MR Protocol Building and Optimization Workbook

MR Protocol Building and [TYPE OF WORKBOOK HERE] | [SYSTEM NAME HERE] Optimization STEP Week 4 Classroom Workbook Education & Workforce Solutions SIEMENS Your potential is calling. Healthineers MR Protocol Building and Optimization- STEP Week 4 Welcome A Message from Julia Sheehy-Chan Welcome to your training experience with Education & Workforce Solutions. I want to personally thank you for choosing Siemens Healthineers. We are honored to have you as our partner and hope you will enjoy this course. Our teams strive to ensure your priorities and needs are met. We sincerely appreciate your hard work around what really matters - the human side of health care. You are our heroes. Thank you for being part of the Siemens Healthineers family and we look forward to our partnership with you. Jeloa Sively - Chan Julia Sheehy-Chan Head, NAM Education & Workforce Solutions CX SV USA – Customer Service Organization Siemens Healthineers Clinical Training and Continuing Education Contact Information Customer Care Center - Clinical Application Support: Call 1-800-888-7436 PEPconnect https://pep.siemens-info.com/en-us 2 MR Protocol Building and Optimization- STEP Week 4 Contents Welcome.......................................................................................................2 Contents .......................................................................................................3 Course Description ........................................................................................6 Day 1............................................................................................................7 myExam Cockpit............................................................................................8 myExam Companion................................................................................11 Overview ................................................................................................12 Explore Browse........................................................................................14 Program Editor ........................................................................................23 User Tree Password Protection..................................................................34 Import & Export.......................................................................................42 myExam Assist Configuration .......................................................................43 myExam Companion................................................................................47 myExam Assist.........................................................................................48 myExam Cockpit Configuration ................................................................58 Strategy ..................................................................................................60 Patient View............................................................................................64 Decisions ................................................................................................68 Standard Add-ins .....................................................................................73 Generic Add-ins .......................................................................................75 Advanced Applications Add-ins...............................................................118 Interaction ............................................................................................120 MPR Planning ........................................................................................122 MPR Assignment....................................................................................124 myExam Assist Simulation Mode ............................................................126 Day 2........................................................................................................128 myExam Brain Assist ..................................................................................130 Workflow Features.................................................................................133 Strategies..............................................................................................134 Neuro Patient View................................................................................135 AutoAlign Head Scout & Region..............................................................136 Organ Box .............................................................................................138 AutoAlign Parameter Card......................................................................147 Generic Views Add-in.............................................................................150 MPR Planning and Assignment ...............................................................152 3 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist .................................................................................155 Introduction ..........................................................................................159 AutoAlign Spine.....................................................................................164 Inline Curverd Planar Reconstructions (CPRs) ..........................................172 Automatic Positioning............................................................................176 AutoCoverage .......................................................................................184 AutoAlign Verification............................................................................185 Transverse Image Labeling .....................................................................190 Examinations ........................................................................................191 Workflow and configuration hints ..........................................................194 Summary ..............................................................................................202 myExam Abdomen Assist ...........................................................................203 Introduction ..........................................................................................207 Protocols ...............................................................................................208 Abdomen Assist Add-ins.........................................................................210 Abdomen Patient View ..........................................................................212 Onco Auto Coverage Scout.....................................................................215 ABLE .....................................................................................................217 General Add-ins Configurations..............................................................225 Guidance Views.....................................................................................226 AutoCoverage .......................................................................................227 AutoTiming ...........................................................................................230 Series Label and Auto Load ....................................................................232 Test Bollus Abdomen Assist ....................................................................233 Assist Library.........................................................................................238 Liver Lab Assist......................................................................................239 GOLiver.................................................................................................240 myExam Cardiac Assist...............................................................................244 Overview ..............................................................................................248 Cardiac Patient View..............................................................................252 Cardiac Basic Add-in ..............................................................................265 AutoAlign Heart.....................................................................................266 Cardiac Marker Localization....................................................................268 Define Long Axis Planning......................................................................269 Cardiac Short Access Planning................................................................273 Cardiac Standard Add-in.........................................................................279 4 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist .................................................................................155 Cardiac Assist Workflows........................................................................290 Introduction ..........................................................................................159 Ventricular Function ..............................................................................291 AutoAlign Spine.....................................................................................164 Cardiac Flow Protocols ...........................................................................298 Inline Curverd Planar Reconstructions (CPRs) ..........................................172 Library ..................................................................................................309 Automatic Positioning............................................................................176 Day 3........................................................................................................311 AutoCoverage .......................................................................................184 myExam Angio Assist.................................................................................313 AutoAlign Verification............................................................................185 Introduction ..........................................................................................315 Transverse Image Labeling .....................................................................190 Angio Assist Add-ins ..............................................................................319 Examinations ........................................................................................191 Configuration........................................................................................331 Workflow and configuration hints ..........................................................194 Care Bolus .............................................................................................336 Summary ..............................................................................................202 Advanced Angio Assist...........................................................................341 myExam Abdomen Assist ...........................................................................203 Test Bolus..............................................................................................345 Introduction ..........................................................................................207 myExam Breast Assist.................................................................................351 Protocols ...............................................................................................208 Workflow Features.................................................................................355 Abdomen Assist Add-ins.........................................................................210 Breast Patient View................................................................................360 Abdomen Patient View ..........................................................................212 Breast AutoCoverage Scout ....................................................................371 Onco Auto Coverage Scout.....................................................................215 Breast Implant Selection Add-in..............................................................373 ABLE .....................................................................................................217 Breast Basic Add-in ................................................................................377 General Add-ins Configurations..............................................................225 Breast Dynamic Add-in...........................................................................380 Guidance Views.....................................................................................226 Care Bolus Add-in ..................................................................................383 AutoCoverage .......................................................................................227 Care Bolus Dynamic Scanning ................................................................385 AutoTiming ...........................................................................................230 Breast Biopsy Assist ...............................................................................387 Series Label and Auto Load ....................................................................232 Configuration and Workflow Hints..........................................................388 Test Bollus Abdomen Assist ....................................................................233 myExam Whole-Body Assist........................................................................393 Assist Library.........................................................................................238 Overview ..............................................................................................397 Liver Lab Assist......................................................................................239 Patient View..........................................................................................400 GOLiver.................................................................................................240 FastView ...............................................................................................403 myExam Cardiac Assist...............................................................................244 Automatic Inline (Region) Segmentation ................................................404 Overview ..............................................................................................248 Coverage Modes....................................................................................412 Cardiac Patient View..............................................................................252 Coverage Scans .....................................................................................417 Cardiac Basic Add-in ..............................................................................265 Focus Scans...........................................................................................422 AutoAlign Heart.....................................................................................266 Configuration........................................................................................423 Cardiac Marker Localization....................................................................268 Motion Insensitive Strategy with GRASP..................................................427 Define Long Axis Planning......................................................................269 2-pt Fat Fraction ....................................................................................428 Cardiac Short Access Planning................................................................273 Considerations ......................................................................................429 Cardiac Standard Add-in.........................................................................279 5 MR Protocol Building and Optimization- STEP Week 4 Day 4........................................................................................................430 myExam Prostate Assist..............................................................................432 Introduction ..........................................................................................436 Workflow ..............................................................................................438 Segmentation .......................................................................................441 Morphology ..........................................................................................447 T2 Sagittal.............................................................................................448 T2 Transverse ........................................................................................449 Diffusion Weighted Imaging (DWI) .........................................................452 Morphology - T2 Coronal .......................................................................458 Lymph Node Evaluation .........................................................................461 4D Imaging ...........................................................................................463 Hints & Tips...........................................................................................465 myExam Autopilot .................................................................................467 Introduction ..........................................................................................471 Autopilot User Interface .........................................................................474 Workflow ..............................................................................................482 Summary ..............................................................................................493 myExam Brain Autopilot.........................................................................507 myExam Knee Autopilot.........................................................................519 Daily Hands-on Exercises............................................................................531 6 MR Protocol Building and Optimization- STEP Week 4 Course Description Day 4........................................................................................................430 myExam Prostate Assist..............................................................................432 Introduction ..........................................................................................436 Course Overview: Workflow ..............................................................................................438 Segmentation .......................................................................................441 STEP – MR Protocol Building with myExam Cockpit & myExam Asisst - Numaris X Morphology ..........................................................................................447 [Based on XA50/XA51 software] T2 Sagittal.............................................................................................448 T2 Transverse ........................................................................................449 The STEP MR Protocol Building with myExam Cockpit & myExam Assist– Numaris X Diffusion Weighted Imaging (DWI) .........................................................452 class in-troduces the MR technologist to the protocol development and maintenance on the Siemens MAGNETOM MR systems. Participants will learn the basic principles Morphology - T2 Coronal .......................................................................458 and workflow for build-ing protocols using myExam Assist and myExam Autopilot Lymph Node Evaluation .........................................................................461 through lecture, and instructor-led demos using simulator consoles. 4D Imaging ...........................................................................................463 Hints & Tips...........................................................................................465 myExam Autopilot .................................................................................467 Upon completion of this course, you will be able to: Introduction ..........................................................................................471 • Describe the features of myExam Cockpit Autopilot User Interface .........................................................................474 • Explain myExam Assist Configuration Workflow ..............................................................................................482 • Recall the features of the available myExam Assist programs • Summary ..............................................................................................493 Summarize myExam Autopilot features myExam Brain Autopilot.........................................................................507 • Demonstrate how to create a myExam Assist and myExam Autopilot programs myExam Knee Autopilot.........................................................................519 • Show how to add Strategies, Decisions, and Interactions to a new or existing protocol Daily Hands-on Exercises............................................................................531 • Modify sequence parameters within a myExam Assist and myExam Autopilot protocol 7 MR Protocol Building and Optimization- STEP Week 4 Day 1 SIEMENS Healthineers myExam Cockpit STEP - MR Protocol Building with myExam Cockpit & myExam Assist QR700021234 – Effective date 4/14/2025 Notes Unrestricted © Siemens Healthineers, 2025 8 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit Agenda SIEMENS Healthineers ... myExam Cockpit • Overview • Explorer Browse • Program Editor • User Tree Password Protection • Import & Export • Teamplay & Protocols Module 2 Unrestricted © Siemens Healthineers, 2025 Notes 9 MR Protocol Building and Optimization- STEP Week 4 Objectives SIEMENS Healthineers ... At this end of this module, you should be able to: • Summarize the myExam Cockpit and features • Recognize the Explorer Browse • Explain the features of the Program Editor • Recall how to password protect the User Tree • Explain how to import and export protocols • Describe Teamplay and the Protocols Module 3 Unrestricted © Siemens Healthineers, 2025 Notes 10 MR Protocol Building and Optimization- STEP Week 4 Disclaimers SIEMENS Healthineers ... The information presented in the myExam Cockpit course is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use their own learning, training, and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Medical Systems to be used for any purpose in that regard. 4 Unrestricted © Siemens Healthineers, 2025 Notes 11 MR Protocol Building and Optimization- STEP Week 4 myExam Companion myExam Companion SIEMENS Healthineers ... myExam Cockpit myExam Assist Is a central exam user interface for intuitive protocol Has dedicated workflow packages for efficient and guided configuration and management. scanning. Brain Assist PLOCH SIEMENS - head . Brain Dot Engine . program 12 he tra $12 Standard 00:14 AAhead_scout @ AutoAlign Scout @ AutoAlign Scout AutoAlign Scout epad.oft Jecan_trace_p2 t1_qtse_dark-fluid_sag_p2 04-38 05.05 11_82d_sag_p2 t1.que_tra @ Generic Views 0 MPR Assignment . Generic Vicas 12.qtse_tra_p] 01:12 12_haste_tra_p2 > advanced applications libraries Generic Views @ MPR Assignment . GOBrain Standard Resolution focus > angiography AAhead_scout 00:14 Ahead_sco 00:14 decan.trace p2. AutoAlign Scout c-spine O AutoAlign Scout 1-spine t1_qtse dark-fluid sag_p2 04:38 t1_space fs sag p2 iso 05:05 I-spine O Generic Views 2 O MPR Assignment whole-spine 12_qtsc_tra_p3 t2_space_sag_p2_iso 32 min $ Auto @ None @ 07-07-30 mm neck soft tissue Generic Views O MPR Assignment 12_qtse_dark- fluid fluid_tra 04:14 t2_space_dark-fluid_sag_p2_iso 05:17 Generic Views O MPR Assignment resolve_3scan_trace_tra_p2_160 01:46 resolve_3scan_trace_tra_p2_160 01:46 Generic Views Generic Views MPR planning @ MPR Planning 11_12d_tra 01:19 O Generic Views contrast agent with contrast agent with contrast agent inject contrast agent inject contrast agent t1_f12d_tra 01:19 _space_is_sag_p2_iso 05:05 Generic Views 2 @ MPR Assignment t1_f12d_cor 01:22 Generic Views 5 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 12 MR Protocol Building and Optimization- STEP Week 4 Overview myExam Cockpit SIEMENS Healthineers ... Introduction myExam Cockpit is a central interface for all myExam Cockpit - Explorer Explorer ogram Editor protocol management tasks. Browse Import Export Edit Simulate X SIEMENS head It has two main tasks: c-spine t-spine 1. Explorer organize structure of User Trees, head I-spine > Coc-spine whole-spine neck soft tissue Regions, Exams and Programs. > 3 t-spine thorax + 3 whole-spine breast 2. Program Editor is used for management of > neck soft tissue abdomen + 3 thorax pelvis female individual program steps, sequence + 3 heart pelvis male > breast tmj parameters, etc. abdomen shoulder > Co pelvis female elbow > Co pelvis male wrist > o tmj hand shoulder hip + 3 elbow knee + D wrist ankle > hand foot hip lower extremity > Co knee whole body oncology whole body diffusion > ankle peripheral angiography foot spectroscopy > o lower extremity intervention > whole body oncology radiotherapy > Do whole body diffusion System > o peripheral angiography › 3 spectroscopy 6 Unrestricted © Siemens Healthineers, 2025 Notes 13 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Assess Home Screen Scan User Interface (UI) myExam Cockpit Access myExam Cockpit Access . SIEMENS O SAR Stimu Inroom Exam Setting Settings AUSSIO Inline Display myExam Display Cockpit Control First Normal Level System Check myExam Cockpit xamination Lock G 7 Unrestricted © Siemens Healthineers, 2025 Notes 14 MR Protocol Building and Optimization- STEP Week 4 Explore Browse myExam Cockpit SIEMENS Healthineers ... Explorer Browse myExam Cockpit - Explorer Explorer Filter Explorer Program Editor Browse Import Export Toolbar • Select a Tree SIEMENS Enter Search text Filter • t-spine I-spine >c-spine whole-spine neck soft tissue Drag&Drop: > t-spine thorax > I-spine heart › whole-spine • To the Queue breast > neck soft tissue abdomen Inside Tree and content area >thorax • pelvis female > heart pelvis male › breast tmj • Between a Tree and the content area >abdomen Tree Content Area shoulder Drag&Drop primary function is to “Move” > pelvis female elbow (Tree, Region, Exam) • wrist Use Ctrl + Drag&Drop to “Copy” >tmj hand • D&D Source › shoulder hip knee D&D Source & Target › elbow • Hit Esc to display all regions in content area & > wrist ankle > hand Target foot hip whole body oncology whole body diffusion > knee peripheral angiography > ankle spectroscopy foot > whole body oncology System > whole body diffusion radiotherapy > peripheral angiography > spectroscopy 8 Unrestricted © Siemens Healthineers, 2025 Notes 15 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Explorer Browse – Tree Directory Select a User Tree myExam Cockpit - Explorer Single or multiple User Trees can be configured. Explorer Program Editor Browse Import Export Edit Simulate New User Trees created can be password protected (optional). SIEMENS head SIEMENS Tree: SIEMENS c-spine Read-only and cannot be edited USER t-spine • Customer A Siemens default sequences (automatically maintained) Customer B I-spine • DEFAULT whole-spine > t-spine neck soft tissue thorax 9 Unrestricted © Siemens Healthineers, 2025 Notes 16 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Explorer Browse – Dynamic Search Perform an instant search myExam Cockpit - Explorer • Explorer rogram Editor • Combine words (e.g., t2 and head) Browse Import Export Edit Simulate X SIEMENS >> head >> angiography >> TOF • Search hits are highlighted (no hide functionality) SIEMENS tof_f13d_tra 05:18 • Number of search hits displayed next to protocols TOF with large z-coverage_ [ head [12] Brain Assist tof_f13d_tra_large 07:04 Brain Autopilot clinical libraries TOF 2D advanced applications libraries tof_f12d_paracor library [8] tof_f12d_sag_obl 03:58 angiography [4] TOF CS Vessel Scout tof_cs_acc3.0 05:41 E PC-arterial E PC-venous-sinuses tof_cs_acc5.0 03:50 angiography ce c-spine tof_cs_acc7.5 02:56 > t-spine [1] I-spine [3] > whole-spine > neck soft tissue [3] > thorax heart [21] breast [1] abdomen [4] pelvis female [1] pelvis male [4] > tmj shoulder [3] 10 Unrestricted © Siemens Healthineers, 2025 Notes 17 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Explorer Browse – Find and Set parameters To edit multiple protocols myExam Cockpit - Explorer First protocol selected in Find & Set Parameters window is the Explorer Program Editor simultaneously: Browse Import Export Edit Simulate master protocol (only measurement steps are considered). 1. Right-click on Region, Exam or X Find and Set Parameters 2 x Program. SIEMENS cine trufi frequency scout Name Q cine 2. Select Find opens the Find and cine flash tagging Location Selected Element Set Parameters window. t-spine Type All Step Types > I-spine 3. Enter Name searches and locates > whole-spine Path Name > neck soft tissue USER/heart/function/cine trufi cine_trufi_retro directories that can be USER/heart/function/cine trufi cine_truff_retro_arryth > thorax USER/heart/function/cine trufi cine_trufi_radial_retro edited(e.g., CINE) heart USER/heart/function/cine trufi cine_trufi_prosp Cardiac Assist USER/heart/function/cine trufi cine_trufi_prosp_5sl 4. Select Location from dropdown. localizer USER/heart/function/cine trufi cine_trufi_retro_BS USER/heart/function/cine trufi cine_trufi_retro_reduced_fov 5. Select Type from dropdown. morphology USER/heart/function/cine trufi cine_trufi_retro_10sl_invf functio USER/heart/function/cine trufi cine_trufi_rt_10sl_trig 6. All protocols in the directory can Collapse USER/heart/function/cine trufi cine_trufi_prosp_reduced_fov El cine New USER/heart/function/cine truff cine_truff_retro_cs_2_shy be selected via the Select All E frequ Find ... cine button. Copy Ctrl+C E taggi Print ... Select all Unselect all 7. Click Edit selected to edit the dynam > [D tissue Export ... selected items. Check License MyoMa Edit Properties ... flow angiography dit selected Cancel angiography ce 11 Unrestricted © Siemens Healthineers, 2025 Notes 18 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Explorer Browse – Mass Protocol Editing All parameters are accessible: Find and Set Parameters • Parameter card Protocol Parameters Properties (e.g., voice commands) Routine Contrast Resolution Geometry System Physio Inline Sequence History of Changes • Voice Commands Execution Slice Group 1 FOV Read 360 mm Flip Angle 90 deg Image Management Slices FoV Phas 81.3 Wrap-up Magn. None 1st Signal/Mode Beat Sensor/Retro Several parameter changes can be Auto Load Slice Thickness 6.0 mm Service Slice Thickness 8.0 mm performed in one procedure step. Distance Factor 20% 42.0 ms Slice Thickness 6.0 mm Position L17.1 A1.0 H0.0 TE 1.54 + ms Change voice commands Use local settings Voice Commands Automatic Orientation T > C27.7 > S-1.8 Averages Before Scan Hold breath (inhaled). History of changes tracks all changes made Phase Encoding Dir. A>> P Concatenations After Scan Continue breathing. Pause Os to the master protocol. Phase Oversampling O % AutoAlign Important to know Slice Thickness 6.0 200.0 mm • First protocol selected is the master protocol • Parameters of master protocol can be Accept Changes Cancel edited and applied to other selected protocols • Accept Changes applies changes to all other protocols selected 12 Unrestricted © Siemens Healthineers, 2025 Notes 19 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Explorer Browse – Mass Protocol Editing Parameter Conflicts Unmodified Protocols x • If changes could not be executed (e.g., due to non- availability of parameters), Unmodified Protocols are None of the changes could be applied in 4 out of 11 protocols due to parameter conflicts: listed USER >> heart » function >> cine trufi >> cine trufi_retro_cs_2_shot USER >> heart >> function >> cine trufi >> cine_trufi_retro_cs_8_shot • In these cases, none of the parameter adaptations are USER >> heart >> function >> cine trufi >> cine_trufi_retro_cs_2_shot_BS USER >> heart >> function >> cine trufi >> cine_trufi_retro_cs_2_shot_10sl_inVF applied to the protocols listed Parameter changes impact: Limitations • If you change a parameter in the master protocol this • Graphical slice objects (e.g., slice groups, saturation leads to other parameter changes in the selected regions) cannot be edited via the Find dialog protocol(s), the user is not informed. • Changes made to these parameters are not applied to • Increasing the number of slices in the master protocol selected protocols and are not visible in the History of may result in “silent” TR changes in the selected Changes protocol(s) Be carefully when performing Mass Protocol Editing! Experienced users only 13 Unrestricted © Siemens Healthineers, 2025 Notes 20 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Explorer Browse – Table Positioning Strategy Configuration can be done at a Region, Exam or Program Directory Properties ? × directory level. USER >> head First configuration in the given order is used. Name head Description Body Part Examined Brain Manage Table Positioning Strategy LOC ISO LOC FIX OK Cancel 14 Unrestricted © Siemens Healthineers, 2025 Notes 21 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Explorer Browse – Body Part Examined Body Part Examined is: Directory Properties Manage Body Part Examined • Assigned at Region level in the USER >> heart SIEMENS Tree or any User Tree Name heart New NEW BODY PART Description • Adapted by all Exam/Program Paired steps unless otherwise specified Body Part Examined Heart Manage Body Part fable Positioning Strategy LOC Abdomen AbdomenPelvis Click Manage to add new user Adrenal Ankle defined body parts. Aorta Arm Axilla Body Part Examined can also be Back Bladder assigned in Protocol Properties. OK Cancel Brain Breast Bronchus Calcaneus Calf Carotid Cerebellum OK Cancel 15 Unrestricted © Siemens Healthineers, 2025 Notes 22 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers .. Explorer Browse – Study Part The User can assign a Study Part to USER > heart >> localizer >> trufi >> localizer_trufi_heart ? > General individual program steps within Protocol Parameters Name localizer_truff_heart myExam Cockpit. Voice Commands Description Execution Image Management Auto Load Image Comment Copy References Body Part Examined Laterality Manage study Part Manage Dot Addin To attach a Dot Addin to a step, drag the Dot Addin from the sidebar on the desired step. OK Cancel 16 Unrestricted © Siemens Healthineers, 2025 Notes 23 MR Protocol Building and Optimization- STEP Week 4 Program Editor myExam Cockpit SIEMENS Healthineers ... Program Editor Explorer > Browse is read only. O x Explorer Browse ort Export Simulate Click on Edit to load the program for editing SIEMENS SIEMENS > head > Brain Assist > program| using the Program Editor task. Brain Assist Neuro Patient View Standard Resolution focus CD head AAhead_scout 00:19 AAhead_scout 00:19 AAhead_scout - CD Brain Assist O AutoAlign Scout AutoAlign Scout t1_se_sag 03:07 t1_space_fs_sag_p2_iso 05:34 t1_12d_sag Brain Autopilot Generic Views 2 O MPR Assignment t2_tse_tra_512 03:37 04:37 t2_haste_tra_p2 clinical libraries t2_space_sag_p2_iso O Generic Views O MPR Assignment advanced applications libraries 12_tse_dark-flui 04:50 t2_space_dark-fluid_sag_p2_ns-t2prep 06:06 ep2d_dark-f a-tra_p2 GOBrain O Generic Views O MPR Assignment library ep2d_diff_3scan_tr 01:47 ep2d_diff_4scan_trace_p2 02:49 ep2d_diff_3scan_ angiography O Generic Views O Generic Views MPR planning E Vessel Scout @ MPR Planning ETOF t1_se_tra 02:25 t1_12d_tra E PC-arterial Generic Views E PC-venous-sinuses contrast agent contrast agent angiography ce with contrast agent with contrast agent with con Cc-spine Inject contrast agent. Inject contrast agent. nject contrast agent. > t-spine t1_se_tra 02:25 t1_space_fs_sag_p2_iso 05:34 t1_f12d_tra > l-spine O Generic Views @ MPR Assignment > whole-spine t1_se_cor 02:27 t1_f12d_cor neck soft tissue Generic Views thorax heart Cardiac Assist localizer morphology function E cine truff 17 Unrestricted © Siemens Healthineers, 2025 Notes 24 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Program Editor Drag&Drop from the side-bar to the Structogram. myExam Cockpit - Program Editor (Program Path - SIEMENS/heart/Cardiac Assist/Ventricular Function) ? @ x Explorer Program Editor Import Export Editor Browse Edit Simulate Mode ... Standard Mode @ @ Browse Search Default SIEMENS . heart > Cardiac Assist > Ventricular Function myExam Autopilot SIEMENS Browse Cardiac Assist @ Cardiac Patient View Filter • breath-hold Realtime • Search localizer 00:01 C l-spine > whole-spine Default center on heart > neck soft tissue • O Table Positioning Strategy > thorax localizer_heart 00:05 O Cardiac Basic heart Beat Sensor Training > Cardiac Assist Working Area Tree Filter localizer Beat Sensor training bh 00:14 Select morphology O Cardiac Basic function • Select a Tree (opened program) thorax_cor_tra 00:29 Cardiac Basic dynamic Program O AAheart_scout 00:12 > tissue characterization • Enter Search text Structogram layout O Cardiac Basic (read-only) MyoMaps define_lax 00:01 flow Cardiac Marker Localization cine_segmented_lax cine_realtime_lax angiography 00:14 00:01 Cardiac Standard Cardiac Standard angiography ce define_sax D&D source & target 00:01 breast Cardiac SAX Planning abdomen cine_segmented_sax 00:11 cine_realtime_sax 00:01 Cardiac Standard O Cardiac Standard Selected Program Select a Program or Library (read-only) Strategy Defaults Decision Interaction Pause 18 Unrestricted © Siemens Healthineers, 2025 Notes 25 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Program Editor – Structogram The Structogram displays the entire program: Cardiac Assist Cardiac Patient View • All Strategies breath-hold Realtime • All Decisions localizer 00:01 • All Branches center on heart Table Positioning Strategy localizer_heart 00:05 Drag&Drop: Cardiac Basic Copy or move steps Beat Sensor Training • yes • Copy Add-ins Beat Sensor training bh 00:14 O Cardiac Basic thorax_cor_tra 00:29 Strategy switch: Cardiac Basic AAheart_scout 00:12 • Same row means same notion Cardiac Basic • Queue treats them accordingly define_lax 00:01 Cardiac Marker Localization cine_segmented_lax 00:14 cine_realtime_lax 00:01 Cardiac Standard Cardiac Standard define_sax 00:01 Cardiac SAX Planning cine_segmented_sax 00:11 cine_realtime_sax 00:01 Cardiac Standard O Cardiac Standard 19 Unrestricted © Siemens Healthineers, 2025 Notes 26 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Program Editor – Configure Program > Steps Display myExam Cockpit - Program Editor (Program Path - SIEMENS/heart/Cardiac Assist/Ventricular Function) • Standard Explorer Program Editor Browse Import Export Edit Simulate X E Image Comme @ @ Browse Search Default • Image Comment SIEMENS >> heart >> Cardiac Assist >> Ventricular Function ... Standard Image Comme SIEMENS Cardiac Assist - Body Part V breath-hold Realtime .. Study Part Q • Body Part localizer 00:01 l-spine > whole-spine center on heart neck soft tissue • Study Part localizer_heart 00:05 > thorax heart at Sensor Training Cardiac Assist localizer Beat Sensor training bh 00:14 morphology function thorax_cor_tra 00:29 dynamic AAheart_scout 00:12 > tissue characterization MyoMaps define_lax 00:01 flow cine_segmented_lax 00:14 cine_realtime_la 00:01 angiography angiography ce define_sax 00:01 breast X abdomen cine_segmented_sax 00:11 cine_realtime_sax 00:01 > pelvis female Select a Program or Library Strategy Decision Interaction Pause 20 Unrestricted © Siemens Healthineers, 2025 Notes 27 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Program Editor – Identical Configuration Enables modification of multiple Password Protected Tree > head > clinical libraries > trauma > 12_tse_tra_512 8 2:44 min & Auto @ None @ 0.4x0.4x4.0 mm3 ₹ 1.00 Identical Configurations program steps. Protocol Parameters Routine Contrast Resolution Geometry System Physio Sequence Also apply changes to Voice Commands Inline Execution Slice Group 1 Y + FOV Read 20 mm All Measurement Steps Image Management Slices 27 ¢ FOV Phase 100.0 ¢ % Auto Load Current Program Also applies changes to steps with Slice Thickness ep2d_diff_4scan_trace_p2 Copy References t2_f12d_tra_hemo Preview Distance Factor 30 % identical: TR 6000.0 t2_tse_dark-fluid_tra Position Isocenter TE 100.00 m t2_tse_tra_512 .. /general • Protocol parameters Orientation Transversal verages t2_tse_tra_512 Phase Encoding Dir. R>> L Add-in configuration Concatenations 1 + .. /general 17 tea tra 517 • Phase Oversampling O % AutoAlign Head > Brain Hint: typically, you check the 1st column of boxes to update program steps that should be identical. Addin Configuration .. OK Cancel 51 Identical EN Be careful since 2nd column is for the add-in which may not necessarily need to be identical. 21 Unrestricted © Siemens Healthineers, 2025 Notes 28 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Program Editor – Show Protocol History Select protocol and click Show Protocol History icon to Explorer Program Editor see protocol edit history. Browse Import Export Edit Simulate Displays what parameters were changed and when performed. Show Protocol History - t2_tse_tra_p2 ? X Parameter Card Parameter 11/14/2022 11/23/2022 11/23/2022 Unsaved 2:01:31 PM 8:59:12 AM 9:07:53 AM Changes Resolution / Acceleration Reference Lines PE 39 39 59 67 Routine TR 4700.0 ms 4700.0 ms 3830.0 ms 3830.0 ms Slice Group 1 Slices 25 25 23 23 Sequence / Part 1 Echo Trains per Slice 5 5 5 Turbo Factor 26 26 28 24 System / Adjust Volume F >>H 149 mm 149 mm 137 mm 137 mm Other 22 Unrestricted © Siemens Healthineers, 2025 Notes 29 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers .. Program Editor – Compare Protocols Select two (or more) protocols in the program and click Compare Protocols icon. Explorer Program Editor Browse Import Export Edit Simulate Provides an overview of protocol parameters that are X 1 B different. Compare Protocols Parameter Card Parameter tof_cs_acc4.4 tof_cs_acc7.2 tof_cs_acc10.3 Resolution / Acceleration Total Factor 4.4 7.2 10.3 Other Acc: 4.4 7.2 0.3 TA 5:03 min 3:25 min 2:40 min Close 23 Unrestricted © Siemens Healthineers, 2025 Notes 30 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Program Editor – Create a Copy Reference 1. Select a single source step and one or more target Explorer Program Editor steps. Browse Import Export Edit Simulate 2. Click on Create Copy Ref. Password Protected Tree >> head >> clinical libraries >> trauma AAhead_scout 00:14 AutoAlign Scout t1_f12d_sag 01:25 Generic Views t2_tse_tra_512 02:44 Generic Views t2_tse_dark-fluid_tra 03:38 Generic Views ep2d_diff_4scan_trace_p2 01:50 Generic Views t2_f12d_tra_hemo 02:44 24 Unrestricted © Siemens Healthineers, 2025 Notes 31 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Program Editor – Copy Reference Create Copy Reference Delete Copy Reference 1. Select a single source step and one or more target 1. Select Copy Ref icon (source or target). steps. 2. Click Delete. 