Artis Systems VD12 with syngo Application Software VD30: 3D Basics Online Training

Continue Continue Continue Continue Continue Continue Welcome Artis Systems (VD12) with syngo Application Software (VD30) 3D Basics In this online training, we will introduce the basics of a 3D acquisition workflow and explain how to review and postprocess these 3D images. This online training is valid for the Artis software version VD12 with the syngo Application Software version VD30 and higher. Recall how 3D Images are created 1 Postprocess Images 4 Review Images 3 Perform 3D Acquisitions 2 Master Template HOOD05162003052540 | Effective Date: 26-Nov-2019 Welcome [artis_vd12_olt_3dbasics_en_1-1.mp3] Welcome to the 3D Basics training for the Artis Systems and syngo Application Software. In this online training, we will introduce the basics of a 3D acquisition workflow and explain how to review and postprocess these 3D images. Please note: This online training is valid for the Artis software version VD12 with the syngo Application Software version VD30 and higher. 3D Images 3D Images C-arm rotates around the isocenter C-arm acquires images at angular increments Reconstruction of images Computing 3D dataset Set the Isocenter Rotation of the C-arm For more information, select the tab arrows below. 3D Images [artis_vd12_olt_3dbasics_en_2-1.mp3] Let’s first talk about how 3D images are created. 3D acquisitions capture a specific region of interest over a series of multiple projections. The C-arm rotates around the isocenter and acquires images at pre-determined angular increments. The images acquired during the rotation are reconstructed to compute a 3D dataset. The result from the 3D acquisition and the reconstruction create CT-like images. The 3D dataset can be used for procedural planning, intra-procedural evaluation or for use within an interventional application workflow. For more information, select the tab arrows below. Rotation of the C-arm For systems with a floor stand (floor system, biplane system), 3D acquisitions are performed with the floor stand positioned at the table head side. For biplane systems , plane B (top stand/ceiling stand) needs to be moved away from the rotation of plane A. Set the Isocenter Setting the isocenter is part of the 3D acquisition workflow. The most accurate way to set the isocenter is to perform fluoroscopy in the AP (frontal) and lateral planes to confirm that the region of interest is centrally located on the image. During the workflow, you will be guided by the isocenter assistant to position the region of interest in the isocenter. For more information, select the orange markers . Isocenter The isocenter is the center of rotation of the C-arm. If an organ is in the center of this rotation, the image of the organ remains in the same place on the screen during C-arm angulations and rotation. Image Receptor Plane Focal Spot of X-ray Tube Table Object Distance (TOD) Perform a 3D Acquisition Perform a 3D Acquisition Prepare the exam room 3D acquisition program Set up and perform 3D acquisitions Perform a 3D Acquisition [artis_vd12_olt_3dbasics_en_3-1.mp3] Alright, now that we have a rough idea how 3D images are created, let’s talk about how to perform a 3D acquisition. In this lesson, we will explain what you need to consider in the exam room before the 3D acquisition workflow starts, which 3D acquisition modes are available, and how to perform a 3D acquisition. Prepare the Exam Room Move all equipment out of the rotational path. Ensure that the patient’s arms are secured and are not obscuring the region of interest. Check that head fixation devices are secure. Secure IV lines and breathing tubes out of the rotational path. Position all cables and other devices out of the rotational path. Immobilize the region of interest as well as possible. Prepare for the injection of contrast media. Prepare the Exam Room [artis_vd12_olt_3dbasics_en_3-2.mp3] Prior to starting any rotational acquisitions, you should ensure that the rotational path is free from all obstructions by all persons and objects. Move all equipment out of the rotational path. This includes IV stands, trolleys, exam room displays and other moveable objects, such as lead shields and surgery lights. Ensure that the patient’s arms are secured and are not obscuring the region of interest. Check that head fixation devices are secure. Secure IV lines and breathing tubes out of the rotational path. Ensure that they are not obscuring the region of interest. Position all cables and other devices out of the rotational path. Ensure for them as well that they are not obscuring the region of interest. Immobilize the region of interest as well as possible. If required, prepare for the injection of contrast media. 3D Acquisition Program Special acquisition modes to create 3D images for various applications Each mode of acquisition varies in the number of C-arm rotations and the timing of contrast media injection System rotation depending on examination type System guidance through workflow For more information, select the tab arrows on the right. 