syngo MR XA61 – What’s New (MAGNETOM Avanto fit and Skyra fit)

MAGNETOM Avantofit and MAGNETOM Skyrafit Advance your magnetic resonance imaging syngo MR XA61A – What’s New siemens-healthineers.us/mri SIEMENS Healthineers Dear MAGNETOM user, We are pleased to announce the arrival of our latest MRI scanner software, syngo MR XA61A. This new software version includes comprehensive improvements to the existing scanner functionalities and provides access to exciting new features. You have received this document to accompany the installation of the syngo MR XA61A software on your MAGNETOM scanner(s). Scanners qualified for this update include the following systems: • MAGNETOM Avantofit • MAGNETOM Skyrafit This document provides a comprehensive overview of the new features and software improvements that are incorporated in the syngo MR XA61A software. We are continuously striving to improve the quality of our products and sincerely believe that this new software version will further improve your daily work with your MAGNETOM scanner. Sincerely yours, Your Siemens Healthineers MR team Contents Contents 1. syngo MR XA platform – XA61A 5 V 1.1 New syngo MR XA User Interface 5 1.2 Dual Monitor Setup 6 1.3 Recon&Go 6 1.4 MR View&GO 7 1.5 Advanced image post-processing at the acquisition workplace 8 1.6 syngo MR Workplace 8 1.7 New MR image data format – Enhanced DICOM (Mulitframe images) 9 1.8 Security Features 10 1.9 Energy Saving with Eco Power Mode 10 v V V V V V V V V 2. New Standard features included as part of syngo MA XA61A 11 V 2.1 TimCT FastView Localizer 11 2.2 2D and 3D Distortion Correction 11 2.3 Soft Tissue Motion Correction 11 2.4 Advanced Diffusion – RESOLVE and QuietX DWI 12 2.5 3D VRT 12 2.6 Image Fusion 12 2.7 Recon&GO Inline Composing 13 2.8 Composing 13 2.9 Expert-i 13 2.10 MR Basic Workflows 13 2.11 Mean Curve Evaluation 14 2.12 CAIPIRINHA SPACE 14 2.13 Multi-dynamic multi-echo (MDME) sequence for SyMRI 15 2.14 Fat Fraction % Maps 15 V V V V V V V V V V V V V V 3. Improvements to sequences, protocols, and workflows 16 V 3.1 Improved standard sequences 16 3.2 Coil-independent protocols and Auto Coil Select 17 3.3 Changes of table modes 18 3.4 Unilateral hip imaging with myExam Large Joints Assist 19 3.5 4D Flow Improvements 20 3.6 Seamless integration of cardiac flow measurements in myExam Cardiac Assist 20 3.7 Care Bolus functionality for myExam Angio Assist 21 3.8 AutoAlign on values and Flow Add-in for myExam Cardiac Assist 21 3.9 3D ASL Improvements 22 3.10 Motion correction for TSE and HASTE with more than a single average 22 3.11 Improved VIBE Phase Encoding Order 22 V V V V V V V V V V V 4. New Coils 23 V 4.1 UltraFlex 18 Large and UltraFlex 18 Small 23 4.2 Flex Loop Coil 23 4.3 Contour 24 Coil 24 V V V 3 Contents Contents 5. New Sequences, protocols and applications 25 5.1 Simultaneous Multi-Slice TSE 25 5.2 Simultaneous Multi-Slice TSE Dixon 25 5.3 Simultaneous Multi-Slice RESOLVE 26 5.4 Compressed Sensing SEMAC 27 5.5 Compressed Sensing SPACE 28 5.6 Compressed Sensing Time of Flight (TOF) 29 5.7 Compressed Sensing GRASP-VIBE 30 5.8 Compressed Sensing Cardiac Cine 31 5.9 Deep Resolve Gain 32 5.10 Deep Resolve Sharp 33 5.11 Deep Resolve Boost 34 5.12 Deep Resolve Swift Brain 35 5.13 Wave-CAIPI SWI 36 5.14 Physiologging 37 5.15 ZOOMitPRO 38 5.16 myExam Prostate Assist 39 5.17 myExam LiverLab Assist 40 5.18 myExam Whole Body Assist 41 5.19 myExam Advanced Angio Assist 42 5.20 High Bandwidth Inversion Recovery 43 5.21 PSIR HeartFreeze 44 5.22 Breast Biopsy Software 45 5.23 MR Protocols Module 46 5.24 RT Respiratory Self-Gating 46 5.25 myExam RT Assist 47 5.26 myExam Large Joint Assist 47 5.27 myExam Spine Assist 48 5.28 Synthetic CT images in myExam RT Assist 48 5.29 HASTE Diffusion 50 5.30 Open Recon 51 5.31 Needle Intervention Add-in 52 5.32 Advanced Interactive Realtime 52 5.33 GOKnee 3D 53 v V v V V V V V V V V V V V V V V V V V V V V V V V V V V V V V VV 6 Obsolete features 54 V 4 syngo MR XA61A – What’s New 1. syngo MR XA platform – XA61A In 2017 our new syngo MR XA platform was introduced scanners, allowing you to achieve clinical results onto the market. With the syngo MR XA61A software faster, easier and with more comfort. syngo MR XA version, we are continuing roll out of this new innovative platform includes improvements to software and platform to our scanner fleet. syngo MR XA platform is hardware features as well as numerous new sequences the latest system software generation of our MAGNETOM and applications as described in this document. 1.1 New syngo MR XA User Interface Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None syngo MR XA platform introduces a completely The acquisition workplace of syngo MR XA61A now redesigned MR user interface (UI) running on a new inlcudes 24” monitors, versus the previous 18”. Central hardware platform. Evolving from the successful UI elements and features have been preserved but newly syngo MR E11 software, the new syngo MR XA user arranged, making use of the extra space on the larger interface is a user-centric control center for patient monitor. Planning segments (orange), queue (yellow), registration, scanning, post-processing, and result scan parameters (purple) have kept their appearance but distribution. positions were slightly adapted. The new layout provides fixed positions for previously hovering UI elements such as the physio display and the inline display (blue). # 5014 × ARR -------- ------- .......... syngo MR E11 syngo MR XA61A 5 E A syngo MR XA61A – What’s New 1.2 Dual Monitor Setup Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Purchasable option Pre-requisites: None The acquisition workplace can be implemented as a side by side providing the best workflow option. single or dual monitor concept. By default, syngo MR Constant context switches are reduced, enabling XA61A offers a single monitor (24” color LCD monitor) multitasking for increased quality and productivity. acquisition workplace. The dual monitor setup is optional The scanning side (left monitor) is primarily used and encompasses two 24” monitors that are operated for scanning and light quality assurance tasks. The with one keyboard and one mouse. viewing side (right monitor) is used for viewing, The dual monitor setup, with separate scanning and additional results generation in the form of basic and viewing monitors, allows the technologist to have a advanced post processing as well as data handling complete overview of the examination and results. (DICOM – export, import, transfer, recording to media). Scanning and viewing / post-processing can be seen Several applications can be opened in parallel. 1.3 Recon&Go Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None With syngo MR XA platform, Recon&GO provides • Inline MIP on-the-fly, e.g., MR Angiography with powerful zero-click post-processing functionalities automatic image subtraction and MIP in three included in the upgrade. A wide range of Inline orthogonal planes and/or full Radial MIP functionalities help to streamline the clinical workflow • Prospective motion correction (1D and 2D PACE) by automating post-processing steps before image on-the-fly viewing. Ready-to-Read results are automatically • provided, even for advanced cases, helping to reduce Automatic perfusion and diffusion maps the workload for the MR technologist. • Automatic on-the-fly calculation of standard deviation, for better differentiation of arterial and venous phases Functionalities include: • Automatic launch of post-processing applications • Inline Composing: automatic composing of multiple • Inline Display: automatically shows reconstructed adjacent coronal or sagittal images of anatomical or images. It offers immediate access to the results and angiographic examinations. opens automatically for, e.g., interactive real-time Inline Subtraction: Automatic subtraction of images, scanning or Care Bolus examinations • e.g., pre- and post-contrast enhancements • Inline Movie: automatically starts the cine image Inline calculation of ADC and extrapolated b-values display • 6 syngo MR XA61A – What’s New 1.4 MR View&GO Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None MR View&GO is a dedicated MR viewer that covers edges of individual image segments. The most important the needs for daily routine work with respect to dynamic analysis and basic post-processing tools are also viewing, quality assurance, routine post-processing, directly available from the viewing context – no need to filming, as well as sending and archiving results in switch to another application. one comprehensive workflow with consecutive steps. MR View&GO is composed of functionalities previously In syngo MR XA61A the tools from Dynamic Analysis available on syngo.via (syngo MR General Engine are reduced to the routinely used tools: Addition, including syngo.via MR Basic as well as MR Tools) but Subtraction, Division, Multiplication, Arithmetic Mean, specifically focused on the use case at the scanner, ADC, b-Value, Image Filter. providing optimized usability for interactions needed Archiving: result / data distribution can be done as in in this context. syngo MR E11 from the patient browser – but as well As soon as a patient has been registered, a corresponding directly from the MR View&GO Distribution Step. MR View&GO automatically opens for the respective MR View&GO guides the user from basic viewing and patient. Every scan that has been acquired and quality control towards result distribution to the PACS reconstructed automatically appears. and other DICOM nodes. To evaluate dynamically Workflow and usability improvements: MR View&GO acquired contrast-enhanced image series MR View&GO provides 2D, 3D and 4D viewing without switching the offers a dedicated TimeCurve tool (similar to the known context, provides direct access to further 3D and 4D MeanCurve tool from syngo MR E11 platform) which is processing tools such as Range reformations or special specifically designed to focus on the scan task related 4D viewing options. The screen layout consists of an needs such as test-bolus evaluation. In addition, the image area and several panels with tools. The user can processing workflows (e.g., MR Basic) include the known configure an individual toolbox of frequently used MeanCurve tool serving basic and advanced needs for features such as image markers, distance measurements evaluation of dynamic data – e.g., the deeper evaluation or ROI analysis in the lower left corner. Further analysis of Prostate DCE series or contrast-enhanced Breast MRI. tools can be found in so-called “corner menus” in the Both tools, TimeCurve and MeanCurve are part of the included standard features. 