Morphometry of the Neurology Workflow Job Aid

Morphometry of the Neurology Workflow Job Aid syngo.via MR The morphometry function of the Neurology workflow is to automatically estimate the volume of different brain regions in a single 3D T‐1 weighted MPRAGE series. 1. Calculation Criteria – calculation of the morphometry results is contingent upon compliance of the input MPRAGE sequence protocol. The following table lists the criteria: Scan/DIcom parameter Value for 1.5 T Value for 3T Manufacturer Siemens Siemens Image Type Contains Norm‐ attribute Contains Norm‐ attribute Repetition Time TR > =2400 ms TR >= 2300 ms Echo Time <= 10 ms <= 10 ms Inversion Time TI = 1000 TI = 900 ms Pixel Spacing (X & Y) < = 2ms < = 2ms Flip Angle FA = 8 deg FA = 9 deg Slice Thickness < = 1.2 mm < = 1.2 mm MR Acquisition 3D 3D 3D Matrix size 256 x 256 176 slices per slab 256 x 256 176 slices per slab Rows x Columns x Slices per slab Contrast Agent none none Orientation Sagittal Sagittal Auto‐align matrix Scan was done with auto‐alignment Scan was done with auto‐alignment Slice Oversampling < = 0.3 < = 0.2 FoV Read > =240 > =256 FoV Phase Ratio = 1 Ration > = 0.9 Magnitude Preparation = 2 = 2 Reconstruction (mode) =1 =1 Base Resolution 192 256 Phase Resolution =1 =1 Phase Partial Fourier =16 =16 PAT Mode >2 >2 PAT Acceleration Factor < = 3 < = 3 No of slab groups = 1 = 1 No of slabs = 1 = 1 Coil Combine Mode = 2 =2 PE Swap Re‐ordering 1 or 2 1 or 2 Asymmetric Echo = 1 = 1 Pixel Bandwidth 170 < = BW < = 190 230 < = BW < = 250 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 SIEMENS Master Template: EFF Date 22 Aug 17 | HOOD/HILS HOOD05162002647849 Healthineers Jobaid: Effective Date 09/19/2019 HOOD05162003032430 Job Aid | Morphometry of the Neurology Workflow Job Aid Effective Date: 09/19/2019 HOOD05162003032430 Scan/Dicom Parameters for 1.5T and 3T, these dicom tags should not be present:  Interpolation, Image Filter, Normalize, BiFicFilter, Raw Filter, Elliptical Filter, Elliptical Scanning Note: In the Morphometry Settings, you can allow calculation even if a scan parameter is not compliant. A warning message will show protocol parameters were not compliant and is documented in the report. Note: The Siemens MPRAGE sequence with Morpho Add‐in is compatible and recommended 2. MR Neurology Settings a. If the box is selected for Automatic generation of morphometry results > results are automated b. Select the language for your report c. If the box is selected for Send generated morphometry results to Pacs > results will be displayed in Browser after workflow status reaches ready. Results will be sent to PACS automatically (provided there is a default archive set). d. If the box is checked for Disable processing of improperly acquired image data > then if the data does not meet internal quality check, no processing will be performed. A report will be generated informing the user of this issue. e. MPRAGE Data Selection i. If the box is selected for Automatic Selection > it will select the MPRAGE data automatically. ii. If the box is selected for Selection based on following Series Description > user must define the exact series description for data selection f. Morphometry Map Settings > Define the Blend Factor for Fused Label and Fused Deviation Maps MR Neurology Settings x Perfusion Map Sellings Meancurve Settings Morphoretry Sellings Automatic generation of morphometry results General Settings Language for report English (United States) Send generated morphometry results to PACS Disable processing of improperly acquired image data MP-RAGE Data Selection Automatic Selection @ Selection based on following Series Description Morphometry Map Settings Blend Factor for Fused Label Map 50 = % Blend Factor for Fused Deviation Map 50 ¢ % Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 Page 2 of 5 Job Aid | Morphometry of the Neurology Workflow Job Aid Effective Date: 09/19/2019 HOOD05162003032430 3. Results – calculated results are 5 DICOM series of Report, Label Map, fused Label Map, Deviation Map, fused Deviation Map a. Report – includes volume estimates for the different brain regions. Both absolute and relative (percentage of total intercranial volume) volumes are reported. For each brain region, a normative range is displayed that corresponds to the 10th and 90th percentiles of an age and gender‐matched healthy population. An asterisk is shown next to the relative volume if its value is below the 10th percentile for cerebral tissue or above the 90th percentile for internal and external cerebrospinal fluid spaces. b. Deviation Map – this map shows the different brain regions, color‐coded to indicate the degree of deviation from the average age and gender‐matched normative volume. The color range (from green to red) is based on the z‐score. No deviations or minor deviations are shown in green, large deviations in red. c. Label Map – this map shows the different brain regions, each region in a different color. i. Color Codes for the different brain areas: Lobar WM (white mat- Lobar GM (gray matter): ter): Frontal Lobe Frontal Lobe Parietal Lobe Parietal Lobe Occipital Lobe Occipital Lobe . Temporal lobe Temporal Lobe . Cingulate gyrus Corpus callosum Cerebellum GM Deep WM Cerebellum WM CSF White Abnormal (WMAb) Thalamus (Left/right) Lateral ventricle Left Caudate (Left/right) Lateral ventricle right Putamen (Left/right) Third ventricle Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 Page 3 of 5 Job Aid | Morphometry of the Neurology Workflow Job Aid Effective Date: 09/19/2019 HOOD05162003032430 i. Color Codes for the different brain areas Continued: Pallidum (Left/right) Fourth ventricle Hippocampus (Left/right) Insula (Left/right) Pons Mesencephalon Medulla oblongata d. Example of Clinical Results HAR HAR HAR DemoMorphometry_ADSuspicion Input Data DemoMorphometry_ADSuspicion Label Map DemoMorphometry_ADSuspi Deviation Map ti _mprage_morpho 11_mprage_morph LABEL ti _mprage_morpho DEV AFL AFL AFL 10cm SP L21.1 SP L21.1 SP L21.1 TR 2400.0 SL 1.2 SL 1.2 SL 1.2 TE 3.5 FoV 240*240 FOV 240 240 FOV 240 240 02 MINORM/DIS3D Zoom 2.19 LABELMORPHO Zoom 2.19 DEWMORPHO Zoom 2.18 "Image quality. high" "Image quality: high" "Image quality. high" HAR HAR HAR DemoMorphometry_ADSuspicion Fused DemoMorphemetry_ADSuspicion Fused DemoMorphometry_ADSuspicion t1_mprage_morph Label Map Report Fused_UM 11_mprage_morph Fused DM Deviation Map 1 _mprage_morph REPORT AFL AFL . H.T ED4.4 - 26.30 10cm 10cm L SPL21,1 SP L21.1 SL 1.2 SL 1.2 FOV 240*240 FOV 240-240 FOV 0º0 FUSEDMAPIMORPHO Zoom 2.19 FUSEDMAP/MORPHO Zoom 2.19 MORPHOREPORT Zoom 0.64 "Image quality: high" "Image quality, high" "Image quality, high" e. Note: For more information on the Morphometry normative reference database, please refer to the owner’s manual. Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 Page 4 of 5 Job Aid | Morphometry of the Neurology Workflow Job Aid Effective Date: 09/19/2019 HOOD05162003032430 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 (herein‐ after 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 2018 ………………………………………………………… Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Telephone: +49 9131 84‐0 siemens.com/healthineers Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 Page 5 of 5