syngo.via MI VB30-VB60 Delta Job Aid Part 2 - Neurology & Cardiology

SIEMENS Healthineers syngo.via MI Neurology and MI Cardiology VB30-VB60 News & Improvements Version 2021 Template Effective Date: 27 May 2019 | HOOD05162003010284 Job Aid Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 Please note This learning material is only providing you with information about the highlights of the syngo.via versions VB40, VB50, and VB60. In order to get the complete information, please consider the corresponding delta training material shown in the ‘Upgrade (Delta Training)’ section of the syngo.via Training Area. 2 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 syngo.via MI Neurology and MI Cardiology VB30-VB60 SIEMENS Healthineers News & Improvements | Table of Contents MI Neurology 4 MI Cardiology 19 -... .... 3 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers MI - News & Improvements MI Neurology 4 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 MI Neurology SIEMENS Healthineers Following enhancements are available in MI SIEMENS Healthineers MI_Neur Scenium_HMPAO2 ... x Tc-99m HMPAO Neurology: Favorite Tools MI Neurology O. stance ROI Circle Area Text Snapshot FAST Rangres Hide • Brain AC-PC automatically orients PET or MI Neurology X Patient Name :_MI_Neuro_Scenium_HMPAO2"SPECT_MR_Epilepsy Patient ID : Tc-99m HMPAO Patient Birthdate, Sex and Age : 01.01.1987, F, 017Y Study Description : Brain Scan Study Date : 16.01.2004 Study Time : 12:35:19 Energy Window 1: 99m Technetium Radiopharmaceutical : ECD Accession Number : 0 Favorite Tools SPECT neurological data to provide quick ALF HLA Fused Basic Volume Functional Fused 2x4 HL Axial 3x ... Display Strip ... Axial 3x ... + Movie _MI_Neuro_Scenium_HMPAO2, SPECT_MR_Epilepsy 0,00 MB MI_Neuro_Scenium_HMPAO2, SPECT_MR_Epilepsy reading in a clinically relevant orientation Tc-99m HMPAO Tc-99m HMPAO 0,00 MBq MI_Neuro_Scenium_HMPAO2, SPECT_MR_Epilepsy Tc-99m HMPAO 0,00 MBq *01.01.1987. F. 17Y *01.01.1987. F. 17Y *01.01.1987, F. 17Y Hybrid 3x3 CURRENT CURRENT CURRENT STUDY ID 1 STUDY ID 1 STUDY ID 1 SPECT [RECON] . 2. SPECT [RECON] 1. 3 SPECT [RECON] .4. 18.01.2004 16.01.2004 16.01.2004 MI Neurology Analysis 12:55:02 12:55:02 12:55:02 SP H69,8 SP L212,0 SP P135,0 Series • Optimized neurology layouts in the Layout RAH ALF RAH Primary Monitor MAR MFR Gallery 1:2 Database Cortical Striatal Subtract indings 128"128 128*128 128*128 Relaunch • Neurology application Relaunch option ALH HPL HPL . 5, 6 Printing RAH ALH RAH MPR FUSION MPR FUSION MPR FUSION SL min SL min SL min SPC 0,5 SPC 0,5 SPC 0,5 10 cm 5 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 HOOD05162003046557_Unrestricted © Siemens Healthineers, 2019 MI Neurology Applications SIEMENS Healthineers SIEMENS Database Comparison Healthineers Server. 192.168.236.155 $500_t ? H & MI Neuro FDG 1 MI_Onco_5TP_1 X MI Neuro Da ... X * 01.01.1929 F MI Neuro FDG 1 MM Oncology MI Neurology View Annotations Tools Databases Help MI Neurology Q + K • Multi Frame Secondary Capture abc MI Reading Database Comparison Uptake SSP Uptake Neurology Analysis PET Brain (AC) F^18^[^ 18^Fluorine] • Fused statistics Analyses Fusion to CT _MI_Neuro_FDG_1 Scale: 0.5 FoV: 21.1x24.1cm MI_Neuro_FDG_1 Scale: 0.5 FoV: 21.2x24.1cm -MI_Neuro_FDG_1 cale: 0.5 FoV: 21.8x24.1cm F 079Y 01-Jan-1929 PET: W 25165.3 L 15378.8 |F 079Y 01-Jan-1929 is PET: W 25165.3 L 15378.8 F 079Y 01-Jan-1929 PET: W 25165.3 L 15378.8 Fusion to Template Universitaetsklinikum Erlangen Universitaetsklinikum Erlangen Universitaetsklinikum Erlangen Primary _MI_Neuro_FDG_1 _MI_Neuro_FDG_1 _MI_Neuro_FDG_1 • Filter statistics 1:2 Analysis Database Cortical Striatal Sobiract Anatomical Review ------------ 3D Hybrid View Color Maps PET Striatal Analysis -10 -8 -6 - Statistics (#Std Dey) Stereotactic Surface Projection Filter Statistics • Multi Frame Secondary Capture 3D Volume Effect Regions of Interest Key Images Factory databases AAL regions • Name Mean (Upta ... # Std.Dev fr Amygdala ( ... 5.28 1.8 Axial Coronal Sagittal Amygdala ( .. 5.11 2.0 PET:14-Oct-2008 09:50:52 Slice 56/91 |PET:14-Oct-2008 09:50:52 Slice 55/109 PET:14-Oct-2008 09:50:52 Slice 48/91 Angular gyr ... 5.18 -3.6 Angular gyr ... 5.13 -3.7 Statistics SSP Statistics CT SD-CT Anterior cin ... 5.05 -1.4 FDG2A: FDG-PET Biograph Age Range: 46 - 79 Normalization: Cerebellum + Vermis (AAL) Anterior cin. 5.36 -1.1 Cortical Analysis Findings Navigator Calcarine fi .. 5.96 -2.0 Right Lateral S Left Lateral S Anterior Posterior Calcarine fi .. 6.61 -1.4 Name Value Source Caudate nu ... 4.92 -2.0 MFSC Neur Caudate nu. 4.47 -1.7 Cerebellum ... 4.03 0.2 Cerebellum ... 3.61 -0.1 Cerebellum ... 4.52 -0.4 P AA PR Cerebellum. 4.23 -0.6 • Multi Frame Secondary Capture Cerebellum ... 5.85 2.0 Cerebellum. 5.90 2.1 Cerebellum ... 6.32 -0.3 Cerebellum. 6.18 0.4 Cerebellum ... 5.31 -2.0 Cerebellum. 4.74 -1.3 Corahallum Superior Inferior Right Medial Left Medial Tools Values displayed are body weight SUVs Subtraction L Synch Full Tex Hide Hide Lines Reset Graphics Timepoints • Multi Frame Secondary Capture Edit Snapshot Print Image Export Undo Redo Layout Image 15:25 6 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 HOOD05162003046557_Unrestricted © Siemens Healthineers, 2019 MI Neurology SIEMENS Healthineers Multi Frame Secondary Capture MFSC – Multiframe Secondary Capture View Annotations Help • abc + Uptake SSP Uptake • One-click export entire volume for Database Comparison Amyloid F^18^[ 18"Fluorine] AV-45 Fusion to MR . Alzheimer's disease (amyloid) Scale: 0.5 FoV: 27.5x24.1cm - Alzheimer's disease (amyloid) Scale: 0.5 FoV: 27.5x24.1cm - Alzheimer's cisease (amloid) O-L-L PET: W 22170 L.13516.7 0-/ --- PET: W 22170 L 13516.7 O-C- archiving Fusion to Template 201011222 201011222 201011222 Analysis Anatomical Review Neurology Analysis Color Maps PET Primary ...... -10 -8 -6 4 2 0 2 1:2 Statistics (#Std Dev) 6 Stereotactic Surface Projection Databar Cortical Striatal Subtract 3D Volume Effect Filter Statistics Regions of Interest Key Images AAL regions Name Mean (Upta ... # Std. Dev fr Amygdala 11084.9 6.2 Aiall Amygdala ( 10595.3 49 PET:-/- Slice 42/91 T- Angular gyr ... 