AI-Rad Companion - Lung Workflow

Lung Workflow Job Aid AI-Rad Companion This document introduces the workflow steps with the Lung Lesions and Lung Parenchyma in AI-Rad Companion. It also describes results generated by Pulmonary Density Assessment. 1. Lung Lesions extension 1. After activating the Lung Lesions extension, you can see all findings in the list of results below the 3D image segment. By selecting one of them, the corresponding image of each lesion will be shown in the 2D image segment. The 3D segment shows you all lesions with their respective label. Lesion Lobe Max. 2D Max. 3D Volume State 9 [mm] 9 [mm] [mm3] L1 Left Lower 8.7 9.7 166.2 Accepted v L2 Right Lower 6.1 6.3 60.2 Accepted L3 Left Upper 6.1 6.2 54.3 Accepted v L4 Left Lower 6.1 6.1 47.7 Accepted v Tumor Burden 27.0 2. The table shows following parameters: • Labels of the lesion • Lobe containing the lesion • Maximum diameter in 2D, 3D and the volume of the lesion • State of the lesion (Accepted/Declined) • Tumor burden, displaying the sum of all max 2D diameters Unrestricted Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 SIEMENS Job Aid Effective Date: 05 AUG 2020 | HOOD05162003115909 Healthineers Job Aid | Lung workflow Effective Date: 05 AUG 2020 | HOOD05162003115909 3. Select each lesion in the list of results and scroll through the 2D images to see the lesion. The 2D segment displays a short series of axial images of each lesion. 2: 6.1 mm 4. Decide for each lesion individually to accept, decline or remeasure it. Select each lesion in the list of results and under the 2D segment, choose the button corresponding to your decision. Preset Lung C-600 W 1200 | Z-1247.7 0 Accept Remeasure Decline 5. Click Decline if you disagree with the finding. The finding will be marked as declined in the results list, will be deleted and will not be sent to the PACS. You can also accept or decline all findings at once by using the Accept All or the Decline All buttons at the right bottom of the result table. Accept All Decline All Click Remeasure if you accept the lesion but disagree with the measurement. In this case the measurement will be deleted, and the contour will be replaced by a marker. The remeasuring will take place in the PACS. Unrestricted Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 05 AUG 2020 | HOOD05162003115909 Healthineers Job Aid | Lung workflow Effective Date: 05 AUG 2020 | HOOD05162003115909 Leave the state on Accepted if you accept the finding. You can always change the state for each lesion in this step. 6. At any time during the workflow you can suspend the case by clicking on the Suspend button and return to the Worklist. If you then open the patient case again, all your prior decisions on the findings will be shown. If you made all your decisions on the findings, click the Send to PACS button. The patient case will be closed, and the data will be sent to the PACS. Suspend Send to PACS 2. Lung Parenchyma 1. After selecting the Lung Parenchyma extension, scroll through the data set in the 2D segment in order to see the lobe segmentation and all lung parenchyma findings below -950 Hounsfield units, indicated with blue contours. 95 / 788 2. The 3D segment also shows the patches, indicating parenchyma below -950 Hounsfield units. A Unrestricted Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 05 AUG 2020 | HOOD05162003115909 Healthineers Job Aid | Lung workflow Effective Date: 05 AUG 2020 | HOOD05162003115909 3. The table below the 3D segment shows the percentage values of lung parenchyma findings below -950 Hounsfield units, separately for the five lobes and for the whole lung, including the state of each finding. Parenchyma Below -950 HU [9 State Total Lung 1.2 Accepted Left Upper Lobe 2.0 Accepted v Left Lower Lobe 0.4 Accepted v Right Upper Lobe 1.8 Accepted v Right Middle Lobe 2.0 Accepted Right Lower Lobe 0.4 Accepted v Lung Parenchyma Range 4. Decide for all findings to accept or decline them by clicking the button corresponding to your decision: Click Decline All if you disagree with the findings. They will be marked as declined in the Results list, will be deleted and will not be sent to the PACS. Leave the state on Accepted if you accept the findings. 