AI-Rad Companion Chest CT Results Configuration Workflow Job Aid

Chest CT Results Configuration Workflow Job Aid Al-Rad Companion This document introduces the results configuration of Chest CT with Pulmonary, Cardiovascular and Musculoskeletal extension in AI-Rad Companion. You can open the configuration tabs with the button. 1. Screen Layout of the Configuration Menu You can use the configuration menu to activate the calculations and to determine all results that are sent to the PACS or to the results review. The configuration menu comprises the following areas: 1 Spine Measurement 2 Send Results for Confirmation Create Structured Report Range Value [%] Green 0 < 20 Yellow 20 < 25 Show findings label Orange 25 < 40 Show findings label 3 IV 40 < 100 Show findings label Windowing Window Center of Sagittal MPRs [HU] 450 Window Width of Sagittal MPRs [HU] Show Volume Rendering of the Spine Rendering Quality Excellent Number of Rotated Images per 360 Degrees 4 Restore Default Settings Save Cancel 5 1. Configuration tabs The tabs display sections that allow you to configure the results related to medical devices. Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 2. Results setting The following options are commonly displayed in each extension. ▪ Send Results for Confirmation: This option enables the calculation of results. It activates the option to review and individually send the results to the PACS. The Pulmonary Density results can only be enabled in the Pulmonary Density configuration. ▪ Create Structured Report: This option enables you to save the measurement results in a DICOM structured report. 3. Results setting section You can configure the results setting, such as ranges based on the amount of Low Attenuation Value (LAV) found, image windowing, and image volume rendering. 4. Restore Default Settings button This button is commonly displayed in each extension. The settings are restored to their default values for the selected extension only when you click the Restore Default Settings button. 5. Save and Cancel buttons These buttons are commonly displayed in each extension. The settings for all extensions are saved when you click the Save button. Changes made to the settings are discarded if Cancel is clicked. SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Page 2 of 17 Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 2. Lung Settings 2.1 Lung Lesion 1. Click on the Pulmonary tab and select Lung Lesion. Input Data Selection Pulmonary Lung Lesion Lung Parenchyma Pulmonary Density Cardiovascular Cardio Vascular Musculoskeletal 2. Activate the Detection of Lung Lesions option to enable the calculation of results. By activating the Send Results for Confirmation option, you can review and individually send images to the PACS. By deactivating this option, results will be sent to the PACS without prior manual review. Lung Lesion Detection of Lung Lesions Send Results for Confirmation 3. Enable the Create Structured Report option to save the measurement results in a DICOM structured report. Create Structured Report SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Page 3 of 17 Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 4. Set values for the following parameters: a. Create Contours as: Burned-in Graphics, Overlay (DICOM 6000) b. Create Lesion Findings: All Lesions, Segmented Lesions Only c. If Segmented Lesions Only is selected: Only Maximum Number of Lesions (values: 1-99) d. If Segmented Lesions Only is selected: Ignore Lesions with Diameters less than [mm] (values: 1-20) e. Thickness of Segmentation Contour [pixels] (values: 1-5) f. Zoom Factor of Lesion Series (values: 1-5): Select the value to identify the anatomy surrounding the lesion g. Number of Outer Slices (values: 1-5): Determine how many additional slices are displayed both above and below the lesion MPR Series Parameters Generate Contours as: O Burned-in Graphics 1 O Overlay (DICOM 6000) i Create Lesion Findings: O All Lesions Segmented Lesions Only i Maximum Number of largest Lesions to show 10 i Ignore Lesions with Diameters less than [mm] i 2 Thickness of Segmentation Contour [pixels] Zoom Factor of Lesion Series i Number of Outer Slices i Show findings label i 5. Select the Show findings label checkbox to display findings labels in the Worklist view if a lung lesion is detected. SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Page 4 of 17 Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 6. Set values for the Windowing: Adapt the values for Window Center (values: -1000-3071) and Window Width (values: 1-2000). Windowing Window Center [HU] -600 Window Width [HU] 1200 Activate the Show Volume Rendering of Lung Lesions option to display VRT data in the 3D segment of the Results Preview and generate VRT result images. If required, you can set the Rendering Quality to Good or Excellent and adapt the Number of Rotated Images per 360 Degrees from one to ten. Show Volume Rendering of Lung Lesions Rendering Quality Excellent Number of Rotated Images per 360 De ... 