3D DR Examination Sequence 3D DSA Examination Sequence 3D CARD Examination Sequence syngo Dyna3D/DynaCT syngo Dyna3D syngo DynaCT Cardiac 3D Acquisition Program [artis_vd12_olt_3dbasics_en_3-3.mp3] Before starting the workflow, you need to select the acquisition mode. There are special acquisition modes to create 3D images for various applications, such as for vessels and bones. Each mode of acquisition varies in the number of C-arm rotations and the timing of contrast media injection. The system will rotate differently depending on the type of examination since there are different types of acquisition programs. After you have selected a 3D program, the system guides you through the workflow for the specific examination. For more information, select the tab arrows on the right. Start Position: Brief fluoroscopy to check the examination region (optional) Test Run: C-arm rotates to ensure that no collisions occur Injection if contrast medium is used and start of acquisition 3D acquisition run 1: C-arm rotated for image acquisition with or without contrast medium Start of 3D acquisition run 2 3D acquisition run 2 Start of acquisition run 3 3D acquisition run 3 End of acquisition 3D CARD Examination Sequence Projection images are acquired on several projection runs, which can be ECG gated, to reduce motion artifacts. No subtraction is performed. Test Run: C-arm rotates to ensure that no collisions occur Fluoroscopy: Brief fluoroscopy to set the acquisition parameters (required) Mask run: The C-arm rotates for image acquisition without contrast medium Reversal in the start position of the test run Return run: No x-ray is performed during this run Injection: Automatic or manual injection at reversal point Fill run: C-arm rotates for image acquisition with contrast medium End of acquisition 3D DSA Examination Sequence The projection images are acquired in a mask run and a fill run and subtraction is performed. Start Position: Brief fluoroscopy to check the examination region (optional) Start Position: Brief fluoroscopy to check the examination region (optional) Test Run: C-arm rotates to ensure that no collisions occur Fluoroscopy: Brief fluoroscopy to set the acquisition parameters (required) Injection: Automatic or manual injection if contrast medium is used Start of Acquisition Fill run: C-arm rotates for image acquisition with/without contrast medium End of acquisition 3D DR Examination Sequence The projection images are acquired in a single rotation and no subtraction is performed. Set up and Perform 3D Acquisitions Now let’s see how 3D acquisitions are set up and performed. Select the Play button to start the video. Set Up and Perform 3D Acquisitions HOOD05162003080798 vid_artis_vd12_3d_acquisition_en_final.docx Voice Script Welcome to the Artis 3D acquisition workflow video. This video will demonstrate how to set up and perform 3D acquisitions using your Artis system. 3D acquisitions are used to create either high contrast or soft tissue views of the pathology of the patient. The result from the 3D acquisition and the reconstruction create CT-like images. The results are often used in guided workflows like Needle Guidance, Embolization Guidance or others. To start the 3D acquisition, select the 3D acquisition protocol. You can use the 3D Wizard to select the protocol and for acquisition guidance. You open the 3D Wizard from the 4D task card on the TSC. Select the 3D acquisition protocol. Please note it is also possible to select the 3D protocol manually from the Exam task card on the TSC. 3D examinations can only be performed in calibrated system positions. The available calibrated positions depend on the system type. Please confirm with your Siemens Healthineers Applications Specialist which calibrated positions are possible. To move the system to the starting position, press down on the left joystick and deflect the joystick away from you. The system moves to the start position for the 3D acquisition. When positioning the system, follow the guidance on the exam room display. Guidance messages appear for all steps of the acquisition workflow. It is a requirement for 3D acquisitions that the region of interest is positioned in the isocenter. Position the region of interest in the center in the AP position. Perform fluoroscopy briefly. Using CAREposition adjust the table longitudinally and transversely so that the region of interest is in the center of the field of view. To position the region of interest in the lateral position, press on the stand/C-arm joystick and deflect the joystick away from you. Perform fluoroscopy briefly. Using CAREposition adjust the tabletop height so that the region of interest is in the isocenter. The optional laser cross might be of help during this step. When you are satisfied that the region of interest is positioned within the isocenter, you can continue with the 3D workflow and enter the test phase. To prepare, move the system to the start position for the test