MM RT Image Suite VB80 What’s New Part 2 (USA)

SIEMENS Healthineers syngo.via MM RT Image Suite VB70-VB80 What’s New Job Aid Part 2 Template Effective Date: 10 Aug 2021 | HILS 2223 This training material is based on the medical device syngo.via RT Image Suite VB80A. Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Restricted Disclaimer SIEMENS Healthineers syngo.via Q Scanner AI-Rad Companion V syngo.via Syngo Carbon View&GO Space Please keep in mind that the user interface may differ slightly from what is shown in this Job Aid. The actual usage of the tool may differ slightly on the different host systems, for example on syngo.via, Syngo Carbon Space, syngo.via View&GO, AI-Rad Companion or on the scanner. However, the intended purpose of the tool is the same. The tool functionality defined in this Job Aid is applicable to any of the Siemens Healthineers products in which you find this tool. 2 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 MM RT Image Suite VB70-VB80 What’s New Job Aid Part 2 SIEMENS Healthineers Table of Contents 4D Data Management – General 4 SIEMENS Healthineers 10.Open_Pro_0018, Eclipse Cli ... 8/13/1960 go.Open_Pro_0018 5 MM RI Image Suite @ X Series MM RT Image Suite 4D Data Management – Evaluating the Lung Ventilation 7 SIMELA FRM na Average_RTIS Deno KEYb 5 IM4-75 SP F27.3 Adel Study Average RTIS Demo 4 Series Nanet MR Data Management – Synthetic CT 17 Structure Set NAPPROVED 8/13/2019 Anatomy & Targets CT, RO_Thor Lung_Dire Favorite Tools Aura 5 Average_RTIS_Demo Structures POI 5 tMaxIP_Various1 Erachia Plexus Left Dose Evaluation – General 20 Erachis Plexus Rght 5 tMiniP_Various1 Name Esophagus 5 Average_Various 1 O Antla AVOIDANCE Heart 14 90% [P14) Kidney Len Body 13 + 80% [P13) Dose Evaluation – Conversion of Isodose to Contour 29 O EXTERNAL Kidney Right 12 + 70% [P12) Brachial Plexus Left Lier Serles o 11 + 60% [P11] AVOIDANCE 10 + 50% [P10] o Brachial Plexus Rüght AVOIDANCE + 40% [P9] Beam Placement – General 35 Esophagus 18 + 30% [P8] AVOIDANCE Me La FRM n a Haart 7 20% [P7] Favorite Tools 6 10% [PG) Findings 5 0% [P5] Interactive Spectral Imaging 37 CT Synthetk CT Placement Marking Merge DVH Display Dose Anatomy & Targets W. IN IN A Criinsert 413Split Series Creste Ventilation Series Deste Mangin Adece Couleurs W 400 COF 3 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 SIEMENS Healthineers 4D Data Management General 4 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Data Management SIEMENS Healthineers 4D Management Tools: Favorite Tools  The functionalities have been converted × into Tools in the Favorite Tools/Tool Gallery. • Correct 4D Data (will be active as soon as Correct 4D Split Series Create a 4D series is loaded, but not opened). Data Series • Split Series. • Create Series. % Lung Ventilation + 5 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Data Management SIEMENS Healthineers 4D Management Tools: MM RT Image Suite A MM RT Image Suite X 22 IM  Lung Ventilation 22 IMA ~35 SP U 4D C SP F387.0 2/3/20 4D CT Liver 3.00 Br40 - 80 IN As soon as a 4D series is active, it opens 2/3/2020 4:40:0 • 4:40:08 PM Structure Set_1 in the application. Anatomy & Targets UNAPPROVED X Favorite Tools Structures POI A + Name • By selecting the icon, you can choose between Lung Ventilation and Rerun Series Ventilation. 