syngo.via MR BreVis Workflow (VA30)

syngo.via MR BreVis Workflow (VA30) 1. Functions of MR BreVis workflow:  Advanced breast reading up to 4 time points  Automatic subtraction and motion correction  Display of color overlay maps and volume statistics  Time curve evaluation 2. MR BreVis Workflow: a. Open the patient using “assign workflow” or “view as read-only with “ BreVis workflow o Open the study only when the workflow state is ready to read MM Das Last Name *breast* Date of Birth MM Basic Compare Study Date and Ti ... Study Description Al MM Onco + CT Bone MM Onco + CT Vascular Workflow State Workflow Description Patient Name Date of Birth Modality MM Oncology Study Description Referi AZZAll> MM Reading breast_cho 7/28/1984 MR, SE mMR General spectroscopy"breast_1H MR_breast A Tumor 1/1/1960 MR MR Abdomen Breast Imaging MR Bre MR Angio MultiStation SEIN IPC^DR ALAEDDINE MR Bre Open MR Angio SingleStation breast^lesion evaluation MR_Bre View as Read-Only MR Angio TimCT breast"Breast Dot Engine MR_Bre View as Read-Only with MR Angio TWIST Breast^Sentinelle_8ch 8 ch. MR_Bre MR Basic (Re-)Assign Workflow Template. Breast^Sentinelle_8ch MR Breast Group and Assign Workflow Template ... MR BreVis Cancel Workflow for Manual Reassignment MR Cardiac Analysis Cancel Procedure MR C-Spine MR Head Prevent Archiving MR Hip MR Knee Delete MR L-Spine Protect from deletion MR Neuro 3D Remove deletion protection MR Neuro Perfusion MR Neuro Tumor MR_Breast_Ae_Carcinoma MR Onco Brain Data MR Onco Liver Instance Number ^ Image Type Instance Creation Date ... Archiving Stat ... MR Onco Multi-Region MR Onco TimCT SOUS 5, 88, MR SOUS 4, 88, MR MR Prostate SOUS 3, 88, MR MR Shoulder SOUS 2, 88, MR MR Spectro SOUS 1, 88, MR MR Tissue4D DI SAG T1 EG 3D TARDIF. 112. MR MR TMJ DICOM MR T-Spine i MR Whole Spine  Note: Additional functions in the BreVis workflow: o Automatic subtraction o Color parameter maps (WI/WO, Curve type, TTP and PEI) o Statistics and suspect location of the VOI SIEMENS www.usa.siemens.com/healthcare 820 Effective Date: 09/06/2016 Page 1 of 11 b. Overview of BreVis user interface MR BreVis Ad-Hoc function, can add Spectro task MR BreVis Reading Preset Select Siemens default preset or Toggle between motion user specific preset corrected and non-motion >> Show/hide color overlays corrected images > Settings Show/hide settings Compare with previous study Follow-Up AutoCollect Automatically add Dynamic and MPR viewing step < Dynamic + MPR measurements to findings navigator Dynamic + DWI Dynamic and subtraction step < 3x3 Dynamic + Sub Dynamic and DWI viewing step Remaining Images O c. Dynamic and MPR processing step  This step allows tumor measurements (to nipple, to chest wall, to skin), color parameter maps and statistic values of the tumor MR BreVis MR_Breast_de_Carcinoma Imagenio MR_Breast_Ae_Carcinoma Imagerie Paris Centre. 