2. Click Create Copy Ref. icon Explorer Program Editor Explorer Program Editor Browse Import Export Edit Simulate Browse Import Export Edit Simulate x Password Protected Tree > head >> clinical libraries >> trauma Password Protected Tree > head >> clinical libraries > trauma AAhead_scout 00:14 AAhead_scout 00:14 AutoAlign Scout AutoAlign Scout t1_f12d_sag 01:25 t1_f12d_sag 01:25 Generic Views Generic Views t2_tse_tra_512 t2_tse_tra_512 02:44 02:44 1 Generic Views Generic Views t2_tse_dark-fluid_tra 03:38 t2_tse_dark-fluid_tra 03:38 Generic Views Generic Views ep2d_diff 4scan trace_p2 01:50 ep2d_diff_4scan_trace_p2 01:50 1 Generic Views Generic Views t2_f12d_tra_hemo 02:44 t2_f12d_tra_hemo 02:44 25 Unrestricted © Siemens Healthineers, 2025 Notes 32 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Program Editor – Browser and Search Browse highlighted results myExam Cockpit - Explorer Search Display results Browse Search Default Explorer Browse Import Export SIEMENS SIEMENS & toff @ tof X TOF 2D [ head [12] head/angiography/TOF Brain Assist TOF CS E program head/angiography/TOF Brain Autopilot tof_fl3d_tra 05:18 clinical libraries [2] head/angiography/TOF E general [1] tof_f13d_tra_large 07:04 lesion [1] head/angiography/TOF trauma tof_f12d_paracor 03:03 atrophy head/angiography/TOF E cortical architecture tof_f12d_sag_obl 03:58 B white matter lesions pituitary head/angiography/TOF tof_cs_acc3.0 E orbits 05:41 Elac head/angiography/TOF advanced applications libraries tof_cs_acc5.0 03:50 GOBrain head/angiography/TOF library tof_cs_acc7.5 02:56 angiography [10] head/angiography/TOF 26 Unrestricted © Siemens Healthineers, 2025 Notes 33 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Program Editor – Highlight Changes User can Highlight changes performed in a nyExam Cockpit - Explorer Highlight Changes selected time range. Explorer Browse Import Export Highlight changed elements in time range: Off Edited directories and directories containing Today edited protocols are highlighted. Create Tree ... .Since Yesterday Duplicate Tree ... Last 7 days Features also available in MR Protocol Manager Rename Tree ... Last 30 days for fleet management. Import Tree ... Delete Tree ... Password Protection ... Save Close Print ... Export ... Highlight Changes ... USER Head Show Inconsistent Head GOBrain E GOBrain 27 Unrestricted © Siemens Healthineers, 2025 Notes 34 MR Protocol Building and Optimization- STEP Week 4 User Tree Password Protection User Tree – Password Protection SIEMENS Healthineers ... Objective Implementation • Quality control can be implemented to a User Trees by • Customers can create multiple User Trees (introduced restricting protocol changes to authorized employees with MR VE11A) • Password must be entered to modify a protected tree • Each User Tree can be protected with its own password • Unprotected User Trees can be modified by all users Disclaimer without further restrictions • It does not address topics like protocol confidentiality • Protected User Trees can only be modified after and intellectual property entering the correct password • Every employee can read and use all trees 28 Unrestricted © Siemens Healthineers, 2025 Notes 35 MR Protocol Building and Optimization- STEP Week 4 User Tree – Password Protection SIEMENS Healthineers ... Password protection can be activated in the Create Tree Lock icon indicates the User Tree is password protected. window. myExam Cockpit - Explorer Password must be entered twice. Explorer Program Editor Browse Import Export Edit Simulate Password must have a minimum of 4 characters, otherwise no special requirements. Password Protected Tree Create Tree X Q tof x Name New Tree Protect tree against unauthorized changes Password ..... Hint – Protect the new User Tree prior Confirm Password ..... to adding sequences. OK Cancel 29 Unrestricted © Siemens Healthineers, 2025 Notes 36 MR Protocol Building and Optimization- STEP Week 4 User Tree – Password Protection SIEMENS Healthineers ... Lock/Unlock User Tree 1. Click on Small Lock icon to lock/unlock the selected User Tree. 2. Click on Large Lock icon to lock all User Trees (e.g., lock all trees if you leave the scanner). myExam Cockpit - Explorer O x Explorer Program Editor 2 Browse Import Export Edit Simulate Password Protected Tree 1 % a tof x 30 Unrestricted © Siemens Healthineers, 2025 Notes 37 MR Protocol Building and Optimization- STEP Week 4 User Tree – Password Protection SIEMENS Healthineers ... Lock/Unlock in different locations myExam Cockpit - Explorer myExam Cockpit - Program Editor (Program Path - Password Protected Explorer Program Editor Explorer Program Editor Browse Import Export Edit Simulate Browse Import Export Edit Simu ate X Password Protected Tree [assword Protected Tree >> head >> Brain Assist >> program & tof X V Standard AAhead_scout 00:19 AAhead_scc Save as ? X AutoAlign Scout t1_se_sag 03:07 t1_space_fs Generic Views Password Protected Tree head t2_tse_tra_512 03:37 t2_space_sa Generic Views t2_tse_dark-fluid_tra 04:50 t2_space_da > head 21 Generic Views 31 Unrestricted © Siemens Healthineers, 2025 Notes 38 MR Protocol Building and Optimization- STEP Week 4 User Tree – Password Protection SIEMENS Healthineers ... Locked Tree When a protected tree is locked: myExam Cockpit - Explorer myExam Cockpit - Program Editor (Program Path - Password Protected T • Menu entries are disabled Explorer Pro Explorer Program Editor (e.g., Rename Tree, Delete Tree) Browse Import Export Browse Import Export Edit Simulate • Toolbar buttons are disabled Create Tree ... Password Protected Tree >> head >> Brain Assist > program X (e.g., Paste, Delete, Save, Undo, Redo) Duplicate Tree ... Rename Tree ... V Standard • Keyboard shortcuts are ignored Import Tree ... AAhead_scout 00:19 AAhead_sco Delete Tree ... AutoAlign Scout t1_se_sag 03:07 Password Protection ... t1_space_fs Generic Views Print .. t2_tse_tra_512 03:37 t2_space_s Export ... Highlight Changes ... Show Inconsistent aries TO GOBrain 32 Unrestricted © Siemens Healthineers, 2025 Notes 39 MR Protocol Building and Optimization- STEP Week 4 User Tree – Password Protection SIEMENS Healthineers ... Use Identical Configuration to save steps in a locked User Tree program: • Changes can be applied to other steps • Unlock User Tree in the Saving Steps from Other Programs window Saving Steps from Other Programs New Tree > head > clinical libraries > general >> t2_tse_tra_512 ? x @ 2:44 min Auto @ None @ 0.4x0.4x4.0 mm3 1.00 Identical Configurations 1 7 steps from other programs have been seleted to be changed. Protocol Parameters Routine Contrast Resolution Geometry System Physio Inline Sequence Voice Commands Also apply changes to Execution Slice Group 1 FoV Read O Save changes for 220 All Measurement Steps Image Management Slices 27 FOV Phase 100.0 -Jgeneral USER HP 4 Step(s) Auto Load Slice Thickness 4.0 m Copy References t2_tse_tra_512 head >> clinical libraries >> general >> ep2d_diff_4scan_trace_p2 Distance Factor 30 % TR 6000.0 .. /general Table Positioning Strategy >> clinical libraries > general >> ep2d_diff_4scan_trace_p2 t2_tse_tra_512 head >> clinical libraries >> lesion >> ep2d_diff_4scan_trace_p2 Position Isocenter TE 100.00 m .. /general Table Positioning Strategy >> clinical libraries >> lesion >> ep2d_diff_4scan_trace_p2 t2_tse_tra_512 Orientation Transversal Averages .. /trauma Password Protected Tred BP 2 Step(s) t2_tse_tra_512 Phase Encoding Dir. R>> L Concatenations .. /trauma New Tree 1 Step(s) Phase Oversampling 0 AutoAlign Head > Brain OK Cancel 99 7 Identical OK Cancel 33 Unrestricted © Siemens Healthineers, 2025 Notes 40 MR Protocol Building and Optimization- STEP Week 4 User Tree – Password Protection SIEMENS Healthineers ... Select Password Protection to change password or remove password protection. myExam Cockpit - Explorer Password Protection X Explorer Pro Current password must be known. Browse Import Export Old Password TE X 7 Protect tree against unauthorized changes Create Tree ... New Password Duplicate Tree ... Rename Tree ... Confirm Password Import Tree ... Delete Tree ... OK Cancel Password Protection ... Print ... Export ... Highlight Changes ... Show Inconsistent aries FU GOBTal 34 Unrestricted © Siemens Healthineers, 2025 Notes 41 MR Protocol Building and Optimization- STEP Week 4 User Tree – Password Protection SIEMENS Healthineers ... myExam Cockpit Administrator Mode Administration of password protection. myExam Cockpit - Explorer myExam Cockpit administrator mode - use for administration of password protection of trees only Quit • Reset forgotten password Remove password protection if old password Explorer Program Editor • not known Browse Import Export Edit Simulate • Password protect existing User Tree Password Protected Tree Password Protected Tree >> head >> Brain Assist >> program Administrator Mode: Password Protection ? x • Old password is not required head • Accessed via User Roles 00:19 User must be assigned a Clinical Administrator Brain Ass Old Password .... Align Scout • E prograr 03:07 or IT Administrator role Protect tree against unauthorized changes Brain Aut neric Views New Password 03:37 • Access via default clinadmin and medadmin clinical lil neric Views accounts advanced Confirm Password 04:50 Mode remains active until Quit GOBrain neric Views • library 01:47 OK Cancel D angiogra neric Views angiography ce 35 Unrestricted © Siemens Healthineers, 2025 Notes 42 MR Protocol Building and Optimization- STEP Week 4 Import & Export User Tree – Password Protection SIEMENS Healthineers ... Import & Export Import myExam Cockpit - Explorer Explorer rogram Editor • Open existing archive Import Export Edit Simulate • Drag&Drop from file (or teamplay) Local Database Password Protected Tree > head > Brain Assist >> program to local (or use shuttle button) Password Protected Tree Brain Assis Conversion notification when Standard Resolution focus • AAhead scout 00:19 AAhead_scout importing into a different system head AutoAlign Scout AutoAlign [ Brain Assist t1_se_sag 03:07 t1_space_fs_sag_p2_iso O Generic Views @ MPR Assigr configuration E program 2 Brain Autopilot t2_tse_tra_512 03:37 t2_space_sag_p2_iso O Generic Views O MPR Assigr > clinical libraries t2_tse_dark-fluid_tra 04:50 t2_space_dark-fluid_sag_p2_ns-t2prep > advanced applications libraries O Generic Views O MPR Assigr Export GOBrain ep2d_diff_3scan_trace_p2 01:47 ep2d_diff_4scan_trace_p2 library Generic Views Generic Data Export angiography APR planning • Create new file, or open existing O MPR Pla To New File file angiography ce t1_se_tra 02:25 O Generic Views » .To Existing File • Drag&Drop from local to archive contrast agent contrast agent with contrast agent To teamplay with contrast agent Inject contrast agent. Inject contrast agent. (or use the shuttle button) Export t1_se_tra 02:25 t1_space_fs_sag_p2_iso 05:34 O Generic Views O MPR Assignment t1_se_cor 02:27 O Generic Views 36 Unrestricted © Siemens Healthineers, 2025 Notes 43 MR Protocol Building and Optimization- STEP Week 4 myExam Assist Configuration SIEMENS Healthineers myExam Assist Configuration STEP - MR Protocol Building with myExam Cockpit & myExam Assist Unrestricted © Siemens Healthineers, 2025 Effective date: 5 August 2025 - QR700026089 Notes 44 MR Protocol Building and Optimization- STEP Week 4 Agenda SIEMENS Healthineers ... myExam Assist Configuration • myExam Companion • myExam Assist configuration • Strategy • Patient View • Decisions • Standard and Generic Add-ins • Advanced Applications Add-ins • Interaction • MPR Planning & MPR Assignment • myExam Assist Simulation Mode 2 Unrestricted © Siemens Healthineers, 2025 Notes 45 MR Protocol Building and Optimization- STEP Week 4 Objectives SIEMENS Healthineers ... At this end of this module, you should be able to: • Explain myExam Companion • Summarize myExam Assist configuration features • Recall how to create Strategy’s when building protocols • Identify the Patient View • Explain how Decisions are implemented in a protocol • Identify the differences between Standard and Generic Add-ins • Explain the Advanced Applications Add-ins • Recall Interactions features • Demonstrate how to add MPR Planning & MPR Assignment to a protocol • Recall how to check myExam Assist programs using Simulation Mode 3 Unrestricted © Siemens Healthineers, 2025 Notes 46 MR Protocol Building and Optimization- STEP Week 4 Disclaimers SIEMENS Healthineers ... The information presented in the myExam Assist Configuration course is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use their own learning, training, and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Medical Systems to be used for any purpose in that regard. 4 Unrestricted © Siemens Healthineers, 2025 Notes 47 MR Protocol Building and Optimization- STEP Week 4 myExam Companion myExam Companion SIEMENS Healthineers ... myExam Cockpit myExam Assist Is a central exam user interface for intuitive protocol Dedicated workflow packages for efficient and guided configuration and management. scanning. Brain Assist PLOCH SIEMENS - head . Brain Dot Engine . program 12 he tra $12 Standard 00:14 AAhead_scout epad.oft Jecan_trace_p2 @ AutoAlign Scout @ AutoAlign Scout AutoAlign Scout t1_qtse_dark-fluid_sag_p2 04-38 05.05 11_82d_sag_p2 t1.que_tra @ Generic Views 0 MPR Assignment . Generic Vicas 12.qtse_tra_p] 01:12 12_haste_tra_p2 > advanced applications libraries Generic Views @ MPR Assignment . GOBrain Standard Resolution focus > angiography AAhead_scout 00:14 Ahead_sco 00:14 decan.trace p2. AutoAlign Scout c-spine O AutoAlign Scout 1-spine t1_qtse dark-fluid sag_p2 04:38 t1_space fs sag p2 iso 05:05 I-spine O Generic Views 2 O MPR Assignment whole-spine neck soft tissue 12_qtsc_tra_p3 t2_space_sag_p2_iso 32 min $ Auto @ None @ 07-07-30 mm Generic Views O MPR Assignment 12_qtse_dark- fluid fluid_tra 04:14 t2_space_dark-fluid_sag_p2_iso 05:17 Generic Views O MPR Assignment resolve_3scan_trace_tra_p2_160 01:46 resolve_3scan_trace_tra_p2_160 01:46 Generic Views Generic Views MPR planning @ MPR Planning 11_12d_tra 01:19 O Generic Views contrast agent with contrast agent with contrast agent inject contrast agent inject contrast agent t1_f12d_tra 01:19 _space_is_sag_p2_iso 05:05 Generic Views 2 @ MPR Assignment t1_f12d_cor 01:22 Generic Views 5 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 48 MR Protocol Building and Optimization- STEP Week 4 myExam Assist myExam Assist SIEMENS Healthineers ... Standardized exams from head to toe seuENS • Adapt strategies to your patients needs Ci Cardiac Assial • Useful automation less software interaction HO • Intuitive guidance for every exam ...... • Specific exam views for the information you need C-Spine Assist 1 • Consistency for every follow-up exam 6 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 49 MR Protocol Building and Optimization- STEP Week 4 myExam Assist SIEMENS Healthineers ... AutoAlign, AutoCoverage and AutoFoV for consistent coverage. demes Assist AutoBolus Detection for consistent timing in dynamic imaging. ----- ----- AutoVoice Commands in multiple languages for comprehensive instruction. - MPR Assignment for consistent reconstructions --- in 3D imaging. Assist Decisions for consistent clinical adaptations to the exam. 7 Unrestricted @ Siemens Healthi Unrestricted © Siemens Healthineers, 2025 Notes 50 MR Protocol Building and Optimization- STEP Week 4 myExam Assist SIEMENS Healthineers ... Specific exam view for workflow Patient View Displays relevant information to adapt to General Parameters Breath-Hold Parameters • the clinical question or patient condition Exam Strategy Breath-hold Breath-Hold Capability 20 ¢ s • Choose strategy, decision, breath-hold Protocol Adaptation BH + AutoCoverage Auto Breath-Hold Commands V English (United ... ... capability and voice instruction language Auto Bolus Detection v Pause Between Breath-Holds 10+ • Tailor workflow to the clinical situation Auto ROI V Liver evaluation y contrast agent with contrast agent Evaluation Method HISTO Patient View 8 Unrestricted © Siemens Healthineers, 2025 Notes 51 MR Protocol Building and Optimization- STEP Week 4 myExam Assist SIEMENS Healthineers ... Specific exam view for optimization Parameter View @ 1:12 min 4 Auto @ 3 0.3x0.3x4.0 mm3 1.00 Guidance • Access all required parameters for direct Parameters optimization • Configurable to your needs Slices 27 FoV Read 220 mm • Ensure the most efficient scanning experience by not searching for Slice Thickness 4.0 - m FoV Phase 100.0 ¢ % parameters during the exam TR 6400.0 + ms Concatenations Parameter View 9 Unrestricted © Siemens Healthineers, 2025 Notes 52 MR Protocol Building and Optimization- STEP Week 4 myExam Assist SIEMENS Healthineers ... Cardiac Abdomen Large Joint Assist Whole-Body Assist Assist Standard Assist Brain Assist Standard Powered by Artificial Intelligence Angio RT LiverLab Assist Assist Breast Assist Spine Assist Prostate Assist Standard Assist Over 90%1 of MRI exam requests covered by the myExam Assist 1) Evaluation of 9 million Siemens MR exams, 2014. 10 Image on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 53 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Key to intuitive protocol management myExam Cockpit - Explorer O X Explorer Program Editor Browse Import Export Edit Simulate SIEMENS > head > Brain Assist > program HEAD Brain Assist @ Neuro Patient View Standard Resolution focus Speed focus head_scout 00:19 Whead_scout 00:19 AAhead_scout STANDARD FAST O AutoAlign Scout AutoAlign Scout Autor 03:07 t1_space_fs_sag_p2_iso 05:34 t1_112d_sag Generic Views 2 O LOCALIZER MPR Assignment @ Ge LOCALIZER (tra_512 03:37 12_space_sog_pZ_is 04:37 t2_haste_tra_p2 O TA_ FL2D_SAG Generic Views O MPR Assignment Ger TA_FL2D_SAG__ P2 t2_space_dark-fluid_sag_p2_ns-t2prep 06:06 ep2d_dark-fluid_tra_p2 T2 HASTE AXIAL Generic Views O MPR Assignment 12 HASTE AXIAL Ge diff_3scan_trace_p2 01:47 ep2d_diff_4scan_trace_p2 02:49 ep2d_diff_3scan_trace_p2 EPi. DiFF AXIAL O Generic Views O Generic Views @ Gen MPR planning FLAIR EPi DIFF AXIAL FLAIR MPR Planning t1_se_tra 02:25 11_12d_ O Generic Views O Gen contrast agent contrast agent contrast agent with contrast agent with contrast agent with contrast agent Inject contrast agent. Inject contrast agent. Inject contrast agent. > thorax t1_se_tra 02:25 t1_space_fs_sag_p2_isc 05:34 t1_f12d_t heart O Generic Views MPR Assignment Generic breast t1_se_cor 02:27 11_f12d_cor abdomen O Generic Views @ Generic pelvis female > Co pelvis male > tmj › shoulder Do elbow 11 Unrestricted © Siemens Healthineers, 2025 Notes 54 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers .. Structogram Layout Programs are displayed in grid format so that all Brain Assist Neuro Patient View 1 steps are visible at once. V Standard 2 Speed focus 2 Linear program, the Structogram resembles a AAhead_scout 00:19 AAhead_scout 00:19 AutoAlign Scout AutoAlign Scout simple sequence of program steps. t1_se_sag 03:07 t1_f12d_sag 01:03 Generic Views Program with strategies or decisions, the Generic Views t2_tse tra 512 03:37 t2_haste_tra_p2 00:52 appearance becomes more chart like, enables you 5 Generic Views 2 5 Generic Views to see the complete exam workflow. (strategies t2_tse_dark-fluid_tra 04:50 ep2d_dark-fluid_tra_p2 01:47 Generic Views 2 Generic Views and decisions, branches, and protocol steps). ep2d_diff_3scan_trace_p2 01:47 ep2d_diff_3scan_trace_p2 00:52 1 Generic Views 2 Generic Views t1_se_tra 02:25 t1_f12d tra 01:08 Generic Views 2 Generic Views 1. Patient View contrast agent 3 contrast agent 3 4 with contrast agent 4 with contrast agent 2. Strategy Inject contrast agent. Inject contrast agent. 3. Decision t1_se_tra 02:25 t1_f12d_tra 01:08 4. Decision Branch Generic Views Generic Views t1_se_cor 02:27 5. Add-in t1_f12d_cor 01:15 O Generic Views O Generic Views 12 Unrestricted © Siemens Healthineers, 2025 Notes 55 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Rows and Columns Brain Assist • Each Strategy is represented as a column Steps in the strategies are represented as rows V Standard Resolution focus • • Each row is equivalent across the strategies AAhead_scout 00:19 AAhead_scout 00:19 AutoAlign Scout AutoAlign Scout • A strategy switch in the queue uses information to t1_qse_sag 03:07 t1_space_fs_sag_p2_iso 05:35 decide which steps in the new strategy are treated Generic Views 2 O MPR Assignment t2_tse tra 512 03:37 t2_space_sag_p2_iso 04:37 as completed O Generic Views · 2 MPR Assignment When switching strategies during the exam, the last t2_qtse_dark-fluid_tra t2_space_dark-fluid_sag_p2_ns-t2prep 05:52 • Generic Views MPR Assignment measured step defines which row is active ep2d_diff_3scan_trace_p2 01:44 ep2d_diff_4scan_trace_p2 02:29 Generic Views O Generic Views • A switch in strategy means the step belonging to the 1 MPR planning same row, but to the new strategy, is taken for the MPR Planning next measurement, and all following steps belong to t1_qse_tra 02:25 1 Generic Views the new strategy contrast agent contrast agent with contrast agent with contrast agent Inject contrast agent. Inject contrast agent. t1_qse_tra 02:25 t1_space_fs_sag_p2_iso 05:35 Generic Views MPR Assignment t1_se_cor 02:25 Generic Views 13 Unrestricted © Siemens Healthineers, 2025 Notes 56 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Empty Cells Empty cells may remain for some strategies, and there Brain Assist is no equivalent step that exists for a given row. V Standard Resolution focus AAhead_scout 00:19 AAhead_scout 00:19 You can drag&drop and move the sequence(s) to fill the AutoAlign Scout AutoAlign Scout t1_qse_sag 03:07 t1_space_fs_sag_p2_iso 05:35 empty cell(s). Generic Views 2 MPR Assignment t2_tse_tra_512 03:37 t2_space_sag_p2_iso 04:37 Generic Views 2 MPR Assignment t2_qtse_dark-fluid_tra 04:32 t2_space_dark-fluid_sag_p2_ns-t2prep 05:52 1 Generic Views 2 O MPR Assignment ep2d_diff_3scan_trace_p2 01:44 ep2d_diff_4scan_trace_p2 02:29 @ Generic Views O Generic Views MPR planning MPR Planning t1_qse_tra 02:25 Generic Views contrast agent contrast agent with contrast agent with contrast agent Inject contrast agent. Inject contrast agent. t1_qse_tra 02:25 t1_space_fs_sag_p2_iso 05:35 Generic Views 2 MPR Assignment t1_se_cor 02:25 O Generic Views 14 Unrestricted © Siemens Healthineers, 2025 Notes 57 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Expand and Collapse Expand a protocol step to extend over all Brain Assist Neuro Patient View strategies in the myExam Assist. V Standard Speed focus 1. Right-click on Step and click Expand. AAhead_scout 00:19 AAhead_scout 00:19 2. Right-click on Expanded step to Collapse Copy Ctrl+C AutoAlign Scout t1_se_sag Paste Ctrl+V 12d_sag 01:03 back to a single cell. Delete Generic Views t2_tse_tra_512 haste tra_p2 Rename 00:52 1 2 Generic Views t2_tse_dark-fluid_tra Check License d_dark-fluid_tra_p2 01:47 Convert 2 Generic Views ep2d_diff_3scan_traf diff_3scan_trace_p2 00:52 1 Expand Generic Views t1_se_tra Collapse J2d_tra 01:08 Show Protocol History Generic Views Compare Protocols contrast agent with c Create Copy Reference ... with contrast agent Inject contrast agent ct contrast agent. View Properties ... t1_se_tra Edit Properties ... 12d tra 01:08 genere views 2 Generic Views t1_se_cor 02:27 t1_f12d_cor 01:15 Generic Views Generic Views 15 Unrestricted © Siemens Healthineers, 2025 Notes 58 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit Configuration myExam Cockpit SIEMENS Healthineers ... Configuration Flexibility to be to customize sequence parameters: Dot 1:31 min 4 Auto @ 2 @ 0.3x0.3x4.0 mm3 1.22 Routine Contrast Resolution Geometry System Physio Inline Sequence • TR Slice Group 1 FoV Read 220 mm • TE Slices 28 FOV Phase 100.0 % Bandwidth, etc. Slice Thickness 4.0 - mm • Distance Factor 30 ¢ 6400.0 ¢ ms Position R1.0 P14.2 F15.7 TE 96.00 + ms Orientation T> C-1.7 Averages Phase Encoding Dir. R>> L Concatenations Step 3 - 12_qtse_tra_p3 Phase Oversampling 30 % AutoAlign Head > Brain Customize Auto-Load options: Coil Elements BC Protocol Parameters Load Images to Stamp Segments Voice Commands • Load images to Stamp Segments Load Images to Graphic Segments Execution Image Management 1st Segment • Load images to Graphic Segments Auto Load Inline Movie Copy References • Inline display Preview Addin Configuration ... OK Cancel 16 Unrestricted © Siemens Healthineers, 2025 Notes 59 MR Protocol Building and Optimization- STEP Week 4 myExam Cockpit SIEMENS Healthineers ... Configuration myExam provides customization and workflow. Guidance Parameters View Tools Customization of GSP display and behavior for Queue GSP Image Text Default Group Graphics Default Series Label Reference Lines Default individual workflow steps: Extent Mode Default Auto Load AutoCoverage Protocol Table Position Default • Display Adjust Volume for fat sat protocols AutoTiming Coil Positions Default Adjust Volume Default Group Graphics on for multi-slice multi-angle spine Physio Display Default • Expand Third Segment Default • Automatically opens physio display for cardiac exams Guidance Parameters ayout 3 images BA Queue GSP / Tooltip Tooltip Tooltip Now you can add guidance images and text to provide Series Label Auto Load ----- 7 the user with instructions for planning protocols steps, AutoCoverage AutoTiming decision-making, etc. Slices are aligned by AutoAlign at the level of the corpus callosum and along a line through the genu (anterior) and the splenium (posterior). Note that if you change slice positions manually, it might be impossible to reproduce these exact slice positions for subsequent protocols and follow-up examinations. Close 17 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 60 MR Protocol Building and Optimization- STEP Week 4 Strategy Strategy SIEMENS Healthineers ... Strategy examples: Brain Assist @ Neuro Patient View • Standard V Standard Speed focus • Speed Focus Annead_scout 00:19 AMhead_scout 00:19 AutoAlign Scout AutoAlign Scout t1_se_sag 03:07 t1_f12d_sag 01:03 Parallel program paths within a program. Generic Views O Generic Views t2_tse_tra 512 03:37 t2_haste tra_p2 00:52 Generic Views 2 Provides user with pre-defined workflow options. Generic Views t2_tse_dark-fluid_tra 04:50 ep2d_dark-fluid_tra_p2 01:47 Generic Views 2 Generic Views Change prior or during workflow, according to the ep2d_diff_3scan_trace_p2 01:47 ep2d_diff_3scan_trace_p2 00:52 1 Generic Views 2 Generic Views patient condition and clinical question. t1_se_tra 02:25 t1_f12d_tra 01:08 1 Generic Views Generic Views contrast agent contrast agent with contrast agent with contrast agent Inject contrast agent. Inject contrast agent. t1_se_tra 02:25 t1_f12d tra 01:08 Generic Views 2 Generic Views t1_se_cor 02:27 t1_f12d_cor 01:15 Generic Views Generic Views 18 Unrestricted © Siemens Healthineers, 2025 Notes 61 MR Protocol Building and Optimization- STEP Week 4 Strategy SIEMENS Healthineers ... Create a Strategy 1. Select a Strategy placeholder and myExam Cockpit - Program Editor (New Program) Explorer Program Editor drag&drop into working area. Browse Import Export Edit Simulat X .. Standard Q @ Browse Search Default 2. Create multiple strategies if required. myExam Autopilot Patient View @ Bysic Patient View SIEMENS 3. By inserting a strategy into a new program, Strategy Strategy 2 head a Patient View step containing the Basic Cc-spine 03 t-spine Patient View is created automatically. > Cl-spine > whole-spine 4. Alternatively, drag&drop a Decision neck soft tissue 0 thorax placeholder into the empty working area. Ca heart › Cardiac Assist 5. By inserting a decision into a new program, localizer morphology a Patient View step containing the Basic a function dynamic Patient View and a Strategy are created tissue characterization MyoMaps automatically. flow angiography › Mannionranhv ce Select a Program or Library Strategy Decision Interaction Pause 19 Unrestricted © Siemens Healthineers, 2025 Notes 62 MR Protocol Building and Optimization- STEP Week 4 Strategy SIEMENS Healthineers ... Strategy Properties Right-click on a Strategy to rename Dot Cockpit - Program Editor (New Program) • Explorer Program Editor -or- Browse Import Export Edit Simulate F2 keyboard shortcut to rename a strategy ... Standard Right-click on the Strategy to Set as Default Dof Patient View Basic Patient View • (optional) Strategy Strategy 2 Delete ename Sort strategies according to importance Set as Default • Edit Properties ... • Add or remove strategies within the program at any time • Deleting a strategy deletes all steps contained within the strategy 20 Unrestricted © Siemens Healthineers, 2025 Notes 63 MR Protocol Building and Optimization- STEP Week 4 Strategy SIEMENS Healthineers ... Changing a Strategy in the Exam Queue • Click on Queue header opens Brain Assist LOC HAR HAR ‘+ Brain Dot Engine Patient View to select a different AAhead_scout 00:19 2020.09.15-16:24:21-DST-1.3.12.2.1107.5.99.3 2020.09.15-16-24:21-DST- 1.3.12.2.11 07.5.99.3 13 IMA 1 FRM 3/5 t1_se_sag 14 IMA 1 FRM 2/3 strategy 03:07 t2_tse_tra_512 03:37 -or- t2_tse_dark-fluid_tra 04:50 • Select a Step in the queue, right- 5 ep2d_diff_3scar Append Pause ... Ctrl+Insert click and select Rerun from here t1_se_tra Insert Table Positioning Strategy ARE RPF 7 Inject contrast Repeat with from the context menu Repeat and Open 8 t1_se_tra Rerun from here LALALALALA (i.e., opens Patient View to 19 11_se_co Rerun from here with ... IA Copy Parameters ... select a different strategy) Update Copy Reference TP O SP R3.1 SP A8.9 Remove Copy Reference FoV 259*259 FoV 259*259 .. JMPRIRESAMP/NORM/DIS3D Sag>Cor(10)>Tra(-1) .JMPRIRESAMP/NORM/DIS3D Cor>Sag(-10)>Tra(-8) Cut Ctrl +X AAhead_scout_MPR_sag W 717 711 C 330 AAhead_scout_MPR_cor 336 Queue updates from selected Copy Ctrl+C 1:04 Not for diagnostic use Not for diagnostic use • Paste Ctrl+V step with the new strategy Delete Del Incel Clear All Shift+Del Exam Strategy Standard Ctrl+S contrast agent Standard Save as ... Resolution focus View Properties ... Alt+Enter Speed focus • Rerun from here with is only Motion-insensitive (BLADE) possible with a myExam Assist workflow 21 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 64 MR Protocol Building and Optimization- STEP Week 4 Patient View Patient View SIEMENS Healthineers ... Add-in configurations associated with a Brain Assist Neuro Patient View workflow step, represents the entire workflow. Standard Speed focus • First step in an Assist workflow AAhead_scout 00:19 AAhead_scout 00:19 Enables user to select strategies and make AutoAlign Scout AutoAlign Scout • t1_se_sag 03:07 t1_f12d_sag 01:03 decisions depending on the current patient Generic Views Generic Views Maximum of one per Assist program t2_tse_tra_512 03:37 t2_haste_tra_p2 00:52 • Provides certain functionality (e.g., Voice Generic Views 2 Generic Views • t2_tse_dark-fluid_tra 04:50 ep2d_dark-fluid_tra_p2 01:47 Command Settings, depending on Patient Generic Views > 2 Generic Views View selected) ep2d_diff_3scan_trace_p2 01:47 ep2d_diff_3scan_trace_p2 00:52 1 Generic Views 2 Generic Views t1_se_tra 02:25 t1_f12d_tra 01:08 Generic Views Generic Views contrast agent contrast agent with contrast agent with contrast agent Inject contrast agent. Inject contrast agent. t1_se_tra 02:25 t1_f12d tra 01:08 Generic Views 2 Generic Views t1_se_cor 02:27 t1_f12d cor 01:15 Generic Views Generic Views 22 Unrestricted © Siemens Healthineers, 2025 Notes 65 MR Protocol Building and Optimization- STEP Week 4 Patient View SIEMENS Healthineers ... Exchanging a Patient View Drag&Drop the Patient View from a myExam Cockpit - Program Editor (New Program) Explorer Program Editor list of default Patient View add-ins Browse Import Export Edit Simulate X ... Standard Browse Search from the sidebar. Default myExam Autopilot Patient View AddIns [13] Patient View| Basic Patient View| Abdomen Patient View Abdomen Patient View The list of Patient View Add-ins Strategy Replace Addin Angio Advanced Patient View Angio Patient View depend on the myExam Assist options O Basic Patient View purchased. O Breast Patient View O Cardiac Patient View O Hip Patient View O Neuro Patient View O Ortho Patient View O Prostate Patient View Shoulder Patient View Spine Patient View Whole Body Patient View 23 Unrestricted © Siemens Healthineers, 2025 Notes 66 MR Protocol Building and Optimization- STEP Week 4 Patient View SIEMENS Healthineers ... Patient View Queue Settings use the Add-in Configurator myExam Add-In Configurator to configure queue settings for Assist programs. Queue Disable Copy&Go Button Default Disable Copy&GO button controls the Copy&GO button Proceed to next Normal being enabled (Off) or disabled (On). Show parameter-card at startup (all steps in workflow) Proceed to next • Normal: next step opens as soon as the measurement of this program step is started • On image reconstruction finish: next program step opens when image reconstruction of this program step is complete Close Show parameter card at startup Parameter View is shown instead of Guidance View when Default in a Program Step applies the settings defined all workflow steps open in the queue. in the Patient View Add-in to this program step. 24 Unrestricted © Siemens Healthineers, 2025 Notes 67 MR Protocol Building and Optimization- STEP Week 4 Patient View SIEMENS Healthineers ... GSP Settings Use the Add-in Configurator in the Patient myExam Add-In Configurator View GSP setting to configure GSP settings for Assist programs. Queue GSP View Tools Image Text Default Group Graphics Default Reference Lines Default Extent Mode Default Protocol Table Position Default Coil Positions Default Adjust Volume Default Physio Display Default Expand Third Segment Default View-Graphics Scroll Display Slice Groups Default Display Order Default Close 25 Unrestricted © Siemens Healthineers, 2025 Notes 68 MR Protocol Building and Optimization- STEP Week 4 Decisions Decisions SIEMENS Healthineers ... Decisions provide the user with two or more Brain Assist Neuro Patient View choices within the workflow. They build the V Standard Speed focus structure of an examination by offering different AAhead_scout 00:19 AAhead_scout 00:19 pathways or branches. AutoAlign Scout AutoAlign Scout t1_se_sag 03:07 t1_f12d_sag 01:03 Generic Views Generic Views Patient View Decisions are made at the t2_tse_tra_512 03:37 t2_haste_tra_p2 00:52 Generic Views 2 Generic Views beginning of the examination and generally t2_tse_dark-fluid_tra 04:50 ep2d_dark-fluid_tra_p2 01:47 based on information known prior to starting the Generic Views · 2 Generic Views ep2d_diff_3scan_trace_p2 01:47 ep2d_diff_3scan_trace_p2 00:52 exam. 1 Generic Views 2 Generic Views (e.g., clinical indications.) t1_se tra 02:25 t1_fl2d tra 01:08 Generic Views 22 Generic Views Workflow Decisions are made during the contrast agent contrast agent with contrast agent with contrast agent examination and generally based on information Inject contrast agent. Inject contrast agent. learned during the examination. t1_se_tra 02:25 t1_f12d_tra 01:08 (e.g., image findings). They contain a Decision Generic Views Generic Views Step in the queue, prompting the user to decide t1_se_cor 02:27 t1_f12d_cor 01:15 Generic Views Generic Views from available options. 26 Unrestricted © Siemens Healthineers, 2025 Notes 69 MR Protocol Building and Optimization- STEP Week 4 Decisions SIEMENS Healthineers ... Patient View Decisions Select a Decision and drag&drop into the myExam Cockpit - Program Editor (New Program) Explorer Program Editor Browse Import Edit working area. Export Simulate X ... Standard Browse Search Default myExam Autopilot SIEMENS Rename Patient View @ Basic Patient View By default, this is a Patient View decision Q Strategy t1_se_sag 03:07 [ head visible in the Patient View. O Generic Views Brain Assist Decision program yes no Brain Autopilot clinical libraries Patient View decisions are made at the > [ advanced applications libraries GOBrain beginning of the examination. library angiography angiography ce Cc-spine Do t-spine > whole-spine > Da neck soft tissue thorax 0 heart >MiCardiac Assist O Click to open full view Strategy Decision Interaction Pause 27 Unrestricted © Siemens Healthineers, 2025 Notes 70 MR Protocol Building and Optimization- STEP Week 4 Decisions SIEMENS Healthineers ... Workflow Decisions Step To create a Workflow Decision Step: 1. Right-click on a Decision Step. Rename Patient View Basic Patient View Rename Patient View Basic Patient View 2. Select Add Decision Step. Strategy t1_se_sag 03:07 Generic Views V Strategy This adds a Decision Step to the workflow. Deri t1_se_sag 03:07 yes Copy Ctrl+C Generic Views Paste Ctrl+V Delete Decision Workflow Decisions are made during the yes O Basic Decision ename examination, based on patient findings. Check License Decision Convert yes no Expand Collapse Add Decision Step Remove Decision Step Show Protocol History Compare Protocols Create Copy Reference ... View Properties ... Edit Properties ... 28 Unrestricted © Siemens Healthineers, 2025 Notes 71 MR Protocol Building and Optimization- STEP Week 4 Decisions SIEMENS Healthineers ... Editing Decision Properties Editing Decision Properties: USER » Course prep > Genreral > Rename Strategy > Decision General 1. Right-click on a Decision. Name Decision 2. Select Edit Properties. Description 3. Name: enter a decision name (i.e., name is applied Decision Point Default Name to a decision point in the workflow). yes no 4. Description: enter a description (optional). Decision Points Decision Type Decision is made in patient view • Add, remove, reorder, or rename decision branches The decision step will be removed. Decision is made during the workflow in a decision step • Set Default decisions Patient View Decisions are made in patient view, and OK Cancel decision steps are not included in the protocol. Workflow Decisions are made while scanning in the measurement queue. Decision steps are included in the protocol. 29 Unrestricted © Siemens Healthineers, 2025 Notes 72 MR Protocol Building and Optimization- STEP Week 4 Decisions SIEMENS Healthineers ... Editing Decision Step Properties Editing Decision Step Properties myExam Add-In Configurator 1. Right-click on Decision Step 2. In the Edit Properties window to access Basic Decision the Add-in Configurator. Queue Layout Text Only 3. Add Guidance Text and Images to the Please decide. Decision Step. Close 30 Unrestricted © Siemens Healthineers, 2025 Notes 73 MR Protocol Building and Optimization- STEP Week 4 Standard Add-ins Standard Add-ins SIEMENS Healthineers ... Default • Auxiliary software components for myExam Assist are assigned to program steps Browse Search Patient View AddIns [12] Default AddIns [38] Abdomen Bolus Timing • Functionality varies, depending on type of Add-in ABLE Access-i Advanced Application • All System Add-ins are available in the sidebar of the Program Editor, they depend on O Angio Bolus Timing the myExam Assist licenses purchased AutoAlign AutoAlign Scout Basic Decision BOLD • Protocols with unlicensed Add-ins are handled the same way as unlicensed Breast Auto Coverage Scout O Breast Basic sequences Breast Dynamic Breast Implant Selection Cardiac Basic Cardiac Flow • Protocols without an Add-in display the syngo MR exam parameter cards Cardiac Marker Localization Cardiac SAX Planning Cardiac Standard Care Bolus Elastography O Generic Views Interactive Real Time Default Sequences [127] Strategy Decision Interaction Pause 31 Unrestricted © Siemens Healthineers, 2025 Notes 74 MR Protocol Building and Optimization- STEP Week 4 Standard Add-ins SIEMENS Healthineers ... Add-in Features (Standard on all MAGNETOM MR systems) • Generic Views User guidance (text, images) • Reduced protocol parameter selection • MPR Planning Definition of MPR reconstruction • User guidance possible • MPR Assignment Used for 3D protocols which are a basis of MPR reconstruction • User guidance and reduced parameter selection • Basic Decision User guidance for decision steps • Automatically selected for decision steps • Basic Patient View Basic Add-in for Assist workflows • Automatically selected when creating new Assist strategies 32 Unrestricted © Siemens Healthineers, 2025 Notes 75 MR Protocol Building and Optimization- STEP Week 4 Generic Add-ins Generic View Add-ins SIEMENS Healthineers' ... Generic View Add-ins are used more frequently and Dot Add-In Configurator define the Guidance View and Parameter View. Guidance Standard with all MAGNETOM MR systems. Parameters Layout 3 images LEBARA Queue GSP Tooltip Tooltip Tooltip Series Label Add-in parameters are listed: Auto Load AutoCoverage • Guidance AutoTiming • Parameters • Queue • GSP Slices are aligned by AutoAlign at the level of the corpus callosum and along a line through the genu (anterior) and the splenium (posterior). • Series Label Note that if you change slice positions manually, it might be impossible to reproduce these exact slice positions for subsequent protocols and follow-up examinations. • Auto Load • Auto Coverage Close • AutoTiming Parameters listed depend on type of Add-in. 33 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 76 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers' ... Guidance The Guidance View of an Add-in contains text and myExam Add-In Configurator images displayed when a step opens in the queue. It provides instructions on how to perform the step. Guidance Parameters Layout 3 images BARA To define a Layout: Queue GSP / Tooltip Tooltip Tooltip 1. Click on Camera icon to capture GSP segments Series Label Auto Load in the Exam task card. AutoCoverage AutoTiming -or- 2. Click on the folder icon to load Offline Guidance images into the respective image display. Save files as a JPG (recommended). "NOTICE: please configure guidance text here" a. Close 34 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 77 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers' ... Guidance Images 1. Click on Camera icon, HAR HAR ARH automatically takes you to the MR XA30 MR XA30 MR XA30 001 001 001 5 IMA 1 FRM 14/28 3 IMA 1 FRM 2/3 4 IMA 1 FRM 2/3 Exam Task card. All Segments kit Capturing Mode 2. Capture images from the GSP segments. a. Yellow square represents the ARF RPF region captured. RPF 3. Zoom/pan image to adapt size 10cm 10cm 10cm and position so it fits inside the A F O. TP O TP O TP O yellow square. SP R5.6 SP A8.9 SP F15.3 FoV 220*220 FoV 259*259 FoV 259 259 p2 MAGN/NORM/DIS2D >Cor(9)>Tra(-1) Cor>Sag(-10)>Tra(-8) >Cor(-2)>Sag(-1) 4. Capture All Segments all t1_qtse_dark-fluid_sag_p2 W 1787 ... /MPR/RESAMP/NORM/DIS3D IMPR/RESAMP/NORM/DIS3D C 854 AAhead_scout_MPR_cor C 711 336 AAhead_scout_MPR_tra 780 366 DE Not for diagnostic use Not for diagnostic use Not for diagnostic use individual segments. (i.e., camera icon can capture individual images) 3. Exit Capturing Mode display takes you back to setup window. 35 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 78 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Guidance Text, Tooltip, & Image Labels Guidance Text, Tooltips, and Image Labels Dot 0 4:14 min | Auto @ None 0.7x0.7x4.0 mm3 1.00 can be configured to assist the operator Guidance Parameters during planning. Use sagittal T1 series to align axi Sag Slices are aligned by AutoAlign at the level of the corpus callosum and along a line through the genu (anterior) and the splenium (posterior). | Note that if you change slice positions manually, it might be impossible to reproduce these exact slice positions for subsequent protocols and follow-up examinations. 36 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 79 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers' ... Guidance Text, Tooltip, & Image Labels Guidance Text is defined by the User. myExam Add-In Configurator Tooltip: Guidance • Text defined by the User (unable to save) Parameters Layout 3 images Queue GSP / Tooltip / Tooltip Image Labels, Guidance images can be labeled. Series Label User-defined Text Auto Load Predefined Text (internation ... AutoCoverage breast_tooltip_on_wate ... AutoTiming O abdomen_tooltip_delay_venous_delayed abdomen_tooltip_delay_venous_equil abdomen_tooltip_delay_venous_late AutomaticTableMoveWarning_Description AutomaticTableMoveWarning_Label breast_tooltip_dotted_line_is_on_water_peak breast_tooltip_dotted_line_is_right_of_water_peak Slic breast_tooltip_on_water_peak callosum and along a line through the genu (anterior) and the breast_tooltip_right_of_water_peak Nor elasto_passive_driver_label be impossible to reproduce these exact slice positions for sub elasto_slice_position_label Metallmplant NoticePleaseConfigureGuidanceTextHere Close 37 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 80 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Guidance Preview Preview can be selected in the Step USER >> Course prep >> Genreral >> Rename Strategy > t2_qtse_dark-fluid_tra ? X General 0 4:14 min | Auto @ None @ 0.7x0.7x4.0 mm3 1.00 Properties window for a preview of the Protocol Parameters Guidance Parameters Voice Commands Guidance configuration. Execution Image Management Auto Load Copy References Preview Slices are aligned by AutoAlign at the level of the corpus callosum and along a line through the genu (anterior) and the splenium (posterior). Note that if you change slice positions manually, it might be impossible to reproduce these exact slice positions for subsequent protocols and follow-up examinations. AddIn Configuration .. OK Cancel 38 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 81 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Guidance To export Guidance Images on Numaris/X: HAR 1. Right-click on image in GSP segment Brain Dot Engine 2020.09.15-16:24:24-DST-1.3.12.2.1107.5.99.3 2. Click Create Snapshot to save as a DICOM image and loaded to MR 11 IMA 1 FRM 14/28 View&GO viewing segments (color is lost). 3. Select Snapshot in MR View&GO and Export non-DICOM. 4. Select the Format and Hide Image Text to anonymize. Clear All Segments Shift to Image PlaneT. Group Graphics ARE Jay Perpendicular Orthogonal Align Parallel Align Fov TP O Copy Image Position SP R5.6 FOV 220*220 p2 MAGN/NORM/DIS2D S Cor(9)>Tra(-1) t1_qtse_dark-fluid_sag_p. Find Localizer W 1787 C 854 N. ER Repeat Step se Repeat & Open Step Dot 1:3 Guidance Parameters Copy Parameters TO Create Snapshot 39 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 82 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Parameters Generic Views Add-ins enables the user to configure a customized parameter card. Guidance Additional slots are available to show parameter settings or Parameters SLICES Slices P FoV Read to add text. GSP Series Label Slice Thickness P FoV Phase Auto Load P AutoCoverage av P AutoTiming Standard mode displays a pre-defined set of commonly P TR P Concatenations used parameters. Advanced mode all parameters in the sequence can be Advanced Mode selected. • P a slot that displays a parameter. T a slot that displays user defined text (e.g., group Close • parameters) Search for a parameter: • Insert beginning of parameter name (e.g., first letter). • Only parameters that match the inserted text are displayed for selection. 40 Unrestricted © Siemens Healthineers, 2025 Notes 83 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Parameters – Standard Mode Default parameters displayed in Standard Mode: • Averages Guidance SLICES • Slices (number of slices) Parameters Queue Slices P FOV Read • Distance factor GSP Series Label Slice Thickness P FoV Phase • Slice thickness Auto Load P AutoCoverage Phase Encoding Direction P • AutoTiming Averages P TR • Phase Oversampling P Concatenations • FoV read, FoV phase P P • Concatenations Base Resolution, and Phase Resolution Advanced Mode • • Flip Angle • TR • TE Close 41 Unrestricted © Siemens Healthineers, 2025 Notes 84 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Parameters – Preview General Auto @ 3 Select Preview in the Step Properties @ 1:12 min 0.3x0.3x4.0 mm3 1.00 Protocol Parameters Guidance Parameters window for a preview of the Parameters Voice Commands Execution configuration. Image Management SLICE PARAMETERS Auto Load Slices 27 + FoV Rea 220 mm Copy References Slice Thickness 4.0 + mm FoV Phase 100.0 ¢ Preview TR 6400.0 + ms Concatenations Addin Configuration ... OK Cancel 42 Unrestricted © Siemens Healthineers, 2025 Notes 85 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Queue Disable Copy&GO button: controls the Copy&GO button enabled: Guidance Disable Copy& Go Button Default • Off disabled Queue Proceed to next Normal GSP • On individual program steps Series Label Show parameter-card at startup Auto Load AutoCoverage AutoTiming Proceed to next: • Normal next step opens as soon as the measurement of this program step has started (default) • On image reconstruction finish next program step opens when the image reconstruction of the program step is complete Close Show parameter card at startup: Parameter View is shown instead of the Guidance View  Local Step Settings overrides Patient View settings. when this workflow step opens in the queue.  Defaults in a Program Step applies the settings defined in the Patient View Add-in to this program step. 43 Unrestricted © Siemens Healthineers, 2025 Notes 86 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... GSP Enables the user to define GSP settings for the workflow step. Guidance Parameters View Tools Local Step Settings overrides Patient View Queue GSP Image Text Default Group Graphics Default settings. Series Label Reference Lines Default Extent Mode Default Auto Load Protocol Table Position Default AutoCoverage AutoTiming Coil Positions Default Default applies settings defined in the Patient Adjust Volume Default View Add-in to this program step. Physio Display Default Expand Third Segment Default View-Graphics Scroll Display Slice Groups Default Display Order Default Close 44 Unrestricted © Siemens Healthineers, 2025 Notes 87 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Series Label & Auto Load Motivation: In some workflows it is beneficial to automatically display dedicated images in GSP segments to plan the following protocols. Implementation Series Label and Auto Load enables the user to automate the display of required images in GSP segments to plan the following steps in the workflow. This reduces user interactions and helps to standardize a workflow. Series Label are assigned to a series by applying properties that belong to a particular category. Auto Load uses a label, or combination of labels, to automatically find and load labeled series into GSP planning segments. 45 Unrestricted © Siemens Healthineers, 2025 Notes 88 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Series Label Labels are assigned to a series by applying properties that belonging to a particular category. Category Image Contrast STIR_TIRM T2 T1 Orientation Transverse Transverse Sagittal 46 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 89 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Series Label Select and assign labels from a list. Guidance Reduce the number of labels by selecting a Parameters All Queue dedicated target organ from the drop-down The following label(s) will be attached to all series acquired in this step. GSP Series Label menu. Auto Load Image Contrast Contrast Media AutoCoverage Laterality AutoTiming Orientation User can apply as many labels as needed to Patient Contrast Patient Stress describe the series. Processing Recon Region Representation Slice Technique View Sequential Number Close 47 Unrestricted © Siemens Healthineers, 2025 Notes 90 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers .. Auto Load Manually assign the same Series Labels in a previous series to find and load an acquired Guidance series automatically into GSP planning segments Parameters Knee (e.g., GSP Segment 1, 2, 3) when opening a Queue GSP GSP Segment 1 GSP Segment 2 GSP Segment 3 workflow step. Series Label Laterality Left Auto Load Laterally AutoCoverage Orientation Sagittal Transversal • AutoTiming • Orientation + Series may only be loaded after the acquisition is completed and saved to the local database. If the same labels were assigned to more than one program step, the images of the most recent step are loaded. Close 48 Unrestricted © Siemens Healthineers, 2025 Notes 91 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers .. Auto Load The Auto Load functionality and applications SIEMENS >> head >> library >> T2 >> t2_tse_tra_512 General within the Add-in is different than the Auto Protocol Parameters Load Images to Stamp Segments Load in protocol step properties. Voice Commands Load Images to Graphic Segments Execution Image Management 1st Segment Auto Load in the Step Properties window Auto Load Inline Movie automatically loads the series into the graphic Copy References Preview segments when finished. Auto Load in the Add-in facilitates the automatic loading of a previously acquired series to a specific GSP planning segments that can be used for planning the current step. Addin Configuration ... OK Cancel Auto Load in Step Properties window 49 Unrestricted © Siemens Healthineers, 2025 Notes 92 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Series Label & Auto Load Patient View Basic Patient View GSP Segments V Routine 1 AAhead_scout 00:14 AutoAlign Scout 2 t1_qtse_dark-fluid_sag_p2 04:38 t1_dark-fluid_sag t2_qtse_tra_p3 t1_fl2d_tra Generic Views GSP Segment 1 GSP Segment 2 GSP Segment 3 01:12 3 t2_qtse_tra_p3 1 Generic Views t2_qtse_dark-fluid tra 04:14 4 1 Generic Views ep2d_diff_3scan_trace_p2 01:38 Images can be loaded into specific GSP Segments, for example: Step 5 1 Generic Views • t1_dark-fluid_sag (Step 2) load to GSP Segment 1 t1_f12d tra 01:19 6 • t2_qtse_tra_p3 (Step 3) load to GSP Segment 2 Generic Views inject contrast agent • t1_fl2d_tra (step 7) to load to GSP segment 3 automatically on the opening of step 8 7 t1_f12d tra 01:19 Generic Views We apply labels to steps 2, 3 and 7 using Series Label. 