Open Recon SubtleMR Integration

SIEMENS Healthineers Open Recon | SubtleMR Integration Job Aid Template Effective Date: 10 Aug 2021| HILS 2223 Effective Date 26 Aug 2022 | HILS/HOOD5162003294841 Unrestricted © Siemens Healthineers, 2022 Open Recon | SubtleMR Integration SIEMENS Healthineers Table of Contents Benefits 3 SubtleMR Workflow 5 SubtleMR Supported Sequences 6 Recommended SubtleMR Jobs 7 : : :. Siemens Protocol Managing 8 Clinical Examples 14 Sample Processing 10 Result Information 14 Printing Results 16 Daily Maintenance 18 Weekly Maintenance 19 Monthly Maintenance 20 As-Needed Maintenance 23 2 Effective Date: 26 Aug 2022|HOOD05162003294841 Unrestricted © Siemens Healthineers, 2022 Benefits SIEMENS Healthineers SubtleMR is an AI-powered software solution used to enhance the quality of up to 60% faster MRI scans by increasing image sharpness and denoising. SubtleMRT™ Benefits: • Improved image quality Faster scan times Original Scan Accelerated Scan Enhanced • by SubtleMR™ • Increased throughput • Better patient experience • More flexibility between patients Acquisition Time: 1:46 min Acquisition Time: 42 sec 3 Effective Date: 26 Aug 2022|HOOD05162003294841 Unrestricted © Siemens Healthineers, 2022 Benefits for all Stakeholders SIEMENS Healthineers rio Patients Radiologists Facility ▪ Scan time reduction ▪ Better patient care ▪ Increase operational efficiency ▪ Improve patient comfort ▪ Fewer motion artifacts, reducing need for rescans ▪ More flexibility in ▪ Increase patient between patients satisfaction ▪ Increase referrals ▪ Less overtime ▪ Fewer rescans 4 Effective Date: 26 Aug 2022|HOOD05162003294841 Unrestricted © Siemens Healthineers, 2022 Open Recon | SubtleMR Workflow SIEMENS Healthineers 1 From the Siemens console, select the tab Open 2 Under Algorithm, use the drop-down menu to Recon. select the desired job. SIEMENS X Healthineers Cron, Maria . 9/18/1986 F df596017-adca-4541 ... X MR View&GO 200:00 Brain ISO ℮ / > + + Delete Skip Cancel 4.7x4.7x8.0 mm3 K Stop Pauze Go ¿ 4 sec ; Auto @ None Continue Copy&Go Routine Contrast Resolution Geometry System Physio Inline Subtraction MIP Composing Maplt Open Recon Algorithm None None 12i_notsigned_mirroring V1 SubtleMR V2 E 00:00 O SAR Stimu Settings Delete Settings Exam Display Display Normal Normal Skip Stop cancel 4 sec / Auto @ None 4.7x4.7x8.0 mm3 @ 1.00 Pause Continue Copy&Go Go Mode Mode Routine Contrast Resol Geometry System Physio Inline Sequence Subtraction MIP Composing Open Recon Waiting for slice positioning Algorithm None 3 Once the appropriate algorithm is selected, the scan can be performed. SAR Stimu Settings Settings Display 5 Display jector Normal Normal Mode Mode Effective Date: 26 Aug 2022|HOOD05162003294841 Waiting for slice positioning. Unrestricted © Siemens Healthineers, 2022 SubtleMR Supported Sequences SIEMENS Healthineers SubtleMR has been trained and tested using a diverse DICOM image dataset collected from different MR imaging applications primarily at 1.5T/3T, H. including: Any imaging sequences/applications outside the above list may result in T1 weighted imaging for neuro, spine, breast, body (e.g., abdomen/pelvis/prostate), MSK (e.g., prolonged processing time (e.g., high- • shoulder/knee) applications: 1) gradient echo (GRE) based 2D/3D sequences (e.g., FLASH) dimensional MR imaging) and/or with/without contrast, using Cartesian/Radial readout trajectories, without/with inversion unreasonable results. preparation (e.g., MPRAGE); 2) spin echo (SE) based 2D sequences including fast SE (FSE) with/without variable refocusing flip angle pulse train. Note that DWI and MPR sequences are not supported when executing with T2 weighted imaging for neuro, spine, breast, body (e.g., abdomen/pelvis/prostate), MSK (e.g., ISMRMRD images. • shoulder/ knee) applications: SE based 2D/ 3D sequences, 2D/3D Dark Fluid TIRM with/without contrast and with/without fat suppression. In addition, Diffusion Tensor Imaging (DTI), functional MRI (fMRI) and MR Proton density weighted imaging for spine, MSK (e.g., shoulder/knee/ankle) applications: 2D SE spectroscopy (MRS) data processing • sequences with/without fat suppression. are out of the scope of SubtleMR. • Susceptibility weighted imaging for neuro and abdomen applications: T2* weighted GRE. Perfusion imaging sequences were not included in the training and testing • STIR sequence for spine imaging. dataset. 6 Effective Date: 26 Aug 2022|HOOD05162003294841 Unrestricted © Siemens Healthineers, 2022 Recommended SubtleMR Jobs SIEMENS Healthineers • For denoising jobs, the recommended job is 0 3:07 min Auto 0.7x0.7x5.0 mm3 ~ 1.00 denoise-enhanced-level1. If less denoising is Routine Contrast Resolution Geometry System Physio Inline Sequence required, use denoise. Similarly, if the images Subtraction MIP Composing Open Recon are not denoised enough, denoise- Algorithm SubtleMR V2 enhanced-level2 is recommended. • For super-resolution jobs (BRAIN), the recommended default is super-resolution. Preset denoise Free Text denoise The job edge-super-resolution will produce denoise-enhanced-level1 results with sharper boundaries. Conversely, denoise-enhanced-level2 super-resolution smooth-super-resolution will produce smooth-super-resolution smoother results. edge-super-resolution • SubtleMR does not support diffusion weighted images (DWI) or multiplanar reformat (MPR) jobs through OpenRecon. 7 Effective Date: 26 Aug 2022|HOOD05162003294841 Unrestricted © Siemens Healthineers, 2022 Siemens Protocol Managing SIEMENS Healthineers 1 Locate Protocol Folders/Exam Cards. Protocols are located in myExam Cockpit: During the examination the protocols can be added into the Queue at any time. myExam Cockpit - Explorer ? O x Brain Assist LOC + Add Program / Steps Explorer Program Editor Browse Import Export Edit Simulate 1 AAhead_scout SIEMENS Brain Assist SIEMENS head 2 t1_se_sag Brain Autopilot c-spine t-spine 7at2_tse__512 clinical libraries 3 W head I-spine advanced applications libraries 4 t2_tse_dark-fluid_tra 04:50 >head Cc-spine whole-spine neck soft tissue % ep2d_diff_3scan_trace_p2 c-spine GOBrain [] t-spine thorax 5 01:47 [t-spine library [ l-spine heart [ whole-spine 6 7 t1_se_tra 3 02:25 angiography breast I-spine neck soft tissue angiography ce abdomen 7 Inject contrast agent. > [ whole-spine [ thorax pelvis female heart pelvis male t1_se_tra 3 02:25 [ neck soft tissue Ci breast tmj 00 thorax [] abdomen shoulder 9 t1_se_cor 02:27 [ pelvis female elbow › heart [] pelvis male wrist breast myExam Cockpit [ tmj hand hip › abdomen shoulder elbow knee [] pelvis female [ wrist ankie foot 2 13:54 [ pelvis male [] hand Chip lower extremity > [ tmj whole body oncology Cu knee whole body diffusion LGo Delete Go Cancel shoulder [ ankle peripheral angiography Skip Stop Pause Continue Copy&Go foot elbow spectroscopy lower extremity intervention whole body oncology radiotherapy > whole body diffusion System [] peripheral angiography spectroscopy 8 Effective Date: 26 Aug 2022|HOOD05162003294841 Unrestricted © Siemens Healthineers, 2022 Siemens Protocol Managing SIEMENS Healthineers 2 Two ways of adding SubtleMR sequences to your USER >> head » clinical libraries » general routinely used Brain, Spine, and MSK protocols. t1_se_r_sag 03:25 t1_se_cor 02:25 A. Copy all sequences In an existing protocol, copy all sequences and add them routine protocols t2 tse tra 512 03:37 underneath for editing. Add a break or pause with Subtle to distinguish [Preferred approach]. t2_tse_dark-fluid_tra 04:50 B. Create a new