phase. Press on the stand/C-arm joystick and deflect the joystick away from you. When the system is in the start position for the test phase, a message appears on the exam room display. It is important in the test phase to ensure that the area of rotation is free from possible collisions. Move any equipment away from the rotation zone, including the exam room display. To start the test phase, press down and deflect the joystick away from you. The C-arm will rotate around the region of interest. This test is performed at a slower speed than the later acquisition to allow a better reaction to possible required changes. Keep the joystick deflected; the test phase will end automatically. For automatic setting of acquisition parameters, you are prompted by the system at the end of the test phase to perform fluoroscopy. When the test phase is complete the system is ready for acquisition. Before you start the 3D acquisition, ensure that you are prepared for the injection of contrast media, if required. C-arm rotation depends on the selected protocol, for example: · In DR acquisitions the system will perform one c-arm rotation. If an injector is armed the contrast agent will be injected. · DSA acquisitions will involve three rotations of the C-arm; the mask run, the return rotation (no x-ray) and the fill run. The injector will be started for the fill run. The system will wait the time that is set in the x-ray delay Some acquisition protocols involve a bolus watching phase after the mask run, for example DynaPBV Neuro. Acquisition can be released by the hand switch or the footswitch. The contrast medium injection can be synced with the acquisition or you can manually trigger the injection of contrast media using the injector interface. During the 3D acquisition, as the C-arm rotates around the region of interest, the 2D images are shown on the exam room and control room displays. This allows you to see the anatomical structures and monitor the injection of contrast media. Continue to release x-ray (handswitch or footswitch) until you are notified by the system that the 3D run is completed. An audible signal indicates that the acqusition is complete. When the 3D acquisition is finalized, the 3D acquisition program is automatically deselected and a 2D acquisition program is selected by default. If configured, the system can be moved back to the working position prior to entering the 3D acquisition workflow. Knowledge Check Knowledge Check Let’s see what we’ve learned so far! Try to answer the following questions. When you’re ready, select Start! Start Knowledge Check Select the Isocenter key. Immobilize the region of interest. Check that the rotational path is free of any obstacles. Question 1 of 3 What do you need to consider prior to starting any rotational acquisitions? Select the two (2) correct answers. Multiple Answer Question Correct Before starting the 3D Wizard, immobilize the region of interest and ensure that the rotational path is free of any obstacles. Incorrect You did not select all correct answers. Which button do you press on the touchscreen to start the 3D Wizard? Question 2 of 3 Look at the image and select the correct button. Which button do you press on the touchscreen to start the 3D Wizard? Incorrect You did not select the correct button to start the 3D Wizard. Correct Selecting this button starts the 3D Wizard. I press the side switch. I press down the joystick. I deflect the joystick away from me. I move the joystick towards me. Question 3 of 3 After selecting the 3D acquisition program, how do you move the system? Look at the stand control module and select two (2) answers. Multiple Answer Question Correct You press on top of the joystick and deflect it away from you to move the system. Incorrect This is not how you move the system. Review Review Retry Knowledge Check Results Continue Knowledge Check Results You did not answer all questions correctly. You can review your answers, try the questions again or continue with the training. Congratulations! You answered all questions correctly. You can try the questions again or move on with the training. Review Scenes Review Images Examination Patient The C-arm symbol indicates the current examination patient on the Artis. Review Patient This folder indicates the review patient. The review patient may differ from the examination patient. 3D Visualization Techniques Interaction Mode QuickZoom Alt + + QuickZoom Review Images [artis_vd12_olt_3dbasics_en_5-1.mp3] Ok, so we have talked about how 3D acquisition images are created and how to perform a 3D acquisition workflow. Now let’s see how images can be reviewed. To review 3D images, you need to select the 4D task card. When performing 3D acquisition, images are loaded automatically into the 4D task card. The 4D task card provides various tools to visualize and postprocess 3D volumes. At the upper right corner, you can view the examination patient and review patient. The current examination patient is highlighted with a C-arm symbol. Please note that the review patient may differ from the examination patient. In the following, we will explain which 3D visualization techniques can be applied for reviewing and which common tools are available. 