8 t1_f12d cor 01:22 Generic Views 50 Unrestricted © Siemens Healthineers, 2025 Notes 93 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Series Label & Auto Load Patient View Basic Patient View myExam Add-In Configurato Step 2 V Routine 1 AAhead_scout 00:14 Guidance Parameters All AutoAlign Scout Queue The following label(s) will be attached to all series acquired in this step. 2 t1_qtse_dark-fluid_sag_p2 GSP 04:38 Series Label Image Contrast T1 Generic Views Auto Load prientatio Sagittal AutoCoverage 3 t2_qtse tra_p3 01:12 AutoTiming myExam Add-In Configurator 1 Generic Views Step 3 4 t2_qtse_dark-fluid_tra 04:14 Generic Views Guidance Parameters All 5 ep2d_diff_3scan_trace_p2 01:38 Queue The following label(s) will be attached to all series acquired in this step. Step 1 Generic Views Series Label Image Contrast T2 t1_f12d tra 01:19 Auto Load 6 AutoCoverage 1 Generic Views myExam Add-In Configurator AutoTiming Step 7 inject contrast agent Guidance 7 t1 fl2d tra 01:19 Parameters All Generic Views Queue The following label(s) will be attached to all series acquired in this step. t1_f12d cor 01:22 Series Label Image Contrast T1 8 Auto Load Generic Views AutoCoverage Orientatic Transversal AutoTiming 51 Unrestricted © Siemens Healthineers, 2025 Notes 94 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers .. Series Label & Auto Load Patient View Basic Patient View myExam Add-In Configurator Step 8 V Routine 1 AAhead_scout 00:14 Guidance AutoAlign Scout Parameters All 2 t1_qtse_dark-fluid_sag_p2 04:38 Queue GSP GSP Segment 1 Generic Views GSP Segment 2 GSP Segment 3 Image Contrast T1 T2 T1 01:12 Auto Load 3 t2_qtse_tra_p3 1 Generic Views AutoCoverage Orientation Sagittal Transversal Transversal AutoTiming 4 t2_qtse_dark-fluid_tra 04:14 1 O Generic Views 5 ep2d_diff_3scan_trace_p2 01:38 Step Generic Views 6 t1_f12d tra 01:19 Generic Views inject contrast agent 7 t1_f12d_tra 01:19 Generic Views Close 8 t1_f12d_cor 01:22 Generic Views We assigned labels to Step 8 using Auto Load 52 Unrestricted © Siemens Healthineers, 2025 Notes 95 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Series Label & Auto Load Patient View Basic Patient View nyExam Add-In Configurator V Routine 1 AAhead_scout 00:14 AutoAlign Scout Guidance Disable Copy&Go Button Default 2 t1_qtse_dark-fluid_sag_p2 04:38 Queue Proceed to next On Image Reconstruction Finish Generic Views Series Label Show parameter-card at startup t2_qtse tra_p3 01:12 Auto Load 3 ICE 1 Generic Views AutoCoverage AutoTiming Use Siemens Path (C:\Program Files\SiemensWumaris\MriProductilcellceConfigurators) 4 t2_qtse_dark-fluid_tra 04:14 Use Customer Path (C:\ProgramData\Siemens\Numaris\MriCustomerilce) 1 O Generic Views ICE program name ep2d_diff_3scan_trace_p2 01:38 Step 5 O Generic Views 6 t1_f12d_tra 01:19 Generic Views inject contrast agent • If Step 8 opens before Step 7 is completed and images are not stored to 7 t1_f12d_tra 01:19 Generic Views data base, Auto Load of Step 8 fails (i.e., additional configuration required) 8 t1_f12d_cor 01:22 • Proceed to Next On Image Reconstruction Finish is configured for Step 7 Generic Views 53 Unrestricted © Siemens Healthineers, 2025 Notes 96 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Auto Coverage Motivation • It may be beneficial to detect the size of the organ of interest automatically • Information may be used to optimize Slice Coverage and FoV with respect to the size of the organ, without any user interaction Implementation • Auto Coverage enables the user to automate the size (and orientation) of a slice group according to an organ box determined by the Auto Coverage Scout (and AutoAlign) algorithm • It adapts protocol parameters saving planning time while ensuring making the region of interest is covered completely • Parameter adaptation follows the rules and respects limits, which can be configured by the user which reduces user interactions and helps to standardize workflow 54 Unrestricted © Siemens Healthineers, 2025 Notes 97 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Auto Coverage – Concept In the programs first step, an AutoAlign Scout or specific Auto Coverage localizer determines organ boxes for a specific body region. est_27.05.2008 ----- M/DIS2D pace_localizer FOU 200-200 AutoAlign Head Scout Onco Auto Coverage Scout Breast Auto Coverage Scout 55 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 98 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Auto Coverage – Concept In subsequent steps, the Add-in applies the calculated organ box to adapt the slice coverage and FoV, according to how it is configured within the Add-in. est_27.05.2008 /DIS20 pace_localizer FOV 200 - 200 AutoAlign Head Scout Onco Auto Coverage Scout Breast Auto Coverage Scout 56 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 99 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Auto Coverage – Configuration 1. Click the Enable AutoCoverage check-box. 2. Organ box selection list drop-down Guidance a. Select an option (e.g., Head > Brain). Parameters Enable AutoCoverage Queue 3. Propagate changes to all the following Organ box Head > Brain GSP Series Label Propagate changes to all following protocols protocols, check box to enable. Auto Load Keep FOV constant Keep FoV constant, check box to enable. AutoCoverage 4. AutoCoverage will execute the following manipulations AutoTiming Parameter Limit Increment 5. Configure AutoCoverage will execute the 1 Slices 30.0 1.0 2 Slice Thickness following manipulations, and the order 4.5 m 0.5 mm 3 Distance Factor 40.0 5.0 % executed to cover the organ box. SAR Assistant a. Parameters SAR Assistant TR Max. TR 6500.0 ¢ ms b. Limits c. Increments 6. SAR Assistant can be enabled (identical Close behavior to Sequence>Assistance tab in protocol). Hint: Slice Copy Reference configuration overrides Auto Coverage. 57 Unrestricted © Siemens Healthineers, 2025 Notes 100 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Auto Coverage – Configuration Protocol manipulations are executed one after the other until the organ box is completely covered, or Guidance the last adaptation has been applied. Parameters Enable AutoCoverage Queue Organ box Head > Brain GSP Propagate changes to all following protocols AutoCoverage will execute the following Series Label Auto Load Keep FOV constant manipulations choose from the following AutoCoverage AutoCoverage will execute the following manipulations AutoTiming Parameter Limit Increment parameters. Slices 30.0 1.0 Slice Thickness 4.5 mm 0.5 m • Slices Distance Factor 40.0 % 5.0 WN 4 4 • Slice thickness SAR Assistant • Distance factor SAR Assistant TR Max. TR 6500.0 • Concatenations • Phase oversampling • Define limit and increment Close 58 Unrestricted © Siemens Healthineers, 2025 Notes 101 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Auto Coverage – Configuration Executed Protocol Manipulations Brain LOC ID + Hover mouse over the information icon to see AAhead_scout this text located at the bottom of the Guidance t1_qtse_dark-fluid_sag_p2 and Parameters Views. 3 10 12_qtse_tra_p3 4 Please open and check this step! V was adapted to th 4 01:31 Failed Auto Coverage 5 Auto Coverage . Please check l 4 04:14 6 • If protocol manipulations defined do not resolve_3scan_trace_tra Dot 1:31 min | Auto @ 2 @ 0.3x0.3x4.0 mm3 1.22 Guidance arameters cover the entire organ box, a warning message is displayed on the Guidance View of the opened protocol indicating that Auto Coverage was not successful • Additionally, an AutoAlign warning symbol is shown in the queue for this step Slices are aligned by AutoAlign at the level of the corpus callosum and along a Executed Protocol Manipulations the splenium (posterior). ------ AutoCoverage - Note that if you change slice positions manually, it might be impossible to rep Slices : 10 -> 12 subsequent protocols and follow-up examinations. 0 The FOV was adapted to the limits of AutoCoverage. Please check! 59 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 102 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Auto Coverage – Configuration The user may increase or decrease the calculated organ box size in the slice, phase and Guidance readout directions. Parameters Enable AutoCoverage Queue 1. Click on … next to the Organ Box Organ box Head > Brain GSP Propagate changes to all following protocols 2. Enter the Shift Parameter. Series Label Auto Load Keep Shift Parameter AutoCoverage AutoCover AutoTiming Additional read out size mm Additional phase encoding size mm O i + Additional slice selection size 20 mm WN - SAR Assist OK Cancel Close 60 Unrestricted © Siemens Healthineers, 2025 Notes 103 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Auto Coverage – Configuration If the Slice Coverage (number of slices, slice thickness, distance factor) of the protocol is larger than the organ Guidance box, Auto Coverage will not automatically decrease the Parameters Enable AutoCoverage Queue Organ box Head > Brain slice coverage. GSP Series Label Propagate changes to all following protocols Keep FOV constant AutoCoverage AutoCoverage will execute the following manipulations Auto Coverage can be configured to reduce the slice AutoTiming Parameter Limit Increment Slices 5.0 0.1 coverage in situations when the organ box size is 2 Slices 30.0 1.0 13 Slice Thickness 4.5 mn 0.5 mm smaller that the coverage defined in the protocol. 4 Distance Factor 40.0 % 5.0 % SAR Assistant SAR Assistant TR Max. TR Example: 6500.0 ¢ ms Auto Coverage begins with 5 slices and increases the number of slices to a maximum of 30. 1 Executed Protocol Manipulations AutoCoverage - Hint: when the protocol is stored with multiple Slices : 50 -> 28 concatenations, the minimum number of slices should be equal to or more than the number of concatenations. 61 Unrestricted © Siemens Healthineers, 2025 Notes 104 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Auto Coverage – Configuration Propagate changes to all following protocols: If check box is selected, manual changes are made Guidance to the automatically calculated organ box volume Parameters Enable AutoCoverage Queue are applied to all following protocols using the Organ box Head >> Brain GSP Series Label Propagate changes to all following protocols same organ box. (e.g., user adds additional slices). Auto Load Keep FOV constant This applies to following protocols. AutoCoverage AutoCoverage will execute the following manipulations AutoTiming Parameter Limit Increment Slices 30.0 1.0 Keep FOV Constant: Slice Thickness 7 4.5 0.5 mm Distance Factor 40.0 5.0 % WN - If check box is selected, the system will not adapt SAR Assistant the Field-of-View (FoV). The user can still adapt SAR Assistant TR Max. TR the Field-of-View (FoV) manually. 6500.0 This applies to current protocol. Close 62 Unrestricted © Siemens Healthineers, 2025 Notes 105 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers' ... Auto Coverage – Configuration Propagate changes to all following protocols: A When enabled changing the FoV in one direction may also influence the slice coverage in another direction. (i.e., changes size of organ box* volume). Example A: Propagate changes to all following protocols from a transverse brain protocol is not enabled. (i.e., results in correct L-R coverage for following sagittal protocol). Example B: Propagate changes to all following protocols from a transverse brain protocol is enabled. (i.e., results in unnecessary L-R B coverage since the organ box was enlarged in Transverse Brain this direction). Protocol *Green box = Organ Box 63 Images courtesy of Bart Schraa SHS AM NAM CAN CS APP Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 106 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Auto Coverage versus Copy Reference Brain and Joint Protocols for source and target protocols requiring the exact slice dimensions (e.g., number of slices, slice thickness, distance factor, slice orientation). Recommendations: 1. Source Protocol. a. Activate Auto Coverage. b. Deactivate Propagate. c. Activate working man. d. Keep FoV Constant (i.e., maintains protocol FoV). 2. Target Protocol a. Activate Auto Coverage (in case Copy Reference is lost). b. Activate Copy Reference slices (obtains same slice dimensions as the source protocol). 3. Copy Reference Slices a. Overrides Auto Coverage. b. Ensures same slice orientation (i.e., if orientation of source protocol is modified by user). c. Does not copy FoV Read/Phase. (i.e., ensures same FoV values in protocols). 64 Unrestricted © Siemens Healthineers, 2025 Notes 107 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Auto Coverage versus Copy Reference Abdomen Transverse Protocols for source and target Abdomen Coronal Protocols for source and target protocols requiring the exact same scan volume, but protocols requiring the exact same scan volume, but different slice dimensions (e.g., 2D versus 3D). different slice dimensions (e.g., 2D versus 3D). Recommendations: Recommendations: 1. Source Protocol. 1. Source Protocol. a. Activate Auto Coverage. a. Activate Auto Coverage. b. Activate Propagate. b. Deactivate Propagate. 2. Target Protocol. 2. Target Protocol. a. Activate Copy References. a. Activate Auto Coverage. 3. Deactivate Copy References. b. Activate Copy Reference Center of Slices (i.e., scans same slice orientation and position as source protocol). 3. Activate Keep FoV Constant (i.e., maintains FoV). a. Activate in target protocol 65 Unrestricted © Siemens Healthineers, 2025 Notes 108 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... AutoTiming Motivation In some workflows it may be beneficial to keep the acquisition time constant, or below a certain limit to achieve optimal and reproducible image quality. Implementation AutoTiming enables the user to automate the acquisition time according to time limits applied. (i.e., to achieve optimal image quality). This reduces user interactions and helps to standardize workflow. 66 Unrestricted © Siemens Healthineers, 2025 Notes 109 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... AutoTiming – Configuration 1. Enable the AutoTiming check box. 2. Define Condition(s) for AutoTiming Guidance (conditions are numbered 0 to n). Parameters Enable AutoTiming Queue 3. Define the protocol adaptations executed and Conditions GSP Time Per Concatenat ... Breath-Hold Capa ... Series Label their order to meet the defined condition(s). Auto Load 4. AutoTiming adaptations are only executed AutoCoverage AutoTiming once when the protocol is activated (opened AutoTiming will adapt the following parameters if the conditions are not met Condition Parameter Limit Increment or scanned without opening). TR 1000.0 ms 20.0 ms TR 1400.0 ms 10.0 ms 5. If both Auto Coverage and AutoTiming are Concatenations 3.0 1.0 0 TR 900.0 ms 20.0 ms configured, Auto Coverage is executed before TR 1400.0 ms 10.0 ms Concatenations 4.0 1.0 AutoTiming. 6. Protocol adaptations are executed one after the other until the condition(s) are met, or until the last adaptation has been applied. Close 67 Unrestricted © Siemens Healthineers, 2025 Notes 110 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... AutoTiming – Configuration Conditions • Acquisition Time Guidance • Captured Cycle Parameters Enable AutoTiming • Concatenations Queue Conditions GSP Time Per Concatenat ... < Breath-Hold Capa ... O TR Series Label Acquisition Time • Auto Load Captured Cycle Time Per Concatenation AutoCoverage Concatenations • TR • Time Per Measurement AutoTiming AutoTin Time Per Concatenation Time Per Measurement parameters if the conditions are not met Condition Parameter Limit Increment O TR 1000.0 ms 20.0 ms TR 1400.0 ms 10.0 ms O O Concatenations 3.0 1.0 TR 900.0 ms 20.0 ms O O TR 1400.0 ms 10.0 ms O Concatenations 4.0 1.0 Close 68 Unrestricted © Siemens Healthineers, 2025 Notes 111 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... AutoTiming – Configuration AutoTiming will adapt the following parameters if the conditions are not met Guidance Parameters Enable AutoTiming Queue Conditions Conditions GSP Time Per Concatenat ... < > Breath-Hold Capa ... Links adaptation of a parameter to conditions as Series Label Auto Load defined in the Conditions listed above. AutoCoverage AutoTiming None this parameter adapts irrespective of AutoTiming will adapt the following parameters if the conditions are not met • Condition Parameter Limit Increment any of the conditions defined above TR V 1000.0 20.0 none TR 1400.0 ms 10.0 ms • 0 this parameter is adapted if the first all Concatenations 3.0 1.0 0 TR y 900.0 ms 20.0 ms condition in the list is not met 0 TR 1400.0 ms 10.0 ms 0 Concatenations 4.0 1.0 • All this parameter is only be adapted if all the above conditions are not met Close 69 Unrestricted © Siemens Healthineers, 2025 Notes 112 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... AutoTiming – Configuration – Example Abdomen Assist (2 of 2) Example with one condition: What process occurs to reach this condition? Guidance Parameters Enable AutoTiming Queue Check 1: has this condition been met? Conditions GSP Time Per Concatenat ... Breath -Hold Capa ... Series Label 1. Decision 1: Auto Load a. Yes > quit. AutoCoverage AutoTiming b. No > decrease TR to 1000ms by increments AutoTiming will adapt the following parameters if the conditions are not met Condition Parameter Limit Increment of 20ms. TR 1000.0 ms 20.0 ms TO O TR 1400.0 ms 10.0 ms 0 Concatenations 3.0 1.0 0 TR 900.0 ms 20.0 ms Check 2: has this condition been met? TR 1400.0 ms 10.0 ms O Concatenations 4.0 1.0 1. Decision 2: a. Yes > quit. b. No > adapt TR to 1400ms. Close Check 3: has this condition been met? ……etc. a. Until the condition is met, or the last Example from Abdomen Assist parameter adaptation has been applied. 70 Unrestricted © Siemens Healthineers, 2025 Notes 113 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... AutoTiming – Configuration – Example Myocarditis Assist (1 of 2) Example with two conditions: What process occurs to reach these conditions? Parameters Queue Enable AutoTiming GSP Conditions 1. First adaptation is only executed if condition Series Label 0 Time Per Measurem ... > > Other 210.(s Time Per Measurem ... Other 270.(5 0 is not met. AutoTiming Cardiac Standard 2. Second adaptation is only executed if Cardiac Config condition 1 is not met. AutoTiming will adapt the following parameters if the conditions are not met Condition Parameter Limit Increment Averages 8.0 1.0 O 1 Averages 2.0 1.0 AutoTiming continues to execute the list of parameter adaptations until the condition is met, or the last parameter adaptation has been applied. Close Example from Myocarditis Assist 71 Unrestricted © Siemens Healthineers, 2025 Notes 114 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Copy & Paste Copy & Paste all parameters of an Add-in • You can Copy & Paste an entire myExam Add-in from one sequence to another Standard You can Insert an Add-in or Replace an Add-in using AAhead_scout 00:14 AAhea • Drag&Drop AutoAlign Scout These options copy all parameters of the Add-in from t1_qtse_dark-fluid_sag_p2 04:38 t1_spa • one sequence to another Generic Views t2_qtse_tra_p3 01:12 t2_spaq 1 Generic Views t2_qtse_dark-fluid_tra 04:14 t2_spaq Generic Views ep2d_diff_3scan_trace_p2 01.20 Generic Views + Insert Addin MPR pla 72 Unrestricted © Siemens Healthineers, 2025 Notes 115 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers' ... Copy & Paste Copy & Paste a Single Add-in parameter myExam Add-In Configurator • Use Copy & Paste icons to copy settings from one Add-in Source Protocol to another Guidance Only settings currently displayed are copied (e.g., Quelle Layout 3images @ HHEBAN • Tooltip Tooltip Guidance Views) Auto Load AutoCoverage AutoTiming Only settings compatible between the Add-ins can be copied: 1. Open Add-in Configuration of the source protocol step. myExam Add-In Configurator Target Protocol 2. Select an Add-in parameter and select Copy. Guidance ayout 3 images 3. Close the Protocol Step. Queue Tooltip Tooltip GSP Tooltip 4. Open the Add-in Configuration of the Target protocol. Series Label Auto Load AutoCoverage 5. Select an equivalent Add-in parameter and select Paste. AutoTiming This inserts the configuration from the clipboard to the "NOTICE: please configure guidance text here" current myExam component. 73 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemens Healthineers, 2025 Notes 116 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... Replace Protocol Replacing a Protocol frequency_scout 00:10 • You can replace a sequence when dropping a new sequence Cardiac Standard on top of an existing sequence with an Add-in cine_segmented_sax 00:09 • If a dropped sequence has no Add-in, an existing Add-in is kept. cine) segmenteStas lard You can replace a sequence and Add-in when dropping a new define_sax Replace Protocol and Addin • sequence on top of an existing sequence with an Add-in cine_segmented_sax 00:09 Cardiac Standard 74 Unrestricted © Siemens Healthineers, 2025 Notes 117 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-ins SIEMENS Healthineers ... AutoAlign Add-in AutoAlign feature is enabled by an Add-in. An AutoAlign Add-in is always present in any step in the queue. Default AddIns [38] Step 8 - 11 tse tra 3mm ? X General @ Abdomen Bolus Timing Protocol Parameters Name t1_tse_tra_3mm Voice Commands Description O ABLE Execution Image Management Access-i Auto Load Image Comment Copy References Preview Body Part Examined Brain Laterality Unpaired Manage Advanced Application Study Part Manage Dot Addin @ AutoAlign Angio Bolus Timing O AutoAlign @ AutoAlign Scout O Basic Decision 75 Unrestricted © Siemens Healthineers, 2025 Notes 118 MR Protocol Building and Optimization- STEP Week 4 Advanced Applications Add-ins Advanced Applications Add-ins SIEMENS Healthineers ... Auto Start Workflow Programs can be configured in myExam Dot Cardiac Dot Engine 6 Cardiac Pati .. myExam Add-In Configurator Breath-hold Cockpit so syngo.via automatically opens localizer in the background. center on heart O Table Positioning Strategy Auto Start Workflow localizer_heart 00:10 Guidance Assign and Auto Start Workflow Cardiac Basic Queue Interactions can be configured with an thorax_cor_tra 00:29 Name of Workflow / Application 1 MR Cardiac Analysis O Cardiac Basic GSP Advanced Application Add-in. AAheart_scout 00:09 matically open workflow in background O Cardiac Basic define_lax 00:01 Cardiac Marker Lo ... cine_segmented_lax 00:11 In the Add-in Configurator, enter the Cardiac Standard define_sax 00:01 exact name of the workflow to assign. Cardiac SAX Plann ... cine_segmented_sax 00:09 Cardiac Standard Interaction Advanced Application After applying this step in the queue, the workflow starts, and all reconstructed series prior to this step are loaded Close automatically to the workflow. 76 Unrestricted © Siemens Healthineers, 2025 Notes 119 MR Protocol Building and Optimization- STEP Week 4 Advanced Applications Add-ins SIEMENS Healthineers ... Spectroscopy Planning Spectroscopy measurements require planning on Non-Distorted (ND) SIEMENS > spectroscopy >> prostate_1H > body-array images: localizer_trufi_2D 00:13 The Spectroscopy Add-in provides a workflow solution for planning the center on prostate Table Positioning Strategy spectroscopy step. T2W- • Generate ND-images for the required table position Load ND-images into GSP segments t2_tse_tra_p3_fast • 01:02 • Perform voxel positioning t2_tse_cor_p3_fast 01:02 Configuration: t2_tse_sag_p2_fast 01:09 • The Add-in is automatically attached to spectroscopy protocols in Siemens Tree and during protocol conversion _CSI • This provides functionality only available for spectroscopy steps, csi3d_se_prostate 07:57 otherwise it is disabled Spectroscopy Auto Start MR Spectro Advanced Application 77 Unrestricted © Siemens Healthineers, 2025 Notes 120 MR Protocol Building and Optimization- STEP Week 4 Interaction Interaction SIEMENS Healthineers ... Interaction Steps Des Standard Default Addins [38] • Are activities other than scanning Motion-insensitive (BLADE) Breast Basic AAhead_scout Breast Dynamic 00:14 • Do not contain a protocol AutoAlign Scout Breast Implant Selection [1_qblade_dark-fluid_sag_p2 05:47 Cardiac Basic • Can be used to plan activities at certain points during a study Generic Views 12_qblade_tra_p2 O Cardiac Flow 02:47 Cardiac Marker Localization (e.g., MPR Planning). Generic Views 12_ablade t2_gblade_dark-fluid_tra_p2 04:14 Cardiac SAX Planning O Generic Views Cardiac Standard ep2d_diff_3scan_trace_p2 01:38 Care Bolus Generic Views O Elastography Select the Interaction placeholder from the sidebar and Drag&Drop Generic Views t1_qblade_dark-fluid_tra 05:38 Interactive Real Time into the working area. Generic Views Liver Quantification with contrast agent O Liver Segmentation • By default, the Interaction uses a Generic Views Add-in inject contrast agent O Morpho MPR Assignment t1_gblade_dark-fluid_tra 05:38 MPR Planning • To use a different Add-in, Drag&Drop from the sidebar 0 Generic Views t1_qblade_dark-fluid_cor_p2 06:09 Prostate • Interactions can be opened and applied in the queue, and once Generic Views QISS Interaction @ Generic Views RT Table Move applied the results of the interaction step are written into the O Spectroscopy Spine Positioning exam memory and can be reused in later workflow steps O Spine Scout Spine Verification Table Positioning Strategy O Whole Body Whole Body FastView Default Sequences [127] Strategy Decision Interaction Pause 78 Unrestricted © Siemens Healthineers, 2025 Notes 121 MR Protocol Building and Optimization- STEP Week 4 Interaction SIEMENS Healthineers ... Editing an Interaction Step SIEMENS >> head >> Brain Dot Engine >> program >> MPR Planning ? X General 1. Open the Edit Properties window and enter Preview Name MPR Planning an interaction name and description. Description 2. Use the Add-in Configuration to configure Dot Addin @ MPR Planning guidance images and text for your % ¥ Confirm before start interaction step. 3. If Confirm before start is checked, users are prompted to confirm step parameters when the queue reaches this step. The interaction step is marked with the working man symbol. Addin Configuration .. OK Cancel 79 Unrestricted © Siemens Healthineers, 2025 Notes 122 MR Protocol Building and Optimization- STEP Week 4 MPR Planning MPR Planning & MPR Assignment SIEMENS Healthineers ... MPR Planning Resolution focus Interaction steps are used to configure MPR ranges reconstructed within the AAhead_scout 00:14 • AutoAlign Scout workflow (e.g., FoV, number of slices, slice thickness, slice orientation) t1_space_fs_sag_p2_iso 05:06 2 MPR Assignment • The user is prompted to select MPR ranges and verify parameters for t2_space_sag_p2_iso 04:46 reconstructing the MPR series from a 3D dataset acquired by one or more MPR Assignment steps in the current workflow t2_space_dark-fluid_sag_p2_ns-t2prep 05:24 O MPR Assignment • MPR Planning can be inserted at any position within a program or strategy ep2d_diff_4scan_trace_p2 01:52 The setup of guidance images and text is possible O Generic Views • MPR planning MPR Planning MPR Assignment Is used for 3D protocols to select what predefined MPR ranges are reconstructed contrast agent for this step. with contrast agent inject contrast agent t1_space_fs sag_p2 iso 05:06 2 O MPR Assignment 80 Unrestricted © Siemens Healthineers, 2025 Notes 123 MR Protocol Building and Optimization- STEP Week 4 MPR Planning SIEMENS Healthineers ... Add a Reconstruction Range: 1. Right-click and rename MPR range. 2. Select a Layout and add Guidance Views and Text. 3. On the Parameters tab specify the reconstruction parameters. 4. Select MPR Ranges in the corresponding MPR Assignment steps. Queue Guidance + Parameters Queue Guidance + ~ Parameters GSP Layout 2 images B A Auto Load Auto Load MPR Planning "NOTICE: please configure guidance text here" Tooltip Tooltip MPR Planning FOV Height x Width 230 mm x 100 1% tra Slice Thickness 0.9 mm Slice Dist. Factor 0 % Slices 220 Image Numbering A>> P AutoAlign Head > Basis Position Iso Center Add MPR range Add MPR range Orientation Coronal Remove MPR range Remove MPR range Remember to select the desired MPR ranges to be processed in the corresponding MPR Assignment steps. Remember to select the desired MPR ranges to be processed in the corresponding MPR Assignment steps. 81 Unrestricted © Siemens Healthineers, 2025 Notes 124 MR Protocol Building and Optimization- STEP Week 4 MPR Assignment MPR Assignment SIEMENS Healthineers ... MPR Assignment is used for 3D protocols, select which of the predefined MPR ranges Guidance are reconstructed for this step. Parameters Generate the following selected MPRs Queue GSP cor Series Label tra Auto Load AutoCoverage AutoTiming MPR Assignment Close 82 Unrestricted © Siemens Healthineers, 2025 Notes 125 MR Protocol Building and Optimization- STEP Week 4 MPR Planning & MPR Assignment SIEMENS Healthineers ... Recommendations 1. MPR Planning Step only AAhead_scout 00:14 Patient View @ Neuro Patient View one allowed per strategy or AutoAlign Scout Standard Resolution focus non-Assist program. t1_space_fs_sag_p2_iso V 05:06 AAhead scout 00:14 AAhead_scout 00:14 O MPR Assignment 2. MPR Planning Steps should AutoAlign Scout AutoAlign Scout ep2d_diff_4scan trace_p2 01:52 t1_space_fs_sag_p2_iso 05:06 t1_space_fs_sag_p2_iso 05:06 be identical for each O Generic Views MPR Assignment O MPR Assignment Strategy within a Assist MPR planning t2_qtse_tra_p3 ep2d_diff_4scan trace_p2 01:52 Generic Views O MPR Planning Generic Views Workflow (e.g., copy & MPR planning t2_space_sag_p2_iso 04:46 paste) in case of any t2_space_sag_p2_iso 04:46 O MPR Planning O MPR Assignment O MPR Assignment t2_qtse_dark-fluid_tra 04:14 MPR planning strategy changes. t2_space_dark-fluid_sag_p2_ns-t2p ... 05:24 Generic Views MPR Planning MPR Assignment ep2d_diff_3scan_trace_p2 01:38 t2_space_dark-fluid_sag_p2_ns-t2p ... 05:24 Generic Views MPR Assignment Expand MPR Planning step across all strategies if needed. 1. Non-Assist Program 2. Assist Program with two Strategies 83 Unrestricted © Siemens Healthineers, 2025 Notes 126 MR Protocol Building and Optimization- STEP Week 4 myExam Assist Simulation Mode Simulation Mode SIEMENS Healthineers ... Check Assist Programs In Simulation Mode verify the Explorer Browse Import Export Simulate program created is working as Examination Preview SIEMENS >> head >> Brain Assist >> program myExam Autopilot intended. Brain Assist @ Neuro Patient View Strategy Standard Standard Resolution focus Speed focus contrast agent with contr ... AAhead_scout AutoAlign Scout AAhead scout AAhead_scout AAhead_sc O AutoAlign Scout AutoAlian Seos AAhead_sco 00:19 Displays different execution t1_qse_sag 03:07 t1_space_fs_sag_p2_iso 05:35 t1_f12d_sag 00:53 t1_blade_da O AutoAlign ... O Generic Views MPR Assignment O Generic Views _qse_sag 03:07 pathways of a program. 12_tse_tra_512 03:37 12_space_sag_p2_iso 04:37 12_haste_tra_p2 00:44 00:44 00:44 t2_qblade_t TO Generic Vi ... Generic Views O MPR Assignment Generic t2_tse_tra_512 03:37 12_qtse_dark-Muld 04:32 12_space_dark-fluid_sag_p2_ns-t2prep 05:52 12_tse_dark_fuld_t und_tra_p2 01:50 01:50 12_qblade Generic Vi ... O Generic Views O MPR Assignment Generic Views t2_qtse_dark-fluid_tra 04:32 ep2d_dift race_p2 01:44 ep2d_diff_4scan_trace_p2 02:29 ep2d_diff_3scan_trace_p2_130 00:41 ep2d_diff 3 Generic Vi ... Examination Preview simulates the O Generic Views O Generic Views Generic Views ep2d_diff_3scan_trace_p2 01:44 MPR planning O Generic Vi ... @ MPR Planning t1_qse_tra 02:25 display in the measurement queue t1_gse_tra 02:25 11_42d_tra 01:08 t1_blade_da Generic Vi ... O Generic Views O Generic Views Inject contrast agent. and total measurement duration. contrast agent contrast agent with contrast agent with contrast agent with contrast agen t1_qse_tra 02:25 Inject contrast agent. Inject contrast agent. Generic Vi ... (i.e., Read-only). Inject contrast agent. Inject contra t1_se_cor 02:25 t1_qse_tra 02:25 Generic Views 11_space_fs_sag_p2_iso 05:35 MPR Assignment 11_12d_tra 01:08 t1_blade_da Generic Vi ... O Generic Views t1_se_cor 02:25 01:13 1_blade_d Generic Views O Generic Views Return to Edit Mode to modify the program. 84 Unrestricted © Siemens Healthineers, 2025 Notes 127 MR Protocol Building and Optimization- STEP Week 4 Simulation Mode SIEMENS Healthineers ... Checking Assist Programs In Simulation Mode switch between Explorer Program Edito Browse Import Export dit Simulate Strategies and Decisions in the Examination Preview SIEMENS >> head >> Brain Assist >> program Examination Preview area to display myExam Autopilot Brain Assist| Neuro Patient View Strategy Standard different execution pathways. Standard Resolution focus Speed focus contrast agent with contr ... AAhead_scout 00:19 AAhead_scout 00:19 AAhead_scout 00:19 AAhead_sco O AutoAlign Scout O AutoAlign Scout AAhead_scout 00:19 -or- t1_qse_sag 03:07 t1_space_fs_sag_p2_iso 05:35 t1_f12d_sag 00:53 t1_blade_da AutoAlign ... Generic Views O MPR Assignment O Generic Views 03:07 Click on a Strategy or Decision in the t2_tse_tra_512 1_qse_sa 03:37 t2_space_sag_p2_iso 04:37 t2_haste_tra_p2 00:44 12_qblade_ O Generic Vi ... O Generic Views O MPR Assignment 3 Generic Views t2_tse_tra_512 03:37 Structogram. Steps outside the t2_qtse_dark-fluid_tr 04:32 t2_space_dark-fluid_sag_p2_ns-t2prep 05:52 t2_tse_dark_fluid_tra_p2 01:50 t2_qblade_ O Generic Vi ... O Generic Views O MPR Assignment O Generic Views t2_qtse_dark-fluid_tra 04:32 simulated execution pathway are ep2d_diff_3scan_trace_p2 01:44 ep2d_diff_4scan_trace_p2 02:29 ep2d_diff_3scan_trace_p2_130 00:41 ep2d_dif_ Generic Vi ... O Generic Views O Generic Views Generic Views ep2d_diff_3scan_trace_p2 01:44 MPR planning @ Generic Vi ... dimmed. MPR Planning t1_qse_tra 02:25 t1_qse_tra 02:25 11_12d_tre 01:08 Generic Views t1_blade_de Generic Vi ... O Generic Views Inject contrast agent. contrast agent with contrast agent with contrast agent t1_qse_tra 02:25 Inject contrast agent. Inject contrast agent. ject contrast agent. Inject contra O Generic Vi ... t1_se_cor 02:25 t1_qse_tra 02:25 t1_space_fs_sag_p2_iso 05:35 t1_f12d_tra 01:08 11 blade da O Generic Vi ... Generic Views MPR Assignment O Generic Views t1_se_cor 02:25 t1_f12d_cor 01:13 1_blade_da Generic Views O Generic Views 85 Unrestricted © Siemens Healthineers, 2025 Notes 128 MR Protocol Building and Optimization- STEP Week 4 Day 2 SIEMENS Healthineers myExam Brain Assist STEP - MR Protocol Building with myExam Cockpit & myExam Assist QR700021234 – Effective date 4/14/2025 Unrestricted © Siemens Healthineers, 2025 Notes 129 MR Protocol Building and Optimization- STEP Week 4 Agenda SIEMENS Healthineers ... myExam Brain Assist • myExam Brain Assist workflow features • Strategies • Neuro Patient View • AutoAlign Head Scout & AutoAlign Region • Organ Box • AutoAlign Parameter card • Generic Views – Add-in • MPR Planning and Assignment 2 Unrestricted © Siemens Healthineers, 2025 Notes 130 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Assist Objectives SIEMENS Healthineers ... At this end of this module, you should be able to: • Identify myExam Brain Assist workflow features • Describe strategies • Recall Neuro Patient View • Indicate the features of AutoAlign Head Scout and AutoAlign Region • Recognize the organ box • Summarize the parameters on the AutoAlign Parameter card • Define the Generic Views-Add-in • Demonstrate how to add MPR Planning and Assignment to a sequence 3 Unrestricted © Siemens Healthineers, 2025 Notes 131 MR Protocol Building and Optimization- STEP Week 4 Disclaimers SIEMENS Healthineers ... The information presented in the myExam Brain Assist course is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use their own learning, training, and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Medical Systems to be used for any purpose in that regard. 4 Unrestricted © Siemens Healthineers, 2025 Notes 132 MR Protocol Building and Optimization- STEP Week 4 myExam Assist SIEMENS Healthineers ... Consistency for every follow-up exam, independent of scanner 11_12d_tra 13_12d_trs Sices are aligned by Autodign af thee level of the corpus cadosurs andt slong a line though the gene Cantedod and o SAM Note That if you change shoe positions maesaily, It might be impossible la seproduce These exact slice poritions hoe nihonquent protocol and folow up examination. Patient 1, system A Patient 2, system B Patient 1, follow-up 5 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 133 MR Protocol Building and Optimization- STEP Week 4 Workflow Features myExam Brain Assist SIEMENS Healthineers' ... Key Workflow Features • AutoPosition SIEMENS ealthineers .15-16:24:21 .... MR View&GO • Strategies and Decisions Brain Assist LOC * Y + AutoAlign Head 16 IMA 1 FRM 14/28 14 MA 1 FRM 2/3 21.DST-1.3.12.2.1107.5.99.3 20 07 15-17: 21-DST.1 1 MAhead_scout 020 60 15- 18 71/4-DST.1.3.12.2. 1107.5.08.3 IMA 1 FRM 2/3 6-14:21-DST. 1.3.12.2.1107.5.99. • 2 t1_qtse_dark-fluld_sag_p2 • Auto Coverage 3 _ 12_qtse_tra_p3 t2_qtse_dark-fluid_tra 04:14 • Guidance Images and Text 5 ep2d_diff_3scan_trace_p2 01:38 6 11_112d_tra 01:19 • Limited Parameter card 7 inject contrast agent 8 t1_f12d_tra 01:19 LALALALALa • Inline MPR’s 9 t1_112d_cor 01:22 [A] TP O TP O SP R5.6 SP A8.9 FoV 220*220 FoV 259*259 or(9)>Tra(-1) ... IMPR/RESAMP/NORM/DIS3D Sag(-10)>Tra(-8) 1787 .. JMPRIRESAMP/NORM/DIS3D Notfor diagnostic use 85.4 AAhead_scout_MPR_cor 711 336 AAhead_scout_MPR_tra 2 09:52 Not for diagnostic use Not for diagnostic use GO @ 1:31 min 4 Auto @ 2 @ 0.3-0.3x4.0 mm' 1.00 Cancel Guidance Parameters Slices are aligned by AutoAlign at the level of the corpus callosum and along a line through the genu (anterior) and the splenium (posterior). Stimu Note that if you change slice positions manually, it might be impossible to reproduce these exact slice positions for subsequent protocols and follow-up examinations. 6 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 134 MR Protocol Building and Optimization- STEP Week 4 Strategies myExam Brain Assist SIEMENS Healthineers ... Strategies 3.OT XQ (Vida-XQ_21x_64RX MNO) > SIEMENS > head >> Brain Assist > program • Standard: 2D protocols Resolution focus: 3D Brain Assist @ Neuro Patient View • Standard Resolution focus Speed focus Motion-insensitive (BLADE) protocols for detailed views, AAhead_scout 00:14 AAhead_scout 00:14 AAhead_scout 00:14 AAhead_scout 00:14 AutoAlign Scout O AutoAlign Scout AutoAlign Scout AutoAlign Scout with automatic inline MPR‘s t1_qtse_dark-fluid_sag_p2 04:38 t1_space_fs_sag_p2_iso 05:06 t1_f12d_sag_p2 00:36 t1_qblade_dark-fluid_sag_p2 05:47 O Generic Views 2 O MPR Assignment Generic Views O Generic Views 12_qtse_tra_ps 01:12 t2_space_sag_p2_iso 04:46 t2_haste_tra_p2 00:42 t2_qblade_tra_p2 02:47 • Speed focus: fast 2D protocols O Generic Views O MPR Assignment O Generic Views O Generic Views 12_qtse_dark-fluid tra 04:14 t2_space_dark-fluid_sag_p2_ns-t2prep 05:10 t2_qtse_dark-fluid_tra_p3 01:50 t2_qblade_dark-fluid_tra_p2 04:14 (e.g., HASTE for a more O Generic Views O MPR Assignment Generic Views O Generic Views ep2d_diff_3scan_trace_p2 01:27 ep2d_diff_4scan_trace_p2 01:40 ep2d_diff_3scan_trace_p2_130 00:43 ep2d_diff_3scan_trace_p2 01:27 streamlined exam) O Generic Views O Generic Views O Generic Views O Generic Views MPR planning • Motion-insensitive: BLADE MPR Planning t1_f12d_tra 01:19 t1_f12d_tra_p2 00:28 t1_qblade_dark-fluid_tra 05:38 protocols to correct for O Generic Views Generic Views Generic Views contrast agent contrast agent with contrast agent with contrast agent motion with contrast agent with contrast agent inject contrast agent inject contrast agent inject contrast agent inject contrast agent • Easily tailored to suit t1_f12d_tra 01:19 t1_space_fs_sag_p2_iso 05:06 t1_f12d_tra_p2 00:28 t1_qblade_dark-fluid_tra 05:38 O Generic Views O MPR Assignment TO Generic Views Generic Views individual patient conditions t1_f12d_cor 01:22 t1_f12d_cor_p2 00:34 t1_qblade_dark-fluid_cor_p2 06:09 O Generic Views O Generic Views Generic Views and clinical needs User can modify the existing myExam Brain Assist or create their own myExam Assist programs according to their clinical practice 7 Unrestricted © Siemens Healthineers, 2025 Notes 135 MR Protocol Building and Optimization- STEP Week 4 Neuro Patient View myExam Brain Assist SIEMENS Healthineers ... Neuro Patient View • Behaves like a Basic Patient View myExam Add-In Configurator • Standard on all systems • Layout view and tools can be customized Queue to suit customer preference GSP View Tools Image Text Default Group Graphics Default Reference Lines Default Extent Mode Default Protocol Table Position Default Coil Positions Default Adjust Volume Default Physio Display Default Expand Third Segment Default View-Graphics Scroll Display Slice Groups Default Display Order Default Close 8 Unrestricted © Siemens Healthineers, 2025 Notes 136 MR Protocol Building and Optimization- STEP Week 4 AutoAlign Head Scout & Region myExam Brain Assist SIEMENS Healthineers ... AutoAlign Head Scout & AutoAlign Region AutoAlign Scout is a 3D T1 weighted 3.0T XQ (Vida-XQ_2Tx_64Rx_MNO) > SIEMENS > head >> Brain Assist > program >> AAhead_scout ? X General Ò 14 sec 4Auto @ 3 1.6x1.6x1.6 mm3 1.00 sagittal volume acquired at isocenter. Protocol Parameters Routine Contrast Resolution Geometry System Physio Inline Sequence It computes the AutoAlign Head references Voice Commands Execution Slab Group 1 FOV Read 260 mm - and enables standardized positioning. Image Management Slabs FoV Phase 100.0 % Contains an AutoAlign Scout Add-in for Auto Load Slices per Slab 128 - Slice Thickness • Copy References 1.6 mm automatic loading of the resulting MPR Preview Distance Factor 20 % TR 3.2 ms localizers in the transverse, sagittal and Position Isocenter 1.37 - ms coronal orientations into the GSP Orientation Sagittal Averages planning segments Phase Encoding Dir. A >> P Concatenations 1 4 Limited protocol adaptations are Phase Oversampling 0 4 % Auto Align Head • Slice Oversampling 0.0 % possible AutoAlign Region defines the anatomical region where the AutoAlign matrices are computed. (e.g., head, knee, spine) Addin Configuration .. OK Cancel 9 Unrestricted © Siemens Healthineers, 2025 Notes 137 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Assist SIEMENS Healthineers ... AutoAlign Head AutoAlign Head scout computes the following AutoAlign Head references. • Head > Basis • Head > Brain • Head > IAC • Head > Orbits • Head > Optic nerves • Head > Optic nerve L • Head > Optic nerve R • Head > Temporal lobe All references are designed to provide high reliability across patient ages and diseases and can provide high reproducibility for follow-up examinations. 