NAEOTOM Alpha CTA coronaire Vidéo

NEA Tom Alpha Coronary CTA. This online training introduces you to the fundamentals of coronary CTA acquisition in NEA Tom Alpha and covers the following areas. Acquisition modes, coronary CTA factory decision tree contrast timing strategies, automatic patient instruction API. Reconstruction types Recon and go and spectral reconstructions. 3 Acquisition modes can be used during coronary CTA acquisition, common to all scanner models. In the sequence mode, the ECG signal is used to trigger a CTE scan at a selected heart phase. The radiation turns on and off during the selected phases. The table moves at determined increments with a 10% overlap between slabs. With sequential scanning. You can open the scanning window to more than just one phase using FLEX Sequential scanning in Spiral CT Data acquisition proceeds continuously while the patient table is moving forward with a constant pitch. The ECG and the CT raw data are recorded simultaneously throughout the entire heart cycle. Data acquisition in a flash spiral scan is performed with a high pitch spiral. Due to the high pitch of up to 3.2, only as much data as needed is acquired for reconstructing a dual source image at the separate slice positions. Protocols. For ultra high resolution cardiac scanning include the coronary CTA stent protocols. These protocols have the high resolution ultra scan mode and will utilize the UHR columnation of 120 by 0.2 millimeters. With ECG. Triggering again, there is a routine protocol with Quantum Plus scan modes. As well. As the alternative protocols with the quantum scan modes. It is important to keep in mind that these protocols will have longer scan times due to the smaller columnation. With this scan sequence and spiral modes are available, but no flash mode is possible. Also there are. Tube limitations in maximum tube current due to a smaller. Focal spot size. This means that this protocol is not recommended for obese patients. The. Reconstructions in this. New protocol. Have no spectral information available, all. Images are AT3D reconstruction. However, the benefits are that the cardiac reconstructions can have high res resolutions with slice thicknesses down to a 0.2 millimeters and kernel sharpness up to a 98 A study. Performed from the University Hospital of Zurich that is published in Investigative Radiology. Gives guidance on parameters for cardiac UHR. You may refer to this. Paper for suggested. Scan and reconstruction parameters to use for optimal results. The title of this paper is. Ultra High resolution Coronary CT and geography with photon counting detector CT. Flash. Phase Spiral is another scan mode exclusive to the Neo Tom Alpha. And enables an ECG triggered high pitch flash scan. Which allows for an independent control of the Z position of the ECG target phase within. The scan range. This enables, for example, a high pitched scan over the entire thorax, while separately specifying the cardiac start phase at 65% at the beginning of the heart. Protocols that have this new scan mode include. Thorax coronary CTA with the Quantum Plus scan modes. Thorax coronary CTA alternative with Quantum scan modes. Tabby with the Quantum Plus scan modes. Tabby alternative with Quantum Scan modes. With Flash Phase. Spiral. You can freely adjust the beginning of the phase. Start using the line in the topogram. Do. This by simply dragging the line to the desired location where the. Selected phase. Should start in the. ECG display. You can see where the line in the topogram. The selected start phase corresponds. In the actual scan range. In the scan parameters, under the Physio Scan tab, the phase start option corresponds to the position of the line in the topogram. The flash scan will be timed automatically to scan with the phase. Start where you. Have positioned the line in the topogram by. Changing the phase start to a diastolic range, the scan range and timing shift automatically. This is to ensure that the timing will be correct with where you have positioned the line and selected the phase start. A good starting point to optimize your coronary CTA acquisitions is the factory protocol Coronary CTA factory. This protocol is equipped with a decision tree that automatically monitors the heart rate and the heart rate variability based on the parameters of the patient's heart rate and heart rate variability. One of five scan strategies is selected in the factory default. These strategies are defined as follows. Standard dual source flex sequence from 70% to 80% of cardiac cycle flash. Low dose flash spiral at 65% of cardiac cycle. Low dose Dual source flex sequence at 75% of cardiac cycle. High heart rate Dual source spiral no flash from 35% to 45% of cardiac cycle and systolic arrhythmia. Dual source flex sequence at fixed time of 300 milliseconds to 400 milliseconds of the cardiac cycle. Depending on the heart rate and the heart rate variability, the factory default decision tree for coronary CTA chooses the most adequate strategy. As first step, the system analyzes the heart rate variability. The patient is then classified as regular, unstable or arrhythmic. Note the arrhythmic branch is not show in this picture as an example for a patient that has regular variability. The system will then determine whether the heart rate is low, moderate or high in the case of a patient with low heart rate. The system will prompt the user to decide whether to use a flash acquisition or not. By proceeding systematically in this way, the system finally chooses one of the five predefined scan strategies. In the event the system cannot determine one of the required parameters or the user does not provide input, a default strategy is always defined in the tree. This is how the decision tree is implemented in the user interface during examination. Following the same example for low and regular heart. Rates the low. Dose scan mode will be chosen. For patients with a regular low heart rate, both flash low dose as well as low dose modes can be performed depending on users choice. For arrhythmic patients, the end systolic arrhythmia scan mode will be chosen independently of the heart rate. The thresholds the scanner uses for heart rate and the heart rate variability can be configured in the patient characteristic dialogue. These can be customized to the user's preferences. 