · shala havtu diffusion • Explorer is partitioned into three subtasks: • Browse – Organize the exam database • Import – Import items (regions, exam, programs, and steps) from an external data (DVD or memory stick) • Export – Export items from the local exam database to an external data Note: All subtasks have a tree view and toolbar • 52 syngo® MR Systems with DOTGo Technology | Turnover Workbook Browser Toolbar Notes • Dot Cockpit - Explorer EXPLORER PROGRAM EDITOR Browse Import Export SIEMENS general lesion Delete | Copy | Paste | Undo | Redo trauma neurodegeneration head . Brain Dot Engine epilepsy · clinical libraries Organize Tree | Organize Directory general - lesion trauma uncoop neurodegeneration vascular X epilepsy New Tree ms Duplicate Tree New region directory pituitary New exam directory orbits Rename Tree iac Delete Tree New Program uncooperative vascular Print ... . advanced applications libraries · programs Export ... · library · c-spine Update Filming Study Layout · t-spine › I-spine Show inconsistent · whole-spine . TimCT whole-spine . neck soft tissue · thorax . heart . breast · abdomen > pelvis female · pelvis male • Browse • Browsing – allows you to view all objects in the exam database • Searching –exam database via arbitrarily entered text • Search field – identified by the magnifying glass Allows you to find programs or steps in a quick and easy way • All unlicensed or inconsistent steps are ignored during search • Search results are highlighted in yellow in the tree view and if • applicable in the content area Number of contained matches is displayed next to the name in • brackets Explorer allows you to create, duplicate, rename, and delete user tree directories • Cannot modify Siemens tree • 53 syngo® MR Systems with DOTGo Technology | Turnover Workbook Notes • Create New Tree Can create multiple user trees • In the toolbar of the Explorer • XPLORER PROGRA Select New Tree from the menu • Browse Import Export New Tree dialog window is opened • New Tree Enter a name for the new tree • Duplicate Tree Confirm with OK Rename Tree • Delete Tree New Tree X Print ... Export ... Name New Tree Update Filming Study Layout ... OK Cancel Show inconsistent • Browse & Search Dot Cockpit - Explorer EXPLORER PROGRAM EDITOR Browse Browse Import Export Search USER Brain Dot Engine clinical libraries Q t2 tse head advanced applications libraries sweet [1] programs library c-spine › t-spine › I-spine whole-spine . TimCT whole-spine . neck soft tissue › thorax › heart › breast › abdomen pelvis female pelvis male › tmj › shoulder elbow › wrist hand hip › knee › ankle › lower extremity whole body oncology [ · shala hadtu diffusion 54 syngo® MR Systems with DOTGo Technology | Turnover Workbook Explorer knows different modes for Drag & drop with different rules applied: Notes • Preview-only mode and read/write mode Explorer Cockpit - Explorer Toolbar ? X DACHER PROGRAM ESTOR Browse Import Export SIEMENS 9xooral Filter (Tree and search criteria) raumma neurodegeneration head . Brain Dot Enginc epilepsy . cirical Ibraries MIS piitary general ortils lesion traunta neurodegener opdopsy Tree Content Area (Tree, pituitary Region, Exam). orbits iac uncooperative vascular . advanced application lorane · programs . Porary · c-spine · t-spine · I-spine · whole-spite · TimCT whole-spine . nock soft Ssuc · thorax . heart · breast · abdomen pelots female pchuts manie Read/write mode: • To Queue • Inside Tree and Conent Area • Tree and content area it is possible to drag and drop source and targets • Can create multiple user trees • Preview-only mode: • Drag & Drop of steps from Preview Area (Content area) to Queue • Content Area only a source and not as target • Tree source and target • 55 syngo® MR Systems with DOTGo Technology | Turnover Workbook 13.5 Program Editor Notes Dot Cockpit - Program Editor (Program Path = USER/I-spine/programs/Standard) ?|X EXPLORER PROGRAM EDITOR Edit Simulate : KV - Standard Search Default USER Start Q Recently Edited Programs Create New Program clinical libraries USER » I-spine » programs » Standard general USER >> I-spine >> library » QUIET lesion USER >> I-spine >> library >> T1 trauma select a program or library =Open other .. New Program Strategy Decision Interaction Pause Dot Cockpit - Program Editor (Program Path = SIEMENS/heart/Cardiac Dot Engine/Ventricular Function) Ean SimulateJ Program Editor - Standard SIEMENS >> heart >> Cardiac Dot Engine >> Ventricular Function X Mode Browse Search Default Cardiac Dot step o Cardiac Patient View SIEMENS Filter (Tree and Breath-hold Realtime Localizer Q . library search criteria) [email protected] localizer o car T1 Thorax_Cor_Tra T2 Car PD+T2 Tree AAHeart_Scout 3D o Car SPACE Select program DefineLongaxis epi_diff_pert_bold o Cardiac Marker Lx flow SWI (read only) CINE_segmented_LAX 00:07 CINE_realtime_LAX BLADE o Cardiac Standard o Cardiac Frequency Scout Working Area (Opened with Frequency Scout o Basi Frequency Scout Frequency Scout Program) with Frequency Scout with Frequency Scout FrequencyScout 00: 12 FrequencyScout select a program or library Structogram o Cardiac Standard o Cardiac Stan CINE_segmented_LAX 00:07 CINE_realtime_LAX o Cardiac Sta Drag & Drop o Cardiac Standard DefineSAX Cardiac SA) Source/Target CINE_segmented_SAX 6 CINE_realtime_SAX . Cardiac Standard CIN o Cardiax Strategy Decision Interaction Pause Simple defaults (Drag & Drop Source) • Program Editor Toolbar Dot Cockpit - Program Editor (Program Path = USER/I-spine/programs/Standard) EXPLORER PROGRAM EDITOR Edit Simulate - Standard Browse Sea Start ? USER New • Open • Save • Save As • 56 syngo® MR Systems with DOTGo Technology | Turnover Workbook Protocol markers can be added to protocols Notes • Standard • . Standard Image Comment • Standard Body Part • Study Part DI Image Comment • * Body Part Study Part Image comments and body parts are valid for series, study parts specify the • study allocation Study part – can configure which images will be assigned to which study in • examinations with multiple studies Program is open in the Program Editor • • Program Editor – allows you to create new or modify existing measurement programs, as well as review complete programs in simulation mode • Program Editor is partitioned into two subtasks: • Edit: Edit programs and protocols • Simulate: Verify new exam protocols Edit measurement programs via: • Drag & drop • Context menus • Keyboard shortcuts • Editing: • ? X EXPLORER PROGRAM EDITOR Edit Simulate Standard USER >> I-spine > library > T1 Browse Search Default t1_tse_sag_320 03:57 USER t1 tse fs sag 04:17 Q Copying and pasting steps • Delete steps • 57 syngo® MR Systems with DOTGo Technology | Turnover Workbook 14 Dot Engines 14.1 Brain Dot Engine (standard) Notes 14.2 Optional Dot Engines: • Abdomen Dot Engine • Angio Dot Engine • Breast Dot Engine • Cardiac Dot Engine • Knee Dot Engine • Large Joint (Knee, Shoulder & Hip) • Spine Dot Engine • TimCT Onco Dot Engine • TimCT Angio Dot Engine 58 syngo® MR Systems with DOTGo Technology | Turnover Workbook 15 Viewing Task Card Tool for viewing, optimizing, and evaluating the patient’s data for diagnosis. A Notes maximum of three patients can be loaded into individual folders within the Viewing Task card simultaneously. If set accordingly, images will automatically load into the Viewing Task Card. 15.1 Manually Load Images • Select > Load to Viewing Icon from toolbar in Patient Browser • Drag and drop data from Patient Browser to Viewing Task Card • Main menu > select Patient > Load to Viewing • Viewing Task Card in foreground > Open Patient Browser and double left mouse click on patient, study, or series folder 15.2 Scrolling Through Images • Symbol Keypad: Image (+ and -) and Series (+ and -) to page through images or series. • Note: This method only works within the active segment. 15.3 Dog ears in image segment • Dog ears only available in series stack mode • Left mouse click on the dog ears to page through images • Page up/Page Down buttons on keyboard A AUBURN DIAGNOSTIC IMAGING 4/1 3/2007 Espree Dog Ears 9:40:57 AM MR B13 3 IMA 11 /18 HFS +LPH 5cm MF 1.00 TR 711.0 om TE 160 SP F1.7 TA 02:16-2 SL 4.0 BY 120.0 FoV 160*160 A2FS 192*320 C:SH Tra toe201 3/150 RIGHT W 772 308 59 syngo® MR Systems with DOTGo Technology | Turnover Workbook 15.4 View – Screen layouts Notes Tools Image View auto • Modify screen layout • Stripe – images from a series populate all segments sequentially • Stack – Images from each series an individual segment. Dog ears can be used to page through the images. • Single View Segments • 1:1 • 2:1 • 4:1 • 9:1 • 16:1 auto • Multi View – Load up to four patients into a single folder. • Multi View Segments • 1:4 • 1:2 • 2:2 • 3:3 • 4:4 auto 60 syngo® MR Systems with DOTGo Technology | Turnover Workbook Notes • Automatic Movie Mode – Plays images in a movie mode in the active segment. • Operator can change the frame rate, pause, reverse or play the images in a cine loop • Click on icon to start and stop movie auto Movie Properties X From To 120 Yoyo Show graphics 8 F/s Frame Rate 8 F/S Popup this dialog each time automatic movie is started Close Help 61 syngo® MR Systems with DOTGo Technology | Turnover Workbook 15.5 View – Image subtask card Notes Tools |Image View D- auto • Minify by 0.5 – Reduces image size by a factor of 0.5 when icon is selected • Magnify by 2.0 – Enlarges image by a factor of 2.0 when the icon is selected • Zoom Factor –Manually type in a zoom factor for magnification • Fit to segment – Returns image to the original size • Zoom/Pan – Manually magnify and minify image. Manually pan the image in the active segment • Home Zoom/Pan – Image returns to original size and position in active segment • Auto Windowing – Default image window setting auto 62 syngo® MR Systems with DOTGo Technology | Turnover Workbook 15.6 View – Tools Subtask Card Notes Tools Imago View • Circle – Mark and evaluate anomalies in the images or evaluate gray scales • Distance – Measure the length between two points • Angle – Calculate an angle after two lines are created that intersect • Freehand ROI – Draw any ROI shape • Pixel Lens – Displays average gray scale value across a small area of 5x5 pixels. Displays the coordinates of the marker relative to the isocenter. • Annotate – Annotate using text and/or an arrow for interesting .XYZ or abnormal areas in the images 63 syngo® MR Systems with DOTGo Technology | Turnover Workbook 15.7 Windowing images Notes • Change image contrast and brightness using the mouse. • Window and level values are displayed in the image. • W (Window width) = contrast • C (Window center) = brightness • Select image with middle mouse button • Drag mouse left/right – contrast changes • Drag mouse up/down – brightness changes Note: To restore original window values, select Image >Home Window in the main menu 15.8 View – Patient Subtask Card Patient | Eval Exam • Patient Registration – Register a new patient or a patient from Scheduler • Position Display: Series – creates position display using two to three reference images utilized when positioning slices in Exam Task Card • Position Display: Selection – creates a reference image so the user can display slices onto a different image other than the one utilized when positioning slices in the Exam Task Card. • Close Patient – closes patient images in an open folder in the Viewing Task Card 64 syngo® MR Systems with DOTGo Technology | Turnover Workbook Notes • Film Preview – shows series/image numbers currently on virtual film sheet (no images are seen) • Copy to Film Sheet – Sends series or images selected to Film Task Card • Local Database – Opens Patient Browser > Defaults to Local Database • 3D MPR – Sends selected images to 3D Task Card and loads into MPR • Send To – Sends selected images to a preferred network node 15.9 View – Evaluation Subtask Card Patient Eval Exam 6 + X ADC T1 0 T20 • Addition – Adds grayscale values from different images/series (equivalent to superimposed images) +0 • Subtraction – subtracts grayscale values from two separate sets of images or series - • Arithmetic mean – combines grayscale values across several images or series XI 65 syngo® MR Systems with DOTGo Technology | Turnover Workbook • ADC – Creates an Apparent Diffusion Coefficient (ADC) image Notes and averages different spatial directions and b-values ADC • T1 – Permits quantification of T1 tissue contrast • T2 – Calculates T2 images, uses images with same slice position and TR, but multiple echo times (TE) T20 • Image Filter – post-processing filter (inline or offline availability) • Standard filters – Smooth, Offline Image Filter Paramete X Medium, Sharp Edge Enhancement Medium (3/3) Edge Enhancement 3 • Smoothing: F 3 • Degree of edge and line enhancement Store • 1: Least amount of edge Result Series Description enhancement 11 f13d tra dynaVIEWS PRE FIL 1 • 5: Maximum amount of edge OK Cancel Help enhancing • Smoothing • Degree of smoothing • 1: Least amount of smoothing • 5: Maximum amount of smoothing 15.10 View – Exam Subtask Card Patient | Eval Exam • Histogram – Evaluates distribution of grayscale values for drawn ROI’s; (e.g., circle, rectangle, freehand ROI) • Selected Marked – Activates all the sequences or images that have been marked • Selected Unmarked – Activates all the sequences or images that are not marked 66 syngo® MR Systems with DOTGo Technology | Turnover Workbook 15.11 Rotating and flipping an Image Notes • Orientation labels are rotated and flipped together with the image. • Select images in viewing > Select > Series – selects all images within the segment • Main menu > Image mage Tools Scroll Evaluation Windowing Windowing OnSelection Windowing OnSucceeding Windowing OnSeries Color Lookup Table ... Invert Home Window Save Window Values Ctrl+W Auto Windowing Auto Windowing On Magnify by 2.0 Minify by 0.5 Zoom Factor Fit to Segment Acquisition Size Zoom/Pan Home Zoom/Pan Zoom/Pan OnSelection Zoom/Pan OnSeries Rotate. Rotate 90 Flip Horizontally Flip Vertically • Rotate – Type amount in degrees Rotate Image X to rotate image • Rotate 90 –rotates image 90 degrees clockwise Rotate by degree • Flip Horizontally – flips images horizontally OK Cancel • Flip Vertically – flips images Help vertically • Save flipped images – Main menu > Patient Save As. Patient Applications Transfer • New series created Register. Num 0 Browser. Num Search Search Selected Schedule Close Patient Save As. 15.12 Save New series • Save an image or images in a new series in the Viewing Task Card • Main menu > Patient > Save As 15.13 Image Text Information • Please refer to Appendix A for Image Text Information 67 syngo® MR Systems with DOTGo Technology | Turnover Workbook 16 Filming Task Card The Filming Task card is where patient images, series, or studies are transferred Notes prior to sending them to the camera for printing. The patient’s name is displayed next to the folder(s) in the upper right hand corner of the Filming Task card virtual film sheet. 16.1 Steps for Filming • Patient Browser, select patient, series(s) or image(s) > select > Copy to Film Sheet icon. (Patient Browser toolbar). • Images can also be sent to the Filming Task card from the Viewing task card. Viewing Task Card > select image segment > right mouse Filming select series > select Copy to Film Sheet icon. • Selected images are loaded to the virtual film sheet on Filming Task Card. Select Filming Task Card • Select One Film Sheet – Click on the border of the film sheet. All images of the displayed film sheet are selected (e.g., marked with a continuous line border). • Select All Film Sheets – Click on the patient folder icon to select all film sheets in the folder (e.g., folder turns LIVER blue) • Deselect all images (or) film sheets: left mouse click outside the film sheet to deselect all images • Change Filming Layout – Click on Patient Folder (e.g., folder turns blue) > select Layout subtask card > select Layout. Layout | Images Camera H Layouts 3x4 • Send Film Sheets to Camera – Select > Expose Film Task icon – All selected film sheets are transferred to the camera. 68 syngo® MR Systems with DOTGo Technology | Turnover Workbook 16.2 Filming Properties Notes • Open Filming Properties window – Right mouse click on Filming Task card > select Properties – Filming properties menu window opens Film Properties X Layout : Layout General Default All text Layout 4x4 · Customized text No text Aspect ratio Fit to segment Scale Bar MOrientation Label · Original Image OPatient Name (100%) Patient ID Clip document OOther Patient IDs Overlay graphics OBirth Date, Patient's Sex and Age Show DAccession Number OStudy ID Hide MAcquisition Date MAcquisition Time Reference image SeriesImageNumberAndTotalNumberOfimages Top right OInstitution Name Bottom right Manufacturers Model Name OSoftware Version OK Help • Filming properties window contains • Layout – pre-defined layouts in drop down menu • Text options – All text, Customized text, No text • Reference image – places a reference image in the Top or Bottom right corner of the image segments(s) • Change Reference Image in Film Sheet segment – Filming Task card in foreground > Open Patient Browser > select one image from a series > Drag and drop image into the reference image box on the Film sheet. 16.3 Copies 1 Copies • Filming Task Card > change number of copies from default selection for a single film job. 16.4 Camera Layout | Images Camera Change Default Camera Camera • • Camera Subtask Card > select different camera MrService from drop down menu. (e.g., available for scanners when multiple cameras are configured). Status: • Note: Change the default camera prior to processing the images and sending to the Film Size camera Lega 69 syngo® MR Systems with DOTGo Technology | Turnover Workbook 17 Archiving • Archiving to a DVD, CD-R, or local network prevents data loss and is used for Notes long term storage of patient data. Patient data should be archived on a regular basis. • Media types – DVD-R or CD-R discs • Write-once media is supported • Re-writable media is not supported • Siemens recommends medical grade discs for long-term archival purposes since medical grade discs are more resistant to scratching • Medical grade discs can be found with an online search • Siemens Medical Solutions Accessory Solutions Corporation 1-888-222-9944, option 1 17.1 Export or Archive Patient Data • Open > Patient Browser • Select patient, study, series or images to be archived. • Select Main Menu > Transfer > Export to or Transfer > Archive to or Archive Icon (e.g., Service configures either Export to or Archive to for data storage) • Enter Label Dialog window – opens only when archiving to a new disc never used • Label on medium – minimum of three characters • Viewing tool • DICOM Viewer allows images to be viewed on any PC • Not recommended for image diagnosis 17.2 