What‘s New in CTH syngo.via VC10

SIEMENS Healthineers What‘s New in CTH syngo.via VC10 Template Effective Date: 26 Mar 2025 | QR700020784 1 This training material is based on the medical device syngo.via RT Image Suite VC10. Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 Disclaimer SIEMENS Healthineers syngo.via Q Scanner AI-Rad Companion V syngo.via Syngo Carbon View&GO Space Please keep in mind that the user interface may differ slightly from what is shown in this Job Aid. The actual usage of the tool may differ slightly on the different host systems, for example on syngo.via, Syngo Carbon Space, syngo.via View&GO, AI-Rad Companion or on the scanner. The tool functionality defined in this Job Aid is applicable to any of the Siemens Healthineers products in which you find this tool. Template Effective Date: 26 Mar 2025 | QR700020784 2 2 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 What‘s New in CTH syngo.via VC10 SIEMENS Healthineers MR – Synthetic CT (sCT) Improvement 5 MR – Auto contouring 9 CT – Auto contouring 15 Convert and import of RT Structure Template 26 Image Orientation 30 CT Windowing Presets 35 Configuration Patient Marking and Beam Placement 37 Courtesy of Diagnostikum Graz, Graz, Austria Template Effective Date: 26 Mar 2025 | QR700020784 3 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers Stay ahead with continuous innovations SIEMENS. Sola_Head X Introduction of auto contouring for MRI: Healthineers 5/1/1962 F Germany_MAC MM RT Image Suite MM RT Image Suite Viewing • Focus on male pelvis organs at risk. • Brain organs at risk and brain metastasis for VII Brainstem example for SRS planning. Favorite Tools Cochlea Lent Cochlea Right Anatomy & Targets * × Cornes Left Cornea Right Structures POI Expand auto contouring for CT: Name Brainstem AVOIDANCE Series Cochlea Left • Included more organs at risk, such as mediastinal AVOIDANCE Cochlea Right lymph nodes. AVOIDANCE Cornea Left O AVOIDANCE O Cornea Right AVOIDANCE • Improved selected organs. Finding Favorite Tools H H = Synthetic Display • Implemented multi-guideline for different cancer Patient Bcam Marking Placement CT Dose Anatomy & Targets sites, like RTOG or ESTRO. DVH Merge Lung Apply Display Dose Ventilation Template C+ auto Contour Adapt Create Crop Creation Contours Margin Structure Correct 40 Create Split Series Export Improvements in Synthetic CT algorithm: Data Series Data 9:09 AM • Updated from 2D-based network to 3D-based neural network. i Besides new features, this software solution receives regular updates, bringing improvements and enhancements • Improved resolution for pelvis and brain. to existing features. Template Effective Date: 26 Mar 2025 | QR700020784 4 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Courtesy of Universitätsklinikum Erlangen, Germany Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 SIEMENS Healthineers MR – Synthetic CT (sCT) Improvement Template Effective Date: 26 Mar 2025 | QR700020784 5 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers MR-based Synthetic CT (sCT) images for brain & pelvis (I) T1 VIBE Dixon Desired features • Ensure high geometric fidelity. • Achieve HU values comparable to CT for various tissue types, from bones to soft tissue and air. • Maintain continuous HU values. In-phase image Opposed-phase image Continuous HU MR-based Synthetic CT (sCT) Template Effective Date: 26 Mar 2025 | QR700020784 6 MR-based Synthetic CT (AI algorithm) is an optional feature available in syngo.via RT Image Suite Job Aid Effective Date: 30 Apr 2025 | QR700022632 starting from software version VB60. Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers MR-based sCT images for brain & pelvis (II) New 3D algorithm model: • Automatically replaces the prior AI algorithm in VB80. • Resolves small spine and narrow bone structures better. • Represents skull base and small features well. • Provides good soft tissue structure. sCT output resolution changes: • Brain: 1 x 1 x 1 mm. • Pelvis: 1 x 1 x 2 mm. • Fixed resolution, previously depended on slice thickness. Continuous HU MR-based sCT Workflow change: • sCT series is saved automatically after generation. • Previously, user needed to manually save and close the workflow. Template Effective Date: 26 Mar 2025 | QR700020784 7 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers MR-based sCT images for brain & pelvis (III) Synthetic CT VB80 (2D model) Synthetic CT VC10 (3D model) Template Effective Date: 26 Mar 2025 | QR700020784 8 MR-based Synthetic CT (AI algorithm) is an optional feature available in syngo.via RT Job Aid Effective Date: 30 Apr 2025 | QR700022632 Image Suite starting from software version VB60. Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 SIEMENS Healthineers MR – Auto contouring Template Effective Date: 26 Mar 2025 | QR700020784 9 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers MR auto contouring for Organs at Risk – Male pelvis T1w Dixon Water • Body • Proximal Femur (L/R) T2w 2D TSE MRI • Anal Canal • Bladder • Penile Bulb • Prostate • Rectum • Seminal Vesicles Template Effective Date: 26 Mar 2025 | QR700020784 10 Courtesy of Universitätsklinikum Erlangen, Germany Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers MR auto contouring – Technical requirements – Male pelvis Pelvis • Axial, T1w and/or T2w sequences • Different structures on T1 and T2 • 2D T2w TSE • 3D T1w VIBE Dixon Water - Same sequence as for sCT (in/opp images for sCT, Water image for auto contour) • Field strength: 1.5T or 3T Template Effective Date: 26 Mar 2025 | QR700020784 11 Courtesy of Universitätsklinikum Erlangen, Germany Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers MR auto contouring for brain OAR and brain metastases (I) T1w 3D CE MPRAGE Metastasis (106 mm^3) Metastasis (49 mm/3) Metastasis (2627 mm^3) Metastasis (38 mm^3) Brainstem Metastasis (855 mm^3) Metastasis (12 mm^3) • Metastasis (223 mm^3) Metastasis (7 mm^3) Metastasis (704 mm^3) Metastasis (175 mm^3) Metastasis (68 mm^3) Metastasis (10 mm^3) • Cochlea (L/R) Metastasis (7 mm^3) Metastasis (61 mm^3) Metastasis (439 mm^3) Metastasis (203 mm^3) Metastasis (379 mm^3) Metastasis (192 mm^3) Metastasis (40 mm^3) Metastasis (13 mm^3) • Cornea (L/R) Metastasis (431 mm^3) Hippocampus Metastasis (438 mm^3) Metastasis (52 mm^3) Metastasis (180 mm^3) Metastasis (77 mm/3) Hippocampus • Eye Globe (L/R) Metastasis (225 mm^3) Metastasis (31 mm^3) Metastasis (34 mm^3) Metastasis (147 mm^3) Metastasis (120 mm^3) Cochlea • Hippocampus (L/R) Brainstem Metastasis (230 mm^3) Metastasis (823 mm^3) Lacrimal Gland Metastasis (39 mm^3) Retina Metastasis (77 mm^3) Eye Metastasis (199 mm^3) • Lacrimal Gland (L/R) Cornea Metastasis (25 mm^3) Lens Metastasis (332 mm^3) Optic Nerve Metastasis (296 mm^3) • Lens (L/R) Pituitary Gland Metastasis (319 mm^3) Metastasis (114 mm^3) Metastasis (251 mm^3) Optic Nerve Cochlea Retina Metastasis (3399 mm/3) • Optic Chiasm Lacrimal Gland - Lens Spinal Cord - Cornea • Optic Nerve (L/R) • Pituitary Gland • Retina (L/R) • Spinal Cord Template Effective Date: 26 Mar 2025 | QR700020784 12 Left image: Courtesy of Clinique de la Reine Blanche, Saran, France; Job Aid Effective Date: 30 Apr 2025 | QR700022632 Right image: Courtesy of Universitätsklinikum Erlangen, Germany Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers MR auto contouring for brain OAR and brain metastases (II) Brain Metastasis (106 mm^3) Metastasis (49 mm/3) Metastasis (2627 mm^3) Metastasis (38 mm^3) Contrast enhanced 3D T1W MPRAGE axial images Metastasis (855 mm^3) Metastasis (12 mm^3) • Metastasis (223 mm^3) Metastasis (7 mm^3) Metastasis (704 mm^3) Metastasis (175 mm^3) Metastasis (68 mm^3) Metastasis (10 mm^3) • ~ 1mm isotropic Metastasis (7 mm^3) Metastasis (61 mm^3) Metastasis (439 mm^3) Metastasis (203 mm^3) Metastasis (379 mm^3) Metastasis (192 mm^3) Metastasis (40 mm^3) Metastasis (13 mm^3) Metastasis (431 mm^3) Hippocampus Metastasis (438 mm^3) Metastasis (52 mm^3) Metastasis (180 mm^3) Metastasis (77 mm/3) Field strength: 1.5T or 3T Hippocampus Metastasis (225 mm^3) • Metastasis (31 mm^3) Metastasis (34 mm^3) Metastasis (147 mm^3) Metastasis (120 mm^3) Cochlea Brainstem Metastasis (230 mm^3) Metastasis (823 mm^3) Lacrimal Gland Metastasis (39 mm^3) Retina Metastasis (77 mm^3) Eye Metastasis (199 mm^3) Cornea Metastasis (25 mm^3) Lens Metastasis (332 mm^3) Optic Nerve Metastasis (296 mm^3) Pituitary Gland Metastases Metastasis (319 mm^3) Metastasis (114 mm^3) Metastasis (251 mm^3) Optic Nerve Cochlea Retina Metastasis (3399 mm/3) Lacrimal Gland - Lens Spinal Cord - Cornea • Intraparenchymal metastases, >2mm size • Pre-surgical, pre-RT Template Effective Date: 26 Mar 2025 | QR700020784 13 Left image: Courtesy of Clinique de la Reine Blanche, Saran, France; Job Aid Effective Date: 30 Apr 2025 | QR700022632 Right image: Courtesy of Universitätsklinikum Erlangen, Germany Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers MR auto contouring for brain OAR and brain metastases (III) MM RT Image Suite A To manually align the positions of the MM RT Image Suite Viewing 30001 IMA n.a. original images, use the Manual Adjust SP H1.0 sCTp1-Dixon_W tool in the Composer panel. 