syngo® MI Applications Advanced Online Training for SPECT

Welcome to the syngo® MI Applications Advanced Online Training for SPECT Systems.  This online training is designed as a follow up to the syngo MI Applications Basic online training for SPECT Systems to provide more information on processing and displaying images. Upon successful completion of this course, you will be able to: Explain how to use the syngo Patient Browser Identify processing workflows and activities Understand the different organ specific processing activities Understand the commonly used non-organ specific post-processing activities Learn how to create customized display pages in Flexible Display Congratulations. You have completed the syngo MI Applications Advanced Online Training for SPECT systems course. Listed below are the key points that have been presented. Take time to review the material before you proceed to the final quiz. Understand how to use the syngo Patient Browser The syngo Patient Browser is used to correct, archive, send, delete, and filter data. Identify processing workflows and activities Processing workflow templates have processing activities that accept raw data from an Acquisition activity or Data Selector activity. This data is input to the processing activity. The output data is a series of reconstructed or analyzed data. Processing workflows do not contain acquisition activities. Understand the different organ specific processing activities Cardiac Workflows Gastrointestinal Workflows Lung Workflows Renal Workflows Thyroid Workflow Understand the different non-organ specific post-processing activities 3D Orientation AutoRecon DICOM Toolbox Quality Control Series Arithmetic Series Reformat Learn how to create customized pages in Flexible Display Page Layout: Layout on Screen and Hard Copy Pages Two Modes: Display and Edit Mode Several Display Objects 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 2019 Please proceed to the assessment.   syngo is the second tier of the software platform hierarchy. It is the common software platform between Siemens modality workstations. In this section, we will dive into the main functions of the syngo software within MI Apps. syngo Keyboard Shortcuts Learn about the syngo Keyboard Shortcuts. On the keyboard, the number keypad functions differently than a standard keyboard when using syngo software. As you can see on the diagram, the different buttons are shortcuts for interacting with the syngo software. The commonly used keys are “0” which opens the Patient Registration window and the “.” which opens the syngo Patient Browser.     Keyboard Shortcuts 1 Window Center +/- 7 Copy to Film Sheet 2 Scrolling Study +/- 8 Mark 3 Scrolling Series +/- 9 Correct 4 Scrolling Image +/- 10 Send to Node 1 5 Patient Registration 11 Configurable 6 Browser 12 Window Width +/- syngo Patient Browser Learn more about the syngo Patient Browser. Slide NumberText BlocksCalloutsAudio ScriptImage File1The syngo Patient Browser is used to correct, archive, send, delete, and filter data. There are 3 ways to access the syngo Patient Browser: Open the Patient pull-down menu and select browser.   Select the Patient Browser icon from the Command Module.   Select the Patient Browser shortcut from the syngo keypad.  The Browser shortcut is found where the decimal is typically located. The syngo Patient Browser is used to correct, archive, send, delete, and filter data. There are 3 ways to access the syngo Patient Browser: -One way is to Open the Patient pull-down menu and select browser. -Another is to select the Patient Browser icon from the Command Module. -Or select the Patient Browser shortcut from the syngo keypad. The Browser shortcut is found where the decimal is typically located on the numerical pad. 2Drop Down Menus – The menus contain various functions within the syngo environment.  Many of these options are the same as the icons from the toolbar.  The drop down menus contain various functions within the syngo environment. Many of these options are the same as the icons from the toolbar.3Toolbar – The toolbar contains icons which perform various functions within the syngo environment.The toolbar contains icons which perform various functions within the syngo environment.4Navigation Area – This is the main area of the syngo Patient Browser.  From here, the user can view the patient database, the scheduler, and any external devices configured for the system.  Within here the data is displayed in structure levels.   Structure Levels – There are 3 levels in which the data can be displayed.  The first is the patient level.  By selecting the patient level, the user can view the study level.  