Eject from & Eject finalized • CPU Tower: Eject discs from the write drive drawer using Eject from or Eject Finalized. e.g., these options close all background files prior to ejecting the media from the write drive drawer. • Eject from • Main Menu > Transfer > Eject from… • Select drive drawer to eject the media Reader (DVD-ROM) (or) Writer (DVD-Write) • Note: It is recommended to remove the DVD or CD from the write drive drawer prior to shutting down or rebooting the system. • Eject Finalize • Closes all sessions on a DVD and finalizes the disk before ejecting the media • If this option is chosen the DVD is write protected and no additional data can be archived to the disk 70 syngo® MR Systems with DOTGo Technology | Turnover Workbook 17.3 Sending to a Network Node Notes Patient data can be sent over the network (e.g., PACS, syngo.via; workstations) when system is connected to a network via the Send to function • Open Patient Browser > Select patient, study, series or images to be sent via the network • Select Send to Icon on the toolbar (Or) • Main Menu > select Transfer > Send to (Or) • Send to node 1 on Symbol keypad • Select Network node > select Send 71 syngo® MR Systems with DOTGo Technology | Turnover Workbook 18 3D Task Card 18.1 Load images into 3D Task Card Notes • Images can be loaded from the Patient Browser or from another Task card • Select Patient Browser > select 3D images for reconstruction • Main menu > Applications 3D > MIP or MPR • MIP – Maximum Intensity Projection, used for vascular reconstructions • MPR – Multi-Planar Reconstruction, used for anatomical reconstructions • Sagittal, Coronal, and Axial projections are visualized • Top left segment (red border) – Sagittal projections displayed • Top right segment (blue border) – Coronal projections displayed • Bottom left segment (Blue border) – Axial projections displayed • Bottom right segment is reserved for 3D image reconstruction 18.2 3D Task Icons Free Hide Reference Orientation Mode Lines Control Rotate Zoom/ Pan Home Images Zoom/Pan • Free Mode – freely change reference lines angulations in any segment • Hide Reference Lines – Removes reference lines from all three image segments • Orientation Control – Controls in-plane rotation of reference and calculated images • Recommended when reformatting MPR Images • Rotate Images – Rotate image freely • Zoom/Pan – Magnify or pan images • Home Zoom/Pan – Resets images to original display (e.g., only effects active segments 72 syngo® MR Systems with DOTGo Technology | Turnover Workbook 18.3 Type Subtask Card Notes MPR MPR Thick SSD Type Orien ... Image MIP Thin MIP • MPR (Multi-Planar Reconstruction) – Calculates two dimensional images from a 3D volume in other orientations and various angulations • MPR Thick – Defines the thickness of the original slice from which the image will be reconstructed • MIP (Maximum Intensity Projection) – Calculates a volume with the most intensive gray scale values for the projected image reconstruction (e.g. blood vessels) • MIP Thin – Projected image is calculated through a slice of the volume (user defines thickness of the slice for reconstruction) • Right mouse click MPR Thin icon – 3D MIP Thin dialog window opens > modify thickness 18.4 Orientation Subtask Card Patient Views Type Image Default Orientation Ortho Sync • Patient Views – Change orientation of the image in the active segment • Default Orientation – Changes all three segments back to the default orientation (sagittal, coronal and axial). • Note: Select default orientation prior to performing a MIP to avoid double oblique reconstructions • Ortho Sync – Two segments are made perpendicular to the reference segment 73 syngo® MR Systems with DOTGo Technology | Turnover Workbook 18.5 Settings Subtask Card Notes Parallel Ranges Radial Ranges Curved Ranges Setti Curved Mode VOI Clip box" VOI Punch Mode • Parallel Ranges – Creates slices with a defined slice thickness and distance perpendicular to the reference image • Radial Ranges – Creates a range of images from different angles • Curved Ranges- Creates a series of curved parallel images with a defined thickness and distance perpendicular to the reference image • VOI Clipbox – Purple box displayed lower right segment, reduce size to remove unwanted tissue (e.g., updates image display in all segments) • VOI Punch mode – draw a freehand region to remove or keep structures (drawing tool) 18.6 Lower Icons • Save – Saves images in the active segment to the Patient Browser • Note: Saved under a generic description; (e.g., MPR Range) • Save and Copy to Film Sheet – Saves and sends images in the active segment to the Filming Task Card • Save As – Modify the series name and place a comment on the images prior to saving reconstructed mages to the Patient Browser • Close Patient – unload patient data in the 3D Task Card K 74 syngo® MR Systems with DOTGo Technology | Turnover Workbook 18.7 3D Task Card – MIP Notes • Select Patient Browser • Select 3D series • Select Applications > 3D > MIP – load images from Patient Browser into the 3D Task Card • Select 3D Task Card > Left mouse click on one of the three segments to activate • Select VOI Punch Mode icon • Select Draw Contour tool (e.g., default selection On) • Depress left mouse and draw by moving cursor over area in the segment • Leave a small space between the start and end of the drawing > Double left mouse click – closes drawing • Select Keep Inside (or) Remove Inside • Note: Repeat Draw Contour tool steps to remove additional areas of unwanted tissue ............. • Select Axial image segment – left mouse click on segment to activate • Rotation: Left to Right (or) Right to Left • Select Radial Ranges icon • 3D: Radial ranges window opens – define the following • Rotation start and end points • Angle between images (or) Number of images • Presets – Select a preset 3D: Radial Ranges from dropdown menu. (e.g., X MIP presets are defined and Presets RT to LT COM saved by user) • Select Start – calculates MIP images in lower 3D: Radial Ranges X right quadrant. Presets right to left Angle between images 10.0 deg Number of images 19 Start Close Help • Select Save As Icon • 3D: Save As window 3D. Save As • Comment – comment placed on all images Patient TOF • Range series name – names series in Patient Modality MR Exam date 02/01/11 13:51:34 Images 13 Browser Image type Range of MIP Reading Physician Comment Left to Right Range series name| Left to Right OK Cancel Help 75 syngo® MR Systems with DOTGo Technology | Turnover Workbook • Select OK – Calculated images saved to patient Notes 3D: Save As browser Patient TOF Modality MR Exam date 02/01/11 13:51:34 Images 20 Image type Range of MIP eading Physician Comment MRA left to right Range series name MRA left to righ OK Cancel Help • Select Sagittal image segment – left mouse click on segment to activate • Rotation: Head to Feet (or) Feet to Head • Select Radial Ranges icon • Define 3D Radial ranges window • Rotation start and end points • Angle between images (or) Number of images • Presets – Select a preset from dropdown menu. (e.g., MIP presets are defined and saved by user) • Select Start – calculates MIP images in lower right quadrant. • Select Save As Icon • 3D: Save As window • Comment – comment placed on all images • Range series name – names series in Patient Browser • Select OK – Calculated images saved to patient browser 18.8 MPR – Workflow • Select Patient Browser • Select 3D series • Select Applications > 3D > MPR loads images from Patient Browser into the 3D Task Card • Select 3D Task Card > Left mouse click on one of the three segments to make it active (e.g., sagittal, coronal, or axial) • Select Parallel Ranges icon – Create a range of slices on one of the images • 3D: Parallel Ranges window opens – define the following • Select Horizontal Ranges icon (or) Vertical Ranges icon • Define ranges start and end points • Swap Range Order – Reverses image numbering (insert image 125 Swap Range Order) • Constant Number of Images • Icon on – keeps number of slices constant and modifies distance between images in millimeters when defining start and end points. • Icon off – keeps distance between images constant and modifies number of slices in millimeters when defining start and end points. 