3D Visualization Techniques Multi-planar Reformatting (MPR) Maximum/Minimum Intensity Projection (MIP/MinIP) Volume Rendering Technique (VRT) For more information, select the tab arrows on the right. Multi-planar Reformatting (MPR) Placement of slices in various orientations 2D images as a result Maximum/Minimum Intensity Projection (MIP/MinIP) Display of contrast medium examinations Angiography Volume Rendering Technique (VRT) Differentiation between organs and tissue structure Colored 3-dimensional display of bone, tissue and organs 3D Visualization Techniques [artis_vd12_olt_3dbasics_en_5-2.mp3] When 3D acquisition is complete, the volume is reconstructed for viewing. You can apply different rendering techniques to the 3D volume like multi-planar reformatting, maximum intensity projection or volume rendering technique. Multi-planar Reformatting, or in short MPR, is used to place the slices in various orientations through the region of interest. The resulting images are two-dimensional. Maximum Intensity Projection or Minimum Intensity Projection, MIP and MinIP for short, are used for the display of contrast medium examinations or especially for angiography. The Volume Rendering Technique, VRT, is used, for example, to differentiate between organs and tissue structures, and for colored, three-dimensional display of bone, tissue, and organs. To learn more about the rendering techniques, select the tabs on the right. Volume Rendering Technique (VRT) The volume rendering technique (VRT) is a way of creating color images in which a 3D effect is achieved with transparency, shading, and color transition. The image on the right shows an example of a VRT. Maximum/Minimum Intensity Projection (MIP/MinIP) Maximum intensity projection (MIP) or minimum intensity projection (MinIP) is a rendering technique that projects the 3D volume onto a 2D image plane. During projection only the maximal grey value is applied to the resulting image (MIP). Minimum intensity projection (MinIP) is the same technique using the minimum grey value. Voxels in MIP Images Most intensive grey scale value Multi-planar Reformatting (MPR) Multi-planar reformatting (MPR) is a rendering technique that shows 2D images of a 3D volume arranged in stacks of slices. Images can be viewed in the transversal/axial, coronal, sagittal and paraxial planes. Using the 3D crosshair, you can move through the volume to gain a 3-dimensional impression. Transversal/Axial Coronal Paraxial Sagittal Paraxial Sagittal Interaction Mode To rotate, zoom and pan a VRT view Available in 4D task card Rotate Mode Zoom/Pan Mode Manipulate Mode For more information, select the tab arrows on the right. Interaction Mode [artis_vd12_olt_3dbasics_en_5-3.mp3] When a volume is loaded and displayed in the 4D task card, you can rotate, zoom and pan it using interaction modes. The interaction modes are available in the 4D task card. Select the required interaction mode in the context menu or the Mode main menu. For more information, select the tab arrows on the right. Zoom/Pan Mode With the Zoom/Pan mode, you can zoom and pan the volume using the left mouse button. Zoom Locate the mouse cursor in the 20% outer area of the image segment. Hold down the left mouse key and drag the cursor up and down to zoom in or out. Pan Locate the mouse cursor in the 60% inner area of the image segment. Hold down the left mouse key and drag the cursor to pan the image section. Rotate Mode With the Rotate mode, you can rotate the volume using the left mouse button. Rotate In-plane Move the mouse pointer in the 5% outer area of the image segment. Hold down the left mouse button and move the mouse. Rotate 3D Move the mouse pointer in the 90% inner area of the image segment. Hold down the left mouse button and move the mouse. Select the X in the right corner to learn more about the other modes. The Manipulate mode is a combination of the Rotate mode and Zoom/Pan mode. You can switch between these two modes using the mouse. With the left mouse button: The VRT view can be rotated. VRT rotation and shift of clip plane are combined. The MPR slides can be scrolled through. With the right mouse button, zooming and panning can be performed. Select the X in the right corner to learn more about the other modes. Manipulate Mode QuickZoom Centers all segments of a volume Center the point of interest Zoom the point of interest Clip the volume defined by the zooming to the segment width Press the ALT key and click the required position in any image segment. Hold down the left mouse key. To zoom the image, move the mouse upwards or downwards. Alt + QuickZoom [artis_vd12_olt_3dbasics_en_5-4.mp3] The QuickZoom function centers all segments of a volume. QuickZoom combines the following functions: Center the point of interest Zoom the point of interest, and Clip the volume defined by