MR Spectroscopy 1H CSI - Numaris X JobAid

MR Spectroscopy 1H CSI Numaris X – Job Aid MR Spectroscopy 1H CSI – Numaris X MR Spectroscopy is a post-processing application to analyze and evaluate MR Spectroscopy 1H datasets. It provides evaluation for MR Chemical Shift Imaging (CSI) data with workflow guidance to support the diagnostic process. A novel fit-algorithm reduces the need for manual data processing and offers the user reproducible evaluation results. Info: MR Spectroscopy does not support the following image types for evaluation. • Distortion-corrected images • Images with different frames of reference (e.g., images acquired with different table positions 1. Open the Patient Browser. 2. Right-click on Patient Name and Select > Open with > MR Spectro. Open Ctrl+O 11 Ca Open with Favorites View as Read-Only with Suggested Batch Open MR Neurology * Assign Workflow MR Oncology * Cancel Workflow MR Prostate * Search Patient with DICOM Q/R MR Spectro * Add to Demo List MR Tissue4D * 3. In the MR Spectro Workflow the MR Spectroscopy Evaluation assigned shows the MR Spectrum in one (1) workflow step. 10.65% MR Spectro 11.30 % MRSpectro Radologe Uni Tuetirgen MR_Spectro Germany_MAC Ref : Congress Germany MAC Radicloge Uni Tuebingen MR Spectro Analysis Ref : Congress +12/1/1983.M. 19Y Avanto CURRENT Byngo MIR 2004Y 4VDMA ES CUR "120/1983.M. 19Y Ararts se 135, CURRENT csi_se_30,11/13/2003 3:32 PM -> Specrol Fetirage 1 L Cui_se_30 Spectrot Spect Svt_te_30.11/13/2003 3:37 PM STUDY Somal 250 STUDY 1ssa81 290-35 L 301_10_30 11/13/0003 11/1 3/2003 3 00:54 PM 2 22:37 PM 311_10_30,11/13/2003 3:43 PM Derles 14 E. 1cm Res Part === == Compare 010 IF 0.00 Viewing TR 9000 SPH37.1 0.05 FoV 310-230 IR 1500 TE 109 Tra-Cor(-6) TE 195 NAT V HEI VON AP UR FH TAOP.12 Chemical stuff [opre] SIZE 10 10 10 Vorel 137 Rojoboge Un Tuebingen MR_Spectre Radiologe Uni Tuebingen Germany_MAC Pet: Congress Germany MAC Ref : Congress MR_Spectro Radiologie Uni Tuslingen $120/1983, M. 19Y Germany MAC Cangen CURRENT Bynge HR 2004Y 4VB11A "121/1983, M, TOY Averto CURRENT Byngo MR 2004Y AVBITA "120/1983.M. 19Y Avarta CURRENT Findings Navigator STUDY Sasat 2 STUDY 181801250 11/1 3/2003 11/13/0003 3:06:47 PM 308:35 PM Serina 4 Serie: 5 1cm Tools SPC 33 VPO 4 MAT SP A22 5 Fo/ 230-342 TR 4210 FeV 210-230 Cor> Tra(s) TE 102 Tra Cor(-0) YOK AP UR TH SHE 10 10 10 1sef201 15/150 Unrestricted | Published by Siemens Healthineers AG, 2024 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers 4. To perform a MR Spectro Analysis. a. The MR Spectro Navigator is displayed in the control area of Spectro Analysis. MR Spectro b. MR Spectro Analysis Step allows the MR Spectro Analysis calculation and visualization of spectroscopy results for all spectro raw data series that are csi_se_135,11/13/2003 3:22 PM contained in the assigned study. Ly csi se 135 • Automatic or Manual selection of a csi se 30,11/13/2003 3:32 PM post-processing protocol Ly csi_se 30 svs_se_30,11/13/2003 3:37 PM svs_se 30 • Automatic Calculation and Visualization of post-processing results svs se 30,11/13/2003 3:43 PM • For each spectroscopy raw data set, Wy SVs se 30 results are generated based on an assigned post-processing protocol Export Export Selected Export Spectro Selected Compare Selected Browser • Displays individual spectra for CSI measurements c. The Spectro Object displays the Spectroscopy Viewing results. • First line is the measurement series • Second line is the post-processing protocol used Icons on left of Spectro Object. Customer Protocol Siemens Protocol F Icons right of Spectro Object Post-processing protocol was successfully applied to measurement series. Post-processing algorithm failed; hover mouse over icon to display reason for failure and suggested corrective action. Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers Page 2 of 16 5. In the MR Spectro Analysis window. MR Spectro Q + a. Select a CSI sequence, the reference images and MR Spectrum Results are automatically MR Spectro Analysis displayed. csi se 135,11/13/2003 3:22 PM Ly csi se 135 csi se 30,11/13/2003 3:32 PM Wy csi_se 30 svs_se 30,11/13/2003 3:37 PM Wy SVs se 30 svs se 30,11/13/2003 3:43 PM Wy svs se 30 AB Export Export Export Selected Selected Spectro Compare Selected Browser 6. MR Spectroscopy CSI image results are automatically displayed. a. Reference Images Viewing b. Metabolite Images c. Spectrum d. Spectral Map e. Result Table I(NAA)/I(Cr1) 1.83 1.64 10.65 % Result Table I(Cho)/I(Cr1) 11.38 % MR_Spectro Radiologie Uni Tuebingen Radiologie Uni Tuebingen Germany_MAC Ref.: Congress Ref.: Congress *12/1/1983, M, 19Y Avanto syngo MR 2004V 4VB11A *12/1/1983, M, 19Y Avanto syngo MR 2004V 4VB11A 11/13/2003 HFS 11/13/2003 27 HFS t2_tirm_tra_dark-fluid +LPH csi_se_135 0.45 +LPH latest latest/csi_se_135/Spectrum -- > Spectro1 .Reflmage.1 -- > Spectro1 .Spectrum.13 2.41 STUDY 1aaaa1 250 STUDY 1aaaa1250 0.35 11/13/2003 11/1 3/2003 0.30 3:00:54 PM 3:22:37 PM 0.25 R R 0.20 1 cm 0.15 Real Part CSI 0.10 SP H47.6 SL 10 F 0.05 AWM AMAM Tra MRI 2 IMA 1 0,00 MPR THICK TR 9000 SP H37.1 -0.05 TE 109 FoV 310*230 TR 1500 TE 135 NA 1 Tra>Cor(-6) NA 4 VOX AP LR FH HE1-4 VOX AP LR FH TA 07:12 Chemical shift [ppm] POS A19 LB H39 "tir 2d1_21/150 SIZE 10 10 10 HE1-4_c_4 E Integral SIZE 10 10 10 csi_se/90 Spectral Map Spectrum MR_Spectro Radiologie Uni Tuebingen MR_Spectro Radiologie Uni Tuebingen Germany_MAC Ref.: Congress Germany_MAC Ref.: Congress MR_Spectro I(NAA) Radiologie Uni Tuebingen *12/1/1983, M, 19Y Avanto Avanto Germany_MAC Ref.: Congress syngo MR 2004V 4VB11A $12/1/1983, M, 19Y syngo MR 2004V 4VB11A Avanto 11/13/2003 *12/1/1983, M, 19Y HFS 11/13/2003 HFS syngo MR 2004V 4VB11A t2_tse_cor_3mm_448 +LPH t2_tse_sag_rst_448 +LPH 11/13/2003 HFS latest latest t2_tirm-tra_dark-fluid +LPH -- > Spectro1 .Reflmage -- > Spectro1.Reflmage.3 latest STUDY 1aaaa1250 STUDY 1aaaa1250 -- > Spectro1 .Metabolitelmage.1 11/13/2003 11/13/2003 STUDY 1aaaa1 250 3:06:47 PM 3:09:36 PM 11/1 3/2003 Series 4 Series 5 3:00:54 PM R A R 3.22 1cm SPC 3.3 5cm SPC 3.3 CSI 2.27 CSI CSI 5cm SP A13.0 SP H47.6 SP L1.2 SL 10 SL 10 SL 10 Tra Tra MRI 4 IMA 1 Tra MPR THICK MRI 5 IMA 1 MPR THICK MRI 2 IMA 1 TR 4000 TES SP A22.5 MPR THICK Sp41 SP L6.2 TR 9000 SP H37.1 TR 4210 TE 104 FoV 230*342 FoV 220*327 TE 109 FoV 310*230 NA 3 Cor>Tra(6) TE 102 Tra>Cor(-6) NA 2 Sag NA 1 HE1-4 VOX AP LR FH HE1-4 FOX AP LR FH HE1-4 `tir2d1 21/150 VOX AP LR FH SIZE 10 10 10 *tse2d1_13/150 SIZE 10 10 10 Voxel Reference Images kel 137 Metabolite Image Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers Page 3 of 16 7. To Edit a Result Table. a. Left-click in the upper right corner menu. b. Left-click on Define Result Table. c. Note: the Result Table is automatically displayed in the upper-right-segment once a CSI sequence is selected. I(NAA)/I(Cr1) 1.83 0.65 % I(Cho)/I(Cr1) 1.64 1 Detine Result Table Radiologie Uni Tuebingen 8. To define a new value in the Result Table. a. Backspace over the current entry and enter the new value. • Examples: click on the Examples icon to see the different suggestions that can be used. [e.g., I(Cho), I(Cho)/I(Cr)] b. Click Add. c. Click OK. Define Result Table X Defined values (NAAM(C1) I(Cho)I(Cr1 Define new value I(NAA)(Cr1) Examples >> Add OK Cancel Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers Page 4 of 16 9. To see examples of Metabolite integral values that can be entered. a. Left-click on the Examples icon to see definitions for: • Integral value fo NAA • Integral of Cho plus integral of NAA • Sum of integral of Cho and Cr diided by integral of Ci • Scale Factor of NAA • Withing