3A4751. *601/1954. F. 56Y MR BreVis Reading 007 CURRENT "6/1/1954, F. 56Y Aera MR D11 OIMA M. ERMM Preset CURRENT HFP AXT1 EG 3D DYNA 18S . 5NV HR .LPH latestPhase_02 -- > Current DYN1 p2 TR 5.4 10cm STUDY TE 26 . Settings 7 IMA 44 MPR :_MINDINORMFMFIL SP HB Follow-Up AutoCollect R H Dynamic + MPR MR_Breast_Ae_Carcinoma Imagerie MR Breast_Ae_Carcinoma Imagenio "6/151954, F. 56Y *601/1954. F. 56Y Dynamic + DWI TR 5. TP 0 CURRENT CURRENT TE 2.6 SP H7.3 9 IMA n.a. FRM n.a. 9 IMA. n.a. FRM n.a. 3x3 Dynamic + Sub TA 01:31 SL 1.5 BW 385.0 FOV 360*360 R Remaining Images O p3 MINDINORWFMFIL 426 448s A1/SFS Tra 7BL:7BRAXL'AXR Zoom 1.05 0cm 10cm 454 TR 5.4 "1301 /10 Dynamic segment 223 TE 2.6 A MPR: . MIND NORMUFME MPR segment OFIL SP A29.9 MR Breast Ae_Carcinoma Imagerie Paris Centre. 344751. Ratio % 007 "6/1/1954. F. 56Y era SMRVA30A Findings Navigator CURRENT HFP Sub_P1_AXT1 EG 3D DYNA 1SS.5IHR 400 Nartie Value Source latestPhase_03 -- > Current SUB1 p3 STUDY IDY 9/1 0/2010 300 200 TR 5.4 TE 2.6 DIE BW 385.0 TP O MIP : ... MINDINORMEMFIL SP H7.3 100 A1/SFS 426 448$ 7BL;7BRAXL'AXR Tra "1301 /10 2:53 PM Subtracted MIP segment Curve and statistic view Dynamic and MPR layout SIEMENS www.usa.siemens.com/healthcare Page 2 of 11 d. Dynamic and DWI processing step  This step allows tumor measurements (to nipple, to chest wall, to skin), color maps and statistic values of the tumor. Additionally, there is the DWI /T2W information and evaluate the ADC value. MR BreVis MR_Breast_Ac_Carcinoma Imagerie Paris Centre. 3A4751 MR Breast Ae Carcinoma Imagerie Paris Centre. 3A4751 MR BreVis Reading 007 007 "6/1/1954. F. 56Y Agra MR DI1 *6/1/1 954, F. 56Y Apra SMRVA30A CURRENT HFP CURRENT HEP Preset . MOCO AX TI EG 3D DYNA ISS.5MV HR Sub_P1_MOCO AXTI EG 3D DYNA ISS+5MV HR latestPhase_01 latestPhase 03 ->> CurrentMOCO_DYN1.pt -- > Current SUB1_MOCO p3 F1 STUDY ID 1 STUDY ID 1. Settings 6 INA 44 9 IMA 1 FRM 44 Calculation Mode Wash-in/Wash-out FI Averaging 0 mm DIE DIE Noise Reduction 179 AU TR 5.4 TP O TR 5.4 TP O Edge Smoothing TE 2.6 P HT.3 TE 2.6 SP H7.3 0 mm Delayed SL 1.51 TA 01:31 SL 1.51 BWV 385.0 FoV 360-360 BW 385.0 FoV 380*360 p3 MOCO NORMFMFIL 160% 426 4485 L/SUBMOCO NORMFMFIL 426+4485 AT/SES 70% Tra AL/SFS Tra 7BL,7BRAXLAXR Zoom 1.07 Follow-Up 1000 7BL,7BRAXLAXR AutoCollect "1301 /10 Dynamic segment 500 "1301 /10 Subtracted segment 200 Dynamic + MPR Dynamic + DWI 3x3 Dynamic + Sub MR Breast Ae Carcinoma Imagene Paris Centre 344751. MR Breast Ae Carcinoma Imagerie Paris Centre 344751. 6/1/1954. F. 56Y 6/171954. F. 56Y CURRENT CURRENT Aera 3 IMA 45 MR D11 IR D11 HEP 2 IMA 15 HEP .LPH +LPH R R TI 1700 Findings Navigator TR 9000.0 TR 4430.0 TE 115.0 TE 64.0 Value Source p2 DIFFITRACEWIND DWI segment SP H5.6 p2 MINDINORMIFWFIL T2W segment 0.26 cm2 Breast $1 Snapshot Reader MR_Breast Ae_Carcinoma Imagerie Paris Centre 3A4751 *8/1/1954, F. 56Y CURRENT 400 4 IMA 15 R D11 HFP +LPH 300 R 200 TR 9000.0 TE 115.0 100 3:18 PM p2 DIFFIADCIND