Off-center Adjustment 3T Elbow Imaging - XA31

Off-center Adjustment in 3T Elbow Imaging Job Aid 1. Current challenge When performing off-center elbow imaging in patients in head-first supine positioning on 3T systems, sporadic severe signal loss and shading in the elbow can occur. ALH 191213as Siemens Healthineers 2019.12.13-10:05:41-STD-1.3.12.2.1107.5.99.3 *01.01.1953, M, 66Y MAGNETOM Vida CURRENT MR XA20 13.12.2019 HFS +LPH pd_tse_fs_tra_320_p2_$2.01 latest STUDY ID Odd2e955-5a2d-48 10:10:13 3 IMA 1 FRM 11/30 O 3,00 L 99 P 78 F 48 RAF 1 cm SL 2,5 SPC 2,8 TR 2500,0 E TE 32,0 TP F60 TA 02:22 SP F49,6 BW 289,0 FoV 120*120 p2 s2 MAGN NORM/SH FIL DIS2D 448*6401 Tra>Sag(1)>Cor(-1) A2/SAT2/FS Zoom 0,95 UFS W 342 *tseR2d1rr7 /120 134 Clinical image that was acquired without the off-center strategy. The signal loss has been highlighted. Unrestricted Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 18-Feb-21 I HOOD05162003157035 Healthineers US Job Aid Effective Date: 12-Apr-21 I HOOD05162003184875 Job Aid I Off-center Adjustment in 3T Elbow Imaging Effective Date: 18-Feb-21 I HOOD05162003157035 US Effective Date: 4.12.2021 I HOOD051620031848 2. What is the off-center strategy? Image quality issues can be caused by imperfect transmit adjustment and strong B1 variation across the elbow. This issue is addressed with the adjustment strategy off-center, which is available for TSE, TSE Dixon, and SE sequences at 3T. The off-center adjustment strategy can avoid these issues by localized transmit adjustment to the imaging volume: The adjustment measurement is performed in the central transversal slice in isocenter. The B1 evaluation and flip angle determination is performed within this transversal slice only within the current FoV. This provides a well-suited transmitter reference amplitude for the current FoV and is also robust against FoV changes. For further optimization, you can also manually adapt the excitation flip angle within the off- center strategy. A flip angle reduction by e.g. 15% can further enhance the signal uniformity. Image comparison: Normal AdjTra (722V) & Off-center AdjTra (540 V) & FAexc=90° FAexc=77° AH AH 20200312as 20200312as 2020.03.12-12:11:57-STD-1.3.12.2.1107.5.99.3 MAGNETOM Lumina 2020.03.12-12:11:57-STD-1.3.12.2.1107.5.99.3 MAGNETOM Lumina *1/1/1952, M, 68Y MR XA20 *1/1/1952, M, 68Y MR XA20 CURRENT HFS HFS 3/12/2020 +LPH CURRENT 3/12/2020 +LPH pd_tse_fs_tra_320 pd_tse_fs_tra_320_WIP latest STUDY ID bae3b3a6-589d-48 STUDY ID bae3b3a6-589d-48 12:36:41 PM 6001 IMA 6 7001 IMA 6 RFA RFA 1 cm 1cm TR 3900.0 TP 0 TR 3900.0 om TE 29.0 SP F23.5 SP F23.5 TA 03:50 SL 2.5/0.25 TE 29.0 SL 2.5/0.25 TA 03:50 BW 300.0 FoV 120*120 256*320 BWV 300.0 FoV 120*120 p2 M/NORM/DIS2D/MF SPLIT p2 M/NORM/DIS2D/MF SPLIT 256*320 Tra>Sag(10)>Cor(-9) Tra>Sag(10)>Cor(-9) A2/SAT1/FS Zoom 1.34 Zoom 1.35 UFS W 244 A2/SAT1/FS 244 *tseR2d1rr7 / 141 110 UFS W tseR2d1rr7 / 141 C 110 FatSat strong, joint FOV based z=0, FA0.85, FatSat strong, joint SIEMENS Unrestricted Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Healthineers Job Aid Effective Date: 18-Feb-21 I HOOD05162003157035 US Job Aid Effective Date: 12-Apr-21 I HOOD05162003184875 Job Aid I Off-center Adjustment in 3T Elbow Imaging Effective Date: 18-Feb-21 I HOOD05162003157035 US Effective Date: 4.12.2021 I HOOD051620031848 3. How can you activate it? 1. Open the Dot Cockpit and SIEMENS tree elbow. 2. Open the library and select PD. 3. Open the pd_tse_fs_tra_320_offcenter protocol by clicking on it. SIEMENS > elbow >> library > PD medium channel coils_ pd_tse_cor 384 02:57 pd_tse_sag_384 02:57 pd_tse_fs_tra_320 03:56 pd_tse_fs_tra_320_offcenter 03:56 pd_tse_fs_cor_320 04:33 pd_tse_fs_sag_320 03:59 4. Select the Protocol Parameters tab on the left side of the window. SIEMENS > elbow >> library > General Protocol Parameters Voice Commands Execution M Image Management Auto Load Copy References 5. Select the System > Adjustments tab and click on Off-center in the Adjustment Strategy drop-down menu. SIEMENS > elbow > library pd_tse_is_tra_320_offcenter 3 3:56 min 1; Auto @ 2 0.3x0.3x2.5 mm3 1. Protocol Parameters Routine Contrast Resolution Geometry System Physio Inline Sequen Voice Commands Execution Miscellaneous Adjustments Adjust Volume PTX Tx/Rx Image Management Adjustment Strategy Offcenter Adjustment Tolerance Auto Auto Load BO Shim Standard Adjust with Body Coil Copy References SliceAdjust B1 Shim FastView OFFCOM Confirm Frequency Never Offcenter Assume Silicone Coilshim Off SIEMENS Unrestricted Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Healthineers Job Aid Effective Date: 18-Feb-21 I HOOD05162003157035 US Job Aid Effective Date: 12-Apr-21 I HOOD05162003184875 Job Aid I Off-center Adjustment in 3T Elbow Imaging Effective Date: 18-Feb-21 I HOOD05162003157035 US Effective Date: 4.12.2021 I HOOD051620031848 6. To change the flip angle for excitation pulse, open the Contrast > Common tab. You can then set the Flip Angle. Select OK to save the changes. SIEMENS >> elbow >> library >> PD >> pd_tse_fs_tra_320_offcenter ? X General LAruta 1.00 Protocol Parameters outine Contrast Resolution Geometry System Physio Inline Seque Voice Commands Execution Common Dynamic Image Management TR 3900.0 + ms Fat-Water Contrast SPAIR Auto Load TE 32.00 - ms Fat Saturation Weak Copy References MTC Dark Blood Magn. Preparation None Contrasts Wrap-up Magn. Restore Flip Angle 2 deg Reconstruction Magnitude Flip Angle for Excitation: 80 deg Flip Angle for Refocussing: 150 deg OK Cancel SIEMENS Unrestricted Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Healthineers Job Aid Effective Date: 18-Feb-21 I HOOD05162003157035 US Job Aid Effective Date: 12-Apr-21 I HOOD05162003184875 Job Aid I Off-center Adjustment in 3T Elbow Imaging Effective Date: 18-Feb-21 I HOOD05162003157035 US Effective Date: 4.12.2021 I HOOD051620031848 Please note that this 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 2021 Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84-0 siemens-healthineers.com SIEMENS Healthineers