76 syngo® MR Systems with DOTGo Technology | Turnover Workbook Notes • Image thickness • Note: Images cannot be reconstructed thinner than acquired. • Distance between images • Note: If defining, type in distance between images > deselect constant number of images > select enter > define start and end points > select start) • Number of images • Note: If defining, type in number of images > define start and end points > select start) • Select Start - calculates MPR images in lower 3D: Parallel Ranges X right quadrant Presets Default Parallel SCORE mage thickness 1.0 mm Distance between images 2.6 mm Number of images 22 Star Close Help • Select Save As Icon • 3D: Save As window • Comment – comment placed on all images 3D: Save As X Patient Wrist, left • Range series name – names series in Patient Modality MR Exam date 09/17/10 16:21:32 Images 20 Browser Image type Range of MPR Reading Physician Comment| Left wrist MPR axial Range series namel Left wrist MPR axial OK Cancel Help • Select OK – Calculated images saved to patient browser 77 syngo® MR Systems with DOT | Turnover Workbook Notes 78 syngo® MR Systems with DOTGo Technology | Turnover Workbook Appendix A: Additional Dot Engines 79 syngo® MR Systems with DOTGo Technology | Turnover Workbook 19 Additional Dot Engines 19.1 Angio Dot Engine – Features Notes Test Bolus – visual display of arterial/venous timing window Feedback of bolus timing information – Timing information is fed back into planning steps and parameters can be adapted automatically AutoVoiceCommands – Integrated into the scanning workflow. The system plays voice commands automatically when programmed. This ensures optimal timing of scanning, breathing and contrast media. The user can monitor which breath-hold or pauses are actually played, and they can add pauses between the automatic breath-hold commands if necessary 19.2 Angio Dot Engine – Customization Existing Dot Engines can be modified by the user to their individual standard of care. • Add/remove protocol steps • Change guidance content (images and text) • Change Dot exam strategies and Decision Points • Modify the Parameter View 19.3 Spine Dot Engine – optional license The Spine Dot Engine provides tools to reduce exam times and to achieve reproducible image quality. • Complete spine examination with ease and fewer errors; i.e., cervical, thoracic and lumbar • Fast and standardized scanning • Consistent and robust image quality • syngo® WARP includes high bandwidth pulses and VAT technique for reduction of susceptibility artfacts, such as from MR conditional implants Throughput is optimized by: • Spine-oriented exam layouts • Automated positioning • Automated vertebra numbering • Intervertebral disc plane detection • Drop & snap for fast positioning for each. • Exam Card – View > Spine Planning UI 19.4 Spine Dot Engine Strategies Cervical and Thoracic Spine • Standard • Lesion 80 syngo® MR Systems with DOTGo Technology | Turnover Workbook Notes • Post surgery • High bandwidth (WARP) Lumbar Spine • Standard • Post surgery • High bandwidth (WARP) 19.5 Spine Dot Engine – Features AutoPositioning – double oblique slices, slab, and saturation bands • Automatic positioning and tilting of transverse slice blocks • Automatic positioning of anterior saturation bands AutoAlign Spine LS – Automated, positioning and alignment of slice groups to the spine anatomy, relying on multiple anatomical landmarks. Provide fast, easy and reproducible patient scanning and facilitates the reading by consistently delivering high image quality with a standardized slice orientation, both for follow-ups and across patients. AutoAlign Spine LS Automatically detects and labels vertebra and body disks, suggests positioning for sagittal, coronal, and double oblique axial slices in the spine, and automatically positions the saturation region. • AASpine_Scout can be: • 1 Station: typically when scanning c-spine or l-spine • 2 Stations: typically when scanning t-spine • 3 stations: typically when scanning l-spine or whole spine localizer • Note: option must be programmed by the user when building and saving a Dot Engine in the Exam Explorer User tree AutoAlign Verification • Automatic suggestion of vertebra labels • Tooling to verify/modify labels and confirm • Save images with labels Autolabeling – Automatic labeling of vertebra for easier examination planning and faster reading • Label displayed on reconstructed axial images Interactive Snapping – Drag slice group over the sagittal plane, AutoAlign Spine LS delivers automatic double oblique positioning of axial slice groups to Intervertebral disk spaces AutoCoverage – Maximize speed of the examination by automatically setting the number of slices and the FoV to fully cover the C, T or L-spine. Based on information delivered by AutoAlign Spine LS, eliminating manual setting and scanning unnecessary slices. 81 syngo® MR Systems with DOTGo Technology | Turnover Workbook syngo® WARP – Susceptibility artifact reduction techniques, 2D TSE Notes sequences combining high bandwidth protocols and VAT (View Angle Tilting)- technique, tailored to reduce susceptibility artifacts (i.e., MR conditional metal implants). Available protocols include T1-weighted, T2-weighted, protocol density and STIR contrast. Inline Curved reconstructions – Automatic curved reconstruction from 3D acquisitions by using the position information from the AutoAlign Spine LS Algorithm Inline MPR Images – Automatic multiplanar reconstruction of 3D datasets. (Sagittal and Transverse) • MPR tool – configure to automatically generate 2D images from high resolution 3D datasets Inline Composing – Automatic anatomical or angiographic composing of multiple adjacent coronal or sagittal images for presentation and further evaluation. • Composed images can be automatically loaded into Graphical Slice Positioning for planning purposes 19.6 Spine Dot Engine – Customization The Spine Dot Engine can be easily modified by the user to their individual standard of care. • Add/remove protocol steps • Change guidance content (images and text) • Change or add Dot exam strategies • Add clinical decision points • Add/remove parameters in the parameter viewing card • User-defined offsets to the standard positions delivered by AutoAlign Spin LS (also for the saturation region) • Customized inline curve and MPR reconstructions 19.7 Large Joint Dot Engine – optional license The Large Joint Dot Engine bundles Dot engines for hip, shoulder and knee MSK procedures with a single Dot engine. Scans are optimized by proposing the most appropriate protocols for the individual patient according to the exam strategy selected. • Increased reproducible image quality and streamlines large joint examinations • Increased consistency and productivity in large joint exams • Personalized exams for individual patient conditions • Standardized examination and reproducible positining with Auto Coverage and AutoAlign • syngo® WARP include high bandwidth pulses and VAT technique for reduction of susceptibility artifacts, such as from MR conditional implants. 82 syngo® MR Systems with DOTGo Technology | Turnover Workbook 19.8 Large Joint Dot Engine – Features Notes AutoAlign – Automated, localizer based positioning and alignment of slice groups to the anatomy, relies on anatomical landmarks. Reproducible patient scanning and supporting the reading by consistently delivering high image quality with a standardized slice orientation. AutoCoverage – Maximize speed of the examination by automatically setting the number of slices and the FoV to fully cover the hip or shoulder. Based on information delivered by AutoAlign, eliminating manual setting and scanning unnecessary slices. syngo® WARP – Susceptibility artifact reduction techniques, 2D TSE sequences combining high bandwidth protocols and VAT (View Angle Tilting)-technique, tailored to reduce susceptibility artifacts (i.e., MR conditional metal implants). Available protocols include T1-weighted, T2-weighted, protocol density and STIR contrast. Disclaimer:MR imaging of patients with metallic implants brings specific risks. However, certain implants are approved by the governing regulatory bodies to be MR conditionally safe. For such implants, the previously mentioned warning may not be applicable. Please contact the implant manufacturer for the specific conditional information. The conditions for MR safety are the responsibility of the implant manufacturer, not of Siemens Inline MPR Images – Automatic multiplanar reconstruction of 3D datasets. • MPR tool – configure to automatically generate 2D images from high resolution 3D datasets 19.9 Large Joint Dot Engine – Customization The Large Joint Dot Engine can be easily modified by the user to their individual standard of care. • Add/remove protocol steps • Change guidance content (images and text) • Change or add Dot exam strategies • Add clinical decision points • Add/remove parameters in the parameter viewing card 19.10 Abdomen Dot Engine – optional license The Abdomen Dot Engine offers a comprehensive and customizable workflow for examinations of the abdomen. Feature of the Abdomen Dot Engine include: • Automatic region-of-interest (ROI) positoning support, which supports positioning of the ROI on the descending aorta • A stop before the pre in case of manual voice commands • Improved timing accuracy for more reproducible results • Consistent image quality for even complex abdomen examinations 83 syngo® MR Systems with DOTGo Technology | Turnover Workbook 19.11 Abdomen Dot Engine Strategies Notes • Breathhold (fast with robust image quality) • Respiratory synchronized (using PACE triggering, high image resolution) • Motion-insensitive (fast, using syngo® BLADE and PACE triggering) 19.12 Abdomen Dot Engine – Features AutoPosition – after registration the patient is positioned automatically at the optimal scanning position Automatic sequence scaling – According to physiological characteristics • AutoFoV • AutoNavigator • Breath-hold adaptions AutoNavigator – Automatic breathing pattern detection and scaling of triggered scans AutoFoV (automatic Field of View calculation) – Based on the localizer images the optimal FoV is automatically estimated. In case the patient moves during the examination, this step can be repeated anytime. MRCP decision point – provides comprehensive guidance, including positioning help. MRCP is measured and inline Radial Ranges are generated. Timeline monitoring – for best overview of multi-phase breath-hold examination. The contrast media enhancement curve is visualized. Automatic Timing – Liver dynamics uses the care bolus approach. • Auto Bolus Detection enables the system to monitor the arrival of contrast agent in a user defined ROI. • Auto Bolus Detection enabled: AutoROI can be enabled in patient view. Allows the system to perform automatic ROI positioning on the descending aorta at the level of the diaphragm. The ROI positioning can be confirmed and adjusted by the user. Bolus Timing – An alternative way of performing liver dynamics. • Optimal time window for data acquisition is derived by the system after the application of a test bolus • Visual guidance and interactive evaluation during the setup provides ease-of-use. AutoVoiceCommands – Seamlessly integrated into the scanning workflow. • System plays voice commands automatically at preferred time point • Assists user in providing the optimal timing of scanning, breathing and contrast media • User can monitor which breath-hold or pauses are actually played, and could add pauses between the automatic breath-hold commands 84 syngo® MR Systems with DOTGo Technology | Turnover Workbook Inline Subtraction- Within the contrast-enhanced abdomen exam, multiple Notes phases are acquired: • Native, arterial phase, portal-venous phase and late-phase • Scanner automatically subtracts the native measurement from the arterial, portal-venous and late phase. Inline Registration – For best visualization of lesions the system can be set to automatically perform a registration/alignment of the anatomy for the different dynamic phases. The importance of registration/correction can be seen when examining nodular enhancing pathologies. 19.13 Cardiac Dot Engine – optional license The Cardiac Dot Engine offers several features that help to handle the complexity of cardiac MRI exams with confidence. Exam strategies can be selected based on the patients physiological conditions, and all protocols are adapted accordingly. The AutoAlign Heart feature makes the localization easier than ever, and gives you the next step in workflow with fully automated positioning of the 2, 3, and 4 chamber views and a stack of short axis views. Standard views of the heart are easily generated and can be reproduced using different scanning techniques. The Cardiac Dot Engine also offers different workflows for ventricular function and ischemic heart disease. 19.14 Cardiac Dot Engine - Features Increased patient throughput Consistency in slice positioning for reliable image quality over multiple exams Ease-of-use, helping bring cardiac MRI into your clinical routine AutoFoV (automatic Field of View calculation) – Based on the localizer images • Optimal FoV is automatically estimated • Patient movement during exam, step can be repeated at any time Automatic parameter adaption – Scan parameters are automatically adapted to the patient’s condition (heart rate, etc.) AutoAlign Heart – Based on the localizer images • Automatic detection of cardiac landmarks is obtained and used to optimally plan cardiac exams without user interaction • Fully automatic planning process results in 2, 3, and 4 chamber views and a stack of short axis views • Patient movement during exam, step can be repeated at any time Automated localization – Automated localization of short-axis views Guided slice positioning – Easy way to match slice positions (short-axis) between cine, dynamic imaging, tissue characterization 85 syngo® MR Systems with DOTGo Technology | Turnover Workbook Cardiac Views – easy selection of cardiac views ( e.g., 3 chamber view) Notes during scan planning Inline Ventricular-Function Evaluation – syngo® Inline VF performs volumetric evaluation of cardiac cine data fully automatically right after image reconstruction. • No user input necessary • If needed, inline calculated segmentation results can be loaded to 4D Ventricular Function Analysis for further review or processing. Cardiac specific layout of Exam Task card – Automatically chosen layouts show the physio display and are configured for every step of the exam Automatic display of images – automatic display of images in dedicated cardiac image orientations instead of the standard DICOM orientations. Adaptive triggering – acquisition adapts in realtime to heart rate variations for non-cine applications. Automated Naming – Automated naming of series depending on cardiac view and contrast. AutoVoiceCommands – AutoVoiceCommands are seamlessly integrated into the scanning workflow • System plays voice commands automatically at preferred time point • Assists user in providing the optimal timing of scanning, breathing and contrast media • User can monitor which breath-hold or pauses are actually played, and could add pauses between the automatic breath-hold commands 19.15 Cardiac Dot Engine – Customization Existing Dot Engines can be modified by the user to their individual standard of care. • Add/remove portocol steps • Changed guidance content (images and text) • Change Dot exam Strategies and Decision Points • Modify the Parameter View 19.16 Breast Dot Engine – optional license There are predefined Breast Dot Engines for lesion and implant evaluation, as well as biopsy procedures. Intelligent frequency handling helps ease implant imaging, individual frequency adjustment is made possible by the Breast Dot engine, allowing you to adapt your scans for different types of breast tissue, such as fatty or glandular tissue, unilateral small silicone or saline implants. Step-by-step guidance with images and text is integrated, and both images and text are easily configurable by the user. In case of biopsy, the Breast Dot Engine immediately dispays the calculated cooridnates at the Dot Display right at the MR scanner. This helps to reduce potential errors and helps to achieve faster results 86 syngo® MR Systems with DOTGo Technology | Turnover Workbook 19.17 Breast Dot Engine – Features Notes Faster planning Standardization Auto coverage • Performs automatic segmentation based on localizer data • Allows the estimation of the optimal field-of-view (FoV) entire FoV for both breast, right or left breast, breast with chest). • Predefine which parameters are automatically adjusted for every protocol Implant situation – Based on implant type identification scan • User can visually select or modify the exam dependent on the actual implant type and laterality. • System automatically modifies the scan queue accordingly and the frequency adjustment setting of the protocols is changed (assume dominate fat or silicone) Autocoverage: (Automatic segmentation, AutoFoV & AutoSlice) – Based on the localizer data an automatic segmentation is performed • Allows an estimation of the optimal FoV (entire FoV for both breasts, right or left breast, breast with chest) • User can predefine for every protocol individually which parameters shall be automatically adjusted, i.e., Time or slice thickness shall remain constant MPR Planning – User-selected protocols, e.g., the high resolution “delayed VIEWS” • Adjustable MPRs are automatically calculated Biopsy Support – Two Biopsy Engines are provided for supporting interventions with the 2/4 channel Sentinelle Breast and the 4 channel BI Breast coils • In case of a Siemens biopsy planning software is used, the target coordinates of the lesion are displayed on the Dot display at the scanner Single frequency adjust – The user can preselect to show the frequency adjustment dialogue only once for the exam queue • Preselection stays valid until a new coil combination or deviating z-position is used 19.18 Breast Dot Engine – Customization Existing Dot Engines can be modified by the user to their individual standard of care • Add/remove protocols steps • Change guidance content (images and text) • Change or add Dot Exam Strategies and Decision Points • Modify the Parameter View 87 syngo® MR Systems with DOTGo Technology | Turnover Workbook Appendix B: Image Text Information 88 B.1 Text Information in Medical Images Various information is shown as image text on medical images. This information is used to identify the patient and to document measurement and image parameters. The image text is sorted by topic and positioned in the four corners of the image. (6) Orientation label (1) <"Birthdate; Age> (3) a (4) < PATImage Type> (5) C Contrast/ Bolus Agent-Flow Duration <"Sequence Name/ Flip Angle> Image Comment Image Comment (2) (1) Patient and examination data (2) Comment lines (3) System-specific information (4) Examination and image parameters (5) Data regarding the MR image (6) Orientation mark (7) Scale bar B.1-1 Content of the image text components Content of the image text components Here is a list of the individual items of information in the image text components. (1) Patient and examination The top left corner shows the patient and examination data. data Text lines Other Patient IDs and Accession Number are suppressed when empty. All subsequent lines are moved upward. Image text Example Description Patient name Peter Patient Patient ID 02081948 Additional patient number 0123456789 Date of birth, age *11/11/1970; 30Y Accession number # 12345 Examination Number STUDY 1 Date acquired 17.10.01 Time acquired 13:47:46 Series and image number and total 2 IMA 5/7 Series 2, a total of 7 images in series 2, number of images image 5 is displayed B.1-2 Parameters & Image Text - B.1 Content of the image text components (2) Comment lines At the lower edge next to the measurement and image parameters, data regarding