the numberator and denominator, addition and multiplication can be used Define Result Table ? X Defined values I(NAA)/I (Cr1) I(Cho)/I(Cr1) Define new value I(NAA)/ (Cr1) << Examples Add Examples: "Integral of NAA" write: I(NAA) "Integral of Cho plus integral of NAA" write: I(Cho) + I(NAA) "Sum of Integral of Cho and Cr divided by integral of Ci" write: (I(Cho) + I(Cr))/I(Ci) 'Scale Factor of NAA" write: SF(NAA) "Within the numerator and denominator, addition and multiplication can be used" write: (9*SF(Cho)+3*SF(Cr1))/(4*SF(Ci)) Note: Availability of items is depending on the underlying protocol. OK Cancel Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers Page 5 of 16 10. To Delete a Result Value (if needed). a. Select the Result Value and left-click the Minus icon. b. Click OK. Define Result Table ? X Defined values I(NAA)/I(Cr1) I(Cho)/I(Cr1) - Define new value I(Cho)/I (Cr1) Examples >> Add OK Cancel 11. To Reorder a Result Value (if needed). Select the Define Result Value. Define Result Table ? X a. b. Click the Up or Down Arrow icon (or) click on a Result Value and Defined values I(NAA)/I(Cr1) drag to a New Position. I(Cho)/I(Cr1) c. Click OK. Define new value I(Cho)/I (Cr1 ) Examples >> Add OK Cancel Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers Page 6 of 16 12. To Compare two voxels in one CSI Spectroscopy dataset. MR Spectro a. CSI Spectrum (e.g., csi_se_135). MR Spectro Analysis OH b. Click the Compare icon. c. In the Top Row select a Voxel in the Spectral csi_se_135,11/13/2003 3:22 PM Map for comparison. Ly csi se 135 iv d. In the Bottom Row select a Voxel in the csi se 30,11/13/2003 3:32 PM Ly csi se 30 i Spectral Map for comparison. svs se 30,11/13/2003 3:37 PM Note: Two different voxels within the same svs se 30 • spectrum are compared. svs se 30,11/13/2003 3:43 PM svs se 30 • Note: Spectral Map, Single Spectrum, & Metabolite images are displayed EE AB Export e. Turn Off Compare Mode when finished com- Selected Compare Selected Export Selected Spectro Browser paring the two voxels. Viewing 15.57 % MR Spectro [(NAA)/I(Cr1) (Cho)/I(Cr1) 0.57 8.74 % MR_Spectro Radiologie Uni Tuebingen MR_Spectro ingen MR_Spectro I(NAA ) Radiologie Uni Tuebingen MR Spectro Analysis Germany_MAC Ref: Congress Germany_MAC gress Germany_MAC Ref.: Congress *12/1/1983, M, 19Y Avanto *12/1/1983, M, 19Y Avanto Avanto syngo MR 2004V 4VB11A syngo MR 2004V 4VB11A *12/1/1983, M, 19Y syngo MR 2004V 4VB11A csi_se_135,11/13/2003 3:22 PM 11/13/2003 HFS 11/13/2003 £ 5.53 HFS 11/13/2003 HFS t2_tirm_tra_dark-fluid +LPH csi_se_135 +LPH Ly csi_se_135 t2_tirm_tra_dark-fluid +LPH csi_se_30,11/13/2003 3:32 PM latest latest/csi_se_135/Spectrum ₩5.13 latest csi_se_30 -- > Spectro1.Refimage.1 -- > Spectro1.Spectrum.1 -- > Spectro1 .Metabolitelmage svs_se_30,11/13/2003 3:37 PM STUDY 1aaaa1250 STUDY 1aaaa1 250 STUDY 1aaaa1250 I SVS_se_30 11/13/2003 11/13/2003 2.20 11/13/2003 sVs_se_30,11/13/2003 3:43 PM 3:00:54 PM 3:22:37 PM 10.3 I SVS_se 30 1.31 1cm Selected Selected Selected Compare CSI CS 2.27 SP H47.6 SP H47.6 SL 10 SL 10 F Tra Viewing MPR THICK MRI 2 IMA 1 Tra SP H37.1 MPR THICK MRI 2 IMA 1 TR 9000 TR 1500 TR 9000 SP H37.1 TE 109 FoV 230*259 Tra>Cor(-6) TE 135 3.0 2.5 2.0 1.5 FoV 230*251 1.0 0.5 TE 109 NA 1 NA 4 NA 1 Tra>Cor(-6) V TA 07:12 Chemical shift [ppm] VOX AP LR FH HE1-4 VOX AP LR FH POS A28 L16 H40 HE1-4 "tir 2d1_21/150 SIZE 10 10 10 HE1-4_c_4 SIZE 10 10 10 "tir 2d1_21/150 SIZE 10 10 10 csi_se/90 Integral xel 122 Voxel 122 Voxel 122 AH I(NAA)/I(Cr1) 1.00 10.4 % (Cho)/I(Cr1) 10.8 % MR_Spectro Radiologie Uni Tuebingen MR_Spectro ingen MR_Spectro I( NAA ) Radiologie Uni Tuebingen Germany_MAC Ref.: Congress Germany_MAC gress Germany_MAC Ref.: Congress *12/1/1983, M, 19Y Avanto *12/1/1983, M, 19Y Avanto Avanto syngo MR 2004V 4VB11A syngo MR 2004V 