10 Unrestricted © Siemens Healthineers, 2025 Notes 138 MR Protocol Building and Optimization- STEP Week 4 Organ Box myExam Brain Assist SIEMENS Healthineers ... AutoAlign Head Scout – Organ Box Two Organ Boxes define the boundaries of the anatomy under examination. • Brain organ box • Temporal lobe organ box • Enables standardized positioning of slices, whilst ensuring the anatomical coverage is tailored to the individual patient’s anatomy (or organ box) Brain organ box volume is Temporal lobe organ box volume • Organ box provides additional used for Auto Coverage is used for Auto Coverage information for the AutoAlign matrices in terms of anatomical boundaries 11 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 139 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Assist SIEMENS Healthineers ... AutoAlign Head Head > Basis Mid-sagittal plane (MSP) reference for use in all standard sagittal and coronal head protocols. Can also be used as a reference for other head regions (e.g., brainstem). Application: Standard sagittal head protocols. • Brain stem imaging (with offset) • Pituitary transverse/coronal imagine (with offset) Alignment • In-plane orientation: parallel to brain stem • Center: 10 mm offset posterior from lower border of the Sella and perpendicular to Meynert axis 12 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 140 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Assist SIEMENS Healthineers ... AutoAlign Head Head > Brain Standard transverse orientation in the head for the most applications in the brain region. (e.g., morphology, diffusion, perfusion, fMRI, etc.). Application: Standard transverse views of the brain. Alignment • Perpendicular to mid-sagittal plane is provided by Head > Basis reference • Tilted Tra > Cor along the lower borders of anterior and posterior part of corpus callosum • If these two landmarks are not covered by the standard clinical protocol, a user interaction is required to adapt positioning manually • Superior frontal gyrus • Center of the foramen magnum 13 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 141 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Assist SIEMENS Healthineers ... AutoAlign Head Head > IAC Clinical routine (e.g., for acoustic neuroma) • Reference is initialized with Head > Basis reference values • Final in-plane rotation of sagittal plane is the same as Head > Basis • Tilted Tra>Sag and Tra>Cor is adapted so the x-axis is along the internal auditory canal (IAC) axis Application: Robust views of the IAC. Alignment • Orientation: along the internal acoustic meatus • Center point is defined by the intersection point of the IAC axis with the mid-sagittal plane 14 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 142 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Assist SIEMENS Healthineers ... AutoAlign Head Head > Orbits Set up protocols in all three standard orientations parallel or perpendicular to the approximate optic plane. Application: Reproducible sag/cor/tra views for follow-up O exams of the optic nerves. Based on bony landmarks so not affected by eye position/movement, orbital, optic nerve lesions, or disease. Alignment • Tilted Tra>Sag: parallel to roof of the two orbits • Tilted Tra>Cor: derived from bony landmarks where two outer optical bony landmarks and optic chiasm are included • Inplane rotation: derived from the perpendicular line that passes through the midpoint between the optical bones • Center: optic chiasm 15 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 143 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Assist SIEMENS Healthineers ... AutoAlign Head Head > Optic nerves Provides a symmetric and robust view of the two optic nerves; soft-tissue landmarks are used on the two nerves and optic chiasm. Application: Alignment to contours of optic nerves. If protocol contains two sagittal slice groups, the following is applied automatically: First slice group aligned by Head > Optic Alignment • nerve L • Tilted Tra>Sag: intercranial part of both optical nerves is • Second slice group aligned by Head > included Optic nerve R • Tilter Tra>Cor: both optical nerves and optic chiasm are included • Inplane rotation: column vector of the resulting transverse plane is within mid-sagittal plane • Center: mid-sagittal plane and optic chiasm 16 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 144 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Assist SIEMENS Healthineers ... AutoAlign Head Head > Optic nerve L/Head Optic nerve R Reference is initialized with the values of the Head > Optic nerves reference. It provides robust and symmetric sagittal views of the left or right optic nerve. THATA Application: Based on optic nerves and optic chiasm. -- Alignment • Tilted Sag>Cor: for each optic nerve, the connection point lies in a plane with the eyeball • Center: the center point lies 4mm behind the center of the optic chiasm 17 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 145 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Assist SIEMENS Healthineers ... AutoAlign Head Head > Temporal lobe Transverse orientation derived from lateral fissure line above the temporal lobe. Center lies at the center of a bounding box around the temporal lobe. Application: transverse and coronal views of the temporal lobe. Alignment • Tilted Tra>Cor: to be parallel to left and right lateral fissure line • Right-left axis: perpendicular to mid-sagittal plane • Right-left center: on mid-sagittal plane • Feet-head center: mid-plane between lateral fissure plane and a parallel plane that passes through the IAC • Anterior-posterior center: midpoint between front and back of temporal lobe 18 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 146 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Assist SIEMENS Healthineers ... AutoAlign Remember to configure clinical protocols 8 6:05 min Auto @ None Head > Basis 71.00 with an AutoAlign reference for consistent Routine Contrast Resolution Geometry System Physio Head > Brain Ence and reproducible slice positioning and Slab Group FoV Read Head > IAC Head > Orbits minimal user interaction. Slabs 1 4 FoV Phase Head > Optic Nerves Head > Optic Nerve L Slices per Slab 192 Slice Thickness Head > Optic Nerve R Distance Factor 50 % TR Head > Temporal Lobe Neck > Carotids Position R5.0 A38.2 F40.1 TE Neck > CARE Bolus Orientation S > C5.3 > T2.1 Averages Neck > Test Bolus Neck > Aortic Arch Phase Encoding Dir. A >> P Concatenations Spine > Cervical Spine > Thoracic Phase Oversampling 0 % AutoAlign Head > Basis 19 Unrestricted © Siemens Healthineers, 2025 Notes 147 MR Protocol Building and Optimization- STEP Week 4 AutoAlign Parameter Card myExam Brain Assist SIEMENS Healthineers ... AutoAlign – Parameter Card AutoAlign enables the user to save AutoAlign 3.OT XQ (Vida-XQ_2Tx_64Rx_MNO) > SIEMENS > head >> Brain Assist > program >> t2_qtse_tra_p3 ? X General @ 1:12 min 4 Auto @ 3 @ 0.3x0.3x4.0 mm3 1.00 protocols with a pre-defined offset. Protocol Parameters Routine Contrast Resolution Geometry System Physio Inline Sequence Voice Commands (e.g., if they prefer a different slice orientation to Execution Common AutoAlign Navigator Saturation Tim Planning Suite the one calculated by the AutoAlign matrix, or if Image Management Slice Group 1 + - nitial Position Isocenter Auto Load Position Isocenter L 0.0 - mm used for pituitary imaging). Copy References Preview Orientation on Transversal P 0.0 - mm • Initial Position: determines initial offset of the Phase Encoding Dir. R>> L 0.0 position of the slice plane with respect to the Auto Align Head > Brain ... Initial Orientation Transversal calculated AutoAlign matrix • Initial Orientation: determines the initial offset Initial Rotation 90.00 + deg of the orientation of the slice plane with respect to the calculated AutoAlign matrix • Initial Rotation: determines the initial offset of the rotation of the slice plane with respect to Note: if protocol saved from a patient study the calculated AutoAlign matrix  Change Orientation to a true plane (Sagittal, Coronal, Transverse) with no angle  Set Position to Isocenter with No Offset. 20 Unrestricted © Siemens Healthineers, 2025 Notes 148 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Assist SIEMENS Healthineers ... AutoAlign – Parameter Card Examples: Initial Position Offset No initial Position Offset Initial Position Offset: F20mm Contrast Resolution Geometry System Physio Inline Sequence Contrast Resolution Geometry System Physio Inline Sequence Comme AutoAlign Navigator Saturation Tim Planning Suite AutoAlign Navigator Saturati Planning Suite Slice Group 11 Initial Position Isocenter Slice Group 1 + Initial Position LO.O PO.O F20.0 Position Isocenter R 0.0 mm Position Isocenter R 0.0 mm Orientation Transversal P 0.0 mm Orientation Transversal A 0.0 mm Phase Encoding Dir. R>> L H 0.0 mm Phase Encoding Dir. R>>L F 20.0 mm AutoAlign Head > Brain itial Orientation Transversal AutoAlign Head > Brain Initial Orientation Transversal Initial Rotation 90.00 + deg nitial Rotation 90.00 + deg H -999.0- 0.0 - 999.0 H -999.0- 20.0 999.0 mm 21 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 149 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Assist SIEMENS Healthineers ... AutoAlign – Parameter Card Examples: Initial Orientation Offset No initial Orientation Offset Initial Orientation Offset: T>C -15° tine Contrast Resolution Geometry System Physio Inline Sequence Contrast Resolution Geometry System Physio Inline Sequence on AutoAlign Navigator Saturation Tim Planning Suite AutoAlign Navigator Saturation Tim Planning Suite Slice Group 1 Initial Position LO.O PO.O F20.0 Slice Group 1 Initial Position Isocenter Position Isocenter R 0.0 mm Position Isocenter 0.0 mm Orientation Transversal A 0.0 Orientation T>> C-15.0 0.0 mm Phase Encoding Dir. R>>L F 20.0 mm Phase Encoding Dir. R>>L ... 0.0 mm AutoAlign Head > Brain Initial Orientation Transversal AutoAlign Head > Brain Initial Orientation T> C -15.00 0.00 Initial Rotation 90.00 ¢ deg Initial Rotation 90.00 + deg H -999.0- 20.0 -15.00 - 999.0 mm T>C 45.00- - 45.00 22 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 150 MR Protocol Building and Optimization- STEP Week 4 Generic Views Add-in myExam Brain Assist SIEMENS Healthineers ... Generic Views Add-in Configuration: Guidance and Parameters cards myExam Add-In Configurator myExam Add-In Configurator Guidance Guidance Parameters Layout 3images BARA Parameters P Queue Tooltip / Tooltip Tooltip Slices P FoV Read GSP GSP Slice Thickness Series Label Series Label P FoV Phase Auto Load Auto Load AutoCoverage AutoCoverage AutoTiming AutoTiming P Concatenations P Slices are aligned by AutoAlign at the level of the corpus callosum and along a line through the genu (anterior) and the splenium (posterior). Advanced Mode Note that if you change slice positions manually, it might be impossible to reproduce these exact slice positions for subsequent protocols and follow-up examinations. 23 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 151 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Assist SIEMENS Healthineers .. Generic Views Add-in Configuration of AutoCoverage myExam Add-In Configurator Organ box Guidance Parameters Enable AutoCoverage • Head > Brain for routine brain imaging Queue Organ box Head > Brain GSP Head > Temporal lobe for temporal lobe imaging Serie cabel • Series Label Propagate changes to all following protocols Keep FOV constant AutoCoverage AutoTiming AutoCoverage will execute the following manipulations Recommendation for head programs: Parameter Limit Increment Slices 4.5 1.0 2 Keep FOV constant (takes FOV from protocol) Slice Thickness 0.5 m • Distance Factor 40.0 5.0 % W • Slice group orientation is according to AutoAlign head SAR Assistant SAR Assistant TR matrix Max. TR 6500.0 + ms • AutoCoverage adapts parameters to ensure the selected organ box is covered • Configure Copy Reference Slices for protocol steps to ensure exact same slice parameters (e.g., number of slices, slice thickness, distance factor, & slice orientation) • Ensures any manual modifications to slice coverage and orientation made by the user are considered 24 Unrestricted © Siemens Healthineers, 2025 Notes 152 MR Protocol Building and Optimization- STEP Week 4 MPR Planning and Assignment myExam Brain Assist SIEMENS Healthineers ... MPR Planning and Assignment MPR Planning MPR Assignment Configure all MPR ranges that may be required in your Remember to select MPR ranges to be to be processed in program. (e.g., IACs). the corresponding MPR Assignment step. myExam Add-In Configurator myExam Add-In Configurator Guidance + - Parameters Guidance GSP Parameters Generate the following selected MPRs MPR Planning FOV Height x Width 160 mm x 100 Queue GSP cor Slice Thickness 1.0 mm Serles Label Slice Dist. Factor VIACS 0 Auto Load Slices 15 AutoCoverage Image Numbering F>>H AutoTiming MIKASSignment AutoAlign Head >> IAC Position Iso Center Add MPR range Orientation Transversal Remove MPR range 1) Remember to select the desired MPR ranges to be processed in the corresponding MPR Assignment steps. Close 25 Unrestricted © Siemens Healthineers, 2025 Notes 153 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Assist SIEMENS Healthineers ... MPR Planning and Assignment Recommendation • Only one MPR Planning step per strategy (or non-myExam Assist program) • MPR Planning step should be identical for each strategy within the myExam Assist (e.g., copy & paste) in case there is a strategy change • Expand MPR Planning step across all strategies if needed Brain Assist Neuro Patient View Brain Assist Neuro Patient View Standard Resolution Focus V Standard Resolution focus AAhead_scout 00:14 AAhead_scout 00:14 AAhead_scout 00:14 AAhead scout 00:14 AutoAlign Scout AutoAlign Scout AutoAlign Scout AutoAlign Scout t1_space_fs_sag_p2_iso 05:06 t1_space_fs_sag_p2_iso 05:06 t1_space_fs_sag_p2_iso 05:06 t1_space_fs_sag_p2_iso 05:06 O MPR Assignment MPR Assignment MPR Assignment MPR Assignment t2_qtse_tra_p3 01:12 t2_space_sag_p2_iso 04:46 t2_qtse_tra_p3 01:12 ep2d_diff_4scan trace_p2 01:52 Generic Views MPR Assignment Generic Views O Generic Views MPR planning MPR planning t2_space_sag_p2_iso 04:46 O MPR Planning MPR Planning MPR Assignment t2_qtse_dark-fluid_tra 04:14 t2_space_dark-fluid_sag_p2_ns-t2p ... 05:24 C Generic Views O MPR Assignment t2_qtse_dark-fluid tra 04:14 MPR planning ep2d_diff_3scan_trace_p2 01:38 Generic Views MPR Planning t2_space_dark-fluid_sag_p2_ns-t2p ... 05:24 C Generic Views MPR Assignment ep2d_diff_3scan_trace_p2 01:38 t2_space_dark-fluid_sag_p2_ns-t2p ... 05:24 ep2d_diff_3scan_trace_p2 01:38 Generic Views O MPR Assignment Generic Views 26 Unrestricted © Siemens Healthineers, 2025 Notes 154 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Assist SIEMENS Healthineers ... Build and customize your own! Neuro Patient View MPR Planning and MPR Assignment Preconfigure GSP settings. Streamline workflow and ensure reproducible ranges. AutoAlign Head Scout Strategies and Decisions Use for consistent and reproducible slice positioning. Implement into your myExam Assist as required. Remember to select AutoAlign reference matrix in following measurement steps. Generic Views • Configure guidance images, text and optimize parameter cards • Configure AutoCoverage (remember Copy Reference Slices) • Configure Series Label and Auto Load 27 Unrestricted © Siemens Healthineers, 2025 Notes 155 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers myExam Spine Assist MR myExam Cockpit & myExam Assist QR700021234 – Effective date 4/14/2025 Unrestricted © Siemens Healthineers, 2025 Notes 156 MR Protocol Building and Optimization- STEP Week 4 Agenda SIEMENS Healthineers ... myExam Spine Assist • Introduction • AutoAlign Spine • Inline Curved Planar Reconstructions (CPRs) • Automatic Positioning • AutoCoverage • AutoAlign Verification • Transverse Image Labeling • myExam Assist examinations • Workflow and configuration hints • Summary 2 Unrestricted © Siemens Healthineers, 2025 Notes 157 MR Protocol Building and Optimization- STEP Week 4 Objectives SIEMENS Healthineers ... At this end of this module, you should be able to: • Identify the features of AutoAlign Spine • Explain Inline Curved Planar Reconstructions (CPRs) • Define Automatic Positioning • Summarize AutoCoverage • Recall AutoAlign Verification • Explain Transverse Image Labeling • Demonstrate how to perform myExam Assist examinations • Restate the workflow and configuration hints 3 Unrestricted © Siemens Healthineers, 2025 Notes 158 MR Protocol Building and Optimization- STEP Week 4 Disclaimers SIEMENS Healthineers ... The information presented in the myExam Spine Assist course is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use their own learning, training, and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Medical Systems to be used for any purpose in that regard. Please refer to a Contrast Agent manufacturer's labeling, and instructions for use, for use of that Contrast Agent with an MRI exam. Siemens Healthineers MAGNETOM MR systems are not labeled for use with implantable medical devices. FDA has not evaluated the safety and effectiveness of these systems for use with implantable medical devices. Siemens Healthineers does not assume any responsibility or liability for the operation of a MAGNETOM MR System with any implantable device. Please direct any safety related questions to your facility’s MR Safety Officer (MRSO), MR Medical Director (MRMD), or Directing Radiologists. MR scanning has not been established as safe for imaging fetuses and infants less than two years of age. The responsible physician must evaluate the benefits of the MR examination compared to those of other imaging procedures. 4 Unrestricted © Siemens Healthineers, 2025 Notes 159 MR Protocol Building and Optimization- STEP Week 4 Introduction myExam Spine Assist SIEMENS Healthineers ... Benefits from standardized workflows SIEMENS .. eolthineers #). º 1191981 FRS, 201402260313487 MR VICARGO MR VIEW&GO Powered by Artificial Intelligence c-spine Assist Doe, Jane Dos.J AAspine_scout RS_20140226031 3487 RS 20140726031 OID OtherPat OD OtherPat 2 %% 12_the_sag 4 IMA1 FRM 3/7 2 IMATERM TA 2 IMA 2 FRM IM 3 t1_tse_dark-fluid_sag 03:58 76 AutoAlign Verification 5 x 12_me2d_tra 04:42 6 x_ 12_space_tra_p2_2mm 04:59 TP O SP F50.0 FOV 400"190 Tra 880 ZERUCPRINORMDISTORT 37 MAspine_scout_CPR 2 13:39 Go 3:11 min & Auto @ None @ 0.6x0.6x3.0 mm? @ 1.00 Cancel Parameters Slices 15 FoV Read 220 m Slice Thickness 3.0 mm Fov Phase 100.0 Distance Factor 10 TR 3500.0 ¢ m AutoAlign Spine > > Concatenations AutoAlign - ----- SAR Stimu 5 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 160 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Benefits from standardized quality of care SIEMENS .. Healthineers ¡D. º 111971981 F 13,20140226031 3487 MR VIEWEGO MR View&GO Powered by Artificial Intelligence c-spine Assist ISO @ / * + + AAspine_scout RS 201402260312487 RS 20140726 RS 20940220031 248 4 MAT FROM 377 2 12_tse_sag 2 MAT FRM IP 2 IMA 2 FROM 11 3 t1_tse_dark-fluid_sag 03:58 4 % AutoAlign Verification 5 x 12_me2d_tra 04:42 6 x 12_space_tra_p2_2mm 04:59 TP O SP F50.0 FOV 400"190 Tra ZERICPR NORMDISTOR AAspine_scout_CPR EPISTORT 13:39 Go Cancel AutoAlign Verificatic RE JOK Show intervertebral disk positions Image Labeling ¥ Label transverse images Confirm Decline 1 Check the shown vertebra labeling and confirm below. AutoLabeling -- - - Before proceeding please confirm or decline the spine geometry shown in GSP. 6 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 161 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Key Workflow Features SIEMENS • AutoPositioning ealthineers ÀD. º 119/1981 F 85,201402260313487 MR VIEWSGO ME View&GO • AutoAlign Spine c-spine Assist ISO ℮ + Dos, Jane RS_201402260313487 RS 201407265 DAS 20140226031248 AAspine_scout • AutoAlign Verification CID OferPat 2 12_tse_sag 4 IMA1 FRM 307 2 IMA 1 FROM 11 2 1MA 2 FROM 19 AutoLabeling 3 t1_tse_dark-fluid_sag • 4 76 AutoAlign Verification • AutoOrientation to vertebrae and 5 x 12_me2d_tra 04:42 6 76_ 12_space_tra_p2_2mm 04:59 intervertebral Discs • Interactive Snapping IF TP O SPF50.0 • AutoCoverage FOV 400*190 Tra 880 ZERICPRINORKDISTORTED 376 AAspine_scout_CPR • Inline MPR’s 13:39 Synmerc CPR ma • Inline CPR’s When we Go Cancel AutoAlign Verification RE STK Show intervertebral disk positions Image Labeling Label transverse images Confirm Decline 1 Check the shown vertebra labeling and confirm below. ---- MR Stimu 0 Before proceeding please confirm or decline the spine geometry shown in GSP. 7 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 162 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Motivation Quality Goals Simplify, speed-up and standardize MR spine imaging. • Fast: reduced setup time to start the first clinical • System suggests vertebral levels protocol • System assists graphical slice positioning and anterior • Robust: can handle individual anatomies, pathologies, saturation band etc. • MR spine exams can be performed with fewer mouse • Reliable: special user notification yes/no clicks • Proven: in a clinical environment • Imaging procedure can be standardized with reliable results • Auto detect spine geometry 8 Unrestricted © Siemens Healthineers, 2025 Notes 163 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Spine Patient View Layout and tools pre-configured to assist workflow myExam Add-In Configurator ? x Queue GSP View Tools Image Text Default Group Graphics Off Reference Lines Default Extent Mode Default Protocol Table Position On Coil Positions On Adjust Volume Off Physio Display Default Expand Third Segment On View-Graphics Scroll Display Slice Groups Default Display Order Default Close 9 Unrestricted © Siemens Healthineers, 2025 Notes 164 MR Protocol Building and Optimization- STEP Week 4 AutoAlign Spine myExam Spine Assist SIEMENS Healthineers ... AutoAlign Spine Localizer Enables the following key features: L-Spine Assist Spine Patient View • Automated positioning and alignment of slice V Standard Post groups to the spine anatomy number AASpine Scout steps 3 steps (laser on chin) • Fast, easy and reproducible patient scanning I_AAspine_scout 00:19 AAspine_scout Spine Scout • Facilitates reading by consistently delivering Il_AAspine_scout 00:19 high image quality with standardized slice Spine Scout orientation for follow-ups and across patients III_AAspine_scout 00:19 Spine Scout Automatically detects and labels vertebral t2_tse_sag 03:46 t2_tse_sag • 1 Spine Positioning 2 bodies and discs t1_tse_dark-fluid_sag 04:38 t1_tse_dark-fluid_sag Suggests positioning for sagittal, coronal and 1 Spine Positioning 2 • double oblique axial slice groups in the spine • Automatic positioning of anterior sat band • Spine Scout Add-in must be linked to this protocol 10 Unrestricted © Siemens Healthineers, 2025 Notes 165 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... AutoAlign Spine Localizer – AAspine-Scout AAspine-Scout is based on one, two, or 3.0T XQ (Vida-XQ_2Tx_64Rx_MNO) > SIEMENS > I-spine >> L-Spine Assist >> program >> |_AAspine_scout ? x General 19 sec Auto@ 3 @ 1.7x1.7x1.7 mm3 ៛ 1.00 three station AASpine_scout localizers. Protocol Parameters Parameters Coronal T1 VIBE 1.7mm³ Voice Commands • Execution OV Read 400 mm Limited protocol adaptations are possible Image Management • Auto Load FOV Phase 100.0 % • Inline Composing Copy References Slices per Slab 112 Slice Thickness 1.7 7 mm • Inline Multi-Planar Reconstructions Preview TR 3.3 7 ms (MPR’s) • Inline Curved Planar Reconstructions Orientation Coronal (CPR’s) AutoAlign Spine • Generates matrices for AutoAlign Spine • 1 Station: C-spine, T-spine, or L-spine exams • 2 Station: C/T-spine or T/L-spine exams • 3 Station: C/T/L-spine (Whole Spine) exams 11 Unrestricted © Siemens Healthineers, 2025 Notes 166 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... AutoAlign Spine – ALPHA® ALPHA® - Automatic Localization and Parsing of Human Anatomy Atlas Siemens patent technology -Axis C2 • • Based on landmark detection by anatomical context C3-C7 • Training on ∼ 200 annotated clinical data sets T1 • High reliability due to internal ranking/weighting • ALPHA® technology introduced with syngo MR VD11A (ALPHA® TA - T5- T2-T7 AutoAlign Knee) T 7 T8 T 9 T 10 T8-T12 T 11 T 12 L1 L2-L5 S1 SACRUM COCCIS 12 Unrestricted © Siemens Healthineers, 2025 Notes 167 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... AutoAlign Spine Steps 1 and 2: Atlas 1. Hierarchical spine element detection -Axis C2 • Anchor vertebrae (C2, T1, L1, S1) C3-C7 • Bundle vertebrae into groups T1 • Estimation of intervertebral discs TA - T5- T2-T7 2. Internal ranking and verification • Propagation of model information across the elements T 7 T8 Prediction of missing elements (distance analysis) T 9 • T 10 T8-T12 • Computation of the center left, right, front and back lines T 11 • Smoothing of the determined spine geometry model T 12 L1 L2-L5 S1 SACRUM COCCIS 13 Unrestricted © Siemens Healthineers, 2025 Notes 168 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... AutoAlign Spine Steps 1 and 2: Atlas 1. Grouping -Axis C2 • C-spine VOI (derived from C2-T2) C3-C7 • T-spine VOI (derived from T1-T12) T1 • L-spine VOI (derived from T12-S1) TA - T5- T2-T7 2. Final Classification • Class I = good T 7 T8 T 9 • Class II = to be checked (marked with AA info icon) T 10 T8-T12 • Class III = not detectable (marked with AA info icon) T 11 T 12 L1 L2-L5 S1 SACRUM COCCIS 14 Unrestricted © Siemens Healthineers, 2025 Notes 169 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... AutoAlign Spine – AAspine_Scout AAspine_Scout provides: L1 L1 Spine Geometry Right line, left line L2 L2 • • Anterior line, posterior line • Intervertebral disc positions L3 L3 L4 L4 Vertebral Labels • To be confirmed by the user L5 L5 Images S1 S1 • 3D volume (coronal T1 vibe) • Inline MPR images (sagittal, transverse) • Inline CPR images (sagittal, coronal) Reliable feedback about the alignment • Inline composed images localizers 15 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 170 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... AutoAlign Spine – AAspine_Scout Sixth Lumbar Vertebra? • ALPHA® spine refers to the last “free” segment • A multi-station localizer approach (C+T+L) is required for the most reliable identification of labels T12 T8 . . T.12 T9 - L1 T10- -L2 T11 12. -L3 -L4 L2 - 5 L-spine scout only: ambiguous Multi-station: L6 16 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 171 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... AutoAlign Spine ALPHA® Detector Results – Anatomy, Pathology Positioning and Setup • Pathologies • Coil elements • Anatomical variants (e.g., kyphosis, scoliosis, • Head/neck position lumbarization, sacralization) • Light marker position • Age, patient condition (T1 contrast) • AAspine_scout coverage (head-feet, anterior-posterior) • Overlap of AAspine_scout stations Trained with the ALPHA® spine detector as thoroughly as possible. Trained as thoroughly as possible to support ´standard` scenarios with myExam Spine Assist. Required correct protocol setup in customer created myExam Spine Assist programs. 17 Unrestricted © Siemens Healthineers, 2025 Notes 172 MR Protocol Building and Optimization- STEP Week 4 Inline Curverd Planar Reconstructions (CPRs) myExam Spine Assist SIEMENS Healthineers ... Inline Curved Planar Reconstructions (CPRs) Spine Dot Engine Spine Dot Engine • Coronal CPR 001 001 Sagittal CPR 14 IMA 1/2 14 IMA 2 / 2 • 5/24/2012 5/24/2012 • Demonstrates the spinal anatomy as complete coronal and sagittal projections onto a virtual center plane, providing an overview of the entire spine geometry • Serves as a basis for validation of vertebral labeling • May be used for positioning sagittal and coronal slice groups • CPR images should not be used for diagnostic purposes P3 CPR/NORM/DIS3D/COMP_SP SPR10.8 P3 CPR/NORM/DIS3D/COMP_SP _AASpine_Scout_COMP_SP_1 ... synthetic CPR i. FoV837"163 P P40.7 Sag I_AASpine_Scout_COMP_SP_1 ... synthetic CPRi ..... FoV837"400 18 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 173 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Inline Curved Planar Reconstructions (CPRs) 12.0 2.0 12.80 T11 20 T11. Cor 3D VIBE T12 2.0 DIS3D/CPR T12 All vertebrae and vertebral discs are displayed in two views 19 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 174 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Inline Curved Planar Reconstructions (CPRs) 4088288 T6 18 12.02.0 Tg 12.0 2.0 TTO 12.00 T11 20 DIS3D/CPR . T12 2.0 DIS3D/CPR All vertebrae and vertebral discs are displayed in two views 20 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 175 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers' ... Inline Curved Planar Reconstructions (CPRs) If the distance between the curved plane and Spine Dot Engine Spine Dot Engine 001 5/24/2012 14 IMA 2 / 2 a ‘central’ linear plane is ≥ 50mm, a warning 5/24/2012 symbol is displayed in CPR images. This indicates possible deviations between the displayed slice group lines and actual intersected anatomy, due to spinal curvature. R P3 CPR/NOR/DIS3D/COMP_SP AASpine_Scout_COMP_SP_1 ... synthetic CPR I. FOV837- 16 SPR10.8 P3 CPR/NORNVOIS3D/COMP_SP Sag I_AASpine_Scout_COMP_SP_1 ... synthetic CPRi ... SP P40.7 FoV 837"400 21 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 176 MR Protocol Building and Optimization- STEP Week 4 Automatic Positioning myExam Spine Assist SIEMENS Healthineers ... Automatic Positioning Automatic positioning of: 3.0T XQ (Vida-XQ_2Tx_64Rx_MNO) > SIEMENS >> I-spine >> L-Spine Assist > program > t2_tse_sag ? X General 3:46 min 1 Auto @ None 0.7x0.7x4.0 mm3 ៛ 1.00 • Sagittal slice groups Protocol Parameters Poutine Contrast Resolution Geometry System Physio Inline Sequence Voice Commands Automatic Positioning and double oblique of axial Execution slice Group 1 - FOV Read 60 _ mm • + Image Management Slices 15 FOV Phase 100.0 ¢ % slice groups (block or multi-slice multi-angle) Auto Load Slice Thickness 4.0 ¢ m Copy References • Coronal slice groups Preview Distance Factor 20 TR 3500.0 ms • Anterior sat band Position L0.0 P20.0 H0.0 95.00 ¢ ms Orientation Sagittal Averages Phase Encoding Dir. H>> F Concatenations Requirements for automatic positioning to work: Phase Oversampling Auto Align Spine > Lumbar Spine > Cervical • Spine Positioning Add-in must be linked to Spine > Thoracic Spine > Lumbar protocols Shoulder >> Para Sag Shoulder >> Para Cor Shoulder > Para Tra • AutoAlign Spine enabled in protocol Elbow > Standard Elbow > Sagittal Addin Configuration ... OK Cancel Elbow > Coronal Elbow > Paracoronal t2_tse_sag 03:46 1 Spine Positioning t1_tse_dark-fluid_sag 04:38 1 Spine Positioning 22 Unrestricted © Siemens Healthineers, 2025 Notes 177 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Automatic Positioning AutoAlign parameter 3.0T XQ (Vida-XQ_2Tx_64Rx_MNO) > SIEMENS >> I-spine >> L-Spine Assist > program > t2_tse_sag ? X General 3:46 min 1 Auto @ None 0.7x0.7x4.0 mm3 ៛ 1.00 • Must be set to Spine>Cervical, Spine>Thoracic or Protocol Parameters Poutine Contrast Resolution Geometry System Physio Inline Sequence Voice Commands Spine>Lumbar to ensure the Spine Positioning Execution slice Group 1 FOV Read 60 _ mm + - Image Management Slices 15 FOV Phase 100.0 ¢ % Add-in will function correctly Auto Load Slice Thickness 4.0 ¢ m Copy References • If AutoAlign is deactivated, the Spine Positioning Preview Distance Factor 20 TR 3500.0 ms Add-in is deactivated Position L0.0 P20.0 H0.0 95.00 ¢ ms Orientation Sagittal Averages • If we use “Copy references” AutoAlign is Phase Encoding Dir. H>> F Concatenations automatically deactivated, therefore the Spine Phase Oversampling Auto Align Spine > Lumbar Spine > Cervical Positioning Add-in is also deactivated Spine > Thoracic Spine > Lumbar AutoAlign Spine only works when used in Shoulder >> Para Sag • Shoulder >> Para Cor combination with the Spine Positioning Add-in Shoulder > Para Tra Elbow > Standard Elbow > Sagittal • Spine>Cervical: focuses the region C2 to T2 Addin Configuration ... OK Cancel Elbow > Coronal Spine>Thoracic: focuses the region T1 to T12 Elbow > Paracoronal • t2_tse_sag 03:46 • Spine>Lumbar: focuses the region L1 to S1 1 Spine Positioning t1_tse_dark-fluid_sag 04:38 1 Spine Positioning 23 Unrestricted © Siemens Healthineers, 2025 Notes 178 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Automatic Positioning Spine Positioning Add-in enables: • Configuration of AutoCoverage • Configuration of Anterior saturation gap • Configuration of guidance and parameter views • Enables AutoAlign Spine to be executed myExam Add-In Configurator 2 x • Attached to each clinical protocol step myExam Add-In Configurator Guidance Parameters Enable AutoCoverage Queue Organ box Spine GSP Guidance Series I abel Propagate changes to all following protocols Parameters Queue Keep FOV constant GSP AutoCoverage Auto Coverage will execute the following manipulations Series Label Spine Positioning Increment MPR Assignment Parameter Limit Slices 18.0 Spine Positioning Mt Assignment Distance Factor 30.0 % 50 Anterior saturation gap 10 2 mm SAR Assistant SAR Assistant Flip Angle, TR Min Flip Angle 130 dec Max. TR 4000.0 ms 24 Unrestricted © Siemens Healthineers, 2025 Notes 179 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Automatic Positioning – Sagittal Slice Groups Sagittal Slice Groups position and orientation of sagittal slice groups are derived from left and right spine geometry lines in the focused region. • Slice group center lies on the posterior spine geometry line • Single oblique tilt; no in-plane rotation • AutoCoverage enabled, slice coverage adapts to cover anatomy • Regular anterior sat band positioned tangential to anterior spine line, with user T7 T4 defined gap User can adapt the positioning T5 • 25 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 180 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers' ... Automatic Positioning – Axial Stack Slice Groups Axial Stack slice groups with Number of slices ≥ 9. • Positioned perpendicular to posterior spine geometry line, which is a spline through all posterior points • Slice group center lies on posterior spine geometry line • Double oblique tilt; no in-plane rotation • Anterior regular sat band positioned tangential to anterior spline geometry line with a pre-configured gap (only one supported; don’t use asymmetric sat band) • If number of slices ≥ 9, positioning follows the posterior line • If number of slices < 9, positioning follows the detected posterior point • User can adapt the positioning T31 T4 T5 26 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 181 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers' ... Automatic Positioning – Multi-Slice Multi-Angle Slice Groups Multi-slice Multi-angle (MSMA) slice groups with Number of slices <9. • Positioned parallel to the detected intervertebral disc cartilages L1 • Double oblique tilt from the averaged upper and lower plates of neighboring vertebrae L2 • No in-plane rotation • Slice group center lies on detected posterior point • Anterior regular sat band positioned tangential to anterior spine L3 geometry line with a pre-configured gap (only one supported; don’t use asymmetric sat band) L4 - -- - - • End user can adapt positioning (e.g., to avoid crosstalk between the intersecting slice groups) L5 Interactive Snapping S1 • Snaps slice group into disc cartilage if number of slices in group is < 9 • To suppress snapping, use Alt key for free translation of slice group (or) Ctrl key for free rotation of slice group 27 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 182 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Automatic Positioning – Coronal Slice Groups Coronal Slice Groups .T10 • Positioning and orientation is derived from .T1' the anterior and posterior spine geometry lines in the focused region • Center line lies on the posterior line, and in the common center of the left and right lines • Single oblique tilt with no in-plane rotation 28 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 183 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... AutoCoverage – Sagittal Slice Groups Sagittal Slice Groups • Enabled for myExam Lumbar Spine Assist protocols in Siemens Tree • May be configured for sagittal cervical 10 7 and thoracic spine protocols Slice group aligned and Slice group not aligned Slice group aligned AutoCoverage 29 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 184 MR Protocol Building and Optimization- STEP Week 4 AutoCoverage myExam Spine Assist SIEMENS Healthineers ... AutoCoverage – Spine Positioning Add-in Spine Positioning Add-in myExam Add-In Configurator • Select the Spine organ box • Keep FOV constant • Don’t click “Propagate changes to all Guidance Parameters Enable AutoCoverage following protocols” option available, Queue Organ box Spine because the spine organ box is GSP Series Label Propagate changes to all following protocols calculated “on the fly” Auto Load Keep FOV constant AutoCoverage AutoCoverage will execute the following manipulations Spine Positioning MPR Assignment Parameter Limit Increment Slices 18.0 1.0 Distance Factor 30.0 5.0 SAR Assistant SAR Assistant Flip Angle, TR Min Flip Angle 130 - de Max. TR 4000.0 ms 30 Unrestricted © Siemens Healthineers, 2025 Notes 185 MR Protocol Building and Optimization- STEP Week 4 AutoAlign Verification myExam Spine Assist SIEMENS Healthineers ... AutoAlign Verification Interaction Step with a Spine Verification Add-in L-Spine Assist Spine Patient View Standard • Automatic suggestion of vertebral levels Post surgery number AASpine Scout steps Tools to verify or modify labels 3 steps (laser on chin) • I_Mspine_scout 00:19 Mspinc_scout Spine Scout • Ability to save labeled images Il_AAspine_scout 00:19 Spine Scoul • Ability to label transverse images Ill_AAspine_scout 00:19 Spine Scout • Usually performed after first clinical sagittal t2_tse_sag 03:46 t2_tse_sag 03:46 Spine Positioning Spine Positioning measurement completed t1_tse_dark-fluid_sag 04:38 t1_tse_dark-fluid_sag 04:38 Spine Positioning Spine Positioning • Can be inserted at any position in program before 12_Use_stir_say 03:25 2 Spine Positioning the first transverse series to be loaded AutoAlign Verification AutoAlign Verification @ Spine Verification Spine Verification t2-tra options t2_tse_tra 04:28 multiple slice groups O Basic Decision 3 Spine Positioning Recommendation: only one AutoAlign Verification step t2-tra options t1_tse_tra 04:41 one slice group multiple slice groups Spine Positioning per strategy (or) non-myExam Assist program. t2_tse_tra 04:28 t2_tse_tra_msma Spine Positioning 04:32 Spine Positioning contrast agent with contrast agent Basic Decision contrast agent with contrast agent inject contrast agent t1_tse_fs_tra 04:51 3 Spine Positioning t1_tse_dixon_sag 03:09 2 Spine Positioning 31 Unrestricted © Siemens Healthineers, 2025 Notes 186 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... AutoAlign Verification • Vertebra selector AutoAlign Verification • Relabeling • Add disc Remove disc Add Save • • Reset to initial AutoAlign results Save selected image orientations with ¥ Show intervertebral disk positions • labels Image Labeling • Show/hide intervertebral disc lines Label transverse images • Label transverse images Confirm Decline • Confirm or Decline vertebral labeling required to unlock the Go button and i Check the shown vertebra labeling and confirm below. continue scanning Note: labels that are confirmed at scanner Before proceeding please confirm or decline the spine geometry shown in GSP cannot be edited using spine labeling in MR View&GO. 32 Unrestricted © Siemens Healthineers, 2025 Notes 187 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... AutoAlign Verification If vertebral labelling is confirmed, the user AutoAlign Verification cannot change the labeling within the current workflow. Safety measure to avoid potential inconsistencies for labeled transverse images. Show intervertebral disk positions Image Labeling Y Label transverse images Confirm Decline i Vertebra labeling was already confirmed and can not be changed within the running workflow. 33 Unrestricted © Siemens Healthineers, 2025 Notes 188 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... AutoAlign Verification If vertebral labeling is declined, AutoAlign Verification transverse images will not be labelled. Add Undo Save Disc Show intervertebral disk positions Image Labeling Y Label transverse images Confirm Decline Transverse images will not be labeled. 34 Unrestricted © Siemens Healthineers, 2025 Notes 189 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... AutoAlign Verification Pre-configuration in myExam Cockpit myExam Add-In Configurator is possible. Queue GSP mage Labeling AutoAlign Verification Label transverse images Visualization Show intervertebral disk positions Enable visibility of vertebra body boxes Save Button Save Coronal Image Save Sagittal Image 35 Unrestricted © Siemens Healthineers, 2025 Notes 190 MR Protocol Building and Optimization- STEP Week 4 Transverse Image Labeling myExam Spine Assist SIEMENS Healthineers ... Transverse Image Labeling Transverse image labeling follows the “one third” rule: • L4 transverse slice intersects middle third of L4 • L4/5 transverse slice intersects vertebral disc L4/5 or one of the neighboring outer thirds of L4 or L5 L4 • Labels are saved as DICOM image comments L4/L5 L4/L5 36 Unrestricted © Siemens Healthineers, 2025 Notes 191 MR Protocol Building and Optimization- STEP Week 4 Examinations myExam Spine Assist SIEMENS Healthineers ... Examinations myExam Lumbar Spine Assist myExam Thoracic Spine Assist Patient View Decision: Patient View Decision: • Single step localizer or 3 step localizer • 2 step localizer or 3 step localizer • 3 steps are recommended for reliable identification of labels (e.g., in case of 6th lumbar vertebra) Exam Strategy | Standard Exam Strategy Standard number AASpine Scout steps single step number AASpine Scout steps 2 steps (laser on chin) 3 steps (laser on chin) 3 steps (laser on chin) single step 2 steps (laser on chin) 37 Unrestricted © Siemens Healthineers, 2025 Notes 192 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Examinations Cervical Spine Standard, Lesion, Post Surgery, WARP strategies Thoracic Spine Standard, Lesion, Post Surgery, WARP strategies Lumbar Spine Standard, Post Surgery, WARP strategies examination myExam Assist Standard Standard examination for clinical routine issues like back pain, osteoporosis, etc. Lesion Standard examination for c-spine and t-spine, with contrast agent and TIRM (for MS, inflammatory processes) Post Surgery Routine post surgery examination with contrast agent Strategies WARP Provides protocols using WARP with reduced sensitivity to susceptibility artifacts if the patient has MR conditional implants 38 Unrestricted © Siemens Healthineers, 2025 Notes 193 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Examinations Copy Reference handling L-Spine Assist Spine Patient View Recommend ‘”Copy reference V Standard Post surgery WARP • number AASpine Scout steps slices” configuration between 3 steps (laser on chin) gle step I_AAspine_scout 00:19 AAspine_scout 00:19 Spine Scout sagittal slice groups if the same Spine Scout Il AAspir 00:19 Spine Scout slice parameters are required Ill_AAspine_scout 00:19 Spine Scout • Copy reference overrides t2_tse_sag 03:46 t2_tse_sag 03:46 t2_tse_warp_sag 04:32 1 Spine Positioning Spine Positioning 4 Spine Positioning AutoCoverage and AutoAlign t1_tse_dark-fluid_sag 04:38 t1_tse_dark-fluid_sag 04:38 11_tse_warp_sag 02:58 Spine Positioning Spine Positioning Spine Positioning If using “Copy references”, t2 tse_Stil 03:25 t2_tse_stir_warp_sag 01:21 • Spine Positioning 4 Spine Positioning AutoAlign is automatically AutoAlign Verification AutoAlign Verification AutoAlign Verification Spine Verification Spine Verification Spine Verification deactivated, and the Spine t2-tra options t2_tse_tra 04:28 t2_tse_warp_tra 05:14 multiple slice groups Basic Decision 3 Spinc Positioning 5 Spinc Positioning t1_tse_tra 04:41 t1_tse_warp_tra Positioning Add-in is 2-tra option one slice group multiple slice groups 3 Spine Positioning 5 Spine Positioning automatically deactivated 12_Use_tra 04:28 12_Use_La_rristria 04:32 Spine Positioning Spine Positioning contrast agent contrast agent with contrast agenlv Basic Decision with contrast agent Basic Decision contrast agent contrast a with contrast agent with contrast agent inject contrast agent inject contrast agent t1_tse_fs_tra 04:51 t1_tse_warp_tra 04:57 3 Spine Positioning 5 Spine Positioning t1_tse_dixon_sag 03:09 t1_tse_warp_sag 02:58 2 Spine Positioning 4 Spine Positioning 39 Unrestricted © Siemens Healthineers, 2025 Notes 194 MR Protocol Building and Optimization- STEP Week 4 Workflow and configuration hints myExam Spine Assist SIEMENS Healthineers ... Workflow & Configuration Hints How many AAspine_Scout stations are needed to cover the whole spine? This depends on the following: 400mm • z-FoV of system (possible distortions) • Clinical requirements (region of interest, patient group, etc.) • AAspine_scout has a fixed FoV of 400mm • Siemens myExam Assist workflows are configured with a 200mm table move, which results in an overlap of 200mm • Never use more than 3 stations Overlap at least 2-3 vertebrae 40 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 195 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Workflow & Configuration Hints What if AutoAlign fails? Incorrect coil Inadequate elements coverage This may be due to the following: 1. If the Overlap between stations is too small. a. Increase the overlap setup between stations. 2. Incorrect coil selection. a. Check the coil setup in the protocol. 3. If the Anatomy is not covered adequately. a. Improve patient positioning (e.g., cushion) b. Reposition slab (e.g., more anterior) c. Add slices to increase coverage C7 4. If there is Patient motion a. Talk to patient and rerun the localizers T3- 5. Repeat and Open’ the “AAspine_scout” and make necessary T4 adaptations T5 T5 16 T6 2.0 T7 14.0 41 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 196 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Workflow & Configuration Hints Is it OK to use a body matrix coil anteriorly? • It may cause anterior/posterior aliasing, thus influencing quality of AutoAlign results • Set CoilFocus to Center and configure protocol with ACS Restricted to exclude the body matrix coil -or- • Increase slab thickness to decrease aliasing Does AAspine_scout work for obese people? • Very bright posterior fat may influence AutoAlign results T10 • Set CoilFocus to Center Does AAspine_scout work for children? • Experience and feedback is that it works for children approximately 9-year’s old or older) 14 synthetic CPR image 42 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 197 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Workflow & Configuration Hints Can we start a 3-step localizer workflow in the lumbar spine region? Yes, the advantage is positioning of lumbar spine clinical protocols can begin after the first stage AAspine_scout has finished. Take care regarding table move configuration: • Laser on chin • I_AAspine_scout (lumbar): table move F420mm • II_AAspine_scout (thoracic): table move H220mm • III_ AAspine_scout (cervical): table move H200mm; inline composing_last step 43 Unrestricted © Siemens Healthineers, 2025 Notes 198 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Workflow & Configuration Hints How is Copy Reference / Copy Parameters managed? AutoAlign is switched off in the target protocol. Can the Spine Positioning Add-in be used with Set-n-Go protocols? No, currently not supported. How many automatically positioned saturation bands are supported? • Spine Positioning Add-in supports one anterior sat band • A second (or more) sat band is possible, but must be configured manually • Asymmetric saturation band not supported (may be rotated by 180 degrees) Can CPR images be used for position display? • Yes, but only if the CPR images do not display a warning symbol • Warning symbol indicates that displayed slice intersection lines may not be reliable 44 Unrestricted © Siemens Healthineers, 2025 Notes 199 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers' ... Workflow & Configuration Hints How is the Spine Positioning Add-in used for coronal slice groups? T1-weighted protocols: • Configure protocol with Spine Positioning Add-in, coronal orientation, AutoAlign Spine (cervical, thoracic or lumbar) • Not possible to configure offsets, as the AutoAlign parameter card is not supported MENORMOISADVFLO 2IFRE ........... Spine Det Engine 18 344 9 /16 Myelography Coronal protocol • Set up as above, but with a working man symbol • Myelography protocols require an additional user interaction to shift the slices Auto-positioning Shift slices manually 45 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 200 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Workflow & Configuration Hints How can we ensure there is always a myExam Add-In Configurator midline sagittal slice when using AutoCoverage? • Configure AutoCoverage to always have Guidance Parameters Enable AutoCoverage an odd number of slices Queue Organ box Spine GSP -or- Series Label Propagate changes to all following protocols Auto Load • Save protocols with a working man Keep FOV constant AutoCoverage Auto Coverage will execute the following manipulations Spine Positioning MPR Assignment Paramete Limit Increment Hint: sequences are saved with an odd Slices 13.0 2.0 15.0 2.0 number of slices, and the increments are set Slices 17.0 2.0 WN to 2.0. SAR Assistant SAR Assistant Flip Angle, TR Min Flip Angle 130 deg Max. TR 4000.0 ms 46 Unrestricted © Siemens Healthineers, 2025 Notes 201 MR Protocol Building and Optimization- STEP Week 4 myExam Spine Assist SIEMENS Healthineers ... Workflow & Configuration Hints How do we scan tall people to have a complete overview Is there a myExam whole spine Assist program? of the spine (whole spine localizers)? • No, but you may build your own myExam whole spine • Protocol coverage is 820 mm Assist (without Set-n-Go) • AAspine_scouts should not be executed in 4 steps; we • Use Spine Positioning Add-in, in-line composing, etc. can only use a maximum of 3 steps • Possible solution is to implement a Patient View Is there an AASpine for the sacrum? decision for “Tall patient” • Currently No • Prepare protocols for the tall patient using a larger table movement • I_AAspine_scout: table position 0mm • II_AAspine_scout: table position F280mm • III_AAspine_scout: table position F560mm • Coverage is now 960mm 47 Unrestricted © Siemens Healthineers, 2025 Notes 202 MR Protocol Building and Optimization- STEP Week 4 Summary myExam Spine Assist SIEMENS Healthineers ... Summary myExam Spine Assist key features Siemens Tree myExam Spine Assist • AAspine_scout (single or multiple steps) • Inline composing (localizers) Examinations: • Inline MPR’s and CPR’s • Lumbar Spine (single or multi-station localizers) • Automatic detection of intervertebral discs and • Thoracic Spine (multi-station localizers) vertebrae • Cervical Spine • AutoAlign® slices, slabs, anterior sat band • AutoCoverage Strategies: • Automatic suggestion of vertebral labels • Standard • Verification tools to modify and confirm labels • Lesion • Ability to save labeled transverse images • Post Surgery • WARP Design myExam Spine Assist programs with your protocols and workflow preferences. 