the zooming to the segment width To perform QuickZoom in the control room: Press the Alt key and click the required position in any image segment and hold down the left mouse key. To zoom the image in or out, move the mouse upwards or downwards, while still holding the Alt key and pressing the left mouse key. Postprocess Images Postprocess Images Punching a Volume of Interest (VOI) Windowing Ranges Clip planes Annotations and measurements Study bookmarks Store Study Bookmark Select this icon to store study bookmarks. X-Ray Subtask Card Here you can find the icon for C-arm orientation bookmarks. Image Subtask Card Here you can find the adjustments for clip planes. Measurement Subtask Card Here you can find the icons for annotations and measurements. Tools Subtask Card Here you can find the icons for punching a VOI, and parallel and radial ranges. Post-process Images [artis_vd12_olt_3dbasics_en_6-1.mp3] In this final lesson, let’s talk about important postprocessing features for 3D images and how to perform them. All postprocessing features for 3D images can be accessed via the 4D task card. Punching a Volume of Interest (VOI) To mask out disturbing regions Only applied to a volume view (VRT) To learn how to punch a VOI, select the steps below. 1 1 1 2 2 2 3 3 3 Punching a Volume of Interest (VOI) [artis_vd12_olt_3dbasics_en_6-2.mp3] Punching is required in order to mask out disturbing regions of the volume, which otherwise would obstruct the visibility of interesting structures. Punching is only applied to a volume view, or in other words: to VRT. The planar image segments, such as MPR, always show the whole image. To learn how to punch a volume of interest, select the steps below. Punching a Volume of Interest (VOI) 3 Specify what you would like to remove and draw a contour using the left mouse button. Select Tools > VOI Punching… …or the Punching icon. Punching a Volume of Interest (VOI) 2 Punching a Volume of Interest (VOI) Select the VRT or MPR image segment. 1 Ranges Parallel ranges to view a volume in a specific direction Radial ranges and volume ranges to store views of a volume from different angles Parallel Ranges Radial Ranges Volume Ranges For more information, select the tab arrows below. Radial Ranges Simulation of step-by-step rotation around the axis perpendicular to an image segment Volume Ranges Simulation of a step-by-step rotation around a reference axis of the volume Ranges [artis_vd12_olt_3dbasics_en_6-3.mp3] In order to view a volume in a specific direction, you can generate parallel ranges. Radial ranges and volume ranges can be generated to store views of a volume from different angles. With radial ranges, you can simulate a step-by-step rotation around the axis perpendicular to an image segment. Volume ranges simulate a step-by-step rotation around a reference axis of the volume. For more information, select the tab arrows below. Volume Ranges To calculate the volume ranges, select an VRT image segment. Select the Volume Ranges icon under Tools. To scroll through the preview images, use the left mouse key on the preview. Scroll through Previous Images To scroll through the preview images, hold down the left mouse key on the preview image and move the mouse up or down. Radial Ranges To calculate the radial ranges, select a planar image segment (e.g. an MPR image segment). Select the Radial Ranges icon under Tools. To scroll through the preview images, use the left mouse key. For more information, select the orange markers . Pre-defined Set of Ranges When you select the Radial Ranges icon, a predefined set of radial ranges is displayed in the image segment, as shown here. You can also adjust the ranges manually. Dotted Frame Highlights the current image selection. Scroll through Previous Images To scroll through the preview images, hold down the left mouse key on the preview image and move the mouse up or down. Parallel Ranges To calculate the parallel ranges, select a planar image segment (e.g. an MPR image segment). Select the Parallel Ranges icon under Tools. To scroll through the preview images, use the left mouse key. For more information, select the orange markers . Dotted Frame Highlights the current image selection Scroll through Previous Images To scroll through the preview images, hold down the left mouse key on the preview image and move the mouse up or down. Pre-defined Set of Ranges When you select the Parallel Ranges icon, a predefined set of parallel ranges is displayed in the image segment, as shown here. You can also adjust the ranges manually. Clip Planes Use a plane to cut the volume Can be moved to any position in the volume VRT image segment must be selected Select Clip Plane Orientation Shift and Rotate a Clip Plane Clip Plane For more information, select the tab arrows below. Clip Planes [artis_vd12_olt_3dbasics_en_6-4.mp3] With clip planes, you can remove some parts of the volume in a VRT view by using a plane that cuts the volume. You can move a clip plane to any position in the volume. To use a clip plane, select