1 NW 2 OC 3 1. Steps for dedicated tasks 2. “Send to ... ” buttons to load a selection into a certain step 3. Configurable tool box 7 E A syngo MR XA61A – What’s New 1.5 Advanced image post-processing at the acquisition workplace Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Basic post-processing features included; advanced post-processing licenses available as purchasable options Pre-requisites: None On syngo MR XA platform it is possible to perform selected for analysis. This allows preparing MR datasets advanced post-processing directly at the acquisition ready-to-read, saving radiologists’ time. workplace. Basic post-processing functionalities are already part of For advanced image processing requirements, e.g., the standard configuration included in the upgrade. to perform neuro perfusion and mismatch analysis, dedicated applications are optionally available. These Included workflows are MR Composing and MR General applications cover the entire radiological spectrum from Engine (including MR Basic, MR Breast and MR Prostate neurology (MR Neurology, Neuro3D Tractography and workflows with MeanCurve evaluation and optimized fMRI), cardio-vascular evaluations (Cardiac Perfusion, viewing layouts). Cardiac Flow, 4D Ventricular Function, Vascular Analysis), The appearance and usability of all applications has been to oncology (Breast, Prostate, OncoCare, 3D Lesion harmonized with our departmental post- processing Segmentation). platform syngo.via, helping to improve workflow This reflects only a selection of advanced applications; efficiency. further options are available. Many of these only The acquisition workplace can host one MR View&GO require minimal user interaction: for example, flow and up to three post-processing applications in parallel. quantification is fully automated after a vessel has been 1.6 syngo MR Workplace Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Purchasable options Pre-requisite: Advanced Host Computer Depending on the institutional setup and needs, it is post-processing applications are shared between MR also possible to operate an additional post-processing Workplace and the acquisition console. Thus one license console (syngo MR Workplace) for basic and advanced can be used on both Acquisition workplace and syngo MR post- processing purposes. This syngo MR Workplace has Workplace. If simultaneous use on Acquisition workplace a shared image database with the acquisition workplace, and syngo MR Workplace of the same post-processing thus images acquired at the acquisition workplace application is intended, then a second license can be appear instantly on the syngo MR Workplace enabling obtained. The syngo MR Workplace can host up to four fast image post-processing. This configuration has the post-processing applications in parallel. additional new advantage that licenses for advanced Acquisition workplace syngo MR Workplace Shared database 8 E A syngo MR XA61A – What’s New 1.7 New MR image data format – Enhanced DICOM (Mulitframe images) Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None syngo MR XA platform uses ‘Enhanced MR/Multiframe’ to be stored as a workaround in private (Siemens data format as opposed to the previously used Healthineers) tags and thus were not recognized ‘Single frame’ format. In addition, the handling of after export. Now connected systems of different graphics has been improved. Both changes provide vendors can make use of these parameters in their several advantages: applications, e.g., in evaluations, image text. 1. Reduced memory consumption and improved 4. Archiving possible of DTI Tensor and network transfer performance Spectroscopy data Multiframe images address the trend that MR studies Enhanced MR provides the new possibility to export are continuously growing in size and data handling DTI Tensor and spectroscopy data directly to a PACS and transfer need to be optimized. DICOM header or post-processing station. data valid for the entire stack of slices, e.g., patient name, study data etc. is no longer replicated for every 5. Color Support of color maps MR image but is included only once in one Multiframe In Enhanced MR color information is stored along image. Thus, memory storage can be reduced on with MR slice information enabling the correct average by 40%. In addition, the performance display of Color images, e.g., T1, T2 maps or DTI of data transfers in the network improves as only overlays after export. single objects need to be handled as opposed to the 6. High-quality graphics and Inline reports handling of individual slices. Desired settings of image display such as windowing, 2. Easier handling of exported multidimensional rotation or zooming will be kept after export. In datasets addition, the high quality of manually inserted Enhanced MR provides improved support for multi- graphics (drawn ROIs, text labels) as well as of Inline dimensional data sets allowing easier and more reports from, for example myExam LiverLab Assist or robust handling after export. Correct sorting will cardiac evaluations, will remain after export enabling be kept and thus viewing on PACS and workstation improved readability. Previous workarounds, like is improved (if Multiframe MR is supported by the archiving snapshots of Inline reports, are no longer receiving system). necessary. Pre-requisite: the receiver node supports Multiframe Image format. 3. Easier exchange and interoperability of advanced MR applications Please note: If your PACS or post-processing station does Enhanced MR Images store parameters of the latest not support Multiframe data then it is also possible to MR application in standard DICOM attributes, e.g., export images in single frame data format. This can be b-values of MR DWI, timing parameters of ASL or configured for each DICOM node individually. cardiac imaging. Previously such parameters had $31 am: R2 Avg. - 6.31 cm/s Peak -14.79 cm/s 2.70 Cm Flow -17.04 ml/s Area 2.70 cm^2 Graphics and annotations can remain in high-quality and are no longer distorted after export (if receiving system supports Enhanced MR data format). 9 E A syngo MR XA61A – What’s New 1.8 Security Features Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None syngo MR XA61A provides security settings to protect • Privileges to grant rights and define functionality the scanner against known security threats. It is based based on user/role/group on a hardened Microsoft Windows 10 operating system • Permissions to control data access providing enhanced security features all part of the • standard configuration included in the upgrade. Features Option to protect user pulse sequence trees against include user management, password strength definition unauthorized modifications and audit trail functionality. It supports the implementa- • Whitelisting (Embedded Control) against manipulation tion of defined security policy and definition of different of scanner software groups of users at the scanner. It includes support to • Audit trail to log system and data access by the achieve compliance with the HIPAA “Privacy” rule. defined users and service • Security Delivery process to frequently distribute Included features for individual configuration are: security updates • User management with authentication to prohibit • Support to implement security policy including unauthorized access compliance with HIPAA (Health Insurance and Password strength according to configured policy Accountability Act) • • Screensaver with password protection and adjustable idle time 1.9 Energy Saving with Eco Power Mode Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None syngo MR XA61A includes energy saving technologies: The unique Eco Power Mode reduces energy consumption by up to 30% when the system is in standby and SIEMENS system-off modes. This means that the cold-head compressor can be automatically switched off during prolonged system idle times while maintaining zero helium boil-off. O The Eco Power Mode is a standard technology that comes in addition to previous Eco Gradient Mode reduce consumption by disabling the Gradient Power Amplifier when the system is in the home position or idle for 10 mins. If you want to benefit from Eco Power Mode, a service engineer must activate it during the upgrade to syngo MR XA61A. 10 E A syngo MR XA61A – What’s New 2. New Standard features included as part of syngo MA XA61A 2.1 TimCT FastView Localizer Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None TimCT FastView is the ‘one go’ localizer for the whole- body or large body regions such as the whole spine or the whole abdomen. It acquires the complete extended Field of View in one volume with isotropic resolution during continuous table movement. 2.2 2D and 3D Distortion Correction Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None 2D And 3D distortion correction is a mechanism to Both methods have already been available in syngo compensate for distortions that result from small MR E11E software. With syngo MR XA61A the non-linearities of gradient fields. The correction distortion correction is activated by default in most yields images with higher fidelity in the geometric of the sequences and cannot be turned off. representation – especially for scans with a large field of view and off-center scans. The 2D corrections takes place within image slices; the 3D correction also corrects for through-plane distortions. 2.3 Soft Tissue Motion Correction Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None 3D Elastic motion correction, for offline 3D correction New image data is reconstructed and saved in a separate in all directions over entire 2D and 3D data sets suitable series within the patient browser. It can be combined for, e.g., soft tissue MR exams. Allows higher conspicuity with the original non-corrected image data. and accuracy especially for multi-focal lesion detection. 11 E A syngo MR XA61A – What’s New 2.4 Advanced Diffusion – RESOLVE and QuietX DWI Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None Advanced Diffusion has two components: RESOLVE and QuietX DWI RESOLVE (Readout Segmentation Of Long Variable Echo-trains) delivers high-resolution, low-distortion diffusion-weighted imaging (DWI) for accurate depiction of lesions. QuietX DWI: Diffusion-weighted sequence in whisper mode (very quiet imaging techniques). 2.5 3D VRT Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None Post-processing: 3D-depiction of complex anatomies and anatomic relationships, for example, in angiography. In addition to color images, a threshold-based segmen- tation of 3D objects is possible. 2.6 Image Fusion Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None Post-processing: Fusion mode is a function for image fusion of multiple 2D/3D data sets with alpha blending, that is, overlay of two images and setting the opacity manually. 12 E A syngo MR XA61A – What’s New 2.7 Recon&GO Inline Composing Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None Recon&GO technology encompasses a wide range of For example: Inline Composing: Automatic composing Inline functionalities to help streamline the clinical of multiple adjacent coronal or sagittal images for workflow by automating post-processing steps before anatomical or angiographic examinations. image viewing. 2.8 Composing Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None With syngo MR XA61A it is again possible to perform satisfying results, e.g. in series with images of different flexible offline composing of images. For example, this image types as when using the DIXON sequence. may be applied when Inline Composing did not provide 2.9 Expert-i Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None Interactive real-time access o imaging data and exam information from any PC within the hospital network during the MR Exam. 2.10 MR Basic Workflows Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None Restrictions: None In addition to MR View&GO a range of further dedicated contain dedicated layouts and tools related to the tasks MR workflows (known from syngo.via) is provided – e.g.: at hand to view and process the related body-part MR Basic, MR Breast, MR Prostate. These MR Workflows specific data. 13 E A syngo MR XA61A – What’s New 2.11 Mean Curve Evaluation Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None syngo MR XA61A offers dedicated TimeCurve/MeanCurve workplace (evaluation of test-bolus scans). For analysis tools for contrast-enhanced examinations as part post-evaluation of dynamic series such as DCE prostate of the Standard configuration. The Time Curve analysis is or breast MRI, the included MeanCurve tool in the MR part of MR View&GO for the use case at the acquisition Basic or other advanced MR Workflows can be used. 2.12 CAIPIRINHA SPACE Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None CAIPIRINHA (Controlled Aliasing in Parallel Imaging On syngo MR XA platform default protocols with T2 Results in Higher Acceleration) is an imaging acceleration fatsat and PD weighting are provided for hand/wrist, technique which distributes the acquired k-space data unilateral hip, knee and foot/ankle exams. In the knee, more heterogeneously and therefore improves the SNR for example, high-resolution scans with isotropic by up to 18%2. The higher SNR can be translated into 0.5 mm resolution can be acquired in 4:41 min, which higher imaging speed. CAIPIRINHA is standard and is is a 50% reduction of the acquisition time compared now also available for the SPACE sequence. to conventional PAT 2. FRA Isotropic, submillimeter 3D MSK examinations with CAIPIRINHA SPACE in 5 minutes acquisition time. 2 Breuer FA, et al., Magn Reson Med 2006; 55 (3):549-56. 