14284.5 6.8 Angular gyr. 14598.2 7.0 Statistics SSP Statistics MR SD-MR Anterior cin .. 14997.1 5.7 florbelapir2A: florbetapir PET Age Range: 50 - 93 Normalization: Cerebellum (orbetapir) Anterior cin 15630.2 6.3 Calcarine fi. 12358.2 7.4 - Alzheimer's disease (amyloid) A Scale: 0.5 Fov: 27.5x24.1cm Alzheimer's die O-L-L Calcanine fi. 12171.6 4.9 Caudale nu 6626.7 -0.4 201011222 01011222 Caudate nu 6816.1 -0.1 Cerebellum 7841.8 0.2 Cerebellum. 7842.9 0.1 Cerebellum 8901.2 0.5 Cerebellum 9935.6 1.8 Cerebellum. 8261.6 1.5 Cerebellum 8544.4 21 Cerebellum. 7382.1 0.3 Cerebellum 7368.8 0.2 Cerebellum 5588.3 -1.4 Cerebellum. 5301.2 -1.9 R Carhallum Values displayed are (-) ARY PET:-4. Axial Sice 42/91 T:-4. HOOD05162003046557_Unrestricted © Siemens Healthineers, 2019 7 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 MI Neurology SIEMENS Healthineers Multi Frame Secondary Capture - How to Create it 1. Select a fused or non-fused image segment. View Annotations Tools Databases Help Delete Delete 2. Choose either: + Select All -‘ ++ Snapshot View Ctrl+S Snapshot Screen Ctrl+Shift+S • Tools > Create MFSC MFSC icon Create MFSC Ctrl+M • Preview 3. MFSC series will show up in Series Navigator under Export Ctrl+E Additional Data and in Findings Navigator Copy to Clipboard Ctrl+C Configure ROI Categories 8 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 HOOD05162003046557_Unrestricted © Siemens Healthineers, 2019 MI Neurology SIEMENS Healthineers Fused Statistics MR SD-MR • Anatomical images of the patient Statistics SSP Statistics can be shown with an overlay of florbetapir2A: florbetapir PET Age Range: 50 - 93 Normalization: Cerebellum (florbetapir) MI_Neuro_Amyloid_AD_1 A Scale: 0.38 _MI_Neuro_Amyloid_AD_1 S Scale: 0.38 MI_Neuro_Amyloid_AD_1 SScale: 0.38 Fov: 21.8x31.1cm the statistics image (overlayed M-A- FoV: 21.1x31.1cm |M -/- - /- FoV: 21.2x31.1cm |M -/- - /- CT/MR) _MI_Neuro_Amyloid_AD_1 MI_Neuro_Amyloid_AD_1 MI_Neuro_Amyloid_AD_1 Neurology Analysis Primary C R LR A Database Cortical Strlatal Subtract PET:-/- Axial |PET:-/- MR: 25-Aug-2008 10:45:39 Slice 42/91 |MR:25-Aug-2008 10:45:39 Coronal |PET:-/- Sagittal Slice 52/109 |MR:25-Aug-2008 10:45:39 Slice 46/91 9 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 HOOD05162003046557_Unrestricted © Siemens Healthineers, 2019 MI Neurology SIEMENS Healthineers Fused Statistics - How to Show them Statistics SSP Statistics CT SD-CT FDG2A: FDG-PET Biograph Age Range: 46 - 79 Normalization: Cerebellum + Vermis (AAL) _MI_Neuro_FDG_1 Scale: 0.38 - _MI_Neuro_FDG_1 Scale: 0.38 MI_Neuro_FDG_1 S Scale: 0.38 FoV: 21.8x31.1cm F 079Y 01-Jan-1929 FoV: 21.1x31.1cm F 079Y 01-Jan-1929 FoV: 21.2x31.1cm F 079Y 01-Jan-1929 Universitaetsklinikum Erlangen! Universitaetsklinikum Erlangen ! Universitaetsklinikum Erlangen • Depending on the available _MI_Neuro_FDG_1 _MI_Neuro_FDG_1 _MI_Neuro_FDG_1 anatomical data (CT or MR), Database Comparison choose the appropriate tab and adjust transparency Fusion to CT LR Fusion to Template • Control transparency and/or Analysis filtering of overlaid statistics Anatomical Review image Color Maps PET:14-Oct-2008 0 CT:24-Nov-2008 13:01:53 Axial PET:14-Oct-2008 09:50:52 Coronal PET:14-Oct-2008 09:50:52 Sagittal P Slice 56/91 CT:24-Nov-2008 13:01:53 Slice 55/109 CT:24-Nov-2008 13:01:53 Slice 48/91 PET CT Statistics SSP Statistics MR SD-MR florbetapir2A: florbetapir PET Age Range: 50 - 93 Normalization: Cerebellum (florbetapir) _MI_Neuro_Amyloid_AD_1 A Scale: 0.38 MI_Neuro_Amyloid_AD_1 $ Scale: 0.38 MI_Neuro_Amyloid_AD_1 ; SScale: 0.38 Fov: 21.8x31.1cm M --- -- FoV: 21.1x31.1cm |M -/- - /- FOV: 21.2x31.1cm |M -/- - /- -10 -8 -6 -4 -2 0 2 4 6 _MI_Neuro_Amyloid_AD_1 MI_Neuro_Amyloid_AD_1 MI_Neuro_Amyloid_AD_1 Statistics (#Std Dev) 18 Stereotactic Surface Projection v 3D Volume Effect Filter Statistics Transparency SD CT PET:-/- Axial |PET:-/- Sagittal MR: 25-Aug-2008 10:45:39 Slice 42/91 | MR: 25-Aug-2008 10:45:39 Coronal |PET:-/- Slice 52/109 |MR:25-Aug-2008 10:45:39 Slice 46/91 10 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 HOOD05162003046557_Unrestricted © Siemens Healthineers, 2019 MI Neurology SIEMENS Healthineers Filter Statistics Statistics SSP Statistics CT SD-CT FDG2A: FDG-PET Biograph Age Range: 46 - 79 Normalization: Cerebellum + Vermis (AAL) - M_Neuro_FDG_1 Scale: 0.38 - M_Neuro_FDO_1 S Scale: 0.38 -MI_Neuro_FDO_1 $ Scale: 0.38 FOV: 21.8x31.1cm F 079Y 01-Jan-1929 FOV: 21.1x31.1em F 079Y 01-Jan-1929 FoV: 21.2x31.1cm F 079Y 01-Jan-1929 Universitactsklinikum Erlangen! Universitactsklinikum Erlangen: Universtaetsklinikum Erk _M_Neuro_FDG_1 M_Neuro_FDG_1 _MI_Neuro_FDG_1 ............ Statistics values from the Statistics color bar can be filtered so that only the standard deviation values of concern are visible on the statistics images. R ... Standard statistics volume The filtered-out values appear as gray background PET:14-Oct-2006 09:50.52 Slice 50/91 PET.14-Oct-2006 09-50.52 Slice 55/109 PET-14-Oct-2008 09:50:52 Sactta ............... • Statistics SSP Statistics CT SD-CT FDG2A: FDG-PET Biograph Age Range: 46 - 79 Normalization: Cerebellum + Vermis (AAL) Right Lateral S Left Lateral S Anterior S osterior SSP statistics image • The filtered-out values appear as gray background Superior Inferior Right Medial Left Medial Statistics fused with MR or CT • The filtered-out values become translucent Statistics SSP Statistics CT SD-CT FDG2A: FDG-PET Biograph Age Range: 46 - 79 Normalization: Cerebellum + Vermis (AAL) -_M_Neuro FDG_1 Scale: 0.38 - MI Neuro_FDG 1 S Scale: 0.38 . MI_Neuro_FDG_1 SScale: 0.38 FoV: 21.8x31.1cm F 079Y 01-Jan-1929 FoV: 21.1x31.1cm F 079Y 01-Jen-1929 FoV: 21.2x31.1cm F 079Y 01-Jan-1929 Univers toetskinkum Erlangent Universitactsklinikum Erlangen Universitoetskinkum Erlangen M_Neuro_FDG_1 MI_Neuro_FDG_1 M_Neuro_FDG_1 ......... -- LR PET:14-Oct-2008 09: 50:52 CT 24-Nov-2008 13:01:32 Since som FET.14-Oct-2003 08.50:52 propos PET:14-Oct-2003 08:50:52 ............ Slice 56/109 CT.24-Nov-2008 13:01:32 ................................... 11 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 HOOD05162003046557_Unrestricted © Siemens Healthineers, 2019 MI Neurology SIEMENS Healthineers Filter Statistics - How to Do it Database Comparison • Adjust handles to remove negative or positive standard deviation numbers Fusion to CT • Set checkmark to apply slider settings to SSP display Fusion to Template Analysis Anatomical Review Color Maps PET CT -10 -8 -6 -4 -2 2 4 Statistics (#Std Dev) Stereotactic Surface Projection v 3D Volume Effect y Filter Statistics Transparency SD CT 12 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 HOOD05162003046557_Unrestricted © Siemens Healthineers, 2019 MI Neurology SIEMENS Healthineers Factory Databases in Striatal Analysis Elle View Annotations Tools Databases Help Neurology Analysis abc Primary C Striatal Analysis BRAIN SPECT "123%lodine I-123-Datscan . DATSCAN30 Seain: 0.53 FoV: 21.2x19cmn . DaTSCAN30 Scale: 8.53 FoV: 21.2x19cm . DaTSCAN30 Scale: 0.53 FoV: 21.8x13cm Fusion to Template M-072Y -L KM: W 272 L 135 |MO72Y -- NM: W 272 L 136|MO72Y -/- NM: W 272 L 13 1:2 DaTSCAN 301 DATSCAN 30 1 DaTSCAN 30 1 Analysis Database Cortical Striata Subtract Color Maps NM Reference Brain Selection X • Factory Normal Database provided for Normalization Region Occipital lobe (AAL) Show Striatal Regions of Interest Patient name: -_MI_Neuro_DaTSCAN_medium_4 Key Images ROI Patient age: 65 Striatal Analysis to compare with Stratum (L) Striatum (R) Patient sex: M Patient radiopharmaceutical: Unknown database of normal subjects Please select a radiopharmaceutical: 1231-FP-CIT NM.15-Sep-2011 13:57:34 - - Siab • DATscan and F-DOPA* Graph DATSCAN30 Available Reference Brains for Selected Radiopharmaceutical: M 072Y -J. Name Age Range Sex Normalization Region DaTSCAN 30 1 FPCIT1A SPECT_Flash3D_(CTAC) [Read-Only] 16 - 88 16 - 88 M/F Occipital lobe FPCIT2A SPECT_FBP_(Chang-AC) [Read-Only] M/F Occipital lobe • Choose an appropriate database 08 Reset Striatal ROI Position according to radiopharmaceutical and Link Left and Right ROI for Editing Display Striatal Box scan parameters OK Exit NM:15-ST0-2011 13:57:34 13 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 HOOD05162003046557_Unrestricted © Siemens Healthineers, 2019 MI Workflow VB60 SIEMENS Healthineers MI Neurology SIEMENS . Scenium_DaTSCAN1 Healthineers F 1123 FP MI Neurology View Annotations Tools Databases Help MI Neurology Striatal Analysis now includes three additional normals abc Fused Volume Display Striatal Analysis BRAIN SPECT 123^lodine 1-123-Datscan - Sceniumn_DaTSCANT Scale: 0.56 Fov: 21.1x19,9cm - Scenium_DGTSCAN1 Scale: 0.56 FoV: 21.1x19.9cm - Sceriun_DaTSCAN Scale: D Scale: 0.56 FoV: 21.0.19.9cm Fusion to Template F 051Y -/- databases for 123I-FP-CIT: NM: V/ 205.6 L 15.1.2 F 051Y -/- NM: W 205.6 L 154.2 F 051Y -/- HRA: W 205.6 L 154.2 Functional Fured 244 Hybrid hoch Axol 3 ... +Movie 123 FP 1123 FP 1123 FP Analysis .......... Favorite Tools MI Neurology Analysis Color Maps ............ Primary Monitor NM ................. .............................. • FPCIT3A: FPCIT calibrated for LPHR Flash3D (CTAC) ..................................... ............................ • FPCIT4A: FPCIT calibrated for LPHR FBP Reference Brain Selection × Series (Chang AC) Favorite Tools Patient name: - Scenium_DaTSCAN1 • FPCIT5A: FPCIT calibrated for LPHR xSPECT (CTAC) C Patient age: 51 Findings Distance ROI Cicle Line Contr .. Patient sex: F Snapshot Parallel Patient radiopharmaceutical: 1-123-Datscan FAST Ranges Fangas Erain AC Referen_ Graphics Please select a radiopharmaceutical: Printing 1231-FP-CIT Please refer to Operator Manual – Striatal Analysis VE40. Available Reference Brains for Selected Radiopharmaceutical: Name Age Range Sex Normalization Region FPCIT1A: FPCIT LEHR Flash 3D (C ... 16 - 88 M/F Occipital lobe FPCIT2A: FPCIT LEHR FBP (Chang. 16 - 88 M/F Occipital lobe FPCIT3A: FPCIT calibrated for LPH. 16 - 88 M/F Occipital lobe FPCIT4A: FPCIT calibrated for LPH. 16 - 88 M/F Occipital lobe FPCIT5A: FPCIT calibrated for LPH. 16 - 88 M/F Occipital lobe OK Exit 14 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 MI Neurology SIEMENS Healthineers Striatal Analysis Databases - How to Use • Analysis workflow step shows an additional graph tab. This graph displays the patient's left and right ratio values for a selected region, along with the values of all subjects present in the database. The graph illustrates patient left (blue) and right (red) ratios against reference (gray). • In the results summary table segment, the patient’s uptake ratios are displayed for anterior and posterior putamen and also normal reference values and Z-scores. Patients are considered normal if their ratios are within +/- 2 SD of the reference mean value. Slab Graph + Database: FPCIT1A_SPECT_Flash3D_(CTAC) (16 - 88 Y) Patient: M, 65 Y 5.6- Database Patients Normalization region: Occipital lobe Plotted values: Striatum 5.4- Patient Left Patient Values Reference Values 5.2- Ratio to Normalization Region Z - Score 5 - Patient Right Left Right Mean + 2 SE Left Right 4.8- Mean + 2 SE Striatum 4.58 4.57 4.00 + 0.79 + 1.48 1.46 4.6- Caudate 4.80 4.49 4.09 + 0.82 + 1.74 + 0.98 4.4- - Reference Mean Putamen 4.28 4.67 3.87 + 0.79 + 1.04 + 2.03 4.2- Anterior Putamen 4.61 5.02 4.02 + 0.84 + 1.40 Mean - 2 SE 2.36 Posterior Putamen 3.79 1.19 3.65 + 0.78 + 0.35 + 1.37 4 - Asymmetry Measures 3.8- Striatum DVR Striatum Asymmetry 0.17 % 3.17 + 5.22 % - 1.15 3.6- Caudate Asymmetry 6.70 % 3.75 + 5.64 % 1.05 3.4- Putamen Asymmetry 8.74 % 3.83 + 5.40 % + 1.82 3.2- Putamen (L) / Caudate (L) 0.89 0.95 + 0.10 - 1.10 3- Putamen (R) / Caudate (R) 1.04 0.95 + 0.10 1.75 2.8- Ratio and asymmetry calculated using mean of the brightest 75% of voxels in striatal regions. 