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MR LiverLab - E-line Job Aid

This Job Aid provides workflow steps for an abdominal examination using the MR LiverLab Dot Engine on an MAGNETOM MR System with E-line software.

MR LiverLab: E-line Job Aid syngo MR Systems with DotGO Technology MR LiverLab can be found within the Siemens Tree, Abdomen Dot Engine protocols. The customer can incorporate their own routine liver sequences into the LiverLab protocols within the Abdomen Dot Engine. Requirement – Must run using a Dot Engine Note: Patient should follow the same breath-hold instructions throughout the exam STUDY All Programs Frequent DotGO head 1. Position the patient for an Abdomen Examination · c-spine Lenine · I-spine · whole-spine TimCT whole-spine neck soft tissue thorax › heart 2. Register Patient and select the LiverLab Abdomen Dot breast abdomen Engine protocol Abdomen Dot Engine Abdomen Dot Engine Liver Eval CB Abdomen Dot Engine CB Abdomen Dot Engine TB · clinical libranes library . library_Dot · pelvis female pelvis male shoulder elhow Load Program to Queue Requested Procedure Study Description abdomen Abdomen Dot Engine Add Study Comment Body Part and Laterality Abdomen - Unpaired Confirm Cancel 3. Optimize Abdomen Patient View Dot Settings a. General Parameters i. Exam Strategy (e.g. Breath-hold, General Parameters uncooperative, etc.) Exam Strategy Breath hold ii. Protocol Adaptation (Options to auto-adjust sequences for breath-hold capability and Protocol Adaption BH + AutoCon AutoCoverage of anatomy) iii. Auto Bolus Detection (Detects contrast bolus Auto Bolus Detection via ROI) Auto ROI iv. Auto ROI (Automatically places ROI) Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 Healthineers Job Aid | MR LiverLab – E-line Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 b. Breath Hold Parameters i. Breath-hold capability Breath-hold Parameters 1. Set maximum breath-hold capability if using BH protocol Breath-hold capability 20 S. adaptation) ii. Automatic breath-hold capability Automatic breath-hold commands (uncheck for manual breath-hold) Language English (United States) 1. Language Before scan Hold breath (inhaled) 8.16 2. Before scan (Command given After scan Continue breathing 1.5€ before acquisition) 3. After scan (Command given after Pause between breath-holds 10 S acquisition) 4. Pause between breath-holds c. Decisions i. Decisions are set/created by user in protocol Decisions building stage Liver evaluation yes ii. If using Siemens Abdomen Dot Engine Liver contrast agent ? with contrast Eval CB protocol 1. Select Yes for Liver Evaluation Evaluation Method Both 2. Select Both for Evaluation Method 4. Select ‘Green Checkmark’ to apply settings and begin scanning Dot Abdomen General Parameters Breath-hold Parameters 00:19 Exam Strategy Breath-hold Breath-hold capability 20 00:13 Protocol Adaption BH + AutoCo ... Automatic breath-hold commands Language English (United States) Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 Healthineers Page 2 of 16 Job Aid | MR LiverLab – E-line Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 5. Begin scanning Routine Pre-contrast Abdomen imaging 6. Open t1_vibe_e-dixon_bh_pre (can be renamed) a. Plan slice volume to include entire liver, and same breath-hold instructions a. Select Apply (Green Checkmark) b. System performs Liver Segmentation and Evaluation 2345 12346 12345 3 IMA 8 /23 43 IMA 12 / 23 3MA 21-1-23- /8/2018 2/8/2018 O= ACS XXXI ACS R R BO2 0cm stoom 57 NORM/DIS2D L TP O -O- SP A33.0 02 M/NORM/DIS2D SP H50. OV 430 430 FoV 430.43 Com |localizer bh liver lab test 11/22/1964 Dot TA: 0:11 PM: ISO PAT: 4 Voxel size: 1.3×1.3x3.0mm Rel. SNR: 1,03 × Guidance Parameters localizer_bh Check slice positions and adjust them, if necessary. 