By selecting the study level, the user can view the series level. CalloutsPatient LevelStudy LevelSeries LevelThe Navigation Area is the main area of the syngo Patient Browser. From here, the user can view the patient database, the scheduler, and any external devices configured for the system. Within here the data is displayed in structure levels. There are 3 levels in which the data can be displayed. The first is the patient level. By selecting the patient level, the user can view the study level. By selecting the study level, the user can view the series level.5Content Area – The content area shows the contents of the selected data level in the navigation area. To change the view, select the view pull down and turn image stamps on or off.  The content area shows the contents of the selected data level in the navigation area. To change the view, select the view pull down and turn image stamps on or off. Patient Browser Toolbar Icons Learn more about the Patient Browser Toolbar Icons. Instructions:Flash File:/content/generator/Course_90021821/1-PatientBrowserToolbarIcons-Interactive-V2/1-PatientBrowserToolbarIcons-Interactive-V2.htmHTML5 File:/content/generator/Course_90021821/1-PatientBrowserToolbarIcons-Interactive-V2/index.htmlPDF File: Processing workflow templates have processing activities that accept raw data from an Acquisition activity or Data Selector activity. This data is input to the Processing activity. The output data is a series of reconstructed or analyzed data. Processing workflows do not contain acquisition activities. The MI Apps software offers several options for processing data. Many of these are used for automatic processing. Over the next several pages we will take a deeper look at the organ and non-organ specific post-processing activities. The activities covered include: Quality Control AutoRecon Gated Bloodpool Gastrointestinal Lung Processing Renal Processing Thyroid Processing 3D Orientation DICOM Toolbox Series Reformat and Series Arithmetic The Flexible Display activity is used to arrange and display all data acquired and processed within MI Apps. The activity can contain one or more display pages (tabs) with each page displaying one or more display objects.  Display objects have specific functions, such as display text, curves, bitmaps, and tomographic slices. Flexible Display Toolbar Learn more about the Flexible Display Activity Toolbar. Instructions:Flash File:HTML5 File:/content/generator/Course_90021821/9-Flexible_Display_Toolbar-Interactive_SPECT/index.htmlPDF File:   The Quality Control activity is used to: Access raw data for motion Apply automatic or manual motion correction Remove uniformity correction Create a tomo series from a dynamic tomo Beat normalize gated tomo data   Quality Control Activity Learn more about the Quality Control Activity. The AutoRecon activity is a multi-purpose activity that reconstructs all compatible tomo data and will automatically align reconstructions of multiple-bed whole body tomo data. AutoRecon can reconstruct SPECT data, perform scatter estimation or correction, perform attenuation correction, process wholebody data, and adjust the orientation of SPECT data. AutoRecon on a Cardiac Tomo Example Learn more about AutoRecon on a Cardiac Tomo. There are a number of cardiac processing workflows available in MI Apps.  In this section we will dive into the different workflows.  Cardiac Workflows covered in this section: Planar Gated Bloodpool Cardiac First Pass Cardiac Tomo Recon Cardiac Workflow - Planar Gated Bloodpool Learn more about Planar Gated Bloodpool Cardiac Workflow. Cardiac Workflows Learn about three examples of Cardiac Workflows. Slide NumberText BlocksCalloutsAudio ScriptImage File1Planar Gated Bloodpool Planar gated bloodpool processing workflows are used to calculate the cardiac ejection fraction and other cardiac functional parameters, display wall motion, and analyze cardiac volume curves.  The gated bloodpool activity calculates an ejection fraction of the left ventricle in an LAO projection.  Cardiac wall motion is displayed as well as an analysis of the volume curves.  Volume curves are created utilizing a synchronized acquisition to the R wave.  Planar gated bloodpool processing workflows are used to calculate the cardiac ejection fraction and other cardiac functional parameters, display wall motion, and analyze cardiac volume curves. The gated bloodpool activity calculates an ejection fraction of the left ventricle in an L.A.O. projection. Cardiac wall motion is displayed as well as an analysis of the volume curves. Volume curves are created utilizing a synchronized acquisition to the R-wave.2Cardiac First Pass The purpose of the cardiac first pass processing workflow is to: Calculate the cardiac ejection fraction Parameters such as wall motion Analyze cardiac volume curves The gated bloodpool activity used in the cardiac first pass workflow is used to convert a first pass image acquired using a dynamic acquisition, synchronized with the R-wave into a gated cardiac pool image to calculate the cardiac ejection fraction.   