48 Unrestricted © Siemens Healthineers, 2025 Notes 203 MR Protocol Building and Optimization- STEP Week 4 myExam Abdomen Assist SIEMENS Healthineers myExam Abdomen Assist STEP - MR Protocol Building with myExam Cockpit & myExam Assist Unrestricted © Siemens Healthineers, 2025 Effective date: 5 August 2025 - QR700026089 Notes 204 MR Protocol Building and Optimization- STEP Week 4 Agenda SIEMENS Healthineers ... myExam Abdomen Assist • Abdomen Assist Add-ins • Abdomen Patient View • Onco Auto Coverage Scout • Care Bolus • ABLE • General Add-ins Configurations • Guidance Views • AutoCoverage and AutoTiming • Series Label and Auto Load • Test Bolus Abdomen Assist • Assist Library • LiverLab Assist • GOLiver 2 Unrestricted © Siemens Healthineers, 2025 Notes 205 MR Protocol Building and Optimization- STEP Week 4 Objectives SIEMENS Healthineers ... At this end of this module, you should be able to: • Identify Abdomen Assist Add-ins • Describe Abdomen Patient View • Recall the Onco Auto Coverage Scout • Summarize Care Bolus • Define ABLE • Identify General Add-ins Configurations • Explain Guidance Views • Recognize AutoCoverage and AutoTiming • Identify Series Label and Auto Load • Describe Test Bolus Abdomen Assist • Define the Assist Library • Demonstrate LiverLab Assist • Summarize GOLiver 3 Unrestricted © Siemens Healthineers, 2025 Notes 206 MR Protocol Building and Optimization- STEP Week 4 Disclaimers SIEMENS Healthineers ... The information presented in the myExam Abdomen Assist course is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use their own learning, training, and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Medical Systems to be used for any purpose in that regard. Please refer to a Contrast Agent manufacturer's labeling, and instructions for use, for use of that Contrast Agent with an MRI exam. 4 Unrestricted © Siemens Healthineers, 2025 Notes 207 MR Protocol Building and Optimization- STEP Week 4 Introduction Introduction SIEMENS Healthineers' ... Abdominal imaging is one of the more Abdomen Assist 150 € / ... + + complex MR examinations to perform. t2_haste_cor_mbh t2_haste_fs_tra_mbh E diffusion with diffusion cp2d_diff_b50_800_tra Experience is needed to obtain consistent 6 %_ 11_vibe_dixon_tra_bh_pre 7 x Check precontrast 8 image quality regardless of patient conditions. Prepare injector 9 x Care Bolus 01:16 10 %_ 11_vibe_dixon_tra_bh_arterial 00:15 TP F6 11 % 11_vibe_dixon_tra_bh_venous SP F8 2 00:15 V 374*4601 Tra 12 " t2_haste_cor_thick_slab_bh 92 MAGNINORE 00:05 426 C ....... 166 Protocol adaptations are necessary to meet ot for diagnostic use at for diagnostic use Not for diagnostic use E 02:59 GO 17 sec & Auto @ 4 @ 1.3x1.3x3.0 mm? @ 1.38 Cancel the requirements of each patient (breath-hold ABLE Parameters capability, motion, etc.). ABLE Arterial Venous Delayed 10 @ s 30 0 5 180 Contrast timing for liver dynamics can be RESP 0 min Auto Bolus Detection V Breath-Hold Capability 20 ₴ challenging. Fast incorporation of additional techniques based on clinical needs (MRCP, DWI) is often required. 5 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 208 MR Protocol Building and Optimization- STEP Week 4 Protocols myExam Abdomen Assist SIEMENS Healthineers ... Protocols Abdomen Assist Liver Eval Care Bolus (CB) mabdomen Workflow for examining the hepatic fat and iron overload for various disease Abdomen Assist processes E Abdomen Assist Liver Eval CB Integrates Care Bolus for liver dynamics E Abdomen Assist CB • E Abdomen Assist TB Abdomen Assist Care Bolus (CB) E LiverLab Assist • Integrates Care Bolus for liver dynamics Angio Assist • Delays between dynamic phases may be preset using ABLE clinical libraries >[ library Abdomen Assist Test Bolus (TB) [ library Assist Integrates a Test Bolus approach for determining timing parameters of E T1 dynamic workflow. E T2 E 3D LiverLab Assist El multiarterial phase A workflow for examining the hepatic fat and iron overload for various E GRASP disease processes angiography angiography ce 6 Unrestricted © Siemens Healthineers, 2025 Notes 209 MR Protocol Building and Optimization- STEP Week 4 myExam Abdomen Assist SIEMENS Healthineers ... Care Bolus (CB) & Test Bolus (TB) Abdomen Assist CB/TB Fons Abdomen Dol Engine @ Ahdoman Patient View Breath-hold Resp synchronized Motion-insensitive 00-10 Onco Auto Coverage Scout t2_haste_cor_mbh 00:52 12_haste_cor_trig 01:59 01:59 Strategies 12_haste_cor_trig TO Generic Views 2 Generic Views Generic Views t2_haste_fs_tra_mbh 01:23 t2_haste_fs_tra_trig 02:13 t2_blade_fs_tra_trig 04:43 Gonoric Viowir Gonoric Viourc diffusion without diffusion Patient View Decisions Basic Decision with diffusion @ Generic Views contrast agent contrast agent Workflow Decisions with contrast agent without contrast agent with contrast agent without contrast agent t1_vibe dixon tra bh_pre 00:15 t1_vibe dixon tra bh 00:15 t1_vibe dixon tra bh pre 00:15 t1_vibe dixon tra bh 00:15 t1_tfl_in-phase tra_triq 02:07 O ABLE Generic Views O ABLE Generic Views O Generic Views Check precontrast Check precontrast t1_tfl_opp phase_tra_trig 02:07 Generic Views Generic Views O Generic Views Prepare injector Prep Prepare injector with contrast agent Care Bolus 01:16 Care Bolus Care Bolus Care Bolus inject contrast agent t1_vibe_dixon_tra_bh_arterial 00:15 t1_vibe_dixon_tra_bh_arterial 00:15 t1_tfh_opp-phase_tra_trig post 02:07 ARIE O ABLE 12 Generic Views t1_vibe_dixon_tra_bh_venous 00:15 t1_vibe_dixon_tra_bh_venous 00:15 O ABLE O ABLE t2_haste_cor_thick_slab_bh 00:05 Generic Views t2_truhi_tra_bh 00:19 Generic Views (1_vibe_dixon_tra_bh_delayed 00:15 (1_vibe_dixon_tra_bh_equil 00:15 O ABLE t1_vibe_dixon_cor_bh_post 00:15 t1_vibe_dixon_cor_bh 00:15 t1_vibe_dixon_cor_bh_post 00:15 t1_vibe_dixon_cor_bh 00:15 Generic Views O Generic Views MRCP with MRCP Basic Decision with MRCP 12_space_cor_trig 04:46 Generic Views 7 Unrestricted © Siemens Healthineers, 2025 Notes 210 MR Protocol Building and Optimization- STEP Week 4 Abdomen Assist Add-ins myExam Abdomen Assist SIEMENS Healthineers ... Add-ins – Abdomen Patient View – Exam Strategies Breath-hold measurements performed with single/multi-breath-hold techniques. General Parameters Breath-Hold Parameters Fast, robust image quality Exam Strategy Breath-hold Breath-Hold Capability 20 ¢ • Protocol Adaptation Breath-hold Compliant patients Resp synchronized Auto Breath-Hold Commands English (United ... • Auto Bolus Detection Motion-insensitive Pause Between Breath-Holds 10 s Resp. synchronized is for patients who have difficulty Auto ROI holding their breath for exams. Liver evaluation yes contrast agent with contrast agent • Some free-breathing measurements with navigator triggering (PACE) Evaluation Method Both • Higher resolution focus Motion insensitive is used for uncooperative or moving patients. • Fast, triggered scans, BLADE • Liver dynamics not included; T1 turboFLASH implemented 8 Unrestricted © Siemens Healthineers, 2025 Notes 211 MR Protocol Building and Optimization- STEP Week 4 myExam Abdomen Assist SIEMENS Healthineers ... Add-ins – Abdomen Patient View – Protocol Adaptions None No automatic adaptations made to protocols. General Parameters Breath-Hold Parameters Exam Strategy Breath-hold Breath-Hold Capability 20 ¢ S AutoCoverage Protocol Adaptation BH + AutoCoverage Auto Breath-Hold Commands V English (United ... Automatic FoV-read, FoV-phase, slice coverage and Auto Bolus Detection V Pause Between Breath-Holds 10 + initial positioning is based on the localizer data. Auto ROI Liver evaluation yes BH + AutoCoverage contrast agent with contrast agent Automatic FoV-read, FoV-phase, slice coverage and Evaluation Method Both initial positioning is based on the localizer data. Automatic protocol adaptation to patient’s breath- hold capability (AutoTiming). 9 Unrestricted © Siemens Healthineers, 2025 Notes 212 MR Protocol Building and Optimization- STEP Week 4 Abdomen Patient View myExam Abdomen Assist SIEMENS Healthineers ... Add-ins – Abdomen Patient View – Breath-hold Parameters Breath-hold capability may be adapted to the patient’s ability to hold their breath. General Parameters Breath-Hold Parameters Parameters of breath-hold protocols are adapted Exam Strategy Breath-hold Breath-Hold Capability 20 + automatically if using BH + AutoCoverage. Protocol Adaptation BH + AutoCoverage Auto Breath-Hold Commands |English (United ... ... Auto Bolus Detection Pause Between Breath-Holds 10 Automatic breath-hold commands can be activated Auto ROI v for an entire examination. Liver evaluation yes Breath-Hold Commands X Set timing and language for the breath-hold contrast agent with contrast agent Evaluation Method Both Before Scan Hold breath (inhaled). 8.9 5 commands. After Scan Continue breathing. 2.7 s Pause between breath-holds can be activated for an Close entire examination. Outside of the ABLE workflow. 10 Unrestricted © Siemens Healthineers, 2025 Notes 213 MR Protocol Building and Optimization- STEP Week 4 myExam Abdomen Assist SIEMENS Healthineers ... Add-ins – Abdomen Patient View – Other features Auto Bolus Detection (for Care Bolus): General Parameters Breath-Hold Parameters ON: automatic detection of the contrast bolus arrival in the region of interest and the start of the arterial Exam Strategy Breath-hold Breath-Hold Capability 20 + s phase measurement. Protocol Adaptation BH + AutoCoverage Auto Breath-Hold Commands V English (United ... Auto Bolus Detection Pause Between Breath-Holds 10 + Auto ROI (for Care Bolus): Auto ROI Liver evaluation yes ON: position of ROI for bolus detection is suggested contrast agent with contrast agent by the system. Evaluation Method Both Contrast Agent Select with contrast agent from the drop-down menu if contrast agent is used. 11 Unrestricted © Siemens Healthineers, 2025 Notes 214 MR Protocol Building and Optimization- STEP Week 4 myExam Abdomen Assist SIEMENS Healthineers ... Add-ins – Abdomen Patient View – Configurations Queue GSP View Tools Image Text Default Group Graphics Default Reference Lines Default Extent Mode Number of Slices Protocol Table Position Default Coil Positions On Adjust Volume Default Physio Display On Expand Third Segment Default View-Graphics Scroll Display Slice Groups Package Mode Display Order Default 12 Unrestricted © Siemens Healthineers, 2025 Notes 215 MR Protocol Building and Optimization- STEP Week 4 Onco Auto Coverage Scout myExam Abdomen Assist SIEMENS Healthineers ... Add-ins – Onco Auto Coverage Scout Abdomen Organ Box is based on the localizer images (FLASH-2D out-of-phase). Coronal localizer liver Axial localizer provides: liver provides: 1 IMA 1 FRM 12/18 • FoV-Read, FoV-Phase 1 IMA 2 FRM 5/5 • Slice coverage (number (transverse slices) of transverse slices) • Initial positioning (R-L, • Initial positioning (H-F) A-P) • Based on liver • Based on ‘bounding ------ segmentation box’ shaped to • 3 cm’s are added in H-F patient’s surface direction • 2-3 cm’s are added in R-L/A-P directions ---------- SPA42.0 oV 430*430 FoV 430*430 p2 MAGN/NORM/DIS2D Co p2 MAGNINORMIDIS2D Tra localizer_bh W 16 C localizer_bh 474 194 13 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 216 MR Protocol Building and Optimization- STEP Week 4 myExam Abdomen Assist SIEMENS Healthineers ... Add-ins – Onco Auto Coverage Scout Onco Auto Coverage Scout defines the Abdomen Guidance Parameters Organ Box for AutoCoverage. Configurations for the Care Bolus step set the region to the segment in the Aorta and liver. Guidance Parameters Select region to segment Aorta and liver Queue GSP Series Label Check slice positions and adjust them, if necessary. Executed Protocol Manipulations AutoCoverage Auto Load Slices : 30 -> 57 AutoCoverage Additional slice selection size: -50 AutoTiming Onco AutoCoverage Scout AutoTiming AutoTiming is running ... TR : 1400 -> 1040 [ms] Concatenations : 2 -> 3 14 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 217 MR Protocol Building and Optimization- STEP Week 4 ABLE myExam Abdomen Assist SIEMENS Healthineers ... Add-ins – ABLE (Automated Breath-hold Liver Exam) ABLE enables you to define the time between multiple measurements of dynamic liver phases. ABLE Phase Pre Delay to arterial phase 10 s Name for last phase Delayed Delay to venous phase 30 ABLE doesn’t have a time point programmed for Delay to last phase 180 pre-scan, however, time points are programmed for Liver registration M Save Original Images the pre, arterial, venous, and delayed (equilibrium) If automatic breath-hold commands are active, the following will be used for all ABLE steps: contrast measurements. Before Scan Short: Hold breath (inhal ... 3.2 s After Scan Continue breathing. 2.7 s Delays are configured in the ABLE Phase-Pre: • Delay to arterial phase is the time between the If manual voice commands are used instead, the following durations are assumed: bolus detection and the k-space center of the Pre sound duration 3 s arterial phase Post sound duration 2 5 • Delay to the venous phase is the time between the k-space center of the arterial phase and k-space center of venous phase • Delay to last phase is the time between the k-space center of the venous phase and k-space center of the last phase 15 Unrestricted © Siemens Healthineers, 2025 Notes 218 MR Protocol Building and Optimization- STEP Week 4 myExam Abdomen Assist SIEMENS Healthineers ... Add-ins – ABLE (Automated Breath-hold Liver Exam) ABLE The minimum pause depends on Time-to-Center ABLE Parameters (TTC) of the measurement and the voice command duration. Pre Arterial Venous Delayed Bolus Detection TTC Tooltip appears when you hover the mouse 10 S 30 180 + $ cursor above the duration numbers. . ...... Voice command Time between bolus Time between k-space center before measurement detection & arterial of venous & delayed phase Always use the shortest voice commands, phase k-space center especially for the arterial phase. Voice command after Time between k-space center of measurement arterial & venous phase Pause between breath-holds from the Patient View is not applied to the ABLE add-in. Delay between bolus detection and k-space center of the arterial phase. Minimum Value: 8s For getting a shorter delay, use shorter voice commands or enter a shorter breathhold capability. Delay between k-space center of the arterial phase and k-space center of the venous phase Minimum Value: 21s 16 Unrestricted © Siemens Healthineers, 2025 Notes 219 MR Protocol Building and Optimization- STEP Week 4 myExam Abdomen Assist SIEMENS Healthineers' ... Add-ins – ABLE (Automated Breath-hold Liver Exam) User configurable delays. Abdomen Dot Engine ISO @ + + localizer_bh MA 1 FRM 5/18 IMA 1 FRM 121 2 t2_haste cor mbh Optimal timing of the arterial phase, use a 3 t2_haste_fs_tra_mbh 14 diffusion with diffusion delay between the bolus detection and the 5 cp2d_diff_b50_800_tra 6 11_vibe_dixon_tra_bh_pre k-space center of 10 seconds (recommended). 7 X Check precontrast 8 Prepare injector 9 % Care Bolus 6 01:16 Hover the mouse over the delay to see the 10 11_vibe_dixon_tra_bh_arterial 6 00:15 11 x t1_vibe_dixon_tra_bh_venous 6 00:15 tooltip for the minimum delay (e.g., minimum 12 t2_haste_cor_thick_slab_bh 00:05 localize, NORMIDIS ot for diagnostic use Not for diagnostic use £ 02:59 delay is 10 seconds). Go Cancel Dot @ 17 sec | Auto @ 4 @ 1.3x1.3x3.0 mm? @ 1.38 BLE Parameters To get shorter delays: ABLE Pre Arterial Venous Delayed Use shorter voice commands or enter a Pre Detection o Menous Delayed ™ 10 ¢ 30 180 shorter breath-hold duration. Dynamic VIBE protocols, select Asymmetric ABLE Echo Weak and set the TR to minimum to get Pre Detection Arterial Venous laved Delayed a shorter delay. 17 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 220 MR Protocol Building and Optimization- STEP Week 4 myExam Abdomen Assist SIEMENS Healthineers ... Add-ins – ABLE Configurations ABLE Phase The correct ABLE phase must be assigned to each ABLE Phase Pre Delay to arterial phase 10 s Name for last phase Arterial Delay to venous phase 30 dynamic measurement. Venous Delay to last phase 180 s • In the Pre-phase define the delay times, post- Last phase Additional Phase processing (Liver registration) and voice commands Liver registration Save Original Images • In other phases we define the output images If automatic breath-hold commands are active, the following will be used for all ABLE steps: Before Scan Short: Hold breath (inhal ... 3.2 s Name for last phase After Scan Continue breathing. 2.7 s Name for last phase can be decided by the user (Equilibrium or Delayed). If manual voice commands are used instead, the following durations are assumed: Pre sound duration 3 s ABLE Phase Arterial Post sound duration 2 5 Generated output: Water M Fat ABLE Phase Pre In Phase Name for last phase Delayed Opposed Phase Equil Delayed Dixon Evaluation 18 Unrestricted © Siemens Healthineers, 2025 Notes 221 MR Protocol Building and Optimization- STEP Week 4 myExam Abdomen Assist SIEMENS Healthineers ... Add-ins – ABLE Configurations Liver registration may be enabled in ABLE. ABLE Phase Pre Delay to arterial phase 10 Name for last phase Delayed Delay to venous phase 30 s Breath-hold commands Delay to last phase 180 s • Enables you to define the automatic breath-hold commands for all ABLE steps for the dynamic liver Liver registration Save Original Images measurements If automatic breath-hold commands are active, the following will be used for all ABLE steps • Use short breath-hold commands before scan to Before Scan Short: Hold breath (inhal ... 3.2 s Automatic voice minimize time between bolus detection and k-space After Scan Continue breathing. 2.7 5 command center of the arterial phase f manual voice commands are used instead, the following durations are assumed: • All protocols outside of ABLE, voice commands from the Patient View are applied Pre sound duration 3 5 Manual voice Post sound duration 2 s command • If manual voice commands are used, pre and post sound durations can be configured 19 Unrestricted © Siemens Healthineers, 2025 Notes 222 MR Protocol Building and Optimization- STEP Week 4 myExam Abdomen Assist SIEMENS Healthineers ... Add-ins – ABLE Configurations Manual Voice Commands. When using manual voice commands there is a Stop General Parameters Breath-Hold Parameters before scanning ABLE pre-phase implemented to Exam Strategy Breath-hold Breath-Hold Capability 20 ¢ inform the user to give manual voice commands. Protocol Adaptation BH + AutoCoverage Auto Breath-Hold Commands English(United. Auto Bolus Detection V Pause Between Breath-Holds 10 After applying the pre-phase, the scan button Auto ROI M becomes active, and a message appears. Please give contrast agent with contrast agent voice command ABLE Please give voice command For the following phases, the system informs the user when to give the breath-hold commands but does not DBolus Pre Arterial Venous Delayed wait! 20 Unrestricted © Siemens Healthineers, 2025 Notes 223 MR Protocol Building and Optimization- STEP Week 4 myExam Abdomen Assist SIEMENS Healthineers' ... Add-ins – Care Bolus Prerequisites for automatic positioning of ROI in Guidance Parameters Care Bolus. Check and adapt the suggested • Auto ROI is selected in the Patient View ROI, or • Onco Auto Coverage Scout Add-in: Select region 1. Select the sagittal slice with the best vessel to segment = Aorta and liver visualization. 2. Position the ROI in the sagittal slice with a left mouse click (if Auto Bolus General Parameters Breath-Hold Parameters Detection is on). 3. Adjust slice position for Care Bolus. Exam Strategy Breath-hold Breath-Hold Capability 20 4. Start Care Bolus and then start the contrast agent Protocol Adaptation BH + AutoCoverage Auto Breath-Hold Commands V English ( United ... injection. Auto Bolus Detection Pause Between Breath-Holds 10 + s Auto ROI contrast agent with contrast agent Auto Load AutoCoverage Select region to segment Aorta and liver AutoTiming Onco AutoCoverage Scout 21 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 224 MR Protocol Building and Optimization- STEP Week 4 myExam Abdomen Assist SIEMENS Healthineers ... Add-ins – Care Bolus with Auto Bolus Detection • Bolus arrival is monitored in the ROI with Auto Bolus Detection ‘On’ 20 • Monitor via corresponding signal-time curve in the inline Phase_02 of 100 display • Stop&Continue icon is available to override the automatic start of arterial phase measurement, or if the automatic bolus detection fails General Parameters Breath-Hold Parameters Exam Strategy Breath-hold Breath-Hold Capability 20 Protocol Adaptation BH + AutoCoverage Auto Breath-Hold Commands V English (United ... Auto Bolus Detection V Pause Between Breath-Holds 10 20.0 ? fps Auto ROI contrast agent with contrast agent 22 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 225 MR Protocol Building and Optimization- STEP Week 4 General Add-ins Configurations General Add-in Configurations SIEMENS Healthineers' ... Guidance Views Check pre-contrast: interaction with Generic View add-in. MRCP: User can plan and acquire an MRCP while waiting for the delayed phase. domen Assist > Abdomen Assist CB >> Check precontrast domen Assist >> Abdomen Assist CB >> 12_haste_cor_thick_slab_bh 8 5 sec c4 Auto @ 2 @ 0.8x0.8x50.0 mm3 1.00 Basic Decision Guidance Parameters Check the pre-contrast images. If the image quality is insufficient, proceed as follows: Select the pre-contrast step and then select Repeat & Open from the context menu. Adapt your protocol parameters and start the measurement. Perform slice positioning for MRCP. 23 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 226 MR Protocol Building and Optimization- STEP Week 4 Guidance Views General Add-in Configurations SIEMENS Healthineers ... Guidance Views Coronal T1 VIBE domen Assist >> Abdomen Assist CB >> t1_vibe_dixon_cor_bh_post ? X Ö 15 sec 4 Auto@ 5 @ 1.4x1.4x3.0 mm3 1.00 Guidance Parameters o- Check slice positions and adjust them, if necessary. 24 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 227 MR Protocol Building and Optimization- STEP Week 4 AutoCoverage General Add-in Configurations SIEMENS Healthineers ... AutoCoverage – T2 HASTE Coronal T2_haste_cor_mbh protocol has a working Shift Parameter x man to enable the user to verify slice coverage of the liver. Additional read out size mm Enable AutoCoverage Additional phase encoding size mm Select the Organ box Abdomen>Small to Organ box Abdomen > Small Additional slice selection size -50 - mm focus on the liver. Propagate changes to all following protocols • Keep FoV constant (FoV 400x100%) Keep FOV constant OK Cancel • Do not propagate changes to all following AutoCoverage will execute the following manipulations protocols Parameter Limit Increment Slices 20.0 1.0 Slices 70.0 2.0 N - To avoid unnecessary slice coverage in the A/P direction, decrease the size of organ box SAR Assistant in the slice direction. SAR Assistant Flip Angle Min Flip Angle 140 + deg 25 Unrestricted © Siemens Healthineers, 2025 Notes 228 MR Protocol Building and Optimization- STEP Week 4 General Add-in Configurations SIEMENS Healthineers ... AutoCoverage – T2 HASTE FS Transverse T2_haste_fs_tra_mbh protocol has a working man to enable the user to verify Enable AutoCoverage slice coverage of the liver. Organ box Abdomen > Small ... Propagate changes to all following protocols Propagate changes to all following Keep FOV constant protocols: AutoCoverage will execute the following manipulations If the user modifies the organ box size Parameter Limit Increment (e.g., adds additional slices), this is Slices 20.0 1.0 propagated to following transverse protocols Slices 60.0 ₴ 2.0 using the Abdomen>Small organ box. SAR Assistant SAR Assistant Flip Angle Min Flip Angle 130 - de 26 Unrestricted © Siemens Healthineers, 2025 Notes 229 MR Protocol Building and Optimization- STEP Week 4 General Add-in Configurations SIEMENS Healthineers .. AutoCoverage – T1 VIBE Dixon Transverse Pre-Contrast T1_vibe_dixon_tra_bh_pre protocol has a Shift Parameter x working man to enable the user to verify slice coverage of the liver Additional read out size mm Enable AutoCoverage Additional phase encoding size 0 mm Abdomen>Small organ box only covers the liver. Organ box Abdomen > Small Additional slice selection size 60 mm O • We could enlarge the organ box by increasing Propagate changes to all following protocols the “additional slice selection size” Keep FOV constant OK Cancel Additional slice selection size adds slices to the AutoCoverage will execute the following manipulations • top and bottom → check correct positioning Parameter Limi Increment Slices per Slab 52.0 1.0 Slices per Slab 96.0 2.0 N Dynamic VIBE measurements a “Copy reference everything” between pre and post contrast SAR Assistant measurements is configured. SAR Assistant Off 27 Unrestricted © Siemens Healthineers, 2025 Notes 230 MR Protocol Building and Optimization- STEP Week 4 AutoTiming General Add-in Configurations SIEMENS Healthineers ... AutoTiming AutoTiming examples implemented into Abdomen Assist. Conditions: • T2_haste_cor_mbh • Multi Breath-hold (BH): Time per concatenation < • T1_vibe_dixon_tra_bh_pre Breath-Hold capability. • Single Breath-hold (BH): Acquisition time < Breath-hold capability. Enable AutoTiming Enable AutoTiming Conditions Conditions 0 Time Per Concatenat ... < Breath-Hold Capa ... + 0 Acquisition Time Breath-Hold Capa ... + ime Por Concatonation AutoTiming will adapt the following parameters if the conditions are not met AutoTiming will adapt the following parameters if the conditions are not met Condition Parameter Limit Increment Condition Parameter Limit Increment 0 TR 1000.0 ms 20.0 ms Slice Partial Fourier 7/8 1.0 O O TR = 1400.0 ms 10.0 ms Slice Partial Fourier 6/8 = 1.0 O 0 Concatenations 3.0 1.0 0 Base Resolution = 288.0 1.0 0 TR 900.0 ms 20.0 ms none TR 0.0 ms 1.0 ms O TR 1400.0 ms 10.0 ms O 10 Slice Partial Fourier 5/8 1.0 Concatenations 4.0 1.0 O Phase Partial Fourier 718 1.0 28 Unrestricted © Siemens Healthineers, 2025 Notes 231 MR Protocol Building and Optimization- STEP Week 4 General Add-in Configurations SIEMENS Healthineers ... AutoTiming & AutoCoverage AutoTiming AutoCoverage and AutoTiming There is no automatic parameter adaptations for a If both AutoCoverage and AutoTiming are protocol that is already open. configured, AutoCoverage is calculated first. If the user increases the number of slices Guidance Parameters recommended by AutoCoverage, thereby increasing the acquisition time, they must compensate for this manually. Increasing the number of slices in turn increases the size of the organ box. Executed Protocol Manipulations AutoCoverage Slices : 30 -> 57 If propagate changes to all following protocols is Additional slice selection size: -50 activated, this impacts all pending transverse scans. Check slice positions and adjust them , if necessary AutoTiming TR : 1400 -> 1040 [ms] However, AutoTiming takes care of the timing for Concatenations : 2 -> 3 pending protocols 29 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 232 MR Protocol Building and Optimization- STEP Week 4 Series Label and Auto Load General Add-in Configurations SIEMENS Healthineers ... Series Label and Auto Load Series Label and Auto Load have been implemented All T2_haste_cor_mbh T1_vibe_dixon_tra_bh_pre All into the Abdomen Assist to enhance some workflow The following label(s) will be attached to all series ac The following label(s) will be attached to all series ac steps. Image Contrast T2 Image Contrast T1 For example, the following steps have been labelled Orientation Coronal Orientation Transversal using Series Label: Patient Contrast Pre-Contrast • T2_haste_cor_mbh • T1_vibe_dixon_tra_bh_pre Auto Load has been implemented for Care Bolus. All GSP Segment 1 GSP Segment 2 GSP Segment 3 Image Contrast T2 Orientation Coronal Transversal Load water image Patient Contrast Pre-Contrast Sequential Numb ... ...... + 30 Unrestricted © Siemens Healthineers, 2025 Notes 233 MR Protocol Building and Optimization- STEP Week 4 Test Bollus Abdomen Assist Test Bolus Abdomen Assist SIEMENS Healthineers ... Abdomen Bolus Timing Abdomen Bolus Timing is an alternative way of performing liver dynamics. contras with contrast agent The optimal time window for data acquisition is derived by Assist after the t1_vibe_dixon_tra_bh pre 00:14 3 Abdomen Bolus Ti. application of a test bolus. Check precontrast Generic Views Visual guidance and interactive evaluation during the set-up provide ease of use. Test bolus 01:00 Generic Views Test bolus evaluation Abdomen Bolus Timing Prepare injector t1_vibe_dixon tra_bh arterial 00:14 Abdomen Bolus Ti ... t1_vibe_dixon tra bh venous 00-14 Abdomen Bolus Ti ... t1_vibe_dixon tra bh delaved 00:14 3 Abdomen Bolus Ti .. t1_vibe_dixon_cor_bh_post 00:15 1 Generic Views 31 Unrestricted © Siemens Healthineers, 2025 Notes 234 MR Protocol Building and Optimization- STEP Week 4 Test Bolus Abdomen Assist SIEMENS Healthineers ... Test Bolus Measurement Pre-contrast images have been measured and Test_bolus 01:00 checked. Generic Views Guidance Parameters User performs guided positioning of test bolus 1. Position the slice as shown slice on the aorta at the level of the diaphragm. in the localizer images on the right. 2. Confirm by clicking the GO button. Start the test bolus measurement with Continue 3. Start the measurement and the contrast-agent and simultaneously inject the contrast agent injection simultaneously. • Use the same injection rate that will be used for subsequent post-contrast measurements. Test bolus images are displayed in GSP segment, ready for evaluation. 32 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 235 MR Protocol Building and Optimization- STEP Week 4 Test Bolus Abdomen Assist SIEMENS Healthineers ... Abdomen Bolus Timing Assignment of correct phase and timing offsets Queue GSP Phase Planning for each phase of the dynamic series: Auto Load Bolus Timing Timing Offset 10 • Pre Smoothing • Planning (Timing offset = 10s) Skip 'Select vein' • Arterial (Timing offset = 0s) Guidance "Select Artery" • Venous (Timing offset = 30s) > Guidance "Select Vein" • Delayed (Timing offset = 180s) Guidance "Finalize Protocol" Planning phase Phase Arterial • Configure data acquisition window relative to Timing Offset O the peak of the signal intensity vs. time curve Timing offset = 10 secs: the time between peak Phase Venous • intensity and k-space center of arterial phase Timing Offset 30 • Skip Select vein: ROI for vein is not required Phase Delayed Timing Offset 180 33 Unrestricted © Siemens Healthineers, 2025 Notes 236 MR Protocol Building and Optimization- STEP Week 4 Test Bolus Abdomen Assist SIEMENS Healthineers ... Test Bolus Evaluation Position ROI on aorta, and arterial SI vs time curve is Test bolus evaluation displayed. Abdomen Bolus Timing • The system makes a proposal for the data Bolus Timing acquisition window • The pre-configured timing offset between contrast . Select Artery Select Vein Finalize Protocol arrival in the aorta at the level of the diaphragm, TTC and the target organ (liver) is taken into consideration Timing offset=10s If necessary, user can adapt the position of the data Change the image • acquisition window in relation to the curve by 0:25 0:15 moving it with the mouse Delay time=25s TA=15s (for count down) Note: user must start the contrast injection and count down simultaneously 34 Unrestricted © Siemens Healthineers, 2025 Notes 237 MR Protocol Building and Optimization- STEP Week 4 Test Bolus Abdomen Assist SIEMENS Healthineers ... Prepare injector Prepare injector t1_vibe_dixon_tra_bh arterial 00:14 1. Configure the contrast agent name and amount. 3 + Abdomen Bolus Ti ... 2. Click Continue. Patient has Contrast Agent (Vol. 10.00) M Patient has Contrast Agent (Vol. 10.00) Agent Name Gd Catalog ... Agent Name Gd Catalog ... Volume 10.00 Volume 10.00 ml Arterial phase scan (t1_vibe_tra_bh_arterial). Total Dose ml Total Dose ml Active Ingredient Active Ingredient Timing window collapses automatically. Dilution Dilution Concentration mg/ml Concentration mg/ml 1. Check count down time. Timing Timing 2. Enable Auto Continue. Injector Control Break time 0 3. Click Start Countdown and inject contrast agent Total Time 0 Countdown 25 simultaneously. Continue Close Auto Continue Start Countdown njector Control Voice Commands Before Scan Hold breath (inhaled). 8.9 After Scan Continue breathing. 2.7 35 Unrestricted © Siemens Healthineers, 2025 Notes 238 MR Protocol Building and Optimization- STEP Week 4 Assist Library Assist Library SIEMENS Healthineers ... The Assist Library provides alternative protocols ... >> abdomen > library Assist > multiarterial phase ... >> abdomen >> library Assist >> GRASP with pre-configured add-ins. To run liver dynamics with multiarterial phases, re To run liver dynamics with GRASP, replace the ent (e.g., AutoCoverage, AutoTiming). t1_vibe_dixon_tra_p4_bh_pre 00:14 Alternative 1: User specifies bolus transit time Generic Views Drag&Drop into Assists. Check precontrast Test Bolus 01:00 Generic Views Generic Views _optional_ Prepare injector Enables faster customization of Assists. Test Bolus 01:00 Inform patient to breathe flat. . >> abdomen >> library Assist >> T1 >> abdomen > library Assist > T2 Generic Views t1_vibe-grasp_fs_tra 04:57 t1_f12d fs tra p2 mbh 01:15 t2_tse fs tra p2 mbh 01:17 GRASP Generic Views Generic Views Prepare injector Alternative 2: Automatic bolus detection t1_f12d_opp-in_tra_p2_mbh 00:49 t2_tse_fs_tra_p2_trig 03:59 Generic Views Generic Views t1_vibe-twist_dixon_tra_p4_bh_art_5phas 00:19 Prepare injector t1_vibe_dixon_tra_p4_bh_venous ... >> abdomen > library Assist >> 3D 00:14 Inform patient to breathe flat. 1 t1_vibe fs tra 00:17 t1_vibe_dixon_tra_p4_bh_delay 00:14 t1_vibe-grasp_fs_tra 05:13 O ABLE 1 @ GRASP t1_vibe_fs_cor_bh_post 00:18 Generic Views 36 Unrestricted © Siemens Healthineers, 2025 Notes 239 MR Protocol Building and Optimization- STEP Week 4 Liver Lab Assist LiverLab Assist SIEMENS Healthineers ... Introduction to LiverLab The protocol/workflow was designed for test_21.05.2014 111 *2/18/1942, M, 72Y STUDY 1 Liver Segmentation 5/21/2014 measuring the fat and iron in the liver. 11:32.45 AM IMA 23 / 88 Segmentation Volume: 1608 ml Pre-evaluation steps: Number of Voxels: 219571 Voxel Volume: 0.007 ml • Dual-echo VIBE DIXON (e-DIXON) • Provides evaluation results and the suggestion Dual-Ratio Dixon Discrimination MF 1.00 for the quantification steps TR 6 6 TE 2.4 TA 10.2G BW 470.0 p4 M/WVATER/NORM Result: fat deposition A1/DDW BO1-3,SP2-4 Quantification steps: Recommendation: run liver evaluation *11302 / 10 fest_21.05.2014 Multi-echo DIXON (q-DIXON) 19 21.05.2014 111 AB1942. M. 72Y FEST • "2/18/1942, M. 72Y STUDY 1 5/21/2014 11:47:05 AM • HISTO (multi-echo SVS) 15 MA 24 /60 21 MA 1 /3 • R2*, T2*, fat fraction, and T2 results could help Fat signal percentage 60% evaluate the fat and iron deposition O 103-1 R2 wate 08-1 358-1 603-1 TR You TR 16.0 TE 2.4 TA 16.94 TP F7 TE 2.4 BWV 1989.0 SP H15.7| TA 16.94 [p4 ODIONIND FAT_FRACTION SL 35 BW 1080.0 FOV 371:450| [p4 00(ONIND/R2_STAR_MAP 208.3201 BO1-3,SP2-4 Tra "11306 ) 6 Gray value 1 equsis 0.1% 498 BO1-3,5P2-4 "1306 /6 Gray value 1 equals 1.0 (s^.1) PESTO.Jepor Colorbar Rep 512.5 37 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 240 MR Protocol Building and Optimization- STEP Week 4 GOLiver GOLiver SIEMENS Healthineers ... Abdominal MRI is a very frequently performed examination (~11.6%1) and substantially above Average Exam duration [min]2 the average in acquisition time. 35 30 GOLiver, a fast, push-button diagnostic 25 25 min abdominal MRI exam. 20 • Clinically-validated, push-button liver exam 15 including all relevant contrasts in 12 minutes 10 • Provide highly consistent exam slots, reduce 5 the workload for radiographers Significantly accelerate routine abdominal MR 0 • examinations with a guided and streamlined Hip Foot Knee workflow Brain Wrist Pelvis Ankle Elbow Breast L-Spine T-Spine C-Spine Shoulder Extremity Abdomen 38 Unrestricted © Siemens Healthineers, 2025 Notes 241 MR Protocol Building and Optimization- STEP Week 4 GOLiver SIEMENS Healthineers ... Localizer AutoAlign Coronal T2 HASTE DWI b1000 Arterial T1 FS Delayed T1 FS 12 minutes including planning, breath-holds, triggering, contrast application etc. LA Axial T2 BLADE FS Pre contrast T1-weighted Portal-venous T1 FS T1 in/opp phase 39 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 242 MR Protocol Building and Optimization- STEP Week 4 GOLiver SIEMENS Healthineers ... Documented to assist in the diagnosis of multiple Protocols available from MAGNETOM World* clinical conditions including • Hepatocellular Carcinoma (HCC) Prerequisite: Abdomen Assist • Gallbladder cancer .......... Dynamics ---.............. • Pelvic masses USER » GOLiver » 3T » GOLiver • Metastases of gastric carcinomas t1_vibe_dixon_tra_pre 00:15 Dot Pa PatientView Abdomen Patient V ... 1 ABLE • Pancreatic cancer • Intestinal neoplasms Check precontrast localizer 00:16 Basic Decision • Fatty liver disease Onco Auto Cover ... Prepare injector Hepatic cirrhosis t2_blade_fs_tra_320_trigRESP 02:14 • Generic Views Hemangioma Care Bolus 01:16 • t2_haste_cor_p3_freebreathing 00:15 1 Care Bolus • Metastases of breast cancer and others. Generic Views t1_vibe_fs_tra_arterial 00:14 ep2d diff b1000 tra bh 01:24 1 O ABLE Generic Views t1_vibe_fs_tra_venous 00:14 1 4 ABLE t1_vibe_fs_tra_delayed 00:14 1 4 ABLE 40 • https://www.magnetomworld.siemens-healthineers.com/clinical-corner/protocols/body-pelvis/goliver-protocols Unrestricted © Siemens Healthineers, 2025 Notes 243 MR Protocol Building and Optimization- STEP Week 4 GOLiver SIEMENS Healthineers ... Patient with a small metastasis of a colon cancer 41 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 244 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers myExam Cardiac Assist STEP - MR Protocol Building with myExam Cockpit & myExam Assist Unrestricted © Siemens Healthineers, 2025 Effective Date: 7 May 2025 - QR700008373 Notes 245 MR Protocol Building and Optimization- STEP Week 4 Agenda SIEMENS Healthineers ... myExam Cardiac Assist • Overview • Cardiac Patient View • Cardiac Basic Add-in • AutoAlign Heart • Cardiac Marker Localization • Cardiac Short Axis Planning • Cardiac Standard Add-in • Cardiac Assist workflows • Ventricular Function • Cardiac Flow protocols • Library 2 Unrestricted © Siemens Healthineers, 2025 Notes 246 MR Protocol Building and Optimization- STEP Week 4 Objectives SIEMENS Healthineers ... At this end of this module, you should be able to: • Summarize the features myExam Cardiac Assist • Identify the Cardiac Patient View, Cardiac Basic Add-in, and Cardiac Standard Add-in’s • Explain the features of AutoAlign Heart • Recall the features of Cardiac Marker Localization, and Cardiac Short Axis Planning • Restate the Cardiac Assist workflows • Recall the Ventricular Function features • Describe how to perform Flow measurement using the myExam Cardiac Assist • State where to locate the Library of protocols 3 Unrestricted © Siemens Healthineers, 2025 Notes 247 MR Protocol Building and Optimization- STEP Week 4 Disclaimers SIEMENS Healthineers ... The information presented in the myExam Cardiac Assist course is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use their own learning, training, and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Medical Systems to be used for any purpose in that regard. Please refer to a Contrast Agent manufacturer's labeling, and instructions for use, for use of that Contrast Agent with an MRI exam. 4 Unrestricted © Siemens Healthineers, 2025 Notes 248 MR Protocol Building and Optimization- STEP Week 4 Overview myExam Cardiac Assist SIEMENS Healthineers' ... • Step-by-Step guidance for Cardiac Assist LOC ₽ standardized CMR exams center on heart • Automated exam planning localizer_heart thorax_cor_tra for shorter examination AAheart_scout % define_lax times cine_segmented_lax % define_sax • AutoAlign Heart algorithm 19 % dynamic_test 10 Inject contrast agent. trained on clinical datasets 11 X dynamic_stress 12 cine_segmented_lax Consistent, reproducible 1 sec f Ats @2 @ 2.1.2.1.8.0 mmd + 1.00 • results Left Atrium Aortic Root Right Ventricle Left Ventricle Apex Display Slices ECG I 5 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 249 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers ... Automated Features • Exam Strategies: Breath-hold and Realtime • AutoAlign: assists in graphical slice positioning • AutoFoV & In-plane rotation Automated capture of heart rate 0 ms • • Automated parameter adaptation • Automatic voice commands Function T1 maps * • Inline Ventricular Function evaluation • Inline Motion correction • Inline Time Course Evaluation • Automatic series renaming ................ Supports the user in many ways to help handle the complexity of CMR examinations with confidence. ................ Time Course Analysis Tissue Characterization Images on file 6 *Available with MyoMaps license Unrestricted © Siemens Healthineers, 2025 Notes 250 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers ... Select&GO Display Select&GO > Guidance Display tab: Healthineers Patient data is displayed at the scanner. AutoPositioning for Cardiac exams. ECO !!! Guidance for positioning ECG leads and ECG I 9 66 mmin RR4 900 ma electrodes. ECG II 66 RR4 900 m Select&GO > Physio Display tab Direct feedback of ECG setup at the ECG IN 9 65 mi RR4 900 ms scanner. BioMatrix Respiratory Sensor for RESp RF 13 kmh RS 4580 - immediate detection of breathing External Signal patterns. 7 Unrestricted © Siemens Healthineers, 2025 Notes 251 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers ... Consistent image appearance All standard Cardiovascular MR imaging planes are presented in a consistent manner. Regardless of how the heart is oriented in the bore with respect to the patient’s anatomy. 4 Chamber View – apex is oriented to upper right side. 2 Chamber View – apex is oriented to right side. 3 Chamber View – apex is oriented to left side. Ensures consistent image appearance for standard cardiac views when using myExam Cardiac Assist or the Cardiac Dot Engine. 8 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 252 MR Protocol Building and Optimization- STEP Week 4 Cardiac Patient View myExam Cardiac Assist SIEMENS Healthineers ... Patient View – General Parameters Exam Strategy: General Parameters Breath-Hold Parameters Segmented breath-hold for standard measurements. Realtime protocols for patients with reduced breath-hold Exam Strategy breath-hold Breath-Hold Capability 15 ¢ s capabilities or arrhythmia. Beat Sensor Training no Auto Breath-Hold Commands V English (United ... ause Between Breath-Holds 10 s Beat Sensor Training (available since XA51): • Default = No. Physio Parameters • If the Beat Sensor triggering is used, then select Yes to add the Beat Sensor training step to the workflow Trigger source ECG Override cardiac cycle Beat Sensor Training (XA61): 0 ms Default = Free-breathing Beat Sensor training step 9 Unrestricted © Siemens Healthineers, 2025 Notes 253 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers .. Patient View – General Parameters Trigger Source – ECG, Pulse, External, Beat Sensor (since XA31). General Parameters Breath-Hold Parameters Exam Strategy breath-hold Breath-Hold Capability 15 + Override cardiac cycle – overrides the Beat Sensor Training no Auto Breath-Hold Commands English (United ... automatically captured heart rate. ... • Specify a cardiac cycle interval in Pause Between Breath-Holds 10 - s milliseconds • Used for patients with arrhythmia • Called Override RR interval prior to XA51 Physio Parameters Trigger source ECG Override cardiac cycle ECG Pulse External Beat Sensor 10 Unrestricted © Siemens Healthineers, 2025 Notes 254 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers .. Patient View – Breath-Hold Parameters Breath-Hold Capability General Parameters Breath-Hold Parameters Adapts number of slices acquired per breath-hold to stay within a predefined breath-hold capability. Exam Strategy breath-hold Breath-Hold Capability 15 • Localizers Beat Sensor Training no Auto Breath-Hold Commands V English (United ... • CINE imaging Pause Between Breath-Holds 10 + • Delayed Enhancement imaging Auto Beath-Hold Commands: Physio Parameters Box checked – automatic Breath-Hold commands Trigger source ECG are enabled for the complete examination. Override cardiac cycle Language – select from the pull-down. 0 ms Pause between Breath-Holds – define the pause between breath-holds in seconds. 