Chondral Quant - USA

SIEMENS Healthineers Chondral Quant Job Aid Template Effective Date: 10 Aug 2021| HILS 2223 Effective 9 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant SIEMENS Healthineers Table of contents What is it? 3 Analysis of knee cartilage 4 Required input data 5 Interactive mode - Open the app 7 Interactive mode - Screen layout 8 Interactive mode - Workflow steps 9 Interactive mode - Tools bar 15 PACS Ready mode 17 How to ensure suitable performance? 19 Saving the Results 15 PACS Ready Mode 16 How to ensure suitable performance 17 Disclaimer: The information presented in this Chondral Quant Job Aid is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use 2 their own learning, training, and expertise in dealing with their individual patients. This material does not substitute for that duty and Effective 5 Jan 2024| QR700002086 is not intended by Siemens Medical Systems to be used for any purpose in that regard. Unrestricted © Siemens Healthineers, 2024 Chondral Quant SIEMENS Healthineers What is it? The OpenApp Chondral Quant is a musculoskeletal post-processing software application that enables you to perform knee cartilage evaluations automatically and quantitatively. You can install Chondral Quant as part of the syngo.via OpenApps Framework on syngo.via VB40 or later. Use Chondral Quant with: a) Interactive mode: You have the option to modify and accept the results. b) PACS Ready mode: All results are processed without any user interaction. Then you can optionally send the results directly to your PACS system.* * syngo.via VB50 or later is required. 3 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant SIEMENS Healthineers Analysis of knee cartilage • Automatic segmentation of the knee cartilage including sub segmentation into 21 zones. • Creation of thickness maps and statistical evaluations providing information on the knee cartilage condition. • Evaluation of parametric maps to provide additional information on cartilage quality not visible on the morphological imaging alone. 4 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant SIEMENS Healthineers Required input data a) Morphological input data: pd_space_fs_sag_p4_iso 05:23 • Morphological 3D series that covers the whole knee t1_vibe_we_sag_iso 02:49 joint including patella in the Field of View, acquired t2_de3d_we_sag_iso 03:56 at field strength 1.5T, 3T or 7T Fat suppression or water excitation active t2_me3d_we_sag_iso 06:58 • • In-plane resolution ≤ 0.8 mm (recommended ≤ 0.5 Protocols from knee library mm) XA50 - 3T system – • Strong fat saturation, high Signal-to-Noise Ratio (SNR) • Sufficient contrast of anatomical component like cartilage and synovial liquid • Slice thickness ≤ 1 mm (recommended ≤ 0.7 mm) T2_de3d_we_sag_iso TxRx18ch - 3T system Recommended protocol: Open the DESS knee protocol from the Siemens tree: Siemens > knee > library > 3D > t2_de3d_we_sag_iso. You can also use other 3D sequences e.g., VIBE, MEDIC, SPACE. Pd_space_fs_sag_p4_iso TxRx18ch - 3T system 5 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant SIEMENS Healthineers Required input data b) Parametric Maps (optional input data): T2 mapping . • T2 or T2* maps and the original image series are optional T2Map_anatomical 06:35 inputs to Chondral Quant. MapIt source images acquired at T2* mapping different echo times are used to compute the T2 or T2* maps. The original images from MapIt (optional license) T2StarMap_anatomical 02:52 improve the registration result. T2StarMap_p2_anatomical 01:32 • The image series covers the whole cartilage. • Images should be free of artifacts. Pulsation artifacts can be Protocols from Knee Library – XA50 3T avoided by scanning with phase-encoding in head-feet direction. • Sufficient SNR (high noise levels can result in erroneously high T2 values). General for both types of input data: • Apply the same type of distortion correction (3D is recommended). • Activate Prescan Normalize. It is activated by default. T2Map - TxRx18ch – 3T system 6 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant – Interactive mode SIEMENS Healthineers Open the app a) Open Chondral Quant in MM Reading. b) Open Chondral Quant from the Patient Browser. 1. In MM Reading, click the OpenApps icon in the 1. Select the required study in the Patient Browser. Favorite Tools area. An OpenApps section is displayed in the Viewing panel. An additional 2. Right-click and select Assign Workflow from the app panel shows all installed apps. menu. 2. Select Chondral Quant. 