MM RT Image Suite VB80 What’s New Part 2

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: 25 Jan 2024 | QR700004459 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 Effective Date: 25 Jan 2024 | QR700004459 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 00.Open Pro_0018, Eclipse Cli ... 8/13/1960 go.Open_Pro_0018 MM RT Image Sulte Q X MM RT Image Sulte Series X 4D Data Management – Evaluating the Lung Ventilation 7 5IMAna FRM n . 5 IMA-75 SP F27 3 Average RTIS Demo @ Serie's Name MR Data Management – Synthetic CT Structure Set_1 17 UNAPPROVED 8/13/2019 Anatomy & Targets X CT. RO Thor Lung Dire Favorite Tools 5 Average_RTIS_Demo Structures POI Esty IMaxIP Various 1 : Erachis Plexus Left Dose Evaluation – General 20 Erachis Pleaus Right 1MinIP_Various1 Name Escphagus Average_Various 1 Aorta AVOIDANCE Heart 14 90% [P14) Kidney Len Body 13 + 80% [P13) Dose Evaluation – Conversion of Isodose to Contour 29 EXTERNAL Kidney Richt 12 . 70% [P12) Brachial Plexus Left 11 Serles AVOIDANCE Lung Len + 60%[P11] Brachial Plexus lght , 50% [PTO) AVOIDANCE + 40% [F9] Beam Placement – General 35 o Esophagus SIMAna FRM n a * 30% [P8] AVOIDANCE Haart 7 B + 20% [P7] Favorite Tools X + 10% [P6] Findings 5 0% (P5] Interactive Spectral Imaging 37 CT AVOIDANCE phase-resolved CT for lung cancer with the clinical Lung Lobe Lett Upper VENT-1. AVOIDANCE Laing Lobe flight Lower VENT- AVOIDANCE 30% PIT Lung Labe Ilight Middle VENT .. AVOIDANCE goals1 of: Lung Lobe Right Upper VENT- AVOIDANCE sulpuly Y 400 Same FOR (not registered) Same FOR (not registered) Selective sparing of functional lung (functional Favorite Tools • SAYAna. FRNna. MAN 14 NADA SIMAND Average_Vanoust avoidance RT) • Response assessment/early toxicity detection LAJ 400 ate 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. Effective Date: 25 Jan 2024 | QR700004459 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 (𝑉in) and maximum ower VENT-15% expiration (𝑉ex). Ipper 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-31% expiration. ▪ And is normalized to the air volume at maximum expiration. 9 Effective Date: 25 Jan 2024 | QR700004459 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Evaluating the Lung Ventilation - Calculation SIEMENS Healthineers Maximum inspiration (𝑉in) and maximum expiration (𝑉ex). 𝑉in−𝑉ex Inspiratory Reserve = VENT [%] Volume Vin (IRV) Inspiratory Capacity 𝑉ex (IC) Vital Capacity (VC) Tidal Volume (TV or Vr) e.g., 𝑉𝑖𝑛 − 𝑉𝑒𝑥 37 − 30 = = 23% Vex Expiratory 𝑉𝑒𝑥 30 Reserve Volume (ERV) Functional Residual Capacity (FRC) Residual Residual Volume Volume RV) (RV) 10 Effective Date: 25 Jan 2024 | QR700004459 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 5 IMAn.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 10cm 5 tMaxIP_Various1 5 tMinIP_Various1 have been identified (e.g., by playing a 4D 5 Average_Various1 14 ¥ 90% [P14] movie). 90 13 ¥ 80% [P13] 5 IMAn.a. FRM n.a. SPA196.5 80 10cm Average_Various1 1. Drag and drop the CT series used for dose 12 70% [P12] 11 50% [P11] calculation into the image segment. 10 >60% [P10] 40% [P9] 40 10cm F 8 > 30% [P8] 7 20% [P7] 400 40 6 10% [P6] ctivate Wint jo to Setthos408 5 0% [P5] 11 Effective Date: 25 Jan 2024 | QR700004459 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 1:009/2019 UNAPPROVED CT. EO Thor Lung tMIDOP_Varioust ▪ The Lung Ventilation layout opens. TMINUP Vanoust Average 14 - 90% |P14] Anatomy & Targets Masirun repeation cotes Madreuni expiration series Drag the moinin erteston CT mags Ton trie Series *:50% JP11] ▪ The current contouring series (e.g., Average) 10 .60%JP10] is displayed in the left segment. 10% [76) F ▪ Two empty segments are displayed on the SIMAN a. FRM n.a right side. Average_Vanous! Average vandes Lung Ventilation ivate Windows Settings to activate Windows 12 Effective Date: 25 Jan 2024 | QR700004459 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 Series 5 MMAna. 