Corridor4DM: How to Exclude Extra-Cardiac Activity

Corridor 4DM: How to Exclude Extra-Cardiac Activity SPECT & SPECT/CT Description: This document explains what to do with patient data containing extra- cardiac activity using the Constraint Tool. Ideally, a patient with significant extra-cardiac activity should be reacquired to minimize the interference. If this is not possible, this document will aid in the use of the Constraint tool, within Manual Processing Mode, to exclude activity that may be included in the left ventricular contours (Figure 1), resulting in less accurate functional and quantitative es- timates. LV Center: (X: 60.5 Y: 67.9 Z: 16.5) Reslice Angle: (X: -- Y: -- Z: -- ) 11 16 23 24 24 23 Mid-HLA Mid-VLA Figure 1: LV contours with extra-cardiac activity. The use of Constraints is not the same as masking and removing extra-cardiac activity. The advantage of using Constraints is that calculations are confined to the area within the constraints’ overlay while still allowing viewing of the extra-cardiac space around the heart. How to Use the Constraint Tool The Constraint tool, highlighted in the toolbar below, can be accessed from the MI Pro- cessing Screen while in Manual Processing mode or Reset mode (Figure 2). For more in- formation on how to access Manual Processing mode, please see the Job Aid “Corridor 4DM: How to Use Manual Mode.” 0 100 3 4 0 100 Figure 2: Manual Processing tool bar with Constraint tool highlighted. SIEMENS Healthineers Effective Date: 07/08/2019 | HOOD05162003011666 siemens.com/healthineers Job Aid | Corridor 4DM: How to Exclude Extra-Cardiac Activity Effective Date: 07/08/2019 | HOOD05162003011666 To apply Constraints: 1. Click the Constraint tool icon from the toolbar at the top of the screen. 4DM automatically positions a constraint border with resizing handles overlaying the SA slice (Figure 3). Figure 3: Constraint border overlay with resizing handles. 2. Adjust the constraint border by clicking and dragging the resize handles. Take care to not clip the myocardium by making the constraint too small or leaving space around the myocardium by making the constraint too large (see Figure 4 for ex- amples). Figure 4: Improperly resized constraints. 3. Visually confirm that the extra-cardiac activity is excluded in the SA, HLA, and VLA views. Adjust if necessary (see Figure 5). LV Center: (X: 63.7 Y: 66.0 Z: 17.0) Reslice Angle: (X: -- Y: -- Z: -- ) 24 10 O O TS VLA Slice SA Slice HLA Slice Figure 5: Properly resized constraints. Siemens Healthineers Services Page 2 of 4 © Siemens Healthcare GmbH, 2017 Job Aid | Corridor 4DM: How to Exclude Extra-Cardiac Activity Effective Date: 07/08/2019 | HOOD05162003011666 4. Perform any other adjustments that may be necessary such as tilt, orientation, centering, basal limit, and apical limit placement changes. Note: For processing assistance, refer to the Job Aids “Corridor 4DM: MI Processing Screen” and “Corridor4DM: How to Use Manual Mode.” 5. After all adjustments are made, click the Process tool to apply surface gen- erating calculations. The updated contours will be displayed. The user can verify the new LV surface calculations after constraints have been applied (Figur e 6). LV Center: (X: 63.7 Y: 66.2 Z: 16.5) Reslice Angle: (X: -- Y: -- Z: -- ) 12 16 24 24 O O 24 124 Mid-HLA Mid-VLA Figure 6: Accurate LV contours after constraints have been applied. Siemens Healthineers Services Page 3 of 4 © Siemens Healthcare GmbH, 2017 Job Aid | Corridor 4DM: How to Exclude Extra-Cardiac Activity Effective Date: 07/08/2019 | HOOD05162003011666 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 Func- tionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales repre- sentative 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. 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