11 Unrestricted © Siemens Healthineers, 2025 Notes 255 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers' ... myExam Add-In Configurator – Slice Group Guidance Slice Group Guidance Card is used to configure myExam Add-In Configurator Guidance Views and Text for all available cardiac views. • Adapt preconfigured Siemens Guidance Views Slice Group Guidance 2 Chamber Add Guidance Remove Guidance Rename View Queue Layout 3 images A AA • Users can add New Guidance Views and New GSP Cardiac Config Guidance Text Tooltip Tooltip Tooltip • Rename a User-defined View: Select a user-defined View from the heart view list, rename View, Add Guidance and text. Shortaxis 4 Chamber 2 Chamber Hint: Guidance Views can (generally) only be Position the slices as shown in the sample images . configured and modified in the Cardiac Patient View. Close 12 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 256 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers ... myExam Add-In Configurator – Queue (1 of 2) Disable Copy&Go Button – availability of the Go myExam Add-In Configurator button in the myExam User Interface (UI). • On – disables the Copy&Go button (dimmed) Guidance in the myExam UI during the cardiac workflow Parameters Disable Copy&Go Button On Queue Proceed to next Default • Default – applies settings defined in the GSP On Series Label Show parameter-card at startup OF Patient View Add-In to this program step Auto Load ICE Off – enables the Copy&Go button in myExam AutoTiming • Cardiac Config Use Siemens Path . (C:\Program FilesiSiemens)NumarisAnProductsllceliceConfigurators) UI during the cardiac workflow Use Customer Path (CaProgramData(SiemensiNumerisiMiCustomerice) ICE program name Numaris X: • On for localizers • Off for other Cardiac Steps E-line: Close • On for Dot Engines Hint: In the Patient View you can set disable the Copy&Go • Off for Delayed Enhancement in the Myocarditis Dot Engine button for the entire workflow, or for individual program steps 13 Unrestricted © Siemens Healthineers, 2025 Notes 257 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers ... myExam Add-In Configurator – Queue (2 of 2) Proceed to next: myExam Add-In Configurator Normal – next program step opens as soon as measurement of this program step is started. Guidance Parameters Disable Copy& Go Button On On Image Reconstruction Finish – next program Queue Proceed to next Normal GSP step opens when image reconstruction of this Series Label Show parameter-card at startup Normal On Image Reconstruction Finish Auto Load ICE program step is completed. AutoTiming Cardiac Config Use Siemens Path . (C:\Program FilesiSiemens NumarisAnProductilceluceConfigurators) Use Customer Path (CaProgramDataSiemensiNumerisiMiCustomeruce) Show parameter card at startup ICE program name If this open is selected, the Parameter view is shown instead of the Guidance view when the program step opens in the queue. Close 14 Unrestricted © Siemens Healthineers, 2025 Notes 258 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers ... myExam Add-In Configurator – Graphical Slice Positioning (GSP) Physio Display = On myExam Add-In Configurator • Automatically opens the Physio Display of the program selection card in the myExam UI Guidance • ECG triggering displayed automatically Parameters View Tools Queue GSP Image Text Default Group Graphics Default Series Label Reference Lines Default Extent Mode Default Auto Load AutoTiming Protocol Table Position On Cardiac Config Coll Positions Default Adjust Volume Default Physio Display On Expand Third Segment Default View-Graphics Scroll Display Slice Groups Package Mode Display Order Default Close 15 Unrestricted © Siemens Healthineers, 2025 Notes 259 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers ... myExam Add-In Configurator – Cardiac Config (1 of 6) Adapt to heart rate myExam Add-In Configurator On – Cardiac Assist (Cardiac Dot Engine) automatically adjusts the acquisition window for Guidance Prospective triggered scans. Parameters Protocol Settings Queue Adapt to heart rate On • Equivalent to pressing Capture Cycle in the GSP Adapt to breath-hold capability Default Physio>Signal parameter card Series Label Auto Load ShimMemory Default Protocol not opened in the queue but executed FOV Adaptations Default • Cardiac Config (starts/runs) the capture cycle is updated (e.g., CS Real Time CINE imaging) Override Cardiac Cycle enables you to overwrite the automatically captured heart rate and specify an RR interval in Patient View. Override cardiac cycle Close 800 ms Cardiac Config component is available in all cardiac specific add-ins 16 Unrestricted © Siemens Healthineers, 2025 Notes 260 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers ... myExam Add-In Configurator – Cardiac Config (2 of 6) Adapt to breath-hold capability myExam Add-In Configurator On – configures the automatic adjustment of the measurement to the patient’s breath-hold Guidance capabilities. Parameters Protocol Settings Adapt to heart rate On • Cardiac Assist and Cardiac Dot Engine acquires Queue GSP Adapt to breath-hold capability On as many slices as possible in one breath-hold Series Label Auto Load ShimMemory Default for localizers, CINE and Delayed Enhancement AutoTiming FOV Adaptations Default Cardiac Config imaging • Depends on the breath-hold capability entered in Patient View Close Cardiac Config component is available in all cardiac specific add-ins 17 Unrestricted © Siemens Healthineers, 2025 Notes 261 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers ... myExam Add-In Configurator – Cardiac Config (3 of 6) Shim Memory myExam Add-In Configurator Shimming occurs in the program step localizer@center. Guidance • Off Parameters Protocol Settings Queue • Shim Volume and Trufi Phase Cycle Adapt to heart rate On GSP Adapt to breath-hold capability On • Shim Volume Series Label Auto Load ShimMemory Default Default • Trufi Phase Cycle FOV Adaptations Cardiac Config Off Shim Volume And Trufi Phase Cycle Shim Volume Trufi Phase Cycle User can decide if Shim Volume and/or TrueFISP Phase Cycle is stored in the Exam Memory and applied to following workflow steps. Most relevant/beneficial for 3T workflows. Close Cardiac Config component is available in all cardiac specific add-ins 18 Unrestricted © Siemens Healthineers, 2025 Notes 262 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers ... myExam Add-In Configurator – Cardiac Config (4 of 6) Alternate GRE Double Echo Shim sequence is Guidance Parameters implemented in a non-triggered 3D shim measurement. ==== Implemented into the thorax overview step and all CH TrueFISP based protocols within all Cardiac Assist or Cardiac Dot Engines @3T. Cardiac Dot Engine workflow at 3T Position the slices as shown in the example images. Center the green "shim" box over the heart as shown in the example images. User only needs to set the shim volume once, which is then stored in the Exam Memory. It automatically propagates to all subsequent protocols using the Protocol Settings Adapt to heart rate On Cardiac Shim. (i.e., ShimMemory setting in Cardiac Adapt to breath-hold capability On Config component of myExam Add-in Configurator). ShimMemory Shim Volume And Trufi Phase Cycle FoV Adaptations Default Show Breath Hold Parameters On 19 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 263 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers .. myExam Add-In Configurator – Cardiac Config (5 of 6) FoV Adaptations myExam Add-In Configurator Configures the automatic adaption of the Field-of- View (FoV), in-plane rotation, or both. This can be Guidance configured globally in the Cardiac Patient View, or Parameters Protocol Settings Queue Adapt to heart rate On step specific. GSP Series Label Adapt to breath-hold capability On • Off – protocol FoV used, no in-plane rotation Auto Load ShimMemory Default performed FOV Adaptations Default Cardiac Config Default • In-plane Rotation – automatic, patient specific Off Inplane Rotation in-plane rotation performed; FoV from protocol Inplane Rotation + FOV Adaptation is used • In-plane Rotation + FoV Adaptation – FoV and in-plane rotation customized to an individual patient Close MR XA20 software and up, the FoV is identical for all SAX slices. FoV SAX all is used for Short Axis Cardiac Config component is available in all cardiac specific add-ins subset and for single SAX slices. 20 Unrestricted © Siemens Healthineers, 2025 Notes 264 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers ... myExam Add-In Configurator – Cardiac Config (6 of 6) Show Breath-Hold Parameters: Slice Group Guidance Queue Protocol Settings On – breath-hold parameters are visible in the Patient GSP Adapt to heart rate On Cardiac Config View. Adapt to breath-hold capability On ShimMemory Default Off – hide breath-hold parameters in the Patient View. FoV Adaptations Default Show Breath Hold Parameters On Cardiac Config component is available in all cardiac specific add-ins 21 Unrestricted © Siemens Healthineers, 2025 Notes 265 MR Protocol Building and Optimization- STEP Week 4 Cardiac Basic Add-in myExam Cardiac Assist SIEMENS Healthineers ... Cardiac Basic Add-in Behaves like a Generic Views Add-in but also Cardlac Assist @ Cardiac Patient View contains a Cardiac Config component. V breath-hold Realtime localizer 00:03 Cardiac Basic Add-In is used to plan localizers and center on heart AAHeart scout steps. Table Positioning Strategy localizer_heart 00:10 Cardiac Basic Guidance Images and Text for slice group thorax cor_tra 00.26 O Cardiac Basic positioning. AAheart scout 00:09 O Cardiac Basic Cardiac Config component, allows adaptation to heart rate, breath-hold capability, and shim memory options. 22 Unrestricted © Siemens Healthineers, 2025 Notes 266 MR Protocol Building and Optimization- STEP Week 4 AutoAlign Heart myExam Cardiac Assist SIEMENS Healthineers ... AutoAlign Heart scout AAheart_scout step, a Pseudo-Short-Axis is measured. Guidance Parameters Position the slices as shown in the example image. Guidance images show how to position the slices on a Ensure complete heart coverage from base to apex. Sagittal image of the three-plane localizer. Do not change the slice orientation. • 18 Slices, 10 mm Slice Thickness, no Gap, pre-defined orientation • Automatic detection of five cardiac landmarks is acquired and used to plan slice positions for subsequent measurements Landmark calculation is enabled in myExam Cardiac Config component of AAHeart scout protocol (myExam Config Tool). Hint: Do not angle the slices if using AutoAlign Do not modify any measurement parameters for the AAHeart_scout, except the Slice Shift in the A-P or H-F direction, but only if necessary. 23 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 267 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers ... AutoAlign Heart scout – Algorithm The algorithm is trained on over multiple patient data sets L Localizers JXEMPR Calc RV - O X 12 MPR Calc LA x that were acquired using the AAHeart_scout protocol. All datasets were manually annotated and used to create a model of the heart. The algorithm performs a 3D segmentation of the 2D contiguous slices and internally generates MPRs (not seen by the user). 256x256 11; loc: -8.50 (-0.52,0.51,0.69) (109.09 ,- 204.43,11 (-0.52,0.51,0.69) (91.46 ,- 187.33, 191 L MPR Calc 2Ch O X 5 MPR Calc 3Ch - OX IL MPR Calc 4C Marker points and Slice Orientations are calculated based on the MPRs. (-0.64 ,- 0.76,0.08) (25.69 ,- 74.39 ,- 23 (-0.72,0.17 ,- 0.67) (196.05 ,- 0.08 ,- 15 / (-0.07,0.78 ,- 0.63) (261.41 ,- 78.76 ,- 5 24 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 268 MR Protocol Building and Optimization- STEP Week 4 Cardiac Marker Localization Cardiac Marker Localization SIEMENS Healthineers ... Define Long Axis (1 of 5) Based on the AAHeart scout. The Define Long Axis step CMR ac Dot Engin results in automatic calculation of main Long Axis imaging planes. 2 Chamber. R -AIR 3 Chamber. 40cm 10cm 4 Chamber. TP F 36 TP F36 P10.7 SPF86.8 JU*4UU TT 842.5 Cor 1108 p2 MAGN/NORM/DIS2D Not for diagnostic yo 528 localizer_heart 123 RAhear N RUDIS 20 Not for diagnostic uce Not for diagnostic uso 2 sec 4 Auto @ 2 6 2.0x2.0x8.0 mm3 9 1.00 Based on 5 automatically determined anatomical Marker Localization landmarks generated from the AAHeart scout. M Left Atrium Y Aortic Root Left Atrium. Right Ventricle Left Ventricle Aortic Root. Apex Display Slices Right Ventricle. Left Ventricle. dapt slices In GSP If required. Apex. elect a marker tab to check or reposition markers . 25 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 269 MR Protocol Building and Optimization- STEP Week 4 Define Long Axis Planning Cardiac Marker Localization SIEMENS Healthineers' ... Define Long Axis (2 of 5) Define and measure the Long-Axis Localizer: Cardiac Dot Engine diac Dot Eng CMR CIR EMALae Dot Engine User can verify/adapt landmarks and LAX slice MA 1 FRM 6/9 A IMA1 FRMAMA'S 2 IMA 2 FRM 2/3 orientations. Optimized FoV for all subsequent LAX measurements is R AIR calculated from a body bounding box around the body 10cm 10cm 10cm surface of the patient, it is based on a large FoV Define A TP F36 TP F36 TP F36 Long Axis localizer. SP P10.7 SP F86.8 TT 842.5 FOV 4UU 400 SP F20.6 TT 842.5 FOV 4UU"4UU TT 817.5 FOV. 4UU"40U p2 MAGN/NORM/DIS2D Cor localizer_heart 1108 P2 MAGN/NORM/DIS2D Tra Tra>Cor(-35)>Sag(30) W localizer_heart W 159/ p2 MAGN/NORM/DIS2D MIhoart_scout W \ 1361 Not for diaanoome yo 697 Not for diagnostic uce Not for diagnostic use All information is stored in the Exam Memory for the Dot 2 sec | Auto @ 2 @ 2.0x2.0x8.0 mm3 1.00 remainder of the examination. Marker Localization M Left Atrium All following 2, 3, and 4 chamber scans can be Y Aortic Root Right Ventricle executed by the myExam Assist or Dot Engine Left Ventricle automatically with no user interaction. Apex Display Slices check sices in esp If required. Select a marker tab to check or reposition markers . 26 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 270 MR Protocol Building and Optimization- STEP Week 4 Cardiac Marker Localization SIEMENS Healthineers ... Define Long Axis (3 of 5) Define Long Axis Stack: myExam Add-In Configurator If the User wants to plan and measure multiple parallel slices for LAX views, this Queue may be pre-configured in the Marker GSP Measure stacked views in this step Localization step. Serles Label Auto Load Number of Slices AutoTiming 2 Chamber Stack Marker Localization Marker Localization Step: 3 Chamber Stack Cardiac Config 4 Chamber Stack 1. Activate Measure stacked views in this step. 2. Set the Number of Slices for each of the standard LAX views. • 2 Chamber Stack • 3 Chamber Stack • 4 Chamber Stack 4. Defined LAX stack views are available in Close the Cardiac Standard Add-in for subsequent measurements. 27 Unrestricted © Siemens Healthineers, 2025 Notes 271 MR Protocol Building and Optimization- STEP Week 4 Cardiac Marker Localization SIEMENS Healthineers ... Define Long Axis (4 of 5) Defining the Long Axis Views Manually: If the AutoAlign step fails, the icon is displayed in the measurement queue. Marker Localization If the AAheart_scout fails: 1. Set the marker points manually with the aid of the Left Atrium guidance images. Aortic Root Right Ventricle 2. Scroll through the AAHeart scout images and select Left Ventricle the slice that best represents the landmark described Apex for each guidance step. Display Slices 3. Set the marker by clicking the image, the system automatically jumps to the next Guidance View. 4. Display the standard LAX heart views with Display Select the slice which best represents the left atrium. Slices. Mark left atrium as shown. 28 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 272 MR Protocol Building and Optimization- STEP Week 4 Cardiac Marker Localization SIEMENS Healthineers ... Define Long Axis (5 of 5) Define Long Axis Overlay Window. 3 7 sec | Auto @ 2 @ 1.6x1.6x6.0 mm3 @ 1.22 If the AAHeart scout results are not yet available and the Define Long Axis step is opened by the User. An overlay window is displayed if enabled in the myExam Add-in Configurator, under Queue. Overlay Window Displayed: Please wait until calculation of previous step has been completed or close step by clicking 'Cancel. Appears when the previous step is configured with Proceed to next: On Image Reconstruction Finish and the User tries to open the next step before the reconstruction of the previous step has finished! Wait until previous step has finished and the window disappears or click Cancel to close the protocol. myExam Add-In Configurator Overlay Window Not Displayed Queue GSP Disable Copy&Go Button Default To avoid this overlay, set the previous step to Proceed to Serles Label Proceed to next On Image Reconstruction Finish Auto Load next: Normal. Show parameter-card at startup Normal AutoTiming On Image Reconstruction Finish 29 Unrestricted © Siemens Healthineers, 2025 Notes 273 MR Protocol Building and Optimization- STEP Week 4 Cardiac Short Access Planning Cardiac Short Axis SIEMENS Healthineers ... Planning (1 of 6) Define and measure the Short-Axis Localizer: Cardiac SAX Plannir arameters 4-chamber CINE has been measured. Shortaxis All Slices have been automatically calculated Shortaxis SUD: lease review and adjust if necessary. No. of Slices 10 + Short Axis All slices is based on automatically detected landmarks, number of Short-Axis slices required to cover the left ventricle from base to apex is estimated (e.g., for LV function, LGE). Short Axis Subset slices is a subset of Short Axis All slices that partially cover the left ventricle (e.g., for perfusion, and mapping). Cardiac SAX Planning arameters Shortavis All Slices have been automatically calculated Short Axis All and Short Axis Subset: Shortaxis Subset Adapt the Position, Orientation, and Number of slices. No. of Slices 4 Show "Shortaxis All" slices Short-Axis localizers are acquired for subset slices (i.e., even if the Snap "Shortaxis Subset" slices to "Shortaxis All" slices slice position is the same). Optimized FoV for all subsequent SAX measurements is calculated from a body bounding box around the surface of the patient, based on large FoV SAX localizer. 30 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 274 MR Protocol Building and Optimization- STEP Week 4 Cardiac Short Axis SIEMENS Healthineers ... Planning (2 of 6) Show ‘Short Axis All’ slices: Cardiac SAX Planning Parameters • Displays both function slices and Short-axis Subset Slices have been automa slices. Shortaxis All Shortaxis Subset lease review and adjust if necessary. • Activate to display the Short Axis all (white) together with the Short Axis subset (yellow) slices. No. of Slices 3 2 Show "Shortaxis All" slices Snap "Shortaxis Subset" slices Snap ‘Short Axis Subset’ slices to ‘Short Axis All’ slices: to "Shortaxis All" slices • Activate so if the Short Axis Subset slices are moved, they will snap to align with the Short Axis All slices. • Deactivate to move the slices to a different position while maintaining the orientation. • All information is stored in the Exam Memory for the remainder of the examination. • All following SAX scans can be executed by the myExam Assist or Dot engine automatically with no User interaction. 31 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 275 MR Protocol Building and Optimization- STEP Week 4 Cardiac Short Axis (3 of 6) SIEMENS Healthineers' ... Planning – Short Axis Heart Views available in Exam Memory Short Axis All – all planned Short Axis All slices Adding / Removing Views are acquired (white slices). Selectable Views Available Views Shortaxis All Shortaxis All B1 Short Axis All B1, B2, etc. – only specified Short Shortaxis All B2 Shortaxis All B3 Axis All slices are acquired (e.g., Short Axis All B5 Shortaxis All B4 Shortaxis All B5 (5th white slice from base). Shortaxis All B6 Shortaxis All B7 Shortaxis All B8 Shortaxis All B9 Short Axis Subset – all planned Short Axis Subset Shortaxis All B10 Shortaxis Subset B1 slices are acquired (yellow slices). Shortaxis Subset B2 Cancel Short Axis Subset B1, B2, etc. – only specified Short Axis Subset slices are acquired (e.g., Short Axis subset B2 (2nd yellow slice from base). 32 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 276 MR Protocol Building and Optimization- STEP Week 4 Cardiac Short Axis SIEMENS Healthineers ... Planning Adaptions (4 of 6) Number of ‘Short Axis Subset’ slices: Parameters Three (3) Slices can be pre-defined (basal, mid, & apical). Queue Number of "Shortaxis Subset" slices 4 + GSP Slice distance of "Shortaxis All" slices 10.00 mm Series Label Slice Distance of ‘Short Axis All’ slices: Auto Load Adapt slice distance for exact coverage A Slice Thickness of 8mm and a Distance Factor of 25% AutoTiming Snap "Shortaxis Subset" slices to "Shortaxis All" slices Short Axis Config corresponds to a Slice Distance of 10 mm. Guidance for "Shortaxis All" Cardiac Config Guidance for "Shortaxis Subset" Adapt Slice Distance for exact coverage: Tooltip • Activate to adapt the Distance Factor for exact coverage of left ventricle from base to apex. • Deactivate to keep Slice Distance constant. Snap ‘Short Axis Subset’ slices to ‘Short Axis All’ slices can be set as the default. Guidance for ‘Short Axis All’ and ‘Short Axis Subset’ can be modified. 33 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 277 MR Protocol Building and Optimization- STEP Week 4 Cardiac Short Axis SIEMENS Healthineers ... Planning (5 of 6) Define Short Axis Overlay Window: 7 sec | Auto @ 2 @ 1.6x1.6x6.0 mm3 @ 1.22 If the CINE 4-chamber results are not yet available and the things for Fun Parameters Define Short Axis step is opened by the User. An overlay window is displayed if enabled in the myExam Add-in Trun Delta Freq. Configurator, under Queue. Overlay Window Displayed: Please wait until calculation of previous step has been completed or close step by clicking 'Cancel". Appears when the previous step is configured with Proceed to next: On Image Reconstruction Finish and the User tries to open the next step before the reconstruction of the previous step has finished! Wait until previous step has finished and the window disappears or click Cancel to close the protocol. myExam Add-In Configurator Overlay Window Not Displayed: Queue Disable Copy&Go Button Default To avoid this overlay, set the previous step to Proceed to Series Labe Selles Lave Auto Load Proceed to next On Image Reconstruction Finish next: Normal. Show parameter-card at startup 34 Unrestricted © Siemens Healthineers, 2025 Notes 278 MR Protocol Building and Optimization- STEP Week 4 Cardiac Short Axis SIEMENS Healthineers ... Labeling (6 of 6) Short Axis Labeling: 12 cine_segmented_sax_b1 • Short Axis slices are labeled individually 13 cine_segmented_sax_b2 • Short Axis All slices are labeled SAX_b1, SAX_b2, etc. 14 cine_segmented_sax_b3 • Short Axis Subset slices are labeled SAX_b1s, SAX_b2s, etc. 15 cine_segmented_sax_b4 16 cine_segmented_sax_b5 The same numbers do not necessarily reflect the same slice positioning: 17 cine_segmented_sax_b6 SAX_b2 may be a basal CINE slice. 18 cine_segmented_sax_b7 SAX_b2s may be a mid-ventricular perfusion slice. 19 cine_segmented_sax_b8 20 cine_segmented_sax_b9 21 cine_segmented_sax_b10 22 cine_segmented_sax_b11 b = slice number 35 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 279 MR Protocol Building and Optimization- STEP Week 4 Cardiac Standard Add-in Cardiac Standard Add-in SIEMENS Healthineers ... Retrieve Slice Orientations and Positioning from Parameters Queue eart Views arameter Configuration the Exam Memory. GSP 2 Chamber Parameter Group Cine retrospective Series Label 3 Chamber Auto Load 4 Chamber Supports the User throughout the examination AutoTiming Cardiac Standard • CINE Cardiac Config • Dynamic • Delayed enhancement Add / Remove • Morphology Text for more ...- Guidance User-defined • Mapping Enables the definition of Heart Views and Parameter Groups. Heart Views – preselects the heart views to be created from the Supports retrieval of Slice Orientation and measurement. Heart View list is defined on the Slice Group Guidance Positioning from the Exam Memory. card of the Cardiac Patient View Add-In. Offers support for planning new Slice Orientations. Guidance Text can be added if required. Parameter Configuration – selects parameters to be displayed on the Guidance View of the Program Step. 36 Unrestricted © Siemens Healthineers, 2025 Notes 280 MR Protocol Building and Optimization- STEP Week 4 Cardiac Standard Add-in SIEMENS Healthineers .. Add/Remove Heart Views 1. Right Click one of the sequences already Settings for Function arameters Adding / Removing Views measured. 2. Choose Repeat and Open from the context menu. Heart Views Selectable Views Available Views 2 Chamber 2 Chamber Shortaxis All 3. Guidance View, click Add/Remove. 3 Chamber 3 Chamber Shortaxis Subset 4 Chamber 4 Chamber RVOT 4. Drag a new Heart View from Available Views to RV 2 Chamber Selectable Views list (or vice versa). Paracoronal LVOT Mitral Valve 5. Click OK – new view now appears in the Heart Tricuspid Valve Aortic Valve Views list. Pulmonary Valve User View 1 User View 2 User View 3 Selected views are available to be scanned for that Add / Remove step by clicking on the checkbox under Heart Views. OK Cancel Heart Views can be pre-configured in myExam Cockpit/Dot Cockpit or adapted during the examination. 37 Unrestricted © Siemens Healthineers, 2025 Notes 281 MR Protocol Building and Optimization- STEP Week 4 Cardiac Standard Add-in SIEMENS Healthineers' ... Plan Additional Heart Views 1. Click Plan – Guidance View opens, and guidance images are ettings for Function meters displayed (defined in Patient View). eart Views Parameters RV 2 Chamber No. of breathholds 2. Position Slices as shown in the Guidance images. CINE Mode Segmented 3. Click Confirm to complete the planning. a. Protocol step can only be applied after the user clicks Confirm for all available Heart Views. Add / Remove b. The additional Heart View is measured and stored in the Exam Memory for the remainder of the examination. 0 Plan all selected slice groups before proceeding Settings for Function rameters c. All following scans with this Heart View can be executed by the myExam Assist or Dot Engine automatically with no User interaction required. 4. Click Go to start the measurement. 4 chamber RV 2 Chamb 5. Press Cancel to cancel the planning. Position the slices as shown in ample images . Cancel Confirm Complete planning with Confirm 38 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 282 MR Protocol Building and Optimization- STEP Week 4 Cardiac Standard Add-in SIEMENS Healthineers ... Editing Heart Views Position, orientation, FoV, and number of Slices can be cardiac Dot Engine Cardiac Dot Engine Cardiac Dot Engine edited directly in the Graphic Slice Positioning (GSP) or 9 IMA1 FRM 6/15 A 1 FRM 212 in the protocol for Heart Views. All changes are stored in the Exam Memory and are ATR 10cm available in subsequent steps that use the same Heart View. TP F36 SP H4.7 TT 830.0 or (44)- Tra(35) TT 727.5 FoV 500*500 p2 MAGN/NORM/DIS20 p2 MAGN/NORM/DIS2D Tra>Saq(-41)>Cor(8) define_sax define_lax_2Ch_3Ch_4Ch W 1173 C Not for diagnostic use Not for diagnostic use 560 @ 1:07 min ; Auto @ 2 @ 1.5x1.5x6.0 mill? @ 1.00 Settings for Function aram rameters leart Views rameters No. of breathh 3 Chamber 4 Chamber CINE Mode Segmented Add / Remove 39 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 283 MR Protocol Building and Optimization- STEP Week 4 Cardiac Standard Add-in SIEMENS Healthineers ... Parameter Configuration Parameter Groups selects parameters to be myExam Add-In Configurator displayed on the Guidance View of the Program Step. Parameters Queue Heart Views Parameter Configuration Different parameter groups can be defined GSP 2 Chamber Parameter Group Cine prospective Series Label and have been optimized according to type 3 Chamber Cine retrospective Auto Load 4 Chamber Cine prospective of protocol. Dynamic Cardiac Standard Tissue characterization Cardiac Config None Morphology Parameters are visible in Assist View when Mapping protocol is opened in queue. Add / Remove ext for 'more ...- Guidance User-defined Close 40 Unrestricted © Siemens Healthineers, 2025 Notes 284 MR Protocol Building and Optimization- STEP Week 4 Cardiac Standard Add-in SIEMENS Healthineers ... Parameter Configuration > Parameter Group CINE Retrospective: CINE Prospective: Dynamic: No. of breath-holds. No. of breath-holds Scan Window - is the time needed CINE Mode. CINE Mode. to scan Guaranteed Slices). Acquisition window. Dynamic Type (Test, Stress, Rest). TR. Parameters Parameters Parameters CINE Mode Segmented Scan Window Dms No. of breath-hold Captured Cycle 800 + 0 Update Dynamic Type Test CINE Mode Acquisition Window 740 ms Captured Cycle Update Segmented 800 + 0 TR 37.29 ms 41 Unrestricted © Siemens Healthineers, 2025 Notes 285 MR Protocol Building and Optimization- STEP Week 4 Cardiac Standard Add-in SIEMENS Healthineers ... Parameter Configuration > Parameter Group Tissue Characterization: Morphology: Mapping: No. of breath-holds. Acquisition Window. Acquisition Window. TI. TR. Trigger Delay. Acquisition Window. TR. TR. Parameters Parameters Parameters TI 300 ms Captured Cycle 800 + 0 Update Captured Cycle 800 = 0 Update Captured Cycle :00 + 0 Update Acquisition Window 741 ms 740 ms Acquisition Window Acquisition Window 740 ms Trigger Delay 398 ms TR 740 ms TR 740 ms TR 342.2 ms 42 Unrestricted © Siemens Healthineers, 2025 Notes 286 MR Protocol Building and Optimization- STEP Week 4 Cardiac Standard Add-in SIEMENS Healthineers ... Parameter Group Dynamic Heart Views – Guaranteed or Optional Settings for Dynamic Imaging|Parameters Enables categorization of slices for Dynamic imaging. Heart Views Parameters Guaranteed Scan Window 506.4 ms Guaranteed Slices: these views are always measured, Shortaxis Subset B1 Dynamic Type Stress irrespective of the RR interval. Shortaxis Subset B2 Shortaxis Subset B3 Captured Cycle 0 + 0 Update Optional Optional Slices: these views can only be measured if the Shortaxis Subset B4 4 Chamber RR interval is long enough. • Scan Window displays the time required to measure the Guaranteed Slices Add / Remove • Modify the Slices using Drag&Drop • Supported by Adaptive Triggering Reduce number of guaranteed slices to avoid skipping heart beats 43 Unrestricted © Siemens Healthineers, 2025 Notes 287 MR Protocol Building and Optimization- STEP Week 4 Cardiac Standard Add-in SIEMENS Healthineers ... Adaptive Triggering Adaptive Triggering Motivation is used for dynamic Routine Contrast Resolution Geometry System Physio Inline Sequence Perfusion imaging to scan as many slices as possible in Signal | Cardiac PACE each RR interval, without missing any heartbeats. Ist Signal/Mode ECG/Trigger Average Cycle No Signal ms Adaptive Triggering Implementation Captured Cycle not set- Groups of Cardiac Views into Guaranteed Slices and Acquisition Window 700 m 0.8 1.6 4[s] Trigger Pulse 1 + Concatenations Optional Slices, when enabled, ensure: Trigger Delay 0 - ms • Only measured if they fit into the actual RR interval. Phases • Define the order the slices are measured TR 168.8 ms Adaptive Triggering M • Implemented in all dynamic scans in the Cardiac Segments 64 Trigger Lock Time 300 ms myExam Assist and Dot Engine workflows • Located in the Physio>Signal parameter card 44 Unrestricted © Siemens Healthineers, 2025 Notes 288 MR Protocol Building and Optimization- STEP Week 4 Cardiac Standard Add-in SIEMENS Healthineers ... Adaptive Triggering Without Adaptive Triggering a complete RR interval may be missed. This occurs when a slice is still being measured when the next R-wave arrives. Without Adaptive Triggering Common in Dynamic Perfusion imaging during stress. Results in loss of temporal information of contrast passage through the myocardium. The User must be conservative when planning the number of slices (i.e., meaning less slices are planned to avoid loss of first pass perfusion temporal information). 45 Unrestricted © Siemens Healthineers, 2025 Notes 289 MR Protocol Building and Optimization- STEP Week 4 Cardiac Standard Add-in SIEMENS Healthineers ... Adaptive Triggering With Adaptive Triggering the User can plan more slices by categorizing them. • Guaranteed • Optional Loss of temporal information can be avoided. Without Adaptive Triggering Optional slices are only acquired when the RR interval is long enough. Can only be defined in the myExam Cardiac Assist or the Cardiac Dot Engine. Guaranteed slices Optional slices With Adaptive Triggering 46 Unrestricted © Siemens Healthineers, 2025 Notes 290 MR Protocol Building and Optimization- STEP Week 4 Cardiac Assist Workflows Cardiac Assist SIEMENS Healthineers ... Workflows myExam Cardiac Assist workflows: Ventricular Function. [] heart Library. [ Cardiac Assist E Ventricular Function El library 47 Unrestricted © Siemens Healthineers, 2025 Notes 291 MR Protocol Building and Optimization- STEP Week 4 Ventricular Function myExam Cardiac Assist SIEMENS Healthineers ... Ventricular Function (VF) Localizers follow the standard center on heart workflow. Cardiac Assist @ Cardiac Patient View V breath-hold Realtime Beat Sensor Training Step (if selected in Patient View): localizer 00:01 If the Beat Sensor is available, then the customer needs to center on heart perform the Beat Sensor training step prior to using the Table Positioning Strategy localizer_heart 00:05 Beat Sensor triggering. Cardiac Basic Implemented into all Cardiac Assist workflows. Beat Sensor Training yes Beat Sensor training bh 00:14 Morphological overview Thorax_cor_tra: O Cardiac Basic thorax_cor_tra 00:29 Overview of the entire chest. O Cardiac Basic Single-Shot HASTE. AAheart_scout 00:12 O Cardiac Basic define_lax 00:01 O Cardiac Marker Localization cine_segmented_lax 00:14 cine_realtime_lax 00:01 Cardiac Standard Cardiac Standard define_sax 00:01 O Cardiac SAX Planning cine_segmented_sax 00:11 cine_realtime_sax 00:01 Cardiac Standard Cardiac Standard 48 Unrestricted © Siemens Healthineers, 2025 Notes 292 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers .. Ventricular Function (VF) Breath-hold Strategy: Cardiac Assist Cardiac Patient View Segmented CINE acquired with higher temporal/spatial V breath-hold Realtime resolution. ocalizer 00:01 Multiple heartbeats per image. center on heart C Table Positioning Strategy localizer heart 00:05 Realtime Strategy: O Cardiac Basic Realtime CINE acquired with lower temporal/spatial Beat Sensor Training resolution. yes Beat Sensor training bh 00:14 One heartbeat per image. Cardiac Basic thorax_cor_tra 00:29 O Cardiac Basic Frequency scout: AAheart scout 00:12 Cardiac Basic Workflow Decision only @ 3T. define_lax 00:01 Adjust offset frequency to move TrueFISP banding artifacts Cardiac Marker Localization cine_segmented_lax 00:14 cine_realtime_lax 00:01 outside region of interest. Cardiac Standard Cardiac Standard Enables repeat of CINE LAX with optimized TrueFISP delta define_sax 00:01 Cardiac SAX Planning frequency. cine_segmented_sax 00:11 cine_realtime_sax 00:01 Cardiac Standard O Cardiac Standard 49 Unrestricted © Siemens Healthineers, 2025 Notes 293 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers' ... Inline Ventricular Function (VF) After all the SAX CINE images have been acquired the Inline Ventricular Function evaluation is performed. • Automatic base plane definition due to consideration of mitral valve level on SAX and LAX views (based on landmarks) for all cardiac phases • Epicardial and Endocardial contours are automatically segmented on SAX views In-line VF produces the following images in the database. • Series with segmented images used in the evaluation • Result table with quantitative functional parameters • LAX mosaic images with ED and ES images of all evaluated slices • SAX mosaic images with ED and ES images of all evaluated slices 50 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 294 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers' ... Inline Ventricular Function (VF) (2 of2) Series with segmented images used in evaluation Result Table HLA FAR HLA Left Ventricular Function Absolut Normalized Ejection Fraction EF 60 % End Diastolic Volume EDV 168 ml EDVI 91 ml/m2 End Systolic Volume ESV 67 ml ESVI 37 ml/m2 Stroke Volume SV 101 ml SVI 55 ml/m2 Cardiac Output CO 6.0 l/min CI 3.3 l/min/m2 Average Heart Rate HR 59 bpm ARH RPF ARH Average Myocardial Mass LVM 93.8 g LVMI 50.9 g/m2 Std. Dev. Myocardial Mass SD 5.1 g SDI 2.8 g/m2 Myocardial Mass at ED LVM ED 90.3 g LVMI ED 49.0 g/m2 *Normalized to body surface area BSA 1.84 m2 Patient Height H Patient Weight 73 kg Check ED & ES. Computer estimated ED & ES settings may not be accurate. Chee Check contours. Computer generated contours may not correspond to anatomy. Results may be different in MR Cardiac Function. 51 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 295 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers ... Inline Ventricular Function (VF) After all the SAX CINE images have been acquired the Inline Ventricular Function evaluation is performed. • Automatic base plane definition due to consideration of mitral valve level on SAX and LAX views (based on landmarks) for all cardiac phases • Epicardial and Endocardial contours are automatically segmented on SAX views In-line VF produces the following images in the database. • Series with segmented images used in the evaluation • LAX mosaic images with End Diastole (ED) and End Systole (ES) images of all evaluated slices 52 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 296 MR Protocol Building and Optimization- STEP Week 4 Ventricular Function SIEMENS Healthineers ... Inline Ventricular Function (VF) In-line VF produces the following images in the database. Series with segmented images used in the evaluation. Result Table with quantitative functional parameters. Left Ventricular Function Absolute Normalized* Ele Ejection Fraction EF End-Diastolic Volume EDV 89 ml EDVI 53 ml/m2 End-Systolic Volume ESV 29 ml ESVI 17 ml/m2 Stroke Volume SV 60 ml SVI 36 ml/m2 Cardiac Output CO 4.8 l/min CI 2.8 l/min/m2 Average Heart Rate 79 bpm Average Myocardial Mass Aver LVM 72.9 g LVMI 43.6 g/m2 Std. Dev. Myocardial Mass SD 2.9 g SDI 1.7 g/m2 Myocardial Mass at ED LVM ED 69.4 g LVMI ED 41.5 g/m2 *Normalized to body surface area BSA 1.67 m2 Patient Height 1.55 m Patient Weight 68 kg Check ED & ES. Computer estimated ED & ES settings may not be accurate. Check contours. Computer generated contours may not correspond to anatomy. Results may be different in MR Cardiac Function. 53 Unrestricted © Siemens Healthineers, 2025 Notes 297 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers ... Inline Ventricular Function (VF) The Slices that are repeated in the subsequent protocol General @ 5 sec ¡ Auto @ 3 @ 1.5x1.5x8.0 mm3 1.00 Protocol Parameters Routine Contrast Resolution Geometry System Physio Inline Sequence steps replace the series already measured. The Slices Voice Commands Dynamic Subtraction Cardiac MIP| Composing Execution that are added in subsequent protocol steps are added Image Management Inline Evaluation Ventricular F ... Auto Load Off to the Inline VF evaluation. In both cases a new Save Original Images Copy References Ventricular Function Preview Magn. Preparation Restart InlineVF evaluation is performed. Off is used when scanning a non-standard LAX view, Contrasts 14 (e.g., LVOT or RV 2-chamber). In this case, it is TE 1.46 ms recommended to turn off Inline Evaluation. TR 46.5 ms Restart Inline VF: Ability to reset the Inline VF process. • Inline VF algorithm differs from ARGUS 2D and takes the Only slices acquired in subsequent acquisitions are used base plane into account. Results may differ from those to generate results. obtained in ARGUS 2D. If the complete stack of SAX slices is repeated, it is • Inline VF algorithm is the same as syngo.via MR Cardiac recommended to Restart Inline VF. Function (slight differences depending on software version). 54 Unrestricted © Siemens Healthineers, 2025 Notes 298 MR Protocol Building and Optimization- STEP Week 4 Cardiac Flow Protocols Cardiac Flow add-in1 SIEMENS Healthineers ... Cardiac Dot Engine & myExam Cardiac Assist – features Cardiac examinations used to be the most complex myExam Cardiac Assist – Features: exams in MR. The myExam Cardiac Assist support the • Anatomical landmarks user in many ways. • Standard Views of the Heart (e.g., dedicated Long-Axis and Short-Axis view) Since XA20 software, the Cardiac Dot Engine has been • Supports blood flow measurements extended to support blood flow measurements. • Para-coronal left ventricular outflow Tract (LVOT), Mitral valve and Aortic valve (at end of Systole) are Cardiac Dot Engine – Features: automatically planned • Anatomical landmarks • Standard Views of the Heart (e.g., dedicated long-axis Workflow for valves consist of: and short-axis view) generated and reproduced readily • Defined step using different scanning techniques • CINE acquisition based on a FLASH sequence to measure valve opening • VENC scout • Flow Quantification measurement 55 Unrestricted © Siemens Healthineers, 2025 Notes 299 MR Protocol Building and Optimization- STEP Week 4 Flow protocols SIEMENS Healthineers ... myExam Cockpit > Cardiac Assist myExam Cockpit - Explorer myExam Cockpit > Cardiac Assist > Library Explorer Program Editor Browse Import Export Edit Simulate CS CINE FLASH protocols available with Compressed X Sensing (CS) license. SIEMENS >> heart >> Cardiac Assist >> library Ldluide Lailudiu flow mitral valve define_mitralvalve 00:01 [ head O Cardiac Standard c-spine cine_segmented_mitralvalve 00:15 t-spine Cardiac Standard I-spine flow_venc-scout_tp_bh_mitralvalve 00:07 > whole-spine Cardiac Flow flow_tp_retro_bh_mitralvalve 00:11 > neck soft tissue Cardiac Flow [] thorax cine_cs_segmented_mitralvalve 00:12 Cardiac Standard Cardiac Assist flow aortic valve E Ventricular Function_ E IschemicHeartDisease_ cine_segmented_Ivot 00:09 Cardiac Standard E Myocarditis define_aorticvalve 00:01 E GOHeart FreeBreathing_ Cardiac Standard E GOHeart IschemicHeartDisease cine_segmented_aorticvalve 00:15 E library + Cardiac Standard flow_venc-scout_tp_bh_aorticvalve 00:07 localizer Cardiac Flow morphology flow_tp_retro_bh_aorticvalve 00:11 function Cardiac Flow dynamic cine_cs_segmented_aorticvalve 00:12 tissue characterization Cardiac Standard 56 Unrestricted © Siemens Healthineers, 2025 Notes 300 MR Protocol Building and Optimization- STEP Week 4 Cardiac Flow Add-in1 SIEMENS Healthineers .. Features Cardiac Flow measurements require imaging at Isocenter flow mitral valve for reliable quantification. define_mitralvalve 00:0 Cardiac Flow Add-in: • Can only be attached to flow protocols (BEAT_FQ) Cardiac Standard FoV is automatically moved to Isocenter for the cine_segmented_mitralvalve 00:26 • respective protocols Cardiac Standard Subsequent scans the table goes back to the general flow_venc-scout_tp_bh_mitralvalve 00:07 • cardiac imaging position automatically, new shims are Cardiac Flow unnecessary flow_tp_retro_mitralvalve 00:13 Automatic positioning if the imaging plane is supported Cardiac Flow • for Aortic and Mitral valve views 57 1Available for the MAGNETOM Avanto fit and the Skyra fit with Numaris XA61; Pre-requisite: myExam Cardiac Assist Unrestricted © Siemens Healthineers, 2025 Notes 301 MR Protocol Building and Optimization- STEP Week 4 Cardiac Flow1 SIEMENS Healthineers ... myExam Add-in Configurator myExam Add-in Configurator: myExam Add-In Configurator Cardiac Flow card defines the Heart views for the flow measurement that can be added to a Parameters myExam Cardiac Assist workflow. Queue Heart View Mitral Valve GSP Aortic Valve Series Label Mitral Valve Auto Load Pulmonary Valve Heart View defines the heart valve through Tricuspid Valve Auto Timing User Flow View 1 which the volumetric flow is measured. Cardiac Config User Flow View 2 Cardiac Flow User Flow View 3 • Aortic valve (automatic planning) User Flow View 4 • Mitral valve (automatic planning) • Pulmonary valve • Tricuspid valve • User Flow View 1 • User Flow View 2 • User Flow View 3 User Flow View 4 Close • 58 1Available for the MAGNETOM Avanto fit and the Skyra fit with Numaris XA61; Pre-requisite: myExam Cardiac Assist Unrestricted © Siemens Healthineers, 2025 Notes 302 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac SIEMENS Healthineers ... Flow protocols – Go to Isocenter Flow protocols are scanned at Cardiac Flow Assist LOC Y + Position Isocenter. localizer 00:03 Position Mode L-P-H 2 % center on heart R 15.7 mm The global positioning mode (LOC) localizer_heart 00:14 P 5.0 mm A thorax_cor_tra 00:40 H 0.0 mm remains unchanged. AAheart_scout 00:18 able Position H 0 mm Go to Isocenter A define_lax 00:01 Flow protocols are stored with Go to cine_segmented_lax 00:14 Isocenter enabled (Routine > Mitral- Close Position “ … ” parameter). 9 % define_mitralvalve 00:01 10 cine_segmented_mitralvalve 00:12 11 flow_venc-scout_tp_bh_mitral ... 00:21 Continue with further cardiac 12 % flow_tp_retro_bh_mitralvalve 00:13 measurements in the LOC mode 203:02 after the flow measurements are Delete Pause Continue Copy&Go Go Cancel finished. 59 Unrestricted © Siemens Healthineers, 2025 Notes 303 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac SIEMENS Healthineers ... Flow protocols – Define step Define step is executed for the mitral valve and aortic myExam Cockpit - Explorer Explorer Program Editor valve views prior to the acquisition of the actual clinical Browse Import Export Edit Simulate images. X SIEMENS .. >> heart >> Cardiac Assist >> library flow mitral valve This is a large FoV localizer and supports: define_mitralvalve 00:01 [ head Optimal size FoV. Cardiac Standard c-spine cine_segmentea_mitraivaive 00:15 Optimal In-plane rotation. t-spine Cardiac Standard I-spine flow_venc-scout_tp_bh_mitralvalve 00:07 > whole-spine Cardiac Flow flow_tp_retro_bh_mitralvalve 00:11 > neck soft tissue Cardiac Flow >thorax cine_cs_segmented_mitralvalve 00:12 [ heart Cardiac Standard Cardiac Assist flow aortic valve E Ventricular Function_ cine_segmented_Ivot 00:09 El IschemicHeartDisease_ Cardiac Ctandard E Myocarditis_ define_aorticvalve 00:01 E GOHeart FreeBreathing_ Cardiac Standard E GOHeart IschemicHeartDisease_ cine_segmented_aorticvalve 00:15 E library Cardiac Standard flow_venc-scout_tp_bh_aorticvalve 00:07 localizer Cardiac Flow morphology flow_tp_retro_bh_aorticvalve 00:11 function Cardiac Flow dynamic cine_cs_segmented_aorticvalve 00:12 tissue characterization Cardiac Standard 60 Unrestricted © Siemens Healthineers, 2025 Notes 304 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac SIEMENS Healthineers ... Flow protocols – CINE measurements The CINE measurements for aortic valve and mitral valve myExam Cockpit - Explorer O x Explorer rogram Editor are set up with a FLASH technique to view and measure Browse Import Export Edit Simulate the valve opening. X Q Q SIEMENS ... > heart >> Cardiac Assist > library _ flow mitral valve__ Optimal Contrast. define_mitralvalve 00:01 [ head Cardiac Standard c-spine cine_segmented_mitralvalve 00:15 Reduced Flow artifacts. t-spine + Cardiac Standard CI-spine flow_venc-scout_tp_bh_mitralvalve 00:07 > whole-spine O Cardiac Flow flow_tp_retro_bh_mitralvalve 00:11 > neck soft tissue CINE LVOT for planning purposes with TrueFISP contrast. Cardiac Flow > thorax cine_cs_segmented_mitralvalve 00:12 heart Cardiac Standard Cardiac Assist flow aortic valve E Ventricular Function_ 00:09 E IschemicHeartDisease_ cine_segmented_Ivot Cardiac Standard E Myocarditis_ denne_dorticvalve UU.UT E GOHeart FreeBreathing_ @ Cardiac Standard E GOHeart IschemicHeartDisease_ cine_segmented_aorticvalve 00:15 E library Cardiac Standard flow_venc-scout_tp_bh_aorticvalve 00:07 localizer Cardiac Flow morphology flow_tp_retro_bh_aorticvalve 00:11 function Cardiac Flow dynamic cine_cs_segmented_aorticvalve 00:12 tissue characterization Cardiac Standard 61 Unrestricted © Siemens Healthineers, 2025 Notes 305 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac SIEMENS Healthineers ... Flow protocols – VENC scout The VENC scout is used to find the SIEMENS > heart >> Cardiac Assist > library >> flow_venc-scout_tp_bh_mitralvalve ? x General appropriate VENC value for the subsequent 21 sec | Auto @ 2 @ 2.0x2.0x6.0 mm3 1.00 Protocol Parameters Settings for Flow arameter flow measurements. Voice Commands Execution Heart Viev Mitral Valve Image Management Aortic Valve Default Auto Load Encodings Make sure the Velocity Encoding values are Mitral Valve suitable for the current study. Conv References Velocity enc. [cm/s] Pulmonary Valve Encodings = 4 different Preview Tricuspid Valve In the event of Velocity Encodings vary depending on the User Flow View 1 aliasing, increase the Velocity User Flow View 2 Encoding values selected Heart View. User Flow View 3 insufficient contrast, decrease the User Flow View 4 Velocity Encoding values Addin Configuration ... OK Cancel 62 Unrestricted © Siemens Healthineers, 2025 Notes 306 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac SIEMENS Healthineers ... Flow protocols – Flow measurements Mitral valve Heart View protocol has a SIEMENS > heart >> Cardiac Assist > library >> flow_venc-scout_tp_bh_mitralvalve ? x General default VENC of 100 cm/s. 21 sec 1| Auto @ 2 @ 2.0x2.0x6.0 mm3 1.00 Protocol Parameters Settings for Flow arameter Voice Commands Execution Aortic valve Heart View protocol has a Heart View Mitral Valve Image Management default VENC of 150 cm/s. Encodings Aortic Valve Auto Load Make sure the Velocity Encoding values are Mitral Valve Velocity enc. [cm/s] | Pulmonary Valve suitable for the current study. Conv References Preview Tricuspid Valve In the event of User Flow View 1 aliasing, increase the Velocity User Flow View 2 Encoding values User Flow View 3 insufficient contrast, decrease the User Flow View 4 Velocity Encoding values Addin Configuration ... OK Cancel 63 Unrestricted © Siemens Healthineers, 2025 Notes 307 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac SIEMENS Healthineers ... Flow protocols – Mitral Valve workflow 1. Define Mitral valve. myExam Cockpit - Explorer Explorer 2. CINE FLASH segmented Mitral valve. Program Editor Browse Import Export Edit Simulate 3. VENC scout Mitral valve (60-150 cm/s). X Q >heart >> Cardiac Assist >> library 4. Flow measurement Mitral valve. SIEMENS flow mitral valve__ a. Mitral valve position is determined from a Q define_mitralvalve 00:01 [ head minimum of one LAX CINE view (e.g., 4 chamber Cardiac Standard [ c-spine cine_segmented_mitralvalve 00:15 CINE). [ t-spine Cardiac Standard [ l-spine flow_venc-scout_tp_bh_mitralvalve 00:07 b. CS CINE FLASH Mitral valve protocol available if the >whole-spine Cardiac Flow flow_tp_retro_bh_mitralvalve 00:11 > neck soft tissue customer has a CS license Cardiac Flow > thorax cine_cs_segmented_mitralvalve 00:12 [ heart Cardiac Standard Cardiac Assist flow aortic valve E Ventricular Function_ cine_segmented_Ivot 00:09 E IschemicHeartDisease_ Cardiac Standard E Myocarditis_ define_aorticvalve 00:01 E GOHeart FreeBreathing_ + Cardiac Standard E GOHeart IschemicHeartDisease cine_segmented_aorticvalve 00:15 E library Cardiac Standard flow_venc-scout_tp_bh_aorticvalve 00:07 localizer Cardiac Flow morphology flow_tp_retro_bh_aorticvalve 00:11 function Cardiac Flow dynamic cine_cs_segmented_aorticvalve 00:12 tissue characterization Cardiac Standard 64 Unrestricted © Siemens Healthineers, 2025 Notes 308 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac SIEMENS Healthineers ... Flow protocols – Aortic Valve workflow 1. CINE TrueFISP LVOT. myExam Cockpit - Explorer 2. Define Aortic valve. Explorer Program Editor Browse Import Export Edit Simulate 3. CINE FLASH Aortic valve. X Q Q 4. VENC scout Aortic valve (100-190 cm/s). SIEMENS >heart > Cardiac Assist > library flow mitral valve 5. Flow measurement Aortic valve. define_mitralvalve 00:01 [ head a. LVOT position is calculated in AAHeart_scout step. Cardiac Standard [ c-spine cine_segmented_mitralvalve 00:15 b. Automatic planning calculates the slice position and [ t-spine Cardiac Standard > I-spine flow_venc-scout_tp_bh_mitralvalve 00:07 orientation (FoV and in-plane rotation are not > whole-spine Cardiac Flow flow_tp_retro_bh_mitralvalve 00:11 > neck soft tissue optimized). Cardiac Flow thorax cine_cs_segmented_mitralvalve 00:12 [ heart 4 Cardiac Standard c. Aortic valve position is determined from 3 chamber Cardiac Assist flow aortic valve and LVOT CINE views. E Ventricular Function_ Line_segmented_Ivo 00:09 E IschemicHeartDisease_ Cardiac Standard E Myocarditis efine_aorticvalve 00:01 E GOHeart FreeBreathing_ + Cardiac Standard E GOHeart IschemicHeartDisease tine_segmented_aorticvalve 00:15 E library Cardiac Standard low_venc-scout_tp_bh_aorticvalve 00:07 localizer Cardiac Flow morphology low_tp_retro_bh_aorticvalve 00:11 function O Cardiac Flow dynamic [ine_cs_segmented_aorticvalve 00:12 tissue characterization Cardiac Standard 65 Unrestricted © Siemens Healthineers, 2025 Notes 309 MR Protocol Building and Optimization- STEP Week 4 Library myExam Cardiac Assist SIEMENS Healthineers .. Library The Library contains a CS CINE 2D single-shot moco fb. flow aortic valve_ variety of protocols with cine_cs_2_shot_lax 00:05 Cardiac Standard de_tfl_high-res_psir_fb_lax 00:34 cine_segmented_Ivot 00:09 Cardiac Add-in‘s. cine_cs_2_shot_sax 00:05 Cardiac Standard Cardiac Standard Cardiac Standard cine_cs_rt_adapt_trig_lax 00:02 de_tfl_high-res_psir_fb_sax 00:34 define_aorticvalve 00:01 Add-in‘s: O Cardiac Standard Cardiac Standard cine_cs_rt_adapt_trig_sax 00:02 Cardiac Standard Cardiac Standard, Cardiac Standard de_tfl_overview_psir_fb_sax 00:24 cine_segmented_aorticvalve 00:15 myomaps Cardiac Standard Cardiac Basic, Cardiac Cardiac Standard t1map_long_t1 00:09 flow mitral valve flow_venc-scout_tp_bh_aorticvalve 00:07 Flow, etc. Cardiac Standard + Cardiac Flow t1 map_short_t1 00:09 Cardiac Standard define_mitralvalve 00:01 flow_tp_retro_bh_aorticvalve 00:11 Add-in‘s are easy to t2map_flash 00:07 Cardiac Flow Cardiac Standard Cardiac Standard 00:12 modify, and it is easy to morphology cine_segmented_mitralvalve cine_cs_segmented_aorticvalve 00:15 Cardiac Standard create your own Assist t1_tse_db 00:08 Cardiac Standard Cardiac Standard workflows. flow venc-scout_tp_bh_mitralvalve 00:07 t2_tse_db 00:05 Cardiac Standard + Cardiac Flow t2_stir_db 00:06 Cardiac Standard flow_tp_retro_bh_mitralvalve 00:11 TI-scout Cardiac Flow ti-scout_cs cine_cs_segmented_mitralvalve 00:12 00:05 Cardiac Standard + Cardiac Standard 66 Unrestricted © Siemens Healthineers, 2025 Notes 310 MR Protocol Building and Optimization- STEP Week 4 myExam Cardiac Assist SIEMENS Healthineers ... TSE protocols As of XA30 TSE protocols are in the Cardiac [heart morphology Assist library with a Cardiac Standard Add-in. [ Cardiac Assist t1_tse_db 00:08 E Ventricular Function_ Configured for 2 chamber, 4 chamber and Cardiac Standard E IschemicHeartDisease_ t2 tse db 00:05 SAX subset Heart Views. E Myocarditis_ Cardiac Standard E GOHeart FreeBreathing_ t2_stir_db 00:06 Individual breath-hold for each slice. E GOHeart IschemicHeartDisease Cardiac Standard Combination of slices is not recommended El library (diminishes the dark blood effect). › localizer morphology function dynamic tissue characterization > [ MyoMaps flow 67 Unrestricted © Siemens Healthineers, 2025 Notes 311 MR Protocol Building and Optimization- STEP Week 4 Day 3 SIEMENS Healthineers myExam Angio Assist MR myExam Cockpit & myExam Assist QR700021234 – Effective date 4/14/2025 Unrestricted © Siemens Healthineers, 2025 Notes 312 MR Protocol Building and Optimization- STEP Week 4 Agenda SIEMENS Healthineers ... myExam Angio Assist • Introduction • myExam Angio Assist Add-ins • myExam Angio Assist Configuration • Angio Assist Test Bous • Angio Assist Care Bolus • Advanced Angio Assist 2 Unrestricted © Siemens Healthineers, 2025 Notes 313 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist Objectives SIEMENS Healthineers ... At this end of this module, you should be able to: • Describe the features of myExam Angio Assist • List the myExam Angio Assist Add-ins • Explain myExam Angio Assist Configuration • Recall the features of Angio Assist Test Bous • Describe the features of Angio Assist Care Bolus • Identify Advanced Angio Assist 3 Unrestricted © Siemens Healthineers, 2025 Notes 314 MR Protocol Building and Optimization- STEP Week 4 Disclaimers SIEMENS Healthineers ... The information presented in the myExam Angio Assist course is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use their own learning, training, and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Medical Systems to be used for any purpose in that regard. Please refer to a Contrast Agent manufacturer's labeling, and instructions for use, for use of that Contrast Agent with an MRI exam. . 