13 IVAna SP F27.3 A SP F27.3 SP F 27.3 A 80% Average_Various1 8/1 3/2019 8/1 3/2019 the required series from the Series Panel. B 8:08:24 AM 8.00:53 AM Series Name Structure Set_1 Structure Set_1 Structure Set_1 UNAPPROVED UNAPPROVED UNAPPROVED 13/000/2019 CT, RO_Thur Lung 40 !Mastr Vancust IMini?_Various1 14 - 90% (P14) Anatomy & Targets Structures POI 13 A Maximal Inspiration series *50% |711] - 40% [Pu] + 20% (97] LE Series 15 400 B Maximal Expiration series Same FOR (not registered ) Same FOR (not registered) Favorite Tools SINAna. FRM n.A. SMAna 5 MARS Average_Varioust W Navate Windows. 13 Effective Date: 25 Jan 2024 | QR700004459 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Lung Ventilation - Calculation Workflow SIEMENS Healthineers 4. Calculation of lung ventilation starts SIEMENS .... X Healthineers go.Open_Pro_0018 13/08/2019 go.Open Pro 0 ... automatically as soon as the two empty MM RT Image Suite 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. 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. FRM n.a. 5 IMAn.a. 5 IMAn.a. SP A196.5 5. Already existing structures are hidden. SP LO.0 SP A196.5 Average_Various1 Average_Various1 8:08 :24 AM 14 Effective Date: 25 Jan 2024 | QR700004459 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% 4 COD Lung Lobe Left Lo .. 2, 4 Lung Lobe Left Lo ... 8, 4 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 cm ▪ Green (high values) Yellow (medium values) F ▪ 400 40 · 2D 400 L+ 3D Draw Nudge Segment Pan/Scale Rect Freehand Contour by Value Rotate H Red (low values) 5 IMAn.a. FRM n.a. 5 IMAn.a. FRM.n.a. 5 IMAn. 5 IMAn.a. 11 IMAn.a. ▪ 11 IMAN SP L0,0 SP A196,5 SP A196,5 SP LO,0 Average_Various1 Average_Variousi 0% 50% 13.08 2019 13.08.2019 1. 6 08:08 2, 5 08:08:24 08:08:45 8. The structures are locked. A R 10cm L 400 400 40 400 400 8 82 15 Effective Date: 25 Jan 2024 | QR700004459 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. SP F27.3 results and recalculate the ventilation: 5 IMA ~75 SP F27.3 0% 8/1 3/2019 Average Various1 8:08:24 AM Structure Set_1 Structure Set UNAPPROVED UNAPPROVED Lung Lobe Lett Lower Favorite Tools 1. Unlock the structures (ventilation results Lung Lobe Left Lower Lung Lohe Left Upper Lung Lobe Left Upper Lung Lobe Right Lower Lung Lobe Right Lower Lung Lobe 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 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 Lung Lobe Left Lo Change Type AVOIDANCE with two other series. Erase Contours F Anatomy & Targets Delete W 400 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. Show as defined in SP A196.5 Average_Varioust Propagate to 1. Click the Lung Ventilation icon again. Lung Lung Ventilation Show Movement LAHAW Ventilation Create ITV Lun Overwrite HU 2. Load another series for maximum Rerun Ventilation inspiration or expiration. 16 Effective Date: 25 Jan 2024 | QR700004459 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 MR Data Management Synthetic CT Effective Date: 25 Jan 2024 | QR700004459 17 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 Effective Date: 25 Jan 2024 | QR700004459 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 Effective Date: 25 Jan 2024 | QR700004459 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Dose Evaluation General Effective Date: 25 Jan 2024 | QR700004459 20 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 Display the Dose Volume Histogram (DVH) Dose Dose 2 Display 1 2 3 3 Merge Dose 21 Effective Date: 25 Jan 2024 | QR700004459 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Dose Evaluation Overview SIEMENS Healthineers SIEMENS. RO PABLO Replan Reg Dose X CO_0071 X Healthineers ... 