SOMATOM go.Sim & SOMATOM go.Open Pro syngo CT VA40 Improvements Job Aid

SIEMENS Healthineers syngo CT VA40 Improvements Job Aid Template Effective Date: 27 May 2019 | HOOD05162003010284 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 syngo CT VA40 Improvements Job Aid SIEMENS Healthineers Table of Contents Workflow Configuration Step 3 Contouring Improvements 5 SIEMENS Improvements Structure Sets 13 Healthineers " Improvements Patient Marking 19 -- Improvements FAST Planning 23 Improvements Respiratory Curve Editing 25 Improvements Open Interface 28 1-Click Offset Functionality 30 Improvements Dual Energy Protocols 33 SOMATOM go.Sim Improvements Direct Laser Check 35 Improvements Direct Laser Check Trending Report 39 Improvements Commissioning Protocols 42 Improvements myExam Satellite 46 Precision Matrix 48 myNeedle Companion 54 2 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers syngo CT VA40 Improvements SIEMENS Job Aid Healthineers Workflow SOMATOM go.Sim Configuration Step Courtesy of University Hospital Erlangen, Erlangen, Germany 3 Click to add footnote Effective Date: 31 Aug 2021 | HOOD05162003202139 second line Unrestricted © Siemens Healthineers, 2021 Workflow Configuration Step SIEMENS Healthineers • In the RT Configuration, there is one new tabs implemented: RT Configuration ? X • Workflow Configuration Workflow Configuration Laser Configuration POI Configuration Machine Configuration • In the Workflow Configuration, an administrator can Available Workflow Steps Selected Workflow Steps Patient Marking • control which steps are shown in the app. A Registration A Contouring B Dose Evaluation adapt the order of steps. B 4D and MR Data Management • Beam Placement • define the default step (when app is opened): C C Active step when entering the application OK Cancel 4 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers syngo CT VA40 Improvements SIEMENS Job Aid Healthineers Contouring SOMATOM go.Sim Improvements Courtesy of University Hospital Erlangen, Erlangen, Germany 5 Click to add footnote Effective Date: 31 Aug 2021 | HOOD05162003202139 second line Unrestricted © Siemens Healthineers, 2021 Contouring Improvements SIEMENS Healthineers DirectORGANS New DirectORGANS have been implemented and the Head & Neck organs have been updated to deep learning based Updated Organs New Organs • Brain** • Optic Nerve (L/R)* • Brainstem** • Optic Chiasm* • Eye Globe (L/R)** • Glottis* • Lens (L/R)** • Supraglottic Larynx (L/R)* • Parotid Gland (L/R)** • Brachial Plexus (L/R)* • Submandibular Gland (L/R)** • Seminal Vesicles* • Oral Cavity** • LN Common Iliac (L/R)* • Mandible (L/R)** • LN Internal Iliac (L/R)* • Lips** • LN External Iliac (L/R)* • Larynx (L/R)** • LN Obturator (L/R)* • LN Presacral* • Individual Ribs (24 ribs)* 6 *optional upgrade Effective Date: 31 Aug 2021 | HOOD05162003202139 **will be updated to deep learning for existing H&N organs Unrestricted © Siemens Healthineers, 2021 Contouring Improvements SIEMENS Healthineers Organ Database Organs can be filtered by Auto Contourable with Organ Database an additional filter in the organ database. Auto Contourable Search New Delete Merge Create Structure Structure Structures Margin The filter shows those structures available as auto Show All Favorites Favorites Auto Type Coding Scheme Code contour. Auto Contourable Contour Scheme Version Value Code Meaning Head and Neck Brain Available AVOIDAN FMA 3.2 50801 Brain Brainstem * Available AVOIDAN FMA 3.2 79876 Brainstem Eye Globe Left * Available AVOIDAN FMA 3.2 12515 Left eyeball Eye Globe Right Available AVOIDAN FMA 3.2 12514 Right eyeball Glottis * Available AVOIDAN FMA 3.2 55414 Glottis Larynx Available AVOIDAN FMA 3.2 55097 Larynx * Lens Left * Available AVOIDAN FMA 3.2 58243 Left lens Lens Right Available AVOIDAN FMA 3.2 58242 Right lens * Lips * Available AVOIDAN FMA 3.2 59815 Labial part of mouth Mandible * Available AVOIDAN FMA 3.2 52748 Mandible Optic Chiasm Available AVOIDAN FMA 3.2 62045 Optic chiasm Optic Nerve Left * Available AVOIDAN FMA 3.2 50878 Left optic nerve Optic Nerve Right Available AVOIDAN FMA 3.2 50875 Right optic nerve Oral Cavity * Available AVOIDAN FMA 3.2 20292 Cavity of mouth Parotid Gland Left Available AVOIDAN FMA 3.2 59798 Left parotid gland Dartid Eland Diaht Availahla 50707 Dinht naratid aland 7 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Contouring Improvements SIEMENS Healthineers Organ Database • Body regions in the organ database are sorted from Head to Toe Organ Database • Favorites are marked as favorites by checking the Star Show All Search New Delete Merge Structure Structure Structures Create Margin symbol Name Favorites Auto Type Coding Scheme Code Contour Scheme Version Value Code Meaning Head and Neck Thorax Cardiac Abdomen Pelvis Limb Body Other 8 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Contouring Improvements SIEMENS Healthineers Organ Database You can Merge Structures in the organ database Show All Search New Delete Merge Create Structure Structure Structures Margin 1. Select the multiple structures in the organ database. Name Favorites Auto Contour Type Coding Scheme Code Scheme Version Value Code Meaning UnUMIY rMM 2. Click the Merge Structure button. Inguinal Nodes