14 E A syngo MR XA61A – What’s New 2.13 Multi-dynamic multi-echo (MDME) sequence for SyMRI Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None TSE MDME is a special variant of the TSE pulse sequence, myelinization with the postprocessing application which acquires several contrasts (with different TI and offered by synthetic MR. SyMRI Neuro for synthetic TE, i.e., multiple delay, multiple echo) within a single MR can be purchased in the Siemens Open Apps store: sequence. The TSE MDME sequence is a prerequisite for https://store.teamplay.siemens.com/ generating synthetic MR images and analyzing brain 2.14 Fat Fraction % Maps Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None Inline calculation of Fat Fraction % Maps based on a T1-weighted images show subtle hyperintensity but the 2-point T1 VIBE Dixon technique (2pt FF % Maps) and contrast between lesions and background is typically composing of respective multi-station exams. not strong. In patients with metastatic bone disease, lesions found For this purpose, 2pt FF % Maps have the advantage of in DWI (a, b) shall be confirmed in other contrasts, e.g., a much stronger lesion-to-background contrast, since to exclude T2 shine through effects. normal red bone marrow is rich in fat (bright) while metastases contain no fat and are dark in fat-fraction maps. a b c d 15 E A syngo MR XA61A – What’s New 3. Improvements to sequences, protocols, and workflows 3.1 Improved standard sequences Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None With the syngo MR XA61A platform an extensive amount • New Absolute B0 Shim: The additional shimming of improvements to sequences and techniques have been option “Absolute” of the parameter B0 Shim in the implemented to further optimize image quality. In the adjustments tab card allows improved fat saturation, following a collection of image quality improvements is e.g., in T-spine Imaging. summarized: • Asymmetric saturation possible for BOLD imaging to improve scanning of patients with, e.g., dental • Dixon – new algorithms prevent local and global swaps (also in dynamic imaging) implants. • Improved image quality and stability with regards to • Additional external phase correction mode for patient motion and irregular respiration for MRCP diffusion-weighted imaging to reduce artifacts in with T2 SPACE. Implementations include an improved challenging body regions such as, e.g., in breast MRI. trigger algorithm, adaptation of ‘Acquisition Window’ • Noise masking possibility for diffusion-weighted and Short Cycle Mode for patients with fast breathing imaging, QuietDWI and RESOLVE for improved image impression. Noise outside of the scanned object is • Various improvements for whole-body composing, e.g., the possibility to compose calculated b-value eliminated in images and ADC maps. images and improved image normalization for more • For 3T systems with Tim TX TrueShape: Left/Right homogeneous image impression between composed Balancing possibility for GRE and TSE sequence to stations reduce B1-induced shading effect in head imaging. Bodyregion-optimized SPAIR pulses available for Image correction is based on individual acquired B1 • improved fat suppression in diffusion-weighted maps and is most targeted for T1 FLASH and T2 FLAIR imaging, RESOLVE, QuietDWI, TSE, SPACE, HASTE sequences in which the inhomogeneous signal and 3D FLASH sequences (for 3T only) distribution (shading effect) may most likely occur. • Various parallel imaging improvements for improved image quality in HASTE, VIBE, SMS EPI, MPRAGE, TSE and TSE Dixon 16 E A syngo MR XA61A – What’s New 3.2 Coil-independent protocols and Auto Coil Select Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None The selection of coils and coil elements is an essential On syngo MR XA61A the following Auto Coil Selection step during the setup of every MRI protocol. It ensures modes exist: that all regions within the field of view are scanned with • high signal whereas regions outside the field of view do Auto Coil Select (automatically selects the most not disturb the image, for example by infolding artifacts. suitable set of coil elements from any of the plugged-in With syngo MR XA61A we broadened the range of the coils within the field of view) Auto Coil Select (ACS) options to allow an automatic coil • ACS All but spine (This mode selects all coils within the selection for all body regions. Additionally, with syngo FOV except the spine coil. This can be helpful if you MR XA61A protocols were implemented independent of want to examine, e.g., hand/wrist, knee, shoulder, and specific coils. This provides several advantages: breast with dedicated coils) • 1. Swapping coils for a specific protocol no longer ACS Restricted (restricts the coils/coil elements that are triggers an info message, which needs to be considered by the Auto Coil Select mechanism) confirmed • Manual (manual preselection of desired coils/coil 2. User-specific protocols which use a manual coil elements can be stored in the protocol) selection set up in the Dot Cockpit can be set up coil-independent by selecting one of the ACS modes. This makes protocol handling faster and protocols may be more easily exchanged between systems. 3. Due to the new Auto Coil Select (ACS) functionality with two new Auto Coil Select modes, ACS functionality is more robust, flexible, and less error- prone. In general, Auto Coil Select function enables you to use the desired, plugged-in coil without further effort as it is selected automatically. The new ACS modes “ACS All but spine” and “ACS Restricted” make it possible that ACS can be used for all body regions and all coil combinations. If ACS is used, instead of a manual coil selection, the protocol will react more flexibly to variations in exams, e.g., when coils are swapped or when adapting to different patient sizes (for example different patient heights in thorax exams and thus different relative position to spine coil elements). In all Siemens Healthineers protocols one of the ACS modes is used. 17 E A syngo MR XA61A – What’s New 3.3 Changes of table modes Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: None With syngo MR XA61A the choice of table modes has been adapted. Following three modes are available: Iso mode: Table Positioning Strategy Guidance In Iso mode, the table moves during each examination so that the center, Select Table Positioning Strategy or region of interest, of the slice Iso Center Local Range Fixed package is always at the iso center. Fixed table mode: Table Positioning Strategy Guidance To avoid unintentional table movement during interventions Select Table Positioning Strategy triggered by running sequences Iso Center Local Range Fixed with different isocentric positions or to enable off-center scanning. Define the Fixed Table Position by dragging the triangle in the planning segment(s) to the body part of interest. H Alternatively select one of the previously used positions or enter a O O particular fixed position. Fixed Position 0 mm Local Range mode: Table Positioning Strategy Guidance In Local Range mode, you define one (or more) Local Range positions. Select Table Positioning Strategy If the focus slice (region of interest) Iso Center Local Range Fixed is within the tolerance range of the Define Local Range Center Position by dragging the triangle in the Local Range position, the stage is planning segment(s) to the body part of interest. not moved for this measurement. o Alternatively select one of the previously used positions or enter a particular position Local Range Position 0 mm 18 E A syngo MR XA61A – What’s New 3.4 Unilateral hip imaging with myExam Large Joints Assist Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Pre-requisites: myExam Large Joint Assist Restrictions: None The myExam Large Joints Assist optimizes image quality Once this has been selected the system automatically of knee, hip and shoulder scans by proposing the most performs the automatic alignment of the slices with appropriate protocols according to the examination AutoAlign and the automatic coverage of the FOV for the strategy chosen for the specific patient. It ensures respective hip side. Manual adaptions to AutoAlign are reproducible image quality and streamlines large joint no longer necessary. In addition, the selected side will examinations to the greatest extent. be included as image comment in the image text of the With syngo MR XA61A the functionality of the myExam series thus making image reading easier and allowing Large Joints Assist was extended to optimize the for faster workflows as manual updates of the image text workflow of unilateral hip imaging. In the patient are no longer necessary. registration window the laterality of the examination can be pre-selected. Please note: this functionality needs to be activated in the configuration panel during system setup. All Programs Examination Information AL 2020.11 06-12:19:30-STD- 1-3.12.2 1033 28201196 Tests 20201106 Tests 2020.11.06 12 19 99 9 2020.11.06-12:19:30-STD- 1-3/124.1107.5.99.3 SIEMENS Procedure SIMAI FRM 8/41 3 IM41 FRM 8M15 Accession Nr. Req. Proc. ID breast Study Description hip Hip Dot Engine abdomen Study Comment pelvis female wrist pelvis male > tmj shoulder elbow FOW 450 - > hand IMPRIRESAMPINORMCIS2D hip Program Selection AHip_Scout_MPR_right AMID_ SCOUR MAR_ COR AAHip Scout MPR_tra Right Right Hip Dot Engine ... » hip >> Hip Dot Engine >> general 2D unilateral G 4:09 min & Auto @2 @ 0.6 06x30mm 9 1.00 general 2D bilateral Load Program to Queue Routine Contrast Resolution Geometry System Physio Inline Sequence general 2D unilateral general 3D RF Transmit Mode Slice Group FOV Read 180 mm > library Any Polarization Slices 30 FOV Phase 100.0 clinical libraries Slice Thickness 3.0 knee Body Part and Laterality Distance Factor 10 TR 790.0 ms ankle Hip Right Position Isocenter TE 9.60 foot 2 AutoAlign Hip > Para Cor R Orientation Coronal Averages >whole body oncology Patient Orientation Phase Encoding Dir. R>> L 2 4 >whole body diffusion Phase Oversampling peripheral angiography Mign Hip > Para Cor R Head First Supine 85 + New possibility to specify the laterality of the examination AutoAlign selection automatically updated in UI based on patient registration during patient registration (marked orange) (marked orange) 19 E A syngo MR XA61A – What’s New 3.5 4D Flow Improvements Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Pre-requisites: Flow Quantification Restrictions: None 4D flow MRI has been broadly applied in cardiovascular 14 14 disease due to its ability to image vascular systems with 12x245:24 3x1.3x2 5mm full volumetric coverage and provide a comprehensive non-invasive assessment of the vascular hemodynamics in a region of interest in many clinical studies over the past 15 to 20 years. As of syngo MR XA30 our improved 4D Flow acquisition offers full volumetric coverage. It provides orientation and enhances visualization of blood flow and velocity in cardiovascular anatomy. Hence it facilitates the analysis of useful hemodynamic parameters over entire cardiac cycle. Benefits: 1. Sequence optimization now expands the benefits of 4D flow information from the aorta to the whole heart. 2. Comprehensive 4D flow information on hemo- dynamics in the entire heart. 4D Flow Whole Heart: Hemodynamic information for the entire heart in a single acquisition* 3.6 Seamless integration of cardiac flow measurements in myExam Cardiac Assist Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Pre-requisite: myExam Cardiac Assist Cardiac Flow measurements require imaging in the isocenter for reliable quantification. With the new flow mitral valve Cardiac Flow AddIn the FOV is automatically moved to the isocenter for the respective protocols and for define_mitralvalve 00:01 subsequent scans the table goes back to the general Cardiac Standard cardiac imaging position automatically, also making new shims unnecessary. The workflow is improved cine_segmented_mitralvalve 00:26 and high quality is ensured. In addition, automatic 4 Cardiac Standard positioning of the imaging plane is supported for the flow_venc-scout_tp_bh_mitralvalve 00:07 following views: Cardiac Flow • Aortic Valve flow_tp_retro_mitralvalve 00:13 • Mitral Valve Cardiac Flow *Post-processing courtesy of Circle Cardiovascular Imaging. Siemens Healthineers is neither the provider nor reseller nor legal manufacturer of this product. Any claims made for this product are under the sole responsibility of the legal manufacturer, Circle Cardiovascular Imaging. Additionally, cmr42 4D Flow may not be commercially available in all countries. Please contact the legal manufacturer for more information. 