01/01/1961 M a4dc80d591 MM RT Image 5 ... Display Dose: Anatomy & Targets X MM RT Image Suite Structures POI + 3 IMA ~78 ... O Name SP F1002.5 Patient needs to be loaded in the MM RT O CTV 1 1. CTV Adaptive_HNO 2.0 B31f CTV 2 Favorite Tools CT 1 Image suite. o APPROVED o CTV 1 GTV 1 CTV 2 GTV CTV 3 O KORPER CTV1neu EXTERNAL In the Favorite Tools click on Display Dose. GTV 1 2. Lunge li. Series AVOIDANCE KÖRPER Lunge re. Lunge li. O AVOIDANCE O Myelon Text AVOIDANCE Myelon +0,5 AVOIDANCE or 6Clip Box Parotis li. Findings AVOIDANCE R Favorite Tools Fit to Segment ROI Circle 3. Left click in the image area and O 10cm 3D Reference Point select Display Dose. Display Distance Line SIPAIDI 10 AMICIDIE Marker 4. Select the desired file in the Display Dose IM Exclude Series F File window and click on Load. Display Dose W 350 50 + 22 Effective Date: 25 Jan 2024 | QR700004459 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Dose Evaluation Overview SIEMENS Healthineers SIEMENS RO PABLO Replan Reg Dose X CO 0071 Healthineers * 01/01/1961 M a4dc80d591 MM RT Image S ... Anatomy & Targets MM RT Image Sulte Hide Dose: Structures POI 3 IMA ~78 + ... Name SP F1002.5 Gy % O CTV 1 CTV Adaptive HNO 2.0 B31f Adaptive Eclipse Dosen 1/22/2015 55.9 90.0 CTV 2 49.6 1. Patient and Dose file need to be loaded in CTV TEXT 80.0 37.2 60.0 Favorite Tools CTV 3 24.8 40.0 CTV Clip Box 18.6 30.0 the MM RT Image suite. CTV1neu CTV 12.4 20.0 O GIV1 Fit to Segment 6.2 10.0 GTV 100% = 62.1 Gy KÖRPER EXTERNAL Max = 35.3 Gy Lunge li. ROI Circle O Series AVOIDANCE .O Left click in the image area and select Hide Lunge re. 2. AVOIDANCE 3D Reference Point o Myelon AVOIDANCE Myelon +0,5 Distance Line Dose. O AVOIDANCE Findings O Parotis li. AVOIDANCE Marker Favorite Tools Exclude Series Anatomy & Targets 3. Select the desired file in the Display Dose Display Dose 10cm File window and click on Load. Hide Dose F W 350 50 23 Effective Date: 25 Jan 2024 | QR700004459 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 90.0 9:39:14 AM 10.002 54.0 9:39:14 AM 48.0 80.0 Dose file is loaded into the MM RT Image Suite. RS: Approved 1 36.0 60.0 Anatomy & Targets × APPROVED 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 ... Name External 100% = 60.0 GY Breast L1 (auto) Gesamtlunge Max= 39.2 Gy To open the Mini Toolbar for the Dose O AVOIDANCE GTV_4D_VL-CT_ITV Breast R1 (auto) HEART1 2 O AVOIDANCE ITV_VL_CT 400 Series Evaluation, click the Dose File label. O ESOPHAGUS KIDNEY_L AVOIDANCE o . . Extemal EXTERNAL o Gesamtlunge ORGAN 2 IMA n.a. FRM n.a. CTV AN VILET ITY 10cm 7-192.1 10 8.40 $3 Favorite Tools Findings Dose Display Merge Anatomy & Targets 2 ¥ Show Isodose Lines A Default Preset X 400 Show Dose Colorwash Adjust Dose + Level 24 Effective Date: 25 Jan 2024 | QR700004459 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 active the adjustments. 25 Effective Date: 25 Jan 2024 | QR700004459 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Dose Evaluation SIEMENS Healthineers Mini Toolbar overview: Default Preset ¥ Show Isodose Lines × 2. The loaded dose files can be displayed Show Dose Colorwash Adjust Dose Level as following: MM RT Image Suite MM RT Image Suite 2 IMAn.a. FRM n.a. | 1 IMAn.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 X 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 Name External 100% = 60.0 Gy ... Gesamtlunge Max= 39.2 Gy O Breast_L1 (auto) AVOIDANCE GTV_4D_VL-CT_ITV Breast_R1 (auto) HEART1 LI AVOIDANCE ITV_VL_CT W 31 C 22 ESOPHAGUS KIDNEY_L a 49.00% Series o AVOIDANCE O External EXTERNAL H O Gesamtlunge ORGAN 2 IMAn.a. FRM n.a. | 1 IMAn.a. FRM n.a. GTV AN VILET 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 MerDE Anatomy & Targets F 31 A a 49.00% 400 W 31 Default Preset Show Isodose Lines 40 I C 22 a 49.00% Show Dose Colorwash Adjust Dose LL Level 26 Effective Date: 25 Jan 2024 | QR700004459 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) Find another possibility on the next slide. Prescribed Dose (Gy) If not available in corresponding RT Plan, Maximum Dose Value is used. 