2/24/2021 12:19:52 PM Structure Set_1 UNAPPROVED Favorite Tools 1 • Each MR auto contouring algorithm Auto Contour Creation ? X needs specific MR series as input. Search Anatomy & Tar Name Guideline / Variant 2 • Trigger MR auto contouring Structures Series Eye Globe Right Eekers et al. 2021 manually. Hippocampus Left Eekers et al. 2021 o Hippocampus Right Eekers et al. 2021 Lacrimal Gland Left Eekers et al. 2021 Lacrimal Gland Right Eekers et al. 2021 Lens Left Eekers et al. 2021 3 • Apply auto contours using Auto Lens Right Eekers et al. 2021 Findings Optic Chiasm Eekers et al. 2021 Contour Creation or Apply Structure Optic Nerve Left Eekers et al. 2021 Optic Nerve Right Eekers et al. 2021 Template. Penile Bulb RTOG Gay et al. 2012 Pituitary Gland Eekers et al. 2021 Prostate Favorite Tools RTOG Gay et al. 2012 Anatomy & Targets Proximal Femur Left RTOG Gay et al. 2012 Proximal Femur Right Patient Beam Rectum RTOG Gay et al. 2012 Marking Placement Eekers et al. 2021 Specific auto contours are available Retina Left Retina Right Eekers et al. 2021 only on specific input series. DVH Merge H. Display Seminal Vesicles RTOG Gay et al. 2012 Dose Spinal Cord Eekers et al. 2021 For example, Body outline auto contour auto Contour Adapt Please note that different structures may require different MR sequences for Creation Contours auto-contouring. For details, refer to the Instructions for Use (IFU). is available only on MR pelvis T1. Create Data OK Cancel Series Template Effective Date: 26 Mar 2025 | QR700020784 14 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 SIEMENS Healthineers CT – Auto contouring Template Effective Date: 26 Mar 2025 | QR700020784 15 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 Organs at Risk (OAR) contouring poses major challenges SIEMENS Healthineers for the workflow in the RT department SIEMENS .. : X Healthineers go.Sim_0214 6/18/2021 M go.Sim_0214 Capacity dependent MM RT Image Suite Ca X Series x MM RT Image Suite Unequal distribution of skills Add Study and capacities in RT 5/26/2021 11:06 AM CT, RO_WholeBody departments. Anatomy & Targets X Favorite Tools Structures Aorta POI Bladder + Body Name Brachial Plexus Left Patientenprotokoll ... [501] Brachial Plexus Right o Aorta Inefficient AVOIDANCE Brain Bladder Brainstem AVOIDANCE Esophagus Body Time consuming routine OAR Series o Eye Globe Left -Nepro 12 3.00 EXTERNAL O Brachial Plexus Left AVOIDANCE R contouring jobs block resources. Brachial Plexus Right AVOIDANCE Rrain Favorite Tools X Tr20 [1] indings CTI Patient Beam Synthetic Display Merge Marking Placement CT Dose Display Dose X Inconsistent auto Lung Apply Auto K Crop Ventilation Template Contour Mentation Adapt Create Margin Structure R Anatomy & Targets Interobserver variability leads Correct 4D Create Split Series Export Snapsho Data Series Data Resto KU to uncertainties in contouring. 2D + Freehand Contour spelest Contour 3:17 PM Template Effective Date: 26 Mar 2025 | QR700020784 16 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Courtesy of Nordstrahl, Praxis für Strahlentherapie, Nürnberg, Germany Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers CT auto contouring for all relevant body regions Deep-learning based auto contouring Head & Neck Breast & Lung Cardiac Pelvic area • Brain • Female breast (L/R) • Whole heart • Bladder • Brainstem • Lung (L/R) • Atrium (L/R) • Prostate • Eye globe (L/R) • Lung lobe left (lower/upper) • Ventricle (L/R) • Penile bulb • Lens (L/R) • Lung lobe right • Ventricle left endocardium • Rectum • Optic nerve (L/R) (lower/middle/ upper) • Left Anterior Descending • Sigmoid • Optic chiasm • Trachea Artery (LAD) • Proximal femur (L/R) • Cochlea (L/R) • Esophagus • Coronary Artery (R) • Seminal vesicles • Parotid gland (L/R) • Bronchial tree • Circumflex Artery (L) • Uterus • Submandibular gland (L/R) • Brachial plexus (L/R) • Pelvic bone (L/R) Oral