ADC segment SP H5.6 Curve and statistic view Dynamic, DWI and morphology image viewing layout SIEMENS www.usa.siemens.com/healthcare Page 3 of 11 e. 3 x 3 Dynamic and Sub-processing step  This step allows tumor measurements (to nipple, to chest wall, to skin), color parameter maps and statistic values of the tumor. Additionally, viewing of the dynamic and subtracted images are easily viewable in a single layout. MR BreVis MR Breast Ae Carcinoma Imagerie Paris Centre MR_Breast_Ae_Carcinoma Imagerie Paris Centre MR Breast Ae Carcinoma Imagerie Paris Centre 3. *6/1/1954, F. 56Y +6/1/1 954. F. 56Y *6/1/1 954. F. 56Y CURRENT CURRENT Multi 1 Asta CURRENT Aera Preset . MOCO_AXT1 EG 30 DYNA 1SS. 5IV HR MOCO_AXT1 EG 3D DYNA 155 -510 AR MOCO_AX TI EG 3D DYNA 155. 5IV HR STUDY-ID 1 STUDY ID 1 STUDY,ID1 9/1 0/2010 9/10/2010 9010/2010 6 IMA 45 8 IMÁ 45 - Settings Calculation Mode Wash-in/Wash-out Averaging 0 mm TR 5.4 FOV 360-360 FOV 360 360 426-448$ TR 5. FoV 360-360 TE 2.6 426-448% TR 5.4 26.448s TE 2.6 TALE Tra Tra TE 2.6 Noise Reduction 79 AU TA DI :31 TA 01:31 0 mm Dynamic phase 1 Dynamic phase 2 p3 M Edge Smoothing Dynamic phase 3 MR Breast_Ae_Carcinoma Imagerie Paris Centre MR Breast Ae Carcinoma Imagerie Paris Centre. MR_Breast_Ae. Carcinoma Imagerie Paris Centre. 3. "@/151954, F. 56Y 8/1/1954. F. 56Y Follow-Up AutoCollect CURRENT Aera 6/1/1 954. F. 56Y CURRENT CURRENT MOCO_AX.I.1 EG 30 DYNA 155.5IV HR Sub_P1_MOCO_AXT1 EG 30 DYNA 15S.51HR Sub_PI_MOCO_AXTI EG 3D DYNA 185.50 HR Dynamic + MPR STUDY ID STUDY ID 1 STUDY ID 1 11 INA45 8 IMA I FRM 45 9 1MA I FRM 45 Dynamic + DWI 3x3 Dynamic + Sub Remaining Images SP H3.8 SL 1 51 FOV 360 360 426.448¢ TR 5:4 FOV 360.360 TR 5.4 FOV 360-360 TE 2.6 426 448s Tra TE 2.6 Tra TE 2.6 426.4485 TA 01:31 TA 01:31 Tra 282 Dynamic phase 6 U/SUBN Sub phase 1 140 LASUBA Sub phase 2 140 Findings Navigator Value Source MR Breast Ae Carcinoma Imagerie Paris Centre MR Breast Ae Carcinoma Imagerie Paris Centre 0.26 cm2 Breast O *6/151954, F. 56Y hera 6/1/1954. F. 56Y CURRENT CURRENT 51 Snapshot Resder Sub_P1_MOCO_AXT1 EG 3D DYNA 188+5M HR AX STIR 400 STUDYID 1 STUDY ID:1 12 1MAS FRM 45 2 IMA 16 300 SP H3 2 200 TI 170.0 SL 4.0/0.8 TR 5.4 FOV 3601360 426*4488 TR 4430.0 FOV 400-400 TE 2.6 314.4488 100 TA 01:31 Tra TE 64.0 282 TA 01:50% LISUBR Sub phase 5 :26 140 T2W image Curve and statistic view 18 PM Dynamic and subtracted image viewing step f. Motion correction MR BreVis MR_Breast_Ae_Carcinoma Imagerie Paris Centre.3A4751. MR BreVis Reading 007 "6/1/1954. F. 56Y era MR D11 Preset " CURRENT HFP AXT1 EG 3D DYNA:ISS+ 5IV HR Original images STUDY ID 1 >se Motion correction 7 IMA 44 Follow-Up AutoCollect R Dynamic + MPR Min/ Max 375/00/453:00 TR 5.4 Mean/SO. 418.56/17.18 DIE Dynamic + DWI TP O TE 2.6 Area: 0 26 cm2 SP H7.3 3x3 Dynamic + Sub O TA 01:31 SL 1.51 BW 385.0 FoV 360-360 Remaining Images p3 M/ND/NORM/FM/FIL 426 448S A1/SFS Tra 7BL-7BRAXL;AXR