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Tissue 4D (MR) Post-processing - Eline Job Aid

This Job Aid will provides Tissue 4D Postprocessing workflow instructions using the Tissue 4D (MR) Task Card for syngo MR Systems with DotGO Technology.

Tissue 4D (MR) Post-processing Eline Job Aid Tissue 4D (MR) Postprocessing – Eline Job Aid This Job Aid will provide Tissue 4D Postprocessing workflow instructions using the Tissue 4D (MR) Task Card for syngo MR Systems with DotGO Technology. Evaluation of Dynamic 3D datasets with Tissue 4D Tissue 4D facilitates the detection of tumors in organs such as the liver and the prostate.  syngo Task Card used for viewing and analysis of dynamic contrast-enhance MRI (DCE)  Standardized quantitative analysis by pharmacokinetic modeling  Create parameter maps as color-coded images  Exchange of contrast agents between blood and tissue is described by the following parameters: o Ktrans – parameter related to vessel permeability and tissue blood flow. (Transfer constant) o Ve – marker for cell density (extra-vascular extra-cellular volume fraction) o Kep – reflux constant  Protocol Requirements o FLASH 3D Sequence (FLASH, VIBE, TWIST,etc) for data acquisition o 3D Acquisition – Minimum of 8 slices required o Optional  Native T1-map required – If conversion of signal intensities into GD concentration values is needed.  T1 Maps are Calculated from Non-contrast Multi-Flip Angle Scans – preferably using a single measurement from the same sequence used for dynamics (Minimum 2 Flip Angles = 2° and 15°). Image Data needed for Tissue 4D  Dynamic Series – acquired with Fixed Flip Angle  Pre-Contrast Series with Variable Flip Angle (i.e., 2° and 15) – for T1 map calculation  Corresponding Morphological Images (recommended) Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 08/07/2020 | HOOD05162003109820 Healthineers Job Aid | Tissue 4D (MR) Postprocessing – Eline Effective Date: 08/07/2020 | HOOD05162003109820 1. Open Patient Browser a. Select Patient Prostate Study Folder > Tissue 4D Icon Tissue 40 Patient Browser Patient Applications Transfer Edit View Filter Evaluation Sort Options Help THEEye FE ?? MR Tissue4D_3 MR_Tissue4D_4 Local Database MR_Tissue4D_Es_Prosta Prostata Diagnosti 1] localizer_Becken R/com/ 1/17 / Scheduler Neuro_ASL & cePerfusion [2] trufi [email protected] Ricom/11171 b. Tissue 4D Task Card i. T1 or Morphologic Data – loaded Upper Left Segment ii. Dynamic Data – loaded Upper Right Segment Patient Applications Data Movie Tools View Display System Options Help JR_Tissue4D_Es_Prostate AF Institut für Mikrotherapie R_Tissue4D_Es_Prostate AF Institut für Mikrotherapie 1/01/1952, M, 056Y MR Tissue4D_Es SIEMENS /01/1952, M. 056Y SIEMENS syngo MR B15 syngo MR B15 Exam TUDY 1 FFS TUDY1 FFS 3/09/2008 /09/2008 3:21:01 -07-01 IMA 28 IMA 12 Viewing 1. Motion Correction 10 10 cm Filming SP-10,9 SL 3.6 SP-10.9 FOV 260-250 SL 3.0 Tras Cor(16.5) FoV 200*200 Vol 1/36 66.60.0 Tra>Cor(16.5) 192-192 107.0 LE:2d1 211 Morphology Images W 1236 W 902 C 626 Dynamic Images C.398 3D 2. 2. Registration 3. Curve Calculation 4. Pre Evaluation 5. Evaluation 6. Results Tissue 4D 7. Export Tools | View |Displ ... Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 08/07/2020 | HOOD05162003109820 Healthineers Page 2 of 9 Job Aid | Tissue 4D (MR) Postprocessing – Eline Effective Date: 08/07/2020 | HOOD05162003109820 MR_Tissue4D_Es. 2. Motion Correction Tab a. Select Dynamic Series (Upper Right) i. Select Play/Stop icon – places Dynamic CINE in movie  Checks for Motion Run CINE of Dynamic Data > Play CINE – opti- + 1 mal way to check changes K K b. Select Register Dynamic Series Icon 1. Motion Correction i. Note: Tissue 4D can only handle minor changes in-plane motion ii. Note: If registration poor, parameter maps from analysis will not be optimal c. Check Registration by Playing CINE again (Optional) 3. Registration Tab a. PreContrast Data > select Register Data Icon i. Blending Slider – to visually evaluate Registration Quality of pre-contrast data with selected dynamic volume b. Morphological Mode > select Register Data Icon 1. Motion Correction 2. Registration Morphological Morphological PreContrast Blending: 50 % Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 08/07/2020 | HOOD05162003109820 Healthineers Page 3 of 9 Job Aid | Tissue 4D (MR) Postprocessing – Eline Effective Date: 08/07/2020 | HOOD05162003109820 1. Motion Correction 4. Curve Calculation Tab 2. Registration a. ROI Selection i. Maximum of 4 ROIs Selections per image – repre- 3. Curve Calculation senting different regions ROI Selection: ROI 1 b. Drawing > ROI Selections (e.g., Draw Contour [Free hand], Draw Ellipse or Draw Rectangle) Drawing i. Select Draw Ellipse (ROIs)  ROI1 – ability to draw Multiple ROI’s under 4 ROI’s selections listed. Delete All: Plotting a. Individual ROI’s drawn can be “Ed- ited” or “Deleted” b. Each ROI Selection – assigned a dif- ferent ROI color ii. Note: Parametric Maps are calculated only for ROI active in dropdown menu. Pre-evaluation step an additional ROI can be specified. c. Select Plot Curves Icon – plots signal enhancement curves i. Calculation results for all defined ROIs are displayed in lower left segment. Curves are shown as relative enhancement curves, first volume services as reference ii. Note: Time-points with corrupted images (motion/other artifacts) are ex- cluded from evaluation using buttons next to time-slider Rel Erhancement 2.5 Roll Roi2 Rni3 2 1.5- 0.5- Time [mir] Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 08/07/2020 | HOOD05162003109820 Healthineers Page 4 of 9 Job Aid | Tissue 4D (MR) Postprocessing – Eline Effective Date: 08/07/2020 | HOOD05162003109820 5. Pre-Evaluation Tab – T1 Map Calculation runs automatically. 1. Motion Correction Once the T2 map has been calculated, pre-contrast data is re- 2. Registration placed. 3. Curve Calculation a. Noise Level (Default 20) – masks out noise b. MR Protocol 4. Pre Evaluation i. Select MR Sequence (Default T1+ Dynamic) Noise Level 20 ii. Note: If No multi-Flip Angle Sequence was ac- quired for MR Protocol then select Dynamic 3D MR Protocol T1 and (Estimates T1) c. Contrast – select Contrast Agent used i. Molarity – defaults to data entered Contrast Ag. Magney ii. Relaxivity – defaults to data entered Molarity 0.50 iii. Enter Volume – contrast in “ml” mmol/ml ............... d. VOI Relaxivity 4.30 Ummol/'s i. Select Create VOI Icon Volume 18.00 ii. Draw an Ellipse VOI around Organ (or) around ml a Sub-volume Upper Right Segment Enclosing VOI Lesion iii. Ellipse is extended to form an ellipsoid in 3D Structure WS AF Imaging Science Instrute Ch. MUR AMB 01/01/1945. M. CE3Y Avanto #51 68875 ST JOY 5168875 Eyngc MR B15 FFS 13/10/2008 13:20:09 37 IMA 9 SIICE Rciz Roi3 5 cm SP56 EL 36 -OV 26U"260 Tra>Ccr(18.2) 11 93.2 Vol 22 : 74 TR 5.2 M>: 256*256 IEZ.0 VT 308 *ilcyn3c1 15.0 Dynamic C 220 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 08/07/2020 | HOOD05162003109820 Healthineers Page 5 of 9 Job Aid | Tissue 4D (MR) Postprocessing – Eline Effective Date: 08/07/2020 | HOOD05162003109820 6. Evaluation Tab 1. Motion Correction a. Selection 2. Registration i. Select “ROI 1, 2, 3, or 4” or “VOI” from drop down 3. Curve Calculation b. Model (Default Tofts) i. Select Pharmacokinetic model to be