2 strategies can be applied to determine the optimum contrast timing test, bolus and bolus tracking. Using test bolus in cardiac, the user injects a small amount of contrast and monitors the desired location to find the peak of the contrast arrival. This gives the user the optimal time for when the contrast has reached the proper location. This will then automatically enable the delay for the scan to start. And also lets the user have a longer API and post instruction delay before the scan starts to ensure the heart rate has stabilized before the scan start. Using bolus tracking, the contrast is monitored in real time and the scan will start upon arrival of contrast. Using this method, the skin needs to start as soon as the contrast has arrived, so a longer API may not be optimal. Cardiac API and Post Instruction Delay when scanning a cardiac study. There is a new API available specific for cardiac. This new API hyperventilates the patient to better assist in stabilizing the heart rate for the scan. The new API can be heard here. Please breathe in, breathe all the way out, Breathe in and hold your breath. Along with the new API, there is also the possibility to add a post instruction delay. This gives a greater possibility to decrease and stabilize the heart rate before the scan. Cardiac reconstruction types. With a single phase reconstruction you can choose and reconstruct any single phase scan within one Recon job. Cardio best phase is used to identify the best diastolic or best systolic phases for image reconstruction. Best phase automatically calculates the motion of the heart in the images and tries to find the phase with the least amount of motion over the reconstructed heart cycles. Based on this, the phase with the least motion is selected for image reconstruction. Best phase can be utilized on all reconstructions. With a multiphase reconstruction, you can reconstruct multiple different phases within one Recon job. In a multiphase reconstruction, the recons can be reconstructed in percentage by every five percent, 10%, or every 20%, or in milliseconds by every 50 milliseconds, 100 milliseconds, or 200 milliseconds. The series splitting parameter in the Auto Tasking tab will define whether result images are split into individual series or they are kept in a single series for best phase or single phase reconstructions. Recon and Go can automatically reconstruct the most typical CARDIAC series to send to your packs. Recon and Go can produce images of 3D spins in MIP or VRT. Curved planar reconstructions of each individual coronary vessel, projections in the common cardiac planes and many more specific cardiac reconstructions. Normally these reconstructions needed a workstation, an experienced user and time. Now Recon and go can produce these automatically with 0 clicks from the operator spectral reconstructions. Many spectral reconstructions are now available for cardiac scanning. If images were acquired with quantum plus scan modes, images can be generated either with spectral Recon or more advanced inline results, multienergy. In a nutshell, the key difference between these technologies is that inline results uses a landmark detection technology to generate results based on a given organ characteristic. For example, multienergy DE parallel ranges for the heart can be reconstructed along the main cardiac planes. This cannot be achieved with spectral Recon. The following spectral Recon types are available in the scanner. Mono Energetic Plus images are equivalent to. Images scanned. With a single photon energy beam. Kev. Changing the energy enhances the contrast. Between different materials. VNC Contrast Agent is removed from a contrast CT scan to generate virtual noncontrast VNC images. Iodine images display the concentration or enhancement of iodine after a contrast CT scan. Pure calcium are images on which the iodine is removed and calcium is left behind for purposes of performing a calcium score after a CTA examination. Pure lumen are images on which the calcium is subtracted from the vessels after a CTA scan. T3D. Generates reconstructed results series that provide images generated from all photons registered and therefore look like a conventional CT scan. At the nominal scan energy. Inline Results In addition to the inline results capabilities available in other scanners, NEA Tom Alpha offers multienergy inline results. If SPP is selected, the scanner generates A dataset specifically designed for further spectral post processing with Singo CT view and Go or the SINGO CT dual energy workflow. Choosing. Either DE parallel or radial ranges alpha technology is utilized for custom cardiac reconstructions. Colored VRT images or heart organ ranges can be selected. These recons now have the ability to use a specific dual energy application class with individual datasets that can be selected for reconstruction lastly. Is the ECG documentation option. In the reconstruction parameters under the Physio Recon tab, you can toggle on or off the. ECG. Documentation per individual reconstruction job. Now you can limit how many ECG series the scanner produces per examination.