2 _ 11_vibe_e-dixon_tra_bh 3 % Liver Evaluation yes 4 % vibe_q-dixon_tra_bh 00:13 XXXXX 5 % HISTO spectroscopy hi TEs for f ... 00:15 6 % HISTO spectroscopy_high_iron_ .... 00:15 7 % 2 00:43 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 Healthineers Page 3 of 16 Job Aid | MR LiverLab – E-line Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 7. Pre-Evaluation Steps a. Liver Segmentation is displayed in the graphic segment i. Evaluate for segmentation only ii. Can attempt to rerun if poor segmentation, system will use most recent segmentation for later evaluation steps iii. Note: Segmentation cannot be manually adjusted, and the same segmentation is used for q-dixon evaluation (not rerun) b. System provides Pre-Evaluation result liver lab test AMRIS- 2345 i. Normal 11/22/1964, M, 53Y Prisma STUDY 1 ii. Fat deposition 419 IMA 1 /2 iii. Iron deposition iv. Both, Fat and Iron deposition Dual-Ratio Dixon Discrimination Result: fat and iron deposition Recommendation: run liver evaluation [28] t1_vibe_e-dixon_tra_bh_pre_Report /com/ 1111 /tel MF 1.00 04 SC 1024*1024 1_vibe_e-dixon_tra_bh_Report W c. System makes a recommendation if further evaluation is required i. Yes ii. No d. Note: Site should always follow the Radiologist recommendation if further evaluation is required e. Apply Evaluation Step with Green Checkmark liver lab test 11/22/1964 Do X Guidance 1 localizer_bh Check the liver segmentation as shown in example images. 2 t1_vibe_e-dixon_tra_bh 3 Liver Evaluation yes Segmentation volume 1374 ... ml 4 ( vibe_q-dixon_tra_bh 00:13 Voxels sampled 279087 Good segmentation result Bad segmentation result 5 % HISTO spectroscopy hi TEs for f ... 00: 15 6 % HISTO spectroscopy_high_iron_ ... 00:15 Pre-evaluation result fat and iron deposition Run liver evaluation .Yes (recommended) No Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 Healthineers Page 4 of 16 Job Aid | MR LiverLab – E-line Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 8. Open vibe_q-dixon_tra_bh (can be renamed) a. Plan slice volume to include entire liver and same breath-hold instruction b. Sequence opens with suggested ROI position i. ROI can be repositioned by technologists ii. ROI should not be placed over the gallbladder or any large vessel c. To Reposition ROI i. Option1: Left click+Hold on ROI and drag to new location (Red Circle in Right GSP) ii. Option 2: Single Left click on ROI until cursor changes to crosshair cursor > Locate optimal area for placement and single left click to drop the ROI to the new desired location iii. Apply Sequence with Green Checkmark liver lab test HL liver lab test 12345 12345 liver lab test 12345 43 IMA 6 /23 2/8/2018 43 IMA 12 / 23 2/6/2018 44 IMA 22 / 60 2/6/2018 SP2 ACS ACS R R ROI BO2 spcm NORM/DIS2D TP O SP. 0.0 p2 /NORM/DIS2D TP F39 FoV 480'430 A33.0 0%430 p4 M/OUT_PHASE/NORM/DIS2D SP F13.1 zer_bh SagSR46(3.0) looalizer bh Cor 11_vibe_@-dixon_tra_bh_opp FoV 308 410 Tra liver lab test 11/22/1964 Dot TA: 0:11 PM: ISO PAT: 4 Voxel size: 1.3×1.3×3.5mm Rel. SNR: 0.77 X Guidance Parameters 1 localizer_bh 11_vibe_e-dixon_tra_bh Check ROI and slice position and adapt if necessary 2 (position the ROI if needed with a left mouse click) 3 Liver Evaluation yes 4 ¿ vibe_q-dixon_tra_bh 5 % HISTO spectroscopy hi TEs for f ... 