cavity • Chest wall (L/R) Abdomen • • Femoral Head • Mandible • Aorta • Stomach • Sacrum • Lips • Vena cava (inf./sup.) • Liver Multi-site • Larynx (L/R) • Pulmonary artery • Spleen • Glottis • Ribs • Body contours • • Supraglottic larynx • Individual ribs (24 ribs) Kidney (L/R) • Pancreas • Spinal cord • Pharyngeal constrictor • Sternum • Abdominopelvic cavity • Spinal canal muscle (inf./mid./sup.) • Humeral head (L/R) • Duodenum • Skeleton Existing structure • Thyroid • Bowel (small/large) New structure • Lacrimal gland (L/R) • • Pituitary gland Bowel Bag Template Effective Date: 26 Mar 2025 | QR700020784 17 Courtesy of University Hospital Aarhus, Denmark (Head & Neck) ; Job Aid Effective Date: 30 Apr 2025 | QR700022632 Courtesy of Leopoldina Krankenhaus Schweinfurt, Germany (Breast) Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers CT auto contouring for lymph nodes may support defining target volumes Deep-learning based auto contouring Head & Neck Breast Thorax • LN Level Ia: Submental triangle • LN Axilla Level I (L/R) • Mediastinal LN Station 1 (L/R) • LN Level Ib: Submandibular triangle (L/R) • LN Axilla Level II (L/R) • Mediastinal LN Station 2 (L/R) LN Axilla Level III (L/R) Mediastinal LN Station 3 Anterior • LN Level II: Upper jugular nodes (L/R) • • • LN Level III: Middle jugular nodes (L/R) • LN Internal Mammary (L/R) • Mediastinal LN Station 3 Posterior LN Supraclavicular (L/R) Mediastinal LN Station 4 (L/R) • LN Level IVa: Lower jugular group (L/R) • • • Mediastinal LN Station 5 • LN Level IVb: Medial supraclavicular group (L/R) • LN Level V: Posterior triangle group (L/R) Pelvic area • Mediastinal LN Station 6 • Mediastinal LN Station 7 • LN Level Vc: Lateral supraclavicular group (L/R) • LN Level VIa: Anterior jugular nodes LN Common Iliac (L/R) • Mediastinal LN Station 8 • • LN Level VIb: Prelaryngeal, pretracheal, and paratracheal nodes LN Internal Iliac (L/R) • Mediastinal LN Station 9 (L/R) • • LN Level VIIa: Retropharyngeal nodes (L/R) LN External Iliac (L/R) • Mediastinal LN Station 10 (L/R) • • • LN Level VIIb: Retro-styloid nodes (L/R) LN Obturator (L/R) • LN Presacral • LN Level VIII: Parotid group (L/R) • LN Level IX: Bucco-facial group (L/R) • LN Level Xa: Retroauricular and subauricular nodes (L/R) • LN Level Xb: Occipital nodes (L/R) Existing structure New structure Template Effective Date: 26 Mar 2025 | QR700020784 18 Courtesy of University Hospital Aarhus, Denmark (Head & Neck) ; Job Aid Effective Date: 30 Apr 2025 | QR700022632 Courtesy of Leopoldina Krankenhaus Schweinfurt, Germany (Breast) Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers CT auto contouring - Multi guidelines support for CT data Siemens Healthineers trains deep learning algorithms using international guidelines and offers multi-guideline support for Organs at Risk: Fixed Guidelines Choose your prefered guideline Head & Neck: Brainstem: OAR: , Brouwer et al ., 2015 Brouwer et al. 2015 or DAHANCA 2020 Head & Neck LN: Gregoire et al ., 2014 Glottis and supraglottic larynx: Breast LN: ESTRO guideline, Brouwer et al. 2015 or Offersen et al ., 2015 DAHANCA 2020 Thoracic OAR: RTOG guideline, Kong et al 2011 Esophagus: RTOG Kong et al. 2011 or DAHANCA 2020 Pelvic OAR: RTOG guideline, Gay et al ., 2012 Left and right breast: Pelvic LN: RTOG guideline, RTOG Kong et al. 2011 or Gay et al ., 2009 ESTRO Offersen et al. 2015 Template Effective Date: 26 Mar 2025 | QR700020784 19 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers Organ Database – Location Organ Database The Organ Database has been reorganized. Q The Organ Database is located under: Show All Search New Structure Delete Merge Create Structure Structures Margin Show All Favorites 1 Type * Method CT Guidelines / Variants MR Guidelines / Coding Schen Configuration → Advanced Visualization → Auto Contourable CT Variants Scheme Versio Auto Contourable MR Contouring Configuration. Guideline Variants AVOIDANCE * Manual N/A N/A FMA 3.2 Arytenoid Cartilage Right AVOIDANCE * Manual N/A N/A FMA 3.2 Base of Tongue AVOIDANCE * Manual N/A N/A FMA 3.2 Brain AVOIDANCE * Automatic RTOG Kong et al. 2011 N/A FMA 3.2 Brain Metastasis GTV * Automatic N/A Proprietary Definition 99VMS 1 Brainstem AVOIDANCE Automatic Brouwer et .. [+1] Eekers et al. 2021 FMA 3.2 1 • Additional filter for MR – Auto Carotid Artery AVOIDANCE * Manual N/A N/A