MR Cardiac Analysis LV Function XA31 Job Aid

MR Cardiac Function Left Ventricular Analysis – Numaris X MR Cardiac Analysis – Numaris X The MR Cardiac Analysis Workflow allows for assessment of Cardiac Function through user- friendly segmentation of the Left Ventricle. The left ventricle is automatically contoured during the work-flow assignment. A set of intuitive tools allows the user to easily adjust the contours as needed. 1. Patient Browser, load data set into MR Cardiac Analysis Workflow  Right-Click on Patient Examination > select Assign Workflow > MR Cardiac Analysis  Double Left-Click on Patient to Open Open Ctrl+O Open with View as Read-Only with Batch Open Assign Workflow Favorites Cancel Workflow Suggested Search Patient with DICOM Q/R MR Breast Biopsy * Add to Demo List MR BreVis Remove from Demo List MR Cardiac Analysis Set Mark state MR Neuro 3D Set Delete Protection state MR Neurology Set Archive state MR Oncology Remove Correction state More 2. Cardiac Reading Step – view Functional, Dynamic, Tissue Characterization and Flow Data using Common Tools 3. Select MR Cardiac Function Step  Note: MR Cardiac Analysis performs segmentation of left ventricle automatically by recognizing the anatomical landmarks (Apical Extent, LV Blood Pool Point, RV Insertion Point and the Base Plane Points) MR Cardiac Analysis + MR Cardiac Reading MR Cardiac Function OB Hide Lines Reset Normal Manual Create Mode Mode Findings LV Analysis Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/29/2021 | HOOD05162003237805 Healthineers Job Aid | MR Cardiac Function - LV Ventricular Analysis – Numaris X Effective Date: 11/29/2021 | HOOD05162003237805 4. Select Guidance Icon – allows user to edit segmentation of LV analysis  Guidance recommends workflow for refining segmentation and guides you through each of the steps required to perform the segmentation  Set Landmarks Tab & Refine Contours Tab – guides you through Segmentation  Refine Contours Tab – once selected activates Icons in Case Navigator  Note: If you don’t want to use Guidance, contours can be created and refined using contour editing and contour creation tools LV Analysis Refine Segmentation O D Endo Epi Pen Circle Nudge Control Freehand Delete Delete All Adjust Point Edit Edit Propagate EDIES Join Guidance 5. Start Segmentation Refinement and Follow Guidance Steps a. Check ED and ES Phase for accurate Segmentation  If Set Landmarks Tab is selected > correct the selection in the TVG segment  Drag ED and ES Slider to appropriate positions 25 225 19.00 0.00 200 175 0.00 150 0.00 0.00 125 100 0.00 75 0.00 50 0.00 25 0.00 20 4 50 60 70 80 100 % O 33 319 815 932 ES 699 1 48 1164 MS ED at SV(ml) ED Vol.(ml) ES Vol.(ml) Mass LV 57.29 140.42 245.12 104.7 149.86 RV .... --- ---- Set Landmarks Refine Contours Check ED and ES Step 1 of 5 Lneck that the positions Of EDIE'S silaers correctly identify ED and ES. To check this scroll through the image stack of the appropriate SAX or LAX slices and compare the anatomy (extension) of the ventricle with the position of the slider. 10 05 474 ED Next Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/29/2021 | HOOD05162003237805 Healthineers Page 2 of 7 Job Aid | MR Cardiac Function - LV Ventricular Analysis – Numaris X Effective Date: 11/29/2021 | HOOD05162003237805 b. Check Apical Extent – by setting the corresponding landmark in Short Axis working segment  Set Landmarks Tab is selected > set landmark at anatomically correct location  Landmark may be moved to a New Slice Location – Click on Landmark and place on new slice (e.g., perform only if needed) Set Landmarks Refine Contours Check Apical Extent Step 2 of 5 Check and correct landmark on ED and ES according to guidance images. Slice position of apex at ED and ES might be different due to heart movement. i Please note: Existing contours below apex will be removed. c. Check Blood Pool Point  Defines Position of Base Plane if only Short-Axis Slices are used or included in the analysis  Base Plane is always Parallel to Short-Axis Slices  You can model through-plane motion of the base by setting LV Blood Pool Point in different slices and in different phases Set Landmarks Refine Contours Check Blood Pool Point Step 3 of 5 This landmark is used to correct the segmentation in case the wrong structure has been segmented (e.g. RV) Check that LV contours shown actually include the LV If not, choose a basal SAX slice at ED and click into the left ventricle to move the landmark accordingly. i Please note: Existing contours will be changed. Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/29/2021 | HOOD05162003237805 Healthineers Page 3 of 7 Job Aid | MR Cardiac Function - LV Ventricular Analysis – Numaris X Effective Date: 11/29/2021 | HOOD05162003237805 d. Check RV insertion point in ED Phase  Step isn’t mandatory; however, RV insertion point is used for calculating wall thick- ening using AHA (American Heart Association) model for the patient report Set Landmarks Refine Contours Check RV Insertion Point Step 4 of 5 This step can be skipped if the AHA model to document wall thickening defects is not used. Check/Refine the RV insertion landmark at ED phase. i Please note: This landmark has no effect on contours. It is used for dividing the myocardium into AHA conformant sectors. e. Check Base Plane in Long Axis working segment  Define Two Points at Height of Base Plane  Note: Typically performed on a 4-Chamber Orientation Set Landmarks Refine Contours Check Base Plane Step 5 of 5 Verify and correct the pink landmarks on all LAX slices you want to use for base plane (=Mitral valve) calculation on ED and ES. Exclude the LAX slices you do not want to use in the LAX mini segments by clicking the "E" button. Note: The yellow line indicates the base plane (=Mitral valve) and is calculated from the average of all pink landmarks on all used LAX slices. Only slices below this line will be used for ventricle calculation. Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/29/2021 | HOOD05162003237805 Healthineers Page 4 of 7 Job Aid | MR Cardiac Function - LV Ventricular Analysis – Numaris X Effective Date: 11/29/2021 | HOOD05162003237805 f. Check Refine Contours Tab – provides an overview of different tools  Check & Change Contours (or) Replace All Contours and Start Segmentation Re- finement Set Landmarks Refine Contours Set Landmarks Refine Contours Check & Change Contours Step 1 of 2 Replace all Contours Step 2 of 2 Select endo or epi contour icon to define which contour you 1) Delete all contours (endo and epi). want to adapt. 2) Select a mid-ventricular to basal slice. Check contours in ED and ES for every SAX slice. 3) Draw endolepi contour on the first phase. 1) If refinements are needed start changing contours on the first phase and check propagation. 4) Propagate in space (endolepi). 2) If further changes are needed continue adapting contours first at ED/ES. 5) Use segmentation refinement guidance from step 1. i Please note: For optimal accuracy check/correct contours for all phases. Please note: This is required if you are interested in parameters that Temporal contour propagation is automatic(3), spatial are not determined by the segmentation on ED/ES alone contour propagation has to be triggered manually(4). (e.g. peak ejection rate). 6. Create/Edit MR Cardiac Function Findings – Throughout MR Cardiac Analysis, all standard measurement tools are available to create findings  Standard Measurement Tools  Finding Details – results of current functional analysis are available  Wall Thickening Results of LV Functional Analysis – documented in an AHA-con- forming model  LV and RV Findings – can be created separately using corresponding buttons in the Findings Details a. MR Cardiac Function Workflow Step > select Create Findings Icon > Findings Details dialog box opens MR Cardiac Analysis Q + MR Cardiac Reading MR Cardiac Function Hide Lines Reset Normal Manual Create Mode Mode Findings Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/29/2021 | HOOD05162003237805 Healthineers Page 5 of 7 Job Aid | MR Cardiac Function - LV Ventricular Analysis – Numaris X Effective Date: 11/29/2021 | HOOD05162003237805 b. Findings Details dialog box – Choose Heart Rate of Patient  Heart Rate influences Cardiac Output Create Findings Patient Name MR_Cardiac Planning Age 45 Years Height 70.86614 inches Weight 176.2115 lbs Heart Rate 50 beats/min ( max:55; min:48; avg:50; med:49 ) c. If Sending Contours to PACS > choose a selection from Export Result Images  All  ED and ES  None: Default Create Findings Patient Name MR_Cardiac Planning Export Result Images All Age 45 Years ED and ES Height 70.86614 inches None Weight 176.2115 lbs Heart Rate 50 beats/min Create LV Findings Create RV Findings ( max:55; min:48; avg:50; med:49 ) d. LV Functional Analysis > Check Box to select Long-Axis and Short-Axis (or) Short- Axis only Results Long- axis and short- axis . Short-axis only Export Results e. Click Create LV Findings Button – Findings are listed in Findings Navigator and added to the Report Create Findings X Patient Name MR_Cardiac Planning Export Result Images All Age 45 Years ED and ES Height 70.86614 inches None Weight 176.2115 lbs Heart Rate 50 Create LV Findings Create RV Findings beats/min ( max:55; min:48; avg:50; med:49 ) Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/29/2021 | HOOD05162003237805 Healthineers Page 6 of 7 Job Aid | MR Cardiac Function - LV Ventricular Analysis – Numaris X Effective Date: 11/29/2021 | HOOD05162003237805 Please note that the 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's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. 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. Copyright © Siemens Healthcare GmbH 2020 Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84-0 siemens-healthineers.com Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 11/29/2021 | HOOD05162003237805 Healthineers Page 7 of 7