contrast agent administration as well as an image comment are provided. The second line of the image comment is optional. Image text Example Description Contrast medium/time after injection GADOLINIUM 1.1 1.1 s after administering in sec GADOLINIUM Image comment Motion: 0.27, -0.07, 1.29, -0.47, Motion correction parameter 0.11, -0.01 (3) System-specific The top right corner shows the name of your hospital or information practice, the system name, the software version as well as the patient position and direction of viewing. Image text Abbreviation Example Institution St. Mary´s, New York - System name MAGNETOM Verio - Software version MR B15V - Patient position (orientation HFS - Head First Supine and position) and viewing HFP - Head First Prone orientation HFDR - Head First Decubitus Right HFDL - Head First Decubitus Left FFS - Feet First Supine FFP - Feet First Prone FFDR - Feet First Decubitus Right FFDL - Feet First Decubitus Left Coordinate system LPH (patient coordinate system left-posterior-head) +LPH Referring physician Dr. Mustermann Phase encoding direction → The phase encoding direction displayed in the system-specific information only refers to the original series. It does not refer to reformatted images like MPR or MIP images. B.1-3 Content of the image text components (4) Examination and image In the bottom left corner you can see the parameters used to parameters generate the image. Image text Abbreviation Example Rate of compression CR (Compression Ratio) CR 100 Loss of quality through compression How much storage space is saved (bits) 100 means that: an image that is normally 512 KB, is now only 5.12 KB This applies to lossless compression as well. CQ (Compression Quality) Measure for loss on resolution CQ 75 100 = no loss, 0 =greatest loss on resolution CQ! Image is compressed, however, the numbers for CR or CQ CQ! are missing Either CR or CQ is shown. Current zoom factor MF MF 1.51 Trigger time TT in msec TT 50 Inversion time TI in msec TI 50 Repetition time TR in msec TR 600 Echo time TE in msec TE 30 Measurement duration * TA TA 02:36*4 concatenations HH:MM:SS (hours range); MM:SS (minutes range); SS:HS (seconds range) Pixel bandwidth BW in Hertz/pixels BW 1000.0 Image type → Page B.1-13 List of image types p(x) - Grappa with acceleration factor x P(x) - Sense with acceleration factor x p2 M/MIP Measurement options (1st line) RG - Respiratory Gating RG/CT CG - Cardiac Gating RT - Respiratory Trigger CT - Cardiac Trigger EXT - External Trigger Averages/measurement options A(y) - Number of averages A4/FS/SAT1/MT (2nd line) FS - fat saturation WS - Water saturation WE - Water excitation SAT (y) - Number of saturation regions DB - Dark blood IR - Inversion recovery SR - Saturation recovery G(x) - Grid tag with x mm grid distance or L (x) - Line tag with x mm line distance MT - MTC pulse PPF - Phase Partial Fourier B.1-4 Parameters & Image Text - B.1 Content of the image text components Image text Abbreviation Example Coil information → Page B.1-7 List of coil abbreviations in the image text NE1;SP1 Sequence name/flip angle A * in front of the sequence name means that an original *TS2_23 80 Siemens sequence was used. (5) Data about the MR The bottom right corner shows data regarding the position, image orientation, and thickness of the acquired slice, about the extent (FoV), as well as the window values. The text line Flow Encoding Direction is suppressed when empty. All subsequent lines are moved upward. Image text Abbreviation Example Sequence mask D - Door open D\I I - Interpolation R - Raw data filter E - Elliptical filter Table position (H,F) TP TP H300 H/F in mm Slice position (+LPH) SP in mm SP L8.7 Slice thickness SL in mm SL 4.0 Interpolated slice thickness SL i in mm SL 4.0 i FoV (field of view) FoV in mm FoV 230×230 Acquisition matrix interpolated I - Interpolation Acquisition matrix not interpolated p - partial Fourier 192p×256s s - swap 192p×256s Image orientation Sag, Tra, Cor Tra>Cor(-20)>Sag(-30) Flow-encoding direction v(XXX)_inplane_xy - in-plane flow encoding v150_inplane_fh v(XXX)_through - through-plane flow encoding XXX - flow velocity in cm/sec xy - direction, e.g., fh (feet to head) Window width (contrast) W W -100 Window center (brightness) C C -200 B.1-5 Content of the image text components Note that the image text only shows information on the first contrast of the measurement. Some sequences are able to measure more than one contrast. For these measurements, only information on the first contrast are available.q B.1-6 Parameters & Image Text - B.1 List of image types List of image types The image type is shown in the lower left image text. Orientation label < Other Patient IDs> *Software Version> *"Birthdate;Age> < Accession Number> a < Trigger Time> *Inversion Time> *Sequence Mask>

< Slice Thickness> PAT Image Type> Contrast' Bolus Agent-Flow Duration swindow width > *"Sequence Name/ Flip Angle> Image Comment Image Comment An image may include more than one image type, e.g., after several post-processing steps. These are appended to one another and separated by a forward slash. If the maximum line length is exceeded, the last image types are omitted. Example Assuming the defined maximum length is 18 characters: From TYP1/TYP2/TYP3/TYP4 (19 characters) will be truncated to TYP1/TYP2/TYP3 (14 characters). B.1-13 List of image types Abbreviation Image type Topic 3D EDITOR Image resulting from 3D editor processing 3D reconstruction 3D FUSION Fusion image 3D reconstruction ADC Apparent Diffusion Coefficient Map Diffusion, Perfusion ADD Image resulting from an addition Dynamic Analysis AVERAGE VRT image 3D reconstruction BLACK IMAGE Graphic image 3D reconstruction BLACK IMAGE Graphics and table image Mean Curve COMB Combination image Diffusion, Perfusion COMPOSED Composed Images Image Composing COR Correlation image Functional imaging Dynamic Analysis CVxx Filtered Images Dynamic Analysis (xx stands for filter strength, integer value) DIFFER Differentiation image Dynamic Analysis DIFFUS Diffusion image Dynamic Analysis DIS2D 2D distortion corrected image Inline post-processing DIS2D* 2D distortion-corrected image. Cannot be used as a Inline post-processing reference image for positioning, because measurement is too far off-center. DIS3D 3D_distortion-corrected image Inline post-processing DIV Division image Dynamic Analysis E1 Diffusion image that shows the weighting of the Diffusion eigenvector E1 E1-E2 Diffusion image that shows the weighting of the Diffusion eigenvector ratio E1-E2 E1-E3 Diffusion image that shows the weighting of the Diffusion eigenvector ratio E1-E3 E2 Diffusion image that shows the weighting of the Diffusion eigenvector E2 E2-E3 Diffusion image that shows the weighting of the Diffusion eigenvector ratio E2-E3 E3 Diffusion image that shows the weighting of the Diffusion eigenvector E3 EXP Exponential Map Diffusion FA Fractional Anisotropy Map Diffusion FIL Inline Image Filter Inline post-processing B.1-14 Parameters & Image Text - B.1 List of image types Abbreviation Image type Topic FILTERED BOLD or perfusion image with spatial filtering Inline post-processing FSx_Y, FSHx_y, FMx_y, Offline Image Filter Dynamic Analysis FS, FSH or FM GBP Global time-density curve (Global Average Bolus Diffusion, Perfusion Curve Plotted; passage of bolus) GSP Reference image with graphic objects Graphic slice position INT Integration image Dynamic Analysis LIN Barycentric Map, category "Linear" Diffusion LOG Logarithmic function image Dynamic Analysis LOW_B Image with low diffusion weighting Diffusion M Rephased image (magnitude image) Flow quantification MAG Magnitude image Phase contrast Angio MEAN Mean value image Functional imaging Dynamic Analysis MIP Maximum Intensity Projection image 3D reconstruction Inline post-processing MIP THIN MIP Thin image 3D reconstruction MIP_COR Coronary image from MIP reconstruction Inline post-processing MIP_SAG Sagittal image from MIP reconstruction Inline post-processing MIP_TRA Transverse image from MIP reconstruction Inline post-processing MITP Maximum Intensity Time Projection image Diffusion, Perfusion MOCO BOLD or perfusion image with motion correction Inline post-processing MOSAIC Mosaic image Functional imaging MPR Multiplanar reconstruction image (MPR) 3D reconstruction MPR CURVED Curved MPR image 3D reconstruction MPR THICK MPR Thick image 3D reconstruction MPR THIN MPR Thin image 3D reconstruction MSUM Sum image from magnitude images of a slice Phase contrast Angio MULT Multiplication image Dynamic Analysis ND non-distortion corrected image Inline post-processing NORM Image after normalization algorithm Inline post-processing OTHER Converted N3/3.5 image or SC (secondary captured) Import/Export image P Phase contrast image Flow quantification B.1-15 List of image types Abbreviation Image type Topic PBP Percentage signal image (Percent-of-Baseline at Diffusion, Perfusion Peak; bolus peak relative to baseline). PDT1 T1-weighted proton density image Dynamic Analysis PDT2 T2-weighted proton density image Dynamic Analysis PEI Positive Enhancement Integral image Diffusion, Perfusion PLAN Barycentric Map, category "Planar" Diffusion POSDISP Position display image Position display PROJECTION IMAGE Projection image Inline post-processing R Real image Flow quantification RA Relative Anisotropy Map (relative FA) Diffusion RELCBF Relative CBF image (relat. cerebr. blood flow) Diffusion RELCBV