applied from 4. Pre Evaluation selection list 5. Evaluation ii. Note: Currently two-compartment Tofts model is provided Selection ROI 1 c. AIF Model – provides applicable information about Concen- Model Tofts tration of Contrast Enhancing Media in Blood Plasma Model AIF Fast i. Fast – recommended for sequences with quick tem- poral resolution (e.g., TWIST) Contrast Arrival Time: ii. Intermediate – recommended for sequences with moderate temporal resolution 0.00 mil iii. Slow – recommended for sequences with lower tem- poral resolution (e.g., FLASH, GRE) iv. Note: AIF is modeled as Fast, Intermediate, or Slow depending on Bolus Injection (or) Organ examined. When in doubt select one with Minimum Chi^2. d. Select Set Arrival Time Icon i. Checks Value and Onsite Time of Enhancement in Contrast Arrival Time Field ii. Set Contrast Arrival Time – move “Red Line” (Yellow Arrow in image) separates Baseline from Contrast Start 12 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 08/07/2020 | HOOD05162003109820 Healthineers Page 6 of 9 Job Aid | Tissue 4D (MR) Postprocessing – Eline Effective Date: 08/07/2020 | HOOD05162003109820 e. Select Mean Curve Modeling Icon i. Curve Fit is Good, then AIF model selection is Correct ii. Note: if Curve Fit poor then return to “Curve Calculation Tab” and redraw ROIs Concentration 'mnol!l] 0.55 Model. Tu'ls AIF: Fast Koll Roi' ri : 0.5 KL ans. 0. 185503 VA. 0 35513 Chi2: 0.C941055 0.45 0.4 0.35 0.3 7 0.25 0.2 0 15 U.1 0.05 Timo [mir] f. Select Voxelwise Modeling Icon – generates parametric maps (Optional) 7. Results Tab 1. Motion Correction a. ROI Selection– Select an existing ROI from dropdown 2. Registration b. Drawing Select Copy ROI Icon – copies ROI from 3. Curve Calculation i. 2nd segment to Parameter Image in 3rd copy 4. Pre Evaluation segment 5. Evaluation ii. Note: Define New ROIs – select Drawing > Draw 6. Results Contour, Draw Ellipse, Draw Rectangle if additional ROI Selection: ROIs needed (Optional) ROL 1 c. Analysis Drawing i. Select Calculate and Show Statistics  Calculates statistical data of pa- rameter values inside ROI Delete All: Copy: ii. Note: Histogram is displayed in 3rd segment copy copy Analysis: Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 08/07/2020 | HOOD05162003109820 Healthineers Page 7 of 9 Job Aid | Tissue 4D (MR) Postprocessing – Eline Effective Date: 08/07/2020 | HOOD05162003109820 8. Export Tab a. Save Pixel Results to a File Icon 1. Motion Correction 2. Registration b. Save Curve to a File Icon 3. Curve Calculation 4. Pre Evaluation c. Save Parametric Map Icon 5. Evaluation i. Note: only saves active map 6. Results 7. Export d. Select Save As Icon – Saves maps and images to Patient Browser e. Copy to Film Sheet Icon 9. Adjust Color of Maps a. Display Tab i. Select Auto Icon – sets colors for parametric maps automatically auto b. Select Display Properties Icon Tools i. Opens a New Window to be able to select Color View Displ .. Map and Set Parameter Range auto 10. Close Tissue 4D Task Card a. Applications > Close Tissue 4D (MR) Patient Applications Data Movie MR_TISSU Tissue 4D (MR) 01/01/1952 Argus BreVis STUDY1 03/09/2008 BOLD 13:21:01 3 IMA 28 Composing Manipulate Mean Curve Perfusion (MR) Spectroscopy Neuro 3D (MR) Close Tissue 4D (MR) R Vessel View Desktop Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 08/07/2020 | HOOD05162003109820 Healthineers Page 8 of 9 Job Aid | Tissue 4D (MR) Postprocessing – Eline Effective Date: 08/07/2020 | HOOD05162003109820 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 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 08/07/2020 | HOOD05162003109820 Healthineers Page 9 of 9