10 20 30 40 50 60 70 80 90 Age Copy Export Results 15 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 HOOD05162003046557_Unrestricted © Siemens Healthineers, 2019 MI Neurology SIEMENS Healthineers Striatal Analysis Databases SPECT-Ioflupane (DaTscan®) PET-FDOPA* Two normal SPECT-Ioflupane (DaTscan®) databases are offered: One normal PET-FDOPA database is offered in Striatal Analysis: FPCIT1A_SPECT_Flash3D_(CTAC) is built from Flash 3D • FDOPA1A: FDOPA-PET is built from OSEM3D reconstruction • reconstructions of Siemens Symbia T2 scanner data with CT of Siemens Biograph mCT scanner data with CT attenuation attenuation correction. correction. • FPCIT2A_SPECT_FBP_(Chang-AC) is built from FBP reconstructions of the same Siemens Symbia T2 scanner This database is derived from PET-FDOPA scans of 53 normal data with Chang attenuation correction. patients with an age range of 42 to 90 years old (20 male and 33 female). The database consists of patients with given clinical These databases are derived from SPECT-Ioflupane (DaTscan®) conditions who were referred by their neurologists to the imaging site and were found to have a negative FDOPA scan and scans of 241 normal patients with an age range of 16 to 88 no evidence of Parkinsonian neurodegeneration (at baseline years old (117 female and 124 male). These normal subjects are and at ≥ 18-month follow-up). not healthy volunteers but patients who were referred to the imaging sites with a clinical condition but had a negative DaTscan® exam and didn’t have any confirmed neurodegenerative Parkinsonism at baseline or at follow up (≥ 3 years). 16 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 HOOD05162003046557_Unrestricted © Siemens Healthineers, 2019 MI Neurology Striatal Analysis Databases In order to use the collected LEHR normal data to assess a scan acquired using a Low For each filling scenario, the phantom image was registered to an MNI Penetration High Resolution (LPHR) collimator, we have performed system calibration template and predefined striatal and background VOIs were applied to by collecting a series of SPECT measurements with an anthropomorphic brain calculate left and right DVR values. Subsequently, linear regression fit was phantom scanned with six different nominal ratios of striatum to background, ranging performed between each pair of measurements sets (e.g., LPHR-FBP vs. LEHR- from normal to abnormal radiotracer binding [Tossici-Bolt-11]* for a total of three FBP) to generate calibration factors allowing the calculation of LPHR normal phantom filling scenarios. values as linear transformations of the LEHR normal values for each of the Each of these fillings corresponds to two different striatum-to background ratios, three considered reconstructions. For instance, the following figure shows the according to tracer activity used in the left and right striata. For each set of regression analysis and calibration factors corresponding to the calibration of measurements, the phantom was scanned using LEHR and LPHR collimators and cross- LPHR data reconstructed with Flash3D and xSPECT reconstructions against calibration factors were generated for three reconstruction methods of the LPHR data: LEHR Flash3D data: • Flash3D with parameters similar to those used for the corresponding LEHR database above. • FBP with parameters similar to those used for the corresponding LEHR databases 7 above. 6 xSPECT: Acquisition (zoom factor 1.0, matrix 256 x 256, pixel size 2.4 x 2.4 mm²) • and reconstruction with 40 iterations and 1 subset, CT-based AC, SC, and 8 mm S FWHM Gaussian post-reconstruction smoothing. Note that the same acquisition parameters for LEHR and conventional LPHR scans as the ones used to acquire the clinical data (described above) were also used to scan the brain phantom where the acquisition time was adjusted to attain ~2 million counts in 2 ........ the photopeak energy window. The LPHR data reconstructed with FBP were calibrated against LEHR-FBP data, 1 whereas both Flash3D and xSPECT LPHR data were calibrated against the Flash3D 1 1,5 2 2,5 3 3,5 4 4,5 5 5,5 6 LEHR data. LPHR measured DVRs (y-axis) plotted against LEHR-measured Flash3D DVRs (x-axis). Note: For LPHR-Flash3D (blue bullets): y = 0.9758x + 0.1644, R2 = 0.985. For LPHR-xSPECT (orange triangles): y = 1.2439x - 0.1601, R2 = 0.9616 * Tossici-Bolt, L., et al. “Calibration of gamma camera systems for a multicentre European FP-CIT SPECT 17 normal database” (2011) EJNMMI; 38(8):1529-40. Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 MI Neurology SIEMENS Factory Databases in Striatal Analysis Healthineers SIEMENS Healthineers supermar • Create New Database Scenium_DaTScan_positive1 X M 2012022000 View Annotations Tools Databases Help Add Current Subject to Database Create New Database • Normalization region should be set here, Striatal Analysis Manage Databases .23^lodine 1-123-Datscan - Scenkm_DaTScan_positive1 Scale: 0.65 Fov: 21.1x20.2cm - Sconium_DalScan_positivet Scale: 0.66 FoV: 21.1x20.2cm . Scerium_DaTScan_positivet Scales Scale: B.ES FoV: 21.8x20.2cm Fusion to Template M O64Y -1- HM; W.127.2 L 95.4 M 054Y -L IM: W 127.2 L 95.4 M 064Y - MPA: W/ 127.2 L. 95.4 and cannot be subsequently modified 2012022000 201 2022000 201 2022000 Analysis -- Color Maps NM ...................... ....................... • Manage databases .................. ................. Normalization Region Occipital lobe Show Striatal Regions of Interest Key ages ................................................. It is necessary to restart Striatal Analysis ............. • Create New Database X after import Database Name DaTSCAN database This is a test database Coronal • After restart, the normal database can be 12.48.06 Sice 40/109 NE 23.Aug-2011 12:46:06 Sagittal Slice 59:91 ...................... Description Normalization region: Occipital lobe Patient Values selected Ratio to Normalization Region Database Settings Manage Databases X Modality NM Radiopharmaceutical 1231-FP-CIT Normalization region Occipital lobe Proportion of Brightest Voxels 100.0% Database name Modality Radiopharmaceutical Sex Age Range DaTSCAN database NM 1231_FP_CIT New Template Basal Ganglia SPECT [Read-Only] NM Other M/F/O 0 - 999 Template Basal Ganglia PET [Read-Only] PET Other M/F/O 0 - 999 Edit Reference Brain Selection Create Cancel Parent name: - Sconium_DafScan_possivel Pament mes 1:123 Datscan NE:23-Aug-2011 12:46:06 18 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers MI - News & Improvements MI Cardiology 19 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 MI Cardiology SIEMENS Healthineers You will learn: SIEMENS althineers MI Cardiology MI Cardiology Optimized Cardiology Layouts 67 yo Male • Supine, IR. SC.CIAC SICTAG Filter: None Mid-HLA Perfusion • Cardiac Planes O O O LAD Favorite Tools U LOX MI Cardiology Reading Cardiac Mask Tool -- O O O O • Region Mean LAD 30.3 +/- 9.1 (37.5) % LCX 78.5 +f- 8.5 (101. Series • Cardiac FAST Ranges RCA TOT 79.6 +f- 8.6 (104.1) % Favorite Tools • New version syngo.MBF VB30 O T. DE RSICTAC FIter, Non Mid-HLA Perfusion VNOM U LOX O Region Mean - LAD LCX 83.2 46- 6.9 (101.0) RCA 1 4-7.8 (36.0) TOT 47-9.7 (103.3) Mid-Y 20 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 HOOD05162003046557_Unrestricted © Siemens Healthineers, 2019 MI Cardiology SIEMENS Healthineers New Tools Cardiac Planes automatic orientation of SIEMENS. DEMO_Cedars_Symbia_Cardiac .. x • Halthineers ... 01.01.1969 M Tc99m PET and SPECT Cardiology data in short Favorite Tools MI Cardiology axis, horizonal long axis and vertical long O Cardiac Cardiac auto ! Area Visual FAST. Contr. Snapshot Synch Mask Planes Alignment axis views provides quick reading in clinically relevant orientation MI Cardiology Patient Name : DEMO_Cedars_Symbia_Cardiac^EU Patient ID : Tc99m Patient Birthdate, Sex and Age : 01.01.1969, M, 039Y Study Description : Cardiac Perfusion Study Time : 11:37:02 Accession Number : 1 Energy Window 1 : 99m Technetium Radiopharmaceutical : Sestamibi xx ********************************************************** ALF HAL HAL Favorite Tools Basic Fused 2x3 DEMO_Cedars_Symbia_Cardiac, EU Planar Savescreen Volume DEMO_Cedars_Symbia_Cardiac, EU DEMO_Cedars_Symbia_Cardiac, EU Volume *01.01.1969, M, 39Y • Cardiac Mask Tool to mask extracardiac Display Gated Stripe Strip ... Tc99m Tc99m Tc99m *01.01.1969, M. 39Y *01.01.1969, M. 39Y HH Stress [Stress CTAC and Scatter] Stress [Stress CTAC and Scatter] Stress [Stress CTAC and Scatter) activity for improved cardiac Functional Fused 2x3 Fused Hybrid 3x3 4D 4D Fused RA com PRH RA 2×3 + M ... + Movie Axial 3x ... Functio ... 1x3 + ... 1 cm 1 cm MPR MPR MPR SL min SL AL min SPC 6.6 SPC SL min normalization and localization Cardiac AC Cardiac 6,6 90 % SPC NAC 0 % 6,6 90 % O 08 Mask R Localize Series ALF HAL HAL MI Cardiology Reading DEMO_Cedars_Symbia_Cardiac, EU DEMO_Cedars_Symbia_Cardiac, EU DEMO_Cedars_Symbia_Cardiac, EU Tc99m Tc99m Tc99m • Cardiac FAST Ranges* can generate short *01.01.1969, M, 39Y *01.01.1969, M, 39Y *01.01.1969, M, 39Y Rest [Rest CTAC and Scatter) Rest [Rest CTAC and Scatter] Rest [Rest CTAC and Scatter] axis result images without the need for RA PRH RA 1 cm 1 cm 1 cm IMPR MPR RA IMPR AL reconstruction for loading in other SL SPC min SL SPC min SL 6,6 90 % SPC min 6,6 90 % 6,6 90 % Findings O 96 0 % o cardiac applications ALF HAL HAL DEMO_Cedars_Symbia_Cardiac, EU DEMO_Cedars_Symbia_Cardiac, EU DEMO_Cedars_Symbia_Cardiac, EU Tc99m Tc99m *01.01.1969, M, 39Y *01.01.1969, M, 39Y *01.01.1969, M, 39Y Stress [Stress No Correction] Stress [Stress No Correction] Stress [Stress No Correction] RA cm PRH RA 1 cm 1 cm Printing MPR MPR SL SPC min IMPR SL A 6,6 min min SPC 6.6 SL SPC 6,6 82 % o ON ON *Dynamic PET data not supported 21 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 HOOD05162003046557_Unrestricted © Siemens Healthineers, 2019 MI Cardiology SIEMENS Healthineers Overview Enhancements in MI Cardiology: SIEMENS. Healthineers .. DEMO_Cedars_Symbia_Cardiac .. X 01.01.1969 M Tc99m MI Cardiology PECT-CT 0 100 100 3 MI Cardiology Tomo QA DEMO_Cedars_Symbia_Cardiac, EU, Tc99m 39 yo Male News for Cardiology analysis Basic Fused 2x3 Planar • GStr Frame: 3 Display Gated Stress-Gated [Stress Pri ... MI Processing 21-Aug-2008 11:48:08 Stress-Gated [Stress .. Rest-Gated [Rest Pri ... 