00:15 6 % HISTO spectroscopy_high_iron_ ... 00:15 d. 2 00:30 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 Healthineers Page 5 of 16 Job Aid | MR LiverLab – E-line Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 e. Note: To ensure all Report Maps are generated check the following parameters i. Contrast > Common > Dixon Evaluation > Ellipsis > Select All Routine Contrast Resolution Geometry System Physio Inline Sequence 7X Common Dynamic TR 15.80 ms Fat suppr. None Fat fraction v TE 1 4 2.39 ms Water fraction v Water suppr. None T2ª V. R2ª V Dixon Report v Dixon evaluation Flip angle 4.0 deg Close 9. HISTO Sequence (Breath-hold Spectroscopy) a. Opens with Voxel Placement copied to the Placement of the ROI >>Highlights Siemens-MAC b. Tips: 82 IMA 27 /52 4/17/2020 i. Plan Voxel off Non-Distortion (ND) Correction images ii. Before opening the HISTO sequence make sure the VIBE eDixon is located in the active graphic segment (blue outline) c. System automatically generates an additional series without Distortion Correction i. Load eDixon series into all 3 graphic segments 94 MWVATER/NORM/DIS2D tt_vibe_t-docon_tra_bh_pr ... 1282 ‘410 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 Healthineers Page 6 of 16 Job Aid | MR LiverLab – E-line Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 d. Creating MPR Reformats for Planning >Highlights_LiverLab. LiverLab A i. Left Click on 1 ND VIBE > Right Click in 83 IMA 25 /62 Exam active GSP > Select Series ii. Select Main Menu > Applications > 3D > MPR Viewing Patient Applications | Transfer Edit Queue BD MMPR 82 1144 25 Argus MIP BreVis SSD BOLD VRT P4 M/WATER/NORM/DIS2D Select Series Composing Eusion Deselect All Mean Curve Movie ON Movie Control ... Zoom/Pan Coupled Graphics On iii. Create & Save Coronal and Sagittal MPR reformats Patient Applications Transfer Edt View Dgs Orientation Type Image Tools Fusion System Options HighlightsLiverLob, LiverLab Jan Ypormen >>Highlighta_LiverLab, Livertab Schens-MAC nYpetition 1/10540 M. 73Y MI Ett Siemens MRc MREN >>Highlights_Liver STUDY 2 STUDY 2 HE'S Exam 4/7/2020 19 55:58 AM 02 MA 0/5 10:55:58 AM 12 MA 015 3D. Parallel Ranges Presets Defaut Paralel S- Cor 45 Viewing image thickness 3.0 mm Type Orion Imago Distance between images 3.0 mm Number of images 76 F 1:00 Filming Start Close Help TE B WV475.0 A 84 MPR MPR MPRAIPR TR#41 SL. 30 BOIS SP2. Cor sitighbgids_LiverLub, LiverLab ghlight Lab, LiverLub 1/171940, M. 73Y MRE!! #1717940, M. 73Y STUDY ? 467/2020 STUDY 2 10 55 58 AM 4/ 7/2020 3D 02 MA 074 10: 55.58 AM cor TH 6,7 TE 2.4 BA 4750 TE 2 A p4 MPR.MAR The iness 30 MX MPRAIPR 301-3.5P2:3 1342 710 W Waiting for slice positioning 77 image(s) saved in SAG NO MPR 4/17/2020 4:38:48 PM Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 Healthineers Page 7 of 16 Job Aid | MR LiverLab – E-line Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 e. Loading created MPR Reformats in Exam Task Card i. Open Patient Browser ii. Locate created MPR series iii. Drag series into GSP in Exam Task Card for planning Patient Applications Transfer Edit Queue Protocol View Image Tools Evaluation Scroll System Add-On Options Help >>Highlights_LiverLab, LiverLab Siemens-MAC H >>Highlights_LiverLab, Liverlab H Siemens MAC >>Highlights_LiverLab, LiverLab A Siemens MAC 101 IMA 38 / 77 100 IMA 27 / 55 82 IMA 27 / 52 4/17/2020 4/17/2020 LOX Transfer Edit View Filter Evaluation ort Options Help TISSUS R///171 /M /com/1111 1 >>Highlights_Cardio_RSN [96] t1_vite_e-dixon tra_bh_pre_opp_REG_S84_ND /com/1111 7 >>Highlights_FREEZEit, S Skyra Liv Lab [97] t2_halte radial /com/1111 4 >>>Highlights_LiverLab. hera_LiverLal TODI COR ND MPR 1/1/1/ Prot/ :/// Prot System 29yr_viability_skyra [101] SAG ND MPR System f. Planning HISTO sequence i. Plan the Histo voxel off all 3 planes ii. Axial Plane – Check Voxel placement 1. Use Tools: Reference Lines, Copy Image Position, and Scroll Nearest to check Voxel Placement on Coronal and Sagittal images iii. It is recommeded to save the placement of the HISTO VOI 1. Select All 3 GSP using Ctrl+Left Click > Main Menu > Patent > Save As 2. Select Apply (Green Checkmark) to run HISTO sequence cam ACS ACS Viewing IDON Filmi MPF Reage rovigo be8 IFFRIMPRIMIATEF/NORMAND Cor 0 355-195 54 MONATEFINORAUND Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 Healthineers Page 8 of 16 Job Aid | MR LiverLab – E-line Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 10. Load Series for Evaluation a. Load acquired sequences to Viewing Task Card for evaluation b. eDixon – provides in one series, in-phase and opposed phase, fat and water, segmentation, and a report c. qDixon – provides both segmentation and ROI Values d. Histo – provides a report only [23] t1_vibe_e-dixon_tra_bh_pre_opp [30] vibe_q-dixon tra bh W Jcom/ 1111 0M [24] t1_vibe_e-dixon_tra_bh_pre_in [31] vite_q-dixon Ja bh F Icom/ //11 /04 [32] vibe q-dixon tra bh Report [25] t1_vibe_e-dixon_tra_bh_pre_F 0 toom/ 11/7 0M [33] vite_q dixon_ra bh FF [26] t1_vibe_e-dixon_tra_bh_pre_W [34] vibe_q-dixon tra bh GoodnessOff t [27] t1_vibe_e-dixon_tra_bh_pre_W_SEG [35] vibe q-dixon ra bh R2s Ef toom/ 1111 IM [36] vibe_q dixon_ra_bh_T2g_Eff [28] [1_vibe_e-dixon_tra_bh_pre_Report Joom/ 1/11 /1 [37] vibe_q dixon_ra_bh WP -------- --- --- 11. Results & Image Quality Evaluation – eDIXON a. Is the Fat image displaying Fat and Water image displaying Water? b. Was the liver segmentation performed by the system good quality? c. Does the segmentation include the entire liver or does it include more than liver tissue? i. Note: The segmentation cannot be altered, if the segmentation isn’t optimal then the segmentation values in the qDIXON results page will be inaccurate. Abdomen_Del_LL Abdonion_Del_LL *10/1 1/1990. F.24Y VEIA #1011/1990, F. 24Y _Spine_Dot Exam STUDY ! 1011.0014 STUDY I Abdomen_Dot_LL 19:06 03 11 06 63 9 MA 55/60 Viewing 3D TA 14. 05 EWWW .10400 DE MFATA GEMACEND BWV 1040.0 04 MWWATERNORM.06.20 BO1-3,5P2-4 Abdomen_Del_L.L Abdomen_Del_LL Tools Image View VERA +10/11/1980, P.24Y VERIA $1001 21980, 7, 24Y STUDY 1 STUDY 1 11 06 03 10 MA 31 756 11 NA 2/2 Patient Eval | Exam TE 1 BWV 10400 PHOTS Di MANATERA ORMOISAD dixon fre th_pre_Resport Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 Healthineers Page 9 of 16 Job Aid | MR LiverLab – E-line Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 12. Results & Image Quality Evaluation – qDIXON a. Results Page – note Fat Signal Patient Applications Transfer Edit View Im >>Highlights LiverLab, LiverLab percentage and R2* Siemens-MAC Anlagenzentrum *1/1/1940, M, 73Y MR SE MR E11 