0 Accept All Decline All 5. At any time during the workflow you can suspend the case by clicking on the Suspend button and return to the Worklist. If you then open the patient case again, all your prior decisions on the findings will be shown. If you made all your decisions on the findings, click the Send to PACS button. The patient case will be closed, and the data will be sent to the PACS. Suspend Send to PACS Unrestricted Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 05 AUG 2020 | HOOD05162003115909 Healthineers Job Aid | Lung workflow Effective Date: 05 AUG 2020 | HOOD05162003115909 3. Pulmonary Density* AI-Rad Companion calculates the following results when the Assessment of Pulmonary Densities is activated. 1. The first series The first series is the original input series including the opacity segmentation contours (red). It includes the opacity segmentation contours (red) and the high opacity segmentation contours. The contours of segmented lung lobes are drawn. The contours of both lungs are implicitly given by the contours of the lobes. 2. The second series The second series contains a DICOM image with a list of the measurement results grouped by the following columns: one column for each lobe, for each lung and one for both lungs. Results Pulmonary Density Al-Rad Companion LUNG OPACITY Both Lungs Right Lung Not for diagnosis Opacity Score Total Volume [ml] 4932.76 2736.95 2195.81 Opacity Volume [ml] 1348.58 825.21 523.37 Opacity Percentage [%] 27.34 30.15 23.83 High Opacity Volume [ml] 210.88 148.79 62.09 High Opacity Percentage [%] 4.28 2.83 Mean HU Total [HU] -749.97 -739.07 -763.56 Mean HU of Opacity [HU] -572.08 -557.59 -594.93 Standard Deviation Total [HU] 256.11 241.00 Standard Deviation of Opacity [HU] 309.72 324.48 283.38 LUNG LOBE OPACITY Right Upper Right Middle Right Lower eft Upper Opacity Score Total Volume [ml] 1370.65 600.95 765.45 1686.67 509.14 Opacity Volume [ml] 307.44 85.62 432.15 232.94 290.43 Opacity Percentage [%] 22.43 14.25 56.46 13.81 57.04 High Opacity Volume [ml] 10.36 2.92 135.52 20.16 41.93 High Opacity Percentage [%] 0.76 0.49 17.70 8.23 Mean HU Total [HU] -806.51 -831.30 -546.93 -808.10 -615.99 Mean HU of Opacity [HU] -724.78 -708.20 -408.81 -630.35 -566.52 Standard Deviation Total [HU] 187.66 171.61 341.79 204.70 288.68 Standard Deviation of Opacity [HU] 204.73 208.24 340.77 260.03 297.78 * Colors are based on institutional settings. They are not an indication or recommendation for treatment. To interpret the results, please refer to the user documentation. Unrestricted Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 05 AUG 2020 | HOOD05162003115909 Healthineers Job Aid | Lung workflow Effective Date: 05 AUG 2020 | HOOD05162003115909 3. The third series (optional) This contains VRTs of lungs and opacity segmentations as defined in the configuration. IP 4. The fourth series (optional) The fourth series contains a DICOM Structured Report with measurement results. * The Pulmonary Density feature is new in VA12A without FDA Clearance. According to FDA policy “Enforcement Policy for Imaging Systems During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency” issued in April 2020, the manufacturer is allowed to market this feature without FDA-clearance. This policy is intended to remain in effect only for the duration of the public health emergency related to COVID-19 declared by the HHS, including any renewals made by the HHS Secretary in accordance with section 319(a)(2) of the Public Health Services Act (42 U.S.C. 247d(a)(2)). Pulmonary Density results are not indicated for the diagnosis of COVID-19. Only in vitro diagnostic testing is currently the definitive method to diagnose COVID-19. Unrestricted Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 05 AUG 2020 | HOOD05162003115909 Healthineers Job Aid | Lung workflow Effective Date: 05 AUG 2020 | HOOD05162003115909 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 co llectively “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 comme rcially 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 Telephone: +49 9131 84-0 siemens.com/healthineers Unrestricted Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 05 AUG 2020 | HOOD05162003115909 Healthineers