20 E A syngo MR XA61A – What’s New 3.7 Care Bolus functionality for myExam Angio Assist Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Pre-requisite: myExam Angio Assist In addition to the existing myExam Angio Assist with Benefits: Test Bolus, we now offer myExam Angio Assist with • an automated Care Bolus for peripheral angiographies Automatic bolus detection and angiographies of the carotids. Guidance and • Fast, robust, and standardized MRA examinations view planning assistance are provided with dedicated • Text and image-based workflow guidance instructions. • Various inline processing tools (e.g., subtraction, MIP generation) Guidance Parameters 1. Select the slice with the best vessel visualization. 2. Position the ROI on the ascending aorta in the sagittal oblique slice with a left mouse click. If the ROI Is positioned too far from the isocenter, it will not be accepted. Please re- position closer to the table position line. 3. If necessary, adjust the slice position for Care Bolus. 4. To correct, click on the red ROI box. 5. Start Care Bolus measurement first and then start the contrast agent injection. Angio Dot Engine with Care Bolus: Guidance view for carotid imaging and Angio Dot Engine with Care Bolus: MIP – Subtraction image of pre- and post-contrast agent measurements 3.8 AutoAlign on values and Flow Add-in for myExam Cardiac Assist Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Pre-requisite: myExam Cardiac Assist Cardiac examinations used to be the most complex The workflow for the valves consists of a exams in MR. Our Cardiac Dot Engine supports the user • defined step in many ways. Using anatomical landmarks, standard • views of the heart, such as dedicated long-axis and cine acquisition based on a FLASH sequence to short-axis views, are easily generated and can be measure the valve opening reproduced readily using different scanning techniques. • venc scout • With syngo MR XA61, myExam Cardiac Assist has been flow measurement extended to support blood flow measurements. Benefits: The paracoronal left ventricular outflow tract (LVOT) as • well as the mitral valve and aortic valve (at systole) are Mitral and aortic valves and LVOT are automatically automatically planned. detected • Automated flow workflow for, e.g., regurgitation measurement in mitral and aortic valves 21 E A syngo MR XA61A – What’s New 3.9 3D ASL Improvements Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Pre-requisite: 3D ASL The acquisition of multi-TI datasets can now be used BAT MO relCBF for the estimation of 3D bolus arrival time (BAT) and relative cerebral blood flow (relCBF). Also, the improved background suppression already available for 2D PCASL is now available for 3D PCASL. For research purposes, 1.5T an M0 image can be generated to enable additional quantification methods. 1aaaa3477 Highlights and benefits: • Estimation of BAT and relCBF are now enabled for 3T 3D ASL acquisitions • Improved background suppression for 3D PCASL 3aaaa1606 • An M0 image can be used for research applications, e.g., absolute quantification of the CBF 3.10 Motion correction for TSE and HASTE with more than a single average Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Pre-requisites: None TSE /HASTE motion correction is an image-based motion New benefits: correction technique in the average-dimension for TSE /HASTE imaging. The motion correction technique The motion correction in the average dimension reduces employs a non-rigid elastic registration to consistently the image blur that would result from organ movement align the images before averaging. The feature has between averages. been optimized and validated for improved prostate TSE imaging. 3.11 Improved VIBE Phase Encoding Order Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Pre-requisites: None In rare cases, when applying the VIBE protocol without motion artifacts. When you have more motion in slice fat saturation or without regional fat saturation, motion direction the Phase Encoding Order “Slices in Lines” is artifacts might occur in the slice direction, resulting beneficial, whereas the Order “Lines in Slices” is better in cloud-like artifacts in the subtraction images. With when the dominant motion is in phase encoding syngo MR XA60, in addition to the “Automatic” Phase direction. Encoding Order, there is the flexibility to choose the Phase Encoding Order as “Lines in Slices” or “Slices in New benefits: Lines”, depending on the needs of the body region being imaged. The choice of the appropriate Phase Encoding Motion artifacts in the VIBE sequence can be reduced Order enables to reduce or change the appearance of by choosing the appropriate Phase Encoding Order for the body region being imaged. 22 E A syngo MR XA61A – What’s New 4. New Coils 4.1 UltraFlex 18 Large and UltraFlex 18 Small Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature UltraFlex Large and Small 18 coils are very flexible multi-purpose coils that can be used for high-resolution imaging in, e.g., unilateral hip, foot/ankle, hand/wrist, or small FOV imaging in the body. The coils encompass an ultra-high coil element density with 18 coil elements (3 rows of 6 elements each) for up to 50% faster scans1 and higher spatial resolution vs. Flex 4 coils. The UltraFlex coils are delivered with dedicated positioning aids for the shoulder, knee, elbow, and foot/ankle for easy and comfortable patient positioning. Applications: • UltraFlex Large 18: Imaging of large regions such as medium to large shoulder, hip, knee, ankle, hand, and head • UltraFlex Small 18: Imaging of small regions such as small to medium shoulder, elbow, wrist, hand, and head 4.2 Flex Loop Coil Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Pre-requisite: Flex Coil Interface The Flex Loop Large is a flexible single-channel loop coil with a large opening for examinations of, e.g., abdomen, pelvis, prostate. It connects to the Flex Coil Interface. This flexible coil has an inner diameter of approximately 19 cm. -- 1 Data on file 23 E A syngo MR XA61A – What’s New 4.3 Contour 24 Coil Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature The Contour 24 has a 24-element design with 24 integrated preamplifiers that are arranged in 4 clusters of 6 coil elements each. The Contour 24 will be typically used in combination with the system’s BioMatrix Spine Coil. It can be positioned in different orientations and X addresses the required range for the examinations of obese patients to small patients. The novel, highly adaptive design offers unmatched patient comfort by enabling positioning of the ultra light-weight coil on the patient without the need for additional fixation. The combination with the SlideConnect technology ensures an efficient set up. No tuning of the fully iPAT-compatible coil is necessary. 24 E A syngo MR XA61A – What’s New 5. New Sequences, protocols and applications 5.1 Simultaneous Multi-Slice TSE Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Simultaneous Multi-Slice (SMS) concurrently excites simultaneously. It is also possible to combine SMS and multiple slices with a multiband pulse and then conventional parallel imaging. spatially encodes their signal simultaneously. While conventionally this would have led to the images from With syngo MR XA61A this disruptive technique can each slice overlaying on top of each other, excellent be applied to TSE sequences with any type of contrast. diagnostic images can be gained by separating the Thereby, entire MSK exams can be accelerated by up signals from each slice by using blipped CAIPIRINHA. to a factor of 50%1. Default SMS TSE protocols will be By applying SMS, imaging can be accelerated by a available for the following body regions: hand, hip, factor equal to the number of slices that are excited knee, ankle, and foot. 5.2 Simultaneous Multi-Slice TSE Dixon Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Simultaneous Multi-Slice (SMS) concurrently excites simultaneously. It is also possible to combine SMS and multiple slices with a multiband pulse and then conventional parallel imaging. spatially encodes their signal simultaneously. While conventionally this would have led to the images from With syngo MR XA61, this technique can now also be each slice being overlaid on top of each other, excellent applied to the TSE Dixon sequence. The shortening of diagnostic images can be gained by separating the TR, which is enabled by activating SMS, can either be signals from each slice by using blipped CAIPIRINHA. used to substantially reduce acquisition times or can By applying SMS, imaging can be accelerated by a also be reinvested in thinner and more slices in the same factor equal to the number of slices that are excited volume. 1aaaa3044 PD TSE Dixon Water, PAT 2, TA 4:12 min PD TSE Dixon Water, PAT 2, SMS2, TA 2:17 min 1 Data on file 25 E A syngo MR XA61A – What’s New 5.3 Simultaneous Multi-Slice RESOLVE Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Simultaneous Multi-Slice (SMS) concurrently excites With syngo MR XA61, this technique, can now also be multiple slices with a multiband pulse and then applied to the RESOLVE sequence. The shortening of TR, spatially encodes their signal simultaneously. While which is enabled by activating SMS, can either be used conventionally this would have led to the images from to substantially reduce acquisition times or can also each slice being overlaid on top of each other, excellent be reinvested in thinner and more slices in the same diagnostic images can be gained by separating the volume. Typical regions where SMS RESOLVE can be used signals from each slice by using blipped CAIPIRINHA. are neuro or breast MRI exams. By applying SMS, imaging can be accelerated by a factor equal to the number of slices that are excited simultaneously. It is also possible to combine SMS and conventional parallel imaging. 3aaaa0784 RESOLVE, b = 1000 s/mm2 RESOLVE, ADC map SMS RESOLVE, b = 1000 s/mm2 RESOLVE, ADC map Sequence RESOLVE, b 1000 and ADC map SMS RESOLVE, b 1000 and ADC map TR (ms) 6280 2970 TE (ms) 70.2 72.2 b-values (s/mm²) 0, 1000 and ADC map 0, 1000 and ADC map TA (min:sec) 4:19 2:12 Matrix 224 x 224 224 x 224 FOV (mm) 220 x 220 220 x 220 Slice thickness (mm) 4 4 Slices 3 x 26 3 x 26 iPAT factor 2 2 SMS factor 2 Images acquired at 3T, examination time will vary with system field strength 26 E A syngo MR XA61A – What’s New 5.4 Compressed Sensing SEMAC Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Pre-requisite: Advanced WARP CS SEMAC enables musculoskeletal imaging in patients encoding factor, the better through-plane artifacts with whole joint replacements1 based on a combination are compensated. However, acquisition time is also of SEMAC (slice encoding for metal artifact correction) increased. Typically, applied slice encoding factors are with Compressed Sensing under sampling and iterative 10–20 resulting in a substantial increase in acquisition reconstruction in considerable scan times. In SEMAC, time. At 3T, acquisition time can exceed 10 minutes, through-plane artifacts are minimized by encoding depending on the chosen slice encoding factor. By and combining the signal from neighboring slices applying Compressed Sensing acceleration to SEMAC, to compensate for signal voids. The higher the slice acquisition times can be substantially reduced: • SEMAC supports Compressed Sensing acceleration with fixed acceleration in addition to conventional GRAPPA acceleration with selectable acceleration factor • SAR optimization feature is included, which reduces the energy applied by the SEMAC pulse sequence • Optimized protocols are offered for the knee 1aaaa2955 SEMAC Compressed Sensing SEMAC Sequence SEMAC CS SEMAC TR (ms) 4360 4360 TE (ms) 40 40 TA (min:sec) 6:54 3:03 Matrix 320 x 320 320 x 320 FOV (mm) 280 x 280 280 x 280 Slice thickness (mm) 3 3 Slices 25 25 iPAT factor 4 CS factor 8 Images acquired at 1.5T, Total examination times may vary with systems field strength 1 The MRI restrictions (if any) of the metal implant must be considered prior to the patient undergoing MRI exam. MR imaging of patients with metallic implants brings specific risks. However, certain implants are approved by the governing regulatory bodies as MR conditionally safe. For such implants, the previously mentioned warning may not be applicable. Please contact the implant manufacturer for the specific conditional information. The conditions for MR safety are the responsibility of the implant manufacturer, not of Siemens Healthineers. 