syngo Application Software (VE2 and higher): syngo CTO Guidance Job Aid

SIEMENS Healthineers syngo Application Software VE20 syngo CTO Guidance R 10 cm A Effective Date: 05.29.2020| HOOD05162003097073 Effective date: 05.29.2020 | HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 Unrestricted © Siemens Healthcare, 2020 syngo CTO Guidance SIEMENS Healthineers Table of Contents Introduction 3 3D Sharing DIUNSER Settings Menu Cluse Im ... Save Bu ... Saspsho. : 3D Polyli ... Interacti. Exportt ... Paralel H FFS CT syngo CTO Guidance workflow overview 5 syngo CTO Guidance workflow steps 6 Load the planning volume to 3D Sharing 9 Select the CTO Guidance workflow 11 10 cm A VRT 364 010 C 294 FPH CT HFS WCALO 30 SL D.B MPR CV 2 Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo CTO Guidance SIEMENS Healthineers Introduction A chronic total occlusion (CTO) occurs when a coronary artery is Live A 3D Sharing Q HFS completely blocked for 3 months or longer resulting in a significant Application Control decrease in blood flow. AgalEaban Check the segmentation result If necessary, segment additional vessels and/or edit vessel conterlines ." guidance The syngo CTO Guidance application provides the ability to safely plan Identity Mesael: Tools Dudorsais Layouts Vessels and perform a PTCA procedure under fluoroscopic or angiographic objocls image guidance. Vessel Colar WOUS CX 3 CX 1 CX 7 syngo CTO Guidance will use a CT volume to create a segmentation of Clese the coronary arteries or use an existing segmentation created by the syngo .via CT Coronary Analysis application. Introduction 3 Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo CTO Guidance SIEMENS Healthineers Introduction Based on the segmentation, the coronary tree will be created. This Livo A Q 3D Sharing Q E Browser MonE Coco In Savo Do ... Ssapsho .. : 3D FolyL .. Interactl ., Exportt.: Psal CT ............................................................................................ HFS CT HF8 structure can be displayed and can be used as a roadmap during a percutaneous intervention. Application Control Application Select vessel overlays for display Then select vessel in image Navigate along vessel by moving the marker. The coronary tree visualizes the course of the artery distal to the Guidance Coronary Analysis Tools waarom Layouts 10 cm Show Vessel blockage and calcifications which cannot be visualized in angiography Caer RCA LAD CX HES images. It also provides information about possible channels across the blockage. Clese syngo CTO Guidance is not used for CTO detection, it is only used to provide guidance during a recanalization procedure. SL 1.5 FEDE / GRAN 52 Introduction 4 Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo CTO Guidance SIEMENS Healthineers Workflow Overview 1 2 3 Planning: Registration: Overlay: Select the 3D Registration icon. Using syngo 3D Roadmap the live image is • Guidance: A warped vessel view (COROwave) • • shows all of the coronary arteries making up overlaid to the 3D volume or you can • Use syngo 3D registration to register the 3D the segmented coronary tree. The planning volume with the examination overlay the Vessel Tree to the live image. centerlines are color-coded to indicate the patient so that it can be used for overlay. • You may adjust the C-arm position amount of foreshortening. according to the image display. Identify Vessels: You can create or refine • You may adjust the volume view according • parts of the segmented coronary vessel tree. to the C-arm position. • Coronary Analysis: You can analyze a single vessel segment using a warped vessel view as well as a curved MPR view and a cross- sectional view. You can also perform distance measurements. Workflow 5 overview Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo CTO Guidance SIEMENS Healthineers Workflow steps Load the 3D volume: • Load the 3D volume (CT volume) to the 3D Sharing (see pages 9 and 10). Application Control Start CTO Guidance: • Select the CTO Guidance workflow from the Workflow Header or from the Application Control window (see pages 11 and 12). • The Vessel Tree is automatically detected and displayed in the Guidance workflow step. ... == 10 cm 29 / CRANS Identify Vessels: Application Control • Select the Identify Vessel icon. • You can see the original CT volume data in three MPR views and a VRT view. • A curved MPR view and a cut plane MPR view enable you to focus on a single vessel segment. • To add a Vessel Tree, select the Add icon or select a Vessel Tree segment in the Vessel list. • To add a vessel segment, select the New Vessel icon. Colo • To edit a vessel, select the Edit Vessel icon. Hint: to return to the Guidance workflow * * + step, select Close in the bottom right corner. • To prune a vessel, select the Prune Vessel icon. Workflow 6 Steps Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo CTO Guidance SIEMENS Healthineers Workflow steps Coronary Analysis: • Select the Coronary Analysis icon. • You can see the warped vessel view in order to select a vessel segment. • A curved MPR view and a cut