22 IM SP A 4D C1 Favorite Tools X 2/3/21 Findings 4:40:0 Correct 4D Data Split Series Create Anatomy & Targets % Lung Ventilation F w. Lung Ventilation Rerun Ventilation W 300 C 40 + 6 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 SIEMENS Healthineers 4D Data Management Evaluating the Lung Ventilation 7 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Evaluating the Lung Ventilation - Overview SIEMENS Healthineers Lung ventilation enables users to evaluate the SIEMENS ... Healthineers R 993/08/2019 go.Open Pro_O ... ₣ RO PABLO_Repl ... X MM RT Image S ... MM RT Image Suite Q x Series ventilation of each lung lobe to obtain functional 14 IMAn.a 9 IMAn.a. SP F27.3 SP F27.3 SP F273 90% 40% Average_Various1 8/1 3/2019 8/1 3/2019 8:08:57 AM 8:08:38 AM Series Name Structure Set_1 Structure Set_1 information in lung radiotherapy workflows. Structure Set_1 UNAPPROVED UNAPPROVED 13/08/2019 UNAPPROVED ILung Lobe Lett Lower V ... Lung Lobe Lett Lower V ... CT, RO_Thor_Lung_4D Favorite Tools ILung Lobe Left Lower VENT =- 1% Lung Lobe Lett Upper V. Lung Lobe Lett Upper V ... 5 tMaxIP_Various1 Lung Lobe Left Upper VENT=18% Lung Lobe Right Lower Lung Lobe Right Lower 15 tMinIP_Various1 ILung Lobe Right Lower VENT=1% Lung Lobe Right Middle ... ILung Lobe Right Middle ... 5 Average_Various1 Lung Lobe Right Middle VENT=18% Lung Lobe Right Upper . Lung Lobe Fight Upper ... 14 - 90% [P14] Anatomy & Targets X Lung Lobe Right Upper VENT=18% Structures 13 80% [P13] 80 Lung ventilation is based on a non-contrasted Series 12 70% [P12] Name 11 > 50% [P11] Lung Lobe Left Lower VENT =-... AVOIDANCE 10 > 60% [P10] 19 40% [P9] phase-resolved CT for lung cancer with the clinical Lung Lobe Left Upper VENT-1 ... AVOIDANCE Lung Lobe Right Lower VENT =... AVOIDANCE 30% [P8] Lung Lobe Right Middle VENT ... 20% [P7] AVOIDANCE Lung Lobe Right Upper VENT =... 10% [P6] goals1 of: AVOIDANCE * 0% [P5] sulpulg Anatomy & Targets 400 400 400 Same FOR (not registered) Same FOR ( not registered ) Selective sparing of functional lung (functional Favorite Tools • SIMAn.a. FRM n.a 5 IMAna FRM na 14 IMAn.a. 9 IMAn.3. Average_Various1 Average _Varic avoidance RT) 10cm • Response assessment/early toxicity detection 6 400 rivate Windows. 1 c.f., Vinogradskiy Y. CT-based ventilation imaging in radiation oncology. BJR Open 2019; 1: 20180035 8 The statements on this slide cannot be used as marketing claims. Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Evaluating the Lung Ventilation - Overview SIEMENS Healthineers The calculation is based on the phases of maximum inspiration (𝑉𝑉in) and maximum Lower VENT-15% expiration (𝑉𝑉ex). Upper VENT-36% The ventilation is defined as the difference Lower VENT-6% between the:  Air volume contained in the respective lobe Middle VENT-35% at maximum inspiration and at maximum Upper VENT-3193 expiration.  And is normalized to the air volume at maximum expiration. 9 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Evaluating the Lung Ventilation - Calculation SIEMENS Healthineers Maximum inspiration (𝑉𝑉in) and maximum expiration (𝑉𝑉ex). 𝑉𝑉in−𝑉𝑉ex Inspiratory Reserve = VENT [%] Volume Vin (IRV) Inspiratory Capacity 𝑉𝑉ex (IC) Vital Capacity VM (VC) Tidal Volume (TV or Vr} e.g., 𝑉𝑉𝑖𝑖𝑖𝑖 − 𝑉𝑉𝑒𝑒𝑒𝑒 37 − 30 = = Expiratory 𝑉𝑉𝑒𝑒𝑒𝑒 30 23% Vex Reserve Volume (ERV) Functional Residual Capacity (FRC) Residual Residual Volume Volume (RV) (RV) 10 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Lung Ventilation - Calculation Workflow SIEMENS Healthineers  4D and MR Data Management is active. Series X 5IMAn.a. FRM n.a. SP LO.O Average_Various1 15 Add Study  CT data with different breathing states of the Series Name lungs (e.g., 4D-CT) is available and loaded. 13/08/2019 CT, RO_Thor_Lung_4D The phases of max. inspiration / expiration tMaxIP_Various1 tMinIP_Various1 have been identified (e.g., by playing a 4D LI 5 Average_Various1 400 14 ¥ 90% [P14] movie). 90 13 ¥80% [P13] 5 IMAn.a. FRM n.a. SPA196.5 Average_Various1 80 10cm 1. Drag and drop the CT series used for dose 12 70% [P12] 11 50% [P11] calculation into the image segment. 