Image Guidance Phantom Application VE2 3D Guidance Step-by-Step Training

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Welcome Navigation Hints Before you start, we would like to give you a few tips on how to navigate: Enjoy the course! Table with 2 columns and 5 rows Select this icon to open the table of contents. Select the Resources tab (top right corner), to download this training as a PDF. Select the CM Protocols tab (top right corner), to view the contrast media protocols. This icon indicates that the step is performed in the examination room. This icon indicates that the step is performed in the control room. Navigation Hints Learning Objectives syngo DynaCT VOI Punching Bookmarks, C-arm Bookmark 3D Position to C-arm Overlay Live Image on 3D (syngo 3D Roadmap) 3D Markers, 3D Polyline Object Manager  Overlay Objects on Live Learning Objectives Examination Room – Screen Capture Step 1/12 Center the phantom Frontal view: Central position Acquire syngo DynaCT Select 5s DCT Body acquisition protocol Auto-run – Frontal view: Central position Auto-run – Lateral view: Optimize table height Auto-run – Move to 3D test run start position Auto-run – Test run: Prevent collision Fluoro: Exposure control syngo DynaCT acquisition (C) [DynaCT 1] or register DynaCT [Abdomen with contrast]* (see also VE2 syngo Fusion Package Step-by-Step Online Training) *CT and MR DICOM data of the AmoVes phantom will be provided separately. Step 1/12 Control Room – Screen Capture Step 2/12 Save bookmark Original Double-click on VRT, rotate Right-click on orientation cube Select A (anterior-posterior) Workflow header – Show Bookmarks – Save Bookmarks as… Enter bookmark name Original [Original] Step 2/12 Control Room – Screen Capture Step 3/12 Perform VOI Punching of the bone Right-click on orientation cube Select F (feet-head) Window Onscreen menu – Segmentation – VOI punching Remove the spine Right-click on orientation cube Select A (anterior-posterior) Step 3/12 Control Room – Screen Capture Step 4/12 Save bookmark Vessel only Workflow header – Show Bookmarks – Save Bookmarks as… Enter bookmark name Vessel only [Vessel only] Load bookmark Original Workflow header – Show Bookmarks Load bookmark Original Step 4/12 Examination Room – Screen Capture Step 5/12 Move C-arm to frontal position (Not shown in Video) Overlay live image on 3D (syngo 3D Roadmap) Activate Overlay Live Image on 3D Fluoro to show result Zoom FOV 32cm Fluoro to show result Step 5/12 Examination Room – Screen Capture Step 6/12 Load bookmark Vessel only Display Layouts – 3D Sharing Bookmarks – Vessel only Change the working projection Rotate the C-arm to 45° RAO Collimate the FOV Fluoro to show result Step 6/12 Examination Room – Screen Capture Step 7/12 Deactivate Overlay Live Image on 3D (syngo 3D Roadmap) Change the working projection Rotate the C-arm to 10° LAO Activate syngo 3D Roadmap Fluoro to show the result Open the Onscreen menu (General 3D Sharing – Save Angulation Bookmark is greyed out) Deactivate syngo 3D Roadmap (General 3D Sharing – Save Angulation Bookmark is now available) Save angulation bookmark Onscreen menu – General 3D Sharing – Save Angulation Bookmark [Angulation Bookmark 1] Step 7/12 Examination Room – Screen Capture Step 8/12 Rotate VRT image Onscreen menu – 3D Sharing VRT – Review Rotate to e. g. ~60° LAO, ~10° CAUD Adjust C-arm to 3D Onscreen menu – 3D Sharing VRT – Adjust C-arm to 3D Auto-run to move the C-arm Activate syngo 3D Roadmap Zoom and collimate FOV 20cm Collimate the FOV Acquire DSA with CM or CO2 DSA acquisition (A) or (D) [Series 1] Step 8/12 Control Room – Screen Capture Step 9/12 Deactivate Overlay Live on 3D (syngo 3D Roadmap) Review MPR Double-click on coronal MPR Choose a slice thickness of 0.5mm Onscreen menu – Images – Slice thickness 0.5mm Indicate the course of the renal arteries with 3D polylines Segment menu – Measurement – 3D polyline Create a first 3D polyline in right renal artery Create a second 3D polyline in left renal artery Double-click on coronal MPR Step 9/12 Control Room – Screen Capture Step 10/12 Change polyline properties Onscreen menu – Measurement – Object List Change color of first 3D polyline to red Deactivate property Show Length Activate VRT segment Left-click on VRT segment Chance VRT opacity Onscreen menu – Volume – Volume Opacity Reduce volume opacity to 20% Visualize the result in VRT Left-double-click on VRT segment Rotate to show result Step 10/12 Examination Room – Screen Capture Step 11/12 Recall Angulation Bookmark 1 Display Layouts – 3D Sharing Bookmarks Automatic run to move the C-arm Activate syngo 3D Roadmap Adjust FOV Use CAREposition to center the FOV on the central phantom FOV 20cm Collimate the FOV Acquire DSA with CM or CO2 DSA acquisition (A) or (D) [Series 2] Step 11/12 Examination Room – Screen Capture