4VB11A *12/1/1983, M, 19Y 11/13/2003 11/13/2003 syngo MR 2004V 4VB11A HFS 11/13/2003 HFS Findings Navigator t2_tirm_tra_dark-fluid ALPH csi_se_1.35_ +LPH t2_tirm_tra_dark-fluid +LPH latest -10.45 latest/csi_se_135/Spectrum latest Name Value Source -- > Spectro2.Reflmage. -- > Spectro2.Spectrum.1 -> Spectro2.Metabolitelmag Pepetroz STUDY 1aaaa1250 STUDY Taaaa1-250 STUDY 1aaaa1250 11/1 3/2003 11/13/2003 3:00:54 PM 3:22:37 PM 3:00:54 PM 1 cm Tools 0.15 0.10 2.27 L SP H47.6 SP H47.6 SL 10 F 0.05 SL 10 F Synch Lock Full Text Hide Hide Lines Reset Tra 0.00 Tra Navigati. Graphics TimepoÏ ... MPR THICK MRI 2 IMA 1 MRI 2 IMA 1 SP H37.1 MPR THICK TR 9000 TR 15000.05 TR 9000 SP H37.1 TE 109 FoV 230*259 Tra>Cor(-6) TE 135 FoV 230*251 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 TE 109 NA 1 NA 4 VOX AP LR FH NA 1 Tra>Cor(-6) Edit Snapshot Print Export Undo Redo TA 07:12 Chemical shift [ppm] Mir 201 21150 VOX AP LR FH HE1-4_c_4 POS A28 R14 H40 HE1-4 SIZE 10 10 10 SIZE 10 10 10 csi_se/90 E Integral SIZE 10 10 10 "tir 2d1_21/150 Voxel 119 Voxel 119 Voxel 11 Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers Page 7 of 16 13. To Compare two CSI Spectroscopy datasets with different TE’s. MR Spectro + a. Depress Ctrl and left mouse and select two (2) CSI datasets with different TE’s. MR Spectro Analysis (e.g., csi_se_30 and csi_se_135). b. Click the Compare icon. csi_se_135,11/13/2003 3:22 PM ly csi_se_135 c. In the Top Row select a Voxel in the csi_se_30,11/13/2003 3:32 PM (csi_se_135) Spectral Map for comparison. csi se 30 d. In the Bottom Row select a Voxel in the svs_se 30,11/13/2003 3:37 PM (csi_se_30) Spectral Map for comparison. 1 5vs_se_30 svs_se_30,11/13/2003 3:43 PM • Note: Two different voxels with two (2) different CSI TE’s are compared. L svs se_30 • Note: Spectral Map, Single Spectrum, & Metabolite images are displayed Spectro compare Browser e. Turn Off Compare Mode when finished comparing the two different CSI TE’s. MR Spectro AH I(NAA)/I(Cr1) I(Cho)/l(Cr1) 0.66 1.86 12.99 % AH 8.59 % MR_Spectro Radiologie Uni Tuebingen MR_Spectro ingen MR_Spectro Radiologie Uni Tuebingen Ref.: Congress gress Germany_MAC I(NAA) MR Spectro Analysis Germany_MAC Germany_MAC Ref.: Congress *12/1/1983, M, 19Y Avanto syngo MR 2004/ 4/B11A *12/1/1983, M, 19Y Avanto syngo MR 2004V 4VB11A *12/1/1983, M, 19Y 11/13/2003 11/13/2003 syngo MR 2004/ 4VB11.A Cho csi_se_135,11/13/2003 3:22 PM I: 4.29 HFS 11/13/2003 lw csi_se_135 t2_tirm_tra_dark-fluid csi_se_1,355 ₮ t2_tirm_tra_dark-fluid csi_se_30,11/13/2003 3:32 PM latest latest/csi_se_135/Spectrum latest Lw csi_se_30 -- > Spectro1 .Reflmage -- > Spectro1.Spectrum.1 Spectro1 Metabolitelmage SVS_se_30,11/13/2003 3:37 PM STUDY 1aaaa1 250 STUDY 1aaaa1 250 Cr STUDY, 1aaaa1250 11/13/2003 11/1 3/20030 4.16 SVS_se_30 11/13/2003 SVs_se_30,11/13/2003 3:43 PM 3:00:54 PM 3:22:37 PM PM NAAR SVS_se 30 .20 3.22 1 cm someoneselect selected Compare CSI SP H47.6 SL 10 F 0.05 SPH F Tra MRI 2 IMA 1 0.00 Viewing MPR THICK SP H37.1 -0.05 TR 9000 TR 1500 TR 9000 TE 109 FoV 230*259 Tra>Cor(-6) TE 135 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 TE 109 Tra Cor( -6 ) NA 4 NA 1 HE1-4 VOX AP LR FH TA 07:12 Chemical shift [ppm] VOX AP LR FH POS A38 L16 H41 HE1-4 stir2d1_21/150 SIZE 10 10 10 HE1-4_c_4 csi_se/90 I: Integral SIZE 10 10 10 "tir 2d1_21/150 SIZE 10 10 10 Voxel 106 Voxel 106 Voxel 106 I(NAA)/I(Cr1) 1.66 5.54 % I(Cho)/I(Cr1) AH 6.07 % MR_Spectro Radiologie Uni Tuebingen MR_Spectro I(mins)/I(Cr1) 10.51 % ingen MR_Spectro I(NAA) Radiologie Uni Tuebingen Radi Germany_MAC Ref.: Congress Germany_MAC bress Germany_MAC Ref.: Congress *12/1/1983, M, 19Y Avanto *12/1/1983, M, 19Y Avanto *12/1/1983, M, 19Y Avanto syngo MR 2004V 4VB11A syngo MR 2004V 4VB11A 11/13/2003 HFS 11/13/2003 syngo MR 2004V 4VB11A 11.22 HFS 11/13/2003 