FMA 3.2 Contourable MR and Guideline Cerebellum AVOIDANCE * Manual N/A N/A FMA 3.2 Cerebellum Left Hemisphere AVOIDANCE * Manual N/A N/A FMA 3.2 Variants available. Cerebellum Right Hemisphere AVOIDANCE * Manual N/A N/A FMA 3.2 Cerebrum AVOIDANCE * Manual N/A N/A FMA 3.2 Cerebrum Left Hemishphere AVOIDANCE * Manual N/A NIA FMA 3.2 Cerebrum Right Hemisphere AVOIDANCE * Manual N/A N/A FMA 3.2 Cochlea AVOIDANCE * Manual NIA N/A FMA 3.2 Columns in the Organ Database are 1 resizable, and their order can be changed. These changes are not saved permanently. Template Effective Date: 26 Mar 2025 | QR700020784 20 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers Organ Database – Guidelines Organ Database 1 Columns for CT and MR Guidelines are separated. Show All Search New Delete Merge Create 2 Auto contouring options Structure Structure Structures Margin Show All 1 update based on available Favorites Auto Contourable CT Type * Method CT Guidelines / Variants MR Guidelines / Coding Schen licenses. Variants Scheme Versio Auto Contourable MR 1 Guideline Variants AVOIDANCE * Manual N/A N/A FMA 3.2 AVOIDANCE * Manual N/A 2 3 When multiple guidelines Arytenoid Cartilage Right N/A FMA 3.2 Base of Tongue AVOIDANCE exist: Manual NIA N/A FMA 3.2 * Brain AVOIDANCE * Automatic RTOG Kong et al. 20 3 N/A FMA 3.2 Add [+..] to show the Brain Metastasis GTV * Automatic N/A Proprietary Definition 99VMS 1 number of additional Brainstem AVOIDANCE * Automatic Brouwer et [+1] Eekers et al. 2021 FMA 3.2 2 guidelines. Carotid Artery AVOIDANCE * Manual N/A N/A FMA 3.2 Cerebellum AVOIDANCE * Manual 2 Guidelines Available for CT 1 Guideline Available for MRI 4 Cerebellum Left Hemisphere AVOIDANCE * Manual 4 Hover to view all details. Brouwer et al. 2015 (default) Cerebellum Right Hemisphere AVOIDANCE * Manual . DAHANCA Gregoire et al. 2015 DAHANCA Gregoire et al. 2015 (default) Cerebrum AVOIDANCE * Manual When you add the organ to a template When you add the organ to a template xou 3 Cerebrum Left Hemishphere AVOIDANCE * Manual you can select can select the imaging modality. Cerebrum Right Hemisphere AVOIDANCE * Manual · the guideline FMA 3.2 Cochlea AVOIDANCE . the imaging modality Manual INIn ININ FMA 3.2 Template Effective Date: 26 Mar 2025 | QR700020784 21 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers Organ Database – Template Configuration Structure Template Configuration 1 Level 1: Template Name and Remarks. 1 Template Name My Organs Remarks Some have variants 2 Level 2: 2 Image Modality Image Modality: Selecting CT MR an Image Modality affects the table below. Organs Auto Tasking Delete Row Name Type Method Guideline / Variant 3 Drop down disabled when Brain AVOIDANCE Automatic RTOG Kong et al. 2011 3 only one Guideline is Brain Metastasis GTV Manual N/A available. Brainstem AVOIDANCE Automatic Brouwer et al. 2015 4 4 A drop down when more Base of Tongue AVOIDANCE Manual N/A 5 than one Guideline is available. 5 N/A if no Guidelines are Please note: available. Then the only Templates are automatically filtered for Image Modality in Method available is Manual. H. syngo.via RT Image Suite, when Apply Template is opened. Template Effective Date: 26 Mar 2025 | QR700020784 22 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers Apply auto contourable organs - Auto Contour Creation dialog Auto Contour Creation ? X 1 Search field Quickly search option to find Search 1 structures. Name Guideline / Variant Duodenum Bridge et al. 2017 Esophagus RTOG Kong et al. 2011 2 New Guideline/Variant column: Eye Globe Left RTOG Kong et al. 2011 2 Eye Globe Right • Drop down enabled if multiple DAHANCA Jensen et al. 2020 Female Breast Left RTOG Kong et al. 2011 2 options are available. Female Breast Right RTOG Kong et al. 2011 Femoral Head Left RTOG Gay et al. 2012 Femoral Head Right RTOG Gay et al. 2012 Glottis • Drop down disabled if only one Brouwer et al. 2015 Heart RTOG Kong et al. 2011 Guideline is available. Hip Bone Left Lee et al. 2014 . Hip Bone Right Lee et al. 2014 Humeral Head Left ESTRO Offersen et al. 2015 Humeral Head Right ESTRO Offersen et al. 2015 Please note: Kidney Left Bridge et al. 2017 Kidney Right • Bridge et al. 2017 Structures are automatically filtered by Image Modality. Lacrimal Gland Left Brouwer et al. 2015 • Only structures for the loaded Image Modality (CT or MR) Lacrimal Gland Right