syngo MR E11E Delta list

syngo MR E11E New features and improvements www.siemens.com/mri SIEMENS Healthineers Contents Contents 1. Basics 1.1 Dixon improvements 3 1.2 CP/EP mode selection prior to exam 4 1.3 T2 dark-fluid improvements 4 2. Application options 2.1 GOKnee3D 5 2.2 Implant Suite on MAGNETOM Aera 6 2.3 Spin-Echo EPI for MR Elastography (SE EPI MRE) 7 2.4 CAIPIRINHA SPACE 8 2.5 Compressed Sensing Cardiac Cine 9 3. Hardware and software options 3.1 Access-i for supporting interventional MRI procedures 10 3.2 HIFU support package 10 3.3 Support of Contour 24 coil 11 3.4 Dual Monitor Set-up 11 Supported systems / configurations: • 1.5T systems (MAGNETOM Aera incl. Aera mobile, MAGNETOM Avantofit) • 3T systems (MAGNETOM Skyra, MAGNETOM Skyrafit, MAGNETOM Prisma, MAGNETOM Prismafit) • All gradient and channel configurations From syngo MR E11C to syngo MR E11E – Timeline of relevant and new topics syngo MR E11C AP02 SH04 AP04 AP03 AP01 syngo MR E11E MAGNETOM Aera 1.5T Compressed Implant Suite3 Sensing CAIPRINHA MAGNETOM Skyra 3T Cardiac Cine SPACE GOKnee3D1 Access-i HIFU CP/EP Mode MAGNETOM Prisma 3T Contour 24 coil file Compressed Compressed MAGNETOM Prismafit 3T Sensing Sensing Cardiac Cine2 Cardiac Cine4 MAGNETOM Skyrafit 3T Dual Monitor MAGNETOM Avantofit 1.5T 02/2016 11/2016 11/2017 12/2017 01/2018 07/2018 01/2019 1MAGNETOM Aera and MAGNETOM Skyra 3MAGNETOM Area 2MAGNETOM Prisma 4MAGNETOM Avantofit 2 syngo MR E11E Basics 1. Basics 1.1 Dixon improvements Dixon is a very robust technique for the separation of fat and water signals, e.g., used for fat suppression in the abdomen or for musculoskeletal applications. Occasionally, however, images reconstructed with the Dixon technique may show local ‘fat/water swaps’ due to strong local inhomogeneities and respective peak shifts. The occurrence of local fat/water swaps is reduced by a new optimized 2-point Dixon algorithm which connects high-confidence areas of water or fat signal with neighboring areas. Dixon old version Dixon improved syngo MR E11E 3 Basics 1.2 CP/EP mode selection prior to exam Following the IEC requirement IEC 60601-2-33 Ed. 3.2 the user can select between “CP only” and “Any” as excitation mode in the patient registration step. This will ensure that in the CP mode all protocols are automatically performed with CP (circularized polarization) even if the protocol is in the EP (elliptical polarization) mode per default. This is recommended in cases where low SAR is indicated, e.g., for pregnant patients or patients with implants. 1.3 T2 Dark-Fluid improvements With 3D SPACE dark-fluid unsuppressed CSF can create artifacts in particular in the pons. By replacing the currently used non-selective T2-IR pulse with a non-selective T2 preparation IR pulse the quality of T2 PACE dark-fluid is significantly improved. 180° 180° 180° 90° -90° 90° Multi spin- echo train T2P T1 WM M1 GM t 0 CSF Unsuppressed CSF with Excellent CSF suppression Acquisition scheme of the T2 SPACE non-selective T2-Inversion with non-selective T2 dark-fluid sequence with non-selective Recovery preparation preparation IR pulse T2 preparation IR pulse in particular in the pons In addition, the new “Non-selective T2-Inversion Recovery” module allows more complete recovery during the inversion time than a classical IR pulse and hence increased GM/WM contrast for a given TR. By also introducing CAIPIRINHA acceleration for the SPACE sequence, the acquisition time can be reduced significantly. 4 syngo MR E11E Application options 2. Application options 2.1 GOKnee3D1 GOKnee3D is a fast 10-minute, push-button examination for diagnostic imaging of the knee developed and clinically validated by the US board certified MSK radiologists at John Hopkins University Hospital. GOKnee3D exam consists of AutoAlign localizer in the knee, PD weighted contrast and T2-weighted contrast with fat suppression. The AutoAlign technology provides a push-button functionality and ensures consistency in imaging. The 3D protocols are high-resolution and isotropic, enabled by SPACE sequence with CAIPIRINHA acceleration. Prerequisites for 1.5T MAGNETOM Aera and 3T MAGNETOM Skyra: AutoAlign knee functionality (requires Large Joint Dot Engine) and a dedicated Tx/Rx Knee coil. To download the GOKnee3D protocols (.exar1 files) please go to: siemens.com/magnetom-world > Clinical Corner > Protocols 1Standard for MAGNETOM Aera and MAGNETOM Skyra with software syngo MR E11C AP04 AutoAlign Localizer IW/T2 FS, 0.8 