05/02/2022 350 21.5 120 10 61 10.3 64 235 72 60 14 76 98 21.8 15 0.20 92 96 36 2.7 25 38 122 35 70 174 300 80 75 45 400 65 0.0 62 85 74 88 100 77 12 30 69 28 90 1413 31 SIEMENS . Healthineers NAEOTOM Alpha Coronary CTA HOOD05162003331316 Unrestricted @ Siemens Healthineers, 2023 to the Video This online training with video introduces you to the fundamentals of Coronary CTA acquisition in NAEOTOM Alpha and covers the following areas: Introduction to the Video NAEOTOM Alpha Coronary CTA · Acquisition modes · Coronary CTA factory decision tree · Contrast timing strategies Automatic Patient Instruction (API) Reconstruction types Recon & GO and spectral reconstructions The table moves at determined increments with a 10% overlap between slabs. With sequential scanning you phase using flex sequential scanning. (1) Scan delay time (2) Patient instruction (3) Scan Time: X-ray on to X-ray off time of a single sequence. The number of all scan times is the Exposure Time (4) Table movement (5) Cycle Time: time of one sequence scan + table movement (6) Exam Time: time of all sequence scans and table movements of a complete sequence range Sequence CT In the sequence mode, the ECG signal is used to trigger a CT scan at a selected heart phase. The radiation turns on and off during the selected phases. can open the scanning window to more than just one Data acquisition proceeds continuously while the patient table is moving forward with a constant pitch. The ECG and the CT raw data are recorded ed phases. simultaneously throughout the entire heart cycle. 10% (3) Table acceleration (5) Table deceleration's is the Exposure Time (6) Exam Time (Exposure Time + Table movement time) Spiral CT (4) Exposure Time (X-ray to X-ray off time) (5) Table deceleration Spiral CTral CT separate slice positions. Flash Spiral CT Data acquisition in a Flash Spiral scan is performed with a high pitch spiral. Due to the high pitch of up to 3.2, only as much data as needed is acquired for reconstructing a dual source image at the Cardiac Ultra-High-Resolution (UHR) Mode Coronary CTA Stent protocol utilizing UHR scan modes and the 120 x 0.2 mm collimation with ECG triggering. Scan/Recon Scan Favorites Scan Mode Acquisition [mm] Coronary CTA Stent [factory] (Adult) Topogram ScanplanningTopoAdultQuantumSn Calcium Scoring CardiacDualsourceSequenceAdultQuantumplus Premonitoring Monitoring CTA Coronary CardiacDualsourceSequenceAdultAngioHighresultraQuantumplus CardiacDualsourceSpiralAdultAngi HighresultraQuantumplus Routine protocols with Quantumplus scan mode. · Alternative protocols with the Quantum scan mode are possible. 2022.05.02-14:22:49-DST-Trauma * 11/18/1858 (163) O 2022.05.02-14:22 :.. Longer scan times due to smaller Recon Ranges syngo CT VA50A collimation. With this scan, Sequence 2 43:29.45 PM 1 IMA 1 TOP 101 LEN 129.1 and Spiral modes are available, but no Preconditions Flash mode is possible. Contrast FAST Planning Scan Parameter Check FAST Adjust 10cm FAST Adjust cannot solve the conflict. Change scan parameters or press GOI KV Sn100 Configured mA 55 Applied 504.0 0/0 General Scan Dose Timing Physio Recon CTDIvol (32 cm) 18.2 mGy SSDE (12.8 cm) 42.2 mGy Patient Type Organ Characteristic Target Region Decision Trees Scan Direction No mm Cardio Head to Feet Exposure Time Check image quality 60 bpm Min: 60 Max: 60 High table speed - increased sto .... Press confirm to