protocol SUBTLE ------ add a Pause Create a new protocol which is a copy of your routine protocols but with SubtleMR as protocol name and then start editing. S-t1_se_r_sag-DNE 03:25 S-t1_se_cor-DNE 02:25 copy of routine protocols S-t2_tse_tra_512-DNE 03:37 S-t2_tse_dark-fluid_tra-DNE 04:50 9 Effective Date: 26 Aug 2022|HOOD05162003294841 Unrestricted © Siemens Healthineers, 2022 Siemens Protocol Managing SIEMENS Healthineers (Brain) 3 Edit sequences: There are two options: (A) Denoising (DNE) and (B) Super-resolution (SRE). A. Denoising (DNE) If multiple Averages → Adjust Averages USER >> head >> clinical libraries >> general >> S-t2_tse_tra_512-DNE ? x USER >> head >> clinical libraries >> general >> S-t2_tse_tra_512-DNE ? X General 3 3:37 min 4 Auto @ None 0.4x0.4x5.0 mm3 1.00 General ¿ 3:37 min Auto @ None @ 0.4x0.4x5.0 mm3 1.00 Protocol Parameters 2 → 1 Routine Contrast Resolution Geometry System Physio Inline Sequence Protocol Parameters Routine Contras Resolution Geometry System Sequence • Voice Commands Physio Inline Voice Commands Execution Slice Group FoV Read 230 mm Execution Slice Group FOV Read 230 - mm • e.g., 4 → 2 Image Management Slices 25 + FoV Phase 90.6 ¢ % Image Management Slices 25 FoV Phase 90.6 % Auto Load Slice Thickness Copy References 5.0 - mm Auto Load Slice Thickness 5.0 + m Copy References Distance Factor 30 % % TR 5000.0 - ms Distance Factor 30 TR 5000.0 + m Position Isocenter TE 89.00 + ms osition Isocenter TE 89.00 + ms Orientation Transversal Averages 2 ... Orientation Transversal Averages 1 ... Phase Encoding Dir. R>>L Concatenations Phase Encoding Dir. R>>L Concatenations Phase Oversampling 0 4 % AutoAlign --- ... Phase Oversampling O % AutoAlign -- .... 2 Averages 32 Averages. 1 32 OK Cancel 2 Identical OK Cancel EB 2 Identical 10 Effective Date: 26 Aug 2022|HOOD05162003294841 Unrestricted © Siemens Healthineers, 2022 Siemens Protocol Managing SIEMENS Healthineers (Brain) 3 Edit sequences: B. Super-resolution (SRE) If multiple Averages → Adjust USER »> head >> clinical libraries »> general »> S-t2_tse tra_512-DNE ? X General 1:52 min Auto @ None @ 0.4x0.4x5.0 mm3 9 0.71 Phase Resolution in Resolution Protocol Parameters Routine Contrast Resolution Geometr System Physio Inline Sequence Voice Commands Execution Common Acceleration Filter tab Image Management FOV Read 230 - mm Auto Load FoV Phase 90.6 ¢ % Copy References Slice Thickness 5.0 ¢ mm • Adjust resolution to 60% of Base Resolution 512 USER >> head >> clinical libraries » general » S-t2 tse_tra_512-DNE ? x Phase Resolution General 75 ¢ % 57 sec Auto @ None @ 0.4x0.4x5.0 mm2 1.08 original resolution Protocol Parameters Resolution Acq. Matrix: 348x512 Routine Contrast Geometry System Physio Inline Sequence Voice Commands Execution Common Acceleration Filter 348 => 158 Image Management FoV Read 230 mm nterpolation Auto Load FoV Phase 90.6 Copy References Slice Thickness 5.0 - mm • Or to 128 at the very Base Resolution 512 minimum resolution Phase Resolution 34 - % OK Cancel F 2 Identical Acq. Matrix: 158×512 158 => 128 Interpolation • If the resolution is higher than 256, adjust to 50% resolution OK Cancel 2 Identical | e.g., 384 -> 192 C. If neither resolution or averages can be decreased (Already 1 Average and below 128) leave as routine. 