the VRT image segment and activate the clip plane icon in the image subtask card. For more information, select the tab arrow below. Shift and Rotate a Clip Plane To shift a clip plane, ensure that the interaction mode Manipulate is active. Position the cursor on the clip plane graphics. Depending on the position, the symbol on the mouse cursor changes its shape. To shift a clip plane, drag the clip plane graphics inside of the clip plane. ​To rotate a clip plane, drag the border of the clip plane graphic. Select the X in the upper right corner to go back to the overview. Border of Clip Plane Clip Plane Graphic Select the clip plane orientation on the Image subtask card. Select the Reset MPR Orientation icon. Select the X in the upper right corner to go back to the overview. To change the orientation, do the following: Select a clip plane. Select Clip Plane Orientation 1 2 3 Annotations and Measurements Add an Annotation You can draw an arrow and then enter an annotation text. Pixel Lens With the pixel lens, you can measure the intensity values of a pixel in 2D images. Measuring Distances Select this icon to measure the distance from one pixel to another pixel in 2D or from one voxel to another voxel in 3D by a straight line. Statistical Measurements You can evaluate a 2D region of interest (ROI) by drawing an ellipse, a circle, a rectangle, a closed polygon or a freehand ROI. For more information, select the orange markers . Annotations and Measurements [artis_vd12_olt_3dbasics_en_6-5.mp3] The 4D task card provides various annotation and measuring tools. You can add 2D annotation and measurement objects, such as an arrow annotation with text, pixel lens, distance line, and statistical measurements. For more information, select the orange markers. Study Bookmarks Visualization bookmarks Viewing and rendering settings from all planar and volume segments C-arm orientation bookmarks Orientation of the volume only Save a C-arm Orientation Bookmark Save a Visualization Bookmark Load a Study Bookmark For more information, select the tab arrows below. Study Bookmarks [artis_vd12_olt_3dbasics_en_6-6.mp3] You can save and reload study bookmarks for the currently displayed volume. There are two types of study bookmarks: visualization bookmarks and C-arm orientation bookmarks. Visualization bookmarks contain all the viewing and rendering settings from all planar and volume segments. The C-arm orientation bookmarks contain the orientation of the volume only so that the C-arm can be moved to this position. For more information, select the tab arrows below. Load a Study Bookmark To load a study bookmark, select the desired bookmark in the bookmark tab. Bookmark Tab Stored bookmarks are displayed here. Or you can select the Layout Gallery in the general menu (exam room display) and select a study bookmark in the syngo 4D Bookmarks. Save a Visualization Bookmark To save a visualization bookmark, display the volume in the way you require. Left-click on the Visualization Bookmark icon. A study bookmark containing the visualization settings is stored in the bookmark tab. It is named automatically by a consecutive number and the current date and shown as a thumbnail in the bookmark area. To save and name a visualization bookmark, right-click on the Visualization Bookmark icon . The Rename Bookmark dialog opens and you can enter a name for the study bookmark and save it. Store Visualization Bookmark Bookmark Tab Stored bookmarks are displayed here. Save a C-arm Orientation Bookmark To save a C-arm orientation bookmark, do the following: Display the volume in the way you require. Select the Store C-arm Orientation icon. A study bookmark containing the orientation is stored in the bookmark tab. It is named automatically by the angulation angles. The study bookmark is stored as a seperate series in the active study of the active patient. It is shown as a thumbnail on the bookmark area. Store C-arm Orientation Bookmark Bookmark Tab Stored bookmarks are displayed here. Knowledge Check Knowledge Check Let’s see what we’ve learned so far! Try to answer the following questions. When you’re ready, select Start! Start Knowledge Check In the upper right corner of the 4D task card, you can see two folders. Which folder shows the examination patient? Question 1 of 4 Select the best answer. Doe, John Major, Mary Doe, John Major, Mary In the upper right corner of the 4D task card, you can see two folders. Which folder shows the examination patient? Incorrect You did not select the button to start the 3D Wizard. Correct The folder with the C-arm symbol indicates the current examination patient on the Artis. … Manipulate mode. … Zoom/Pan mode. … Zoom icon in the Tools subtask card. Question 2 of 4 Complete the following sentence: “To zoom an image in the 4D task card, you need to select the…” Select the two (2) answers. Multiple Answer Question Correct You can either use the Manipulate or Zoom mode to zoom an image in the 4D task card. Incorrect This is not how you zoom in an image. 