continue. Confirm Heart DLP Config Max. mAS 235 mGy*cm Limits There are tube limitations in max tube current due to smaller focus spot size. (no obese patients recommended) CARE Dose4D CARE keV IQ level CTDivol [mGy] SSDE [mGy] Rot. Time & CARE keV optimized for [s] Auto (Vascular) (32 cm) 18.2 (12.8 cm) 42.2 Full Max. mAs No Spectral information available. All Recon Favori ... Recon&GO Image Impression Recon Box Auto Tasking Inline Options Window@120kV Cardiac - Heart Full Wide None Auto (VasNone 60 60 images are a T3D recon. Slice Thickness Fix Axial Width Inline Results Multi Recons CardiacDualsourceSequenceAdultAngioFlexHighres ... 12.8 cm) 42.2 Inline Results Multi Recons CTA Coronary 0.20 Bv44 Q3 BestDiast Cardiac - Heart None ancel High resolutions are possible with slice thicknesses down to 0.2 mm and Kernel sharpness up to 98. Cardiac UHR Mode iges are a 13D ORIGINAL ARTICLE The University Hospital of Zurich performed a study that is Ultra-High-Resolution Coronary CT Angiography With published in Investigative Radiology. The study gives guidance Photon-Counting Detector CT Feasibility and Image Characterization on parameters for Cardiac UHR. You may refer to this paper for suggested scan and reconstruction parameters to use for optimal results. The title of this paper is: The statements by Siemens Healthineers' customers described herein are based on results that were achieved in the customer's unique setting. Since there is no "typical" hospital and many variables exist (e.g ., hospital size, case mix, level of IT adoption) there can be no guarantee that other customers will achieve the same result. Flash Phase Spiral Flash Phase Spiral: This feature enables an ECG triggered High Pitch Flash scan mode, which allows for an independent control of the z-position of the ECG target phase within the scan range. This enables, for example, a high pitch scan over the entire thorax, while separately specifying the cardiac start phase at 65% at the beginning of the heart. Protocols that include this new scan mode are: Thorax Coronary CTA (Quantumplus) . Thorax Coronary CTA Alt (Quantum) TAVI (Quantumplus) TAVI Alt (Quantum) FAST Topo Region Thorax Coronary CTA [factory] (Adult) Adult Chest Thorax Scanplanning TopoAdultQuantumSn Vascular Body CTA Thorax Coronary CardiacFlashSpiralAdultAngioPhaseChestQuantumplus TAVI [factory] (Adult) TAVI 2022.05.02-10:35:49-DST-Trauma * 11/18/1858 (163) O 2022.05.02-10:35 :... Flash Phase myExam Compass HFS 10:39:02.51 AM LEN 595.4 CTDIvol (32 cm) 2.73 mGy Check image qualityhorax Coronary CTA Alt (Quantum) Reconstruction - Close PHes )High table speed - increased sto ... Cancel Scan Recon SSDE (11.4 cm) 6.77 mGy 174 mGy*cm Eff. mAs 0.92 s Simulator Filter Sn GO 2.7s You can freely adjust the beginning of the phase start using the line in the Topogram. Do this by simply dragging the line to the desired location. 