10 60% [P10] 9 ¥ 40% [P9] 40 10cm 8 >30% [P8] 7 20% [P7] W C 400 40 6 10% [P6] ctivate Wint Go to Settings408 0% [P5] UI 11 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Lung Ventilation - Calculation Workflow SIEMENS Healthineers 2. Click the Lung Ventilation button. MM RT Image Suite Series SIMA -75 Average_Various1 Series Name Structure Set_1 13/08/2019 JNAPPROVED CT, RO_Thor Lung 5 tMaxIP Various1  The Lung Ventilation layout opens. 5 tMinIP_Various1 14 - 90% [P14] Anatomy & Targets 90 Structures POI 13 - 80% [P13] Maximum inspiration series Maximum expiration series 80 Drag the maximum inspiration of the merithe Series 12 .70%[12] CT image from the Series panel 11 > 50% [P11]  The current contouring series (e.g., Average) 10 * 60% [P10] 9 ¥ 40% [P9] 40 8 + 30% [P8] is displayed in the left segment. 7 > 20% [P7] 16 10% [P6] 5 0% [P5] IF W 400  Two empty segments are displayed on the 5 IMAn.a. FRM n.a. SIMAn.a. FRM n. right side. Average_Varioust Lung Ventilation W Ativate Windows Settings to activate Windows. 12 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Lung Ventilation - Calculation Workflow SIEMENS Healthineers 3. You are instructed by the system to drag MM RT Image Suite Ch Series 5 IMAn.a. 13 IMAn.a SP F27.3 SP F27.3 30 E27.3 0% A 80% Average_Various1 8/1 3/2019 8/13/2019 the required series from the Series Panel. A B 8:08:24 AM 8:08:53 AM Series Name Structure Set_1 Structure Set_1 Structure Set_1 UNAPPROVED UNAPPROVED UNAPPROVED 13/08/2019 CT, RO_Thor_Lung_4D 15 tMaxIP Various1 5 tMinIP_Various1 5 Average_Various1 14 ¥ 90% [P14] Anatomy & Targets * × 90 Structures POI 13 ¥ 80% [P13] A Maximal Inspiration series o 12 > 70% [P12] 11 > 50% [P11] 10 + 60% [P10] ¥ 40% [P9] 30% [P8] 7 > 20% [P7] 6 >10% [P6] 5 + 0% [P5] 1 400 B Maximal Expiration series 400 Same FOR (not registered) Same FOR (not registered) Favorite Tools SP . FRM n.a. SUMADE FRM n.a SIMAn a SIMAn.3. IS IMAn.a. 13 MAn.3. Average_Various1 Average various LLLLLLLLLIN 400 Activate Windows. 13 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Lung Ventilation - Calculation Workflow SIEMENS Healthineers 4. Calculation of lung ventilation starts SIEMENS .... go.Open_Pro_0018 X Healthineers 13/08/2019 go.Open_Pro_O ... automatically as soon as the two empty MM RT Image Suite CE X MM RT Image Suite MM RT Image Suite 5 IMAn.a. 5 IMA ~75 SP F27.3 segments are filled with series. SP F27.3 0% 8/1 3/2019 Average_Various1 8:08:24 AM Structure Set_1 Structure Set_1 UNAPPROVED UNAPPROVED Favorite Tools a. The calculation progress is indicated by the inactive Plugin. Anatomy & Targets X Structures POI Series o Name R b. The lung lobes are segmented. 10cm Findings c. The lung ventilation per lung lobe is Anatomy & Targets calculated. W 400 40 Same FOR (not registered) Favorite Tools X -H 5 IMAn.a. FRM n.a. 5 IMAn.a. 5 IMAn.a. FRM n.a. SIMAn.a. SP A196.5 5. Already existing structures are hidden. SP LO.0 SP A196.5 Average_Various1 Average_Varioust 8:08:24 AM 14 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Evaluating the Lung Ventilation - Result SIEMENS Healthineers 6. Lung ventilation values (in %) are attached Structure Set_1 5 IMAn.a. 11 IMAn.a. UNAPPROVED SP F27,3 SP F27,3 to structure names in result image. 0% 50% 13.08.2019 13.08.2019 08:08:24 08:08:45 ILung Lobe Left Lower VENT=11% Structure Set_1 Structure Set_1 Lung Lobe Left Upper VENT=25% UNAPPROVED UNAPPROVED Lung Lobe Right Lower VENT=4% Lung Lobe Left Lo ... 2, 4 Lung Lobe Left Lo ... 