STUDY 2 Liver Evaluation i. (R2* is 1/T2*) – displayed in 67 IMA 1 / 2 ivoxels mean fit error seconds to the inverse of 1 (sec-1) ROI (46 1.6% Segmentation Volume 152407 2.3% ii. Values displayed for both the ROI Segmentation segmented volume and the ROI 0% Fat signal percentage 50% mean std ROI 10.3% 0.6% Segmentation Volume 2.7% 7.4% ROI Segmentation Os4-1 R2" 400s^-1 mean std ROI 23.5s^-1 2.0s^-1 MF 1.00 Segmentation Volume ¡25.05^-1 12.45^-1 512 512 vibe_q-dixon_tra_bh_Report Potentially off-label use in USA b. Poor Liver Segmentation leads to poor results for the segmented volume i. ROI will still have good results with proper placement. A Liver Evaluation MR E11 MR E14 # 26944020 STUDY 165524443 COHEN JENNIFER # 26944020 STUDY 165524443 voxels mean fit error 3/8/2016 COHEN JENNIF 21 IMA 1 /2 ROI 55 13.9% 9:17:28 AM Segmentation Volume 10.5% 22 MA 25 / 64 116299 ROI Segmentation 0% Fat signal percentage 60% mean std ROI 0.2% 0.7% Segmentation Volume 10.7% 21.6% Segmentation RO OSM R2* 400S^-1 mean std p4 DIXONANDIF AT FRACTION MF 1.00 ROI 188.3s^-1 108.0s^-1 Segmentation Volume DV 3143 138.3s^-1 128.3s^-1 p4 512*512 vibe_q-dixon_tra_bh_Report BO2,3;SP3,4 f13d6 / 4 Gray value 1 equals 0.1% ₩ 1543 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 Healthineers Page 10 of 16 Job Aid | MR LiverLab – E-line Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 c. Goodness of Fitness Map – Evaluation i. Image shows the segmentation and ROI used ii. Image Text, lower portion of images – States “Gray value = .1%” 1. Check Goodness of Fit and get a Mean Value a. Draw an ROI over the liver -or- b. Place a Pixel Lens 2. Goodness of fit % = Mean Value x 0.1 a. Example: ROI/Pixel lens = 43, then Goodness of Fit = 4.3% b. Goodness of Fit should be 5% or less. Then this is an indication of the fitting residual errors, the fat parentage and the R2* results. c. Smaller the value the more reliable the results MR -12 26919879 STUDY 165154091 3/4/2016 MARK HENRY 2:28:45 PM 5 IMA 25 / 64 DIXONUND (91.ª SP3.4 9ml multihange Gray value 1 equais 0. 196 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 Healthineers Page 11 of 16 Job Aid | MR LiverLab – E-line Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 d. R2* Map – Evaluation i. Evaluate 1. If Liver segmentation not performed properly 2. If Radiologist wants to evaluate area of the liver not included in the ROI ii. R2* Value (sec-1) = Mean Value 1. R2* Values are for Iron evaluation Aera MR E11 HFS +LPH 2. R2* Values increase as O'HARA MARK HENRY iron deposition increases DIXON/ND/T2_STAR_MAP 9,81-3 SP3,4 Gray value 1 equals 0.1 ms e. T2* Map – Evaluation i. Decreasing T2 values – Aera MR E11 HFS indication of increased iron ¥ 165154091 +LPH O'HARA MARK HENRY deposition ii. Acquire Mean Value 1. Draw an ROI over the liver -or- A MiEM36 082 28. 2. Place a Pixel Lens iii. T2* Value (ms) = Mean Value x 0.1 --- 84 DIXON/ND/T2_STAR_MAP BO1-3;SP3,4 13de /4 9ml multihance eutouals 0.1 ms Gray value 1 equals 0.1 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 Healthineers Page 12 of 16 Job Aid | MR LiverLab – E-line Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 f. Fat Fraction and Water Fraction – Evaluation i. Acquire Mean Value 1. Draw an ROI over the liver -or- 2. Place a Pixel Lens ii. Fat/Water % = Mean Value x 0.1 MR E12 #26919879 STUDY 165154091 STUDY 165154091 ALPH 3/4/2016 O'HARA MARK HENRY 12:28:45 