Step 12/12 Create an opaque reference image Onscreen menu – DSA (A) – Review Select the first DSA image Enable opacification Onscreen menu – DSA (A) Opacification Step forward to perform Opac Store reference image as Ref1 [Reference Image 1] Onscreen menu – Store as Reference – Store Ref1 Overlay Reference Fluoro and adjust overlay % Activate overlay objects on Live Step 12/12 Siemens Healthineers are neither the provider nor legal manufacturer of this training. Any claims and statements made in this training and any content shown in the training are under the sole responsibility of the Comprehenso GmbH. Additionally, the training may not be available in all countries and the content may not be commercially available in all countries. Please contact the Comprehenso GmbH for more information. Comprehenso GmbH Sophie-Küppers-Straße 50 30559 Hannover Disclaimer Disclaimer Exit You have completed the 3D Guidance Step-by-Step Online Training for the Image Guidance Phantom Application. 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. Completion VE20 CM Protocols Contrast Media Contrast media consumption for this module: Dual Barrel Injector 24ml Single Barrel Injector 30ml Manual Injection 32ml Proposals for contrast media administration protocols are given on the following four slides. The letters (A), (B), (C) and (D) on the training slides refer to these protocols. DSA can be performed with ambient air using CO2 acquisition protocols to avoid the use of iodine-based contrast material (Manual Injection, Protocol D). Contrast Media CM Protocol – Dual Barrel Injector Table with 5 columns and 5 rows X-Ray delay[s] Rise time[s] Contrast material Total CM[ml] 0 0.8 Imeron 300 5 Injection delay[s] Volume[ml] Concentration[%] Flow[ml/s] Injection time[s] 1.5 5 100 5 1 0 10 0 5 2 Fluoro, DSA (A) Table with 5 columns and 5 rows X-Ray delay[s] Rise time[s] Contrast material Total CM[ml] 2.5 0.8 Imeron 300 21 Injection delay[s] Volume[ml] Concentration[%] Flow[ml/s] Injection time[s] 0 30 70 5 6 0 20 0 5 4 4sDSA Body (B) 5sDynaCT Body (C) Table with 5 columns and 5 rows X-Ray delay[s] Rise time[s] Contrast material Total CM[ml] 2.5 0.8 Imeron 300 14 Injection delay[s] Volume[ml] Concentration[%] Flow[ml/s] Injection time[s] 0 28 50 4 7 0 16 0 4 4 CM Protocol – Dual Barrel Injector CM Protocol – Single Barrel Injector Table with 5 columns and 4 rows X-Ray delay[s] Rise time[s] Contrast material Total CM[ml] 0 0.8 Imeron 300 6 Injection delay[s] Volume[ml] Concentration[%] Flow[ml/s] Injection time[s] 1.5 6 100 6 1 Fluoro, DSA (A) Table with 5 columns and 4 rows X-Ray delay[s] Rise time[s] Contrast material Total CM[ml] 1 0.8 Imeron 300 20 Injection delay[s] Volume[ml] Concentration[%] Flow[ml/s] Injection time[s] 0 20 100 3.4 5.9 4sDSA Body (B) 5sDynaCT Body (C) Table with 5 columns and 4 rows X-Ray delay[s] Rise time[s] Contrast material Total CM[ml] 1.5 0.8 Imeron 300 18 Injection delay[s] Volume[ml] Concentration[%] Flow[ml/s] Injection time[s] 0 18 100 2.5 7.2 CM Protocol – Single Barrel Injector CM Protocol – Manual Injection Table with 5 columns and 4 rows X-Ray delay[s] Rise time[s] Contrast material Syringe Type Total CM[ml] 0 Min (<1s) Imeron 300 10ml 6 Injection delay[s] Volume[ml] Concentration[%] Flow[ml/s] Injection time[s] None/Mask 6 100 Max (~6) ~1 Fluoro, DSA (A) Table with 5 columns and 4 rows X-Ray delay[s] Rise time[s] Contrast material Syringe Type Total CM[ml] 2(1) Min (<1s) Imeron 300 20ml 20 Injection delay[s] Volume[ml] Concentration[%] Flow[ml/s] Injection time[s] None(1) 20 100 2.5 8 4sDSA Body (B) 5sDynaCT Body (C) Table with 5 columns and 4 rows X-Ray delay[s] Rise time[s] Contrast material Syringe Type Total CM[ml] 1.5(2) Min (<1s) Imeron 300 20ml 20 Injection delay[s] Volume[ml] Concentration[%] Flow[ml/s] Injection time[s] 0(2) 20 100 2.5 8 (1) Start manual Injection after mask run and 2 seconds before fill run acquisition (2) Start manual Injection 1.5 seconds before syngo DynaCT acquisition CM Protocol – Manual Injection CM Protocol – Manual Injection with CO2 Table with 5 columns and 4 rows X-Ray delay[s] Rise time[s] Contrast material Syringe Type Total CO2[ml] 0 Min (<1s) CO2 or Air(1) 20ml 20 Injection delay[s] Volume[ml] Flow[ml/s] Injection time[s] None/Mask 20 Max (~10) ~1-2 Fluoro, DSA (D) (1) With the phantom, air can be used to mimic carbon dioxide gas angiography. CM Protocol – Manual Injection with CO2 Question Bank 1 HOOD05162003301843 | Effective Date: 17 Feb 2023 CM Protocols Image Guidance Phantom Application VE2 3D Guidance Step-by-Step Online Training 1.1 Welcome 1.2 Navigation Hints 1.3 Learning Objectives 1.4 Step 1/12 1.5 Step 2/12 1.6 Step 3/12 1.7 Step 4/12 1.8 Step 5/12 1.9 Step 6/12 1.10 Step 7/12 1.11 Step 8/12 1.12 Step 9/12 1.13 Step 10/12 1.14 Step 11/12 1.15 Step 12/12 1.16 Disclaimer