The purpose of the cardiac first pass processing workflow is to calculate the cardiac ejection fraction parameters such as wall motion and analyze cardiac volume curves. This can be used for both left and right ventricles. The gated bloodpool activity used in the cardiac first pass workflow is used to convert a first pass image acquired using a dynamic acquisition, synchronized with the R-wave into a gated cardiac pool image to calculate the cardiac ejection fraction. 3Cardiac Tomo Recon The AutoRecon activity is a multipurpose activity that reconstructs all compatible tomo data and will automatically align, or zip, reconstructions of multiple-bed whole body tomo data.  The AutoRecon activity can correct tomo input data for scatter and attenuation and will output reconstructed Filtered Back Projection or Iterative Reconstruction Volumes.  The AutoRecon activity is a multipurpose activity that reconstructs all compatible tomo data and will automatically align, or zip, reconstructions of multiple-bed whole body tomo data. The auto recon activity can correct tomo input data for scatter and attenuation and will output reconstructed Filtered Back Projection or iterative reconstruction volumes. The Gastrointestinal Processing workflows contain the Gastrointestinal activity. The purpose of the Gastrointestinal activity is to assess the amount of excretion from the gallbladder, provide an ejection fraction, and evaluate gastric emptying. It contains two processing methods for either gastric emptying calculations or hepatobiliary calculations depending on how the activity is saved within the workflow. Gastrointestinal Workflows Gastric Emptying Hepatobiliary Gastrointestinal Workflow - Gastric Empty Learn more about Gastric Emptying Workflow. Gastrointestinal Workflow - Hepatobiliary Learn more about Hepatobiliary Workflow. Lung processing workflows contain the lung processing activity. The lung processing activity creates functional images that are useful for pulmonary function analysis. The Lung processing activity accepts two series: Vent-Perfusion Lung Perfusion The output of the lung processing activity is statistical results, time activity curves, wash in/wash out analysis, and regional analysis. Lung Perfusion Learn more about Lung Perfusion Workflow. Renal Processing workflows contain the renal processing activity which is used to measure kidney function, such as blood flow, glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and split uptake. The following renal methods are available: •Captopril Comparison •Gates GFR (DTPA) •Itoh ERPF (MAG3) •MAG3 (without Samples) •Oberhausen •Oriuchi Clearance (MAG3) •Bubeck (TER) •Generic (None) Renal Processing Learn more about Renal Processing Workflow. The thyroid processing workflows contain the thyroid processing activity which is used to compute the thyroid uptake as a percentage of the injected dose. There are two thyroid processing methods for the calculation of the injection: syringe images or dose calibrator. The syringe image method utilizes count values obtained from a capsule or syringe image prior to dosing the patient. Uptake values are corrected for decay. The dose calibrator uses a correction factor based upon the administered dose measurement and a calibration factor which was entered manually. Thyroid Uptake Learn more about Thyroid Uptake. The Thyroid processing activity calculates the area, volume, weight, and split uptake of the thyroid. The user can calculate the uptake using syringe images, a combination of syringe images and dose calibrator, or dose calibrator only. The workflow opens to the Thyroid Processing activity’s ROI tab. Verify the system has correctly identified the thyroid image, full syringe, and empty syringe images. Verify the regions are correct. Select the Results tab and then review the results.   Series Reformat and Series Arithmetic are post-processing activities.  Series Arithmetic Learn more about the Series Arithmetic Activity. The Series Arithmetic activity is used to perform frame mathematics on one or more series and then the results can be saved as a new series.  This activity is used to perform a scaled subtraction function for automatic normalization of count differences between images, image registration, and variable subtraction within the parathyroid processing workflow. This activity performs as a macro recorder so all operations performed as remembered by the activity.  