7. The color coding of the created structures Lung Lobe Left Up ... Lung Lobe Left Up ... Lung Lobe Right Middle VENT=15% Lung LobelRight Lo ... Lung Lobe Right Lo ... Lung Lobe Right Mi ... Lung Lobe Right Mi ... (results) varies: Lung Lobe Right Upper VENT=23% Lung Lobe Right U ... Lung Lobe Right U ... R 0cm 10cm  Green (high values)  Yellow (medium values) 400 2D 21 400 400 3D Draw Nudge Segment Pan/Scale Freehand Contour by Value Rotate Rect H Red (low values) H 5 IMA n.a. 5 IMAn.a. 11 IMAn.a H  5 IMAn.a. FRM n.a. 5 IMAn.a. FRM.n.a. 11 IMAn.a SP LO,0 SP A196,5 SP L0,0 SP A196,5 Average_Various1 Average_Various 19 0% 13.08.2019 6 08:08:24 2, 5 13.08 3, 5 8. The structures are locked. 2 .... 10cm LAJ 400 400 140 200 880 15 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Editing Results SIEMENS Healthineers If necessary, you can edit the lung segmentation MM RT Image Suite Q X MM RT Image Suite 5 IMAn.a. results and recalculate the ventilation: 5 IMA ~75 SP F27.3 SP F27.3 0% 8/13/2019 Average_Various1 8:08:24 AM StructureSet_1 Structure Set_1 UNAPPROVED UNAPPROVED Lung Lobe Left Lower Favorite Tools 1. Unlock the structures (ventilation results Lung Lobe Left Lower Lung Lobe Left Upper Lung Lobe Left Upper Lung Lobe Right Lower Lung Lobe Right Lower Lung Loke Right Middle will be removed). Lung Lobe Right Middle Lung Lobe, Right Upper Anatomy & Targets X Lung Lobe Right Upper Structures POI 2. Edit the segmentation. Series + ... Name R 3. Click Rerun Ventilation (palette button). Lung Lobe Right Upper AVOIDANCE O Lung Lobe Right Middle 10cm AVOIDANCE O Lung Lobe Right Lower AVOIDANCE Findings O Lung Lobe Left Up Rename AVOIDANCE If necessary, you can recalculate the ventilation o Lung Lobe Left Lo AVOIDANCE Change Type with two other series. Erase Contours F Anatomy & Targets Delete W 400 40 The calculation will not be restarted if you load Duplicate Merge Same FOR (not register other series in the two right segments. Unlock 5 IMAn.a. FRM n.a. 5 IMAn.a. 5 IMAn.a. SPA1 96. SP A196.5 Show as defined in Average_Varioust 1. Click the Lung Ventilation icon again. W Propagate to 1% Lung Ventilation Show Movement Lung ilation Create ITV Lund Overwrite HU 2. Load another series for maximum Rerun Ventilation inspiration or expiration. 16 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 SIEMENS Healthineers MR Data Management Synthetic CT 17 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Data Management – Synthetic CT SIEMENS Healthineers MR Management Tools: The functionalities have been converted into Favorite Tools × tools in the Favorite Tools/Tool Gallery. • Synthetic CT CT Synthetic CT + 18 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Data Management – Synthetic CT SIEMENS Healthineers MR Management Tool configuration: MM RT Image Suite 2 X MM RT Image Suite 5 IMA n.a. FRM n.a.  SP LO.O Synthetic CT series is loaded. 5 IMA ~75 SP F27.3 Average_RTIS_Demo Average_RTIS_Demo V II Stru UNA SyntheticCT Configuration ? x Right-click Synthetic CT in the Favorite Anatomy & Targets X 1. Favorite Tools Structures POI Tools or Tool Gallery to open the + The following result images shall be created by the SyntheticCT feature (check at least one option): ... O Name MCT-like image configuration. O Aorta AVOIDANCE Relative electron density O Body Relative mass density EXTERNAL Brachial Plexus Left Series AVOIDANCE Brachial Plexus Right AVOIDANCE OK Cancel 2. Define how the Series should be exported: O E Esophagus AVOIDANCE 5 IMA n.a. FRM n.a. Haart SP A196.5 10cm Average_RTIS_Demo Favorite Tools Findings • CT-like image Configuration • Relative electron density Remove from Favorites Anat • Relative mass density 19 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 SIEMENS Healthineers Dose Evaluation General 20 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Dose Evaluation Overview SIEMENS Healthineers Dose evaluations are converted into Tools: Favorite Tools × 1 Display Dose Display DVH Merge 4 Display the Dose Volume Histogram (DVH) Dose Display Dose 2 1 2 3 3 Merge Dose 21 