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 Effective Date: 25 Jan 2024 | QR700004459 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 Effective Date: 25 Jan 2024 | QR700004459 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Dose Evaluation Conversion of Isodose to Contour Effective Date: 25 Jan 2024 | QR700004459 29 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. MA n.a. SP R8,2 | SP R8,2 F936,5 Gy % Kopf_HNO 2.0 B31f | Adapt B31f | 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 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 30 Effective Date: 25 Jan 2024 | QR700004459 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 T Kopf_HNO 2.0 B31f Kopf_HNC Text Clip Box Structure Set UNAPPROVE Fit to Segment ROI Circle A 2. Display Dose: 3D Reference Point TTT Distance Line a. Click in the image segment. - Marker W C 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. atent SP A234,0 10cm Kopf_HNO 2.0 B31f ITTTTTTTTT c. Select Load. R - F W 350 50 W 2D 3D Draw Nudge Segment Pan/Scale Freehand Contour by Value Rotate Rect 31 Effective Date: 25 Jan 2024 | QR700004459 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 32 Effective Date: 25 Jan 2024 | QR700004459 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 Gy 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 24.0 40.0 segment. UNAPPROVED 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 CIV CTV1 neu d. These structures are listed in the RT CTV GTV 1 GTV Navigator. Iso 24.0 Gy 10cm DOSE REGION KORPER Convert To Structure EXTERNAL Favorite Tools Convert All To Structures X Display Doje Display F 33 Effective Date: 25 Jan 2024 | QR700004459 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 0 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 O Iso 18.0 Gy DOSE REGION Iso 12.0 Gy DOSE REGION Iso 6.0 Gy DOSE_REGION 34 Effective Date: 25 Jan 2024 | QR700004459 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Beam Placement General Effective Date: 25 Jan 2024 | QR700004459 35 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 CH X MM RT Image Suite Beam Placement X Plan Label + RT Image Suite Patient Marking Beam Isocenter [cm] E| + Registration Source to Surface Distance: cm Contouring V II Beam Placement Anatomy & Targets X Structures POI Plan Label + + O Name Favorite Tools X + CT Patient Beam Isocenter [cm] Marking Beam Synthetic CT Display Dose x y 2 Source to Surface Distance: Cm + 36 Effective Date: 25 Jan 2024 | QR700004459 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 MM RT Image Suite Interactive Spectral Imaging Effective Date: 25 Jan 2024 | QR700004459 37 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Interactive Spectral Imaging – Overview SIEMENS Healthineers The interactive Spectral Imaging feature uses a single post-processing series in the file format 900 IMA n.a. 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 600 C 150 2, Nudga Contour Smart Freehand Contour Froview Interpol .... 38 Effective Date: 25 Jan 2024 | QR700004459 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. 3D W 600 c ? 150 Nudge Contour Smart Freehand Contour Structures Proview Interpol. 39 Effective Date: 25 Jan 2024 | QR700004459 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Available representations SIEMENS Healthineers Conv. CT (Conventional CT) 900 IMA n.a. ▪ The Conventional CT representation 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 40 Effective Date: 25 Jan 2024 | QR700004459 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024 Available representations SIEMENS Healthineers Monoenergetic+ Dual Energy Mono+ Properties ? X ▪ Monoenergetic+ simulates an image 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 directly type the required number. 41 Effective Date: 25 Jan 2024 | QR700004459 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. 42 Effective Date: 25 Jan 2024 | QR700004459 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 43 Effective Date: 25 Jan 2024 | QR700004459 Unrestricted I Published by Siemens Healthineers AG I © Siemens Healthineers, 2024