syngo Osteo CT - Somaris 7 Job Aid

SIEMENS Healthineers syngo Osteo CT Somaris 7 HOOD05162003301250 | Effective: 10/12/2022 Unestricted © Siemens Healthineers, 2022 Osteo CT* – Table of Contents SIEMENS Healthineers Clinical Overview Required Hardware Default Protocol Patient Positioning Scanning Reconstructions Postprocessing Osteo Results Caution and Configuration *Osteo CT is an optional plug-in for CT View&GO on all Somaris 10 scanners 2 Unrestricted © Siemens Healthineers, 2022 Osteo CT – Clinical Overview SIEMENS Healthineers Osteoporosis, a metabolic disease, causes bones to become weak and brittle Normal bone so brittle that a fall or even mild stresses such as bending over or coughing — can cause a fracture. Osteoporosis-related fractures most commonly occur in the hip, wrist, or spine. Bone is living tissue that is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone doesn't keep up with the loss of old bone. Osteoporosis affects men and women of all races. But white and Asian women Osteoporotic bone especially older women who are past menopause — are at highest risk. O MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH. ALL RIGHTS RESERVED. — Medications, healthy diet, and weight-bearing exercise can help prevent bone loss or strengthen already weak bones. Source: https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968 3 Unrestricted © Siemens Healthineers, 2022 Osteo CT – Clinical Overview SIEMENS Healthineers There typically are no symptoms in the early stages of bone loss. But once your bones have been weakened by osteoporosis, you might have signs and symptoms that include: • Back pain, caused by a fractured or collapsed vertebra • Loss of height over time A stooped posture CHATO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH . ALL RIGHTS RESERVED. • • A bone that breaks much more easily than expected Prevention: Good nutrition and regular exercise are essential for keeping your bones healthy throughout your life. Source: https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968 4 Unrestricted © Siemens Healthineers, 2022 Osteo CT – Clinical Overview SIEMENS Healthineers The diagnosis and follow-up of osteoporosis are commonly carried out by non-invasive measurements of bone mineral density (BMD). These measurements must be highly reproducible because they are required to determine small changes in bone mineral density. Siemens Osteo CT evaluation requires the use of special hardware and scan protocols for image acquisition. For that reason, the Siemens SOMATOM CT Scanners offer a special default Osteo CT scan protocol. 5 Unrestricted © Siemens Healthineers, 2022 Osteo CT - Hardware SIEMENS Healthineers Required Hardware for Osteo CT scanning: • Osteo Positioning Mattress – to hold the phantom Osteo positioning mattress Use the Osteo positioning mattress to position the patient appropriately for the Osteo • Reference Phantom – to measure bone mineral density examination. Table top mattress The table top mattress has a cut-out in the vertebral region for the reference phantom and the gel pack. • Gel Pack – to fill the air gap in lower back between skin/phantom Reference phantom and gel pack TOP Use the table top mattress in combination with the reference phantom and the gel pack. Other non-Osteo examinations For standard examinations, use the Osteo positioning mattress with the PE pad. Reference phantom and gel pack 6 Unrestricted © Siemens Healthineers, 2022 Osteo CT - Scan Technique SIEMENS Healthineers Simultaneous Calibration Technique CT slices are obtained through several lumbar vertebrae with the patientlying on the reference phantom. H The attenuation of the vertebral body is compared with the reference phantom & expressed in mg/ml Ca-HA. • Tips & Tricks 4/1 • Maximize patient’s comfort • Minimize lordosis with gel pad & leg support • Lateral topogram to localize the mid vertebralslice (L1-L3) • Label the slice (max. 2 digits) L1 • FOV to include the whole phantom • Spine in the center (Specific table height 125) 7 Unrestricted © Siemens Healthineers, 2022 Osteo CT – Protocol SIEMENS Healthineers Siemens Default Osteo CT Protocol: Patient Model Dialog • Is found in the Patient Model Dialogue under the . Adult Dual Energy Child Spine region (C Spine IR Vol Cardiac C_Spine IR • It consists of a Topogram and 3 separate vertebral C_Spine_Vol C_Spine Vascular scan ranges Spine IR Vol Spine IR SpineRoutine Vol RT • Scan at least three (3) vertebral bodies (evaluation SpineRoutine requires at least 3 vertebrae) SpineNeuro Vol SpineNeuro Specials Typically, the three bodies are L1, L2, and L3 level. Osteo • Spineinterver PET However, if there is metal or damage in those SpineSeq Osteo areas, use a different level and/or scan more than 3 SpineIntervention and choose which are best for the evaluation OK Cancel • Use image comments for labels (i.e., L1, L2, L3, L4, L5, or T12). These comments will be used for Osteo evaluation results. 