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SIEMENS O - MR Perfusion Task Card Postprocessing VILT - Eline VILT Workbook SIEMENS Healthineers www.siemens-healthineers.us I. Contact Information Summary Welcome to Siemens Healthineers Visit www.usa.siemens.com/clinicaleducation for more information regarding the current Siemens Siemens Healthineers is dedicated to helping you get the Clinical Training and Continuing Education portfolio. most out of your investment throughout the entire product life cycle and beyond. Our goal is to enable you Discover. Try. Buy. on webShop to take technology further, profitability higher, and patient care to the next level. Find the information, resources, and Do you want to “Discover. Try. Buy.” options, accessories, tools you need to get the most out of your recent and clinical education to make the most of your investment and stay up-to-date. imaging equipment? Discover images, case studies, Visit https://new.siemens.com/us/en.html. and video demonstrations with the latest clinical applications. Try advanced applications utilizing Clinical Training and Continuing Education free software trials. Buy applications, coils, clinical education, and accessories, conveniently at any time. Customer Care Center - Clinical Application Support: Visit www.usa.siemens.com/webShop today! Call 1-800-888-7436 Siemens Training Centers Troubleshooting assistance • Immediate assistance for software Siemens Clinical Education • applications and workflow issues Training Center – TDC2 110 Mac Alyson Court Please provide the Functional Location Number when • Cary, NC 27511 calling for assistance. Clinical Education Offerings: Call 1-888-221-8010 (follow the prompts) Classroom Training (Offerings, Registration • & Scheduling) Educational Symposia • On-site Training • Printed Self-studies • Virtual Education (Offerings & Registration) • Workshops & Fellowships • 2 II. Contents I. Contact Information Summary ...........................................................................................................................2 II. Contents ..................................................................................................................................................................3 III Course Description ................................................................................................................................................4 IV Agenda .....................................................................................................................................................................5 Perfusion (MR) Task Card – Exercises .................................................................................................................. 6 Job Aid ..........................................................................................................................................................................7 Perfusion Evaluation (MR) (Global & Local Methods) A to E-line ........................................................ 8 3 III Course Description Course Overview: The MR Perfusion Virtual Instructor Led course reviews post-processing using the Perfusion (MR) Task Card. Perfusion is used to display and evaluate Perfusion weighted images and calculate Perfusion Maps. Upon completion of this VILT the Siemens MAGNETOM® Technologist will be able to: Review Perfusion (MR) Task Card Post-Processing workflow • Demonstrate the Global AIF workflow • Demonstrate the Local AIF workflow • Demonstrate how to save Perfusion Maps using Global or Local AIF workflow • Demonstrate how to save Perfusion Maps as an RGB image • 4 IV Agenda Virtual Training overview ...................................................................Didactic 1. Introductions 2. WebEx Tools and Features 3. Virtual Training Suggestions 4. Learning Objectives 5. Questions Perfusion (MR) Task Card Post-Processing .....................................Didactic 1. Review how to load series into the Perfusion (MR) Task Card 2. Review Perfusion (MR) Task Card layout 3. Review Global AIF Method a. Select Global AIF Icon b. AIF Input Function Icon Position the AIF ROI • c. Select AIF Input Curves d. Set Time Ranges 1st Line • 2nd Line • i3rd Line • Confirm Time Ranges • e. Select Perfusion Maps for Calculation f. Execute Protocol Icon g. Save each Perfusion Map (Repeat to save each Map) Enter Perfusion Map Name • iSelect OK • 4. Review Local AIF Method a. Select Local AIF Icon b. Select Maps – from dropdown c. Execute Protocol Icon d. Save each Map (Repeat to save each Map) Enter Map Name • Select OK • 5. Review how to Save Perfusion Maps as an RGB a. Open Patient Browser Select Perfusion Map and save as RGB • Send Perfusion Color Maps to PACS • 5 VILT Workbook | MR Perfusion Task Card Postprocessing VILT - Eline Perfusion (MR) Task Card – Exercises Perform Perfusion (MR) Task Card workflow 1. Load series into the Perfusion (MR) Task Card 2. Review Perfusion (MR) Task Card layout 3. Perform the Global AIF Method a. Select Global AIF Icon b. AIF Input Function Icon Position the AIF ROI • c. Select AIF Input Curves d. Set Time Ranges 1st Line • 2nd Line • 3rd Line • Confirm Time Ranges • e. Select Perfusion Maps for Calculation f. Select the Execute Protocol Icon g. Save each Perfusion Map (Repeat to save each Map) Enter Perfusion Map Name • Select OK • 4. Review Local AIF Method a. Select Local AIF Icon b. Select Maps – from dropdown c. Execute Protocol Icon d. Save each Map (Repeat to save each Map) Enter Map Name • Select OK • 5. Save Perfusion Maps as an RGB a. Open Patient Browser Select Perfusion Map and save as RGB • Send Perfusion Color Maps to PACS • 6 Job Aid 7 Perfusion Evaluation (MR) (Global & Local Methods) A to 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 >selectPerfusion series (ep2D_perf) Report Open a. SelectApplications > Perfusion (MR) Report Tools Mosaic 3D Argus BreVis 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. SelectAIF 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 8 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 9 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. SelectExecute Protocol Icon – Starts Perfusion Map Reconstruction Scroll Protocol System Options Help Step 1: Select AIF Step 2 Set Time Ranges wy Viewing 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. SelectSegment > Right MouseSelect Series ii. SelectPatient > 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 Patient WORKFLOW_ADV_NEURO_1 Browser Num Study ANW HEAD Close Patient Series RELMIT GLOBAL_ep2d_perf_pz 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 Home Window Home Zoom/Pan Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 Page 3 of 5 10 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. SelectMaps i. Drop down select Maps needed for calculation All Maps All Maps All_Maps_Moco reIMTT relCBF TTP_reIMTT c. SelectExecute Protocol Icon – Starts Perfusion Map Reconstruction d. Save Maps – each series must be saved independently i. SelectSegment > Right MouseSelect Series ii. SelectPatient > 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 Patient WORKFLOW_ADV_NEURO_1 Num Study ANW HEAD Close Patient Series RELCBV_LOCAL_ep2d_perf_p2 Save As Images 1 Filming Layout. . Save images in new series relCBV Map 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 11 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 (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. 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Availability and packaging may vary by country and is subject to change without prior notice. Some/All of the features and products described herein may not be available in the United States. The information in this document contains general technical descriptions of specifications and options as well as standard and optional features which Local Contact Information do not always have to be present in Siemens Medical Solutions USA, Inc. individual cases. 40 Liberty Blvd. Malvern, PA 19355-9998 Siemens reserves the right to modify the USA design, packaging, specifications and Telephone: +1-888-826-9702 options described herein without prior siemens.com/healthcare notice. Please contact your local Siemens sales representative for the most current information. Legal Manufacturer Imaging & Therapy Systems Magnetic Resonance Note: Any technical data contained in Henkestr. 127 this document may vary within defined DE-91052 Erlangen tolerances. 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