8 Fr, Supine, FBP AS Perfusion-Blackout Tc-99m Sestamibi Perfusion-Blackout applications Savescreen Volume Volume Fusion EDV: 87 ml Stripe ESV: 25 ml EF: 71% Images Mass: 130 g, CO: 4.5 l/min GRst Frame: Anterior Anterior Functional Fused 2×3 Fused UgVol: 35 ml, TID: 0.70 Favorite Tools 2x3 + M ... + Movie Axial 3x .... ons C Images V2-GSRD/TC/NC/M O Bas Septal Septa Cedars reporting is now a purchasable Hybrid 3x3 4D Fused Images + Quant Ap Ape • Str AC Images + Quant Inferior Rest-Gated [Rest Primary] 21-Aug-2008 15:19:57 option for Cedars Cardiac Suite Cardiac AC Cardiac on Triferior 8 Fr, Supine, FBP Func + Quant Tc-99m Sestamibi EDV: 96 ml ESV: 31 ml OpenApps Dyssynchrony EF: 68% Rst Series Mass: 130 g, CO: 4.2 l/min UgVol: 50 ml, TID: -- PI Summary O O 100% 100% SRS: 0 . V2-GSRD/TC/NC/M Stress [Stress No Cor ... Rest [Rest No Correc ... • The new version of syngo.MBF VB30 App Home CT Viewer Perfusion-Blackout Perfusion-Blackout Perfusion-Blackout Ca Soaring with enhanced features and LLE 4DM Stress [Stress No Correction] Stress-Gated [Stress Primary] Rest-Gated [Rest Primary] Stress [Stress No Correction] Rest [Rest No Correction] 21-Aug-2008 11:50:28 Anterior Anterior Findings Ung, Supine, IR:3D Corridor4DM Tc-99m Sestamibi UgVol: 39 ml, TID: 0.71 functionalities SSS: 1 V-Flash3D/TC/NC/M Apex Apex Inferior- Triferior Favorite Tools × 0 Printing Rest [Rest No Correction] SSS SRS SSS SRS Cardiac Cardiac Mask Planes FAST ... 21-Aug-2008 15:22:15 2 4 cm Ung, Supine, IR:3D 0 100% 0 100% Tc-99m Sestamibi UgVol: 55 ml, TID: -- 114 GStr GRst Area Visual Snapshot SRS: 0 Contr ... Alignment 91 Show M Reporting V-Flash3D/TC/NC/M 68 EDV (ml)| 87 96 ESV (ml) 25 31 OpenApps Full Text Screen Capture 46 EF (%)| 71 68 LV Vol (ml) 23 Help Perf: 0: Normal 1: Mild 2: Moderate 3. Severe 4: Absent Preferences Auto 7 fps Gating Frame + None Ungated Blackout None 17 Seg None Epi(Opaque) 22 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 MI Cardiology Applications SIEMENS Healthineers New Versions S AA • Cedars 2017* • 4DM 2018* CEDARS-SINAI ® • syngo.MBF VB30 INVIA Medical Imaging Solutions * For further information, see the Delta Online Training VB50 MI Cardiology Applications Part 2 available on PEPconnect SIEMENS Healthineers 23 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 MI Cardiology SIEMENS Healthineers Cardiology Analysis Applications The Cardiology analysis applications Corridor4DM, syngo.MBF, Favorite Tools Series X MI Cardiology Planes Area Vitu and Cedars Cardiac Suite (QPS+QGS, QBS) are now hosted in Contr .... Alignm Snapshot dd Study the Digital Marketplace*. MI Cardiology × Data Selection C CT Rest 5.0 CURRENT BOBS [4] [4] lest [Rest CIACan Scatter] [1000) All Data 99m Technetium_Stress-Gated 99m Technetium Lower Scatter Favorite Tools 21.08.2008 Basic Fused 2x3 Planar 11:42:55.34 VIDEO 21.08.2008 21.08.2008 Display Gated 2 IMA 1 SP H1672,0 11:48:08 11:48:08 O R PR PR Applications can be accessed via the syngo.via Open Apps Savescreen Volume Volume Stripe Strip SL 5,0 10cm CT Coronary Correction] [1000) lest-Gated [R. Functional Fused 2×3 Fused Plaque F 95 button in the Tool Gallery: 2x3 + M ... + Movie Axial 3x ... Analysis CQ! Additional Data Frontier 27s Series Hybrid 3<3 4D 4D Fused H Functio 1x3 + Lower Scatter_Stress 99m Technetium CURRENT CURRENT 21.08.2008 21.08.2008 15:16:44.64 15:16:44.64 Cardiac AC Cardiat 21.08.2008 11:50:28 4 IMA 37 4 IMA 37 NAC • An additional panel shows all installed apps.** I SP H1688,5 SP H1688,5 CT Skull Unfolding PR R Technetium Sum OpenApps X Frontier SL 5,0 10cm SL 5,0 Findings 400 % App He E 4DM CQ! CQ! 27 $ • You can toggle between apps by selecting the H H Technetium_Rest- atund [10001 4DM Corridor4DM Lower Scatter_Rest-Gated 99m Technetium 99m Technetium_Rest 99m Technetium Lower Scatter corresponding icon. 21.08.2008 21.08.2008 Corridor4DM 21.08.2008 15:22:15 15:22:15 Printing PR PR PR Cedars-Sinai Cardiac Suite atter Stras [10 -0,50 Cnts T 1,3555 kCnts B -0,50 Cnts • Multiple apps can be opened simultaneously. 28s HAL HAL syngo MBF Rest-Gated [Rest Primary] 99m Technetium 99m Technetium Stress [Stress CTAC and Scatter] Rest [Rest CT. 99m 22:48-2008 110001 21.08.2008 21.08.2008 Snapshots taken in any app are sent as secondary capture 11:50:28 15:22:15 • RA RA RA images to the Series panel. See -0,50 Ents B 0,00 Ent's *available for a 90-day trial download 24 **depending on your product license(s) Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 MI Cardiology SIEMENS Healthineers Cardiology Analysis Applications More flexible launch options are provided: Open Ctrl+O Open with • Installed applications can be accessed just like any other workflow View as Read-Only with Favorites in the patient browser. Batch Open MM Reading Assign Workflow Suggested Group Studies Cedars-Sinai Cardiac Suite • The applications open in their own patient tab, with no syngo.via elements visible (Series Navigator, findings, etc.). Batch Assign Workflow Corridor4DM Cancel Workflow CT Cardiac Planning Installed apps can also be seen and launched in the Digital Search Patient with DICOM Q/R MI Cardiology • Marketplace dialog. Add to Demo List MI General Remove from Demo List MI Neurology For further information, see the syngo.via OpenApps User Guide Job Set Mark state > More Aid available on PEPconnect. ? 25 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 MI Cardiology SIEMENS Healthineers Cedars Sinai Cardiac Suite In OpenApps, only one apps icon is available: SIEMENS × Healthineers .... R DEMO_Cedars Symbia_Cardiac ... 