8 SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Page 5 of 17 Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 2.2 Lung Parenchyma 1. Click on the Pulmonary tab and select Lung Parenchyma. Input Data Selection Pulmonary Lung Lesion Lung Parenchyma Pulmonary Density Cardiovascular Cardio Vascular Musculoskeletal Activate the Analysis of Lung Parenchyma option to enable the calculation of results. By activating the Send Results for Confirmation option, you can review and individually send images to the PACS. By deactivating this option, results will be sent to the PACS without prior manual review. Lung Parenchyma Data Transfer Lung Parenchyma Analysis Send Results for Confirmation 2. Enable the Create Structured Report option to save the measurement results in a DICOM structured report. Create Structured Report SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Page 6 of 17 Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 3. Define the threshold values for the four ranges. Range Value [%] Green <12.5 Yellow 12.5 <25 Show findings label = Orange Show findings label III 25 <37.5 Red Show findings label IV 37.5 <100 4. Select one of the Show findings label checkboxes to display the desired findings labels in the Worklist view. 5. Activate the Show Volume Rendering of Lung Parenchyma option to display VRT data in the 3D segment of the Results Preview and generate VRT result images. If required, you can define the Rendering Quality as Good or Excellent and adapt the Number of Rotated Images per 360 Degrees from one to ten. Show Volume Rendering of Lung Parenchyma Rendering Quality Excellent Number of Rotated Images per 360 De ... CO SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Page 7 of 17 Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 2.3 Pulmonary Density 1. Click on the Pulmonary tab and select Pulmonary Density. Input Data Selection Pulmonary Lung Lesion Lung Parenchyma Pulmonary Density Cardiovascular Cardio Vascular Musculoskeletal 2. Activate the Assessment of Pulmonary Densities option to enable the calculation of results. By activating the Send Results for Confirmation option, you can review and individually send images to the PACS. By deactivating this option, results will be sent to the PACS without prior manual review. Data Transfer Assessment of Pulmonary Densities Send Results for Confirmation 3. Enable the Create Structured Report option to save the measurement results in a DICOM structured report. Create Structured Report SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Page 8 of 17 Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 4. In the MPR Series Parameters section, enable the Show High Opacity Segmentation Contours option to also display high opacity segmentation contours (areas of -200HU or higher inside the detected opacity regions) in the axial segment and adapt the Thickness of segmentation contour [pixels] from one to five. MPR Series Parameters Show High Opacity Segmentation Contours Thickness of segmentation contour [pixels] 2 5. In the VRT Series Parameters section, enable the Show Volume Rendering of Pulmonary Densities option to display VRT data in the 3D segment of the Results Preview and generate VRT result images. If required, you can define the Rendering Quality as Good or Excellent and adapt the Number of Rotated Images per 360 Degrees from one to ten. VRT Series Parameters Show Volume Rendering of Pulmonary Densities Rendering Quality Excellent Number of Rotated Images per 360 Degrees SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Page 9 of 17 Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 3. Cardio Settings 1. Click on the Cardiovascular tab and select Cardio. Input Data Selection Pulmonary Lung Lesion Lung Parenchyma Pulmonary Density Cardiovascular Cardio Vascular Musculoskeletal 2. Activate the Heart and Coronary Calcium Analysis option to enable the calculation of results. By activating the Send Results for Confirmation option, you can review and individually send images to the PACS. By deactivating this option, results will be sent to the PACS without prior manual review. Cardio Heart and Coronary Calcium Analysis Send Results for Confirmation 3. Enable the Create Structured Report option to save the measurement results in a DICOM structured report. Create Structured Report SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Page 10 of 17 Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 4. Define the threshold values for the four ranges and the relevant categories. MPR Series Parameters Range Total Calcium Volume [mm3] Green $ 999.0 Yellow $ 999.0 [Show findings label i Orange $ 999.0 Show findings label Red IV $ 999.0 Show findings label 5. Select one of the Show findings label checkboxes to display the desired findings labels in the Worklist view. 6. Activate the Show Volume Rendering of the Heart option to display VRT data in the 3D segment of the Results Preview and generate VRT result images. If required, you can define the Rendering Quality as Good or Excellent and adapt the Number of Rotated Images per 360 Degrees from one to ten. Show Volume Rendering of the Heart Rendering Quality Excellent Number of Rotated Images per 360 Degrees 8 SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Page 11 of 17 Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 4. Vascular Settings 1. Click on the Cardiovascular tab and select Vascular. Input Data Selection Pulmonary Lung Lesion Lung Parenchyma Pulmonary Density Cardiovascular Cardio Vascular Musculoskeletal 2. Activate the Aorta Analysis option to enable the calculation of results. By activating the Send Results for Confirmation option, you can review and individually send images to the PACS. By deactivating this option, results will be sent to the PACS without prior manual review. Vascular Aorta Analysis Send Results for Confirmation SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Page 