mm iso IW/PD, 0.6 mm iso TA 10:16 TA 0:16 min TA 5:56 min TA 4:03 min min Further Reading GOKnee3D - Fully-automated One-button- push High-resolution MRI of the Knee Jon Fritz, M.D. R.E. D.A.B.R.: Flippe bel Cronde. M.D. MBA. MHEM: Neil Rumor, M Du berek F Popp. M.D. washyuds J Lee, M.D. jobra Hopkins University School of Medicine Baltimore MD, USA GOKnee3D – Fully-automated One-button-push High-resolution MRI of the Knee Jan Fritz, M.D., P.D., D.A.B.R.; et al. (Johns Hopkins University School of Medicine, Baltimore, MD, USA) MAGNETOM Flash (69) 3/2017 page 81–89 The article is online at www.siemens.com/magnetom-world syngo MR E11E 5 Application options 2.2 Implant Suite on MAGNETOM Aera Implant Suite1 enables to perform MRI examinations in patients with MR conditional implants2 in accordance with MR safety guidelines (IEC 62570:2014-2). With Implant Suite, the MR system is able to set limits to critical MR parameters to fulfill MR conditions of use specified by the implant manufacturer. With a simple workflow, different operational modes of the MR system can be selected complying with MR conditions of use of the MR conditional implant. Limits to RF-specific parameters like the specific absorption rate (SAR) and the B1+ magnetic field intensity (rms) as well as relevant gradient field parameters can be set. During the MR examination the selected operational mode is always indicated and supports the operator in editing imaging protocols within the given limits. Different scan modes provide the possibility to address different implant requirements, addressing a wide range of both active and passive MR Conditional implants, e.g., stents, pacemakers, deep brain stimulators. • Prerequisite: An emergency power off switch needs to be installed and must be operable for the system, if not already installed. • To insure safe scanning of patients with implants, the Implant Suite limits the MR system during the examination according to MR conditional implants (no support of local TX coils). Included into the Implant Suite is dedicated safety hardware. 1Optional on MAGNETOM Aera 2The MRI restrictions (if any) of the metal implant must be considered prior to patient undergoing MRI exam. 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 manu- facturer, not of Siemens. Select MR Conditional Implant Scan Mode Patient Confirmation Check the specification of the VR Conditional @ more into The comesponding scan mode Scan Limits 1 Scan Limits ? can Limits 3 PATIENT SAFETY STUDY and SAR Limes All Pro Body SAR $ 2.0 W/kg < 08 WINg 1 0.8 Wikg Name Aera_Implant_Suite_1 USER Head SAR $ 3.2 W/kg $ 1.25 Wkg $ 1 25 Wkg Position Head First - Supine limited by SAR MAC 11. Peak Height 1.54 Head Weight 63.00 [kg] Implant_S Gradient related Lames Implant_S 4 50 17 Incu Phys $ 200 T/m/S $ 200 Tim/s : 125 Tant HSC Gradient $ 19 T/m ($ 1900 Gs/cm) $ 19 Tim (S 1900 Gscm) : 19 Tan ($ 1900 Gskcm) SCAN MODES NIA RT-Interven Select Implant Please Select RF Transmit Mode No Implant test WIP1057 That you have connected an cos MR Safe Implant . what you do not une local transmitting (TwPoc) com First Level Mode MR Conditional Implant Gradient MEDICAL INFORMATION Clinical Corner > Protocols 1 Data on file 2 Breuer FA, et al., Magn Reson Med 2006; 55 (3): 54–56. ID 1aaaa2269 3D T2 CAIPIRINHA SPACE DIR AM ID 1aaaa2269 3D T2 CAIPIRINHA SPACE Dark-Fluid Further Reading CAIPRINHA and SPACE - a Winning Combination Several questions, however, temain: . How can speed and diagnosde potential be combined? with coovestlo (The GOBrain protocol is the perfect answer to this" and specificity Michel Faret': Fr FG Barralf; Christophe Barles'; Sylvain Doupsin, Ph.D." question [2-411. Immediataly ty GIF IRMAS. Saint-Priest-en-jargr, France Is speed calated to 20 acquisition? Chan Frier et al parameters it Department of Neuroradiology, University Hospital Saint Etienne, France propose COKneeJO for efficient 30 imaging of the ISiemens Healthingers, Abr en-Provence, France knee joint [SIX roton density egion and it is *Siemens Healthineens, Erlangen, Germany GOKnee 3D is the esplosive combination, mixing SPACE acquisition lin chelquit (Sampling Perfection with parameters to Application optimized Contrasts using different tip Detection of b To avoid CAIPIRINHA and SPACE – a Winning Combination Introduction is relatively slow, can be considered a limiting factos angle Evolution and the parallel imaging lechnique We decided to MRI is, or is becoming, the medical imaging