Left * NA ORGAN FMA 3.2 236341 cocz Left inguinal lym Inguinal Nodes Righ' * NA ORGAN MA B.2 236339 Right inguinal lyr Internal iliac nodes NA ORGAN FMA 3.2 224275 Internal iliac lym 3. A new structure will be created, define the name and LN Common Iliac Let Available ORGAN Y FMA 3.2 224273 Left common ilia * properties. LN Common Iliac Ric Available ORGAN Y FMA 224271 Right common * LN External Iliac Left Available ORGAN FMA 3.2 229181 Left external iliac LN External Iliac Righ Available ORGAN FMA 3.2 229179 Right external ilia LN Internal Iliac Left Available ORGAN Y FMA 3.2 224279 Left internal iliac LN Internal Iliac Righ Available ORGAN FMA 3.2 224277 Right internal ilia LN Obturator Left Available OREAN SHS_STRUC 1 71830 L Set of left obtura LN Obturator Right * Available ORGAN SHS_STRUC 1 71830_R Set of right obtur LN Presacral Available FMA B. 234280 Sacral lymphatic Medial Inguinofemo NA ORGAN FMA 3.2 44304 Intermediate dee * Medial Inguinofemo * NA ORGAN FMA 3.2 276021 Left intermediate Medial Inguinofemo NA ORGAN FMA 3.2 276019 Right intermediai Obturator nodes NA ORGAN FMA 3.2 16656 Obturator lymph 9 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Contouring Improvements SIEMENS Healthineers Organ Database You can Create Margins of a structure in Organ Database the organ database Q 1. Select structures in the organ database. Show All Search ctv Delete Merge Structure Structure Structures Margin Name Favorites Auto Coding Scheme Code 2. Click the Create Margin button. Contour Type Scheme Version Value Code Meaning Other Define the margin in Uniform or Non-uniform. CTV High Risk NA 3. 99VMS_STR CTV_High Clinical Target Volume - CTV Intermediate Ris NA CTV 99VMS_STR CTV_Inter Target Volume Interm 4. Confirm the changes with OK. 3D Margin Creation O Shrink Limit Result to External Structures 5. Define the name and properties of the newly · Expand created structure. Uniform 0.5 cm .Non-uniform Anterior 0.5 cm Right 0.5 cm Head 0.5 cm Feet 0.5 cm Left 0.5 cm Posterior 0.5 cm OK Cancel 10 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Contouring Improvements SIEMENS Healthineers Organ Database – Structure Templates • Existing structure templates can be opened in the Edit Template mode by double-clicking the template or clicking the button. RT Structure Template Configuration • Changes of structures in the Organ Database will be immediately updated in the structure templates. Template Name Prostate Remarks Organs Auto Tasking Delete Row RT Structure Template Configuration Name Type Method Bladder AVOIDANCE Model LN Common Iliac Left ORGAN Model LN Common Iliac Right ORGAN Model LN External Iliac Left ORGAN Model Add Copy Edit Delete Template Template Template Template LN External Iliac Right ORGAN Model LN Internal Iliac Left ORGAN Model Name Last Modified User Remarks LN Internal Iliac Right ORGAN Model Prostate 11/15/2019 adminUser LN Obturator Left ORGAN Model LN Obturator Right ORGAN Model LN Presacral ORGAN Model Prostate AVOIDANCE Model Proximal Femur Left AVOIDANCE Model Proximal Femur Right AVOIDANCE Model Rectum AVOIDANCE Model Seminal Vesicles AVOIDANCE Model OK Cancel 11 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Contouring Improvements SIEMENS Healthineers Enhanced Color Picker • Enhanced Color Picker available in Available Colors • RT Navigator • Dose Level Presets • Organ Database • Organ Contours Dialogue • Beam Placement – Beams • Beam Placement – Beam Plan Overview • RT Configuration – Laser Configuration #FFFFA500 • Available Colors: R 255 • 48 standard colors • now nicely aligned Recent Colors G 165 B O • Recent Colors: last 8 used colors are remembered A 255 • • Advanced: Any color can be picked based on Advanced Color map Standard • • RGB sliders • RGB values (manually entered) 12 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers syngo CT VA40 Improvements SIEMENS Job Aid Healthineers Improvements SOMATOM go.Sim Structure Sets Courtesy of University Hospital Erlangen, Erlangen, Germany 13 Click to add footnote Effective Date: 31 Aug 2021 | HOOD05162003202139 second line Unrestricted © Siemens Healthineers, 2021 Improved Structure Set SIEMENS Healthineers Sort Structures / POIs by Type • In the RT Navigator, the Structures and POIs can be sorted by Type, in addition to Name. RT Navigator Findings RT Navigator Findings O. Structures POI Structures POI o Name Type o Name Type CTV 1 CTV o LaserOrigin ISOCENT ... CTV 2 CTV O TableOrigin ISOCENT ... O CTV 3 CTV ISO Hypopharynx MARKER Body EXTERNAL GTV 1 GTV PTV1 PTV . PTV1 opt. PTV PTV2 PTV PTV2 opt. PTV PTV3 PTV PTV3 opt. PTV Couchinterior SUPPORT CouchSurface SUPPORT 14 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Improved Structure Set SIEMENS Healthineers Approve Structure Set • Approve Structure Sets can be performed with a left mouse click on CT View&GO CT View&GO UNAPPROVED in the images . 