27 E A syngo MR XA61A – What’s New 5.5 Compressed Sensing SPACE Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Compressed Sensing (CS) SPACE enables highly • CS SPACE supports typical contrast such as T1, PD, accelerated 3D imaging based on the SPACE pulse T2, T2 Dark-Fluid, Double-Inversion Recovery and sequence with Compressed Sensing and iterative combination with Fat Saturation reconstruction: • Best results can be achieved for contrast-rich, Spatial and/or temporal resolution can be improved, high-resolution applications such as T2 or T2 IR • and scan time substantially reduced protocols • Optimized protocols are available for body imaging (triggered and breath-hold 3D MRCP), imaging of the brain and various musculoskeletal applications. Provided CS protocols are indicated and can be searched for as “ _ csX _ ” in the Siemens Healthineers protocol tree, i.e. “t1_space_sag_cs7_iso” 3aaaa0783 Sequence 3D SPACE, resp. trigg. 3D CS SPACE, resp. trigg. 3D CS SPACE, breath-hold TR (ms) 4791.5 4546,3 2300 TE (ms) 703 700 701 TA (min:sec) 7:16 1:26 0:15 Matrix 753 x 768i 576 x 768i 560 x 704 FOV (mm) 380 x 380 285 x 380 239 x 300 Slice thickness (mm) 1 1 1.6 Slices 64 64 40 iPAT factor 3 CS factor 20 23 Images acquired at 3T, Total examination times may vary with systems field strength 28 E A syngo MR XA61A – What’s New 5.6 Compressed Sensing Time of Flight (TOF) Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Compressed Sensing TOF enables highly accelerated • Typical acceleration factors are between 6–10-fold Time-of-Flight (TOF) MR angiography with Compressed acceleration, enabling 0.4-mm isotropic TOF Sensing under- sampling combined with iterative acquisitions in 2-minute acquisition time reconstruction: • Optimized protocols are offered for TOF MR angiography of the head (intracranial vasculature) • Spatial and/or temporal resolution can be improved, and scan time substantially reduced 3aaaa0784 TOF Angio, TA 4:48 min CS TOF Angio, TA 1:59 min Sequence TOF CS TOF TR (ms) 19 21 TE (ms) 3.4 3.7 TA (min:sec) 4:28 1:59 Matrix 441 x 512i 517 x 576i FOV (mm) 181 x 200 199 x 220 Slice thickness (mm) 0.4 0.4 Slices 178 178 iPAT factor 2 CS factor 10.3 Images acquired at 3T, Total examination times may vary with systems field strength 29 E A syngo MR XA61A – What’s New 5.7 Compressed Sensing GRASP-VIBE Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Pre-requisite: High-End Computing Compressed Sensing GRASP-VIBE (Golden-Angle RAdial Additional features: Sparse Parallel) makes it possible to conduct dynamic • contrast-enhanced abdominal exams in free breathing. Auto Bolus Detection at reconstruction time Acquisition is performed in one continuous run, using • Configuration of exam phases in terms of start time a golden-angle stack-of-stars radial scheme that confers relative to the auto-detected bolus arrival, duration, robustness towards motion and the flexibility to choose temporal resolution, and pre-selection for export the temporal resolution at reconstruction time. The to PACS temporal resolution may even vary over the duration • Self-gating for further reduction of residual motion of the scan. Reconstruction is performed using a blur Compressed Sensing accelerated iterative algorithm with • Includes FREEZEit+ per-voxel through-time regularization. The algorithm also automatically recognizes the typical phases in liver dynamics and therefore has the capability to only reconstruct a subset of clinically relevant images with respective labeling. sub-optimal breath-hold Free-breathing Compressed Sensing GRASP-VIBE 30 E A syngo MR XA61A – What’s New 5.8 Compressed Sensing Cardiac Cine Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Pre-requisite: High-End Computing Compressed Sensing Cardiac Cine is based on the BEAT Highlights and benefits: TrueFISP sequence with excellent myocardium-blood • contrast. It allows higher temporal resolution imaging in Acquire free-breathing, high-resolution Cardiac Cine real time or in segmented mode, without compromising images Compressed Sensing Cardiac Cine facilitates on spatial resolution. Protocols are provided for full exams for patients that cannot easily hold their breath. coverage of the heart within a single breath-hold for It also opens MR imaging to arrhythmic patients where quantitative functional assessment. In real-time mode, CMR could not be done before or was inconclusive. it is robust against arrhythmia and breathing artifacts. • Capture the whole cardiac cycle for precise quantifica- tion Have it all: Compressed Sensing Cardiac Cine With “Adaptive Triggering” the full heart cycle can be employs adaptive triggering, covering the whole left examined, even in late diastole. Compressed Sensing ventricle in a single breath-hold. Real-time acquisition Cardiac Cine can be combined with Inline Ventricular provides excellent accuracy of left ventricular function Function evaluation for inline quantitative assessment and volume evaluation even in the late diastolic phase. of the heart function. CS Cardiac Cine was the first Compressed Sensing application available in the industry. Rather than taking nearly six minutes with multiple breath-holds, a Cardiac Cine scan can now be done within 15–25 seconds1 – in free-breathing. 31 E A syngo MR XA61A – What’s New 5.9 Deep Resolve Gain Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Restrictions: SE, TSE_Dixon & TSE is supported with the exception of BLADE Deep Resolve Gain is our solution for intelligent Highlights and benefits: denoising, addressing local noise variations. Image noise • usually is not uniformly distributed in MR images. This is Deep Resolve Gain addresses local noise variations due to coil array geometries and acceleration techniques arising from coil array geometries and parallel such as parallel imaging. These local variations cannot be imaging techniques addressed by standard image filters. Deep Resolve Gain • Individual noise maps are generated from the uses individual noise maps in the reconstruction process acquired raw data and fed into the reconstruction to reduce noise where it is most needed in the image. process Deep Resolve Gain can be used for the reduction of • Areas in the image with low SNR can be denoised image acquisition times. There are mainly two ways how stronger this can be accomplished: Deep Resolve Gain can be used • Deep Resolve Gain is applicable from head to toe to mitigate noise introduced by reducing the number of and is not limited to certain coils averages in the acquisition, or it can be used to reduce image noise introduced by increasing acceleration factors such as PAT. 1aaaa3592 T2 TSE, conventional reconstruction T2 TSE, Deep Resolve Gain 32 E A syngo MR XA61A – What’s New 5.10 Deep Resolve Sharp Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Restrictions: SE, TSE_Dixon & TSE is supported with the exception of BLADE Deep Resolve Sharp is a novel image reconstruction Highlights and benefits: technology to increase resolution and sharpness in the • resulting images. The deep neural network at the core Deep Resolve Sharp uses a neural network to of Deep Resolve Sharp generates a high-resolution increase the sharpness of the reconstructed images image from low resolution input data. The network was • The matrix size can be doubled along each axis trained on a large number of pairs of low-resolution in-plane and high-resolution data. As the training data for Deep • Robust results are ensured by incorporating the Resolve Gain covered a wide range of anatomies, the originally acquired raw data into the reconstruction reconstruction network can be applied to all body • Deep Resolve Sharp is used in combination with regions. Deep Resolve Sharp can increase the matrix Deep Resolve Gain, to obtain sharper images, faster size by a factor of up to two along both in-plane axis, • resulting in substantially increased image sharpness. Deep Resolve Sharp is applicable from head to toe Deep Resolve Sharp can also be used to reduce and is not limited to certain coils acquisition times: Images can be acquired with reduced phase resolution; the resolution can then be recovered when reconstructing the images with Deep Resolve Sharp. 1aaaa3588 T2 TSE, conventional reconstruction T2 TSE, Deep Resolve Gain & Sharp 33 E A syngo MR XA61A – What’s New 5.11 Deep Resolve Boost Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Pre-requisite: High-end Computing Restrictions: TSE is supported with the exception of BLADE TSE and DIXON Deep Resolve Boost takes Deep Learning Reconstruction Highlights and benefits: to the next level. It enables previously inaccessible • parallel imaging acceleration. This is made possible by Deep Learning Reconstruction with effective denoising our first raw-data-to-image Deep Learning reconstruc- • Three levels selectable for the denoising strength tion. The neural network behind Deep Resolve Boost • Deep Resolve Boost outperforms Deep Resolve Gain enables effective denoising that improves the visual in its denoising capability signal-to-noise ratio of the images. The Deep Learning • Employ parallel imaging factors previously inaccessible reconstruction used in Deep Resolve Boost achieves in MR imaging a stronger denoising than Deep Resolve Gain and • the denoising strength can be adapted by choosing Significantly cut down scan times where TSE is a from three levels. With this, Deep Resolve Boost will mandatory imaging sequence significantly cut scan times in clinical routine areas such • Deep Resolve Boost is compatible with SMS TSE, a as neuro, spine, and MSK while not compromising on Siemens Healthineers exclusive feature image quality. Deep Resolve Boost can be combined with SMS TSE, rendering this the industry first k-space to-image-space Deep Learning Reconstruction that can be combined with SMS TSE. Deep Resolve Boost example of T2 TSE imaging employing PAT4 acceleration. Left: conventional reconstruction (GRAPPA); right: Deep Resolve Boost. PD TSE fs p3 s2 PD TSE fs p3 s2 PD TSE fs p3 s2 T1 TSE p4 s2 0.2 x 0.2 x 3 mm3 0.2 x 0.2 x 3 mm3 0.2 x 0.2 x 3 mm3 0.2 x 0.2 x 3 mm3 TA: 39 sec TA: 36 sec TA: 28 sec TA: 15 sec Total exam time: 1:58 min 2aaaa2200 Deep Resolve Boost supports SMS TSE, a Siemens Healthineers exclusive feature. This enables, for example, ultra-fast high-resolution knee imaging in 1:58 min with 8-fold acceleration for each contrast (PAT3 S2). 