3. From the list of workflows, select Chondral Quant. Assign Workflow Favorites Viewing Data Selection Group Studies MR general Suggested All Data Viewing Batch Assign Workflow Chondral Quant Stack 3x2 MPR MIP Results 2x2 v 4. Wait until the workflow status shows Ready. Then Chondral double-click to open the study. Quant Favorite Tools OpenApps × Workflow Status Workflow Description Ready Chondral Quant Digital Marketplace 7 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant – Interactive mode SIEMENS Healthineers Screen layout Chondral Quant image segments Chondral Quant i Laterality 1. Workflow steps Segmentation Registration 1 2. Tools bar CC Results 3. Clinical images and examination Overlay: Segmentation 3 4th Segment: Statistics results Create Results Export Statistics Common tools as PDF P as CSV Morphology Mapping Femur Patella Tibia You can use the same mouse and Thickness (mm) Region Volume(ml) Mean StdDev Median keyboard controls for the common Femur 12.75 1.90 0.68 1.89 -medial posterior 0.69 1.59 0.51 1.75 features in each segment within the -medial central 1.46 1.66 0.52 1.78 -medial anterior 1.33 1.84 0.67 1.88 workflow steps. Hover over a trochlea medial 1.20 1.82 0.63 1.91 -trochlea central 2.25 2.39 0.80 2.21 segment to use the different tools: Tools 2 -trochlea lateral 2.06 2.01 0.59 2.01 lateral posterior 0.99 1.77 0.60 1.89 • Zooming & Panning View Text Color Bar Settings -lateral central 1.57 2.06 0.68 2.20 • Windowing • Enlarging segments 8 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant – Interactive mode SIEMENS Healthineers Workflow steps Laterality The following workflow steps are available to modify the results: Segmentation 1. Laterality Registration 2. Segmentation Results 3. Overlay: Thickness Registration 4th Viewer: Statistics 4. Results If you refine the results in one of these steps, the results are Create Results recalculated. Export Statistics as PDF as CSV 9 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant – Interactive mode SIEMENS Healthineers Workflow steps a) Change the laterality Chondral Quant automatically sets the laterality of the Laterality knee based on the DICOM images. Left Knee You can correct an assignment of the laterality in the Laterality step. Left Knee Right Knee 1. Select the correct laterality from the drop-down list. A confirmation dialog box opens. 2. Click Yes to confirm the change. The recalculation starts and the results are updated accordingly. 10 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant – Interactive mode SIEMENS Healthineers Workflow steps b) Refine the segmentation A In the Segmentation step, you can refine the segmentation results. The color legend in the lower-right segment shows the color definitions of the individual cartilage regions. Segmentation P 1. To change the opacity of the segmentation, Change Overlay Opacity Alt keep the Alt key and the scroll wheel pressed Select Cartilage Region Shift and move the mouse pointer to the left or right. + PR 2. To modify the segmentation results, use the Use Paint Tool required tools: Paint, Nudge or Erase tool. Change Brush Size Shift + Ctrl + 3. If necessary, click the Restore button to restore Femur Medial Anterior Patella lateral inferior Femur Medial Central Patella medial superior Femur Medial Posterior Patella medial central the automatic segmentation. Femur Trochlea Lateral Patella medial inferior Femur Trochlea Medial Tibia Medial Anterior Femur Trochlea Central Tibia Medial Central Paint Nudge Erase Femur Lateral Anterior Tibia Medial Posterior 4. To confirm your changes, click the Accept button. Femur Lateral Central Tibia Lateral Anterior Femur Lateral Posterior Tibia Lateral Central Recalculation starts and the results are updated Patella lateral superior Tibia Lateral Posterior Accept Restore Patella lateral central accordingly. 11 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant – Interactive mode SIEMENS Healthineers Workflow steps c) Verify the registration 76.3 In the Registration step, you can check the alignment of the 25.8 morphological images and the parametric map. 76.8 1. Change the windowing values according to your needs. • To change the base image, window on the left 76.8 side of the segment. 51.3 L 25.8 • To change the overlaid image, window on the right side of the segment. 2. If necessary, you can remove the automatically applied image registration by deselecting Apply Registration. Then check if this results in better alignment. Click the Apply Apply Registr. Registr. icon to restore automatic registration. Accept 3. To confirm your changes, click Accept. 12 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant – Interactive mode SIEMENS Healthineers Workflow steps d) Checking the results er: Overlay: Thickness Statistics A Thickness Statistics The Results step shows the Chondral Quant results. 4th Segment: Mapping Layers Cartilage Thickness Create 3D Segmentation 3D Thickness Segmentation None • In three image segments, you can view the images in Create Results different orientations. You can switch between different overlays to show the cartilage information on the morphology images: 4.9 • Segmentation 3.7 37 2.5 PR 25 • Thickness 1.2 -0.0 • Mapping • Layers Morphology Mapping Femur Patela Tibla Thickness (mm) • None Region Volume(ml) Mean StdDev Median Femur 12.75 1.90 0.68 1.89 -medial posterior The lower-right segment (4th segment) shows statistics 0.69 1.59 0.51 1.75 • 37 -medial central 1.46 1.66 0.52 1.78 2.5 L -medial anterior 1.33 1.84 0.67 1.88 tables or 3D models of the cartilage. 1.2 -trochlea medial 1.20 1.82 0.63 1.91 -0.0 -trochlea centra 2.25 2.39 0.80 2.21 Statistics -trochlea lateral 2.06 2.01 0.59 2.01 • lateral posterior 0.99 1.77 0.60 1.89 lateral centra 1.57 2.06 0.68 2.20 • 3D segmentation 13 • 3D thickness Overlay : Thickness Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant – Interactive mode SIEMENS Healthineers Workflow steps e) Saving the results Results After you have checked the results, you can save and send the results. You can also export the result tables to a specified Overlay: Thickness location. 