2 IMA n.a. 2 IMA n.a. Stack 3x2 Stack 4x4 Follow Up MPR VRT MPR MIP MPR 2TP Compare SP F1117.5 SP A135.0 Thorax 1.50 Qr40 A3 Thorax 1.50 Qr40 A3 2/10/2021 2/10/2021 10:38:26 AM 10:38:26 AM Enter the User Name and Password in the dialog box. Auto+POI_Lung Favorite Tools • InlineApp UNAPPROVED Sim&GO Patient Marking Body Heart Approve Structure Set X The status will be changed from UNAPPROVED to APPROVED. Laser Offset in IEC(cm) Lung Lobe Left Lower • Foer X Y Z Po R Lung Lobe Leit Upper User Name| Lung Lobe Right Lower Lung Lobe Right Middle Password Series Lung Lobe Right Upper • All Structures / POIs are locked. Ream Plarament OK Cancel Favorite Tools × F • DICOM approval tags (status, data/time, reviewer) will be entered in Printing 400 Distance ROI Circle Parallel Snapshot Export Show 40 Line Ranges Image DICOM file when the Structure Set is saved subsequently. 20 Sim & GO 3D Draw colour by vaine Pappscale L+ ............ H I 2 IMA n.a. A Structure Set will be changed to UNAPPROVE as soon as a structure SP100 2 IMA n.a. SP A135 0 2 IMA n.a SP LO 0 • will be unlocked. 2 IMA n.a. MMPR mpare SP F1117.5 Thorax 1.50 Qr40 A3 2/10/2021 10:38:26 AM Auto+POI_Lung x APPROVED Body Heart 15 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Improved Structure Set SIEMENS Healthineers Save Structure Set Available in Send and Archive • Structure Sets can be saved immediately by clicking the Save InlineApp × UNAPPROVED icon: Sim&GO Patient Marking Body Laser Offset in IEC(cm) Save Structure Set ? X X Y Z Po • Define a name for the Structure Set. Structure Set Label ||Auto+POI_Lung onfor Accept the changes by clicking OK. Roam Plaromant Only the currently loaded Structure Set of the current contouring • series is saved. VII Favorite Tools OK Cancel 3D O Results created within the Sim&Go session are published to Distance ROI Circle Parallel Snapshot Export Show in • Line Ranges Image BD Absolute Offset IEC Send and Archive. Sim&GO CT View&GO 2 IMA n.a H Series × • This allows the user to send results to a transfer node other RT Navigator SP L0.0 2/10/202 Send and Archive X than the default node. 10:38:26 Structures POI Number | Preview Description Current # Images Name Type A - CT. 2/10/2021 RIP Thorax [factory](Adult) IsoCenter ISOCENTER -4 97 Thorax 1.50 Qr40 A3 192 Topegram 0.60 1:20 Auto_Lung_20210210_104034 Auto+POI_Lung_20210210_104303 88 Send Close 16 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Improved Structure Set SIEMENS Healthineers Merging Structure Sets • Two Structure Sets can be merged to one Strucure Set. Sim&GO Patient Marking Load Structure Sets Laser Offset in IEC(cm) In Load Structure Sets dialog you will find the merge button. X Y Z PO: • Structure Sets for Loaded Images Lazer On/of Lazer Mar Brea Series Description Approval Status Reviewer Name Creation Date Creation • The selected structure set is merged with the currently Kopf_HNO 2.0 B31f 4/26/2013 3:22:38 Raam Placement loaded structure set instead of replacing it completely. StructureSet UNAPPROVED 11/6/2019 9:17:40 VSimStructureSet APPROVED ak 5/7/2013 2:47:23 Favorite Tools 3D Distance ROI Circle Parallel Snapshot Export Show in Line Ranges Image 3D Sim&GO RT Navigator Structures POI Load Merge Cancel o Type IsoCenter ISOCENTER 17 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Improved Structure Set SIEMENS Healthineers Merging Structure Sets + POI • The DirectORGANS Structure Set will automatically merge with the POI structure when the patient is closed in Sim&GO: • Results seen in browser is StructureSet_1 (only the POI) and Auto+POI_template name (DirectORGANS and POI) Series Series Number Series Description Modality Series Instance UID 601 CT Raw data CT 1.3.12.2.1107.5.1.7.999999.30000020082417152145600000150 Topogram 0.60 Tr20 cor CT 1.3.12.2.1107.5.1.7.999999.30000020082417152145600000152 Thorax 1.50 Or40 A3 CT 1.3.12.2.1107.5.1.7.999999.30000020082417152145600000342 2 StructureSet_1_20200826_134209 RTSTRUCT 1.3.12.2.1107.5.1.7.999999.30000020082613414898200000020 Auto+POI_thorax 20200826_134248 RTSTRUCT 1.3.12.2.1107.5.1.7.999999.30000020082613415410600000007 • If the DirectORGANS Structure set and POI merge happens when the dataset is opened in Sim&GO, the results seen in the browser are: • Auto_TemplateName (only DirectORGANS) • Auto+POI_TemplateName (always DirectORGANS + POI) Series Number Series Description Modality Series Instance UID 601 CT Raw data CT 1.3.12.2.1107.5.1.7.999999.30000020082417160201600000144 Topogram 0.60 Tr20 cor CT 1.3.12.2.1107.5.1.7.999999.30000020082417160201600000146 50:0:40 A2 2 12:22 11075 1 7:000000 20000020082417160201600000286 2 Auto_thorax 20200826_135205 RTSTRUCT 1.3.12.2.1107.5.1.7.999999.30000020082613415410600000009 2 Auto+POI_thorax 20200826_135218 RTSTRUCT 1.3.12.2.1107.5.1.7.999999.30000020082613414898200000057 18 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers syngo CT VA40 Improvements SIEMENS Job Aid Healthineers Improvements SOMATOM go.Sim Patient Marking Courtesy of University Hospital Erlangen, Erlangen, Germany 19 Click to add footnote Effective Date: 31 Aug 2021 | HOOD05162003202139 second line Unrestricted © Siemens Healthineers, 2021 Improvements Patient Marking SIEMENS Healthineers POI Creation and Editing Workflow • POI Minitoolbar was redesigned to improve usability Absolute Offset IEC (new icons and names) * x 0.61 Y -24.33 ¢ Z 4.17 cm Set POI Move POI A ▪ Create at Crosshair: Creates new point at current crosshair position Absolute Offset IEC B ▪ Set To Crosshair: Sets the selected POI to the × current crosshair position 0.00 -20.90 ¢ -94.90 Create at Set To Manual