modality Inducing patient discomfort and patient motion. of choice in more and more diverse applications .. " [1]. Furthermore, data acquired is mainly 20 Magnetic resonance Imaging can be described as Acquisition time acceleration has become a major target in these last few years, on the one hand to reduce The success story of medical imaging mainly due to two examination time and, on the other hand, to make Michel Paret, et al. characteristics: its harmlessness and its ability so manipu- Mil accessible to patienes suffering from pain andior late contrast However, the acquisition technique, which non-cooperative patients. SPACE var TI CAIPIRINHA Sios thickness Total TA minitec Method (GIE IRMAS, Saint-Priest-en-Jarez, France) MAGNETOM Flash (71) 2/2018 page 4–51 The article is online at www.siemens.com/magnetom-world -- 8 syngo MR E11E Application options 2.5 Compressed Sensing Cardiac Cine1 Compressed Sensing Cardiac Cine is based on the BEAT TrueFISP sequence with excellent myocardium-blood contrast for functional assessment of the ventricles. It allows higher temporal resolution imaging in real time mode, without compromising on spatial resolution. Protocols are provided for full coverage of the heart within a single breath-hold for quantitative functional assessment. In real-time mode, it is robust against arrhythmia and breathing artifacts. With “Adaptive Triggering” the full heart cycle can be examined, even in late diastole. Compressed Sensing Cardiac Cine can be combined with Inline Ventricular Function evaluation for inline quantitative assessment of the heart function. Rather than taking nearly six minutes with multiple breath-holds, a Cardiac Cine scan can now be done within 15–25 seconds – in free-breathing. • Prerequisite: Software syngo MR E11C (MAGNETOM Aera, Skyra, Prisma, Prismafit) • Prerequisite: Software syngo MR E11E (MAGNETOM Avantofit), delivery presumably starts 1st quarter 2019 • Prerequisite: Available for MAGNETOM Aera with XQ gradients and Tim [204x48] or [204x64] configurations • Prerequisite: Available for MAGNETOM Skyra with Tim [204x48], [204x64] or [204x128] configurations • Prerequisite: for MAGNETOM Aera/Skyra with Tim [204x48] configurations and for MAGNETOM Avantofit/Prismafit upgrades, the “High-End Computing” or “High-End Computing Upgrade” option is required 1Optional Standard Cardiac Cine Compressed Sensing Cardiac Cine Standard Cardiac Cine Compressed Sensing Cardiac Cine segmented (8 heart-beats) real-time (1 heart-beat) segmented (8 heart-beats) real-time (1 heart-beat) - ---- Further Reading Impact of Compressed Sensing Cardiac Cine in a busy clinical practice Nome Gont, M.D. Ph.D; Gilles Auroy vestibul Cordovasculore Ports Sud Masbg, Fronce Impact of Compressed Sensing Cardiac Cine in a Busy Clinical Practice Jérome Garot, M.D., Ph.D., et al. (Institut Cardiovasculaire Paris Sud, Massy, France) MAGNETOM Flash (70) 1/2018 page 76–78 The article is online at www.siemens.com/magnetom-world syngo MR E11E 9 Hardware and software options Learn more Example 2: female, 26 yo. Tetralogy of Fallot irregular heart-rate & poor breath-hold + Paramatar + chambers Short-ex's François Pontana How to improve time efficiency in Cardiac MRI: Caril image quality Score 2 Clinical experience with compressed sensing incasa val cincel excelente OSSFP AVER : 51% Francois Pontana, M.D. (Heart and Lung Institute, Lille University Hospital, France) Overall image quality Score 3 CS BVEF: 48% SIEMENS. Healthineers You will find everything you always wanted to know ome : Medical ingre : Magnetic Resonance Imaging > MAGNETOM World : Hot Toples . Compressed Sensire about Compressed Sensing at Compressed Sensing Articles and keynotes www.siemens.com/magnetom-world Overview Cardiovascular MRI Body MRI Musculoskeletal MRI > Hot Topics > Compressed Sensing Get beyond the barrier of acquisition speed Compressed Sensing (CS) is an exciting new method with the potential to accelerate MR imaging beyond what is possible with any other method. The successful utilization of Compressed Sensing is a team play of data acquisition and image reconstruction. Read the articles below to learn how it works. > Cardiovascular MRI > Body MRI Christoph Forman explains the three golden rules of Compressed Sensing Sensing Watch the video and learn how the technology works. 