34 E A syngo MR XA61A – What’s New 5.12 Deep Resolve Swift Brain Available for: MAGNETOM Skyrafit Category: Optional feature Pre-requisite: High-end Computing Restrictions: Exclusive for 3T systems Deep Resolve Swift Brain is an ultra-fast brain protocol leveraging the fastest available imaging sequence, EPI, together with a Deep Learning Reconstruction to push acceleration to the edge. The protocol consists of five contrasts: T1, T2, T2*, T2 dark-fluid, and diffusion. While T1 is based on a fast GRE imaging sequence, the remaining contrasts are multi-shot EPI-based. Multi-shot EPI together with a new static field correction minimizes geometric distortions that are intrinsic to EPI imaging. Within this multi-shot EPI approach, T2 and T2* are acquired simultaneously by a Siemens Healthineers exclusive EPI-implementation, further accelerating this protocol. Multi-shot EPI-based T2 dark-fluid reduces imaging times substantially compared to standard TSE imaging and offers true FLAIR contrast due to magnetization transfer preparation. Highest image quality is ensured by a Deep Learning Reconstruction to push the limits of parallel imaging acceleration. The unique combination of multi-shot EPI imaging and Deep Learning Reconstruction enables net scan times of less than two minutes. The total table time including pre-scans and adjustments can be less than five minutes with this protocol. Highlights and benefits: • Ultra-fast brain examination with a Siemens Healthineers exclusive multi-shot EPI implementation supported by Deep Learning Reconstruction • Five resulting contrasts: T1, T2, T2*, T2 dark-fluid, diffusion • Net scan time < 2 minutes • Total table time including prescans, adjustments, and imaging < 5 minutes • New static field correction to further minimize EPI-intrinsic geometric distortions; available for all EPI sequences after purchasing of Deep Resolve Swift Brain license 35 E A syngo MR XA61A – What’s New 5.13 Wave-CAIPI SWI Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Purchasable feature, separate or as part of Turbo Suite Excelerate Pre-requisite: SWI Wave-CAIPI SWI enables the extension of parallel Highlights and benefits: imaging to three spatial dimensions as well as reducing • the amount of noise in the reconstruction process. Extend parallel imaging techniques to all three The reduction in noise can be used to accelerate spatial dimensions acquisitions, resulting in shorter scan times compared • Wave-CAIPI SWI reduces noise in accelerated SWI to standard CAIPIRINHA SWI imaging. acquisitions • Achieve higher acceleration compared to standard parallel imaging • Wave-CAIPI SWI is a Siemens Healthineers exclusive technology Current Superior image quality No compromise in IQ standard SWI Faster scan time Significantly faster iPAT 4 16% Wave-CAIPI 4 44% Wave-CAIPI 6 TA: 3:11 min TA: 2:41 min TA: 1:46 min 3aaaa1542 36 E A syngo MR XA61A – What’s New 5.14 Physiologging Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisite: Respiratory belt, ECG, PMU Physiologging enables the extraction of physio data via Highlights and benefits: a checkbox on the Physio > Signal tab of the UI. As a • new feature, time stamps are added to allow easier Timestamped physiological data for easier synchronisation of physio data to corresponding fMRI synchronisation with fMRI data data acquired with either EPI BOLD or EPI PACE. This will • Recording can be started via a checkbox on the UI help researchers to correct fMRI data for physiological (Physio > Signal tab) motion and noise. All parameters recorded by internal • Physio data are stored as a separate DICOM file physiological sensors (such as respiratory sensor, which can also be archived respiratory belt, ECG, Pulse sensor, beat sensor) are then available in a convenient data format for further offline processing. The physio curves will be stored in a separate DICOM file including timestamps. 00:32 Access time-synced sensor data for fMRI scans as part of the DICOM study -Sample code available for extraction Planned Available for EPI BOLD & PACE Physiologging 37 E A syngo MR XA61A – What’s New 5.15 ZOOMitPRO Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Diffusion-weighted imaging (DWI) is a decisive tool in Benefits: body oncology for detection and characterization of disease. Artifacts caused by susceptibility effects are an ZOOMitPRO allows for high-resolution and fast selective issue but can be addressed with shorter echo times and volume-of-interest diffusion-weighted imaging, e.g., of echo spacing. One mean to reduce the echo spacing is the prostate, the pancreas, the kidneys, the breast or the reduced FOV imaging with dedicated excitation pulses. brain. With zoomed EPI, there is substantially less image Introducing a new sequence scheme for excitation and blur and respiratory motion artifact and significantly readout, reduced FOV imaging with DWI is enabled at higher diagnostic confidence. With the optimized pulse both 1.5T and 3T. sequence scheme the acquisition technique is more robust in the presence of off-resonance effects, i.e., metal implants1. Images courtesy of Shanghai 6th People Hospital, Shanghai, P.R. China 2aaaa1515 Conventional DWI ZOOMitPRO Sequence Conventional DWI, b1500 ZOOMitPRO, DWI, b1500 TR (ms) 4600 4600 TE (ms) 79 76 b-values (s/mm2) 50, 1000, 1500 and ADC map 50, 1000, 1500 and ADC map TA (min:sec) 3:23 3:29 Matrix 132 x 178 56 x 100 FOV (mm) 282 x 380 106 x 190 Slice thickness (mm) 3 3 Slices 4 x 20 4 x 20 iPAT factor 2 Images acquired at 3T images quality and acquisition time may vary 1 The MRI restrictions (if any) of the metal implant must be considered prior to the patient undergoing MRI exam. MR imaging of patients with metallic implants brings specific risks. However, certain implants are approved by the governing regulatory bodies as MR conditionally safe. For such implants, the previously mentioned warning may not be applicable. Please contact the implant manufacturer for the specific conditional information. The conditions for MR safety are the responsibility of the implant manufacturer, not of Siemens Healthineers. 38 E A syngo MR XA61A – What’s New 5.16 myExam Prostate Assist Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature myExam Prostate Assist is designed for fast, reproducible, is guided through one comprehensive workflow with and standardized prostate MR examinations and supports decision points to adapt the strategy to individual patient multi-parametric, multi-plane MR imaging according to conditions, while artificial intelligence provides support the latest PI-RADS v2.1 recommendations. The operator for planning and performing the procedure steps. SIEMENS >> pelvis male >> Prostate Dot Engine > Prostate Dot Engine Dot Prostate Dot Engine Prostate Patient View V Standard localizer 00:19 Generic Views AA_Prostate_Segm 00:49 Onco Auto Coverage Scout t2_tse_sag_p2_320 01:46 O Prostate t2_tse_tra_336 03:22 Prostate Air in rectum ? no Basic Decision Air in rectum ? yes no resolve_diff_b50_800_tra_p2 04:14 ep2d_diff_zoomit_b50_800_tra 03:30 Prostate Prostate t2_tse_cor_p2_320 01:59 O Prostate Lymph nodes eval ? no Basic Decision Lymph nodes eval ? yes t1_vibe_dixon_tra_p2_352_lymph_nodes 01:28 Generic Views 4D Imaging ? yes Basic Decision 4D Imaging ? yes inject contrast after 2 measurements t1_vibe-twist_dixon_tra_dyn_p4 03:55 Prostate SIEMENS. Healthineers Bahn, Bob MiddleName 23-Jan-68 M 95e02483-a8b1-4d7f ... X Prostate Dot Engine Bahn, Bob, MiddleName, Title, Suffix Bahn, Bob, MiddleName, Title, Suffix Bahn, Bob, MiddleName, Title, Suffix localizer 95e02483-88b1-407f-80fb-5c7808ae2032 95e02483-88b1-407-80fb-5c7868ae2032 95e02483-a8b1-4d71-8dfb-5c78de2032 OID Other Pa. OID Other Pa OID Other Pa ... 2 AA_Prostate_Segm 14 IMA 1 FRM 10/20 10 IMA 1 FRM 9/17 6 IMA 1 FRM 13/26 3 t2_tse_sag_p2_fast %_ 12_tse_tra_p3_368 5 % Air in rectum ? no xep2d_diff zoomit_b50 800_tra 03:30 7 % (2_tse_cor_p3_368 03:18 8 X Lymph nodes eval ? 9 % Dynamics ? 10 inject contrast after 3 measurements 11 %_ 11_vibe-twist_dixon_tra_dyn_p4 05:06 2 11:54 GO Cancel A TP F1 TP F1 SP P13.5 FoV 200*200 SP F2.5 FoV 200"200 PZ MAGNINOR WISHIFIL/DIS20 AA Prostate_ Sepm. MPR Cor P2 MAGN/NORM/SH/FIL/DIS20 Tra 1125 551 AA_Prostate_Segm_SEG 1771 842 Study comment study comments @ 5:33 min 4 Auto @ 2 @ 0.3x0.3x3.0 mm 1.20 study comments. Contoured Prostate O. Check slice positions and adjust if necessary. 39 E A syngo MR XA61A – What’s New 5.17 myExam LiverLab Assist Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Evaluating the iron and fat content of the liver is an Benefits: important step in monitoring the early stages of disorders like nonalcoholic fatty liver disease (NAFLD), myExam LiverLab Assist is offered as a standalone Assist, which are on the rise due to changing nutritional which is available independently of the Abdomen Dot habits. myExam LiverLab Assist non-invasively provides Engine. The package allows for the detection of liver information on liver fat content and iron overload. deposition disease (fat, iron, combined) with guided workflow steps and fully automated post-processing. Results are intuitively displayed in a color bar and maps (fat fraction/R2*) indicating fat/iron overload. Liver Lab provides a quantitative assessment of fat concentration and a qualitative assessment of iron overload. 0% Fal signal percentage 60% Voxel 4.3% 0.81 Voxel Images courtesy of University Hospital Tübingen, Department of Radiology, Germany 40 E A syngo MR XA61A – What’s New 5.18 myExam Whole Body Assist Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Pre-requisites: myExam Abdomen Assist, FREEZEit+ myExam Whole Body Assist allows easy, seamless • Core Protocol with WB T2 HASTE, WB T1 VIBE, WB DWI, planning of multi-parametric multi-station exams with and whole-spine exam automated recognition of individual anatomy and • Protocol can be extended with dedicated scans of the consistent settings for spatial resolution, image contrast, focus regions Chest, Abdomen, Pelvis with dynamic and breath-hold capacity. exams of the respective region • Landmark-based automatic segmentation of the • AutoBolus detection for focus region Abdomen (liver) anatomical regions based on FastView scan • Supports 2D and 3D acquisitions in axial and coronal • AutoCoverage: scan range across the chest, abdomen orientation and pelvis can be easily defined with a coverage slider • Option to repeat stations flexibly (results are • Automatic overlap of stations integrated accordingly during composing) • Additional stations for head and leg coverage can be added using the coverage slider SIEMENS >> whole body oncology > Whole-Body Dot Engine >> Whole-Body Dot Engine > Whole-Body Dot Engine ? x General Preview General Parameters Breath-Hold Parameters Exam Strategy Standard Breath-Hold Capability 20 + Focus Adaptation BH + AutoCoverage Auto Breath-Hold Commands V. English (United ... ... Auto Bolus Detection Pause Between Breath-Holds 10 Auto ROI Coverage Head Thorax Focus Abdomen Focus Pelvis Focus Legs FastView Addin Configuration ... Close 41 E A syngo MR XA61A – What’s New 5.19 myExam Advanced Angio Assist Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Pre-requisites: myExam Angio Assist Restrictions: Exclusive for Care Bolus What is myExam Angio Advanced Assist? together in the GSP. After planning is complete, the myExam Angio Advanced Assist is a semi-automated angio pre-contrast data-acquisition is executed for workflow for peripheral angiography examination all planned stations. With the following care bolus with step-by-step guidance throughout the exam. step the arrival of the contrast agent is manually This workflow support feature offers clear planning for or automatically detected. Once the contrast agent all multi-station angiography exams by enabling the is detected the angio post-contrast measurement planning in the GSP for all stations in one common is performed in accordance with the pre-contrast planning step. This new Assist workflow uses the care measurement. Finally, an optional dynamic CE MRA bolus-functionality to optionally track the care bolus (TWIST) measurement can be performed. arrival in the vessels. Highlights and benefits: myExam Angio Advanced Assist provides workflow • support for peripherical MR angiography exams. After Automation and guidance for robust peripheral MRI performing an overview scan, the relevant peripherical exams vessels and the aorta are localized. Then planning of • Easy planning with coverage boxes, overlap clearly the actual angiography measurement is performed by visible using the Angio Advanced Planning Add-in, which • Individual parametrization enables to plan all stations (abdomen, legs, feet) Angio Assist Advanced Angio Advanced Patien ... Care Bolus Feet first - Position 20cm / 7in above feet FastView 00:35 Whole Body FastView Vessel Scout