cm Crosshair Crosshair Move N A B C C ▪ Manual Move: Enables moving of selected POI RT Navigato Findings D D ▪ New POI: Create „empty“ POI (analogous to New Structure) Structures POI O Name Type O LaserOrigin ISOCENT ... o TableOrigin ISOCENT ... o ISO Hypopharynx MARKER 20 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Improvements Patient Marking SIEMENS Healthineers Laser Configuration • Now there is a clear distinction between the two workflows. RT Configuration ? X • No default Calibration Offset set. Workflow Configuration Laser Configuration POI Configuration Machine Configuration Workflow Type Markerless workflow .Marker workflow Workflow Setup Create Laser Origin on Startup Default Color and Name of Laser Origin LaserOrigin Create Isocenter on Startup Default Color and Name of Isocenter IsoCenter Laser System Properties 2 movable laser axes Calibration Offset mm The calibration offset directly impacts the Export to Laser System O calculation of the treatment isocenter coordinates. A change in this value can lead to incorrect patient Export as LAP File Format 2.0 marking. Export Path Export as RT Plan Plan Name Network Node Enable Direct Laser mode IP Address localhost Port 2000 Offset Unit cm 6 mm OK Cancel 21 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Improvements Patient Marking SIEMENS Healthineers Calibration Offset (Laser Offset) • In case the Calibration Offset A Laser Calibration Offset AF X A • will be set or changed in the RT configuration, a pop-up message appears. Please ensure that the correct calibration offset value is entered at the scanner in - the Laser System Configuration tab in Technical Configuration, RT Laser. OK B Laser Calibration Offset AF X B • did not match in the RT configuration and the Technical Patient marking is not possible. The laser calibration offset values entered at the -- configuration, a pop-up message appears. scanner and in the RT application do not match. Remove the patient from the table, measure the calibration offset value then enter the value in the RT application and at the scanner. OK 22 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers syngo CT VA40 Improvements SIEMENS Job Aid Healthineers Improvements SOMATOM go.Sim FAST Planning Courtesy of University Hospital Erlangen, Erlangen, Germany 23 Click to add footnote Effective Date: 31 Aug 2021 | HOOD05162003202139 second line Unrestricted © Siemens Healthineers, 2021 Improvements SIEMENS Healthineers FAST Planning 2021.02.08-10:53:44-STD-Trauma H 2021.02.08-10:53:44-STD-1 3.12.2.1107 5.1 7 SOMATOM X.ceed +11/18/1858, 0, 162Y syngo CT VA40A #AC 0eela6b90c3d4 HFS • New FAST planning width parameter Full. 2/8/2021 10:55:45.75AM TP1 -970.2 1 IMA 1 TP2 -1,256.3 TOP 101 LEN 286.1 FOV 500×500 • The maximum FoV will be used with the FAST Planning Width Full. TP -750 0 • Not available for tilted scan ranges. R • Length of the scan will be determined by the FAST Planning algorithm. Users may 10cm still need to adjust the length. KV Sn100 mA 55 A TI 3.32 512.0 0/0 C 350 Simulator Filter Sn 50 Recon Favorites General Recon Recon&GO Image Impression | Recon Box Physio Recon Auto Ta - - Scan/Recon Slice Thickness Increment [mm] [mm] Window@120kV Kernel FAST Planning FAST Planning Width Inline Results Multi Recons Thorax 1.50 Qr40 A3 1.50 1.50 Mediastinum Qr40 Thorax - Chest Full RT Automatic ... "None Wide Narrow Full 24 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers syngo CT VA40 Improvements SIEMENS Job Aid Healthineers Improvements SOMATOM go.Sim Respiratory Curve Editing Courtesy of University Hospital Erlangen, Erlangen, Germany 25 Click to add footnote Effective Date: 31 Aug 2021 | HOOD05162003202139 second line Unrestricted © Siemens Healthineers, 2021 Improvements SIEMENS Healthineers Respiratory Curve Editing • A Open the Edit Mode A • B Move the sync Points to an other position 13 rpm • C Delete exciting sync Points Min: 12 Max: 15 • D Add additional syn Points • E Disable sync Points, the points are still there and hidden • F Reset all changes and go back to the original curve • Respiratory curve editing is only available for the standard 4D spiral scan (not Directi4D). • Respiratory curve editing is done per scan range and not per recon job. B C D E F X Move Delete Insert Disable Reset 12 13 14 12 13 rpm Min: 12 Max: 15 26 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Improvements SIEMENS Healthineers Respiratory Curve Editing A • Disable sync Points state for amplitude based reconstruction 12 a 12 rpm KIOSK Mode (restart Min: 12 Max: 12 B • Disable sync Points state for phase based reconstruction 12 × KIOSK Mode (restart C • Disable sync Points state showing both amplitude and phase based recon - the user has planned phase based and amplitude based recons 12 12 X KIOSK Mode (restart 27 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers syngo CT VA40 Improvements SIEMENS Job Aid Healthineers Improvements SOMATOM go.Sim Open Interface Courtesy of University Hospital Erlangen, Erlangen, Germany 28 Click to add footnote Effective Date: 31 Aug 2021 | HOOD05162003202139 second line Unrestricted © Siemens Healthineers, 2021 Improvements SIEMENS Healthineers Open Interface • It is possible to configure the x-ray on