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Dose Evaluation Overview SIEMENS Healthineers SIEMENS . RO_PABLO_Replan_Reg_Dose × CO 007 X Healthineers 01/01/1961 M a4dc80d591 MM RT Image S ... Display Dose: Anatomy & Targets X MM RT Image Suite Structures POI + 3 IMA ~78 ... o Name SP F1002.5 O CTV 1 1. Patient needs to be loaded in the MM RT CTV Adaptive_HNO 2.0 B31f CTV 2 Favorite Tools CT 1 Image suite. o CTV APPROVED o CTV1neu CTV CTV 1 GTV 1 CTV 2 GTV CTV 3 O KÖRPER CTV1neu EXTERNAL In the Favorite Tools click on Display Dose. GTV 1 2. Lunge li, KÖRPER Series AVOIDANCE Lunge re. Lunge li. AVOIDANCE Text O Myelon AVOIDANCE Myelon +0,5 AVOIDANCE or Findings AVOIDANC R Favorite Tools Fit to Segment ROI Cirde 3. Left click in the image area and 10cm 3D Reference Point select Display Dose. Display Distance Line -Marker 4. Select the desired file in the Display Dose lil Exclude Series F File window and click on Load. Display Dose W 350 50 + 22 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Dose Evaluation Overview SIEMENS Healthineers SIEMENS Healthineers RO PABLO_Replan_Reg_Dose_ .. + 01/01/1961 M a4dc80d591 CO_0071 MM RT Image S ... Hide Dose: Anatomy & Targets MM RT Image Suite Structures POI 3 IMA ~78 + ... O Name SP F1002.5 Gy % CTV 1 CTV Adaptive_HNO 2.0 B31f Adaptive Eclipse Dosen 1/22/2015 55.9 90.0 CTV 2 49.6 80.0 1. Patient and Dose file need to be loaded in CTV TEXT 37.2 60.0 Favorite Tools CTV 3 CTV 24.8 40.0 Clip Box 18.6 30.0 the MM RT Image suite. CTV1 neu CTV 12.4 20.0 GTV 1 6.2 10.0 GTV Fit to Segment 100% = 62.1 Gy KÖRPER Max = 35.3 Gy EXTERNAL O ROI Circle O Lunge li. Series AVOIDANCE 2. Left click in the image area and select Hide o Lunge re. > 3D Reference Point AVOIDANCE o . Myelon AVOIDANCE Myelon +0,5 Dose. Distance Line AVOIDANCE Parotis li. Findings -is Marker Favorite Tools Exclude Series Anatomy & Targets 3. Select the desired file in the Display Dose Display Dose 10cm Display File window and click on Load. Hide Dose F W 350 50 23 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Dose Evaluation SIEMENS Healthineers Open the Mini Toolbar: MM RT Image Suite MM RT Image Suite 2 IMA n.a. FRM n.a. 2 IMA -83 SP RO.1 SP F249.0 Lunge 3.00 Br40 S3 Lunge 3.00 Br40 S3 1/19/2021 Replan (B) Lung 1/20/2021 54.0 90.0 9:39:14 AM 9:39:14 AM 48.0 80.0 RS: Approved 1 Dose file is loaded into the MM RT Image Suite. 36.0 60.0 X APPROVED Anatomy & Targets 1 24.0 40.0 Favorite Tools Breast_L1 (auto) 18.0 30.0 Structures POI Breast_R1 (auto) 12.0 20.0 ESOPHAGUS 6.0 10.0 ... O Name External 100% = 60.0 GY O Breast L1 (auto) Gesamtlunge Max= 39.2 GY To open the Mini Toolbar for the Dose AVOIDANCE GTV_4D_VL-CT_ITV O Breast_R1 (auto) HEART1 2 AVOIDANCE ITV_VL_CT 400 Evaluation, click the Dose File label. O ESOPHAGUS KIDNEY_L Series AVOIDANCE o .. External EXTERNAL o Gesamtlunge ORGAN 2 IMAn.a. FRM n.a. GTV AN VILET ITV 10cm -192.1 Favorite Tools Findings Dose Display Merge Anatomy & Targets 2 Default Preset ¥ Show Isodose Lines X 400 Show Dose Colorwash Adjust Dose + Level 24 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Dose Evaluation SIEMENS Healthineers Mini Toolbar overview: Default Preset ¥ Show Isodose Lines × 1. Adjusted Dose Level temporarily: Show Dose Colorwash | Adjust Dose Level • Isodose Levels can be added or deleted from the list temporarily for the loaded file. • Click OK to activate the adjustments. 