Relative CBV image (relat. cerebr. blood volume) Diffusion RELMTT Relative MTT image (relat. average transit time) Diffusion, Perfusion RESAMPLED Zooming/panning image 3D reconstruction RETRO Retro-Gating image Inline post-processing SCM Signal Change image Diffusion, Perfusion SDEV Standard deviation image Dynamic Analysis SLOPE SLOPE evaluation result Dynamic Analysis sMRI Structural MRI (Anatomy) Diffusion SPEC Spectrum Spectroscopy SPHER Barycentric Map, category "Spherical" Diffusion SSD SSD reconstruction (Shaded Surface Display) 3D reconstruction STDDEV_COR Coronal standard deviation image Inline post-processing STDDEV_SAG Sagittal standard deviation image Inline post-processing STDDEV_TRA Transverse standard deviation image Inline post-processing SUB Subtraction image Dynamic Analysis SUBTRACT Subtraction image 3D reconstruction T1 T1 image Dynamic Analysis T2 T2 image Dynamic Analysis TCS Time Course of Signal Diffusion, Perfusion TG Tensor graphic Diffusion TMIP Temporal MIP, MIP reconstruction of time sequence Inline post-processing of images B.1-16 Parameters & Image Text - B.1 List of image types Abbreviation Image type Topic TMIP_COR Coronal TMIP image Inline post-processing TMIP_SAG Sagittal TMIP image Inline post-processing TMIP_TRA Transverse TMIP image Inline post-processing TRACE Trace weighted image Diffusion TSTDDEV Temporary standard deviation image Inline post-processing TTEST Student's t-test image (for BOLD images) Functional imaging Dynamic Analysis TTP Time To Peak image Diffusion, Perfusion TU The protocol parameters were automatically General changed by a tool (e. g. AutoAlign Spine) TU M Protocol parameters were automatically changed by General a tool (e. g. AutoAlign Spine) and then one more time manually. VR Volume Ratio Map Diffusion VRT VRT (Volume Rendering Technique) image 3D reconstruction WI Wash In image Diffusion, Perfusion WO Wash Out image Diffusion, Perfusion B.1-17 syngo® MR Systems with DOTGo Technology | Turnover Workbook Appendix C: MRI Acronyms 100 Vendor MRI Acronyms Siemens GE Philips Hitachi Toshiba Sequence Type Spin Echo SE SE SE SE SE Gradient Echo GRE GRE Fast Field Echo (FFE) GE Field Echo Spoiled Gradient Echo FLASH SPGR T1-FFE RF Spoiled SARGE, RSSG FastFE Coherent Gradient Echo FISP GRASS SSFP Rephased SARGE FFE Steady-State Free Precession PSIF SSFP T2-FFE Time-Reversed SARGE True FISP TrueFISP FIESTA True SSFP Balanced FFE Balanced SARGE, BASG True FISP/Dual Excitation CISS FIESTA-C Phase Balanced SARGE, PBSG – – Double Echo Steady State DESS – – – – Multi-Echo Data Image Combination MEDIC MERGE M-FFE – – Ultrafast Gradient Echo TurboFLASH Fast GRE, Fast SPGR TFE RGE Fast FE Ultrafast Gradient Echo 3D MPRAGE 3D FGRE, 3D Fast SPGR 3D TFE MPRAGE 3D Fast FE Volume Interpolated GRE VIBE LAVA-XV THRIVE TIGRE Body Diffusion REVEAL DWIBS Body Vision Susceptibility-Weighted Imaging SWI (SWAN) (Venous BOLD) – Dynamic MRA with k-space Manipulation TWIST TRICKS-XV Keyhole (4D-TRAK) – High-Resolution Bilateral Breast Imaging VIEWS VIBRANT-XV BLISS RADIANCE Non-contrast MR Angio, TSE-based NATIVE-SPACE TRANCE VASC FSE FBI, CIA – Non-contrast MR Angio, TrueFISP-based NATIVE-TrueFISP Inhance Inflow IR B-TRANCE VASC ASL Time-SLIP Parametric Mapping MapIT CartiGram – – Inversion Recovery IR,Turbo IR (TIR) IR, MPIR, FastIR IR-TSE IR IR Short Tau IR STIR STIR STIR FastSTIR STIR Long Tau IR Turbo Dark Fluid FLAIR FLAIR FLAIR FastFLAIR True IR True IR Real IR FastIR – – Turbo Spin Echo/Fast Spin Echo TSE (Turbo Spin Echo) FSE (Fast Spin Echo) TSE (Turbo Spin Echo) FSE (Fast Spin Echo) FSE (Fast Spin Echo) Single-Shot TSE/FSE HASTE Single-Shot FSE Single-Shot TSE Single-Shot FSE FASE FSE/TSE with 90° Flip-Back Pulse RESTORE Fast Recovery FSE (FRFSE) Driven Equillibrium FSE T2 Puls FSE DRIVE Hyper Echoes Hyperecho – – – – 3D TSE with Variable Flip Angle SPACE CUBE VISTA – – Number of Echoes Turbo Factor Echo Train Length (ETL) Turbo Factor Shot Factor Echo Train Length (ETL) Time Between Echoes Echo Spacing Echo Spacing Echo Spacing Echo Spacing Interecho Time (ITE) Echo Planar Imaging (EPI) EPI EPI EPI EPI EPI Number of Echoes EPI Factor ETL EPI Factor Shot Factor Echo Train Length (ETL) Diffusion-Weighted Imaging DWI DWI DWI DWI DWI Apparent Diffusion Coefficient Map ADC ADC ADC ADC Map ADC Diffusion Tensor Imaging DTI Diffusion Tensor Imaging Diffusion Tensor Imaging DTI – DTI Tractography (Fiber Tracking) DTI Tractography FiberTrak FiberTrak – – Turbo Gradient Spin Echo (GRASE) TurboGSE, TGSE GRASE Hybrid EPI – – Motion Correction 1D Navigators for Cardiac Imaging 1D PACE Navigators 2D Navigators for Abdominal Imaging 2D PACE Navigators – – – 3D Prospective Motion Correction for fMRI 3D PACE – – – – 3D Retrospective Motion Correction for fMRI 3D ART – – Motion Correction with Radial Blades BLADE PROPELLER MultiVane RADAR JET Soft Tissue Motion Correction BRACE 2 Vendor MRI Acronyms Siemens GE Philips Hitachi Toshiba Sequence Type Spin Echo SE SE SE SE SE GRE GRE Gradient Echo Fast Field Echo (FFE) GE Field Echo Spoiled Gradient Echo FLASH SPGR T1-FFE RF Spoiled SARGE, RSSG FastFE Coherent Gradient Echo FISP GRASS FFE Rephased SARGE SSFP Steady-State Free Precession PSIF SSFP T2-FFE Time-Reversed SARGE True FISP TrueFISP FIESTA Balanced FFE Balanced SARGE, BASG True SSFP True FISP/Dual Excitation CISS FIESTA-C Phase Balanced SARGE, PBSG – – Double Echo Steady State DESS – – – – Multi-Echo Data Image Combination MEDIC MERGE M-FFE – – Fast GRE, Fast SPGR TurboFLASH Ultrafast Gradient Echo TFE RGE Fast FE Ultrafast Gradient Echo 3D MPRAGE 3D FGRE, 3D Fast SPGR 3D TFE MPRAGE 3D Fast FE Volume Interpolated GRE VIBE LAVA-XV THRIVE TIGRE Body Diffusion REVEAL DWIBS Body Vision Susceptibility-Weighted Imaging SWI (SWAN) (Venous BOLD) – Dynamic MRA with k-space Manipulation TWIST TRICKS-XV Keyhole (4D-TRAK) – VIBRANT-XV VIEWS High-Resolution Bilateral Breast Imaging BLISS RADIANCE Non-contrast MR Angio, TSE-based NATIVE-SPACE TRANCE VASC FSE FBI, CIA – Non-contrast MR Angio, TrueFISP-based NATIVE-TrueFISP Inhance Inflow IR B-TRANCE VASC ASL Time-SLIP CartiGram Parametric Mapping MapIT – – Inversion Recovery IR,Turbo IR (TIR) IR, MPIR, FastIR IR-TSE IR IR Short Tau IR STIR STIR STIR STIR FastSTIR Long Tau IR Turbo Dark Fluid FLAIR FLAIR FLAIR FastFLAIR True IR True IR Real IR FastIR – – Turbo Spin Echo/Fast Spin Echo TSE (Turbo Spin Echo) FSE (Fast Spin Echo) TSE (Turbo Spin Echo) FSE (Fast Spin Echo) FSE (Fast Spin Echo) Single-Shot TSE/FSE HASTE Single-Shot FSE Single-Shot TSE Single-Shot FSE FASE FSE/TSE with 90° Flip-Back Pulse RESTORE Fast Recovery FSE (FRFSE) DRIVE Driven Equillibrium FSE T2 Puls FSE Hyperecho Hyper Echoes – – – – 3D TSE with Variable Flip Angle SPACE CUBE VISTA – – Number of Echoes Turbo Factor Echo Train Length (ETL) Turbo Factor Shot Factor Echo Train Length (ETL) Time Between Echoes Echo Spacing Echo Spacing Echo Spacing Interecho Time (ITE) Echo Spacing Echo Planar Imaging (EPI) EPI EPI EPI EPI EPI EPI Factor ETL Number of Echoes EPI Factor Shot Factor Echo Train Length (ETL) Diffusion-Weighted Imaging DWI DWI DWI DWI DWI Apparent Diffusion Coefficient Map ADC ADC ADC ADC Map ADC Diffusion Tensor Imaging DTI Diffusion Tensor Imaging Diffusion Tensor Imaging DTI – DTI Tractography (Fiber Tracking) DTI Tractography FiberTrak FiberTrak – – Turbo Gradient Spin Echo (GRASE) TurboGSE, TGSE GRASE Hybrid EPI – – Motion Correction 1D Navigators for Cardiac Imaging 1D PACE Navigators 2D Navigators for Abdominal Imaging 2D PACE Navigators – – – 3D PACE 3D Prospective Motion Correction for fMRI – – – – 3D Retrospective Motion Correction for fMRI 3D ART – – Motion Correction with Radial Blades BLADE PROPELLER MultiVane RADAR JET BRACE Soft Tissue Motion Correction 3 Vendor MRI Acronyms Siemens GE Philips Hitachi Toshiba Parallel Acquisition Techniques iPAT PAT: Image-based Algorithm mSENSE ASSET RAPID SENSE SPEEDER PAT: k-space-based Algorithm GRAPPA ARC – – – Integrated Calibration Auto-Calibration Self-Calibration (with ARC) – – – Separate Calibration Turbo-Calibration (Calibration for ASSET) (Calibration for SPEEDER) (Calibration for RAPID) (Calibration for SENSE) / CLEAR Multiple datasets calibrate each other Self-Calibration, T-PAT – – – – Spectroscopy Prostate Spectroscopy 3D CSI PROSE – – Breast Spectroscopy GRACE BREASE – – – Comprehensive Cardiac Tool BEAT (2D/3D) – – – – Patient Orientation Sequence Localizer, Scout Localizer Locator Plan Scan Scanogram Contrast Bolus Timing/Visualization CARE Bolus Smart Prep; FluoroTriggered MRA BolusTrak FLUTE Visual Prep Sequence Parameters Repetition Time, Echo Time (in msec) TR, TE TR, TE TR, TE TR, TE Inversion Time (in msec) TI TI TI TI TI Averages Average NEX NSA NSA NSA Simultaneous Excitation Simultaneous Excitation POMP (Phase Offset Multiplanar) QuadScan Dual Slice Multi-Slice RF Pulse in Gradient Echo Flip Angle Flip Angle Flip Angle Flip Angle Flip Angle Scan Measurement Time Acquisition Time, TA Acquisition Time Acquisition Time Acquisition Time Scan Time Distance Between Slices Distance Factor (% of slice thickness) Gap Gap Slice Interval Gap Shifting Slices Off Center Off-center Shift Off-center FoV Off-center FoV Off-center FoV Phase & Frequency Shift Field of View (FoV) FoV [mm] FoV [cm] FoV [mm] FoV FoV Rectangular FoV FoV Phase/Rectangular FoV Partial FoV (PFoV) Rectangular FoV Rectangular FoV Rectangular FoV Bandwidth Bandwidth [Hz/Px] Receive Bandwidth [kHz] Fat/Water