Brouwer et al. 2015 Larynx are listed. H. Brouwer et al. 2015 Lens Left Brouwer et al. 2015 • Only licensed structures are listed. Lens Right Brouwer et al. 2015 Lips Brouwer et al. 2015 OK Cancel Template Effective Date: 26 Mar 2025 | QR700020784 23 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers Apply structure Templates – Structure Template dialog Structure Template ? X 1 Filtered List of Templates Templates are automatically filtered for Image Modality (for example, only MR templates for Select Structure Template an MR dataset). My Organs 1 Remarks Some have variants Please note: Template functionality is also available for customers with no OK Cancel auto-contouring licenses (functionality can be used to pre- H. define organ list of structures to be segmented). Template Effective Date: 26 Mar 2025 | QR700020784 24 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 Organ Database SIEMENS Healthineers New Licenses VC10 Title License String Prerequisite license Usage CT RT_IMA_SUITE_AC_CT_ORGANS_VC10 CT_RT_IMA_SUITE_ATLAS_SEG New CT auto contouring structures RT_IMA_SUITE_AC_CT_MULTIGUIDELINE CT_RT_IMA_SUITE_ATLAS_SEG Support for multiple guidelines MR RT_IMA_SUITE_AC_MR_BRAIN_METS CT_RT_IMA_SUITE_ATLAS_SEG New MR auto contouring structures RT_IMA_SUITE_AC_MR_BRAIN_OAR CT_RT_IMA_SUITE_ATLAS_SEG New MR auto contouring structures RT_IMA_SUITE_AC_MR_PELVIS_OAR CT_RT_IMA_SUITE_ATLAS_SEG New MR auto contouring structures RT_IMA_SUITE_SYN_CT_HEADNECK CT_RT_IMAGE_SUITE_BASIC New Synthetic CT of H&N ARIA RT_IMA_SUITE_SEMANTIC_INTEROP CT_RT_IMAGE_SUITE_BASIC Interoperability with ARIA (treatment sites in templates) Template Effective Date: 26 Mar 2025 | QR700020784 25 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 SIEMENS Healthineers Convert and import of RT Structure Template Template Effective Date: 26 Mar 2025 | QR700020784 26 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers Convert a loaded Structure Set to an Organ Template (I) Convert a loaded RT Structure Set to a Structure Template and DE Inline Results Contouring Configuration import it into the Structure Template Configuration. Structure Configuration Organ Database 1 • Identify structures based on Code Values in the Organ Database. Create 2 Show All Search Delete Merge 1 Structure Structures Margin Name ethod CT Guidelines / MR Guidelines / Variants Variants Scheme Version Value Code Meani 2 • Synchronization updates Name, Color, and Type according to the Organ Database: CT/MR Template type is set automatically based on Atrium Left utomatic RTOG Kong et al. 201 N/A FMA 3.2 7097 Left atrium • Atrium Right .utomatic RTOG Kong et al. 201 N/A FMA 3.2 7096 Right atriur Image Modality. CA Left Anterior Descending Artery (LAutomatic RTOG Kong et al. 201 N/A FMA 3.2 3862 Anterior int CA Left Circumflex (LCX) utomatic Proprietary Definition NIA FMA 3.2 3895 Circumflex Auto contouring structures are set to default, as if CA Right Coronary Artery (RCA) utomatic Proprietary Definition N/A FMA 3.2 50039 Right coron • Heart utomatic RTOG Kong et al. 201 N/A FMA 3.2 7088 Heart manually filled. Pulmonary Artery utomatic RTOG Kong et al. 201. N/A FMA 3.2 66326 Pulmonary Ventricle Left .utomatic RTOG Kong et al. 201 N/A FMA 3.2 7101 Left ventric Ventricle Left Endocardium utomatic RTOG Kong et al. 201 N/A FMA 3.2 9559 Left ventric Ventricle Left Myocardium Manual NIA NIA FMA 3.2 9558 Left ventric - Vontrirla Right automatic PTAG Kann of al 201. NIA CAMA 37 7008 Dinht wantr Please note: No specific template information (for example, Guidelines) or Auto Tasking rules will be converted and imported. H. Template Effective Date: 26 Mar 2025 | QR700020784 27 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers Convert a loaded Structure Set to an Organ Template (II) SIEMENS ... X Healthineers 90.Sim_0214 6/18/2021 M go.Sim_0214 • Create Structure Template 1 Load the dataset with the ? X MM RT Image Suite CH X Series x corresponding RT Structure Set into MM RT Image Suite Add Study 1 Template Name Pelvis syngo.via RT Image Suite. 