PM 54 IMA 23 / 64 Min/Max: 0 /153 Mean/SD: 27.7 /39. Area: 3.15 sq.cm Pixel: 6 Min/Max TE TA 18:17 BW 1080.0 SP H50 p4 DIXON/ND/FAT_FRACTION SL 3 oV 314 380 5X DIXON/ND/WATER_FRACTION FOV 314 3 A1 208 320 | BO1-3;SP3.4 9ml multihance #13d6 / 4 Gray value 1 equals 0.1% 143 301-3;SP3.4 9ml multihance Gray value 1 equals 0.1% 2 1848 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 Healthineers Page 13 of 16 Job Aid | MR LiverLab – E-line Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 13. HISTO Results Evaluation a. Results Display i. Fat Percentage ii. R2 Value for Water (for Iron Evaluation) 1. Shows Fat that was T2 corrected and R2 of Water b. Spin Echo sequence with Multiple Echoes i. R2 value is displayed, not the R2* c. Color Bar Map i. Fat shown at top in a percent (%) ii. R2 Water = value in seconds inverted over 1 iii. Fit value = rsq fit “R-squared” 1. Value should be as close to 1 as possible, preferably >0.95 Aera MR E11 STUDY 1 HOSTO OHARA MARK HENRY BO IMA 1/ 3 Voxel Fat signal percentage rq fit Vore 2.2% 0.09 Voorel R:2 water 304-1 456-1 Vore 27.63-1 MF 1.00 512 512 HISTO_reports Colorbar Report Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 Healthineers Page 14 of 16 Job Aid | MR LiverLab – E-line Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 14. PACS – Image Archiving a. Tip – for some PACS systems the eDIXON, qDIXON and HISTO results need to be saved as RGB (Red, Green, Blue) images i. Save As RGB Workflow 1. Open Patient Browser 2. Select Result/Report Series 3. Main Menu > Application > DICOM Tools > Save as RGB 4. New series created with RGB at end of series name (e.g., t1_VIBE_e- DIXON_tra_th_pre_F_RGB) 15. Tips a. When drawing ROI”s on the PACS system, confirm results have the same values as those drawn on the MR system. b. If Fat/Water Swap on qDIXON the system will note an unusually high fat signal percentage on the qDIXON Report. (e.g., Water image displays fat, and fat image displays water) i. Refer to HISTO results in these instances Acra MR C11 STUDY 1 HFS STUDY 1 3/4/2016 +LPH O'HARA MARK HENRY O'HARA MARK HENRY 2:14:14 PM 50 MMA 17 /84 51 IMA 64 / 64 VF 1.20 IIMF 1.20 TR 16.6 TR 16.6 TE 2.4 TA 18.17 TP F2 TE 2.4 D TP F2 BW 1080.0 SP H52.4 TA 18.17 SP F112.1 04 DIXONWATER/NORMDIS2D BW.1080.0 V 201:340 p4 DIXON/ AT/NORMDIS2D FoV. 201-340 ALIXW 200*320 1 200 320 1 DO1-3.SP Tra A1/XP W BO1-3.SP Aora Livor Evaluation MR E11 MR E11 STUDY 1 HFS O'HARA MARK HENRY STUDY 1 3/4/2016 OHARA MARK HENRY 32 IMA 1/2 voxels mean fit error 1:14:14 PM ROI 09 1,7% 53 IMA 64 /64 Segmentation Volume 69265 2.5% Unusually high fot signal percentage. Check for fat/water swaps. Kun HISTO for comparison 0% Fat signal percentage 60% ROI 99.0% std 0.0% Segmentation Volumo 08.4% 4.5% Segmentationkol 1.20 R2ª 400$^1 TE 2:4. mean sta TA 16.1 36.48^1 DW 1080.0 SPF112.1 ROI 4.48^.1 04 DIXON/ND/ AT FRACTION MF 1.00 Sogmontation Volume FoV 201 340 36.1o^1 13.50^1 512.612 208*320 1 991-3,SP2-4 gray value 1 cauols 0.1%. Unusualy .. Tro ilbo_q-dixon_tra_bh_Report Check for fat/water swaps. Run les ... W 109¢ C 1023 Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 Healthineers Page 15 of 16 Job Aid | MR LiverLab – E-line Job Aid Effective Date: 11/23/2020 | HOOD05162003141153 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: 11/23/2020 | HOOD05162003141153 Healthineers Page 16 of 16

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