yes O Abdomen O Abdomen vessel_scout 02:19 E Generic Views localizer aorta 00:31 Generic Views angio_f13d_cor_pre 00:39 1 Angio Advanced Planning Check pre images, prepare injector Legs Legs Care Bolus 01:21 Care Bolus angio_f13d_cor_post 00:39 TWIST feet Feet yes Basic Decision WIST feet Feet yes angio_twist_cor_iso_feet 02:03 Generic Views 42 E A syngo MR XA61A – What’s New 5.20 High Bandwidth Inversion Recovery Available for: MAGNETOM Avantofit Category: Optional feature Pre-requisites: 1.5T systems only MRI is the gold standard modality when it comes This technique has been evaluated under clinical to gaining information on myocardial tissue conditions and has shown robustness. characterization. Benefits: High Bandwidth Inversion Recovery uses wideband techniques to reduce susceptibility artifacts, 1. Extends benefits of cardiac inversion recovery and therefore, extends the benefits of tissue imaging to patients prone to susceptibility artifacts. characterization to these patients, enabling them 2. Myocardial tissue characterization based on to receive diagnostically robust imaging to visualize inversion recovery imaging. myocardial injury using tissue characterization. HR Conventional LGE High Bandwidth Inversion Recovery LGE 43 E A syngo MR XA61A – What’s New 5.21 PSIR HeartFreeze Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Pre-requisite: 1.5T systems only PSIR HeartFreeze with motion compensation algorithms Benefits: enables high-resolution PSIR imaging in free-breathing. • This means you can extend the benefits of cardiac Acquire high-resolution PSIR imaging in free-breathing MRI viability assessment to even more patients, even • Extend the benefits of cardiac MRI to even more to those with arrhythmias and those who cannot hold patients, even those with arrhythmias and those who their breath. cannot hold their breath. • Increase efficiency with shorter scan times. Image courtesy of Klinikum, St. Georg, Leipzig, Germany 1aaaa2598 PSIR HeartFreeze motion compensation algorithm 44 E A syngo MR XA61A – What’s New 5.22 Breast Biopsy Software Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature The newly developed and designed Breast Biopsy • Projection of needle path on the planning images software guides breast interventions such as vacuum for control assisted biopsy and wire localization for streamlined • Support of coil-specific guidance with graphical interventions and high accuracy. instructions on both the console and the Select&GO Guidance for intervention planning and execution display at the scanner • for both grid method and post/pillar method • Support of following MR breast coils: Breast BI 7, • Automatic extraction of coordinates for the selected 2-/4-/8-Channel Sentinelle Breast Coil, 2-/10-/16- target and calculation of required point of entry, Channel Sentinelle Breast Coil angulation (for post/pillar method) and penetration depth SIEMENS .. Healthineers 12 . 01.01.1978 F 2023.02.27-10:59:3. MR Breast Biopsy ? = = MR Breast Biopsy benes MR Erssat Hingay MR Pesant Pongay Target 2 MR Breast Biopsy 27.02.2023 27.02 2023 FFP 27.02.2023 Target Selection Series Name 11.01.41 27.02-2023 Target 1 left lateral Target 2 Left Lateral (on display) Send V --------- - Target 2 . Locked L48, P 12:34 27 Findings Navigator P [Cheer Wat) 27.02.2023 27.02.2023 AT Name Uzurca Target MERre ... MRDre .. WARS FIMna C4 04 Tools CO Snaps set Export Layout 11:19:2 Device Settings ? × Presets Generic 12g Name Sen 16 left grid 12g grid post pillar Coil Breast BI 7 Sen 16 left grid 12g Intervention Method Grid Marker Position C4 Needle Generic/Invivo 12g Automatic Marker Detection off . Lateral Medial + Add Copy Delete OK Apply Cancel 45 E A syngo MR XA61A – What’s New 5.23 MR Protocols Module Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature With the MR protocols module, we are introducing a Changes are distributed across the scanner fleet with new generation of MR protocol management in teamplay one click. protocols. With this solution, the technologist or chief radiologist is now able to manage scan protocols from Furthermore, the feature supports the setup of one central location. It is now possible to edit and consistent examination protocols to maintain a distribute scan protocols across scanner types and common protocol structure across an enterprise configurations without interrupting scanner operation. fleet of scanners for different clinical demands. This ensures highest imaging standards for all patients. MR Protocols Module powered by teamplay protocols Access, edit and distribute protocols MAGNETOM fleet MAGNETOM Sola MAGNETOM Skyra MAGNETOM Prismafit syngo MR XA20 syngo MR XA30 syngo MR XA30 5.24 RT Respiratory Self-Gating Available for: MAGNETOM Skyrafit Category: Optional feature Pre-requisites: FREEZEit+, myExam RT Assist Note: High-end Computing is highly recommended 4D MRI – RT Respiratory Self-Gating is an MRI technique for capturing organ motion in the abdomen and thorax DC[a.u.] Bin 5 with excellent soft tissue contrast and automatic ........ ................... .................... .......................... ................. respiratory phase sorting during the entire acquisition time, all without the need for external respiratory Bin 4 ........ ..................... devices or surrogates. • 4D MRI is a free-breathing, non-contrast, 3D radial Bin 3 acquisition technique ............ .......... .................. • Images are automatically binned, or sorted, into Bin 2 separate discrete phases that correspond to a patient’s ............... ................ distinct respiratory motion Bin 1 • Allows for precise target delineation in the abdomen t[s] and thorax at each phase of the respiratory cycle ..................... .................. .......................................................... ...... • Supports MR-based radiotherapy planning of moving targets in the thorax and abdomen without the need for external respiratory devices or surrogates 46 E A syngo MR XA61A – What’s New 5.25 myExam RT Assist Available for: MAGNETOM Skyrafit Category: Optional feature Pre-requisites: FREEZEit+, myExam RT Assist myExam RT Assist supports you in the acquisition of myExam RT Assist engine provides 2 preconfigured suitable radiation therapy (RT) planning images to be examination strategies: further processed in external RT applications. It provides guided and automated workflows customizable to the Image quality focus: Examination with 3D protocols site-specific standards of care for RT imaging. for detailed views of challenging anatomical situations. myExam RT Assist takes care, that the MR data is Speed focus: Examination with time-optimized 3D acquired in the right format and the right orientation protocols. Step-by-step user guidance is seamlessly for importing into the RT planning software. Whenever integrated. possible, it makes sure that distortion correction is activated during acquisition. The imaging workflow myExam RT Assist provides: can be personalized to the individual patient condition • Dedicated RT Planning protocols for: and clinical need. Several predefined strategies are Brain - included, which can be easily selected. Head & Neck - • Other features include Negative distance factors, Distortion correction (3D, 2D), Axial reconstruction, B1 value monitoring, Laser off-set consideration. 5.26 myExam Large Joint Assist Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Pre-requisites: None myExam Large Joint Assist optimizes image quality of techniques (including high-bandwidth pulse sequences, knee, hip, and shoulder scans by proposing the most VAT and SEMAC1) provide susceptibility artifact reduction appropriate protocols according to the examination functionality, e.g., from MR Conditional1 metal implants strategy chosen for the specific patient. It ensures and include optimized pulse sequences for knee and reproducible image quality and streamlines large joint hip examinations. High-resolution 3D imaging programs examinations to the greatest extent. myExam Large together with user-configurable automatic Inline MPR Joint Assist features AutoAlign and AutoCoverage for (multiplanar reconstruction) calculations provide knee, hip and shoulder. The WARP and Advanced WARP increased efficiency, reproducibility and ease of use. 1 MR imaging of patients with metallic implants brings specific risks. However, certain implants are approved by the governing regulatory bodies to be MR conditionally safe. For such implants, the previously mentioned warning may not be applicable. Please contact the implant manufacturer for the specific conditional information. The conditions for MR safety are the responsibility of the implant manufacturer, not of Siemens Healthineers. 47 E A syngo MR XA61A – What’s New 5.27 myExam Spine Assist Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Pre-requisites: None myExam Spine Assist delivers optimized cervical, to your standards of care. myExam Spine Assist supports thoracic, and lumbar spine imaging for all patients and the user in achieving reproducible image quality. provides guided and automated workflows customized 5.28 Synthetic CT images in myExam RT Assist Available for: MAGNETOM Skyrafit Category: Optional feature Pre-requisites: FREEZEit+ and High-end Computing Note: Synthetic CT is a separate syngo.via RT Image Suite License myExam RT Assist includes optimized protocols and pelvis includes scan protocols for generating Synthetic sequences for radiotherapy planning. With syngo CT images. The synthetic CT images can be generated MR XA30, the RT Dot Engine now covers brain, head on the right monitor on a separate workstation with the & neck, and pelvis. myExam RT Assist for brain and corresponding license. 48 E A syngo MR XA61A – What’s New Synthetic CT1 generation for the brain MR clinical image Probability of voxel belonging to tissue class CT-like image T1 VIBE Dixon Water Fat T2 SPACE Image pre- Class processing Classifier White matter property Synthetic assignment CT image PETRA Gray matter FLASH Gradient Echo “Time to Flight” Bone Total acquisition time: ~14:00 min (1.5T) Generation of Synthetic CT ~09:20 min (3T) on syngo.via RT Image Suite (approx. 1 min) Source: “Assessing the Domestic Accuracy of Magnetic Resonance-Generated Synthetic CT Images for Focal Brain VMAT Radiation Therapy” Paradis et al, International Journal of Radiation Oncology * biology * physics, Vol. 93, No. 5, p. 1154e1161, 2015; Visualization of the Synthetic CT algorithm for the brain from image acquisition to Synthetic CT image generation T1 VIBE DIXON – Water & Fat Synthetic CT In Phase Water Fat (& Opp Phase opt.) Flash (Gradient Echo) PETRA – T2 SPACE – Anatomy TOF – Vessels Bones and Brain Morphology Images courtesy of Centre Hospitalier de l’ Université de Montréal (CHUM), Canada Image examples of MR sequences required to generate the Synthetic CT image for the brain arrange. 1 The data acquisition protocols for Synthetic CT are available on VA11A software with MAGNETOM RT Pro edition for MAGNETOM Vida and MAGNETOM Sola. 49 E A syngo MR XA61A – What’s New 5.29 HASTE Diffusion Available for: MAGNETOM Skyrafit Category: Standard feature HASTE Diffusion is a non-EPI based diffusion sequence Literature: to reliably detect diffusion-restrictive abnormalities such 1 De Foer B, Vercruysse JP, Bernaerts A, Maes J, Deckers F, Michiels J, et al. as cholesteatomas [1–3]. This functionality has been The value of single-shot turbo spin-echo diffusion-weighted MR imaging available on other systems (≤ 1.5T) for a while and has in the detection of middle ear cholesteatoma. Neuroradiology. 2007 now been extended to 3T. Oct;49(10):841-8. 2 Fan X, Liu Z, Ding C, Chang Z, Ma Q. The value of turbo spin-echo diffusion- weighted imaging apparent diffusion coefficient in the diagnosis of New benefits: temporal bone cholesteatoma. Clin Radiol. 2019 Dec;74(12):977. 3 Henninger B, Kremser C. Diffusion weighted imaging for the detection and • HASTE Diffusion is now available on 3T systems evaluation of cholesteatoma. World J Radiol. 