1 2 3 4 Which function masks out disturbing regions? Question 3 of 4 Select the best answer. 3 1 2 4 Multiple Choice Question Incorrect This would not open the punching a VOI menu. Incorrect This would not open the punching a VOI menu. Correct The punching a VOI function masks out disturbing regions. Correct This would not open the punching a VOI menu. 1 2 3 4 How can you generate radial ranges? Question 4 of 4 Select the best answer. 1 2 3 4 Multiple Choice Question Correct Select this icon to generate radial ranges. Incorrect This would not open the radial ranges menu. Incorrect This would not open the radial ranges menu. Correct This would not open the radial ranges menu. Review Review Retry Knowledge Check Results Continue Knowledge Check Results You did not answer all questions correctly. You can review your answers, try the questions again or continue with the training. Congratulations! You answered all questions correctly. You can try the questions again or move on with the training. Course Review Review Images Perform 3D Acquisitions Recall how 3D Images are Created Course Review Congratulations. You have completed the 3D Basics course for the Artis systems (VD12) with the syngo Application Software (VD30). Select the objectives listed below to review the material before proceeding to the final assessment. Postprocess Images 1 1 1 2 2 2 3 3 3 4 4 4 Course Review Postprocess Images Clip Plane With clip planes, you can remove some parts of the volume in a VRT view by using a plane that cuts the volume. You can move a clip plane to any position in the volume. Add an Annotation You can draw an arrow and then enter an annotation text. Pixel Lens With the pixel lens, you can measure the intensity values of a pixel in 2D images. Measuring Distances Select this icon to measure the distance from one pixel to another pixel in 2D or from one voxel to another voxel in 3D by a straight line. Statistical Measurements You can evaluate a 2D region of interest (ROI) by drawing an ellipse, a circle, a rectangle, a closed polygon, or a freehand ROI. Bookmark Area Stored C-arm and visualization bookmarks are displayed here as thumbnails. Store Visualization Bookmark Visualization bookmarks contain all the viewing and rendering settings from all planar and volume segments. Left-click on this icon to save a visualization bookmark. When you right-click on this icon, you can enter a name for the bookmark and save it. Store C-arm Orientation Bookmark C-arm orientation bookmarks contain the orientation of the volume only so that the C-arm can be moved to this position. Select this icon to store a C-arm orientation bookmark. 4D Task Card All postprocessing features for 3D images can be accessed via the 4D task card. Parallel Ranges Select this icon to open the parallel ranges menu. Parallel ranges are used to view a volume in a specific direction. Punching a VOI Select this icon to open the punching a VOI menu. Punching is required in order to mask out disturbing regions of the volume, which otherwise would obstruct the visibility of interesting structures. Punching is only applied to a volume view. Radial and Volume Ranges Select this icon to open the radial ranges menu to create radial or volume ranges. With radial ranges, you can simulate a step-by-step rotation around the axis perpendicular to an image segment. Volume ranges simulate a step-by-step rotation around a reference axis of the volume. Review Images Examination Patient and Review Patient Here you can view the examination patient and review patient. The current examination patient is highlighted with a C-arm symbol. Examination Patient The C-arm symbol indicates the current examination patient on the Artis. Review Patient This folder indicates the review patient. The review patient may differ from the examination patient. Alt + + QuickZoom 4D Task Card 3D images are reviewed in the 4D task card. When 3D acquisition is complete, the volume is reconstructed for viewing. Different rendering techniques can be applied to the 3D volume like MPR, MIP or VRT. Interaction Modes When a volume is loaded and displayed in the 4D task card, you can rotate, zoom and pan it using interaction modes. Additionally, you can use the QuickZoom function to center all segments of a volume. QuickZoom Use the QuickZoom function to center all segments of a volume. Perform 3D Acquisitions There are special acquisition modes to create 3D images for various applications, such as syngo Dyna3D, syngo DynaCT and syngo DynaCT Cardiac. Each mode of acquisition varies in the number of C-arm rotations and the timing of contrast media injection. The system will rotate differently depending on the type of examination since there are different types of acquisition protocols. Prior to starting any rotational acquisitions, ensure that the rotational path is free from all obstructions by all persons and objects. After you have selected a 3D program, the system guides you through the workflow for the specific examination. 