11 Effective Date: 26 Aug 2022|HOOD05162003294841 Unrestricted © Siemens Healthineers, 2022 Siemens Protocol Managing SIEMENS Healthineers (Spine & MSK) USER >> c-spine » clinical libraries » general » S-t2_tse_stir_sag_DNE ? X 3 Edit sequences: General 3:53 min 4 Auto @ 2 @ 0.9x0.9x3.0 mm3 1.22 Protocol Parameters Routine Contrast Resolution Geometry System Physio Inline Sequence Voice Commands For Spine and MSK: all will be Denoising (DNE) or Execution Slice Group 1 - FoV Read 220 - mm Image Management Slices 15 FoV Phase 100.0 reduction in average. Auto Load Copy References Slice Thickness 3.0 ¢ mm Distance Factor 104 TR 3800.0 ms Position Isocenter TE 37.00 + ms • Adjust Averages (Avgs) Orientation Sagittal Averages 3 ... Phase Encoding Dir. H>> F Concatenations • 2 → 1 Phase Oversampling 80 0 AutoAlign -- • e.g., 4 → 2 Averages 3 32 • If the sequence is a STIR or FS, ensure sufficient SNR is present. Be less aggressive: OK Cancel F 3 Identical [1 • (ex: If Avgs = 2, don’t change it. If Avgs = 3, USER >> c-spine >> clinical libraries >> general >> S-t2_tse_stir_sag-DNE ? X General 2:37 min & Auto@ 2@ 0.9x0.9x3.0 mm3 1.00 reduce it to 2) Protocol Parameters Routine Contrast Resolution Geometry System Physio Inline Sequence Voice Commands Execution Slice Group 1 FOV Read 220 mm Image Management Slices 15 FoV Phase 100.0 % Auto Load • If Average = 1, then leave the sequence as routine Copy References Slice Thickness 3.0 mm Distance Factor 10 ¢ % TR 3800.0 ¢ m Position Isocenter TE 37.00 + ms Orientation Sagittal Averages 2 ... Phase Encoding Dir. H>> F ... Concatenations Phase Oversampling 80 % Auto Align ... Averages 2 OK Cancel F 3 Identical 1 12 Effective Date: 26 Aug 2022|HOOD05162003294841 Unrestricted © Siemens Healthineers, 2022 Siemens Protocol Managing SIEMENS Healthineers USER >> head >> clinical libraries »> general t1_se_r_sag 03:25 t1_se_cor 02:25 t2_tse_tra 512 03:37 regular protocol t2_tse_dark-fluid_tra 04:50 H. • If making copies of protocols rather than adding to current protocols: Adjust protocol name to: Subtle-Routine Brain. SUBTLE ------ • It is very important to save all your work before moving to edit S-t1_se_r_sag-DNE 03:25 the next protocol. S-t1_se_cor-DNE 02:25 S-t2_tse_tra_512-DNE 03:40 DNE example S-t2_tse_tra_512-SRE 00:57 SRE example S-t2_tse_dark-fluid_tra-DNE 04:50 13 Effective Date: 26 Aug 2022|HOOD05162003294841 Unrestricted © Siemens Healthineers, 2022 Clinical Examples SIEMENS Healthineers 1.5 T MAGNETOM Systems – Brain – Sag T1 (DNE) Accelerated scan enhanced by SubtleMR Original scan Time Acq Time: Savings: 0:54 min. 28% Acq Time: Fast Acq Matrix: 1:15 320x320 Acq Matrix: Enhanced 320x320 Matrix: 320x320 NEX/Avgs: 2 NEX/Avgs: 1 14 The information shown herein refers to products of 3rd party manufacturers and thus are in their regulatory responsibility. Effective Date: 26 Aug 2022|HOOD05162003294841 Please contact the 3rd party manufacturer for further information. Unrestricted © Siemens Healthineers, 2022 Clinical Examples SIEMENS Healthineers 1.5 T MAGNETOM Systems – Knee – Cor T2 (DNE) Accelerated scan enhanced by SubtleMR Original scan Time Savings: 51% Acq Time: Acq Time: 1:50 min. 3:46 Acq Matrix: 320x224 Acq Matrix: 320x224 NEX/Avgs: 2 NEX/Avgs: 1 15 The information shown herein refers to products of 3rd party manufacturers and thus are in their regulatory responsibility. Effective Date: 26 Aug 2022|HOOD05162003294841 Please contact the 3rd party manufacturer for further information. Unrestricted © Siemens Healthineers, 2022 Clinical Examples SIEMENS Healthineers 1.5 T MAGNETOM Systems – Hip – Cor STIR (DNE) Accelerated scan enhanced by SubtleMR Original scan Time Savings: 49% Acq Time: Acq Time: 2:24 min. 4:42 Acq Matrix: 320x240 Acq Matrix: 320x240 NEX/Avgs: 2 NEX/Avgs: 1 16 The information shown herein refers to products of 3rd party manufacturers and thus are in their regulatory responsibility. Effective Date: 26 Aug 2022|HOOD05162003294841 Please contact the 3rd party manufacturer for further information. Unrestricted © Siemens Healthineers, 2022 SIEMENS Healthineers 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 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. 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