plane MPR view enables you to focus on a single vessel segment. • To perform distance measurements, select the measurement icon. Hint: to return to the Guidance workflow step, select Close in the bottom right corner. Perform syngo 3D Registration: • Select the syngo 3D Registration icon. • Select 3D/3D Registration (syngo 3D Fusion) or select 2D/3D registration (syngo 2D/3D Fusion). Application Control Overlay: Applicatice × Overlay the live image on 3D Apolcancan Compare Live image to CT volume side-by-side 2000 Registration is recommended to increase the accuracy. • Select the Live on 3D icon in the workflow header in the Segment Menu or in the Application Tech Bockwerts Control dialog box. Show Vessel RCA + LAD • To adjust 2D/3D blending, drag the slider. .... • To select another frame from the scene, press the ← or → key on the keyboard. CH • To invert the grayscale of the 2D image, click the Invert 2D icon. Workflow 7 Steps Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo CTO Guidance SIEMENS Healthineers Workflow steps Overlay: Application Control 3D Sharing Overlay the vessel tree to the Live image: • Select the Objects on Live icon. Application CTO Guidance X The 3D objects are projected to the perspective of the C-arm position. They are displayed Close Application Object List • Compare Live image to CT volume side-by-side, in the Live segment. 2D3D Registration is recommended to increase the accuracy. Show Vessel Guidance Colo RCA Tools Bookmarks Layouts LAD CX Show Vessel Color > BP RCA You may hide or show individual You may hide or show the whole LAD vessel centerlines. Select the vessel tree. CX BP check mark next to the vessel. 3D Toggle 300 folows Pare ABS C-ami Coronary Analysis • 3D image follows the C-arm position. 3D Objects on Live on 3D Uve Registra 3D • Adjust the C-arm position to the 3D image. Workflow 8 Steps Effective Date: 05.29.2020| HOOD05162003097073 Unrestricted © Siemens Healthcare GmbH, 2020 syngo CTO Guidance SIEMENS Healthineers Load the planning volume 1 If you are using a pre-procedure 3D volume for planning, 3D Sharing Browser E Images Settings Menu Close Im ... Save Bo 3D Polyli. Snapsho ... 3D Polyli Interacti Export t .. Parallel Viewing Review loaded or acquired volumes. Review and Processing New acquisitions will replace existing volumes. Bookma Layouts import the data to the patient browser before starting Image Directory 3D Sharing ? x V Overlay. Send To SelectAll Deselect ... Multiple. All Scenes + 3D 3D REF/ Bookmarks Key Images Custom December 11, 2015, CTA Herz Load the planning volume to the 3D Sharing segment 2 If the patient is the currently registered examination: VOLUME 1. Open the Image Directory in 3D Sharing. 2. Select the exam data, when the 3D volume was 1: DS_CorAdSeq 0.75 1 ... created. Load the 9 planning Effective Date: 05.29.2020| HOOD05162003097073 volume Unrestricted © Siemens Healthcare GmbH, 2020 syngo CTO Guidance SIEMENS Healthineers Load the planning volume If the 3D volume data is not under the current examination, 1 Live A T. 3D Sharing Q = EP for example if the data is from another hospital and not Viewing Review loaded ot acquired valunes New acquisitions will replace existing volumes. poukind. Laut matched to the current patient: Patient Browser 3 x Local Data 1951 2 (1) Test $ 10) 2 3d patient X Q More Fitans 1. Select the Patient Browser in 3D Sharing. Results (7 reell, 1:03.28 AM) Series Shady Deacrption Study Date and Time + Series Number a Series Description Modality Series Dale and Tirne Serine Al + 3D Patient, Siemens Healthineers DS ConAcSoq 0.75 1261 3 DoctDias 72 % CT 12/10/2015 2:39:00 PM 2. Double click on the required volume to open the '11/11/1978, M BSO 30 Objecis 11/8/2018 11:35:10 AM 1234567 FremdC1 Getdise 1248/2011 12:55:22 PM volume in 3D Sharing and confirm that the data is for 3D Patient, Siemens Healthineers *11/11/1911. M 0020329965 3D Patient, Siemens Healthineers *1/1/1551. M the current patient. 4/18-2018 7:28.12 PM - 3D Patient, Siemens Healthineers Instances CTA HAIE Coreriary " Disprosse Coronary Cathelanzatien 12:11:2015 2:22 52 PM 12/11/2015 7.48.28 AM Search successfuly comalated Load the 10 planning Effective Date: 05.29.2020| HOOD05162003097073 volume Unrestricted © Siemens Healthcare GmbH, 2020 syngo CTO Guidance SIEMENS Healthineers Select the CTO Guidance workflow You select the CTO Guidance workflow from the Application 3D Sharing Q SOUTE Browser Images Settings Menu Close Im. ... Seve Bo ... Snapsno. . 30 l'olyll .. Interact ... Export t ... Parallel. Viewing Review loaded or acquired volumes. Review and Processing New acquisitions will replace existing volumes. Doukris Layouts Control. CT HFS CT HFS The Application Control may be docked (fixed) in the Workflow Header or undocked. You can undock the application control in the top right corner of the 3D Sharing segment. 10 cm 10 cm SL 0.8 SL 0.8 MPR 743 LAO 90 / 0 C 145 MPR 0 / 0 HFS CT HFS R 10 cm Neecle Quittance SL 0.8 SL 0.8 2 123 Spine Guidance LAO 80/0 MPR 743 145 MPR LAO 90 / 0 010 Stenosis Analyst CT HFS CT HFS Ne beckmarks stared