5/26/2021 11:06 AM Remarks New Template from Structure Set CT, RO_WholeBody Anatomy & Targets X Favorite Tools Aorta Structures Only structures, that exist in the Organ Database, can be added 2 2 • Select the three dots to open the Bladder + to a template. Structure parameters, like Name, Color and Type Body are taken from the Organ Database. Please check the created Patientenprotokoll drop down menu. O Name [501] Structure Set Overview Templates in the Configuration. O Aorta AVOIDANCE . Bladder AVOIDANCE Copy Structure Set OK Cance Series o Body RT-Neuroachse 3,00 EXTERNAL Qr40 [2] 3 • Click on Create Structure Template. o Brachial Ple AVOIDANCE Load Structure Set Brachial Ple AVOIDANCE Rrain Save Structure Set Topogramm 0,60 Favorite Tools Tr20 [1] 4 • The Create Structure Template dialog Finding CT Create Structure Template Patient Beam Synthetic Di 3 opens. You can define a new name if Marking Placement CT C Lung Apply auto Auto Adapt Create K Crop Ventilation Template Contour Contours Margin needed. Then click OK. Structure Anatomy & Targets WAWI Correct 4D Create Split Series Export de Lines Snapshot Data Series Data Undo 2D 3D The Template Creation Report is shown + Draw Nudge Reflect Contour Pan/Scale after the import. The new structure Freehand Contour Structures Preview Rotate 3:17 PM template will be available in the Structure Template Configuration. Template Effective Date: 26 Mar 2025 | QR700020784 28 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Courtesy of Nordstrahl, Praxis für Strahlentherapie, Nürnberg, Germany Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers Convert a loaded Structure Set to an Organ Template (III) Template Creation Report if x Show an information screen after import: • 1 Structure added with the same name. 1 The following structures were added to the template (please note the changed 2 • Structure added, but renamed with name 1 names according to the organ database): from Organ Database. Liver Lung_L ->> Lung Left Lung_R -- > Lung Right 2 3 • Structures not added due to no or unknown Spinal Cord structure code. The following structures could not be identified (missing or unknown structure code) and were not added to the template: MyOrgan Tumor 3 OK Template Effective Date: 26 Mar 2025 | QR700020784 29 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 SIEMENS Healthineers Image Orientation Template Effective Date: 26 Mar 2025 | QR700020784 30 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers Image Orientation (I) Motivation CT_11061660_128138_Video-002 CT View&GO X CT View&GO 2 IMAn.a. Stack 2x1 Stack 3x2 Stack 4x4 Follow Up MPR VRT MPR MIP SP H713,2 Hand Planung 3,00 Qr40 Currently, non-HFS (Headfirst Supine) orientations are 14.04.2023 MPR 12:39:48 Compare flipped to appear as HFS. Structure Set_1 UNAPPROVED Werkzeug-Favoriten For example, L and R are shown on opposite sides, and the InlineApp × Sim&GO purple crosshair (reference line) moves in opposite Patientenmarkierung Laser-Offset in IEC (mm) Tisch (mm) directions when scrolling through the image volume. L X Y Position GroBe N Serien In TPS (Treatment planning systems), patient orientation +0+ Lazer Ein/Aus Laser Null Patienten Brust links markieren matches the scanning position. Drucken F For example, if the patient was scanned with feet first or 350 Werkzeug-Favoriten X 3D in prone position, the image should display accordingly. Distanzli ... ROI Parallele Aufnahme In 3D kreisfor ... Serien anzeigen 2 IMAn.a. SP R151,9 SP P137,0 Hand Planung 3,00 Qr40 New behavior: Users can now display the images as RT-Navigator 14.04.2023 12:39:48 scanned. Strukturen POI Name R Typ IZ-CT ISOCENTER 10cm Template Effective Date: 26 Mar 2025 | QR700020784 31 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers Image Orientation (II) SIEMENS Healthineers 98 SDK 4 O x A palette menu has been added in the upper left 14D Scan Recon * 11/18/1858 0 14D 1 MM RT Image Suite X Windowing corner with two options: MM RT Image Suite Viewing Zoom/Pan Scroll Fit to Segment3.00 Qr40 Q3 Average CT • View in Scanned Position 3D Reference Point • View in HFS (Headfirst-Supine Position) Favorite Tools Lock Reference Lines View in Scanned Position View in Scanned 1 11 Position 1 View in Head First- Anatomy & Targets X Supine Position Structures POI Series + 2 ... O Name O Please note: Findings 10cm • By default, View in Scanned Position is selected. 