3. Hardware and software options 3.1 Access-i for supporting interventional MRI procedures1 Access-i is a new interface which supports to operate a MAGNETOM system from another computer (client) in addition to the syngo Acquisition Workplace. It allows the remote client to receive images in real time from the MR, as well as to remotely control the MR Acquisition Workplace from the third party device by using the Access-i Dot AddIn. 3.2 HIFU support package The HIFU support package supports customers to perform MR-guided HIFU procedures with the INSIGHTEC Exablate2 system. It includes the following hardware and software components: Hardware: • A hardware router to enable connections to third party computers based on the Access-i interface functionality • A trigger converter to convert optical signal from the MR to an electrical signal input to third party devices Software licenses: • Access-i interface to allow the third party workstation to interface with the MR • Phase Imaging license (which provides raw data for generation of temperature maps on third party devices) • Projection license (supports tracking of third party devices in the MR) 1Optional 2The INSIGHTEC Exablate is not included in this package. 10 syngo MR E11E Hardware and software options 3.3 Support of Contour 24 coil1,2 Technical support of Contour 24 coil is enabled with syngo MR E11E. Protocols have to be optimized by the MR application specialist. The Contour 24 has a 24-element design with 24 integrated preamplifiers that are arranged in four clusters of six coil elements each. The Contour 24 will typically be used in combination with the Spine 32 for examinations of the abdomen. It can be positioned in different orientations and addresses the required range for the examinations of obese patient to small patients. The lightweight coil with its new viscoelastic material improves patient comfort and can be easily connected via Slide Connect technology. No tuning of the fully iPAT-compatible Contour 24 is necessary allowing for efficient and patient friendly set-up. Available for the following system configurations: • MAGNETOM Aera with Tim [204x48] and [204x64] • MAGNETOM Skyra with Tim [204x48], [204x64] and [204x128] 3.4 Dual Monitor Set-up2 The Dual Monitor Option will substantially improve the workflow of MR examinations with dedicated monitors for planning and processing examinations. With a comfortable work space that avoids interruptions between planning, scanning and viewing the interaction between the user and the MRI is more smooth and natural. It allows to keep running patient examinations always in sight to allow for fast interactions whilst reserving the second screen for standard and advanced processing and reviewing steps. The option includes a second 19” LCD monitor identical to the system main host monitor. The left monitor will be used for the examination exclusively, whereas all post processing tasks are performed on the right monitor. The Dot Cockpit can be placed on both monitors. 1Excluded are Tim TX Shape systems 2Optional 3WIP, the product is currently under development and is not for sale in the U.S. and in other countries. Its future availability cannot be ensured. syngo MR E11E 11 Not for distribution in the US On account of certain regional limitations of sales rights may not be commercially available in all countries. and service availability, we cannot guarantee that all Due to regulatory reasons their future availability products included in this brochure are available through cannot be guaranteed. Please contact your local the Siemens sales organization worldwide. Availability Siemens organization for further details. and packaging may vary by country and is subject to change without prior notice. Some/All of the features Siemens reserves the right to modify the design, and products described herein may not be available in packaging, specifications, and options described herein the United States. without prior notice. Please contact your local Siemens sales representative for the most current information. The information in this document contains general technical descriptions of specifications and options as Note: Any technical data contained in this document well as standard and optional features which do not may vary within defined tolerances. Original images always have to be present in individual cases, and which always lose a certain amount of detail when reproduced. Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84-0 siemens-healthineers.com Published by Siemens Healthcare GmbH · Order No. A91MR-975-14C-7600 · © Siemens Healthcare GmbH, 2019