syngo.via - CT Dual Energy Liver VNC

syngo.via® CT Dual Energy Liver VNC The syngo.via CT Dual Energy Liver VNC application class allows for the visualization of the contrast agent concentration in the liver without an additional non-contrast scan. It generates virtual non-contrast (VNC) images by subtracting iodine from the Dual Energy data sets. The basis for this approach is the decomposi- tion of the liver into its component parts: iodine contrast agent, fat, and liver tissue. 1. From the Patient Worklist, load an appropriate data set into the CT Dual Energy Workflow: • If the examination has been correctly mapped, double click to load • If manual mapping is required, right-click the examination and select Open With > CT Dual Energy • When data is loaded into syngo.CT Dual Energy, relevant application classes are also loaded as configured. Se- Body Bone Removal V lect the Liver VNC application class Liver VNC V Resolution 2. The Liver VNC application class provides the following im- 2 age types depending on the selected layout: Maximum [HU] 3071 Default lodine Ratio 3.01 2 • Mixed images Calculate • Virtual non-contrast images Fat Map • Iodine overlay images Fused images Monoenergetic Plus V • • Fat Map Hard Plaques 3. The Dual Energy Mixing Ratio mini tool bar slider allows for the adjustment of the composition of the fused images. Move the slider to the left to display more CT image data with the colored overlay (io- dine enhancement) removed. This is a DE virtual non-contrast (VNC) image of the contrast-enhanced source images. 200 [HU] 200 [HU] 200 [HU] Mixing Ratio Overlay CT xing Rat Overlay CT Mixing Ratio overlay 100% 0% 50% 50% 0% 100% 0 (HU] (HU] SIEMENS Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Healthineers Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 5/1/2017| HOOD05162002591623 Job Aid | syngo.via CT Dual Energy Liver VNC Effective Date: 5/1/2017| HOOD05162002591623 4. In the Liver VNC workflow step, the calculated parameters of the loaded data can be changed, if de- sired: • Change the Resolution filed to adapt the range of the smooth- Resolution ing filter Maximum [HU] 3071 • Low resolution values are better for spatial resolution lodine Ratio 3.01 • High resolution values are better for low contrast reso- lution • Enter a threshold in the Maximum [HU] field to remove all voxels in mixed images that are above this value. • Enter a value in the Iodine Ratio field to change the ratio of contrast and enhancement to low en- ergy and high energy. • Click the Calculate icon to apply the new value(s) to all images, or click the Default Parameters icon to restore the default values that are predefined in the Configuration Panel. Calculate Default The Fat Map can be viewed by selecting the Fat Map icon on the Liver VNC workflow step. Fat Map can be used for both contrasted and non-contrasted CT scans. Default settings display water and liver with > 30% fat content in grey, and a DE ROI will display the Fat Fraction. 30% 9% Fat Map 10 % 30 % SIEMENS Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Healthineers Job Aid Effective Date: 5/1/2017| HOOD05162002591623 Page 2 of 4 Job Aid | syngo.via CT Dual Energy Liver VNC Effective Date: 5/1/2017| HOOD05162002591623 5. Elliptical or Freehand ROIs (Region of Interest) can be drawn to obtain additional quantitative infor- mation about the Dual Energy data set. Displayed ROI parameters – including iodine density and Fat Fraction - can be configured via the Dual Energy ROI Properties. Distance Line Dual Energy ROI Circle Dual Energy ROI Circle Properties Send To Context Menu Pixel Lens Marker - IT Dual Energy ROI Properties X Arrow Angle Display the following evaluations: [4] App: VNC/ CM/ Mixed 0.4 Mean [HU] Text T Mean: 66.7/ 84.1/ 151.5 HU Stddev: 10.8/ 18.9/ 19.5 HU Stddev [HU] Area: 2.8 cm2 Min [HU] lodine Density: 3.8 mg/ml / ??? Max [HU] Fat Fraction: -6.6 % v Area [cm2] lodine Density [mg/ml] / Rel. Enhancement [%] Fat Fraction [%] Display the following volumes: VNC LOW KV CM High KV Mixed OK Cancel Defaults SIEMENS Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Healthineers Job Aid Effective Date: 5/1/2017| HOOD05162002591623 Page 3 of 4 Job Aid | syngo.via CT Dual Energy Liver VNC Effective Date: 5/1/2017| HOOD05162002591623 Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright © Siemens Healthcare GmbH 2020 Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84-0 siemens-healthineers.com SIEMENS Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Healthineers Job Aid Effective Date: 5/1/2017| HOOD05162002591623 Page 4 of 4