Adjusting to Tc99m Shortages Job Aid

Adjusting to Tc99m Shortages Job Aid / All Symbia Scanners Adjusting to Tc99m Shortages All Symbia Scanners Description: This job aid will assist the user in increasing scan time, adjusting reconstruction values, and using Enhanced Planar Processing in order to adjust to working with lower Tc99m radiopharmaceutical doses due to shortages. 1. Adjusting Scan Time and Tomo Views Increasing scan time for planar views, such as static and wholebody, will allow the system to acquire more counts. Scan time data is found in the Stop Conditions tab in the Acquisition Activity. Summary Series Information|Camera Parameters Stop Conditions For Static Images, either the scan time can be increased, or the image may be set to stop when a certain number of Counts are acquired. Be sure to click Update View after adjusting the stop condition. Summary Series Information Camera Parameters |Stop Conditions Stop Conditions Stops on either detector. Detector 1 Detector 2 Use the same parameters for Detector 2 . Time First View by Counts Counts · Time or Counts O Count Density · Manual Time: min Counts 500 Kcts Any Window Group Initial Starting Angle View Control Detector 1: RTAnterior LT Detector 2: RT Posterior LT Add View Insert View Update View Delete View View Detector 1 Stop On |Detector 2 |Stop On | Orientation Corr. RTAnten 3 min RT Post 3 min Head Out Yes 2. Rt. Lateral 3 min Lt. Lateral 3 min Head Out Yes SIEMENS 1 Healthineers Adjusting to Tc99m Shortages Job Aid / All Symbia Scanners Wholebody images can be slowed down by decreasing the Scan Speed. Summary Series Information |Camera Parameters |Stop Conditions Stop Conditions Scan Length: 200 cm Scan Speed: 12 cm/min View Names View 1 RT ANTERIOR LT View 2 LT POSTERIOR RT Scan Parameters Autocontour For Tomo imaging, Time Per View should be increased to ensure enough data is being acquired. Camera Parameters Gate Stop Conditions Stop Conditions . Time per View: 25 sec Accepted Beats/View. Beats View Control Patient State: Gantry Settings Rotation Direction: · CW · CCW Starting Angle: Detector Configuration: 45 90 Degrees of Rotation: Orbit 90 NCO Prescan Number of Views: Mode: 32 Step and Shoot 2 Adjusting to Tc99m Shortages Job Aid / All Symbia Scanners Gated Planar (MUGA) imaging can also have the time be increased, or set to acquire a certain number of counts to acquire adequate data. Camera Parameters |Gate Stop Conditions Stop Conditions . Time Counts Heartbeats Manual Time: 300 sec Counts: Window Group: 10 Kcts 99m Technetium Heartbeats: Beats o 2. Changing SPECT Reconstruction Parameters Tomo reconstruction parameters data should also be considered for adjustment with reduced- dose imaging. Tomo Processing parameter values are found in the Settings tab in the AutoRecon activity. Settings Reconstruction Masking/Centering Iterative Reconstruction (Flash3D) values can be adjusted to smooth or sharpen the slices. With less counts due to reduction of dose, lowering iterations or subsets may assist in decreasing noise and prevent over-processing of the images. Analytical Iterative Wallis OSEM 2D · Flash 3D # Iterations: 10 # Subsets: 4 3 Adjusting to Tc99m Shortages Job Aid / All Symbia Scanners The Gaussian FWHM filter may also be changed to adjust the post-processing smoothness filter. Increasing the FWHM will smooth the slices. Pixel Size: (4.80 4.80) mm % 100 0 Change Filter ... Gaussian 9.00 All Filtered Backprojection values can be adjusted by selecting the Change Filter option. Pixel Size: (4.80 4.80) mm % 100 O Change Filter ... Butterworth 0.40 5 4 Adjusting to Tc99m Shortages Job Aid / All Symbia Scanners Lowering the filter order or cutoff will result in smoother, less noisy images. Filter Tool 1.00- 0.80 0.60 0,40 0.20- Amplitude O 0 0.05 0.15 0 25 0.35 0.45 0.55 0.65 0.75 0.85 0.95 Nyquist ERH Filter. Butterworth 100 Cutoff 0.4 Order. 15 Alpha: Trial Reconstruction 3. Enhanced Planar Processing (optional) Enhanced Planar Processing is an optional software feature that uses the Pixon Processing method to reduce image noise. Raw image data can be run through the Planar Processing workflow to apply this correction, which can help enhance the image signal-to-noise ratio for recovered scan quality. Enhanced Planar Processing 5 Adjusting to Tc99m Shortages Job Aid / All Symbia Scanners Data will be processed automatically, but the Alpha level of the planar processing can be increased or decreased using the blending tool. Display Input Series MMEDIATE IMMEDIATE Data Selector IMMEDIATE [EPP-Complete] 11/21/2022 % IMMEDIATE 01/12/2015 100 % 30 % 100 100 Processing Flexible Display 0 LT POST RT 500K Counts Duration:453sec 256x256 Pix 2.4mm 99m 0 00 LT POST RT 500K Counts Duration:453sec 256x256 Pix2.4mm 99m Technetium Parameters % 30 % Auto 6 Adjusting to Tc99m Shortages Job Aid / All Symbia Scanners 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 com- mercially 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 cur- rent 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 2022 ………………………………………………………… Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Telephone: +49 9131 84-0 siemens.com/healthineers 7 HOOD05162003318606 Effective Date: 11/28/2022