12 of 17 Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 3. You can see a table containing the nine locations for the nine aortic landmarks, showing the mean value and standard deviation (std) factor for each landmark. The Red range can be set in millimeters and has a default value of 55 mm. The Lower Limits for the Yellow range and Orange range are calculated based on the following formulas: LL = Mean factor * Mean + std factor * STD Ranges are calculated as follows: • Yellow range: 1 x Mean + 2 x STD • Orange range: 1.5 x Mean MPR Series Parameters Range Value Green Lower Limit [mm] Yellow Mean Factor x Mean + STD. Factor 1.0 2.0 X STD. Show findings label i Orange Mean Factor STD. Factor 1.5 x Mean + 0.0 x STD. Show findings label Lower Limit [mm] 55 Show findings label Table of Values [mm] Valsalva Junction Aortic Arch Origin Aorta Mid Aortic Diaphragm Sinuses of Descending Aorta at Celiac Artery Proxima AHA Sinotubular Location Ascending Arch Proximal Aorta Aorta Descending Aorta at Mid Mid Mean 37.7 33.2 28.6 28.2 27.7 27.3 26.9 25.6 26.1 m STD. 3.8 3.7 3.6 3.5 .3 3.2 3.1 3.4 Lower Limit 0 0 0 O 0 0 O O o Lower Limit 45 41 36 35 34 34 33 32 32 Lower Limit (57) 50 43 42 42 41 40 38 39 Lower Limit 55 55 55 55 55 55 55 55 55 * The mean value (mean) and standard deviation (std) and the resulting lower value for the yellow range and orange range is calculated for the chosen mean factor and std factor based on [ Mean Factor x Mean + STD. Factor x STD]. 2010 ACCF/AHA/AATS/ACRIASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease. SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Page 13 of 17 Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 The application of the formula might lead to overlapping segments: For the Sinuses of Valsalva the lower limit of the Orange range (57 mm) is greater than the lower limit of the Red range (55 mm). Thus, the Orange range does not exist for this landmark. In the table this is indicated by brackets. Reference: 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients with Thoracic Aortic Disease 4. Enable the Create Structured Report option to save the measurement results in a DICOM structured report. Create Structured Report 5. Select one of the Show findings label checkboxes to display the desired findings labels in the Worklist view. 6. Activate the Show Volume Rendering of Aorta option to display VRT data in the 3D segment of the Results Preview and generate VRT result images. If required, you can define the Rendering Quality as Good or Excellent and adapt the Number of Rotated Images per 360 Degrees from one to ten. Show Volume Rendering of Aorta Rendering Quality Excellent Number of Rotated Images per 360 Degrees 8 SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Page 14 of 17 Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 5. Musculoskeletal Settings 1. Click on the Musculoskeletal tab. Input Data Selection Pulmonary Lung Lesion Lung Parenchyma Pulmonary Density Cardiovascular Cardio Vascular Musculoskeletal 2. Activate the Spine Measurement option to enable the calculation of results. By activating the Send Results for Confirmation option, you can review and individually send images to the PACS. By deactivating this option, results will be regarded as automatically confirmed and sent to the PACS without prior manual review. Spine Measurement Send Results for Confirmation 3. Enable the Create Structured Report option to save the measurement results in a DICOM structured report. Create Structured Report 4. Define the threshold values for the four ranges. For the calculation of the ranges, the height of corresponding measurements of neighboring vertebrae are compared. SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Page 15 of 17 Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 For example, if the posterior height of T7 is 22% smaller than the posterior height of its neighbor T6, the measurement is dedicated to the Yellow range (assuming the current setting for the Yellow range to be 20%-25%). Range Value [%] Green < 20 Yellow 20 < 25 Show findings label Orange 25 < 40 Show findings label Red IV 40 < 100 Show findings label 5. Select one of the Show findings label checkboxes to display the desired findings labels in the Worklist view. 6. In the Windowing section, adapt the windowing values for Window Center of Sagittal MPRs (value range: -1000-3071) and Window Width of Sagittal MPRs (value range: 1-2000). Windowing Window Center of Sagittal MPRs [HU] 450 Window Width of Sagittal MPRs [HU] 1500 7. Activate the Show Volume Rendering of the Spine option to display VRT data in the 3D segment of the Results Preview and generate VRT result images. If required, you can define the Rendering Quality as Good or Excellent and adapt the Number of Rotated Images per 360 Degrees from one to ten. Show Volume Rendering of the Spine Rendering Quality Excellent Number of Rotated Images per 360 Degrees 8 SIEMENS Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 Master Effective Date: 10 Aug 2021 | HILS 2224 Job Aid Effective Date: 09 Nov 2022 | HOOD05162003312540 Healthineers Page 16 of 17 Job Aid | Chest CT Results Configuration Workflow Effective Date: 09 Nov 2022 | HOOD05162003312540 Please note this 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 Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Please 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. 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