DANTE - Blood suppression improvement Job Aid

SIEMENS Healthineers DANTE – Blood suppression improvement Job Aid Template Effective Date: 10 Aug 2021 | HILS 2223 Effective Date: 16 Aug 2024 | QR700011851 Unrestricted | Published by Siemens Healthineers AG | © Siemens Healthineers AG, 2024 DANTE – Blood suppression improvement SIEMENS Healthineers Table of contents Introduction 3 T1 without DANTE T1 with DANTE Vessel wall imaging 5 Vessel wall imaging with contrast agent 6 Where to find the protocols 7 Parameter card settings 8 2 Effective Date: 16 Aug 2024 | QR700011851 Unrestricted | Published by Siemens Healthineers AG | © Siemens Healthineers AG, 2024 DANTE – Blood suppression improvement SIEMENS Healthineers Introduction Background: HP HP In general, blood suppression is already available in the SPACE sequence and is based on a low b-value diffusion preparation. When applying diffusion preparation to segmented acquisitions such as SPACE, it results in high sensitivity to motion. This may result in signal voids, banding artifacts, AH AH unwanted T2, or diffusion contrast on T1-weighted images. Solution with DANTE: DANTE was incorporated into SPACE sequences to Conventional blood improve arterial and venous blood signal suppression suppression DANTE (e.g., carotid arteries and the intracranial vessels). DANTE provides good blood suppression, less signal loss, and less T2-weighting. 3 Effective Date: 16 Aug 2024 | QR700011851 Unrestricted | Published by Siemens Healthineers AG | © Siemens Healthineers AG, 2024 DANTE – Blood suppression improvement SIEMENS Healthineers Introduction Technical implementation: DANTE preparation module Imaging module DANTE blood suppression adds a preparation module before the excitation pulse to the SPACE sequence. It is a RF series of low flip angle RF pulses interspersed with dephasing gradients to generate intravoxel phase dispersion 11 Slice among flowing spins and thus suppress the flow signal. Read ... Benefits: Blood suppressed signal is stored in the longitudinal Phase magnetization: • No T2 or diffusion contrast • No diffusion-sensitizing gradients needed = Less sensitive to motion 4 Effective Date: 16 Aug 2024 | QR700011851 Unrestricted | Published by Siemens Healthineers AG | © Siemens Healthineers AG, 2024 DANTE – Blood suppression improvement SIEMENS Healthineers Vessel wall imaging You can use vessel wall imaging to assess the pathology of intracranial vessel walls. For visualization of the middle cerebral arteries, the signal from both the internal Probable metastasis lumen and the external CSF needs to be suppressed. Improved blood suppression and image quality with DANTE: Vessel contour • DANTE improves the flow-sensitive signal suppression of CSF and the lumen. bright, lumen Internal attenuated cerebral vein • This results in increased contrast and differentiation between the vessel wall bright and CSF (e.g., metastases). The vessel wall remains bright. Conventional blood suppression 5 Effective Date: 16 Aug 2024 | QR700011851 Unrestricted | Published by Siemens Healthineers AG | © Siemens Healthineers AG, 2024 DANTE – Blood suppression improvement SIEMENS Healthineers Vessel wall imaging with contrast agent After administering contrast agent, the blood signal is increased, including the signal from the vessel walls. Post-contrast blood suppression is more difficult due to T1 blood shortening. Improved blood suppression and image quality with DANTE: The blood inside the vessel can be suppressed while still visualizing the enhancement of the vessel walls. The original contrast is preserved. A 3,5 1,5 Conventional blood suppression 6 Effective Date: 16 Aug 2024 | QR700011851 Unrestricted | Published by Siemens Healthineers AG | © Siemens Healthineers AG, 2024 DANTE – Blood suppression improvement SIEMENS Healthineers Where to find the protocols Protocols are available in the SIEMENS tree under SIEMENS > head > library angiography > vessel wall or SIEMENS > neck soft tissue > library angiography > vessel wall > _3D SPACE_. SIEMENS >> head >> library angiography >> vessel wall SIEMENS >> neck soft tissue >> library angiography >> vessel wall t1_space_fs_sag 05:24 3D SPACE t2_space_fs_sag_iso 05:43 t1_space_sfs_sag 05:40 t1_space_fs_sag 05:36 t1_space_sfs_sag 05:31 t1_space_fs_tra 06:26 7 Effective Date: 16 Aug 2024 | QR700011851 Unrestricted | Published by Siemens Healthineers AG | © Siemens Healthineers AG, 2024 DANTE – Blood suppression improvement SIEMENS Healthineers Parameter card settings Select DANTE manually in the SPACE sequence in Protocol Parameters > Contrast > Common > Blood Suppression. The parameters for the DANTE preparation module can be set in the Blood Suppression dialog box, which is accessible via the [...] button next to the parameter field. Routine Contrast Resolution Geometry System Physio Inline Sequence Blood Suppression ? X Common Dynamic TR 3000.0 - ms Fat-Water Contrast Standard TE 131.00 + ms Gradient Moment DANTE 12 - ms mT/m MTC Dark Blood Number of Pulses DANTE 150 + Magn. Preparation None Blood Suppression Off ... Off Flip Angle DANTE 10 + deg Free Wrap-up Magn. Body Flip Angle Mode DANTE T2 Var ... Flip Angle 1 120 + deg Close Reconstruction Magnitude 8 Effective Date: 16 Aug 2024 | QR700011851 Unrestricted | Published by Siemens Healthineers AG | © Siemens Healthineers AG, 2024 DANTE – Blood suppression improvement SIEMENS Healthineers Parameter card settings It is important to maximize the contrast between vessel wall and blood. To do this, set the parameters for the DANTE preparation Blood Suppression ? X module: Gradient Moment DANTE: Sets the gradient moment of one gradient pulse in the DANTE preparation module. A large matrix requires a higher gradient moment to avoid stripe artifacts. Gradient Moment DANTE 12 - ms mT/m Number of Pulses DANTE 150 + Number of Pulses DANTE: Sets the total number of pulses in the Flip Angle DANTE 10 deg DANTE preparation module between 50-300. Flip Angle DANTE: Sets the flip angle of one RF pulse in the DANTE Close preparation module between 6-15 deg. Please note: The combination of parameters is important to consider: A smaller flip angle requires more pulses and vice versa. In addition, reducing the number of pulses and the flip angle increases the SNR while reducing the SAR of the sequence. However, this can have an impact on the vessel wall contrast and vessel wall sharpness. 9 Effective Date: 16 Aug 2024 | QR700011851 Unrestricted | Published by Siemens Healthineers AG | © Siemens Healthineers AG, 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 Healthineers HQ I Siemens Healthineers AG Siemensstr. 3 91301 Forchheim Germany Phone: +49 9191 18-0 siemens-healthineers.com 10 Effective Date: 16 Aug 2024 | QR700011851 Unrestricted | Published by Siemens Healthineers AG | © Siemens Healthineers AG, 2024