Optimizing your c.cam Image Quality

Optimizing Your c.cam Image Quality 1. Proper Patient Positioning Proper patient positioning is extremely important when using a small field of view camera. Truncation can be an issue. To properly position a patient using the c.cam, follow these instructions. 2. Position the patient on the chair so that his spine is centered on the chair. Chair center 3. Once the camera is in the MARK position, ensure the that heart does get truncated by viewing of the patient positioning monitor on the acquisition laptop. Lt Lateral Anterior www.usa.siemens.com/healthcare SIEMENS 533 Effective Date: 09/09/2016 Page 1 of 4 4. Prior to marking the points for determining the scanning orbit, ensure that the detectors are approximately an inch from the front and side of the patient. 5. When the patient is positioned properly, the sinogram should look like the image below. % 68 O Patient Spine - Center of the Chair 6. Troubleshooting The most common issues that arise with cardiac imaging are: a. Truncation caused by improper patient positioning b. Excessive patient motion c. Cardiac creep www.usa.siemens.com/healthcare SIEMENS Page 2 of 4 7. Improper Patient Positioning The first indication of improper patient positioning can be seen, not only in the cine of the raw data, but also in the sinograms. The sinogram in Step 5 was the result of good patient positioning. The sinogram displayed below demonstrates patient positioning that may lead to truncation of the myocardium. 8 Truncation 8. Excessive Patient Motion This can be caused by patients shifting their bodies during the scan or significant changes in breathing. Another common cause is cardiac creep. This is typically caused by excessive excursion of the diaphragm post stress. The best way to avoid the issue is to let the patient relax on the chair for a couple minutes before starting the scan. 9. In the case of motion, it is always best to rescan the patient. If this is not possible, some motion can be corrected for the Quality Control Activity. Once in the activity, proceed to Motion Correction and select the Head Misregistration option. Please note that the option allows the data from the detectors to be corrected independently and does not indicate a mechanical issue with the camera. This may correct the slow upward creep of the myocardium over the length of the scan. www.usa.siemens.com/healthcare SIEMENS Page 3 of 4 10. In the image below, the heart shadow in the top linogram shows a steady incline between frames 1-32 and 33-64. The bottom linogram demonstrates how the motion correction can solve this issue. Before X Motion 0 Sinogram Linogram 5600 2X45.00 305.00 345.00 305.CO Y Mcgon After ‹Motion Sinogram Linogram 285.00 505.00 508.00 345 00 385.00 11. Top 5 Takeaways for Optimizing Image Quality a. Always center the patient in the chair to avoid truncation b. Avoid cardiac creep by having the patient relax on the chair before starting the scan c. Decrease patient motion by stressing the importance of holding very still and not breathing deeply during the scan d. Review the raw cine for excessive motion before releasing the patient e. Repeat scans on those patients who have greater than 5mm of motion or a hot loop of bowel overlapping the inferior wall. SIEMENS www.usa.siemens.com/healthcare Page 4 of 4