3D DSA Examination Sequence Recall how 3D Images are Created 3D acquisitions capture a specific region of interest over a series of multiple projections. The C-arm rotates about the isocenter and acquires images at pre-determined angular increments. The images acquired during the rotation are reconstructed to compute a 3D dataset. The result from the 3D acquisition and the reconstruction create CT-like images. The 3D dataset can be used for procedural planning, intra-procedural evaluation or for use within an interventional application workflow. Isocenter The isocenter is the center of rotation of the C-arm. If an organ is in the center of this rotation, the image of the organ remains in the same place on the screen during C-arm angulations and rotation. Table Object Distance (TOD) Image Receptor Plane Focal Spot of X-ray Tube 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 2020 Siemens Healthineers Headquarters\Siemens Healthcare GmbH\Henkestr. 127\ 91052 Erlangen, Germany\Telephone: +49 9131 84-0\siemens-healthineers.com Disclaimer Disclaimer Assessment Assessment This assessment will test your retention of the presented content. A passing score of 80% or higher is required to complete the course and earn your certificate. You may repeat the assessment as many times as needed. Start Assessment Only one C-arm rotation is required. Two C-arm rotations are always required. Three C-arm rotations are always required. The number of C-arm rotations required depends on the selected program. How many rotations of the C-arm are required for a 3D acquisition? Question 1 of 7 Select the best answer. Multiple Choice Question Incorrect Incorrect This is not the correct answer. Incorrect This is not the correct answer. Correct This is not the correct answer. I hold down the ALT key and left mouse key and drag the mouse up or down. I select QuickZoom in the Mode menu. I select the QuickZoom icon under Tools. How can you use the QuickZoom function from the control room? Question 2 of 7 Select the best answer. Multiple Choice Question Incorrect You cannot select QuickZoom under Tools. Incorrect You cannot select QuickZoom in the Mode menu. Correct 1 2 3 4 Which icon do you need to select to generate parallel ranges? Question 3 of 7 Select the best answer. 1 2 3 4 Multiple Choice Question Incorrect Incorrect You did not select the icon for parallel ranges. Incorrect You did not select the icon for parallel ranges. Correct You did not select the icon for parallel ranges. 1 2 3 4 Which icon do you need to select to save a visualization bookmark? Question 4 of 7 Select the best answer. 1 3 2 4 Multiple Choice Question Correct Incorrect This would not save a visualization bookmark. Incorrect This would not save a visualization bookmark. Correct This would not save a visualization bookmark. 1 2 3 4 Which function enables you to measure a 2D ROI? Question 5 of 7 Select the best answer. 3 1 2 4 Multiple Choice Question Incorrect You cannot measure a 2D ROI if you select this icon. Incorrect Incorrect You cannot measure a 2D ROI if you select this icon. Correct You cannot measure a 2D ROI if you select this icon. 1 2 3 4 Which icon do you need to press to store a C-arm orientation bookmark? Question 6 of 7 Select the best answer. 3 1 2 4 Multiple Choice Question Incorrect This icon is not for storing a C-arm orientation bookmark. Incorrect Incorrect This icon is not for storing a C-arm orientation bookmark. Correct This icon is not for storing a C-arm orientation bookmark. 1 2 3 4 Which icon do you need to select to measure the intensity values of a pixel in 2D images? Question 7 of 7 Select the best answer. 3 1 2 4 Multiple Choice Question Incorrect Incorrect You cannot measure the intensity values of a pixel in 2D images with this function. Incorrect You cannot measure the intensity values of a pixel in 2D images with this function. Correct You cannot measure the intensity values of a pixel in 2D images with this function. Review Review Retry Assessment Results %Results.ScorePercent%% %Results.PassPercent%% Continue YOUR SCORE: PASSING SCORE: Assessment Results You did not pass the course. Take time to review the assessment then select Retry to continue. Congratulations. You passed the course. Exit To access your Certificate of Completion, select the Launch button drop down on the course overview page. You can also access the certificate from your PEPconnect transcript. You have completed the 3D Basics Online Training for the Artis Systems with the syngo Application Software. Completion HOOD05162003125180 | Effective Date: 25-Sept-2020 1.1 Welcome 2.1 3D Images 3.1 Perform a 3D Acquisition 3.2 Prepare the Exam Room 3.3 3D Acquisition Program 3.4 Set Up and Perform 3D Acquisitions 4.1 Knowledge Check 5.1 Review Images 5.2 3D Visualization Techniques 5.3 Interaction Mode 5.4 QuickZoom 6.1 Post-process Images 6.2 Punching a Volume of Interest (VOI) 6.3 Ranges 6.4 Clip Planes 6.5 Annotations and Measurements 6.6 Study Bookmarks 7.1 Knowledge Check 8.1 Course Review 8.2 Disclaimer 9.1 Assessment 9.10 Completion