01.01.1969 M Tc99m MI Cardiology MI Cardiology Basic Fused 233 Planar Selecting this presents the user with the option Display Gated • Savescreen Volume Volume Stripe Strip. to either run QGS+QPS or QBS. Functional Fusod 2x2 Fused Favorite Tools 2×3 . M ... . Movie Axial 3x ... Hybrid 333 40 40 Fused Flanctio 1x3- Cedars Sinai Oaim Cedars reporting is now a purchasable option for Series OpenApps Study Type Cedars Cardiac Suite: APP Home O 0 Myocardial Perfusion QGS + QPS 4DM Findings Cardine Starts Corridor4DM Resting Wall Motion • Capability to generate reports directly inside Cedars Cardiac Suite. Favorite Tools Printing O Cardiac Cardiac Cardiac Mask Planes FAST Includes support for PDF and ASCII TEXT, HL7 Area Visual Snapshot • Contr ... Alignment OpenApps Full Text output, ASNC image guide registry, custom fields, admin reports and blood pool reports. + 26 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 MI Cardiology SIEMENS Healthineers syngo.MBF VB30 The new version of syngo.MBF VB30 is available with SIEMENS .. X Healthineers .. Cardiac_MBF_Dyn_1_NH3 01.01.1943 M NH3 MI Cardiology Qo x Elle Edit View Help the following updates: No Database MI Cardiology Flanar Display Gatod Cardiac_MBF_Dyn_1_NH3 : NH3 : 067Y : 1/1/43 : M : Unknown BMI : PET/UNAM Stress : dvn Ammonia Stress (AC) : 3/29/10 16:29:20 : Radionuclide Total Dose 370.0 MBa Advanced Options Savescreen Volume Volume Stripe Strip SA ant HLA apex VLA Normalize by Rate Pressure Product (RPP) = High Motion Correction • [] Stress Favorite Tools O Rest Hybrid 3x3 4D 4D Fred ht sep lat base apex Residual Activity Correction O Stress + • Spillover factors (SF) Cardiac AC Canglas Rest Frame E Frame E Frame £ 00:04:00 00:04:00 00:04:00 Normalize using Rate Pressure Product inf 360s base 360s 360s Series · OpenApps X Rest : dyn Ammonia Rest (AC) : 3/29/10 16:10:15 : Radionuclide Total Dose 370.0 MBq BEGEE Resting Heart Rate 0pm SA ant HLA apex VLA Resting Systolic Blood Pressure mmHg App Home • Automatic window/level for each frame Rate Pressure Product Rate Pressure Product Threshold 10000 Edit at sep lat base apex Findings syngo Mar E + • Global LV Time Activity Curves Frame 2 Frame E Frame E 00:04:00 00:04:00 00:04:00 360s base 360s 360s 15058 Favorite Tools × Process Cancel Printing Cardiac Cantiac Cardiac You will learn more about these functions in the Mask Plantes FAST ... Ares Vitua? Snapshot Contr ... following sections. Alignment OpenAppa: Full Text + Please watch the syngo.MBF eclip on PEPconnect to get more insights into the extended handling capabilities. For more information regarding the new features, refer to the syngo.MBF VB30 Operator Manual. 27 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 MI Cardiology SIEMENS Healthineers syngo.MBF VB30 Normalize by Rate Pressure Product (RPP) Cardiac_MBF_Dyn_1_NH3 X 01.01.1943 M NH3 provides the function to normalize the rest flow No Database quantification results and thereby the reserve H3 : 067Y : 1/1/43 : M : Unknown BMI : PET/UNAM by means of the product of the heart rate and AC) : 3/29/10 16:29:20 : Radionuclide Total Dose 370.0 MBq Advanced Options HLA apex VLA ant 109690 High Motion Correction the blood pressure [ Stress Rest Residual Activity Correction lat sep lat base apex O Stress ORest 2] Normalize using Rate Pressure Product Frame E Frame E Frame E 00:04:00 00:04:00 Resting Heart Rate bpm 360s base 360s inf 3605 33938 Resting Systolic Blood Pressure mmHg 3/29/10 16:10:15 : Radionuclide Total Dose 370.0 MBq Rate Pressure Product HLA apex VLA 75274 Rate Pressure Product Threshold 8000 Edit Please enter the resting heart rate and blood pressure lo proceed or de-select Normalize using Rate Presauma Produc lat sep lat base apex Frame E Frame E Frame E 00:04:00 00:04:00 00:04:00 360s base 360s inf 360s 15055 Cancel 28 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 HOOD05162003046557_Unrestricted © Siemens Healthineers, 2019 MI Cardiology SIEMENS Healthineers Spillover Factor (SF) Formula The spillover factor (SF) is an important part of the MBF SIEMENS " Cardiac_MBF_Dyn_1_NH3 × Healthineers 01.01.1943 M NH3 File Edit View Help computation, shown in a simple formula on the right. In < No Database > BUIO Cardiac_MBF_Dyn_1_NH3 : NH3 : 067Y : 1/1/43 : M : Unknown BMI : PET/UNAM the formula, the myocardial tissue (MYO) is derived as a Stress : dvn Ammonia Stress (AC) : 3/29/10 16:29:20 : Radionuclide Total Dose 370.0 MBa SA ant HLA apex VLA Uptake MBF LAD LCX LAD LCX combination of the blood input function (BIF) and a 2.78 model of perfusion (MP) in myocardial tissue. sep O --- fat base apex 2.93 Frame E Frame E Frame E 00:04:00 00:04:00 00:04:00 RCA RCA 360s 360s 3605 15917 Baarl Int 85/168 15917 Bq/ml base 41/81 15917 Bohrl 85/168 0:04 00 33838 Rest : dyn Ammonia Rest (AC) : 3/29/10 16:10:15 : Radionuclide Total Dose 370.0 MBq This model is a convolution of the BIF with an SA ant HLA apex VLA 74 Uptake 10 Norm Fed MBF LAD LCX LAD LCX 0.98 exponential term that includes the K1 value, which is a apex 0.99 function of MBF. Frame £ Frame E Frame E 00:04:00 00:04:00 00:04:00 360s 360s 3605 RCA RCA 11985 Bakel 85/168 11985 Bq/ml base 41/81 11985 Bohl 85/168 15056 Flow (ml/g/min) 1.8E5 Reserv 1.6E5 Ammonia Norma red Reserve Stress Rest LAD 1.4E5 LOX The SF value is an important indicator of the accuracy of mean SF mean SF mean std dev. 1.2E5 LAD 2.78 0.36 0.98 0.38 2.87 2.87 0.32 1E5 LCX 2.96 0.32 0.99 0.31 3.02 0.36 BE 8.02 6E4 monsily (Bq'D the kinetic modeling used to compute the MBF value. RCA 2.68 0.52 0.94 0.42 2.87 0.39 4E4 Global 2.80 0.39 0.97 0,37 2.91 0,35 2E4 Resting HR 90 bpm RPP 11700 Resting Systolic BP 130 mmHg RPP Threshold 100 150 350 9000 250 300 400 RCA 'RPP normalized A high SF number will cause the MBF value to be dominated by the SF*BIF term and not the term MY0=SF∙BIF+(1-SF)∙MP 0 • When a segment inside the polar plot is selected, the Cardiac_MBF_Dyn_1_NH3 : NH3 : 067Y : 1/1/43 : M : Unknown BMI : PET/UNAM Stress : dvn Ammonia Stress (AC) : 3/29/10 16:29:20 : Radionuclide Total Dose 370.0 MBq spillover value is displayed in the bottom right corner. SA ant HLA esa50 Uptake apex VLA LAD LCX LAD LCX 2.78 Values above the threshold are displayed in red. sep apex 2.96 • If any region is above the threshold in either stress or Frame E Frame E Frame E 00:04:00 00:04:00 00:04:00 360s RCA RCA 360s 15917 Bgard inf 85/168 15917 Bq/ml base 41/81 15917 Bq/ml 5/168 35938 00.04.00 rest, those region(s) will also be represented on the Rest : dyn Ammonia Rest (AC) : 3/29/10 16:10:15 : Radionuclide Total Dose 370.0 MBq SA ant HLA apex VIA 75274 Uptake 010 Norma ed MBF LAD LC LAD LCx reserve plot. 0.98 0.99 • The spillover factors are also displayed in the Statistics sep apex Frame E Frame Frame E 0.94 00:04:00 00:04:00 00:04:00 table. 