duration check during the import of the respiratory gating curve for the open interface. Box is checked: • X-ray duration in the breathing curve file is compared to the x-ray on duration of the scan range. • Import is only allowed if these match. Box is checked: ▪ The x-ray on duration is not compared. ▪ Import is allowed even if the durations do not match. SIEMENS 0 X Healthineers 3 O Clinical Configuration Scan Recon SIEMENS Meotthineers MS-CT-APPSX09 / syadmin Free (Restricted Remote Access) Diagnose Installation ₭º Technical Configuration Quality Assurance Clinical Configuration Examination Configuration Respiratory Configuration Dose Respiratory Gating System Cardiac Open Interface Anzai Respiratory Varian RGSC Image Siemens Healthineers Peak Detection for Spiral Range Table Automatic phase recalculation using Siemens Healthineers peak detection Patient Respiratory Curve Import Check General Allow respiratory curve file import only when the duration of the performed scan and the X-ray signal recorded in the respiratory curve file match. Audio Data Preprocessing 29 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers SIEMENS Healthineers ... syngo CT VA40 Improvements Job Aid 1-Click Offset Calibration offset Functionality - - CT Isocenter UMAIUM 90.Sim (Image plane) + + RT Laser home position Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 1-Click Offset Functionality SIEMENS Healthineers • Reproducible RT patient positioning by enabling 1-click table movement between External RT Laser and the CT Isocenter Z-offset depends on installation (e.g.: 50cm) + + + External RT Laser home position + CT Isocenter (Image plane) 31 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 1-Click Offset Functionality SIEMENS Healthineers • On the mobile table, click Table Position to open the dialog. • Move to CT Laser SIEMENS Healthineers Guthrie, Aron X 21.01.1980 • The current table position and height are saved, allowing the user to return to the saved table position when the function is pressed. Adult Child Anatomy Vascular Others • The play button on the remote control flashes by pressing play, the table will move the configured distance into the gantry. Table Position × ICT Mode - Move Table Top Only • Move to RT Laser -1000 mm 400 mm • The table is moved out the gantry to the RT laser position (previously Save as A Save as B stored table position and height). A Table Position [mm] Table Height [mm] Move to A 400.0 100.0 Table Position [mm] Table Height [mm] -400.0 100.0 Move to B • In order to cancel either the Move to CT Laser or Move to RT Laser operation, Radiotherapy Table Movement the dialog has to be closed (same behavior as with Move to A/B). Calibration Offset [mm] : 500.0 Move to CT Laser Move to RT Laser Move to CT Laser = - 1000 PAT Back Go Move to RT Laser 32 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers syngo CT VA40 Improvements SIEMENS Job Aid Healthineers Improvements SOMATOM go.Sim Dual Energy Protocols Courtesy of University Hospital Erlangen, Erlangen, Germany 33 Click to add footnote Effective Date: 31 Aug 2021 | HOOD05162003202139 second line Unrestricted © Siemens Healthineers, 2021 Improvements SIEMENS Healthineers Dual Energy Protocols RTP Head DE and RTP Head and Neck DE have been adapted: • Both protocols consist of a single energy scan that can be used for dose calculation and a TwinSpiral DE scan with a 40 keV monoenergetic spectral recon for tumor delineation. • DE scan should used together with contrast agent. • To achieve a constant contrast distribution, it is important that the delay between injecting the contrast and the start of the DE scan is greater than 75 sec. ➢ Decision tree informing user about delay is added to DE scan. Scan Strategies Decision Tree TwinSpiral contrast medium [factory] Information for TwinSpiral + Add Strategy Info Level Important Information Info Text To ensure constant contrast distr + Add Parameter To ensure constant contrast distrubution, the delay needs to be larger than 75 seconds. RTP Head DE [factory] (Adult) Topogram Off Head for dose calculation Off Head for contouring Off TwinSpiral contrast medium [factory] RTP Head and Neck DE [factory] (Adult) Topogram Off Head and Neck for dose calculation Off Head and Neck for contouring Off TwinSpiral contrast medium [factory] Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers SIEMENS syngo CT VA40 Improvements Healthineers Job Aid Improvements Direct Laser Check .................... SOMATOM go.Sim Courtesy of University Hospital Erlangen, Erlangen, Germany 35 Click to add footnote Effective Date: 31 Aug 2021 | HOOD05162003202139 second line Unrestricted © Siemens Healthineers, 2021 Improvements SIEMENS Healthineers Direct Laser Check • Progress bar has been implemented. • The bar is shown from the end of the scan until the results have been calculated and get displayed. SIEMENS Healthineers Direct Laser Check System Check Direct Laser Check X 1. Enter the scan room. Close 2. Place the RTP phantom on the table using a Lok-Bar. 3. Manually adjust the longitudinal table position until the Direct Laser lights are aligned with the center groove on the top and sides of the RTP phantom. 