Zoom 1.05 454 *1301 / 10 223  The toggle motion correction button permits switching between the motion corrected and uncorrected images SIEMENS www.usa.siemens.com/healthcare Page 4 of 11 MR BreVis A MR Breast Ae Carcinoma Imagerie Paris Centre.3A4751 MR BreVis Reading 007 "6/1/1954, F. 56Y Aera MR D11 CURRENT HFP Preset MOCO_AXTI EG 3D DYNA 1SS+5IV HR Tatestphase 11 MoCo images STUDY ID 1 Setti Motion correction 7 IMA 44 Follow-Up AutoCollect R Dynamic + MPR Dynamic + DWI TR 5. DE TE 2.6 TP O SP H7.3 3×3 Dynamic + Sub TA 01:31 BW 385.0 Min / Max 356.00 /479,00 SL 1,51 Remaining Images O p3 MOCO/NORM/FM/FIL Mean/SD: 414.24 /21.10 FoV 360*360 426*448s A1/SFS Area: 0.37 cm2 Tra 7BL:7BR AXL AXR *113d1 /10 774 418 MoCo: elastic 3d  Motion correction icon is indentation, the segment will load MoCo dynamic images g. Display color parameter maps MR BreVis A MR_Breast_Ae_Carcinoma Imagerie Paris Centre. 3A4751 MR BreVis Reading 007 *6/1/1954. F. 56Y Aera CURRENT MR D11 HFP Preset " MOCO_AXT1 EG 3D DYNA 1SS+5IV HR latestPhase_02 Current MOCO_DYN1 p2 STUDY ID 1 Settings 7 IMA ~41 Calculation Mode Wash-in/Wash-out R 1 cm Averaging 0 mm IF Noise Reduction 103 AU Edge Smoothing 0 mm TR 5.4 TE 2.6 Delayed. SP H2.8 160% SL 0.8 MPR THICK: ... ORMFMIFIL 70% SPC 0.8 Initial A1/SFS -10% 10% Tra Follow-Up AutoCollect *11301 /10 Phases: 1, 3, 6 1000 MoCo: elastic 3d Dynamic + MPR  Selecting the show/hide color overlay feature displays the color map on the dynamic image h. Color parameter maps setting Four calculation modes: 1. Wash-in/Wash-out - Settings 2. Curve Type Calculation Mode Wath-in/Wath-out 3. Enhancement Rate Averages signal 4. PEI intensities of images Averaging 0 mm used for color overlay Noise Reduction Reduces noise in color overlay 103 AL & VOI statistics Edge Smoothing 0 mm Removes small isolated colored Save the preset areas from color overlays for color maps Reference time points t1, 12 and t3 limit initial and delayed Curve settings phase SIEMENS www.usa.siemens.com/healthcare Page 5 of 11 MR BreVis MR BreVis Reading Preset " Color map calculation modes: 1. Wash-in/Wash-out: visualization of wash-in/wash-out - Settings based on predetermined time points Calculation Mode Wash-in/Wash-out 2. Curve Type: visualization of wash-in/wash-out based on Wash-in Wash-qual predetermined time points, but with different coloring than Averaging Curve Type wash-in/wash-out calculation mode Noise Reduction Enhancement Rate PEI 3. Enhancement Rate: calculates the wash-in behavior from Edge Smoothing 01 mm the initial phase t1 to t2 4. PEI: calculates the area under the enhancement curve over all time points Click to set the time point Reference Time Points ? × Setting the reference time points to calculate maps: WI= ti to t2 WO= 12 to t3 Enhancement rate is the WI from t1 to t2 PEI is the area under the curve from tl to t3 11 12 Start of Initial Phase (t1) Select the latest