After saving the workflow, all operations performed within Series Arithmetic will be applied automatically in the future. Additional functions include: Series arithmetic using a constant Frame arithmetic Creating a composite Extracting Merging static series Scaled subtraction Geometric mean Series Reformat Learn more about the Series Reformat Activity. The series reformat activity can be used to: Pan Zoom Rotate Flip horizontal Flip vertical Adjust brightness and contrast Normalize Revert image Annotate Draw arrows Measure distance Measure angle Correlate cursors Masking Matrix conversion This activity also operates like a macro recorder, meaning all operations performed will be remembered by the activity.  Results can be saved as a new series. As mentioned in the Basic training, the hard copy activity can be used to: Save print areas to the database Save screen Configure print area properties Generate hard copy output, such as film or paper One or more print areas can be saved into a single save screen series. By selecting the desired screen shown in the Results list, then move it using the arrows to either the Hard Copy box for prints or the Save Screens box to create a save screen series. Steps to Immediate Printing Learn more about the Steps to Immediate Printing. A print area can be sent to printer prior to completion of the workflow within the Hard Copy activity.   To do this, select the print area either in the Results list or the Hard Copies list so that the print area appears in the Preview area.  If the preview is acceptable, then select the “Print Selected Print Area” button.   There are tools available to help troubleshoot the system. They can all be found in the Options menu under Service. MI Apps Cleanup Get Logs* Save Log* *When logs are captured, they will be saved to H:\SiteData\MI\Log   MI Apps Cleanup Learn more about Troubleshooting using MI Apps Cleanup. Click here for a downloadable procedure for running MI Apps Cleanup   MI Apps Cleanup is a utility available for when a workflow will not exit normally. There are two options within MI Apps Cleanup: Force Shutdown of High-Level Processes Force Shutdown of High-Level Processes and Low-Level Servers A log of the following will be captured: List of processes killed during the cleanup Log files captured in the Get Logs process List of running processes on the system The pages within Flexible Display allow the user to customize the presentation of the clinical data and results. The pages can be created as layout pages to be reviewed or hard copy pages. Users can create as many pages as desired. There are two modes for the viewing a page: Display mode and Edit mode. Display mode is used to view the final layout while edit mode is used to configure the page with display objects. When in edit mode, the display object toolbar allows you to create a page layout using display objects. The display object properties vary between the different display object types. Display Mode Options Learn more about Display Mode Options. The display can be customized to the user’s preferences. The color bar displays the color look-up tables, or LUT, for the frameset, which enables brightness, contrast, and color to be adjusted for the displayed images. All frames in the frame set share the same color bar; however each individual frame set can have its own color bar.       Creating a New Page in Flexible Display Learn how to create a New Page in Flexible Display. Instructions:Flash File:/content/generator/Course_90021821/10-NewPageFlexDisplay-Interactive-V2/10-NewPageFlexDisplay-Interactive-V2.htmHTML5 File:/content/generator/Course_90021821/10-NewPageFlexDisplay-Interactive-V2/index.htmlPDF File: The 3D orientation activity performs volume rotations, zooming, and centering of reconstructed data. In automatic mode, angles and zoom factors can automatically be applied without user interaction. In interactive mode, the user applies the parameters manually each time. The DICOM toolbox activity has four primary functions: Remove flood corrections from nuclear medicine data prior to transferring to other vendor’s workstations   Display a Siemens nuclear medicine static or whole body series in order to edit the view name for all the frames belonging to the same detector   Convert Siemens nuclear medicine dual detector representation of Tomo and Gated Tomo data into a single detector representation so that other vendors can accept syngo MI Applications data formats prior to processing   Convert Siemens PET DICOM formatted data into a nuclear medicine DICOM format to aid interpretation on workstations that do not recognize PET DICOM formats