2017 May 28;9(5):217-222. • Comprehensive diffusion portfolio with single-shot EPI, RESOLVE, BLADE, and HASTE Diffusion 50 E A syngo MR XA61A – What’s New 5.30 Open Recon Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Standard feature Pre-requisites: High-end computing Open Recon is a developer-friendly interface that Highlights and benefits: facilitates the creation and deployment of innovative • MR reconstruction algorithms. Open Recon opens Simplified reconstruction environment for scientists the MR system for such algorithms to be deployed • Convenient access to reconstruction parameters via by scientists, 3rd party companies and Siemens dedicated “inline” card Healthineers. Different reconstruction algorithms • Facilitated scientific collaboration via the ISMRM can be executed in a container on the reconstruction raw-data format system, exchanging data via a dedicated interface. • Possibility of MR reconstruction algorithms deployment With Open Recon, custom reconstruction algorithms for third parties and SHS can easily be run and adjusted, enabling seamless workflow. Open Recon also facilitates the sharing of algorithms across institutions relying on the ISMRM raw data format. With syngo MR XA60A, customized reconstructions are possible both in image-to-image as well as in raw data-to-image domain. USER > head >> Brain Assist > program >> t1_qtse_dark-fluid_sag_p2 ? x General @ 4:38 min 4Auto @ 2 @ 0.7x0.7x4.0 mm3 1.00 Protocol Parameters ............... Inline Use Routine Contrast Resolution Geometry System Physio Inline Sequence Voice Commands Run custom prototype image Execution Subtraction MIP Composing Open Recon reconstruction on the scanner Image Management Algorithm myRecon 1 Auto Load 3rd party or custom Copy References algorithm Preview Select 3rd party or custom Preset denoise Parameter 1 Setting A reconstruction algorithm to Free Text denoise denoise-enhanced-level1 Parameter 2 Setting B = mg be run denoise-enhanced-level2 denoise-enhanced-level3 Option 1 User-friendly interface super-resolution Option 2 smooth-super-resolution Adapt parameters provided by edge-super-resolution the algorithm like on any other super-resolution-gre-mpr tab card super-resolution-dwi The Open Recon tab can be found under “Inline”. 51 E A syngo MR XA61A – What’s New 5.31 Needle Intervention Add-in Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Purchasable feature Pre-requisite: Advanced Interactive Realtime Note: In-room monitor and in-room input modality (e.g. foot switch) highly recommended This Dot Add-In provides a user interface for workflow New benefits: improvement of MR-guided needle interventions. It supports planning a needle trajectory, laser-based The Dot Add-In combines different already available localization of the entry point as well as automatic system functionalities in order to simplify the workflow. slice positioning. 5.32 Advanced Interactive Realtime Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Purchasable feature The Advanced Interactive Realtime license now also recommended includes the HASTE Interactive sequence giving the user the opportunity to interactively change a subset of imaging parameters, e.g. slice position and orientation, during the acquisition. 52 E A syngo MR XA61A – What’s New 5.33 GOKnee 3D Available for: MAGNETOM Avantofit and MAGNETOM Skyrafit Category: Optional feature Pre-requisites: myExam Large Joint Assist Conventional clinical imaging of the knee is typically Push-button functionality is enabled by AutoAlign Knee3 performed with 2D TSE pulse sequences with high providing high consistency in imaging. The 3D protocols in-plane resolution (0.5 mm) but low through-plane are enabled by SPACE sequence with CAIPIRINHA resolution (2–4 mm) and with a slice gap. With 2D scans, acceleration. As the images are high-resolution 3D multi-planar reformats are not possible, and the need to isotropic, they can be read in any plane. acquire each orientation separately can lead to longer exam times of approximately 20 minutes. On syngo MR XA61 the GOKnee3D protocol becomes available also for MAGNETOM Avantofit and MAGNETOM GOKnee3D is a push-button, clinically validated, Skyrafit. Prerequisite is the optional myExam Large high-resolution 3D isotropic exam of the knee which Joint Assist. Once the Assist is available the protocol is takes only 10 minutes.2 GOKnee3D exam consists of available on the system directly – no need to download AutoAlign localizer in the knee, PD-weighted contrast the protocol separately. To achieve the mentioned exam and T2-weighted contrast with fat suppression. times a dedicated Tx/Rx Knee coil is required. GOKnee3D – Push-button, high-resolution 3D exam in 10 minutes1, 2, 3 AutoAlign Localizer IW/PD Total IW/T2 FS, 0.6 mm TA 13 s 0.5 mm 9:39 min iso TA 4:45 min Acquired at 3 Tesla with Tx/Rx Knee 15. Total exam time will vary with system field strength with up to 11 minutes at 1.5 Tesla. 1 Fritz J, et al. Three-dimensional CAIPIRINHA SPACE TSE for 5-minute high-resolution MRI of the knee. Invest Radiol 2016;51(10): 666-676. 2 Thawait GK. High resolution istropic 3D CAIPIRINHA SPACE MRI of the musculoskeletal system. MAGNETOM Flash 2016;(66):30-38. 3 Del Grande F, Fritz J, et al. Fully Automated 10-Minute 3D CAIPIRINHA SPACE TSE MRI of the Knee in Adults: A Multicenter, Multireader, Multifield-Strength Validation Study. Invest Radiol. 2018;53(11):689-697. 53 E A syngo MR XA61A – What’s New 6 Obsolete features The following features have been removed from syngo MR XA60 for those migrating directly from syngo MR VE line software. This will not affect those who are already on syngo MR XA30. 6.1 TimCT Onco Dot Engine 6.6 Fly Through TimCT Onco Dot Engine is not available with syngo MR Fly Through is not available with syngo MR XA60. XA60. There is, however, myExam Whole Body Assist (prerequisite: table rear support, FREEZEit+ and myExam Abdomen Assist). 6.7 MR View&GO – Dynamic Analysis 6.2 TimCT Angio Dot Engine The following parameters are not available: TimCT Angio Dot Engine is not available with syngo MR • Diff, Int XA60. Please check with your local Siemens Healthineers • Log team about future availability. • Standard Deviation • Slope • TTP • T1 / T2 / T2* – these are now available with MapIt 6.3 Mosaic images for BOLD/DTI • Test is available with Neuro 3D New in the syngo MR XA software line: b-value Due to a new data format, the export of BOLD images as a mosaic view is no longer supported. A mosaic view of DICOM images is available since the software version syngo MR XA11B. Real time acquisition “dynamic t-maps” 6.8 Access on image level is also no longer available. Operations on single frames (e.g., rotate one image out of an image series) are limited. 6.4 Real-time BOLD evaluation Already available with XA60: • Deletion of frames – i.e., deletion of single images Visualization and evaluation of BOLD data during the out of a multiframe series. acquisition are limited to syngo.via capabilities. • Windowing on a subset of images (= frames) – e.g., just one image or a selection of frames. 6.5 Printing Other operations such as sorting options, individual interaction with single images such as rotation will be available starting with software version syngo No assignment of print layouts based on scan protocols MR XA60A. is available. The deletion of every nth image of a selection of images from a film sheet (e.g. just one out of several series) will be available again with syngo MR XA50A. Please check with your local Siemens Healthineers team about the availability of the software version appropriate for your system. 54 E A syngo MR XA61A – What’s New 6.9 Position Display 6.12 MR Spectroscopy The Inline Position Display is no longer available. The following features are not implemented in syngo MR XA60 and are not planned to be implemented: • Open instances from one dataset (HISTO data, save 6.10 Breast biopsy single averages, save uncombined data, GABA) • Grid shift for CSI Not all biopsy needles are supported. Please check with • Change matrix interpolation your local Siemens Healthineers sales team. • Average Spectrum Computation / Multi Voxel Spectral Addition • Free-hand ROI. It is still possible to select multiple 6.11 Postprocessing Breast voxels by clicking them individually. • Eddy Current Estimation. The sequences svs_se and MR Soft Tissue postprocessing on VE line software svs_st offer a water reference scan which allows for contained motion correction and color maps (Wash-in, inline eddy current compensation processing, which Wash-out, TTP, PEI, MIP Time). makes the post-processing compensation redundant. • MR View&GO, MR Breast and MR Brevis offer motion Layout for multiple spectra is limited to two spectras. correction with BRACE for enhanced DICOM images, but without the specific color maps. MR Brevis offers color overlay maps in a different way. 6.13 MR Spectroscopy Workflow The data displayed on the color-coded map can be analyzed further by semi-automatically identifying Handling of copy references is available. CAVE: Reference the most suspicious enhancing area of a lesion. This images of copy references target step are not loaded is done by simply drawing a volume of interest (VOI) automatically in syngo MR Spectro if the copy reference around a color-coded lesion. Volumetric data on voxel target step is not opened in the queue. percentages of enhancement, curve type distribution and the lesion volume are also obtained. 55 Siemens Healthineers AG (listed in Frankfurt, Germany: The outcomes and statements provided by customers SHL) pioneers breakthroughs in healthcare. For everyone. of Siemens Healthineers are unique to each customer’s Everywhere. Sustainably. As a leading medical setting. Since there is no “typical” hospital and many technology company headquartered in Erlangen, variables exist (e.g., hospital size, case mix, and level of Germany, Siemens Healthineers and its regional service/technology adoption), there can be no guarantee companies are continuously developing their product that others will achieve the same results. and service portfolio, with AI-supported applications and digital offerings that play an increasingly important role On account of certain regional limitations of sales rights in the next generation of medical technology. These new and service availability, we cannot guarantee that all applications will enhance the company’s foundation in products included in this brochure are available through in-vitro diagnostics, image-guided therapy, in-vivo the Siemens Healthineers sales organization worldwide. diagnostics, and innovative cancer care. Availability and packaging may vary by country and is subject to change without prior notice. Some/All of the Siemens Healthineers also provides a range of services features and products described herein may not be and solutions to enhance healthcare providers’ ability to available in the United States. provide high-quality, efficient care. In fiscal 2022, which ended on September 30, 2022, Siemens Healthineers, The information in this document contains general which has approximately 69,500 employees worldwide, technical descriptions of specifications and options as generated revenue of around €21.7 billion and adjusted well as standard and optional features, which do not EBIT of almost €3.7 billion. always have to be present in individual cases. Further information is available at Siemens Healthineers reserves the right to modify the www.siemens-healthineers.com. design, packaging, specifications, and options described herein without prior notice. For the most current information, please contact your local sales representative from Siemens Healthineers. Note: Any technical data contained in this document may vary within defined tolerances. Original images always lose a certain amount of detail when reproduced. Siemens Healthineers Headquarters USA Siemens Healthineers AG Siemens Medical Solutions USA, Inc. Siemensstr. 3 Healthcare 91301 Forchheim, Germany 40 Liberty Boulevard siemens-healthineers.com Malvern, PA 19355-9998, USA siemens-healthineers.us Published by Siemens Healthineers AG · Order No. IBD-24-NAM-5692 · QR700006916 · 03.2024 · © Siemens Healthineers AG, 2024