syngo.via - CT Myocardial Perfusion

syngo.via® CT Myocardial Perfusion syngo.via CT Myocardial Perfusion is designed to aid in the evaluation of blood perfusion of the cardiac mus- cle. The software can calculate blood flow, blood volume, and other parameters from sets of images recon- structed from dynamic CT data of the heart. Quantitative evaluation of the myocardial blood flow may ena- ble a more robust assessment of the hemodynamic relevance of intermediate coronary stenosis. 1. From the Patient Worklist, load an appropriate data set into the CT Myocardial Perfusion Workflow: • If the examination has been correctly mapped, double click to load • If manual mapping is required, right-click the examination and select Open With > CT Myocardial Perfusion 2. Myocardial Perfusion results are auto-processed and can be 1: Motion Correction viewed on the Perfusion Evaluation step. Align Exclude Information if x Exclude Align Baseline Range Base 2: Segmentation i Results are already available and can be viewed in the Perfusion Evaluation Task. 3: Vessel Definition 4: Results Preview 5: Results OK Perfusion Evaluation MM Reading 3. In the Perfusion Evaluation step, Circular or Freehand ROIs can be drawn to obtain additional quanti- tative information about the myocardial perfusion data set. Results are populated to the Statistics tab, which can be exported with a right mouse click. Perfusion Evaluation O FIT Circular Freehand VOI TAC Marker 32.00 Statistics GIRO ROI/VOI MIP BF [1] ROI (MPR) [1] ROI 141.09 83.85 Mean: 83.85 mL/100mL/min . Mean Value /HU Standard Deviation / HU Area/cm2 or Volicm3 SIEMENS Unrestricted 0 Published by Siemens Healthcare GmbH “ Siemens Healthcare GmbH, 2020 Healthineers Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 5/1/2017| HOOD05162002591642 Job Aid | syngo.via CT Myocardial Perfusion Effective Date: 5/1/2017| HOOD05162002591642 CT Myocardial Perfusion 4. Should a manual evaluation be desired or necessary, return to the CT Myocardial Perfusion workflow step and select the Myocard tem- Myocard Myocard TAC Reset plate. Clinical administrators can create new custom templates using 0.00s the Configuration under the gear icon 1: Motion Correction Evaluate the quality of the CT examination by navigating through the time points of the data set using the Time Slider. Align Exclude Exclude Range Align Baseline Base 2.43s 2: Segmentation 3: Vessel Definition 4: Results Preview 5: Results Perfusion Evaluation MM Reading Motion Correction and Time Point Exclusion: During preprocessing, syngo.via performs a motion correc- tion of the dynamic data set. Use the Motion Correction step to improve images that still show motion. • To perform an automated myocardial motion correction, click the Align icon. Possible shifts between the caudal the cranial cardiac parts are corrected, followed by a non-rigid Align registration of the volume. • To define a new motion correction base: • Navigate on the Time Slider to the desired time point. Align Base • Click the Align Base icon on the Case Navigator, and the white triangle will jump to the selected time point. • To exclude time points from evaluation: • Navigate on the Time Slider to the desired time point. • In the Case Navigator, click the Exclude icon to exclude the currently displayed BE time point, or click the Range Exclude icon to exclude all time points from the cur- rently displayed to the last available time point. E Segmentation and 4D Noise Reduction: Use the Segmentation step to reduce image noise and to check and define the volume and structures for evaluation. SIEMENS Unrestricted 0 Published by Siemens Healthcare GmbH “ Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Healthineers Job Aid Effective Date: 5/1/2017| HOOD05162002591642 Page 2 of 4 Job Aid | syngo.via CT Myocardial Perfusion Effective Date: 5/1/2017| HOOD05162002591642 • If the images are very noisy because of low kV or low dose, enable the Reduce Noise icon to perform a 4D Noise Reduction. This should be applied only after motion correction Reduce and only if no motion (or negligible motion) is still present. If there is still motion in the Noise image, do not use. • The Segment Myocard icon is used to edit the Volume of Interest (VOI) which is automatically created to include all of the left ventricle. Segment Myocard • HU Segment is used to exclude bone, air, and fat. You can fine tune the results by adjusting the values of the HU-based segmentation. min -50 HU HU Segment max 150 HU In the Vessel Definition step the Arterial Input Function (AIF) is defined by the system. Use the Cranial and/or Caudal icons to redefine the respective arteries manually if necessary 3: Vessel Definition max. Enhance. 422 HU Cranial Caudal Window • The Max. Enhancement is automatically calculated after the reference vessel has been identified. You can change the value for maximum enhancement of the reference vessel if the value is underestimated or was not properly identified. • Adjust the threshold of the purple vessels overlay if the overlay wrongly covers other tissues or big vessels are not covered. • Enable the Window icon • Use the middle mouse to window vessels in and out, or manually enter a value in the Window current threshold window. • Disable the Window icon to complete. Results Preview: Click the Results Preview step once the vessels are properly defined. SIEMENS Unrestricted 0 Published by Siemens Healthcare GmbH “ Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Healthineers Job Aid Effective Date: 5/1/2017| HOOD05162002591642 Page 3 of 4 Job Aid | syngo.via CT Myocardial Perfusion Effective Date: 5/1/2017| HOOD05162002591642 • Check the displayed result images 5: Results Preview Check result images. Click Confirm to save and start the evaluation. Unsaved results • Click Confirm to start the evaluation and to will be deleted. proceed to the Results step. Confirm Results: In the Results step, Circular or Freehand ROIs can be drawn to obtain additional quantitative in- formation about the myocardial perfusion data set. Results are populated to the Statistics tab, which can be exported with a right mouse click. 6: Results Fit Circular Freehand VOI Marke SIEMENS Unrestricted 0 Published by Siemens Healthcare GmbH “ Siemens Healthcare GmbH, 2020 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Healthineers Job Aid Effective Date: 5/1/2017| HOOD05162002591642 Page 4 of 4