3 • It is available in all segments. • The function is dimmed in Patient Marking and Beam Favorite Tools Anatomy & Targets X Placement, where View in Scanned Position is automatically H. Patient Beam Display Marking Placement DOSE applied. DVH Merge Lung Display Dose F • The orientation of fixed series is the master, and all floating Ventilation Template K Contour Adapt Creation Contoues Margin Structure 400 series will adopt this orientation during registration. Create Crop W 40 Correct 4D Create Split Series Export Data Series Data Courtesy of Nordstrahl, Praxis für Strahlentherapie, Nürnberg, Germany + Template Effective Date: 26 Mar 2025 | QR700020784 32 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers Image Orientation – Table (I) HFS FFS HFP FFP A A P P 1 R L R 1 • Axial View F H F H H F H F 2 • Coronal View 2 R L R A P d A 3 • Sagittal View H F 3 A A P P L R R L Template Effective Date: 26 Mar 2025 | QR700020784 33 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers Image Orientation – Table (II) HFDL FFDL HFDR FFDR R R 1 P A A P 1 • Axial View I LL 2 • Coronal View 2 P A A P R L R L 3 • Sagittal View I F H 3 R R A d P A Template Effective Date: 26 Mar 2025 | QR700020784 34 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 SIEMENS Healthineers CT Windowing Presets Template Effective Date: 26 Mar 2025 | QR700020784 35 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers CT Windowing Presets Motivation: Soft-Tissue F5 • The differences in HU density are small in the Brain and Lung F6 Head-Neck region when viewing CT images. • Specific windowing settings, such as narrow width and Bone F7 F specific center, can improve the detection of small features. Liver F8 Improvement: Brain W 400 Head-Neck CT Presets Two additional CT windowing presets are introduced for Brain and Head-Neck viewing: CT Color LUT Reset Windowing Brain windowing presets Head-Neck windowing presets (same as in MM Oncology): (same as in MM Oncology): • Width: 80 HU • Width: 350 HU • Center: 40 HU • Center: 90 HU Template Effective Date: 26 Mar 2025 | QR700020784 36 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 SIEMENS Healthineers Configuration Patient Marking and Beam Placement Template Effective Date: 26 Mar 2025 | QR700020784 37 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 syngo.via RT Image Suite SIEMENS Healthineers Direct access to the configuration Motivation: Patient Marking Configuration MM RT Image Suite X MM RT Image Suite Viewing Workflow Type Markerless workflow . Marker workflow The existing access to the configuration of Patient 2 IMAr • SP F10 Respira Workflow Setup (Default names can be set in POI Configuration) Marking and Beam Placement (right-click on 04/01/2 1:04:27 Create Marker on Startup Create Isocenter on Startup Favorite Tools Favorite Tools icon) was not intuitive. Laser System Properties 2 movable laser axes Calibration Offset 0.0 mm The calibration offset directly impacts th II Export to Laser System calculation of the treatment isocenter coordinate A change in this value can lead to incorrect patier Now: Anatomy & Targets Export as LAP File Format 2.0 marking. Structures POI Export Path 1/ Series + Export as RT Plan ... Name PlanName Network Node • Access to the configurations for Patient Marking and Enable Direct Communication to the LAP System R IP Address 132.186.252.121 Port 2000 Beam Placement via the configuration wheel in the Offset Unit Findings cmmm title bar of complex tools. OK Cancel • Left-click the wheel to open the respective Favorite Tools Anatomy & Targets configurations. CT Patient S Display Marking Placement CT Dose % DVH Merge Lung Apply Display Dose Ventilation Template C+ Contour Adapt Creation Contours Structure Correct 4D Create Split Series Export Data Series Data + Template Effective Date: 26 Mar 2025 | QR700020784 38 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025 SIEMENS Healthineers Please note that this learning material is for training purposes only. For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Please note: Some functions shown in this material are optional and might not be part of your system. Certain products, product-related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration-dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Siemens Healthineers Headquarters Siemens Healthineers AG Siemensstr. 3 91301 Forchheim, Germany Phone: +49 9191 180 siemens-healthineers.com Template Effective Date: 26 Mar 2025 | QR700020784 39 Job Aid Effective Date: 30 Apr 2025 | QR700022632 Published by Siemens Healthineers AG I © Siemens Healthineers, 2025