pre-contrast phase as t1 (default is phase 1) Phase 1 Start of Delayed Phase (12) Select the first post-contrast phase as t2 (phase 2 is default setting) End of Delayed Phase (13) Select the last post-contrast phase to be evaluated as t3 Latest Phase OK Cancel Setting the phase by the curve of ROI in breast Draw a ROI on the tumor T1 T3 or vessel in T2 the breast Shift the T2 to the peak Calculation mode and time point settings SIEMENS www.usa.siemens.com/healthcare Page 6 of 11 Preset Configuration MR BreVis Preset MR BreVis Reading Preset * User can create their own setting and select it from the - Settings preset drop down. Calculation Mode Wash-in/Wash-out Averaging Wash-in/Wash-out Curve Type + Noise Reduction Enhancement Rate PEI Edge Smoothing 0 mn OK Cancel Time Curve Settings ? X Display curves with signal intensity or enhancement values Curve Display Enhancement Scale intensity/enhancement axis manually or automatically Axis Scaling Manual Display values at one or all time Curve Values Active Curve curves Show/hide standard deviation for- Show ROI Standard Deviation ROIs OK Cancel Delayed 160% Press the left mouse and move to change the 70% WI threshold of color maps. Initial -10%10% Press the left mouse and move to change the Phases used to Phases: 1, 3, 6 WO threshold of color calculate the color maps. maps SIEMENS www.usa.siemens.com/healthcare Page 7 of 11 i. Color overlay maps |MR_Breast_he_Carcinoma imagerie Paris Centre. 344751. MR_Breast_Ae_Carcinoma Imagerie Paris Centre.344751. *8/1/1954, F. 56Y MRD11| 154. F. 56Y CURRENT R D11 CURRENT MOCO ANTI EO 3D DYNA ISS-WMVHR MOCO AX TI EG 3D DYNA 188 5IHR Current MOGO DYN1:p2 STUDY 01 STUDY ID 1 7 IMA-41 IR ticm SP H2.8 | TR 5.4 SP HZ 0 160% SL 0.8 TE 26 160% SLOB MPRT IRWTWFIL 70% SPC 0.0 IMPR THICK: ORHFMFIL 70% EPC 0.8 Initial AL/SES -105 10% Tra AL/SES -10% 10% 1381110 Phases: 1, 3, 6 Phases: 1, 3, 6 MoCo: elastic 3d Wash- in/Wash-out Curve type | MR_Breast_Ae_Carcinoma imagerie Paris Centre.344751 Ne Carcinoma 007 Innaperig Paris Centre 344751. 1997 DI1 CURRENT HEP MOCO ANTI EO 3D DYNA 189+5IHR CO AXT1 WOCOLDYNI OF ' Current dict #1 F1 STUDYID41 STUDY |TR 5.4 SP H TR 5.4 SPH21 TE 76 1607 SLOB TE 26 SL 0.8 MPR THICK; ORNEMFIL SPC 0.8 IMPR THICK: _ORDEMFIL SPC08 Initial AUISES Phases: 1,3 AUSES 100 50044 min Tra Phases: 1. 6 982 MoCo: elasac 3d MoCo: elastic 3d Enhancement rate PEI j. Statistic and suspect location of the VOI Distance Line Imagerie Fans Gonbe 344751 MR Breast Ae Carcinoma Pull Lena HR HOCO AX TI EO 3D DYNA 188+5VHR Marker Anow STUDYIDT STUDYID 1 Angle Vol Freshand VAT Thin VOI Freshand Min P Thin 2 vol Sphere MP EP H7 TR 5.4 TE.26 MR Segmentation SLOO MPR THICK ORMFMELL 70% 5 MPR Thek .3. 6 5:00 Phase 13. 0 20 SIEMENS www.usa.siemens.com/healthcare Page 8 of 11 MR BreVis - MR BreVis Reading TE 18 . Setting Follow-Up Ed Dynamic + Sub Remaining Imagen F Display the suspect location: 3 4 1. Switch the dynamic segment from 2D mode to MPR. Findingn Navigater 2. Draw a sphere VOI on the area of interest. 