4 Unrestricted © Siemens Healthineers, 2025 Notes 315 MR Protocol Building and Optimization- STEP Week 4 Introduction myExam Angio Assist SIEMENS Healthineers ... Introduction Timing of the contrast injection is a Angio Assist challenging part of an angiographic exam. vessel_scout_neck test_bolus %% angio_f13d_cor_pre 00:18 Prepare Injector Angio Assist provides a simplified workflow angio_f13d_cor_post_arterial 199 4 00:18 for CE MRA, using Test Bolus or Care Bolus techniques for the protocol setup. Not for diagnostic use E 00:36 Test Bolus: GO @ 1:00 min & Auto @ None @ 0.8-0.8 Cancel Dot • Guidance: visualization of arterial and Position the test bolus slice on the carotid artery as shown in the example venous timing windows localizer and vessel scout Images on the left. Confirm the slice position by hitting the Go button. Start the acquisition and the • Optimized timing: supports planning test bolus contrast medium injection simultaneously. phase to acquire optimally timed contrast images with interactive bolus timing Care Bolus: Automatic bolus detection and start of the post-contrast scan automatically. 5 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 316 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Introduction – Key Features Guidance View offers step-by-step user Angio Dot Engine 1 MA 2 FRM UN guidance for each step of the workflow. ve Angio Assist 150 € 4 x angio_113d_cor_pre 5 Prepare injector Parameter View displays parameters needed for angio_113d_cor_post_arterial 402 2 00:18 scan setup. MAON/NORMDI820 localcher Test bolus offers a visual display of the arterial- 2 00:18 Not for diagnostic use @ 24 sec $ Auto @ 2 @ 0.9-0.9-0.9 mm' + 1.22 K Go Cancel venous timing window. Pause Continue Copy&Go Bolus Timing Parameters Feedback of bolus timing information is fed back Select Artery into planning steps and parameters can be adapted automatically. 0:24 Time to Center 5.0 9 : Timing Ofset AutoVoice Commands are integrated into the scanning workflow, at the right point in time. Customization for existing Assist Workflow can be modified by the user to suit individual needs. 6 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 317 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Introduction – Angio Assist Angio Assist Workflows are available in three regions: SIEMENS hip • Neck soft tissue knee • Abdomen 1% Q Angio Assist x ankle Peripheral angiography [ neck soft tissue [24] foot • Angio Assist [24] lower extremity Two techniques are configured into the workflow: E Test Bolus [11] >[ whole body oncology Test Bolus E Care Bolus [13] • clinical libraries whole body diffusion • Care Bolus library [ peripheral angiography [73] angiography [Angio Assist [73] angiography ce E Test Bolus [20] thorax E] Care Bolus [21] heart E] Advanced Care Bolus [16] breast E Advanced Test Bolus [16] abdomen [20] Abdomen Assist angiography Angio Assist [20] angiography ce E Test Bolus [10] El Care Bolus [10] 7 Unrestricted © Siemens Healthineers, 2025 Notes 318 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Test Bolus Neck Soft Tissue Abdomen Peripheral Angiography Angio Assist Angio Patient View Angio Assist Angio Patient View Angio Assist @ Angio Patient View Ill_angio_f13d_cor_abd_post 00:14 Standard High resolution v Standard Il_angio_f13d_cor_legs_post 00:18 localizer 00:12 V Standard Feet first - position 20cm / 7in above feet. localizer 00:23 I_angio_f13d_cor_feet_post 00:29 vessel_scout_neck 00:29 Generic Views localizer 01:11 TWIST feet Test Bolus tra 01:00 localizer_aorta 00:11 yes Basic Decision Generic Views Generic Views Vessel Scout TWIST feet O Basic Decision angio_113a_cor_pre 00:19 angio_113a_cor_nignres_pre UT:05 yes Test Bolus cor 01:31 yes O Angio Bolus Timing O Angio Bolus Timing Vessel Scout I_angio_twist_cor_iso_feet 02:16 Prepare injector. Prepare injector. Generic Views yes Generic Views angio_f13d_cor_pre 00:19 vessel_scout_peripheral 02:05 angio_f13d_cor_post_arterial 00:19 angio_f13d_cor_highres_post 01-05 O Angio Bolus Timing = Generic Vie Prepare injector. Test Bolus cor 01:31 Generic Views Ill_angio_f13d_cor_abd_pre 00:14 angio_f13d_cor_post_arterial 00:19 Angio Bolus Timing Il_angio_f13d_cor_legs_pre 00:18 angio_f13d_cor_post_venous 00:19 2 O Generic Views 1 L_angio_f13d_cor_feet_pre 00:29 3 angio_f13d_cor_post_equil. 00:19 Generic Views Check precontrast images, prepare injector. 8 Unrestricted © Siemens Healthineers, 2025 Notes 319 MR Protocol Building and Optimization- STEP Week 4 Angio Assist Add-ins myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Angio Patient View Soft Neck Tissue Strategies _MNO) > SIEMENS > neck soft tissue > Angio Assist > Test Bolus > Angio Assist • Standard: breath-hold scan General Parameters Breath-Hold Parameters • High resolution: free-breathing scan Exam Strategy Standard Auto Breath-Hold Commands V German (Germ ... ... Automatic Breath-hold Commands Pause Between Breath-Holds • Can be integrated into the scanning workflow System plays them automatically at the right Breath-Hold Commands x • point in time Before Scan Hold breath ( inhaled ). 9.1 s You can set the breath-hold commands After Scan Continue breathing 2.4 5 individually for each protocol step in the Step Properties window. Close 9 Unrestricted © Siemens Healthineers, 2025 Notes 320 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Generic View in Test Bolus Step Generic Views in Test Bolus Step provides visual Guidance Parameters guidance and text for the planning and execution of the Test Bolus scan. /12 Position the test bolus slice on the carotid artery as shown in the example localizer and vessel scout images on the left. Test Bolus Confirm the slice position by hitting the Go button. 1. Inject a small amount of contrast agent at the Start the acquisition and the test bolus contrast medium same injection rate as for the CE MRA. injection simultaneously. 2. A rapid 2D measurement (typically 40–80 images with a 1 second temporal resolution) is used to view the passage of the test bolus in the vicinity of the target vessel. 3. Start the test bolus measurement and localizer vessel_scout_neck contrast injection simultaneously. 4. Execution: Wait for user to start is configured. 10 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 321 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Generic View in Test Bolus Step Queue has been configured with Proceed to next – On Image Reconstruction Finish. Guidance Parameters Disable Copy& Go Button Default Queue Proceed to next On Image Reconstruction Finish GSP Series Label Show parameter-card at startup Auto Load ICE AutoCoverage AutoTiming Use Siemens Path (C:\Program Files\Siemens\Numaris\MriProductluceliceConfigurators) Use Customer Path (C:\ProgramDatalSiemens)NumarisMriCustomerilce) ICE program name 11 Unrestricted © Siemens Healthineers, 2025 Notes 322 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Angio Bolus Timing Angio Bolus Timing displays the vessel signal intensity versus time curves to determine the transit time of the test bolus. • Automatic suggested proposal for the correct timing of the data acquisition window • User can manually interact and adapt the data acquisition window relating to the time curves • Bolus Timing Tooltip shows length of breath-hold commands before and after the measurement Angio Assist Angio Patient View V Standard High resolution Select Artery Select Vein ] Finalize Protocol localizer 00:12 vessel_scout_neck 00:29 O Generic Views Hold breath (inhaled). (8.9s) Test Bolus tra 01:00 Generic Views ...................... angio_f13d_cor_pre 00:19 angio_f13d_cor_highres_pre 01:05 1 Angio Bolus Timing 2 Angio Bolus Timing Prepare injector. Prepare injector. 0:15 0:18 angio_f13d_cor_post_arterial 00:19 angio_f13d_cor_highres_post 01:05 1 2 Time to Center 5.0 s Timing Offset w 12 Unrestricted © Siemens Healthineers, 2025 Notes 323 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Angio Bolus Timing The measurement delay is used in the countdown timer after choosing the ROI from test bolus images. M Patient has Contrast Agent (Vol. 10.00) Agent Name Gd Catalog ... The quality of curve depends on patient’s physiology. If curves are not Volume 10.00 ml Total Dose satisfactory, draw new ROIs. Active Ingredient Dilution Concentration mg/ml Timing Break time O Select Artery Select Vein Finalize Protocol Total Time TTC=5s Countdown 25 s Auto Continue Start Countdown Timing offset=3s Injector Control Voice Commands 0:25 0:18 Before Scan Hold breath (inhaled). 8.9 Delay time=25s TA=18s After Scan Continue breathing. 2.7 s (for count down) Time to Center 5.0 + s Timing Offset BS 13 Unrestricted © Siemens Healthineers, 2025 Notes 324 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Angio Bolus Timing To ensure the measurement of the post-contrast sequence starts automatically, select the Auto Start checkbox in the Step Properties window. M Patient has Contrast Agent (Vol. 10.00) 1. Click Start and inject contrast simultaneously. Agent Name Gd Catalog ... 2. When countdown reaches 0 seconds, the arterial measurement starts Volume 10.00 ml Total Dose automatically (Voice before duration considered also). Active Ingredient Dilution SIEMENS >> neck soft tissue > Angio Assist >> Test Bolus> angio_f13d_cor_post_arterial Concentration mg/ml General Timing Protocol Parameters Start measurement without further preparation Voice Commands Break tim Wait for User to Start otal Time Execution O Image Management . Single Measurement Countdown 25 s Auto Load Repeated Measurement Auto Continue Copy References Start Countdown V Auto Start Prio Recon Injector Control Voice Commands Auto Open Inline Display 8.9 s Auto Close Inline Display Before Scan Hold breath (inhaled). After Scan Continue breathing. 2.7 5 Auto Open Contrast Injector Dialog 14 Unrestricted © Siemens Healthineers, 2025 Notes 325 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Angio Bolus Timing – Timing Offset Timing Offset Select Artery Select Vein Finalize Protocol On the update of the arterial signal intensity versus time curve, the system adapts the position of the data acquisition window relative to the time curve. Set the Timing Offset to 0 seconds to position the data acquisition window so the k-space center is acquired at 0:25 0:18 the peak of the test bolus arterial phase. Time to Center 5.0 + S Timing Offset 3 S Example: • If you set the Timing Offset to 2 seconds • Data acquisition window shifts accordingly, so the center of k-space is acquired at 2 seconds after the peak signal intensity of the test bolus arterial curve 0:18 0:18 Timing offset=0s Timing offset=2s 15 Unrestricted © Siemens Healthineers, 2025 Notes 326 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Angio Bolus Timing – Timing Offset Why do we need the Timing Offset? No timing offset increases the risk of starting the scan too early. • True signal curve after the full bolus administration has a maximum peak later than the test bolus • Small changes in the patient’s physiology may lead to a later arrival of the second injection Timing Offset enables the user to adapt the timing by delaying the start of the scan. This allows for better adaptation to the expected signal curve after the full bolus administration. Acquisition time Time to center Arterial enhancement from Contrast full injection Arterial Injection enhancement from Test Bolus (1-2ml) Venous enhancement from TB Transit time Scan delay Timing offset Time (sec) 16 Unrestricted © Siemens Healthineers, 2025 Notes 327 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Angio Bolus Timing – Timing Offset What do we consider with the Timing Offset? Actual Bolus Actual Bolus Contrast Contrast Injection Injection .............. Test Bolus Test Bolus ........... .................................... Time (sec) Time (sec) Short Arterial Venous Delay Long Arterial Venous Delay 17 Unrestricted © Siemens Healthineers, 2025 Notes 328 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Angio Bolus Timing – Timing Offset versus TTC Shorter Time-to-Center (TTC) starts the acquisition later. Longer Time-to-Center (TTC) starts the acquisition earlier. The arteries are brighter, but more veins are visualized. The arteries are darker, but less veins are visualized. Time to center -> Time to center Actual Bolus Actual Bolus Contrast Contrast Injection Injection Test Bolus Test Bolus Test Bolus .............. .............. Timing offset Time (sec) Timing offset Time (sec) 18 Unrestricted © Siemens Healthineers, 2025 Notes 329 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Angio Bolus Timing – Carotid Arteries Carotid Arteries Example a, R "HA"" BHM - SkyLa 31 ID: 1698187 k-space center after arterial peak, but before too much /24/1951, F, 61Y ICHES 15842855 TUDY 15842855 POLEO JOSE R venous contrast. /21/2012 Start the acquisition as soon as possible, but not before arrival of arterial bolus. Time to center Contrast Injection Ocm Test Bolus MF 1.0 TE 1.2 BW 590.0 Timing offset Time (sec) :p2 MIP_COR/NORM/DIS2D/SUB DES A NE1,2;SP1,2 Co 25 19 Image on file Unrestricted © Siemens Healthineers, 2025 Notes 330 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Angio Bolus Timing – Timing Offset Default Values: HAR Memmingen BBA Feb04 ......... MR DIZ Neck soft tissue (Carotid): TTC=5s, Offset=3s. MR101142W-137 04.02.201 Abdomen: TTC=8s, Offset=6s. 13 MA 1 /1 Peripheral: TTC=5s, Offset=6s. Note: R These are default values and are not optimal values. 10cm Adjust the Time-to-Center (TTC) and Timing F 1.00 MF 1.00 TR 2.8 Offset to the patient and the facilities TE 1.1 TP HIS :TA 17.06 BW 750.0 TP H880 preference. 52 MIP_CORMORMIENS 2 DISUB SP A6.0 SL 87.36i p2 MIP_COR/NORM/DIS2D.FM./FIL SP A0.5 SL 104.0i V 248 330 DV 325*400 266p 512 A1/PFP 226p*352 FROM HFA;HEP;NF1,2 1.0 zes >Tra(-1.9) BO1-3;SP4-7 *f13d1 / 25 30ml K Cor W 2390 W 360 179 TTC 1s, Timing Offset unknown TTC 4s, Timing Offset 0s Too late – venous contamination Too early – no contrast in arteries 20 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 331 MR Protocol Building and Optimization- STEP Week 4 Configuration myExam Angio Assist SIEMENS Healthineers .. Angio Assist Add-ins – Angio Bolus Timing – Configuration Timing offset 7 Set the default value in the protocol. Parameters Queue Timing Offset 6 Smoothing GSP Check box to interpolate the data points of the Smoothing Series Label time curves in the display. Auto Load Skip 'Select vein' AutoCoverage Guidance "Select Artery" Skip “Select vein” AutoTiming Bolus Timing Guidance "Select Vein" Check box when venous signal versus time curve >Guidance "Finalize Protocol" is not required. 21 Unrestricted © Siemens Healthineers, 2025 Notes 332 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Angio Bolus Timing – Configuration Guidance: Select artery, Select vein, and Guidance "Select Artery" Layout 1 image Finalize protocol. E BA AA • Configurations of guidance images for Tooltip Mark the aorta on the test bolus image. positioning ROI for artery and vein, and positioning of 3D slab • Guidance images and text have been tailored to individual Angio Assists Guidance "Finalize Protocol" Note: Use of the Angio Bolus Timing Add-in is Layout 3 images not restricted to the Angio Assist Tooltip / Tooltip / Tooltip The Add-in accepts any series of test bolus images for signal intensity versus time curve evaluation. Position the 3D slab on the localizer images , ensuring a complete coverage of the entire region of interest . 22 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 333 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Angio Bolus Timing – Configuration Neck Soft Tissue – Execution. Angio Assist Angio Patient View V Standard High resolution localizer 00:12 SIEMENS >> neck soft tissue >> Angio Assist >> Test Bolus >> angio_f13d_cor_pre SIEMENS > neck soft tissue > Angio Assist > Test Bolu »angio_f13d_cor_post_arterial General General Protocol Parameters Start measurement without further preparation Protocol Parameters Start measurement without further preparation Voice Commands Wait for User to Start Voice Commands Wait for User to Start Execution DO Execution Image Management Single Measurement Image Management .Single Measurement Auto Load Repeated Measurement im Auto Load Repeated Measurement Copy References Auto Start Copy References v Auto Star Preview Prio Recon DO Prio Recon Auto Open Inline Display Auto Open Inline Display Auto Close Inline Display Auto Close Inline Display Auto Open Contrast Injector Dialog Auto Open Contrast Injector Dialog 23 Unrestricted © Siemens Healthineers, 2025 Notes 334 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Angio Bolus Timing – Configuration Abdomen – Execution. SIEMENS > abdomen > Angio Assist > Test Bolus Voice Commands implement a pause before venous and equilibrium phases, Angio Assist Angio Patient View switch to Use local settings. Standard SIEMENS >> abdomen >> Angio Assist >> Test Bolus >> angio_f13d_cor_post_arterial localizer 00:23 General Protocol Parameters No voice commands localizer_aorta 00:11 Voice Commands Generic Views Execution Use local settings Test Bolus cor 01:31 nagement Canaris MiQuic SIEMENS >> abdomen >> Angio Assist Test Bolus >> angio_f13d_cor_post_venous SIEMENS >> abdomen >> Angio Assis >> Test Bolus >> angio_f13d_cor_post_equil. General General Protocol Parameters No voice commands Protocol Parameters No voice commands Voice Commands Voice Commands Execution Use local settings Execution .Use local settings Image Management Voice commands 4) Automatic Image Management Auto Load Voice commands ) Automatic Before scan Hold breath (inhaled). Auto Load Copy References Copy References Before scan Hold breath (inhaled). After scan Continue breathing. After scan Continue breathing. Pause 5 + s Pause 15 24 Unrestricted © Siemens Healthineers, 2025 Notes 335 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist Add-ins – Angio Bolus Timing – Configuration Peripheral IV_angio_f13d_cor_abd_pre 00:17 Application Hint: post contrast protocols should have the same table Angio Bolus Timing move direction as the pre-contrast protocols. Ill_angio_f13d_cor_upper_legs_pre 00:14 Generic Views Ensure Copy reference everything is configured between pre and post Il_angio_f13d_cor_legs_pre 00:15 3 contrast measurement steps. + Generic Views L_angio_f13d_cor_feet_pre 00:2 Generic Views Prepare injector IV_angio_f13d_cor_abd_post 00:12 Ill_angio_f13d_cor_upper_legs_post 00:14 Il_angio_f13d_cor_legs_post 00:15 I_angio_f13d_cor_feet_post 00:25 25 Unrestricted © Siemens Healthineers, 2025 Notes 336 MR Protocol Building and Optimization- STEP Week 4 Care Bolus myExam Angio Assist SIEMENS Healthineers ... Angio Assist – Care Bolus Neck Soft Tissue Abdomen Peripheral Angiography Angio Assist . Angio Patient View Angio Assist Angio Patient View Angio Assist Angio Patient View Care Bolus 01:30 Standard High resolution O Care Bolus localizer V are Bolus Standard Ill_angio_f13d_cor_abd_post 00:14 00:17 localizer 00:23 Feet first - position 20cm / 7in above feet. Il_angio_f13d_cor_legs_post localizer_aorta 00:03 localizer 01:11 2 O Generic Views localizer_aorta 00:11 I_angio_f13d_cor_feet_post 00:29 vessel_scout_neck 00:29 Generic Views X localizer_aorta 00:10 TWIST feet angio_f13d_cor_pre 00:19 angio_f13d_cor_highres_pre angio_f13d_cor_pre 00:19 01:05 O Generic Views O Generic Views Vessel Scout yes Basic Decision Generic Views 2 Generic Views Check precontrast images, prepare injector. yes Basic Decision TWIST feel Check precontrast images, prepare injector. Vessel Scout yes I angio_twist_cor_iso_feet 02:16 Care Bolus 01:00 Care Bolus 01:00 Care Bolus 01:22 yes Generic Views Care Bolus 2 O Care Bolus Care Bolus vessel_scout_peripheral 02:05 angio_#13d_cor_post 00:19 angio_#13d_cor_highres_post 01:05 O Generic Views angio_#13d_cor_post_arterial 00:19 Ill_angio_f13d_cor_abd_pre 00:14 1 Generic Views angio_f13d_cor_post_venous 00:19 Il_angio_f13d_cor_legs_pre 00:18 1 2 Generic Views angio_f13d_cor_post_equil. 00:19 I_angio_f13d_cor_feet_pre 00:29 1 Generic Views Check precontrast images, prepare injector. Care Bolus 01:30 Care Bolus 26 Unrestricted © Siemens Healthineers, 2025 Notes 337 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers' ... Angio Assist – Care Bolus Fast, robust and standardized MRA exams. Guidance Parameters Text and image-based workflow guidance. 1. Select the slice with the best vessel visualization. 2. Position the ROI on the ascending aorta in the Automatic Bolus detection. 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- Inline processing tools: position closer to the table position line. Subtraction, and MIP generation. 3. If necessary, adjust the slice position for Care Bolus. 4. To correct, click on the red For Carotid Arteries position the Care Bolus ROI box. 5. Start Care Bolus ROI on the ascending aorta in the sagittal measurement first and then start the contrast oblique localizer slice. agent injection. 27 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 338 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist – Care Bolus Care Bolus Carotid Arteries MIP Subtraction image of the pre and post contrast agent measurements. The post contrast image was measured after the automatic bolus detection (TA= 1:01). 28 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 339 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers' ... Angio Assist – Care Bolus Peripheral Angiography Guidance Parameters The FastView localizer was replaced with a 3-step 1. Select the slice with the best vessel visualization. localizer @1.5T. 2. Position the ROI in this slice with a left mouse click. 3. If necessary, adjust the slice position for Care This applies to all contrast enhanced peripheral Bolus. 4. To correct, click on the red ROI box. If the ROI is angiography protocols. positioned too far from the isocenter, it will not be accepted. Please re- position closer to the table SIEMENS > peripheral angiography > Angio Assist >> Care Bolus SIEMENS >> peripheral angiography >> Angio Assist > Care Bolus position line. 5. Start Care Bolus measurement first and Angio Assist Angio Patient View Angio Assist Angio Patient View then start the contrast agent injection. V Standard V Standard Feet first - position 20cm / 7in above feet. Position 180mm above feet - Feet first localizer 01:11 FastView 00:32 localizer_aorta 00:10 localizer_aorta 00:22 Generic Views Generic Views Vessel Scout Vessel Scout yes Basic Decision yes Basic Decision 1.5T (XA51) 3T (XA50) 29 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 340 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Angio Assist – Care Bolus – Hints The Care Bolus slice is positioned in the same plane as the image orientation in which the ROI is defined. • If the ROI is defined on a Sagittal oblique slice, the Care Bolus measurement is acquired in a sagittal oblique orientation • If the ROI is defined on a Transverse slice, the Care Bolus measurement is acquired transversally The ROI cannot be positioned too far off-center. The Go button is dimmed if the ROI is outside of the homogeneous FoV. 30 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 341 MR Protocol Building and Optimization- STEP Week 4 Advanced Angio Assist myExam Angio Assist SIEMENS Healthineers .. Advanced Angio Assist – Peripheral Angiography Advanced Care Bolus was new with XA50. ankle foot Advanced Test Bolus was new with XA51. lower extremity whole body oncology whole body diffusion peripheral angiography Angio Assist E Test Bolus E Care Bolus E Advanced Care Bolus E Advanced Test Bolus angiography angiography ce spectroscopy intervention 31 Unrestricted © Siemens Healthineers, 2025 Notes 342 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Advanced Angio Assist – Care Bolus Advanced Angio Assist – Care Bolus SIEMENS >> peripheral angiography >> Angio Assist >> Care Bolus SIEMENS >> peripheral angiography >> Angio Assist > Advanced Care Bolus Angio Assist Angio Patient View Patient View Angio Advanced Patient View Standard V Feet first - position 20cm / 7in above feet. standard set-n-go protocols instead of individual stations: Feet first - position 20cm / 7in above feet. localizer 01:11 • Easier and faster planning FastVier 00:44 localizer_aorta 00-10 Whole Body FastView • Better overview Generic Views Vessel Scout localizer_aorta 00:10 yes Basic Decision Generic Views Vessel Scout Vessel Scout Automatic positioning and FoV adaptions are based on vessel_scout_peripheral 02:05 yes O Generic Views vessel_scout_peripheral 02:05 FastView localizer with Whole Body FastView add-in. Ill_angio_f13d_cor_abd_pre 00:14 Generic Views O Generic Views angio_f13d_cor_pre 00:48 Il_angio_f13d_cor_legs_pre 00:18 2 Angio Advanced Planning Generic Views I_angio_f13d_cor_feet_pre 00:29 Check precontrast images, prepare injector. Generic Views Check precontrast images, prepare injector. Care Bolus 01:30 O Care Bolus Care Bolus 01:30 O Care Bolus angio_f13d_cor_post 00:48 Ill_angio_f13d_cor_abd_post 00:14 TWIST feet Il_angio_f13d_cor_legs_post 00:18 ₭ yes Basic Decision I_angio_f13d_cor_feet_post 00:29 TWIST feet yes TWIST feet I_angio_twist_cor_iso_feet 02:16 ‚ yes O Basic Decision Generic Views TWIST feet yes I_angio_twist_cor_iso_feet 02:16 O Generic Views 32 Unrestricted © Siemens Healthineers, 2025 Notes 343 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Advanced Angio Assist – Care Bolus – Patient View If Auto Bolus Detection is enabled in the Patient General Parameters Breath-Hold Parameters View, only the first station of the planning has an automatic breath-hold command. Exam Strategy standard Auto Breath-Hold Commands English (United ... Same automatic bolus detection as the Angio Auto Bolus Detecti ... • Assist Care Bolus Vessel Scout yes Can only be used with feet-first positioning Coverage • Abdomen Legs Feet 33 Unrestricted © Siemens Healthineers, 2025 Notes 344 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Advanced Angio Assist – Care Bolus SIEMENS > peripheral angiography > Angio Assist > A Patient View @ Angio Advanced Patient View myExam Add-In Configurator V standard Feet first - position 20cm / 7in above feet. FastView 00:44 Whole Body FastView localizer_aorta Angio Advanced 00:10 O Generic Views Guidance FOV Vessel Scout Parameters HF-size 460 - mm System dependent FoV yes vessel_scout_peripheral 02:05 Queue Min. Overlap 100 - mm O Generic Views GSP angio_f13d_cor_pre 00:48 Auto Load Optimize Protocol v Automatic Protocol Adaptions Angio Advanced Planning Check precontrast images, prepare injector. AutoTiming Station Slices Thickness Base Resolut ... Care Bolus 01:30 Abdomen 96 1.3 352 O Care Bolus angio_f13d_cor_post 00:48 Legs 88 1.2 416 Feet 96 0.9 - 480 TWIST feet yes Basic Decision TWIST feet yes Langio_twist_cor_iso_feet 02:16 Generic Views 34 Unrestricted © Siemens Healthineers, 2025 Notes 345 MR Protocol Building and Optimization- STEP Week 4 Test Bolus myExam Angio Assist SIEMENS Healthineers ... Advanced Angio Assist – Test Bolus set-n-go protocols instead of individual stations: Angio Assist Angio Patient View Angio Advanced Assist @ Angio Advanced Patien ... Easier and faster planning Standard V standard • tion 20cm / 7in above feet. • Better overview Feet first - position 20cm / 7in above feet. localizer 01:11 Vessel Scout FastView 00:44 Basic Decision O Whole Body FastView Automatic positioning and FoV adaptions are based on Vessel Scout localizer_aorta 00:10 FastView localizer with Whole Body FastView add-in. vessel_scout_peripheral 02:05 O Generic Views O Generic Views Vessel Scout Test Bolus cor 01:31 yes 0 Generic Views Ill_angio_f13d_cor_abd_pre vessel_scout_peripheral 02:05 00:14 O Angio Bolus Timing O Generic Views Il_angio_f13d_cor_legs_pre 00:18 Test Bolus cor 01:31 2 Generic Views Langio_f13d_cor_feet_pre Generic Views 00:29 Generic Views angio_f13d_cor_pre 00:45 Check precontrast images, prepare injector. Angio Advanced Bolus Timing Ill_angio_f13d_cor_abd_post Prepare injector. 00:14 Il_angio_f13d_cor_legs_post 00:18 angio_f13d_cor_post 00:45 1 Langio_f13d_cor_feet_post 00-29 TWIST feet TWIST feet yes Basic Decision yes O Basic Decision TWIST feet TWIST feet yes yes I_angio_twist_cor_iso_feet 02:16 I_angio_twist_cor_iso_feet_post 01:41 Generic Views 35 Unrestricted © Siemens Healthineers, 2025 Notes 346 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Advanced Angio Assist – Test Bolus – Patient View If Auto Breath Hold Commands is enabled in the General Parameters Breath-Hold Parameters Patient View, only the first station of the planning has an automatic breath-hold command. Exam Strategy standard Auto Breath-Hold Commands V English (United ... Vessel Scout yes Can only be used with feet-first positioning Coverage Abdomen Legs Feet 36 Unrestricted © Siemens Healthineers, 2025 Notes 347 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers .. Advanced Angio Assist – Test Bolus – Patient View Same parameter table options as in the O 15 sec 1 Auto @ 2 1.3x1.3x1.3 mm3 @ 1.18 Advanced Care Bolus. Angio Advanced Bolus Timing Parameters Same Bolus Timing Curve as in the Angio Station TA[S] Slices Thickn .. Base Res .. Phase Re ... Slice Res .. Slice Ove. Abdomen 00:15 96 1.3 352 78.0 62.5 16.7 Assist Test Bolus. Legs 88 1.1 416 85.0 66.5 16.7 Feet 96 0.9 448 100.0 60.0 8.3 4 Time-to-Center refers to the first station Bolus Timing for Abdomen Time to Center 5.0 ¢ Timing Offset (abdomen). ................................... 0:19 0:15 37 Unrestricted © Siemens Healthineers, 2025 Notes 348 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Advanced Angio Assist – Test Bolus Angio Advanced Assist Angio Advanced Patien ... V standard Feet first - position 20cm / 7in above feet. Bolus Timing Configuration Timing Offset 2 FastView 00:44 Whole Body FastView localizer_aorta Smoothing 00:10 O Generic Views FOV Vessel Scout yes HF-size 460 - mm vessel_scout_peripheral 02:05 O Generic Views Min. Overlap 100 mm Test Bolus cor 01:31 O Generic Views Optimize Protocol M angio_f13d_cor_pre Angio Advanced Bolus Timing Prepare injector. Station Slices Thickness Base Resolut ... angio_f13d_cor_post 00:45 Abdomen 96 1.3 352 + Legs 88 - 1.1 416 TWIST feet yes Basic Decision Feet 96 0.9 480 + TWIST feet yes Langio_twist_cor_iso_feet_post 01:41 38 Unrestricted © Siemens Healthineers, 2025 Notes 349 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Advanced Angio Assist – Planning The FastView localizer with Whole Body FastView Add-In is used to automatically adapt the coverage to the patient’s anatomy. diaphragm For automatic coverage, the Abdomen Organ Box is used. O • Starting point in H-F direction is the upper kidney rim • End point in H-F direction is estimated from the patient's height Coverage in R-L direction is calculated based on the hips. os ilium Abdomen Organ Box Large 39 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 350 MR Protocol Building and Optimization- STEP Week 4 myExam Angio Assist SIEMENS Healthineers ... Advanced Angio Assist – Planning Coverage in H-F direction can be changed by dragging the FoV. • Changes the overlap between the individual stations • If minimum overlap is reached, a 4th station is inserted Coverage in R-L (phase encoding direction) can also be changed by dragging the FoV. O All stations will have the same FoV in R-L. Coverage in A-P can be changed independently. Additional slices are added by dragging the FoV. FOV can not be tilted. • All steps have the same FoV in read/phase direction • Steps can only be moved in A-P direction 40 Imaging on file Unrestricted © Siemens Healthineers, 2025 Notes 351 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers myExam Breast Assist STEP - MR Protocol Building with myExam Cockpit & myExam Assist QR700021234 – Effective date 4/14/2025 Unrestricted © Siemens Healthineers, 2025 Notes 352 MR Protocol Building and Optimization- STEP Week 4 Agenda SIEMENS Healthineers ... myExam Breast Assist • myExam Breast Assist workflow features • Breast Patient View • Breast AutoCoverage Scout • Breast Implant Selection Add-in • Breast Basic Add-in • Breast Dynamic Add-in • Care Bolus Add-in • Care Bolus Dynamic Scanning • Breast Biopsy Assist • Configuration & Workflow Hints 2 Unrestricted © Siemens Healthineers, 2025 Notes 353 MR Protocol Building and Optimization- STEP Week 4 Objectives SIEMENS Healthineers ... At this end of this module, you should be able to: • Identify myExam Breast Assist workflow features • Describe the Breast Patient View • Recall the Breast AutoCoverage Scout • Explain the Breast Implant Selection Add-in • Identify the Breast Basic Add-in • Recall the Breast Dynamic Add-in • Describe the Care Bolus Add-in • Recall how to perform Care Bolus Dynamic Scanning • Explain the features of Breast Biopsy Assist • Summarize configuration and workflow hints 3 Unrestricted © Siemens Healthineers, 2025 Notes 354 MR Protocol Building and Optimization- STEP Week 4 Disclaimers SIEMENS Healthineers ... The information presented in the myExam Breast Assist course is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use their own learning, training, and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Medical Systems to be used for any purpose in that regard. Please refer to a Contrast Agent manufacturer's labeling, and instructions for use, for use of that Contrast Agent with an MRI exam. 4 Unrestricted © Siemens Healthineers, 2025 Notes 355 MR Protocol Building and Optimization- STEP Week 4 Workflow Features myExam Breast Assist – Guided workflow for consistent SIEMENS Healthineers ... results independent of external variables Rely on consistent results, independent of the technologist’s expertise with: • AutoCoverage of the breast • Automatically adapted shim volumes BAR BCR 5 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 356 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist – Guided workflow for consistent SIEMENS Healthineers' ... results independent of external variables Consistent timing of post-contrast scans with automated Care Bolus detection and start. NumX_Breast7_Fh4_4_GB A 45 IMA 1 Breast Dynamic Parameters Position Care Bolus ROI Pre Post 1 Post 2 ... Post n Bolus Detection Delay 10 PH1.2 Step 4 - Care Bolus M Save Display Continue Position Co Continue 6 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 357 MR Protocol Building and Optimization- STEP Week 4 Patients with Breast implants SIEMENS Healthineers ... Setting the resonance frequency correctly can be challenging! Challenge #1: Which peak to select as the resonance frequency? Resolved with Right Left myExam None Challenge #2: Where exactly Breast is the water, fat and silicone Assist Silicone signal? Saline Automated implant type identification with guidance increases scan consistency in challenging cases. 7 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 358 MR Protocol Building and Optimization- STEP Week 4 Breast Motivation SIEMENS Healthineers ... Challenges faced by our customers • Frequency adjustments • Timing support for dynamic contrast measurements • Large number of coils, each with their own strengths and properties • Imaging philosophy examples: • Fat sat versus non-fat sat • 60 seconds versus 90 seconds temporal resolution • Care Bolus versus non-Care Bolus, etc. 8 Unrestricted © Siemens Healthineers, 2025 Notes 359 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Key Workflow features Do Breast Dot Engine @ Renner Parione View • AutoPosition Non Fat Sat Standard Non Fat Sat INTERVIEWS @ Breast Auto Coverage scout • AutoCoil selection implant type contrmation type_scan 00:27 • AutoCoverage additional Silicone Protocol @ Breast Implant Selection stir_ws_tra_silicone_bilateral 03:20 TO Breast Basic • AutoFoV stir_ws_sag_silicone_left 03:16 Breast Basic stir_ws_sag_silicone_right 03:16 Breast Basic Implant Guidance and selection 03:29 • stir_tra_p2 Breast Basic Optimized Shim Volume Care Bolus are Bolus • yes no yes no Planning of Dynamic Scanning Prepare injector Planning of Dynamic Scanning Prepare injector Generic Views Generic Views t1_#13d_nonfs_tra_p2_1 01:08 t1_f13d_nonfs_tra_p2_1+5 07:15 t1_#13d_nonfs_tra_p2_1 01:08 t1_f13d_nonfs_tra_p2_1+2 03:50 • Single Frequency Adjust O Breast Dynamic O Breast Basic Breast Dynamic 3 Breast Basic Prepare Injector Prepare Injector Care Bolus 01:16 Care Bolus Care Bolus 01.16 Care Bolus Care Bolus • Automatic Bolus Detection t1_#13d_nonfs_tra_p2_2-6 05:42 11_#3d_nonfs_tra_p2_2-3 02:17 Breast Dynamic 2 22 O Breast Dynamic • Inline MPR images MPR planning MPR Planning t1_#13d_spair_tra_p2_high_res_VIEWS @ Breast Basic Care Bolus yes t1_#3d_nonfs_tra_p2_end 01:08 11_#13d_nonfs_tra_p2 01:08 Breast Basic Breast Basic 03:48 ep2d_diff_spair_tra zd en 351 2 O Breast Basic 01:53 O Breast Basic 9 Unrestricted © Siemens Healthineers, 2025 Notes 360 MR Protocol Building and Optimization- STEP Week 4 Breast Patient View myExam Breast Assist SIEMENS Healthineers ... Breast Patient View – Exam Strategy Standard Dynamic workflow consists of a pre-contrast scan General Parameters with multiple post-contrast phases. Exam Strategy Non Fat Sat Standard Non Fat Sat Standard Followed by a high-resolution morphological scan AutoCoverage Non Fat Sat INTERVIEWS (hi_res_VIEWS). Confirm Frequency Adjustment Fat Sat Standard Fat Sat INTERVIEWS Auto Adjust Volume INTERVIEWS Dynamic workflow consists of a pre-contrast scan Implant Type Confirmation no with two initial post-contrast phases (wash-in). Additional Silicone Protocols no Followed by a high-resolution morphological scan. Care Bolus no Ending with a final post-contrast dynamic phase Inline MPR no (wash-out). 10 Unrestricted © Siemens Healthineers, 2025 Notes 361 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Patient View Breast Assist LOC .y + Breast Assist LOC + 1 localizer 00:11 1 localizer 00:11 2 % stir_tra_p2 03:29 2 stir_tra_p2 03:29 B t1_f13d_nonfs_tra_p2 01:33 3 t1_f13d_nonfs_tra_p2 01:33 4 Prepare injector 4 Prepare injector 5 1_f13d_spair_tra_p2_dynaVIEWS_1+4 > 08:13 5 t1_f13d_spair_tra_p2_dynaVIEWS_1+2 7 5 04:39 6 8 MPR planning MPR planning 7 1_f13d_spair_tra_p2_high_res_VIEWS 02:23 7 t1_fl3d_spair_tra_p2_high res_VIEWS 02:23 t2_tse_tra_p2 03:48 18 t1_fl3d_spair_tra_p2_dynaVIEWS_end 01:25 00 9 ep2d_diff_spair_tra 01:53 9 t2_tse_tra_p2 03:48 10 ep2d_diff_spair_tra 01:53 Example: Fat Sat Standard Strategy Example: Fat Sat INTERVIEWS Strategy 11 Unrestricted © Siemens Healthineers, 2025 Notes 362 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Patient View – AutoCoverage On: Auto-coverage is activated in all imaging protocols. General Parameters Exam Strategy Non Fat Sat Standard Off: no protocol adaptations are performed. AutoCoverage V Confirm Frequency Adjustment Off Auto Adjust Volume V Implant Type Confirmation no Additional Silicone Protocols no are Bolus no Inline MPR no 12 Unrestricted © Siemens Healthineers, 2025 Notes 363 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Patient View – Confirm Frequency Adjustment Confirm Frequency Adjustment General Parameters Activates the corresponding checkbox on the System Adjustments parameter card. Exam Strategy Non Fat Sat Standard AutoCoverage • Off: Confirm Frequency Adjustment window never appears Confirm Frequency Adjustment Off • Always: Confirm Frequency Adjustment Auto Adjust Volume Only After Change Off window appears before every measurement Always Implant Type Confirmation no • Only After Change: Confirm Frequency Adjustment window appears only when the Additional Silicone Protocols no system requires a new frequency adjustment Care Bolus no (e.g., selection of new coil elements) Inline MPR no 13 Unrestricted © Siemens Healthineers, 2025 Notes 364 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Patient View – Auto Adjust Volume Select Auto Adjust Volume to automatically adapt the adjustment volume to the Breast Organ Box General Parameters volume (calculated from the Breast Auto Exam Strategy Non Fat Sat Standard Coverage Scout). AutoCoverage V Confirm Frequency Adjustment Off TimTX TrueShape Auto Adjust Volume V The Auto pTx Volume can also be selected in the Breast Patient View to automatically adapt the Implant Type Confirmation no pTx Volume to the Breast Organ Box volume. Additional Silicone Protocols no no Inline MPR no 14 Unrestricted © Siemens Healthineers, 2025 Notes 365 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Patient View – Auto Adjust Volume Adjustment volume is automatically adapted and is linked to Breast Organ Box. If user adapts the adjustment volume while preparing a measurement, it is propagated to following measurements in the queue (implemented with MR XA10 software). Bilateral Transverse imaging ......................... Unilateral Sagittal imaging 15 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 366 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Patient View – Implant Type Confirmation Implant Type Confirmation Select Yes, if implants are present and you wish General Parameters to confirm the location and type. Exam Strategy Non Fat Sat Standard AutoCoverage v Two additional steps are added to the queue if Confirm Frequency Adjustment Off yes is selected: Auto Adjust Volume v 1. Implant type scan measurement to confirm the implant type. Implant Type Confirmation yes 2. Implant Situation step; an interaction which Additional Silicone Protocols yes has the Breast Implant Selection and add-in Care Bolus no attached. Inline MPR no implant_type_scan 00:27 Implant Situation Breast Implant Selection 16 Unrestricted © Siemens Healthineers, 2025 Notes 367 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Patient View – Additional Silicone Protocols Additional Silicone Protocols General Parameters Select Yes, if you want additional protocols added to the queue for silicone evaluation imaging. Exam Strategy Non Fat Sat Standard AutoCoverage v Confirm Frequency Adjustment Off Auto Adjust Volume Implant Type Confirmation yes Additional Silicone Protocols yes Care Bolus no Inline MPR no stir_ws_tra_silicone_bilateral 03:20 O Breast Basic stir_ws_sag_silicone_left 03:16 Breast Basic stir_ws_sag_silicone_right 03:16 O Breast Basic 17 Unrestricted © Siemens Healthineers, 2025 Notes 368 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Patient View – Care Bolus Care Bolus Select Yes, to perform dynamic measurements using a Care Bolus approach with automatic bolus detection. General Parameters Exam Strategy Non Fat Sat Standard AutoCoverage Confirm Frequency Adjustment Off Auto Adjust Volume Planning of Dynamic Scanning Implant Type Confirmation no Additional Silicone Protocols no t1_f13d_nonfs_tra_p2_1 01:08 Care Bolus yes Prepare injector Inline MPR no Care Bolus 4 01:16 t1_f13d_nonfs_tra_p2_2-6 05:42 18 Unrestricted © Siemens Healthineers, 2025 Notes 369 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Patient View – Care Bolus Care Bolus Select No, to perform dynamic measurements using the standard approach. General Parameters Exam Strategy Non Fat Sat Standard AutoCoverage v Confirm Frequency Adjustment Off Auto Adjust Volume Implant Type Confirmation no Additional Silicone Protocols no Care Bolus no Inline MPR no 9 Prepare injector 10 %_ 11_f13d_spair_tra_p2_dynaVIEWS_1+4 08:13 19 Unrestricted © Siemens Healthineers, 2025 Notes 370 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Patient View – Inline MPR Inline MPR Select Yes, to perform inline MPR’s. • Adds an MPR Planning step and high- resolution VIEWS protocol to the queue • Linked to MPR Assignment in high-resolution General Parameters VIEWS protocol Exam Strategy Non Fat Sat Standard AutoCoverage v Confirm Frequency Adjustment Off Auto Adjust Volume Implant Type Confirmation no Prepare injector Additional Silicone Protocols no t1_f13d_nonfs_tra_p2_1+5 07:15 Care Bolus no nline MPR yes & MPR planning %% t1_f13d_spair_tra_p2_high_res_VIEWS 02:23 20 Unrestricted © Siemens Healthineers, 2025 Notes 371 MR Protocol Building and Optimization- STEP Week 4 Breast AutoCoverage Scout myExam Breast Assist SIEMENS Healthineers ... Breast AutoCoverage Scout Large FoV 2D FLASH localizer with multiple slice Dot 11 sec | Auto @ 2 @ 1.0x1.0x6.0 mm? @ 1.00 orientations (cor, tra, sag left, sag right). Parameters Enables AutoCoverage to be used in the Slices FoV Read 500 mm remainder of the clinical protocols. Slice Thickness 6.0 - mm FoV Phase 100.0 ¢ % TR 7.6 ¢ ms Concatenations 12 21 Unrestricted © Siemens Healthineers, 2025 Notes 372 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast AutoCoverage Scout Four organ boxes are calculated from the Breast AutoCoverage Scout. Guidance • Breast > Chest is used for bilateral Parameters Select region to segment Breast transverse imaging, excluding DWI Queue GSP • Breast is used for bilateral transverse DWI Series Label Auto Load and auto adjust volume (and auto pTx AutoCoverage volume for pTx systems) Onco AutoCoverage Scout • Breast > Left is used for unilateral left sagittal imaging • Breast > Right is used for unilateral right sagittal imaging There is no organ box for unilateral Transverse imaging. 