4. Manually adjust the table height until the Direct Laser lights are aligned with the grooves on both sides of the phantom. 5. Exit the scan room. 6. Press GO to start the Direct Laser Check. 7. The table will automatically move to the scan plane. 8. X-rays will be produced during the procedure. 9. The table will automatically move back to the Patient Marking Laser plane at the end of the procedure. Direct Laser Check Progress Repeat Next Cancel 36 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Improvements SIEMENS Healthineers Direct Laser Check Siemens Service 9YVPZ-2HBCG Service 11061670| 130004 SOMATOM go Open Pro • Visual verification is directly available in Direct Laser Check. 1/1/1996. 0 syngo CT VA40A 6/23/2020 30 HFS 1:51:06:01 PM 101 IMA 335 2AC 100 26 • For visual verification the image can be windowed. TP -782.9 • Can use image grid to visually verify the results. 10cm -KV 120 Eff. mAs 208 TI 0 83 GT 0.0 SL 1.0/64×0.6 30 600 0/0 600 Br36f?.n1 :02780:0Ah AS1afA HD FOV 37 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Improvements SIEMENS Healthineers Direct Laser Check Direct Laser Check • New messages in case the Direct Laser Check Close failed Z Yaw Roll At Pitch IEC Coordinate System Value Tolerance Unit Status X -0.2 +/- 1 mm V Y -2.2 +/- 1 mm X -0.5 +/ - 1 mm V Pitch (X) -0.3 +/- 0.3 deg Roll (Y) O +/- 0.3 deg Yaw (Z) +/- 0.3 deg V O The Direct Laser Check failed, Please contact a Siemens Healthineers service technician. Repeat OK Cancel X Please check the images in image segment and press OK to continue. 38 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers SIEMENS syngo CT VA40 Improvements Healthineers Job Aid Improvements Direct Laser Check .................... Trending Report SOMATOM go.Sim Courtesy of University Hospital Erlangen, Erlangen, Germany 39 Click to add footnote Effective Date: 31 Aug 2021 | HOOD05162003202139 second line Unrestricted © Siemens Healthineers, 2021 Improvements SIEMENS Healthineers Direct Laser Check Trending Report Results for Pitch rotation • Trending Report will be available in the Service Report section. [deg] 1.0 or more Legend • 6 graphs shall be available showing the Direct Laser 0.9 check results over time (X, Y, Z, Roll, Yaw and Pitch). 0.8 0.7 • Direct Laser Check will be shown in a table format. 0.6 Last and valid 0.5 scan on that day 0.4 A maximum of 30 results (Direct Laser Check, not 0.3 • one Date) can be saved as part of the report 0.2 Previous scan on 0.1 that day ▪ E.g., if 30 results are configured and result 0.0 ...... ......................... ................... .............................. .................. number 31 is created, the 1st result will be -0.1 -0.2 deleted Several scans 0.3 with the same -0.4 result on that day -0.5 0.6 -0.7 -0.8 -0.9 -1.0 or more [Date] 10.06.2020 11.06.2020 13.06.2020 18.06.2020 14.06.2020 15.06.2020 16.06.2020 19.06.2020 12.06.2020 17.06.2020 28.05.2020 20.06.2020 29.06.2020 26.06.2020 29.05.2020 24.06.2020 27.06.2020 22.06.2020 25.06.2020 30.06.2020 28.06.2020 23.06.2020 40 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Improvements SIEMENS Healthineers Direct Laser Check Trending Report Direct Laser check results • All Trending Reports/results are shown in a table sorted by date. IEC [mm] - Tolerance +/-1 IEC [deg] - Tolerance +/-0.3 Date • A The orange exclamation mark means the result is × Y Pitch (X) Roll (Y) Yaw (Z) N exactly within the tolerance value. 26.06.2020 A 4.0 -2.2 -0.1 0.0 0.0 • B The red cross means the result has exceeded the tolerance. 26.06.2020 0.0 1.0 0.0 -0.1 0.0 0.0 No icon means the result is within tolerance. 26.06.2020 0 B 1.0 0.0 -0.1 0.0 0.0 • C It is possible to export the result table in CSV 21.09.2020 0.0 1.0 0.0 0.0 -0.1 0.0 • format (dialog pops up behind the Service report dialog). 21.09.2020 0.0 1.0 0.0 0.0 -0.1 0.0 File Dewnlead B Do you want to open or save this file? C X are: 2025.09 23.211144_ResortDirectLaterCheckc. csv LEcrosoft Excel Comma Separated Va CSV File Oper Save Cancel Back Refresh Show Verbose Show PDF While fies bom Be Hlemit can be useful, some lles can potertialy hann your computer. If you do not sud the source, do not open or 41 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers syngo CT VA40 Improvements Organ and tumor Job Aid segmentation Improvements Image- Therapy guided decision Commissioning therapy & treatment Protocols planning Dose optimization O Courtesy of University Hospital Erlangen, Erlangen, Germany 42 Click to add footnote Effective Date: 31 Aug 2021 | HOOD05162003202139 second line Unrestricted © Siemens Healthineers, 2021 Improvements SIEMENS Healthineers Commissioning Protocols 2 9- 1004 1250 OUT 2 D tore 1750 OUT • RTP Direct Density commissioning protocol available 59 Wer OUT MO Lang Enak W MD Lung Exhale OUT 62 3 Lung Instale OUT 62 9 Musde IN 549 Muscle OUT 22-'-Oigne utbuteur • 3 recons available for different energy levels: • Qr40 (with iBHC bone) O O • Sd40 (electron density, iBHC bone integrated) • Sm40 (mass density, iBHC bone integrated) RTP Direct Density co ... ¡ Recon Ranges Topogram Topogram IF supine HF prone HF right HF lett 120 kV FF supine FF prone FF right FF left Length 512 mm 70 kv CIDIvol SPR (32 cm) 0.01 mGy DLP 0.5 mGy cm MA 80 KV Sn 100 80 KV Exposure Time 3.32 $ =120 k\ . 