syngo.via - CT Liver Analysis

syngo.via® CT Liver Analysis syngo.via CT Liver Analysis supports diagnostic evaluation of the liver, its lobes, and its intrahepatic vessel struc-tures. It helps to identify the vascular territories of sub-vessel systems and enables volumetric measurements of the complete liver, liver segments, and tumors. This is especially helpful in the pre-surgical planning of liver donors and oncological resections. 1. From the Patient Worklist, load an appropriate data set into the CT Liver Analysis 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 Liver Analy- sis 2. Phase Selection - up to six different phase volumes are automatically assigned to different segments based on DICOM header information: • Liver (LIV) – venous phase or most contrasted se- ries • Tumor (TUM) – arterial or venous, depending on tumor type • Portal Vein/Portal Venous (PV) • Hepatic Vein (HV) • Hepatic Artery (HA) • Bile Ducts (BD) or Magnetic Resonance (MR) • Move or add series from the series navigator by man- ually dragging and dropping with the left mouse but- ton (LMB) into the desired segment. Note that the same series can be allocated to multiple segments. Phase Selection • Click the Finalize Phase Selection icon to confirm phase selection and automatically begin pre-processing. Finalize 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: 06/23/2017 | HOOD05162002613075 Job Aid | syngo.via CT Liver Analysis Effective Date: 06/23/2017 | HOOD05162002613075 3. Phase Registration corrects for phases that do not overlap properly. It allows for a man- Phase Registration ual rigid alignment of different O LIV. TUM, PV, HV on HA CT phase volumes to the refer- LIV. TUM, PV, HV on BD ence liver CT phase in the LIV segment. Select the desired Register Reset Phases phases in the Case Navigator. Shift or rotate the overlying data set to ensure the anatomy is aligned. 4. In the Liver Segmentation step, verify the results of the automatic liver segmentation. Liver Segmentation H Freehand Nudge Accept Discard Reset HD_BisOucts Anonymous Hostpzal HD_BisOucts de3879-358 Edit "1/1/1954, F. 58Y SOMATOM Deintion Flash de3879d358 "1/1/1954, F. 58Y Edit Leber ven 3/2 1301 3 synga CT 20128 Leber ven 3/2 13Of 3 9/28/2012 1:34:00 AM 3/08/2012 1:34:00 AM 275 Save -4 00 cm (67) 2.00 cm (07 0:00 cm 180 200 em 92) 400 cm (107) Manually HD_BileDucts Anonymous Hospital de36794358 "1/1/1954. F. 5BY SCMATOM Definden De Leber ven 32 001 3 9/23/2012 1:34:00 AM F A L • If necessary, manually optimize the liver segmentation/contour using the 2D or 3D correction icons, as corrections might be useful in axial, coronal, or sagittal views. Note: 3D editing enables corrections to the volume (current slice and neighboring slices), while 2D editing provides fine tun- ing of the current slice contour only. 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: 06/23/2017 | HOOD05162002613075 Page 2 of 5 Job Aid | syngo.via CT Liver Analysis Effective Date: 06/23/2017 | HOOD05162002613075 5. The Lesion Segmentation step is optional, and only active if a CT phase was assigned to the Tumor (TUM) segment. Draw a Lesion Segmentation OH straight line across the lesion and the semi-automatic seg- mentation algorithm starts. Contours can be modified using Reset the tools in the mini toolbar and the results are sent to the Segment Lesion Findings Navigator. AS_Liver3Phases_AEF RSNA2013AS_Uver3 Onco + AEF + Liver Analysis Gold AS_Liver3Phases_AEF "1/24/1 936, F. 69Y RSNA2013AS_Liver3 Once + AEF + Liver Analysis Go "1/24/1936, F. 69Y Arterial Phase 2.0 B30fVIA on ART Arterial Phase 2.0 B30f VIA on ART F F W.400 A terielle Phase 6. In the Vessel Segmentation, you can semi-automatically segment up to four vascular anatomies based on the CT phases previously defined for the HV, PV, HA, and/or BD segments. The Vena Cava can also be segmented semi-automatically. From the Case Navigator, select the vascular anatomy you wish to segment first. • Using the provided graphic as a guide, click in the desired anatomy. Vascular segments can be added, removed, split, or otherwise modified using the tools provided. Vessel Segmentation HV PV . HV. PV . HA O BD Cut Off Value 3071 HU Vessel Marker 1024 3071 Default Details Edit Prepare Finish V. Reset Vessel V. Cava Cava 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: 06/23/2017 | HOOD05162002613075 Page 3 of 5 Job Aid | syngo.via CT Liver Analysis Effective Date: 06/23/2017 | HOOD05162002613075 7. In the Vascular Territories step, vascular anatomy is further classified into territories based on the prior vessel segmentation. Select each segmented vessel and label the vascular tree in the MPR or VRT. Labels are displayed in the mini toolbar, each with its own color. Vascular Territories . HV O PV vol in ml Mark Calculate Reset 613 Regions 531 751 H08 H09 H10 H11 112 H13 H14 H13 MH RH Int.H H05 H06 H07 A 8. The Virtual Planning step allows for a virtual resection of the liver to help simulate surgical planning. There are three default proposals, or alternate proposals can be defined by drawing a contour in the MPR or VRT segments. • Using the Object Navigator, you can show or hide the volume of all segmented structures to display relationships between anatomies. • The report and results series are saved and archived by completing the workflow with the Save and Send button Presets Virtual Planning Proposal 1 Proposal 2 . Proposal 3 Vascular Structures PV Draw Plane Wedge HV Surface Plain Planning PV Territories Modify Smooth Reset HV Territories Lesions Safety Margin 20 mm Unclassified Benign Malignant Surface Part 1 Exclude Vessel from Total Liver Volume: > 15 mm Part 2 Image Data HA, Lesion BD 0 .............................. 30 PV, Liver, HV 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: 06/23/2017 | HOOD05162002613075 Page 4 of 5 Job Aid | syngo.via CT Liver Analysis Effective Date: 06/23/2017 | HOOD05162002613075 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 ŶOperator Manualŷ) 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 ŶFunctionalityŷ) 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: 06/23/2017 | HOOD05162002613075 Page 5 of 5