5.4s CTDIvol (32 cm) 2.73 mGy min The ECG shows where the line in the Topogram corresponds to the actual scan range with the selected phase. Under the Physio Scan tab, the phase start option corresponds to the line in the topogram. kV Physio Scan Phase Start Phase Unit The Flash scan will be timed to scan with the corresponding phase start where you have positioned the line in By changing the phase start to a diastolic range, the scan range and timing shift automatically. This is to ensure that the timing will be correct with where you have positioned kv the line and selected the phase start. TAVI [fact Factory Protocol Coronary CTA A good starting point to optimize your Coronary CTA (32 cm) 2.73 acquisitions is the factory protocol Coronary CTA [factory] (Adult). re timing will be This protocol is equipped with a decision tree + Add Strategy (Coronary CTA HR variability and HR [factory]) that automatically monitors the heart rate and the heart rate variability. Based on the parameters of heart rate and heart rate variability, one of five scan strategies is selected. Testy McTest Exam Designer Back to Exam Designer myExam Cockpit 1. Select Decision Trees 2. Modify Decision Trees 3. Confirm Decision Trees Modify Decision Trees Scan Strategies Coronary CTA HR variability and HR [factory] standard Flash low dose low dose Info Level Non Important Information Info Text Due to a high table speed a test run ... Phase End Post Instruction Delay + Add Parameter Decision Tree Filter CardiacAngioAdult Edit Trees Select Decision Trees Confirm Changes Test Decision Tree high heart rate end systolic arrhythmia + Add Strategy CardiacDualsourceSequenceAdultA ... CardiacFlashSpiralAdultAngioQuant ... CardiacDualsourceSequenceAdultA ... |CardiacDualsourceSpiralAdultAngioQ .. |CardiacDualsourceSequenceAdultAngi ... ms Scan Recon Trees kt ode truction Delay meter Filter CardiacAngioAdult CardiacDualsourceSequenceAdultA .. Standard: Dual Source Flex Sequence from 70% to 80% of cardiac cycle CardiacDualsourceSequenceAdultAngioFlexQuantumplus Jnit tart Flash low dose: Flash Spiral at 65% of cardiac cycle CardiacFlashSpiralAdultAngioQuantumplus aR Low dose: Dual Source Flex Sequence at 75% of cardiac cycle High heart rate: Dual Source Spiral (no Flash) from 35% to 45% of cardiac cycle CardiacDualsourceSpiralAdultAngioQuantumplus End systolic arrythmia: Dual Source Flex Sequence at fixed time of 300ms to 400ms of the cardiac cycle SIEMENS 2021.10.05-13:28:19-DST-Trauma Heart Rate Variability Regular Unstable Heart Rate Low Moderate CCTA FlashCheck Recommendation Flash No Flash Edit Strategies High Arrhythmic Test Bolus Reconstruction Activate Test Bolus scan 4.1s 10.8s * 11/18/1858 (162) O 2021.10.05-13:28 :... Patient Characteristics yExam Compass Recon Rar 0.0 bpm bpm 17.2 bpm 78 bpm 115 . 88 Examination Configuration Patient Categories Patient Questions Age (Years) Weight (kg) Answer 2: 1-2+ years old Answer 3: 3-12 years old Answer 4: Young Adult Senior Average Cardiac CCTA Mode and HR Tree CREA (mg/dl) (e)GFR (ml/min/1.73m2) Which cardiac scan mode would you like to use? Normal Elevated Decreased Severely decreased Answer 1: Sequence Heart Rate (bpm) Heart Rate Variability (bpm) Spiral Cardiac Mode- Seq or Spiral? If applicable: Do you want to perform a cardiac sequence or spiral scan? Seq Spi Cardiac Recon- Stent/High CaSc? Does the patient have a stent/CaSc>400? Yes + Add Patient Question Save Obese Patient Questionsdiac CCTA Mode and HR Tree 12 Arrhythmic Answer 2: Answer 2: Coronary CTA [factory ... m 1:29:40.26 PM Precondition LEN 5.0 CTDivol (32 cm) 10.7 mGy SSDE (6.8 cm) 30.8 mGy 5.33 mGy*cm mA55 Instruction Language Mute Exam Audio Control English Connect Ranges Pause Command Patient Instruction Apply to all Bolus Tracking Injector Coupling Contrast Protocols Inspiration SSDE (6.7 cm) 2.30 mGy High table speed - increased sto ... 2.1s 0.3s