70 kV 100 KV -80 kV = 100 k\ 140 kV 140 kV 43 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Improvements SIEMENS Healthineers Commissioning and Quality Assurance with End-To-End Test Phantom positioning & Manual Manual CT acquisition segmentation evaluation Check & approval O G O O O O Treatment Treatment planning delivery Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Improvements SIEMENS Healthineers Dual Energy Commissioning Protocol To help customers feel more comfortable with Dual Energy, we have a new RTP DE commissioning protocol: • Standardized parameters for DE scans. • Customer gets overview on options available for DE (different monoenergetic keV levels, Rho/Z images). • Customer can evaluate DE images in TPS (look at differences in image quality, decide which option to use for planning). • Please note: DirectORGANS can only be used with spectral recons. Scan/Recon Recon&GO X Inline Options X Scan/Recon Spectral Spectral Inline Results Multi Recons Fix Axial Inline Viewing High Applicatio Recon Recon kev Results Direction Resolution n Class Data Set Thick Axial RTP DE commissioning [fact (Adult) Topogram 80/Sn140 80/Sn140 1.50 Qr40 A3 None None None On None 80/5n140 1.50 Qr40 A3 Monoenerget .. 50 None None On None 80/5n140 1.50 Qr40 A3 Monoenerget .. 70 None None On None 80/Sn140 1.50 Qr40 A3 Monoenerget. 100 None None On None 80/5n140 1.50 Qr40 A3 ax None DE Parallel Ra ... None DE Parallel R ... Feet to He ... Off Rho/Z Rho; Z On 100/Sn 140 100/Sn140 1.50 Qr40 A3 None None None On None 100/Sn140 1.50 Qr40 A3 Monoenerget 50 None None On None 100/Sn140 1.50 Qr40 A3 Monoenerget. 70 None None On None 100/Sn140 1.50 Qr40 A3 Monoenerget. 100 None None On None 100/Sn140 1.50 Qr40 A3 ax None DE Parallel Ra .. None DE Parallel R ... Feet to He ... Off Rho/Z Rho; Z On Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers syngo CT VA40 Improvements SIEMENS Job Aid Healthineers Improvements SOMATOM go.Sim myExam Satellite Courtesy of University Hospital Erlangen, Erlangen, Germany 46 Click to add footnote Effective Date: 31 Aug 2021 | HOOD05162003202139 second line Unrestricted © Siemens Healthineers, 2021 Improvements SIEMENS Healthineers Second Workplace – myExam Satellite* • Centrally shared database with CT scanner • Postprocessing licenses from CT console are mirrored CT console • Client computer, extra mouse, monitor and 2nd console keyboard included New in VA40 • Up to 2 satellite consoles can be purchased server 3rd console • During scan acquisition, another user / further users can work at a satellite console: E.g, the oncologist can open a patient and look at the DirectORGANS coming from the scanner, edit or add structures, and prepare the patient for the next step. 47 Effective Date: 31 Aug 2021 | HOOD05162003202139 *optional Unrestricted © Siemens Healthineers, 2021 SIEMENS Healthineers syngo CT VA40 Improvements SIEMENS Job Aid Healthineers Precision Matrix SOMATOM go.Sim Courtesy of University Hospital Erlangen, Erlangen, Germany 48 Click to add footnote Effective Date: 31 Aug 2021 | HOOD05162003202139 second line Unrestricted © Siemens Healthineers, 2021 Precision Matrix SIEMENS Healthineers at Full Scan FOV (60 cm) Precision Matrix: The matching reconstruction for the highest acquired spatial resolution Reconstructions of images with matrix sizes of up to 1024 x 1024 and 768 x 768, useful to keep spatial resolution high even at full scan FOV or even HD FOV Powered by myExam Companion Powered by myExam Companion, the right image matrix size for axial and 3D reconstructions is automatically selected depending on the FOV offering a balance between storage demand, reconstruction 512 x 512* 1024 x 1024 time and spatial resolution Images Courtesy of nordstrahl, Praxis für Strahlentherapie, Nürnberg, Germany *By default, the RT protocols have the matrix 512 x 512. 49 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Precision Matrix SIEMENS Healthineers Role of Matrix Size in High-Resolution Imaging In addition to the kernel selection, the size of the volumetric image pixel (voxel) plays an important role for image resolution. The in-plane size is determined by the displayed field of view (FOV) and the size of the reconstruction matrix. The reconstruction matrix is a two-dimensional matrix with a certain number of rows and columns. Typically, it is a square matrix with an equal number of rows and columns. 512 x 512 768 x 768 1024 x 1024 Images Courtesy of University Hospital of Erlangen, Erlangen, Germany In most CT scanners and clinical applications, the reconstruction matrix is fixed to 512 x 512 voxels (“512”). Sometimes smaller (“256”) or larger matrices are available, like 1024 x 1024 voxels (“1024”) or 768 x 768 voxels (“768”). 