3. View the statistics of the VOI. 4. Right mouse click on the VOI and select "Show most suspect 152% location and its time curve*to view the curve of the VOI 234% 2 100 % k. Create findings MR BreVis MH Breant_As_Carcinoma 6.10 cm Right mouse click on the M measurement and select "Create OCO DINIET Breast Finding" to -- STUDY EN Delete Measurement add a finding. Copy Mewdurement Create Break Finding Create Buonvic Finding When using "Auto Bring to Current Sace Collect" all Go To End Point Sice TR &4 DelFy measurements will be Go To Start Pont Sior saved as basic Folow Up AutoColect MAR THICK: ORMEMEL findings which cannot be added to the breast Dynamic + DWi pictogram. Remaining Images SIEMENS www.usa.siemens.com/healthcare Page 9 of 11 Findings Navigator >Findings details Name Value Source Multi 0.26 ¢ ... Breast MR Different type findings will distribute to ¥ S1 Snapshot Reader different part of report V D4 2.02 4m MR B. MR Findings Details Findings details MR Brevis Breast Findings Baile Fladings Amodated Findingi Procedure Breast Finding: Assessment and Location Enhancement and Morphology Shape Letion Type Muito Enhancement Laberaity Enhancement Distno. Mod Quadrant internal Enhancement Clock fice Two o clock poutio Symmetry [] 5,10 Hineoc Curve Delayed Distance to Hippie [xml Awewert Category Pathology Comment Snapshots Cancel The breastfindings are used to graphically visualize the location of the tumor along with any descriptions or assessments Findings details MR Brevis Breast Findings Associated Findings Procedure Finding [4 Region Finding Ste pathology ng Brventy Pathology Comment Snapshots Apply Cancel The basicfindings allows for limited descriptions of the lesion SIEMENS www.usa.siemens.com/healthcare Page 10 of 11 Findings details MR Bravis Benaid Findings Baile Findings Associated Findings Procedure Assessment Nipple Retraction Edema Nipple invision Lymphadenopathy Pre-Contrast High Ductal Signal Pectorain Muscle imarion Skin Retraction Chest Wa Invasion Skin Thickening (dinurie) Hematoma Skin Thickening (roca0) Abnormal Signal Void Skin Invasion Enhancing inbemnal Septacion None Apply Background Enhancement OK Appy Cancel Associated findings can be filled in by the clinician and be found in the report. Breast Findings Barille Findings Janociated Findings Procedure Procedures Procedure Description Frit Signal Mode Procedure Step Flow Compensation Protocol Name Contrast Agent quence Nome Fov Head [mm] Orientation Foy Phase [%] Resolution Matrix Echo Time [msec] Subtraction Flip Angle 13epl Acquisition Time Sice Cop [%] Repetition Time [msec] Fat Suppression Sice Thickness [mm] Water Suppression Number of Suces OK APPY' Cancel The procedure shows information provided by the PhoenixZIP file. SIEMENS www.usa.siemens.com/healthcare Page 11 of 11