HFS Findings Navigator t2_tirm_tra_dark-fluid +LPH csi_se_30 +LPH t2_tirm_tra_dark-fluid +LPH latest latest/csi_se_30/Spectrum 17,26 latest Name Value Source -- > Spectro2.Reflmage. -- > Spectro2.Spectrum.1 -- > Spectro2 Metabolitelmage STUDY 1aaaa1 250 dalilaLalalalal. STUDY 1aaaa1 250 Cho 11/13/2003 11/1 3/2003.8 L: 6.37 3:00:54 PM 3:32:38 PM mins chal 11.56 Tools 1cm cm CSI CS 8.72 Et= L SP H47.6 SL 15 SL 15 F Synch Lock Hide Hide Lines Rezet Tra Tra Navigati ... Graphics Timepoi ... MPR THICK MRI 2 IMA 1 MRI 2 IMA 1 TR 9000 SP H37.1 MPB. JHICK TR 9000 SP H37.1 FoV 230*259 TR 1500 EP. TE 109 3.5 FoV 230*251 Tra>Cor(-6) TE 30 4.0 3.0 2.5 2.0 1.5 1.0 0.5 TE 109 NA 1 INA 4 Tra>Cor(-6) Snapshot Print Undo Redo KU Chemical shift [ppm] VOX AP LR FH Edit HE1-4 VOX AP LR FH TA 07:12 POS A38 R14 H41 HE1-4 Layout Image "tir 2d1_21/150 SIZE 10 10 15 HE1-4_c_4 csi_se/90 t: Integral SIZE 10 10 15 "tir 2d1_21/150 SIZE 10 10 15 Voxel 103 Voxel 103 Voxel 103 Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers Page 8 of 16 14. To Create Metabolite images. AH Define Metabolite Image a. Select a Metabolite Image. MR_Spectro Germany_MAC I(NAA) Distance Line b. In the upper right corner menu, select *12/1/1983, M, 19Y Define Metabolite Image. ROI, Freehand 11/13/2003 t2_tirm tra_dark-fluid Pixel Lens latest -- > Spectro1 .Metabolitelmage.1 Marke STUDY, 1aaaa1 250 11/1 13/2008 Arrow 3:00:54 P 4 PM y si- R 3.22 Angle A VOI Freehand CSI 2.27 SP H47.6 Text T SL 10 Tra MPR THICK MRI 2 IMA 1 TR 9000 SP H37.1 TE 109 FoV 230*251 NA 1 Tra>Cor(-6) HE1-4 *tir2d1_21/150 VOX AP LR FH SIZE 10 10 10 Voxel 106 15. The Define Metabolite Image window is displayed. Define Metabolite Image ? x a. Value, enter and define the metabolite. b. Left-click on the Examples icon to see Value definitions for: I (NAA ) • Integral values: I(Cho) << Examples Examples: • Integral of Cho plus integral of NAA: "Integral of NAA" write: I(Cho) + I(NAA) I(NAA) "Integral of Cho plus integral of NAA" write: I(Cho) + I(NAA) • Sum of Integral of Cho and Cr divided "Sum of Integral of Cho and Cr divided by integral of Ci" write: (I(Cho) + I(Cr))/I(Ci) by integral of Ci: (I(Cho) + I(Cr)/I(Ci) "Scale Factor of NAA" write: SF(NAA) "Within the numerator and denominator, addition and multiplication • Ratios of integral values: I(Cho)/I(Cr) can be used" write: (9*SF(Cho)+3*SF(Cr1))/(4*SF(Ci)) • Scale-factors: SF(Cho) • Note: availability of items depends on Note: Availability of items is depending on the underlying protocol. the underlying protocol c. Click OK, the newly defined metabolite im- age is displayed in the segment. OK Delete Cancel Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers Page 9 of 16 16. To Adjust Range and Transparency in a AH Metabolite image. MR_Spectro I(NAA) Radiologie Uni Tuebingen a. In the lower right corner menu, se- Germany_MAC Ref.: Congress Avanto lect Adjust Range & Transparency *12/1/1983, M, 19Y syngo MR 2004V 4VB11A Intensity. 11/13/2003 HFS t2 tirm tra_dark-fluid +LPH 5.13 latest -- > Spectro2.Metabolitelmage.1 STUDY, 1aaaa1250 4.18 3:00:54 PM Check Spectral Quality R 3.22 auto Metabolite Image Color LUT ... CSI 2.27 Interpolation On/Off SP H47.6 SL 10 Adjust Range & Transparency Tra MPR THICK TR 9000 Auto Windowing auto TE 109 NA 1 MR Color LUT HE1-4 "tir 2c1_21/150 MR Presets Voxel 79 Reset Windowing b. In the Intensity Range field: • Define Upper and Lower limits • Select Absolute or Percentage from the drop down a. Automatic: when activated it automatically displays the intensity range. (i.e., range be- tween the maximum and minimum values in the metabolite images is used). b. Transparency: a. Slider: Modifies the transparency of metabolite image. -or- b. Enter Percentage. c. Reset button is used to select to reset the range and transparency. IP FA Intensity Range 5.87 17.26 Absolute Automatic Reset Transparency 50 % Information: The intensity range is set for the complete CSI slab in the case of 3D. The Intensity range in relative percentages represents the minimum occurring value in the metabolite image as 0% and the maximum occurring value as 100%. Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers Page 10 of 16 17. To Show/Hide the Peak Information Map. a. In the upper left corner menu, select Show/Hide Peak Information Map. (i.e., click to toggle on or off). Show Peak Information Map Hide Peak Information MasH Show Quality Markers I(NAA) Radiologie Uni Tuebingen Ref.: Congress Show Quality Markers I(NAA) Radiologie Uni Tuebinger Ref.: Congress Avanto Show Selected Voxel Only Avantc syngo MR 2004V 4VB11A Show Selected Voxel Only HFS syngo MR 2004V 4VB11 A HFS Show/Hide .. +LPH O Show/Hide ... +LPH Fit To Field of View Fit To Field of Viewy 011.131.10.410.712.911.38 AH AH MR_Spectro I(NAA) Radiologie Uni Tuebingen MR_Spectro I(NAA) Radiologie Uni Tuebingen Germany_MAC Ref.: Congress Germany_MAC Ref.: Congress *12/1/1983, M, 19Y Avanto Avanto syngo MR 2004V 4VB11A 11/13/2003 L syngo MR 2004V 4VB11A *12/1/1983, M, 19Y HFS 11/13/2003 HFS t2_tirm_tra_dark-fluid t2_tirm tra_dark-fluid +LPH latest latest -- > Spectro2.Metabolitelmage:1, 3.363.983.572.853.13.544.023.46 -- > Spectro2.Metabolitelmage.1 PRECI STUDY, 1aaaa1 250 4.16 4.464.744.083.893.443.634.874.57 STUDY 1aaaa1250 11/13/2003 14.18 3:00:54 PM 4.583.963.013.222.141.533.334.19 11/13/2003 3:00:54 PM 4.964.153.273.351.961.312.433.72 R 3.22 4.754.623.57 3.5 2.72.433.173.63 R 3.22 5.035.134.013.933.993.724.274.13 1 cm 1 cm CSI 2.27 4.38 5 4.354.214.434.1 4.494.33 2.263.122.342.392.72.582.752.49 CSI 2.27 SP H47.6 SP H47.6 SL 10 F SL 10 Tra MRI 2 IMA 1 Tra MPR THICK MRI 2 IMA 1 TR 9000 SP H37.1 MPR THICK TR 9000 SP H37.1 TE 109 FoV 230*251 Tra>Cor(-6) TE 109 FoV 230*251 NA 1 NA 1 Tra>Cor(-6) HE1-4 VOX AP LR FH HE1-4 VOX AP LR FH *tir 2d1_21/1 50 SIZE 10 10 10 *tir 2d1_21/150 SIZE 10 10 10 77 Show Peak Information Hide Peak Information 18. To Update a Spectrum in Real Time. Clip Box AH MR_Spectro a. Right-click on a Peak Information Radiologie Uni Tuebinger Germany_MAC O. ROI Circle Ref.: Congress Avantc Map or Metabolite image 12/1/1983, M, 19Y Distance Line syngo MR 2004V 4VB11 A 11/13/2003 HFS segment. t2_tirm_tra_dark-fluid i- Marker +LPH latest b. In the Context Menu, click Real -- > Spectro1 .Reflmage.1 3D Reference Point LALaLa.L. STUDY 1aaaa1 250 Time Spectrum update. 11/1 3/2003 3:00:54 PM Enlarge Series c. Move the mouse over the voxels Mark Voxel as Low QualityL ., A.L. to see Real Time Spectrum up- 1 cm dates. CSI Enlarge Orientation SP H47.6 SL 10 DA Real Time Spectrum_Update ... IF Tra MPR THICK Paste to the same organ position MRI 2 IMA TR 9000 FoV 272*20 TE 109 NA 1 .O.: Auto Windowing Tra>Cor(-6 HE1-4 auto Paste to the current image VOX AP LR FF "tir 2d1_21/150 SIZE 10 10 10 paste to the cursor position Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers Page 11 of 16 19. To Show/Hide the Spectral Map. a. In the upper left corner menu, select Show/Hide Peak Information Map. (i.e., click to toggle on or off). Show Spectral Map AH Hide Spectral Map AH Show Quality Markers Radiologie Uni Tuebingen Radiologie Uni Tuebingen Ref.: Congress Show Quality Markers Ref.: Congress Avanto Avanto O Show Selected Voxel Only syngo MR 2004V 4VB11A Show Selected Voxel Only syngo MR 2004V 4VB11A HFS HFS AH MR_Spectro Radiologie Uni Tuebingen Germany_MAC MR_Spectro Radiologie Uni Tuebingen Ref.: Congress Germany_MAC Ref.: Congress "12M/1983, M, 19Y Avanto syngo MR 2004V 4VB11A "12/1/1983, M. 1) Avanto 11/13/2003 syngo MR 2004V 4VB11A HFS 11/13/20035 HFS 12_tirm_tra_dark-fluid +LPH 12_tirm_tra_dark-fluid +LPH latest latest -- > Spectro1.Refimage.1 -- > Spectro1.Refimage.1 STUDY 1aaaa1250 STUDY 1a88a1 250 11/13/2003 11/13/2003 3:00:54 PM 3:00:54 PM 1cm SP H47.6 F SP H47.6 SL 10 F SL 10 Tra Tra MPR THICK MRI 2 IMA 1 MPR THICK SP H37 .1 TR 9000 SP H37.1 TE 109 FoV 310 230 Tra-Cor(-6) TE 109 FoV 310'230 Tra=Cor(-6) NA 1 NA 1 HE1-4 VOX AP LR FH HE1-4 VOX AP LR FH "tir 2d1_21/150 SIZE 10 10 10 "tir 2d1_21/150 SIZE 10 10 10 Voxel 122 Voxel 122 Show Spectral Map Hide Spectral Map 20. To show the Curve Display. a. Select a Spectrum. b. In the lower right corner menu, select Curve Display Options. • Check Fit radial button to add Red Curve Fit • Un-Check Fit radial button to remove Red Curve Fit • Peak Information: select up to three (3) to display on the Spectrum • Metabolites: select metabolites to be labeled c. Click OK. 0.00 IiCheck Spectral Quality YILWU Display Options ? X -0.05 TR 1500 Show Individual Fit Curves T TE 135 4.0 Peak Information NA 4 3.5 3.0 2.5 2.0 Manual Phasing 1.5 Curves Metabolites TA 07:12 Chemical shift Innml HE1-4_c_4 al Curve Display Options Signal Name NAA csi_se/90 I: Integ Fit Integral Voxel 105Adjust Range & Scale ILA Cr1 . Baseline Width Cho Subtract Baseline Scale Factor Cr2 Position OK Reset Cancel Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers Page 12 of 16 21. To Check the Spectral Quality. a. In the lower right corner menu, select Check Spectral Quality. b. Quality Check Condition. • Checked: quality check condition for each voxel not manually marked as low quality is re-evaluated. Based on the result, the display of the spectral map and metabolite image are updated. • Un-checked: voxels that were marked as low quality by the quality check are now marked as high quality. The status of any voxels that were manually marked as low quality is not changed. c. Mark Saturated Voxels as Low Quality: when checked the voxels that have low Quality Spectra discard the values. Checks all “hot spots” in metabolite images and ensures they have corresponding high-quality spectra. 0.00 Check Spectral Quality Check Spectral Quality ? X -0.05 TR 1500 Show Individual Fit Curves TT TE 135 4.0 3.5 3.0 2.5 2.0 1.5 1 Quality Check Condition NA 4 Manual Phasing TA 07:12 Chemical shift [ppm] Quality Check Condition HE1-4_c_4 csi_se/90 I: Integral Curve Display Options LA :)<15&&Residual(Lipids_vs_Noise)<300&&I(Cr2)<2*(I(NAA)+I(Cr1)+I(Cho))&&SNR()>3 Voxel 105Adjust Range & Scale ILA << Examples Examples If the Signal to noise ratio must be greater than 5 then write: SNR() > 5 If the Signal to noise ratio must be greater than 5 and width of Cr2 must be smaller than 15 then write: SNRO > 5 && W(Cr2) < 15 If the Standard Deviation of integral of Cho must be smaller than 20% then write: StdDev(I(Cho)) < 20 Note: Availability of items is depending on the underlying protocol. Mark Saturated Voxels as Low Quality OK Apply Reset Cancel Information: Spectral Quality Check is performed by the system. • Voxels of Low Spectral Quality are marked and results are not used or displayed on the Spectral Map or Metabolite Image. • Quality Check Condition determines whether or not a voxel is high quality. • Voxels that don’t pass the Quality Check Condition marked as low quality. Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers Page 13 of 16 22. To Show Voxels with Low Quality in the Spectral Map. a. Right-click (Context Menu) on the low-quality voxel and select Mark Voxel as High Quality. b. Note: allows user to manually select the voxel as High Quality, so the voxel with the low quality is shown in the spectral map. T Text AH Clip Box AH MR_Spectro Clip Box Radiologie Uni Tuebingen MR_Spectro O ROI Circle Radiologie Uni Tuebingen Germany_MAC Ref.: Congress Germany_MAC Ref.: Congress *12/1/1983, M, 1: Avanto Avanto ROI Circle syngo MR 2004V 4VB11A *12/1/1983, M, 19Y syngo MR 2004V 4VB11A 11/13/2003 3D Reference Point HFS 11/13/2003 HFS t2_tirm_tra_dark-flc 3D Reference Point +LPH t2_tirm_tra_dark-fluid Distance Line +LPH latest latest -- > Spectro1 .Reflma. Distance Line -- > Spectro1 .Reflmage.1 STUDY 1aaaa1250 ALALALALALALALAL Marker STUDY 1aaaa1250 11/1 3/2003 -is Marker 11/13/2003 3:00:54 PM 3:00:54 PM Mark Voxel as High Quality R Mark Voxel as Low Quality 1 44- 1- 04 1 cm Enlarge Series 4.L 1 cm CSI Enlarge Series CSI Enlarge Orientation SP H47.6 SL 10 Enlarge Orientation IF SP H47.6 SL 10 >> Real Time Spectrum Update F Tra Tra MPR THICK >> Real Time Spectrum Update MRI 2 IMA 1 MPR THICK MRI 2 IMA 1 TR 9000 SP H37.1 FoV 310*230 TR 9000 Paste to the same organ position SP H37.1 TE 109 FoV 310*230 NA 1 Paste to the same organ position Tra>Cor(-6) TE 109 NA 1 O. Auto Windowing Tra>Cor(-6) HE1-4 "tir 2d1_21/1 50 : Auto Windowing VOX AP LR FH SIZE 10 10 10 HE1-4 *tir 2d1_21/150 Paste to the current image VOX AP LR FH SIZE 10 10 10 Paste to the cupreht 7hage Voxt Paste to the cursor position I(NAA)/I(Cr1) I(Cho)/I(Cr1) 12.51 70 10.44 % I(NAA)/I(Cr1) 1.05 12.91 % I(Cho)/I(Cr1) 2.28 10.44 % MR_Spectro Radiologie Uni Tuebingen MR_Spectro Radiologie Uni Tuebingen Germany_MAC Ref: Congress Germany_MAC Ref.: Congress *12/1/1983, M, 19Y Avanto syngo MR 2004Y 4VB11A *12/1/1983, M, 19Y Avanto syngo MR 2004V 4VB11A 11/13/2003 HFS 11/13/2003 4.25 HFS csi_se_135 +LPH csi_se_135 +LPH latest/csi_se_135/Spectrum latest/csi_se_135/Spectrum 10 40 -- > Spectro1 .Spectrum.1 -- > Spectro1 .Spectrum.1ª STUDY 1aaaa1259.30 11/13/2003 0.25 1.87 NAA STUDY 1aaaa1259.30 I: 1.96 11/1 3/2003 3:22:37 PM 3:22:37 PM 0.25 1.96 0.20 R 0.20 0.15 R 0.15 Real Part Real Part 0.10 0.10 0.05 0.05 0.00 TR 1500 TR 1500 -0.05 NA 4 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 TE 135 2.5 2.0 0.5 NA 4 TA 07:12 Chemical shift [ppm] VO VOX AP LR FH POS A28 L6 H40 TA 07:12 Chemical shift [ppm] VOX AP LR FH HE1-4_c_4 HE1-4_c_4 POS A28 L6 H40 csi_se/90 I: Integral SIZE 10 10 10 Low Qual : Integral SIZE 10 10 10 csi_se/90 Voxel 121 Marked as Low Quality Marked as High Quality Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers Page 14 of 16 23. To Create a Finding. a. In the Tools area, click the Snapshot/Layout Snapshot icon. • Snapshot - a finding is created for the image segments selected. • Layout Snapshot – a finding is created for the screen layout. b. Findings are saved in the Findings Navigator. Findings Navigator Findings Navigator Name Value Source Name Value Source 4 51 Snapshot Spectr .. 52 Snapshot Spectr Tools Tools LO Snapshot ETS Synch Layout Snapshot ide Lines Reset Lock Full Text Timepoi ... Synch Hide Hide Lines Reset Navigati. Graphics Timepoi ... Snapshot to Finding Edit Snapshot Print Undo Redo KU Layout Image Export Edit Layout Print Undo Redo Image Snapshot Image 24. To Save Results. a. Click Save and Send. -or- b. Click Save and Pause. V Save and Send: results are stored on the system and sent to your archive. Save and Pause: results are stored on the system. Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers Page 15 of 16 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 Healthineers AG 2024 Siemens Healthineers Headquarters Local Contact Information Legal Manufacturer Siemens Healthineers AG Siemens Medical Solutions USA, Inc. Imaging & Therapy Systems Siemensstraße 3 40 Liberty Blvd. Magnetic Resonance 91301 Forcheim, Germany Malvern, PA 19355-9998 USA Henkestr. 127 Phone: +49 9191 18-0 Telephone: +1-888-826-9702 DE-91052 Erlangen siemens-healthineers.com Customer Care Telephone: Germany +1-800-888-7436 Telephone: +49 9191 18-0 Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2022 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 2/28/2024 | QR700005768 Healthineers Page 16 of 16