50 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Precision Matrix SIEMENS Healthineers Role of Matrix Size in High-Resolution Imaging The Matrix Size can be selected via a dropdown list under the Recon Box tab card. econ&GO | Image Impression Recon Box Physio Recon Auto Tasking FAST Planning FAST Planning Matrix Size Matrix Width Height Width [mm] [mm] The list contains Auto, 256, 512, 768, and 1024. Thorax - Lung Wide Auto (512) Square 300.00 300 Auto mode: Auto (512) The matrix size displayed in brackets shows the calculated 256 512 appropriate matrix size according to selected kernel and 768 field-of-view size. 1024 The large matrix size is compatible with DirectORGANS and Multiphase 4D data set. 51 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Precision Matrix SIEMENS Healthineers Role of matrix size in high-resolution imaging Precision Matrix also offers Automode. Parameters to be considered Benefits with Automode The output of the Automode is the best matrix · Image visualization optimized size that maintains the sharpness of the · Scan protocol · Matrix size optimized reconstruction kernel within the final CT image · Field of view Reconstruction kernel · Reconstruction time optimized while minimizing reconstruction effort and image · Reconstruction method · Image size optimized data size. · Number of reconstructions Automode on optimized 52 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 Precision Matrix SIEMENS Healthineers Role of Matrix Size in High-Resolution Imaging SIEMENS It is possible to limit the selection for the Auto- Healthineers MS-CT-APPSX09 / syadmin Free (Restricted Remote Access) mode setting a Minimum / Maximum Matrix Diagnose Installation 8.ª Technical Configuration Quality Assurance Clinical Configuration Size under Clinical Configuration. Examination Configuration Image Configuration Dose Windowing Matrix Size Common This configuration will be supported by the Cardiac Respiratory Minimum Matrix Size 512 application specialist. Maximum Matrix Size 256 Image 512 Table SIEMENS Healthineers MS-CT-APPSX09 / syadmin Free (Restricted Remote Access) Diagnose Installation 8.ª Technical Configuration Quality Assurance Clinical Configuration Examination Configuration Image Configuration Dose Windowing Matrix Size Common Cardiac Respiratory Minimum Matrix Size 512 Image Maximum Matrix Size 1024 512 Table 768 Patient 1024 General 53 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021 HA SIEMENS Healthineers syngo CT VA40 Improvements Job Aid myNeedle Companion Multiple needle path planning & image Fusion 635 635 119 119 Fused image of non-contrast i-spiral scan to monitor the needle approach with contrast 54 enhanced planning scan Effective Date: 31 Aug 2021 | HOOD05162003202139 Image Courtesy of University Hospital Erlangen, Erlangen, Germany Unrestricted © Siemens Healthineers, 2021 myNeedle Companion for CT SIEMENS Healthineers myNeedle Guide 2D* SIEMENS ... Easily plan in-plane and angulated procedures Healthineers' ... Demo, Intervention * 12/7/1964 F 2020.12.07-15:03:28-STD -. CH ? @ along the z-axis Define Path 1 Continue planning or go to Progress Needle' step Demo, Intervention SOMATOM X.ceed syngo CT VA40A Demo, Intervention SOMATOM.ceed Demo, Intervention SOMATOM X.ceed Angulated path planning and guidance along 2020.12.07-15:03:28-STD ... HFS 2020.12.07-15:03:28-ST. syngo CT VA40A 2020.12.07-15:03:28-STD ... i-Spiral Abdomen 5.00 Br ... HFS *12/7/1964 i-Spiral Abdomen 5.00 B .. HFS i-Spiral Abdomen 5.00 Br ... syngo CT VA40A • CT *12/7/1964 *12/7/1964 CT CT 12/7/2020 3:59:39 PM 12/7/2020 12/7/2020 the z-axis 16 3:59:39 PM 3:59:39 PM 15 14 • Visual guidance for targeted needle placement TTTTTT • Dedicated layouts • With space for reference images (other modalities or prior(s)) • FAST i-Sequence mode with a maximum coverage of 15 mm F F F • 3 x 3 mm Center 60 BEE Feet BEE Head • 3 x 5 mm 55 Effective Date: 31 Aug 2021 | HOOD05162003202139 *For more information, please visit the myNeedle Companion online training material on PEPconnect Unrestricted © Siemens Healthineers, 2021 myNeedle Companion for CT SIEMENS Healthineers myNeedle Guide 3D* Simplify advanced workflows with powerful 3D guidance Continue planning or go to "Progress Needler stop • Plan and navigate double-angulated and multiple-needle procedures in 3D on MPRs with real-time feedback • Switch quickly between patient- and path-aligned views Center • Monitor the needle progression with the i-Spiral scan mode ALM Go to Settings to activate Window i-Spiral scan mode for flexible volume coverage 56 Effective Date: 31 Aug 2021 | HOOD05162003202139 *For more information, please visit the myNeedle Companion online training material on PEPconnect Unrestricted © Siemens Healthineers, 2021 myNeedle Companion for CT SIEMENS Healthineers i-Fluoro For precise and fast placement in even the most complex, moving anatomies, the i-Fluoro scan mode delivers real-time needle guidance in 2D. • At up to 10 frames per second • HandCARE real-time dose modulation / reduction offers significant protection to both radiologist and patient1 CO. X-ray off X-ray off X-ray off X-ray on X-ray on X-ray on Image Courtesy of University Hospital of Erlangen, Erlangen, Germany 57 Effective Date: 31 Aug 2021 | HOOD05162003202139 *For more information, please visit the myNeedle Companion online training material on PEPconnect Unrestricted © Siemens Healthineers, 2021 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. 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 Healthcare GmbH 2021 Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Telephone: +49 9131 84-0 siemens-healthineers.com 58 Effective Date: 31 Aug 2021 | HOOD05162003202139 Unrestricted © Siemens Healthineers, 2021