4th Viewer: Statistics 1. Click Create Results to confirm all results. Create Results 2. In the Export Statistics section, click the as PDF button to export the result tables as a PDF file. To export the result Export Statistics tables as a CSV file, select as CSV. as PDF 3. On the access bar, click the X icon in the Patient tab. The Close Patient dialog box opens. as CSV 4. Click Save and Send to close reading and send all results from this session. 14 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant – Interactive mode SIEMENS Healthineers Tools bar The following tools are available to modify the results: Tools Laterality Segmentation Registration • View: Reset the windowing, zoom and pan values. Results View Text Color Bar Settings Overlay: Segmentation • Text: Hide or display image text in the image area. 4th Viewer: Statistics Create Results • Color Bar: Show or hide color bar. Export Statistics as PDF Settings: Configure the data selection rules based on a as CSV • series description having multiple series for morphological data and parametric map original data. Tools View Text Color Bar Settings 15 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant – Interactive mode SIEMENS Healthineers Tools bar Settings The system selects input data to perform the calculation based Data Selection Configuration X on default settings (image requirements). Morphology Series Parametric Map Series Parametric Map Descriptions Descriptions Original Series Descriptions If the default settings do not fit your requirements, you can create your own rules based on the DICOM series description and specify which series are processed by the app. 1. Click the Settings icon on the lower-left Tools section. Add New Item Add New Item Add New Item The Data Selection Configuration dialog box opens. + + + Add Remove Add Remove Add Remove 2. Enter a series description string and click the + icon to add a O Apply Settings Save Cancel series description or parts of a series description. 3. To remove a series description, select the entry and click the Remove icon. 4. To apply settings, select Apply Settings and click Save. 16 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant – PACS Ready mode SIEMENS Healthineers (VB50 and later versions) Chondral Quant supports PACS Ready technology and Configuration Panel Client Settings Advanced Visualization Display And Behavior Export OpenApps Reporting enables automatic processing of incoming studies that OpenApps PACS Ready Technology M Activate automatic processing on incoming studies meet the configured requirements. Results are Limit processing to studies that arrive on the same day of the aquisition automatically generated without the need to open the Available Processing Apps study in a workflow and are sent to the configured archive. Rule #1 Modality (0008,0060) contains MR + Add Condition Chondral Quant Configuring automatic processing rules Version: 1.0 Supports: MR Automatic processing on request of sending modality (administrator rights): Automatic Archiving Rule Name Rule #2 Add New Rule 1. On the access bar, click the Configuration icon and choose Configuration Panel > OpenApps tab. 2. Select the Automatic processing on incoming studies check box to apply processing to all studies that arrive in syngo.via. 17 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant – PACS Ready mode SIEMENS Healthineers (VB50 and later versions) 3. In the Chondral Quant section, select the Automatic Archiving check box if the processed results are to be automatically sent to an archive. 4. If required, configure further rules to specify the Chondral Quant data to be processed. Version: 1.0 Supports: MR Please note: For further details, refer to the syngo.via instructions Automatic processing on request of sending modality ¥ Automatic Archiving for use. 18 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 Chondral Quant SIEMENS Healthineers How to ensure suitable performance? • Please verify the segmentation and registration for the interactive mode in the app. • Please check the extra series (segmentation mask and registration overlay) that are exported and written to PACS for the PACS Ready mode. • Regarding consistency for follow-up exams, we recommend using the same protocols, the same scanner model and same coil type for both modes. • In the statistical evaluation, mean, median and standard deviation are given. We recommend using the median instead of the mean value for comparison purposes. 19 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024 SIEMENS Healthineers 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. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. © Siemens Healthcare AG 2024 Siemens Healthineers Headquarters Siemens Healthcare AG Siemensstraße 3 91301 Forchheim, Germany siemens-healthineers.com 20 Effective 5 Jan 2024| QR700002086 Unrestricted © Siemens Healthineers, 2024