25 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Dose Evaluation SIEMENS Healthineers Mini Toolbar overview: Default Preset V Show Isodose Lines × 2. The loaded dose files can be displayed Show Dose Colorwash Adjust Dose as following: Level MM RT Image Suite MM RT Image Suite 2 IMAn.a. FRM n.a. | 1 IMA n.a. FRM n.a. Show Isodose Lines SP RO. 1 | SP RO. 1- • 2 IMA -83 | 1 IMA ~53 SP F249.0 | SP F249.0 Lunge 3.00 Br40 S3 | Replan (B) Lung Lunge 3.00 Br40 S3 | Replan (B) Lung 1/19/2021 1/19/2021 Replan (B) Lung 1/20/2021 54.0 90.0 9:39:14 AM 9:39:14 AM 48.0 80.0 RS: Approved 36.0 60.0 Anatomy & Targets × APPROVED 24.0 40.0 Favorite Tools Breast_L1 (auto) 18.0 30.0 • Show Dose Colorwash Structures POI Breast_R1 (auto) 12.0 20.0 + ESOPHAGUS 6.0 10.0 ... o Name External 100% = 60.0 Gy O Breast L1 (auto) Gesamtlunge Max= 39.2 Gy AVOIDANCE GTV_4D_VL-CT_ITV Breast_R1 (auto) HEART1 LI o AVOIDANCE ITV_VL_CT 31 C 22 ESOPHAGUS KIDNEY_L Series o a 49.00% AVOIDANCE O External EXTERNAL H o Gesamtlunge ORGAN 2 IMAn.a. FRM n.a. | 1 IMA n.a. FRM n.a. GTV AN VEST ITV SPA192.1 | SP A192.1 10cm Lunge 3.00 Br40 S3 | Replan (B) Lung Favorite Tools 1/19/2021 Findings 9:39:14 AM DiSPRO DVH Anatomy & Targets F W 400 31 A a 49.00% 400 | W 31 Default Preset Show Isodose Lines 40 | C 22 a 49.00% Show Dose Colorwash Adjust Dose LL Level 26 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Dose Evaluation SIEMENS Healthineers Mini Toolbar overview: Default Preset Show Isodose Lines × 3. You can select the customize Presets / Show Dose Colorwash Adjust Dose Level from the Default Preset drop down. Dose Level Presets ? > 4. Default Preset configuration Select Visualization Preset • You can define customized presets by Default Preset Set as Copy Delete opening the Dose Level Presets with Preset Name Default Preset the configuration wheel. 100% value corresponds to: Fixed Value 60.00 ¢ Gy Levels can be specified in Gy or % Maximum Dose Value (Gy) Another possibility can be found on the next Prescribed Dose (Gy) If not available in corresponding RT Plan, Maximum Dose Value is used. slide. Isodose Levels Gy % 6.0 10.0 12.0 20.0 18.0 30.0 24.0 40.0 36.0 60.0 + 48.0 80.0 54.0 90.0 OK Cancel 27 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Dose Evaluation SIEMENS Healthineers Mini Toolbar overview: Favorite Tools X Dose Level Presets ? Select Visualization Preset 5. Default Preset configuration. Display DVH Default Preset + Merge Set as Copy Delete Dose Display Dose Configuration Preset Name Default Preset Remove from Favorites 100% value corresponds to: or Fixed Value 60.00 + Gy Levels can be specified in Gy or % Maximum Dose Value (Gy) Right-click Display Dose in the Favorite Prescribed Dose (Gy) If not available in corresponding RT Plan, Maximum Dose Value is used. Tools or Tool Gallery. Isodose Levels Gy 6.0 10.0 12.0 20.0 18.0 30.0 24.0 40.0 36.0 60.0 48.0 80.0 + 54.0 90.0 + OK Cancel 28 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 SIEMENS Healthineers Conversion of Isodose to Contour 29 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 SIEMENS Healthineers Dose Evaluation Conversion of Isodose to Contour 30 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Conversion of Isodose to Contour - Overview SIEMENS Healthineers  You can convert Isodose lines to structures. 3 MMVIA n.a. | 504 IMA n.a. IMA n.a. SP R8,2 | SP R8,2 F936,5 Gy % Kopf_HNO 2.0 B31f | Adapt B3 1f | Adaptive Eclipse Dosen Adaptive Eclipse Dosen 22.01.2015 28,8 90,0  This allows you to take dose distributions 25,6 80,0 19,2 60,0 from previous irradiations into account for a 12,8 40,0 9,6 30,0 new irradiation. You can exclude volumes 6,4 20,0 A 3,2 10,0 1 that have already received a high dose 100% = 32,0 Gy Max = 35,3 Gy previously. W H 3 IMA n.a. | 504 IMA n.a. SP A220,0 | SP A220,0 Kopf_HNO 2.0 B31f | Adapt 10cm R F 31 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Conversion of Isodose to Contour - Workflow SIEMENS Healthineers  Data set with dose file is available. onymized_00001_PABLO, R ... × 1961 M a4dc80d591 1. Load the data set into the MM RT Image A 3 IMA n.a. FRM