8 Unrestricted © Siemens Healthineers, 2022 Osteo CT – Protocol SIEMENS Healthineers Default protocol parameters: Osteo • 10mm slice thickness • CARE kV (if applicable) • Kernel = S80 (special Osteo kernel – do not change)! • Table Height MUST be at 125mm 9 Unrestricted © Siemens Healthineers, 2022 Osteo CT – Patient Positioning SIEMENS Healthineers Place the required Osteo mattress pad with Phantom on the tabletop; · Adult with the word Top towards the Gantry. . Child Patient Position – HF Supine or FF Supine (ensure area of interest is directly over Phantom). Best way to line up the patient is to position the bottom of the phantom at a level between the Iliac Crest and ASIS. Place gel pack under the patient’s Lumbar Spine (to reduce air gap). OK Cancel 10 Unrestricted © Siemens Healthineers, 2022 Osteo CT – Scanning SIEMENS Healthineers If you are on a SOMATOM Force, Drive, or SOMATOM Definition Flash AH scanner, you will not be able to angle. Be sure to include at least 3 usable vertebral bodies. If you are on a SOMATOM Definition AS, Edge, or SOMATOM Perspective scanner, you will use sequence and tilt to each vertebral body. If the Osteo Phantom is not in the image, no evaluation will be able to be performed. Water Bone equivalent equivalent 11 Unrestricted © Siemens Healthineers, 2022 Osteo CT – Postprocessing SIEMENS Healthineers Postprocessing workflow: Load the image data into Osteo CT. It will populate and automatically create the contours of the vertebrae. You can also adjust the contours if you wish by moving the dots with the mouse. 12 Unrestricted © Siemens Healthineers, 2022 Automatic Contour Tracing SIEMENS Healthineers Mark phantom • Center of spinal canal • Top of vertebral body • Left & Right points • Automatic contour Pitfalls • Phantom not in FOV • Sloppy positioning Aortic calcifications O • • Degenerative changes? Osteophytes? • Bowel gas 13 Unrestricted © Siemens Healthineers, 2022 Presentation of the Results SIEMENS Healthineers Bone Mineral Density of L3 [ mg Ca-HA 'ml] +- Standard deviation : Numerical values of BMD & the standard deviation (SD) for: Left Right Total • Trabecular Bone Trabecular 48.3 +- 32.9 46.8 +- 30.2 47.6 +- 31.6 • Cortical Bone Cortical 206.6 +- 65.8 188.9 +- 44.9 197.7 +- 57.0 Resultsfor each vertebra & Total average of all vertebrae. Trabecular bone Cortical bone OSTEO- Evaluation Summary Osteo CT Tuebingen 8816080 Amb 1 Male, 62 Years 12-Jul-2000 Bone Mineral Density [mg Ca-HA /ml] +- Standard deviation : Vertebra Scan Number Trabecular Cortical 4 100.1 +- 44.4 343.5 +- 110.9 3 86.9 +- 44.8 299.1 +- 114.6 2 108.6 +- 64.5 292.3 +- 117.3 Average 98.5 +- 51.3 311.6 +- 114.2 14 For internal use only! Th Unrestricted © Siemens Healthineers, 2022 Osteo CT – Results SIEMENS Healthineers T-Score (what doctors typically look for) This is the deviation of the average BMD of the patient from that of a young healthy control. It represents bone loss with reference to the peak bone mass. Z-Score This is the deviation of the average BMD of the patient from that of a healthy person of the same age. It is an indicator of biological variability. Both T & Z Scores are normalized using the Standard Deviation of the reference data. • The reference database and calibration values with other phantom & T-score age values can be changed under Osteo Configuration. • The results can be exported to a diskette in ASCII format. 15 Unrestricted © Siemens Healthineers, 2022 Osteo CT – Postprocessing SIEMENS Healthineers Contour Labels: AH (A) Anterior point of the vertebral body (L) Left Intermediate point (C) Center of the spinal canal (T) Posterior point of the vertebral body (R) Right Intermediate point 16 Unrestricted © Siemens Healthineers, 2022 Osteo CT – Results SIEMENS Healthineers Osteo CT has an age restriction. If a patient is age 81 or higher, no results will be provided. The database cuts off at age 81. (e.g., an 80 y/o will get results, but an 81 y/o will not). Osteo CT also provides results based on gender (male/female). Be sure to assure both gender and the correct D.O.B. are provided. NOTE: It is NOT acceptable to change the patient’s D.O.B. in order to obtain Osteo CT results. 17 Unrestricted © Siemens Healthineers, 2022 Interpretations, WHO Guidelines (T-score) SIEMENS Healthineers Normal Less than 1.0 SD below young adult mean value. Osteopenia Between 1.0 & 2.5 SD below the mean for young, (low bone mass) healthy adults (30-40 years) moderate risk, watchful monitoring. Osteoporosis More than 2.5 SD below the mean for young adult but no fractures yet. High risk, warrants immediate attention. Severe/Established Osteoporosis More than 2.5 SD below young adult mean plus history of nonviolent fracture. Requirestreatmentsto increase bone mass. 18 Source: Diagnosis | International Osteoporosis Foundation Unrestricted © Siemens Healthineers, 2022 Survey SIEMENS Healthineers https://forms.office.com/Pages/ResponsePage.aspx?id=3Rq_XSogjUuBW78PsCTgMweuvglp4Q1InElnh3yC6St UNTUyUFNRSTdERE1FQTFYVklTMVZGMDc2Ui4u 19 Unrestricted © Siemens Healthineers, 2022