360s 360s 360s RCA 30 04:00 RCA 11985 Bakel 85/168 11985 Balml 41.31 85/168 15055 ™3608 0 Flow (ml/g/min) Normal ed Reserve Stress Rest Reserve Ammonia LAD LCX mean SF mean" mean Std dev LAD 2.78 0.98 0.38 2.87 2.87 0.36 0.32 global LCX 2.96 0.32 0.99 0.31 3.02 0.36 Uptoke 8.02 Intensiy (Bq'm) RCA 2.68 0.52 0.94 0.42 2.87 0.39 ++ blood input Global 2.80 0.39 0.97 0.37 2.91 0.35 global - rost Resting HR 90 bpm 11700 100 1.50 250 350 400 uptake RCA Resting Systolic BP 130 mmHg PP Threshold 9000 Time (S) *RPP normalized 30 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 MI Cardiology SIEMENS Healthineers Setting the Automatic Window Level To set the Automatic Window Level, select Set Elle Edit View Help Automatic Window Level in the Edit menu or Cardiac_MBF_Dyn_1_NH3 : NH3 : 067Y : 1/1/43 : M : Unknown BMI : PET/UNAM Stress : dyn_Ammonia_Stress (AC) : 3/29/10 16:29:20 : Radionuclide Total Dose 370.0 MBq Advanced Options SA click the button in the toolbar. You can also press ant HLA apex VIDEO High Motion Correction O Stress [] Rest Ctrl + W. Residual Activity Correction sep at sep base apex O Stress + O Rest Normalize using Rate Pressure Product The feature is enabled by default. Frame E Frame E Frame E = 00:04:00 00:04:00 00:04:00 Resting Heart Rate bpm inf 360s base 360s 360s 33938 Resting Systolic Blood Pressure mmHg Rest : dyn_Ammonia_Rest (AC) : 3/29/10 16:10:15 : Radionuclide Total Dose 370.0 MBq Rate Pressure Product SA ant HLA apex VLA Rate Pressure Product Threshold 9000 Edit If you perform any manual adjustment for either = the Stress or the Rest series, the automatic sep at sep lat base apex + window level setting is switched off. Frame E Frame E 00:04:00 360s base 360s 3605 15058 Process Cancel 31 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 MI Cardiology SIEMENS Healthineers Automatic Window Level The system can apply the default window level values of each frame 4DynamicPET_patient : 97166896 : 066Y : 1/1/42 : M : Unknown BMI : MI Anon Hospital automatically. The algorithm defines a bounding box based on the Stress : Dynamic NH3 STRESSprogressif AC CT#1 (AC) : 5/29/09 13:51:27 : Radionuclide Total Dose 708.0 MBq SA ant HLA apex VLA ant 73384 center of the LV and windows the data within this bounding box using a histogram approach: sep lat sep lat base- apex Frame 3/21 Frame 3/21 Frame 3/21 It takes away the 5 % of the data points with the highest 00:00:20 00:00:20 00:00:20 • 10s 10s 10s 19450 Bq/ml inf 129/256 119450 Ball base 41/81 19450 Bq/ml 129/256 14558 intensity within the box. File Edit View Help < No Database > v • Defines the maximum intensity value as the intensity 4DynamicPET_patient : 97166896 : 066Y : 1/1/42 : M : Unknown BMI : MI Anon Hospital corresponding to the bin which contains the point of maximum Stress : Dynamic NH3 STRESSprogressif AC CT#1 (AC) : 5/29/09 13:51:27 : Radionuclide Total Dose 708.0 MBq SA 73384 ant HLA apex VLA ant intensity. Takes the minimum window level as the bin defined by 0.2 * sep --- --- lat sep -- - - --- lat base- - --- -apex • maximum window level. Frame 21/21 Frame 21/21 Frame 21/21 00:05:30 00:05:30 00:05:30 30s 30s 30s 15133 Bell 129/256 15133 Bq/ml base 41/81 15133 Bq/ml inf 129/256 14558 • Window and levels are defined from the new min and max. 32 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 MI Cardiology SIEMENS Healthineers Global Time Activity Curve Elle Edit View Help e No Database > Cardiac_MBF_Dyn_1_NH3 : NH3 : 067Y : 1/1/43 : M : Unknown BMI : PET/UNAM Stress : dvn Ammonia Stress (AC) : 3/29/10 16:29:20 : Radionuclide Total Dose 370.0 MBq SA and HLA apex VIA ant LAD LAD • Before this update, selecting an area of the images in 2.38 MBF did not correspond to the myocardial tissue. In lat base 2.88 Frame E Frame I Frame I DO:04:00 00:04:00 00:04:00 RCA RCA 360s 360s 360s this case, the time activity curves (TACs) displayed in 24315 8qfel nt 89/168 24315 8amml base 43,81 24315 Bafnl 87/168 po- 04.00 Rest : dyn Ammonia Rest (AC) : 3/29/10 16:10:15 : Radionuclide Total Dose 370.0 MBq HLA apex VLA Uplake ant LAD LAD the plot area where removed. 1.28 3605 43:81 181 68 Ba RCA int Global LV time activity curves can now be calculated 89/168 87/168 18980 WWW • Flow (ml/g/min) Reserve 1.665- Reserve Ammonia LAD Stress Rest 1.4E5- and displayed. The global time activity curve mean sto dev. mean std dev. mean std dev. 21,265 155 global LAD 2.78 0:29 1.27 0.13 2.21 0.25 BE4 Local 6E4 0.10 2.32 0.20 4E4 blood represents the amount of tracer for the entire LCX 2.96 0.24 1.28 input ZE4- 2.21 Global RCA 2.68 0.39 1.22 0.11 2.21 0.30 -rost 50 100 150 200 250 300 350 400 RCA Global 2.80 0.32 1.26 0.12 2.24 0.27 Time (s) myocardium. 1.8E5 1.6E5 Ammonia 1.4E5 stress 1.2E5- blood input 1E5- global 8E4- stress uptake 6E4 - * rest Intensity (Bq'ml) 4E4 blood input 2E4 global + rest uptake 50 100 150 200 250 300 350 400 O Time (s) 33 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers 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 2021 Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Telephone: +49 9131 84-0 siemens.com/healthineers 34 Effective Date: 27 May 2021 | HOOD05162003196036 Unrestricted © Siemens Healthineers, 2021