n.a. Suite, with drag and drop. 3 IMA ~78 SP L0,0 SP F1002 Kopf_HNC T Text Kopf_HNO 2.0 B31f Clip Box Structure Set « Fit to Segment UNAPPROVE O ., ROI Circle A 2. Display Dose: 3D Reference Point Distance Line a. Click in the image segment. - Marker W 2 Display Dose b. In the Display Dose File box, select the III] Exclude Series H dose file. 3 IMA n.a. FRM n.a. acet SP A234,0 10cm Kopf_HNO 2.0 B31f c. Select Load. R - F W 350 50 2D 21 @ 3D + Draw Nudge Segment Pan/Scale Freehand Rect Contour by Value Rotate 32 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Conversion of Isodose to Contour - Workflow SIEMENS Healthineers  Data set with dose file is loaded and Anatomy & Targets X Isodose lines are displayed. Structures POI 3. If necessary, hide the structures display by + ... selecting the eye symbol in the Anatomy & Name CouchInterior Targets Structures tab. SUPPORT CouchSurface SUPPORT CTV 1 CTV CTV 2 CTV CTV 3 CTV CTV1 neu CTV GTV 1 GTV KÖRPER EXTERNAL Lunge li. AVOIDANCE 33 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Conversion of Isodose to Contour - Workflow SIEMENS Healthineers 4. You can convert a single Isodose line into a MM RT Image Suite Q X structure: 3 IMA n.a. | 504 IMA n.a. SP F1010.5 | SP F1010.5 G % Adaptive_HNO 2.0 B31f | Adaptive Eclipse Dosen 54.0 90.0 a. Right-click the Isodose line in the Adaptive Eclipse Dosen 1/22/2015 48.0 80.0 CT 1 36.0 60.0 UNAPPROVED 24.0 40.0 segment. 18.0 30.0 Iso 24.0 Gy 12.0 20.0 6.0 10.0 b. Select Convert to Structure or Convert All Anatomy & Targets X 100% = 60.0 Gy Structures POI Max = 35.3 Gy to Structures from the context menu. Name CouchInterior SUPPORT D CouchSurface c. The Isodose lines are converted to a new SUPPORT CTV 1 CTV structure. CTV 2 CTV CTV 3 R CTV CTV1 neu d. These structures are listed in the RT CTV GTV 1 GTV Navigator. O Iso 24.0 Gy 10cm DOSE REGION KORPER Convert To Structure EXTERNAL Favorite Tools Convert All To Structures X Digghay F 34 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Conversion of Isodose to Contour - Workflow SIEMENS Healthineers 5. The default attributes of the newly created structure (color, name, and type) are copied Anatomy & Targets X from the selected Isodose line. Structures POI  Color = copied from Isodose + Name  Name = " Gy / %" (x, y values Iso 54.0 Gy O copied from Isodose) DOSE REGION Iso 48.0 Gy  Type = DOSE_REGION O DOSE REGION If required, the newly created structures Iso 36.0 Gy DOSE REGION (name, color) can be changed according to Iso 24.0 Gy1 your needs by using the known contouring DOSE REGION Iso 24.0 Gy tools. DOSE_REGION Iso 18.0 Gy DOSE REGION Iso 12.0 Gy DOSE REGION Iso 6.0 Gy DOSE REGION 35 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 SIEMENS Healthineers Beam Placement General 36 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Beam Placement SIEMENS Healthineers Beam Placement is converted into a tool in the Favorite Tools/Tool Gallery. • To perform the machine configuration, right mouse button click on Beam Placement. VB70 vs. VB80 MM RT Image Suite X MM RT Image Suite Beam Placement X Plan Label + RT Image Suite + Patient Marking Beam Isocenter [cm] Registration Source to Surface Distance: cm Contouring V II Beam Placement Anatomy & Targets X Structures PO Plan Label + + O Name + Favorite Tools LCT Synthet Display Beam Isocenter [cm] Patient Marking Beam Placement Dose x Z Source to Surface Distance: cm + 37 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 SIEMENS Healthineers MM RT Image Suite Interactive Spectral Imaging 38 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Interactive Spectral Imaging – Overview SIEMENS Healthineers The interactive Spectral Imaging feature uses a 900 IMA n.a. single post-processing series in the file format SP F3,0 Spectral Post-Processing (SPP). This contains all the DE Neck SPP 20.03.2018 necessary information from the CT Dual Energy 11:02:35 data. Structure Set_1 2, 3 UNAPPROVED ................................................ The Spectral Post-Processing (SPP) feature improves your clinical workflow by bundling the spectral low R and high kV series into one spectral post-processing MixE (SPP) data series. Thus, high and low kV data % Reset Mono+ reconstruction is no longer needed. 10cm Mixed The feature gives you the possibility to interactively change different monoenergetic energy levels and F 2D 3D to evaluate certain Dual Energy representations. W C 600 150 Nudge Conour Smart Freehand Contour F review Interpol 39 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Interactive Spectral Imaging – Overview SIEMENS Healthineers To use the Interactive Spectral Imaging 900 IMA n.a. functionality, you need to load a Spectral Post- SP F3,0 Processing (SPP) data set. When you initially DE Neck SPP 20.03.2018 load an SPP data set, the main representation is 11:02:35 displayed. Structure Set_1 2. 3 UNAPPROVED Depending on the SPP data set, the main representation is one of the following: R  Conv. CT (Conventional CT) MixE  Monoenergetic+ % Reset Mono+ 10cm Mixed The Spectral Post-Processing (SPP) series shows a conventional CT Image or a generated Monoenergetic+ Image, readable in your PACS F system without blowing up your storage. 2D 3D W 600 C 150 Nudge Conour Freehand Contour F Interpol 40 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Available representations SIEMENS Healthineers Conv. CT (Conventional CT)  The Conventional CT representation 900 IMA n.a. SP R3,2 displays the conventional CT DE Neck SPP 20.03.2018 reconstruction of the low energy and 11:02:35 high energy images: Either mixed images Structure Set_1 with a defined mixing ratio or UNAPPROVED monoenergetic images with a defined keV value from Quantum technology systems.  Reset will always bring you to the conventional CT, even if Mono+ , Mixed or VNC are disabled. A Conv CT Reset Mono+ Mixed 41 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Available representations SIEMENS Healthineers Monoenergetic+  Monoenergetic+ simulates an image Dual Energy Mono+ Properties ? X that is scanned with a single photon energy beam depending on the energy (keV).  By changing the energy (keV), you can enhance the contrast between different 58keV materials. OK Cancel • Left click on the keV number to see the slider. With the slider, you can change the value. A Mono+ • After right-clicking the keV value, you keV 58 can type in the desired keV value. 42 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Available representations SIEMENS Healthineers Mixed Image  Mixed Images is a weighted average of the low Dual Energy Mixed Properties ? X energy image and the high energy image.  The Mixed representation depends on three values: • CT value of the low energy image 80kV 140kV • CT value of the high energy image % • Mixing ratio 30 / 70  Left click on the interactive image text to change the OK Cancel mixing ratio. Use the slider to either display more data from the low or from the high energy spectrum. Click the % symbol to see the slider. A VNC (Virtual Non-Contrast) Mixed In the VNC representation, the iodine (contrast % 30 /70  media) is subtracted from the image. 43 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © 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 Healthineers HQ I Siemens Healthineers AG Siemensstr. 3 91301 Forchheim Germany Phone: +49 9191 18-0 siemens-healthineers.com 44 Job Aid Effective Date: 21 Oct 2024 | QR700013945 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024