Shift [pixel] Bandwidth Bandwidth Variable Bandwidth Optimized bandwidth Variable Bandwidth Optimized Bandwidth Variable Bandwidth Matched Bandwidth Frequency Oversampling Oversampling Anti-Aliasing Frequency Oversampling Frequency Oversampling Frequency Wrap Suppression Phase Oversampling Phase Oversampling No Phase Wrap Fold-over Suppression Anti-Wrap Phase Wrap Suppression Segmented k-Space Lines/Segments Views per segment Segments Views/Segment Time Delay/Block k-space Time Delay Intersegment Delay TD TD Half Fourier Imaging Half Fourier 1/2 NEX; fractional NEX Half Scan Half Scan AFI Partial Echo Asymmetric Echo Partial Echo Matched Bandwidth Half Echo Partial Echo Gradient Moment Nulling GMR/Flow Comp Flow Comp Flow Comp; Flag GR FC Ramped RF Pulse TONE Ramped Pulse TONE ISCE SSP Magnetization Transfer Contrast MTC; MTS MTC SORS-STC MTC MTC Prep Pulse – Chemically Fat Sat Fat Sat/Chem Sat SPIR Fat Sat MSOFT Water Excitation Water Excitation PASTA Proset Water Excitation – Fat-Water separation DIXON IDEAL FatSep – Prep Pulse - Spatially Presat SAT REST Pre Sat Pre Sat Moving Sat Pulse Travel Sat; Tracking Sat Walking Sat BFAST Sequential Pre Sat Travel REST Scan Synchronization with ECG ECG Triggered Cardiac Gated/Triggering ECG Triggered/VCG ECG Triggered Cardiac Gated Delay after R-Wave Trigger Delay; TD Trigger Delay; TD Delay Time Trigger Delay; TD Trigger Delay; TD Respiratory Gating Respiratory Gated Respiratory Comp Trigger; PEAR MAR Respiratory Gated Multi-Channel RF Coil Sensitivity Normalization Prescan Normalize PURE NATURAL CLEAR – Central k-space Filling Arterial Visualization Elliptical Scanning Elliptic Centric PEAKS DRKS CENTRA Competition product descriptions, comparison, and specifications contained in this document are based on interpretation of available data at the time this material was being prepared and may require independent verification. Specifications have been obtained from competition brochures, websites, and other independent published sources. 4 Vendor MRI Acronyms Siemens GE Philips Hitachi Toshiba Parallel Acquisition Techniques iPAT PAT: Image-based Algorithm mSENSE ASSET SENSE RAPID SPEEDER ARC GRAPPA PAT: k-space-based Algorithm – – – Integrated Calibration Auto-Calibration Self-Calibration (with ARC) – – – Separate Calibration Turbo-Calibration (Calibration for ASSET) (Calibration for SENSE) / CLEAR (Calibration for RAPID) (Calibration for SPEEDER) Multiple datasets calibrate each other Self-Calibration, T-PAT – – – – Spectroscopy Prostate Spectroscopy 3D CSI PROSE – – Breast Spectroscopy GRACE BREASE – – – Comprehensive Cardiac Tool BEAT (2D/3D) – – – – Patient Orientation Sequence Localizer, Scout Localizer Plan Scan Scanogram Locator Smart Prep; FluoroTriggered MRA Contrast Bolus Timing/Visualization CARE Bolus BolusTrak FLUTE Visual Prep Sequence Parameters Repetition Time, Echo Time (in msec) TR, TE TR, TE TR, TE TR, TE Inversion Time (in msec) TI TI TI TI TI Averages Average NEX NSA NSA NSA Simultaneous Excitation Simultaneous Excitation POMP (Phase Offset Multiplanar) Multi-Slice Dual Slice QuadScan Flip Angle RF Pulse in Gradient Echo Flip Angle Flip Angle Flip Angle Flip Angle Scan Measurement Time Acquisition Time, TA Acquisition Time Acquisition Time Scan Time Acquisition Time Gap Distance Between Slices Distance Factor (% of slice thickness) Gap Slice Interval Gap Shifting Slices Off Center Off-center Shift Off-center FoV Off-center FoV Off-center FoV Phase & Frequency Shift Field of View (FoV) FoV [mm] FoV [cm] FoV [mm] FoV FoV FoV Phase/Rectangular FoV Rectangular FoV Partial FoV (PFoV) Rectangular FoV Rectangular FoV Rectangular FoV Bandwidth Bandwidth [Hz/Px] Receive Bandwidth [kHz] Fat/Water Shift [pixel] Bandwidth Bandwidth Variable Bandwidth Optimized bandwidth Variable Bandwidth Optimized Bandwidth Variable Bandwidth Matched Bandwidth Anti-Aliasing Frequency Oversampling Oversampling Frequency Oversampling Frequency Oversampling Frequency Wrap Suppression Phase Oversampling Phase Oversampling No Phase Wrap Fold-over Suppression Anti-Wrap Phase Wrap Suppression Views per segment Segmented k-Space Lines/Segments Views/Segment Segments Time Delay/Block k-space Time Delay Intersegment Delay TD TD Half Fourier Imaging Half Fourier 1/2 NEX; fractional NEX Half Scan Half Scan AFI Partial Echo Asymmetric Echo Partial Echo Partial Echo Half Echo Matched Bandwidth Gradient Moment Nulling GMR/Flow Comp Flow Comp Flow Comp; Flag GR FC Ramped RF Pulse TONE Ramped Pulse TONE SSP ISCE MTC; MTS MTC Magnetization Transfer Contrast MTC MTC SORS-STC Prep Pulse – Chemically Fat Sat Fat Sat/Chem Sat SPIR Fat Sat MSOFT Water Excitation Water Excitation Proset Water Excitation PASTA – Fat-Water separation DIXON IDEAL FatSep – Prep Pulse - Spatially Presat SAT REST Pre Sat Pre Sat Walking Sat Moving Sat Pulse Travel Sat; Tracking Sat Travel REST Sequential Pre Sat BFAST Scan Synchronization with ECG ECG Triggered Cardiac Gated/Triggering ECG Triggered/VCG ECG Triggered Cardiac Gated Delay after R-Wave Trigger Delay; TD Trigger Delay; TD Trigger Delay; TD Delay Time Trigger Delay; TD Respiratory Comp Respiratory Gated Respiratory Gating Trigger; PEAR MAR Respiratory Gated Multi-Channel RF Coil Sensitivity Normalization Prescan Normalize PURE CLEAR NATURAL – Central k-space Filling Arterial Visualization Elliptical Scanning Elliptic Centric CENTRA PEAKS DRKS 5 syngo® MR Systems with DOTGo Technology | Turnover Workbook Appendix D: Sequences and Abbreviations 105 ci CISS (Constructive Interference in spcR NATIVE SPACE Steady State) csi Chemical shift imaging svs Single voxel spectroscopy de DESS (Dual Echo Steady State) swi Susceptibility-weighted imaging epfid EPI-FID tfi TrueFISP (trufi) epir EPI spin echo with inversion recovery tfi NATIVE TrueFISP epse EPI spin echo tfl TurboFLASH fi FISP (Fast Imaging with Steady State), tgir Turbo gradient spin echo with gradient echo sequence without RF inversion recovery spoiling fid Free induction decay tgse Turbo gradient spin echo fl FLASH (Fast Low Angle Shot), gradient tir Turbo spin echo with inversion echo sequence with active RF spoiling recovery h HASTE (Half Fourier Single Shot tirB Turbo spin echo with inversion TurboSE) recovery and BLADE trajectory hir HASTE with inversion recovery tirBR Turbo spin echo with inversion recovery, BLADE trajectory and “restore pulse” ir Spin Echo with inversion recovery tirR Turbo spin echo with inversion recovery and “restore pulse” me MEDIC (Multi Echo Data Image tse Turbo Spin Echo Combination) ps PSIF (time-reversed FISP) tseB Turbo spin echo with BLADE trajectory resolve RESOLVE (Readout Segmentation Of tseBR Turbo spin echo with BLADE Long Variable Echo trains), multi-shot, trajectory and “restore pulse” diffusion-weighted EPI se Spin Echo tseR Turbo spin echo with “restore pulse” spc SPACE (Sampling Perfection with Application-optimized Contrast using different flip angle Evolutions) syngo® MR Systems with DOTGo Technology | Turnover Workbook Appendix E: Bandwith Conversion Chart Siemens to GE 107 syngo® MR Systems with DOTGo Technology | Turnover Workbook Bandwidth Conversion Chart: Siemens to GE Siemens Bandwidth [Hz/pixel] 50 55 60 65 70 75 80 85 90 95 GE Bandwidth (256 Acquisition Matrix) [+/- kHz] 6.4 7.04 7.68 8.32 8.96 9.6 10.24 10.88 11.52 12.16 GE Bandwidth (512 Acquisition Matrix) [+/- kHz] 12.8 14.08 15.36 16.64 17.92 19.2 20.48 21.76 23.04 24.32 Siemens Bandwidth [Hz/pixel] 100 110 120 130 140 150 160 170 180 190 GE Bandwidth (256 Acquisition Matrix) [+/- kHz] 12.8 14.08 15.36 16.64 17.92 19.2 20.48 21.76 23.04 24.32 GE Bandwidth (512 Acquisition Matrix) [+/- kHz] 25.6 28.16 30.72 33.28 35.84 38.4 40.96 43.52 46.08 48.64 Siemens Bandwidth [Hz/pixel] 200 250 300 350 400 450 500 600 750 1000 GE Bandwidth (256 Acquisition Matrix) [+ / - kHz] 25.6 32 38.4 44.8 51.2 57.6 64 76.8 96 128 GE Bandwidth (512 Acquisition Matrix) [+ / - kHz] 51.2 64 76.8 89.6 102.4 115.2 128 153.6 192 256 Competitive information provided is based on interpretation of available data and may require independent verification. SIEMENS medical 108 syngo® MR Systems with DOT | Turnover Workbook Notes 109 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 Local Contact Information and options as well as standard and optional Siemens Medical Solutions USA, Inc. features which do not always have to be 51 Valley Stream Parkway present in individual cases. Malvern, PA 19355-1406 Siemens reserves the right to modify the USA design, packaging, specifications and options Telephone: +1-888-826-9702 described herein without prior notice. Please www.usa.siemens.com/healthcare contact your local Siemens sales representative for the most current information. Global Business Unit Note: Any technical data contained in this Siemens AG document may vary within defined tolerances. Medical Solutions Original images always lose a certain amount Imaging & Therapy Systems of detail when reproduced. Magnetic Resonance Henkestr. 127 DE-91052 Erlangen Order No. A914CX-CS-15596-P1-4A00 Germany Printed in USA 01-2015 | All rights reserved Telephone: +49 9191 18-0 © 2015 Siemens Medical Solutions USA, Inc. www.siemens.com/healthcare Global Siemens Headquarters Global Siemens Healthcare Siemens AG Headquarters Wittelsbacherplatz 2 Siemens AG 80333 Muenchen Healthcare Sector Germany Henkestrasse 127 91052 Erlangen Germany Telephone: +49 9131 84-0 www.siemens.com/healthcare www.siemens.com/healthcare