Neuro Perfusion Evaluation (A-E Line)

Perfusion Evaluation (MR) (Global & Local Methods) A to E-line The Perfusion post-processing function allows you to display and evaluate perfusion- weighted images. The reconstructed parameter images are based on a post-processing protocol, a calculated arterial input function (AIF), and a set time range. Applications Transfer 1. From the Patient Bowser > select Perfusion series (ep2D_perf) Report Open Report Tools a. Select Applications > Perfusion (MR) Mosaic 3D Argus Bre Vis BOLD BOLD Evaluation Soft Tissue (MR) Composing 2. Global AIF Method determines incoming flow of contrast agent in one Mean Curve reference ROI for all voxels. Perfusion (MR) Spectroscopy a. Deselect “Local AIF” box to calculate maps using Global AIF Neuro 3D (MR) b. Scroll through Series “Top Left Segment” to find a suitable basic Tissue 4D (MR) image for positioning AIF ROI Vessel View c. Select AIF Input function Icon d. Depress left mouse > Move AIF Input Function box over selected artery i. Locate AIF ROI closest to Perfusion Anomaly ii. Position AIF ROI over healthy arteries  A. Cerebri Media  Smaller arteries not explicitly recogizable as vessels in basic image iii. Note: AIF Input Function placement is based on Radiologists discretion Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 SIEMENS Master Template: EFF Date 22 Aug 17 | HOOD/HILS HOOD05162002647849 Healthineers Jobaid: Effective Date:02/18/2020 | HOOD/HILS HOOD05162003063692 Job Aid | Insert Title of Job Aid Effective Date: 02/18/2020 | HOOD/HILS HOOD05162003063692 e. Step 1: Select AIF Input Curves – AIF curves are displayed for all pixels within AIF ROI i. Ctrl/left mouse > select AIF optimal curves  Curves should have flattest baseline and deepest curve ii. Note: Number of AIF Input Function curves selected is based on Radiologists discretion Step 1. Select Al |Step 2: Set Time Ranges | Total measurement time : 01:08 Time Points : 50 iii. Mean AIF Curve is calcuated and displayed in control Mean - Value - Curve area – indicates arithmetic mean of selected AIF curves f. Step 2: Set Time Ranges – define time ranges used for perfusion analysis by moving lines i. Set 1st line > Define Initial point for Baseline ii. Set 2nd line > Define End point for Baseline iii. Set 3rd line > Define End of First pass iv. Check box > Confirm Time Ranges Hint: Observe GBP Curve [Step 1: Select AIF Step 2: Set Time Ranges  Bolus arrives later in tissue than in vessel  Dont define End of First Pass (Right Line) to far left. Bolus in tissue could be cut off. 0:13.87 777 0:27.75 768 1:05.22 743 Confirm Time Ranges Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 Page 2 of 5 Job Aid | Insert Title of Job Aid Effective Date: 02/18/2020 | HOOD/HILS HOOD05162003063692 g. Select Maps i. Drop down select Maps needed for calculation All Maps All Maps All Maps_Moco reIMTT_relCBF TTP reIMTT h. Select Execute Protocol Icon – Starts Perfusion Map Reconstruction Patent Applications Edit View Image Tools Scroll Protocol System Options Help Step 1: Select AIF Step 2 Set Time Ranges Filming 0:13.87 777 0:27.75 768 1:05.22 743 Confirm Time Ranges Mean - Value - Curve Perf MR All_Maps Il Locel AIF i. Save Maps – each series must be saved independently i. Select Segment > Right Mouse Select Series ii. Select Patient > Save As  Enter Map Name  Select OK iii. Note: Repeat steps to save additional perfusion maps Patient Applications Edit View Save As X E Register. Num 0 Patient WORKFLOW ADV NEURO_1 Browser Num . Study ANW HEAD Close Patient Series RELMIT GLOBAL_ep2d_perf_p. Images 19 Save As ... . Save images in new series ReIMTT Map Filming Layout .. Append images to series 65, RELMIT_GLOBAL_ep2d_ Select Series Film Task Status ... Select OnSucceeding Film Preview ... OK Cancel Help Deselect All Expose Film Task Ctrl+P Clear Document(s) Copy to Film Sheet Num Enter H Home Window Home Zoom/Pan Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 Page 3 of 5 Job Aid | Insert Title of Job Aid Effective Date: 02/18/2020 | HOOD/HILS HOOD05162003063692 3. Local AIF Method determines incoming flow of contrast agent for a reference volume around every voxel. a. Check box “Local AIF” b. Select Maps i. Drop down select Maps needed for calculation All_Maps All Maps All Maps_Moco reIMTT relCBF TTP reIMTT c. Select Execute Protocol Icon – Starts Perfusion Map Reconstruction d. Save Maps – each series must be saved independently i. Select Segment > Right Mouse Select Series ii. Select Patient > Save As  Enter Map Name  Select OK iii. Note: Repeat steps to save additional perfusion maps Patient Applications Edit View Save As X Register Num O Browser Num . Patient WORKFLOW_ADV_NEURO_1 Study ANW HEAD Close Patient Series RELCBV LOCAL_ep2d_perf_p2 Save As .. Images 1 . Save images in new series reICBV Mapl Filming Layout .. Film Task Status ... Append images to series 70, RELCBV_LOCAL_ep2d_p] Select Series Select OnSucceeding Film Preview .. OK Cancel Help Deselect All Expose Film Task Ctrl+P Clear Document(s) Copy to Film Sheet Num Enter Home Window Home Zoom/Pan Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 Page 4 of 5 Job Aid | Insert Title of Job Aid Effective Date: 02/18/2020 | HOOD/HILS HOOD05162003063692 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