22 Unrestricted © Siemens Healthineers, 2025 Notes 373 MR Protocol Building and Optimization- STEP Week 4 Breast Implant Selection Add-in myExam Breast Assist SIEMENS Healthineers ... Breast Implant Selection Add-In Select Implant Type Confirmation in the Patient Implant Type Confirmation View. yes • An additional implant type scan protocol is implant_type_scan 00:27 added to the exam queue to confirm the implant type Implant Situation Breast Implant Selection • An Implant Situation step is added to the exam queue, this is an interaction that has the Breast Implant Selection add-in attached 23 Unrestricted © Siemens Healthineers, 2025 Notes 374 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers .. Breast Implant Selection Add-In Implant Type Scan Inversion recovery protocol with a long inversion time Breast Implant Situation to suppress silicone. Choose type and location of implants. In the Implant Type Scan, silicone implants appear dark, and saline implants appear bright. • Silicone implants appear dark • Saline implants appear bright Right Left Breast Implant Situation None • User must define type and location of implants, Silicone Saline based on the implant type scan appearance • This influences the Assume Silicone parameter in the System Adjustments parameter card Routine Contrast Resolution Geometry System Physio Inline Sequence Coils Miscellaneous Adjustments Adjust Volume Tx/Rx Adjustment Strategy Standard Adjustment Tolerance Auto (Maxi ... BO Shim Standard Adjust with Body Coil B1 Shim TrueForm onfirm Frequency When Chang ... Assume Silicone Manual Adjustments 24 Unrestricted © Siemens Healthineers, 2025 Notes 375 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Implant Selection Add-In Patients without implants Confirm Frequency Adjustment ? x Confirm Frequency Adjustment • Processing of spectrum using an optimized algorithm [Maxj 4.437 FWHM [Hz) 241.3 Max| 7,528 • The system automatically adjusts the frequency to the water peak 2 2 • If two peaks exist, the system automatically 123.208.305 123.213.413 123.208.148 selects the right peak as the water peak Col Combined = ADC . Coll Combined = ADC . - • In very rare cases, the peak is not correctly set; Frequency (sys) Ptz) 123210942 Frequency (sys) |He] 123210797 Frequency (Demo) [Ptz] 123210942 : Apply Frequency Demp) [r] 123210797 Apply correct resonance frequency must be set manually • Optimized spectrum processing algorithm in Continue Cancel Continue Cancel XA software has eliminated the need for Assume Dominant Fat parameter (1) Fat (2) Water 25 Unrestricted © Siemens Healthineers, 2025 Notes 376 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Implant Selection Add-In Patients with silicone implants Confirm Frequency Adjustment Confirm Frequency Adjustment • The peak behavior can differ depending on the 2 size of the implant or whether there is an Max| 13,129 FWHM [HZ] 200 2 implant in one or both breasts 1) Maxi 14,810 -3 • If the Assume Silicone parameter has been 3 Mag selected, the system automatically adjusts the 123.253.259 123 256 367 123 253.158 123.264 14 frequency to the water peak, using a 3-peak Coil Combined = ADC Coll Combined . ADC . . model Frequency (sys) [H] 123255835 Frequency (sys) [H] 123255829 Frequency Demo) [u] 123255835 Apply Frequency (emp) [u] 123255829 Apply • In rare cases, the peak is not correctly set; correct resonance frequency must be set manually Continue Cancel Continue Cancel Left Spectrum: Dominant Fat. Right Spectrum: Dominant Silicone. (1) Silicone (2) Fat (3) Water 26 Unrestricted © Siemens Healthineers, 2025 Notes 377 MR Protocol Building and Optimization- STEP Week 4 Breast Basic Add-in myExam Breast Assist SIEMENS Healthineers ... Breast Basic Add-in – AutoCoverage Add-in AutoCoverage select an organ box: t1_f13d_nonfs_tra_1+5 06:31 t1_fl3d_nonfs_tra_1 00:59 Breast Basic 2 Breast > Chest: bilateral transverse imaging, Breast Dynamic • Prepare injector excluding DWI Breast: bilateral transverse DWI Care Bolus 01:16 • 2 Care Bolus • Breast > Left: unilateral left sagittal imaging t1_f13d_nonfs tra_2-3 02:23 2 Breast Dynamic • Breast > Right: unilateral right sagittal imaging AutoCoverage can also be configured in the Breast Guidance Dynamic Add-in for care bolus dynamic workflow. Parameters Enable AutoCoverage Queue Organ box Breast > Chest GSP Series Label Propagate changes to all following protocols AutoCoverage protocol manipulations should not Auto Load Keep FOV constant AutoCoverage AutoCoverage will execute the following manipulations influence temporal resolution for breast dynamic AutoTiming Breast Step Parameter Limit Increment MPR Assignment Slice Thickness 0.1+ measurements, and should still comply with ACR 2.0 + imaging guidelines. SAR Assistant SAR Assistant Off 27 Unrestricted © Siemens Healthineers, 2025 Notes 378 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Basic Add-in Force Confirm Frequency Adjustment Message. 7 1 • This message overrides the Patient View Guidance Parameters Force Confirm Frequency Adjustment Message setting, and forces a confirm frequency Queue GSP pop-up for this protocol Series Label Auto Load • This can also be configured in Breast AutoCoverage Dynamic Add-in AutoTiming Breast Step MPR Assignment 28 Unrestricted © Siemens Healthineers, 2025 Notes 379 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Basic Add-in MPR Assignment • Generates inline MPR’s for this step when Guidance Inline MPR are selected in Patient View Parameters Generate the following selected MPRs • Enabled by the default in the high- Queue GSP V Sag resolution VIEWS protocols Series Label Cor Auto Load • This can also be configured in Breast AutoCoverage Dynamic Add-in AutoTiming Breast Step MPR Assignment 29 Unrestricted © Siemens Healthineers, 2025 Notes 380 MR Protocol Building and Optimization- STEP Week 4 Breast Dynamic Add-in myExam Breast Assist SIEMENS Healthineers ... Breast Dynamic Add-in The Breast Dynamic Add-in is used for Care Bolus pre- and post-contrast dynamic yes no protocols using a Care Bolus approach. Planning of Dynamic Scanning Prepare injector Generic Views t1_fl3d_nonfs_tra_p2_1 01:08 t1_f13d_nonfs_tra_p2_1+5 07:15 Breast Dynamic Breast Basic Prepare injector Care Bolus 01:16 Care Bolus t1_f13d_nonfs_tra_p2_2-6 05:42 Breast Dynamic 30 Unrestricted © Siemens Healthineers, 2025 Notes 381 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Dynamic Add-in Phase: yes Planning of Dynamic Scanning Pre is assigned to pre-contrast dynamic protocol. Generic Views t1_f13d_nonfs_tra_p2_1 01:08 Breast Dynamic Phase = pre Measurements: Prepare injector Defines the number of post-contrast dynamic Care Bolus 01:16 phases. Care Bolus t1_f13d nonfs_tra_p2_2-6 05:42 Overrides the number of measurements defined in Breast Dynamic Phase = remaining phases with contrast the Dynamic parameter card. 7 6 Parameters Queue Delay: GSP Pre post 1 Post 2 Post n Series Label Defines the pause between automatic bolus Detection Auto Load AutoCoverage detection and start of first post-contrast dynamic Delay 10 ¢ s Breast Dynamic Phase pre measurement. Breast Step MPR Assignment Measurements Allows time for the contrast agent to arrive in the breast (default value = 10 seconds). Pre-contrast phase configuration 31 Unrestricted © Siemens Healthineers, 2025 Notes 382 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Breast Dynamic Add-in Phase: yes Planning of Dynamic Scanning Arterial is assigned to post-contrast dynamic Generic Views protocol. t1_f13d_nonfs_tra_p2_1 01:08 Breast Dynamic Phase = pre Prepare injector Care Bolus 01:16 Care Bolus t1_f13d nonfs_tra_p2_2-6 05:42 1 Breast Dynamic Phase = arterial Parameters Post 1 GSP Pre Post 2 Post n Series Label Detection ª D Auto Load AutoCoverage AutoTiming 10 Breast Dynamic Phase arterial Breast Step MPR Assignment Arterial phase configuration 32 Unrestricted © Siemens Healthineers, 2025 Notes 383 MR Protocol Building and Optimization- STEP Week 4 Care Bolus Add-in myExam Breast Assist SIEMENS Healthineers .. Care Bolus Add-in Care Bolus Planning 3 1:16 min | Auto @ None @ 1.8x1.8x80.0 mm3 1.00 1. Select the Transverse localizer slice showing Guidance Parameters the right ventricle. Planning the position of the ROI for Care Bolus: 2. Position the ROI as shown in the image with Have the injector ready by the "Prepare injector" pause. Care Bolus scan will start immediately after confirming a left-click. said pause. 3. Adjust the ROI and/or Care Bolus FoV 1. Select the localizer's transverse slice showing the right ventricle. positions, as necessary. 2. Position the ROI as shown in the image with a left mouse click; adjust ROI and/or Care Bolus' 4. Click Go to complete Care Bolus planning. FoV positions, if necessary. 3. Click "Go" to complete planning. 33 Unrestricted © Siemens Healthineers, 2025 Notes 384 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Care Bolus Add-in Automatic Bolus Detection NumX_Breast7_Fh4_4_GB A 1. Right ventricle for bolus monitoring is shown in the Inline Display 45 IMA 1 at a rate of approximately one image per second. 2. Begin contrast injection as soon as the images appear in Inline Display. 3. Bolus arrival can be monitored in the ROI and visualized via signal intensity versus time curve. R 4. Once the system has detected the arrival of the bolus in the ROI, Stop&Continue is activated. 5. After the countdown of the delay configured in the Breast Dynamic pre-phase add-in (e.g., 10 seconds), post-contrast TTTT measurements start automatically. F SP H1.2 10 20 30 90 Lima 50 60 70 80 100 Step 4 - Care Bolus X M Auto Save Save Current Pause Stop Copy Continue Display Continue Position 34 Unrestricted © Siemens Healthineers, 2025 Notes 385 MR Protocol Building and Optimization- STEP Week 4 Care Bolus Dynamic Scanning myExam Breast Assist SIEMENS Healthineers ... Care Bolus Dynamic Scanning Timing is important!! yes Planning of Dynamic Scanning • Care Bolus workflow introduces a Generic Views variable time between pre- and post- t1_f13d_nonfs_tra_p2_1 01:08 Breast Dynamic contrast phases (kept to a minimum) Prepare injector • Preparation of the Care Bolus workflow Care Bolus 01:16 steps must be done before the pre- O Care Bolus t1_f13d_nonfs_tra_p2_2-6 05:42 contrast dynamic measurement begins 1 Breast Dynamic • Contrast agent must be injected as soon as possible after the Care Bolus measurement starts Why? • Ensures Signal Intensity versus Time curves are not distorted 0'00 2:34- 432" 6'31" • Minimizes motion artifacts • Reduces scan duration SI versus Time SI versus Time Short delay between pre- & post-contrast phases Long delay between pre- and post-contrast phases 35 Unrestricted © Siemens Healthineers, 2025 Notes 386 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers .. Care Bolus Dynamic Scanning Planning of Dynamic Scanning Guidance 1. Check position of 3D slab for pre-contrast Please plan the following steps before starting the pre-contrast scan: measurement and select Go. 1. Position & check the 3D slab for the pre-contrast scan. Select "Go". 2. Pre-contrast measurement configured with Wait for 2. Leave the pre-contrast pause open. 3. Position the ROI for the Care Bolus scan. Select "Go". user to start, so Exam paused window opens. 4. Have the injector ready before the "Prepare injector" pause. AWN Care Bolus scan will start immediately after confirming the "Prepare injector" pause. Post contrast measurements must 3. Leave Exam paused window opens, go directly to start as close to the end of the pre-contrast as possible. planning Care Bolus step. Position ROI as shown and select Go. 4. Prepare and arm the injector. 5. Return to Exam paused window and press Continue yes Planning of Dynamic Scanning to start the pre-contrast measurement. O Generic Views 6. Care Bolus scan starts immediately after confirming t1_f13d_nonfs_tra_p2_1 01:08 Breast Dynamic the Prepare injector pause. Prepare injector 7. Inject contrast without delay once Care Bolus Care Bolus 01:16 measurement has started. 1 Care Bolus t1_f13d_nonfs_tra_p2_2-6 05:42 Breast Dynamic 36 Unrestricted © Siemens Healthineers, 2025 Notes 387 MR Protocol Building and Optimization- STEP Week 4 Breast Biopsy Assist myExam Breast Assist SIEMENS Healthineers ... Breast Biopsy Assist Breast BI 7 and Sentinelle Coils: Breast Biopsy @ Breast Patient View Left Breast Right Breast localizer • Supports Post&Pillar and Grid biopsy workflows for left breast, right breast or both Breast Biopsy workflow Prepare injector. breasts Method Method Post&Pillar Grid Post&Pillar Grid • Post&Pillar workflow can be selected for t1_f13d_nonfs_tra_p2_1+2_left 05:33 t1_f13d_nonfs_sag_1+2_left 07:41 t1_f13d_nonfs_tra_p2_1+2_right 05:33 t1_f13d_nonfs_sag_1+2_right 07:41 t1_f13d_ Breast Basic 2 Breast Basic Breast Basic O Breast Basic Breast BI 7 coil; transverse slice orientation Method t1_13d Post&Pillar Grid Grid for mini-dynamic scan t1_f13d_nonfs_tra_p2_left 01:43 t1_f13d_nonfs_sag_left 02:25 t1_f13d_nonfs_tra_p2_right 01:43 t1_f13d_nonfs_sag_rig 02:27 t1_tse_tr Breast Basic Breast Basic O Breast Basic Breast Basic t1_tse_tra_left 02:05 t1_tse_tra_left 02:05 t1_tse_tra_right 02:05 t1_tse_tra_right 02:05 t1_tse_tr • Grid workflow can be selected for Breast BI 7 Breast Basic O O Breast Basic O Breast Basic O Breast Basic intervention or Sentinelle coils; sagittal slice orientation Method Method for mini-dynamic scan Grid Post&Pillar 11_13d_tra_cavity left 01:40 t1_f13d_sag_cavity_left 02:08 t1_f13d_tra_cavity_right 11:40| 11_A3d_sag_cavity_right 02:08 Breast Basic Breast Basic Breast Basic % Breast Basic • Breast Biopsy workflow step automatically opens the MR Breast Biopsy workflow (Interaction with an Advanced Application add-in) • Note there is no Biopsy Assist for the 4-ch BI coil; customer can import E11 Assist post upgrade 37 Unrestricted © Siemens Healthineers, 2025 Notes 388 MR Protocol Building and Optimization- STEP Week 4 Configuration and Workflow Hints myExam Breast Assist SIEMENS Healthineers ... Configuration & Workflow Hints – Assist Library Assortment of pre-configured protocol .. >> breast > library Assist > T1 options are available in the Assist Library SIEMENS _medium channel coils making it easier to adapt customer Assists. t1_f13d_tra_nonfatsat_1+4_p2 07:50 breast Breast Basic Breast Assist t1_f13d_spair_tra_dynaVIEWS_1+4_p2 07:52 E Medium channel coils Breast Basic El High channel coils t1_f13d_tra_high_res_VIEWS_p2 03:24 El Biopsy Breast Basic [ library Assist high channel coils El localizer t1_fl3d_tra_nonfatsat_1+5_p3 06:31 O Breast Basic E T1 t1_f13d_spair_tra_dynaVIEWS_1+4_p2 07:52 E implant Breast Basic t1_f13d_spair_tra_p2_high_res_VIEWS other 02:52 Breast Basic 10 mr guided biopsy >[ library 38 Unrestricted © Siemens Healthineers, 2025 Notes 389 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Configuration & Workflow Hints – AutoCoverage When using AutoCoverage, the Field-of-View (FoV) is often calculated too large (includes chest). Meaning the voxel size is outside of Guidance Parameters Enable AutoCoverage imaging guidelines. Queue Organ box Breast > Chest GSP Series Label Propagate changes to all following protocols Keep FoV constant and Propagate changes to Auto Load Keep FOV constant all following protocols is enabled in the AutoCoverage AutoCoverage will execute the following manipulations AutoTiming stir_tra protocol. Breast Step Parameter Limi Increment 1 MPR Assignment Slices 40.0 1.0 ¢ The FoV is not adapted automatically. If the user manually adapts the FoV, changes are SAR Assistant SAR Assistant Flip Angle, TR propagated to the following protocols which Min Flip Angle 80 deg use the same organ box (Breast>Chest). Max. TR 6000.0 ms Slice Coverage is also propagated if changed. (3D organ box propagated). 39 Unrestricted © Siemens Healthineers, 2025 Notes 390 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Configuration & Workflow Hints – AutoCoverage Breast Assist LOC + All Transverse protocols are configured with a FoV of 360mm. Usually %localizer 00:11 the stir_tra protocol is measured first. FoV is not changed by 2 % implant_type_scan 00:27 AutoCoverage (can be changed manually). FoV changes are propagated Implant Situation to following measurements using the same organ box. W stir_ws_tra_silicone_bilateral optional 03:20 Keep FOV constant On (propagate enabled) 5 stir_ws_sag_silicone_left 03:16 Keep FOV constant Off (unilateral, sag) stir_ws_sag_silicone_right 03:16 Keep FOV constant Off (unilateral, sag) % stir_tra_p2 03:29 Keep FOV constant On (if changed, propagated) t1_f13d_nonfs_tra_p2 01:33 Keep FOV constant Off 00 Prepare injector 10 t1_f13d_spair_tra_p2_dynaVIEWS_1+2 10 04:39 Keep FOV constant Off 11 & MPR planning 12 %_ 11_f13d_spair_tra_p2_high_res_VIEWS 02:23 Keep FOV constant Off 13 t1_f13d_spair_tra_p2_dynaVIEWS_end 01:25 Keep FOV constant Off (copy reference) 14 % t2_tse_tra_p2 03:48 Keep FOV constant On 15 % ep2d_diff_spair_tra 01:53 Keep FOV constant Off (different organ box) 40 Unrestricted © Siemens Healthineers, 2025 Notes 391 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Configuration & Workflow Hints – Confirm Frequency Adjustment When using a Care Bolus workflow, always select Only After Change. This avoids a Confirm Frequency pop-up between the Care Bolus and the post-contrast Dynamic General Parameters protocol. Exam Strategy Fat Sat Standard AutoCoverage Confirm Frequency Adjustment Only After Change Auto Adjust Volume Implant Type Confirmation yes Additional Silicone Protocols yes 10 %_ t1_f13d_spair_tra_p2_dynaVIEWS_1 10 01:34 Care Bolus yes 11 Prepare injector Inline MPR yes 12 % Care Bolus 01:16 13 t1_f13d_spair_tra_p2_dynaVIEWS_2-5 06:15 41 Unrestricted © Siemens Healthineers, 2025 Notes 392 MR Protocol Building and Optimization- STEP Week 4 myExam Breast Assist SIEMENS Healthineers ... Configuration & Workflow Hints – InterVIEWS Workflow If more than one end measurement is configured, set Subtrahend to -1. Subtract V Standard Subtract M Standard Save Subtracted Images v Ensures mask for subtractions is pre-contrast phase. Save Subtracted Images V Subtrahend Subtrahend Subtraction Group Subtraction Group 1 4 Measurements Measurements 2 + 9 Prepare injector Autoscaling Autoscaling 10 t1_f13d_spair_tra_p2_dynaVIEWS_1+2 10 04:39 Scaling Factor Scaling Factor 1 11 MPR planning Offset 50 Offset 50+ 2 12 t1_f3d_spair_tra_p2_high_res_VIEWS 02:23 Measurements 13 (1_f13d_spair_tra_p2_dynaVIEWS_end 01:25 One measurement Two or more measurements 42 Unrestricted © Siemens Healthineers, 2025 Notes 393 MR Protocol Building and Optimization- STEP Week 4 myExam Whole-Body Assist SIEMENS Healthineers myExam Whole-Body Assist MR myExam Cockpit & myExam Assist Unrestricted © Siemens Healthineers, 2025 Effective date: 5 August 2025 - QR700026089 Notes 394 MR Protocol Building and Optimization- STEP Week 4 Agenda SIEMENS Healthineers ... myExam Whole-Body Assist • Overview • Patient View • FastView • Automatic Inline (Region) Segmentation • Coverage Mode • Coverage Scans • Focus Scans • Configuration • Motion Insensitive Strategy with GRASP • 2-pt Fat Fraction • Considerations 2 Unrestricted © Siemens Healthineers, 2025 Notes 395 MR Protocol Building and Optimization- STEP Week 4 Objectives SIEMENS Healthineers ... At this end of this module, you should be able to: • Summarize the features of myExam Whole-Body Assist • Explain Patient View features • Identify FastView • Recall features of Automatic Inline (Region) Segmentation • Explain the difference between Coverage Mode, Coverage Scans, and Focus Scans • Explain the configuration options • Review Motion Insensitive Strategy with GRASP • Identify 2-pt Fat Fraction • Summarize considerations for myExam Whole- Body Assist 3 Unrestricted © Siemens Healthineers, 2025 Notes 396 MR Protocol Building and Optimization- STEP Week 4 Disclaimers SIEMENS Healthineers ... The information presented in the myExam Whole-Body Assist course is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use their own learning, training, and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Medical Systems to be used for any purpose in that regard. Please refer to a Contrast Agent manufacturer's labeling, and instructions for use, for use of that Contrast Agent with an MRI exam. 4 Unrestricted © Siemens Healthineers, 2025 Notes 397 MR Protocol Building and Optimization- STEP Week 4 Overview myExam Whole Body Assist SIEMENS Healthineers ... Overview myExam Whole-Body Assist takes you through a typical MR Whole-Body examination. Workflow supports: • Fast, robust and standardized • Automatic coverage of anatomy • Supports multi-region MR examinations covering the thorax, abdomen, pelvis, and extensions toward the head and legs • Combination of multi-region scans with contrast enhanced examination of focus regions • AutoTiming supports adaptation to patient’s breath-hold capability or breathing characteristics Optional License supports acquisition of Whole-Body imaging. 5 Unrestricted © Siemens Healthineers, 2025 Notes 398 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... Overview pre contrast (optional) post contrast Coverage scans Focus scans T2w STIR cor bh DWI tra T2w STIR cor T1w VIBE Dixon free br DWI T1w VIBE Dixon T1w VIBE bh cor bh cor bh T2w STIR T1w VIBE Tra ABLE / GRASP Dixon tra FastView T2w STIR cor cor Dixon tra DWI tra pre/arterial/venous/delayed bh Localizer bh bh free br +radial MIPs* T1w VIBE Dixon tra post Landmark based T1w VIBE Dixon T1w VIBE Dixon segmentation: C / A / P T2w STIR cor cor bh DWI tra cor bh free br free br T2w STIR T1w VIBE DWI T1w VIBE COMP Dixon COMB Dixon COMB COMB post sagittal spine (pre) sagittal spine (post) (optional) 6 *in MR View&GO Unrestricted © Siemens Healthineers, 2025 Notes 399 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... Overview lote Body Assist @ whole Body Povere vi Motion insensitive Whole Body FastView 12_haste_stir_cor_mbh 0 whole Body % D 01:00 Whole Body t1_vibe_dixon_tra_bh 01:53 -D Whole Body ep2d_diff_b50_800_tra 02:47 Whole Body Sagittal spine scans (only Head-First) no Basic Decision LAMspine_sc 00:23 Coverage scans Spine Scout (including sag spine) Spine Scout E2:00 00:23 Spine Scout 02:43 O Spine Positioning 02:43 Spine Positioning 02:43 Spine Positioning 01:06 12 haste_Is_ tra_ mbh 01:15| 12 haste fis_tra_mbh Pelvis thora 00:54 12 haste fs tra 00:55 12 haste_fs tra 0 Generic Views X 4) Generic Views X 4) Generic Views 00:55 Generic Views Generic Views @ Generic Views Inform patient to breathe fat. localizer aorta bh 00:17 Inform patient to breathe fat. 00:17 Inform patient to breathe flat. Onco Auto Coverage 5. Onco Auto Coverage 5 ... 11_vibe_dixon_tra_bh_pre 11_vibe_doron_tra_pre 00:22 00:44 O ABLE X @ Generic Views t1_vibe_dixcon_tra_pre ABLE ID Generic Views Check precontrast Check precontrast Check precontrast Generic Views @ Generic Views Generic Views O Generic Views Focus scans Prepare Injector Prepare injector Prepare injector Prepare injector epare injector Prepare injector he: in - out - in - stop as long as possible Care Bolus 01:07 t1_twist_dyn_cor_p2 01:39 @ Generic Views reathe: in - out - in - stop as long as possible, 01:07 t1_twist_dyn_cor_p2 Care Bolus Care Bolus Generic Views 00:47 t1_vibe_doion_tra_bh_arterial 00:19 11_vibe_dicon_tra_post etwast_ cor_dyn_Insp 00:22 t1_vibe_dixon_tra_post 00:44 Generic Views ABLE Generic Views Generic Views ABLE Generic Views t1_vibe_dixon tra bh venous 00:19 00-22 ABLE ABLE t1_vibe_dixon_tra_bh_delayed 00:19 00-22 O ABLE ABLE t1_vibe_dixon_tra_bh_post 00:19 t1_vibe_dixon_tra_bh_post 00:19 t1_vibe_dixon_tra_bh_post 00:19 Whole Body Whole Body 4- 01:53 ti_starvibe_fs tra Whole Body Coverage scan Whole Body Whole Body Whole Body (post CM optional) 7 Unrestricted © Siemens Healthineers, 2025 Notes 400 MR Protocol Building and Optimization- STEP Week 4 Patient View myExam Whole Body Assist SIEMENS Healthineers ... Patient View myExam Whole Body Assist coverage: Head, Chest, Abdomen, Pelvis, Legs. Exam Strategy: • Standard measurements are performed with single and multi-breath-hold techniques. Reduced measurement times reproducible image quality • Motion Insensitive uncooperative/moving patients Focus Adaption • None: no protocol adaptions are performed, only positioning is assisted • AutoFoV: FoV, Slice coverage, and positioning are automatically adapted • AutoFoV+bh: in addition to Auto Coverage, protocol is adapted to patient’s breath-hold capability Auto Bolus Detection: (only focus Abdomen): • Checkbox to automatically detect the arrival of the contrast bolus in the region of interest • Checkbox to automatically start the arterial phase measurement • Only available if focus region Abdomen is selected 8 Unrestricted © Siemens Healthineers, 2025 Notes 401 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... Patient View Auto ROI: Coverage: Checkbox if you want the system to suggest the ROI Focus regions for Thorax (Chest), Abdomen, Pelvis. position. (i.e., Only available if focus region Abdomen is selected). Legs (extended FastView range): Checkbox to activate/Uncheck box to deactivate. Breath-hold Parameters • Breath-hold Capability: seconds. • Automatic voice commands: • Checkbox automatically plays breath-hold commands throughout the examination • Choose a language for breath-hold commands • Choose different voice commands for individual sequences • Pause between Breath-holds: seconds 9 Unrestricted © Siemens Healthineers, 2025 Notes 402 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... Patient View Examination Strategy General Parameters Breath-Hold Parameters (Standard, Motion-insensitive) Exam Strategy Standard Breath-Hold Capability 20 + s Breath-hold capability and Focus Adaptation BH + AutoCoverage Auto Breath-Hold Commands V English (United .. ... Automatic breath-hold Focus adaptation Auto Bolus Detection Pause Between Breath-Holds 10 + s settings specifies protocol adaptation Auto ROI for focus region Coverage Head Thorax Focus Focus Auto Bolus Detection Select one focus region Abdomen Focus and Auto ROI (optional) selectable only Pelvis Focus for focus Abdomen Legs FastView FastView Extend localizer to include legs 10 Unrestricted © Siemens Healthineers, 2025 Notes 403 MR Protocol Building and Optimization- STEP Week 4 FastView myExam Whole Body Assist SIEMENS Healthineers ... FastView Localizer & Range FastView Localizer: • Executes automatic breath-hold commands! • If breath-hold commands exceed the capability of the patient, a Continue Breathing command is automatically given after the configured breath-hold capability Range of FastView localizer is determined by the patient orientation entered during registration and the selected coverage Patient Orientation Coverage Range Range of FastView Localizer Head-First Supine Legs excluded Patient height x 0.7 Legs included Patient height Feet-First Supine Coverage is set in FastView protocol via the Total FoV parameter. Other protocol changes regarding scan direction are needed (H>>F). 11 Unrestricted © Siemens Healthineers, 2025 Notes 404 MR Protocol Building and Optimization- STEP Week 4 Automatic Inline (Region) Segmentation myExam Whole Body Assist SIEMENS Healthineers ... Automatic Inline (Region) Segmentation Based on the FastView data, the system perform automatic segmentation of the anatomical regions. Calculated volumes (organ boxes) visually propose the scan area for three (3) body regions. • Thorax Small & Thorax Large • Abdomen Small & Abdomen Large • Pelvis Note: segmentation only works for patient heights > 120cm. Organ Boxes define: • Positions, coverage and Field-of-View (FoV) suggestions for subsequent measurements • Ensure identical organ positions for all breath-hold measurements • FastView Localizer should always be performed with the same breath-hold technique 12 Unrestricted © Siemens Healthineers, 2025 Notes 405 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... FastView & Automatic Inline (Region) Segmentation Chest Large organ box (Chest Small organ box stops at the diaphragm) Lung Apex Diaphragm Posterior Diaphragm Humerus Lung Recesses Shoulder-R Shoulder-L Organ Boxes: Chest Large – covers apices to posterior lung recesses (complete lung) Chest Small – covers from apices to diaphragm MIP cor MIP sag 13 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 406 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... FastView & Automatic Inline (Region) Segmentation H Chest Small H H Chest Large H 14 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 407 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... FastView & Automatic Inline (Region) Segmentation Abdomen Small (liver) organ box Diaphragm Liver Apex Abdomen Small Organ Box Covers the liver from diaphragm to liver apex. MIP cor MIP sag 15 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 408 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... FastView & Automatic Inline (Region) Segmentation Abdomen Large (liver) organ box Diaphragm OS Iilium Abdomen Large Organ Box Covers the diaphragm to Iliac Crests. MIP cor MIP sag 16 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 409 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... FastView & Automatic Inline (Region) Segmentation Abdomen Small Abdomen Large 17 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 410 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... FastView & Automatic Inline (Region) Segmentation Pelvis Organ Box OS iIium Lower Ischium Pelvis Organ Box Starts at Iliac Crest to Lower Ischium. MIP cor MIP sag 18 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 411 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... FastView & Automatic Inline (Region) Segmentation H Pelvis Organ Box H Abdomen Small Organ Box Covers the liver from diaphragm to liver apex. 19 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 412 MR Protocol Building and Optimization- STEP Week 4 Coverage Modes myExam Whole Body Assist SIEMENS Healthineers ... Coverage Modes Coverage Mode defines how the anatomy is covered for the actual measurement step. Two (2) Coverage Modes are supported within myExam Whole Body Assist: • Anatomical different sizes in H-F direction • Uniform equal sizes in H-F direction The coverage can be adapted manually, as needed. • Repositioning • Changing outer/inner boundaries, etc. 20 Unrestricted © Siemens Healthineers, 2025 Notes 413 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... Anatomical Coverage Mode & FoV Measurement Volumes are adapted according to the segmented anatomical regions. • Measurement Volumes have different sizes in H-F direction Field-of-View (FoV) is adjusted to properly cover the anatomy. Chest • FoV is adjusted to cover the anatomy properly • FoV’s for the different regions are always aligned • Maximum FoV in A-P and R-L directions are propagated • Configured overlap is checked and the configured Abdomen margins are considered (refer to configuration) • Overlap is the same for all stations Pelvis 21 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 414 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers' ... Anatomical Coverage Mode – Splitting within a Region Splitting within a Region: • Configured to reduce compromises in image quality • Performed when the configured maximum extension along the H-F direction is exceeded and if splitting is allowed for this region (refer to configuration) Chest_1 Normally the coverage proposed by the system satisfies user chest demands and the coverage scan can be started. Chest_2 Coverage can be adapted by the user manually (repositioning, changing of outer/inner boundaries, etc.). Changes are stored and affect the non-applied pending protocols. 22 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 415 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... Uniform Coverage Uniform Coverage uses the same size imaging volumes for the entire Whole-Body exam. • No need to separate the measurement volumes in the different regions • All imaging volumes have the same size in the R/L, A/P, and H/F directions • Uniform Coverage Mode is used in Diffusion protocols for consistent image quality across all stations • Dot Add-in, configure the size of the imaging volume in the H/F direction and the overlap (determines size of volumes) • System determines the optimal size and minimum number of individual measurement volumes needed to cover the selected anatomy (*refer to configuration) No splitting is available for uniform coverage mode. 23 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 416 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... Uniform Coverage Mode FoV is adjusted to cover the anatomy properly. FoV’s is always aligned, and maximum FoV in Read and Phase is propagated. Configured overlap is checked and the configured margins are considered (refer to configuration). Normally the coverage proposed by the system will satisfy user demands and the coverage scan can be started. Coverage can be adapted by the user manually (repositioning, changing of outer boundaries, etc.). Changes stored affect the non-applied pending protocols. 24 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 417 MR Protocol Building and Optimization- STEP Week 4 Coverage Scans myExam Whole Body Assist SIEMENS Healthineers ... Coverage Scans Coverage Scans starts from a configured Master Protocol in myExam Whole-Body Assist. Master Protocol • Multiplied into as many protocols as needed, to cover the regions (including splitting) • Within each region the master protocol adapts its naming by adding a region-specific suffix or index (refer to configuration) • Adapts specific physiologic settings for each region, switches off physiologic control, if not needed (refer to configuration) • AutoTiming ensures that none of the measurements performed in a breath-hold exceed the breath-hold capability of the patient • All measurements are performed with identical spatial resolution and contrast to allow combining or composing 25 Unrestricted © Siemens Healthineers, 2025 Notes 418 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers .. Coverage Scans – Library Assist Library Assist T1 3D GRASP t1_tse_co 01:22 t1_vibe_dixon_tra_bh 00:15 whole body oncology To run liver dynamics with GRASP, Whole Body Whole Body Whole Body Assist t1_vibe_dixon_cor_bh 00:17 Alternative 1: User specifies bolus transit ti ... T2 Whole Body E Whole Body Assist t2 haste_stir_cor_mbh 01:16 t1_starvibe_fs_tra 02:37 Test_bolus 01:00 Whole Body Whole Body Generic Views [ library Assist t2_haste_stir_cor_mbh_272 01:16 t1 starvibe_dixon_tra 02:17 Prepare injector E T1 Whole Body Whole Body t2_haste_stir_tra_mbh 01:16 t1_vibe_dixon_FF2pt_tra_bh 00:15 Inform patient to breathe flat. E T2 Whole Body Whole Body t2_fblade_fs_tra_trig 04:14 t1_vibe_dixon_FF2pt_cor_bh 00:17 t1_vibe-grasp_fs_tra 04:58 E 3D Whole Body Whole Body GRASP E diffusion t2 tse_dixon_cor_p2_trig 02:47 Alternative 2: Automatic bolus detection Whole Body DWI E GRASP t2_tse_stir_cor_trig ep2d_diff_b50_800_tra Prepare injector 05:19 03:53 Whole Body Whole Body Inform patient to breathe flat. Coverage Scans: only coronal and transverse orientations are supported within Whole Body Assist t1_vibe-grasp_fs_tra 05:13 GRASP 26 Unrestricted © Siemens Healthineers, 2025 Notes 419 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... Coverage Scans – Contrasts Typical contrasts and orientations needed in Whole Body imaging: • T2 STIR cor/tra (sag spine) • T1 tra/cor • DWI tra Individual contrasts (STIR, in-phase; opposed-phase, Fat, Water, b-values, ADC) are acquired and calculated over multiple regions are combined and composed in a separate series. Coverage scans are strategy specific. 27 Unrestricted © Siemens Healthineers, 2025 Notes 420 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... Coverage Scans – Rollout Example for rollout of coverage scans within the measurement queue. Whole Body Assist ISO ℮ + FastView t2_haste_stir_cor_mbh_thorax • t2_haste_stir_cor_mbh has multiplied itself to cover the regions thorax, t2_haste_stir_cor_mbh_abdomen w abdomen, pelvis 4 t2_haste_stir_cor_mbh_pelvis 5 t1_vibe_dixon_tra_bh_thorax t1_vibe_dixon_tra_bh finished thorax t1_vibe_dixon_tra_bh_abdomen • region, running in abdomen and setup t1_vibe_dixon_tra_bh :1:00 5 00:16 Number of next for the pelvis 8 ep2d_diff_b50_800_tra remaining 11:39 9 7 Sagittal spine scans (only Head-First) steps no • ep2d_diff_b50_800_tra is pending 10 x t2_haste_fs_tra_mbh 01:23 11 localizer_aorta_bh ND 00:19 12 x t1_vibe_dixon_tra_bh_pre 47 10 00:15 13 x Check precontrast 14 Prepare injector 15 Care Bolus 01:16 28 Unrestricted © Siemens Healthineers, 2025 Notes 421 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... Coverage Scans – Rollout 1. When Opening or Appling a sequence, the most critical measurement volume regarding breath-hold capability is identified and AutoTiming is applied. These parameters are applied to all measurements in this protocol for consistency 2. Changing planning data (e.g., coverage) or breath-hold capability affects non-applied pending protocols or applied pending protocols when re-opened. 3. Only a graphical visualization of coverage is displayed within the GSP. (no real slice , not a Set-n-Go protocol!) 4. Phase and slice oversampling, regional saturation bands and navigators are not displayed. 5. Running coverage scans. user can Stop & Continue the running measurement step (e.g., patient moves). The scan continues with the previously stopped measurement step. Note: last measurement step can be stopped but continue is not possible (only Repeat) 6. Inserting a new master protocol into the queue triggers a new coverage scan (as configured). 29 Unrestricted © Siemens Healthineers, 2025 Notes 422 MR Protocol Building and Optimization- STEP Week 4 Focus Scans myExam Whole Body Assist SIEMENS Healthineers ... Focus Scans The user can select a single focus region, either Thorax, Abdomen or Pelvis. Focus Scans are acquired if contrast enhancements of the focus region is needed. Focus Region Abdomen: Liver dynamics performed using ABLE workflow (or GRASP) Focus Region Thorax Dynamic scans for lesion characterization in the thorax (chest) are based on Coronal T1-weighted TWIST-VIBE sequence. Focus Region Pelvis Dynamic scans for lesion characterization in the pelvis are based on Axial T1-weighted TWIST sequence. If needed, at the end of the Whole-Body workflow, a multi-stage T1-weighted scan after contrast injection can be performed. 30 Unrestricted © Siemens Healthineers, 2025 Notes 423 MR Protocol Building and Optimization- STEP Week 4 Configuration myExam Whole Body Assist SIEMENS Healthineers ... Configuration – Measurement Step Anatomical Coverage Mode Select Coverage Mode Coverage Mode anatomical (anatomical/uniform) Min HF-size is the minimum HF(AP)-size of a measurement volume Min. HF-size 180 - mm Physio Control ¥ thorax Physio Control specifies Max HF-size is the maximum Max. HF-size 360 - mm abdomen in which region physiologic control HF(AP)-size of a measurement volume (breath-hold or triggering) Overlap 60 - mm pelvis is enabled Overlap (constant for anatomical) Margin Anterior/Posterior/Lateral Margin Anterior 0 mm Deactivate Split thorax Deactivate Split defines specifies an additional margin Margin Posterior the region splitting added to the respective direction. 0 mm abdomen of measurement volumes is not allowed. Margin Lateral 30 - mm pelvis Whole-Body-Add-in can only be configured in the presence of Whole-Body Patient View 31 Unrestricted © Siemens Healthineers, 2025 Notes 424 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... Configuration – Measurement Step Uniform Coverage Mode Coverage Mode uniform Coverage Mode uniform Overlap Mode constant Overlap Mode variable Overlap Mode = Constant, Min. HF-size 180 mm Overlap mode = Variable, system determines optimal size Max. HF-size 360 mm HF-size 360 - mm system adapts the Overlap of measurement volumes between the measurement (Overlap is constant) volumes while preserving Overlap 60 mm Min. Overlap 60 mm coverage defined in the protocol. Margin Anterior mm Margin Anterior 0 mm Margin Posterior 0 mm Margin Posterior 0 mm Margin Lateral 30 mm Margin Lateral 30 - mm 32 Unrestricted © Siemens Healthineers, 2025 Notes 425 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... Configuration – Measurement Step Guidelines Coverage Mode = Anatomical and Coverage Mode = Uniform with Overlap Mode = Constant. • Min. HF-size must be smaller than half of Max. HF-size • Min. HF-size must be larger than twice the Overlap • Max. HF-size must be larger than twice the Min. HF-size • Overlap must be smaller than half of Min. HF-size Coverage Mode = Uniform with Overlap Mode = Variable • Min. overlap must be smaller than half of HF-size 33 Unrestricted © Siemens Healthineers, 2025 Notes 426 MR Protocol Building and Optimization- STEP Week 4 myExam Whole Body Assist SIEMENS Healthineers ... Configuration – Protocol Adaptions Protocol Adaptions when no Physio control is needed. Breath-hold protocols • Breath-hold is switched off (Physio > PACE card internally) • Concatenations are minimized, keeping TR constant (valid only for 2D protocols) Triggered protocols • Triggering is switched off (Physio > PACE card internally) • TR is set to user specified value within configuration of the measurement step (TR is typically set to the average breathing cycle: 4000ms). This is done to preserve the contrast between measurements in triggered and non-triggered mode • Concatenations are minimized, keeping TR constant (valid only for 2D protocols) 34 Unrestricted © Siemens Healthineers, 2025 Notes 427 MR Protocol Building and Optimization- STEP Week 4 Motion Insensitive Strategy with GRASP myExam Whole Body Assist SIEMENS Healthineers ... Motion Insensitive Strategy – GRASP* ABLE scans can be replaced with GRASP for a Motion Insensitive To run liver dynamics with GRASP, haste_ @ Whole Body _starvibe_fs_tra Strategy. Whole Body ep2d_diff_b50_800_tra Alternative 1: User specifies bolus transit ti ... Sagittal spine scans (only Head-First) no TWIST and TWIST-VIBE: Test_bolus 01:00 LAAspine_scout Save with Asymmetric Sharing Generic Views Il_AAspine_scout (A25%, and B20%) to help Prepare injector III_AAspine_scout prevent artifacts. Inform patient to breathe flat. WL_12_the_stir_ 999 t1_vibe-grasp_fs_tra 04:58 22_haste_stir_tra Generic Views 12_haste_fs_tra abdome 01:03 | 12_haste_fs_tra @ GRASP ent to breathe fat. @ Generic Views Alternative 2: Automatic bolus detection cer_aorta_bh 00:19 Sent to breathe fat. Onco Auto Covera ... arvibe_fs_pre 00:21 00:28 ABLE Generic Views Prepare injector Check precontrast Check precontrast Generic Views Generic Views Prepare injector spare injecto Prepare injector breathe : in - out - in - stop as long as poss re Bolus 01:16 t1_twist_dyn_cor_p2 02:31 Inform patient to breathe flat. @ Care Bolus Generic Views dicon_tra_post 00:28 Generic Views ABLE Generic Views t1_starvibe_fs_tra_venous 00:21 ABLE t1_vibe-grasp_fs_tra 05:13 delayed t1_starvibe_fs_tra_delayed 00:21 O GRASP t1_starvibe_fs_tra_post 02:37 t1_starvibe_fs_tra_post 02:37 t1_starvibe_fs_tra_post 02:37 Whole Body Whole Body Whole Body 35 *Optional license Unrestricted © Siemens Healthineers, 2025 Notes 428 MR Protocol Building and Optimization- STEP Week 4 2-pt Fat Fraction myExam Whole Body Assist SIEMENS Healthineers ... 2-pt Fat Fraction 2pt Fat Fraction gives a rough estimate of the fat. • Takes the fat image and divides by the Fat + water x 100. • Fat fraction maps can be generated from Dixon data with 2 echoes • Activated on Inline > Liver parameter card SIEMENS >> whole body oncology >> library Dot >> 3D t1_vibe_dixon_tra_bh 00:15 % Whole Body t1_vibe dixon cor bh 00:17 Whole Body t1_starvibe fs tra 02:37 Whole Body t1_starvibe_dixon_tra 02:17 Whole Body t1_vibe_dixon_FF2pt_tra_bh 00:15 Whole Body Fat t1_vibe_dixon_FF2pt_cor_bh Water 2pt-FF 00:17 Whole Body t1_vibe_dixon_FF2pt_cor_bh 36 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 429 MR Protocol Building and Optimization- STEP Week 4 Considerations myExam Whole Body Assist SIEMENS Healthineers ... Considerations 1. If splitting is not allowed and the size of the measurement volume in H-F is larger than the configured max. H-F size, the color of the affected measurement volume becomes orange. 2. Minimum/Maximum size of the measurement volume in H-F direction is checked and the color of the affected measurement volume becomes orange if coverage is below/above the configured min./max. H-F size. 3. User can repeat steps (e.g., thorax region), new composing with the most recent results for the different regions is triggered. 4. While repeating the FastView localizer the GSP is blocked, as new planning data (segmentation results) are calculated. 5. Changing of planning data (e.g., coverage) or breath-hold capability will affect non-applied pending protocols, or applied, pending protocols when re-opened. 6. Radial sequences: displayed FoV shows real coverage model. 7. When planning coverage scans, the FoV cannot exceed the sequence limits (graphics are readapted). 37 Unrestricted © Siemens Healthineers, 2025 Notes 430 MR Protocol Building and Optimization- STEP Week 4 Day 4 SIEMENS Healthineers myExam Prostate Assist STEP - MR Protocol Building with myExam Cockpit & myExam Assist Unrestricted © Siemens Healthineers, 2025 Effective date: 5 August 2025 - QR700026089 Notes 431 MR Protocol Building and Optimization- STEP Week 4 Agenda SIEMENS Healthineers ... myExam Prostate Assist • myExam Prostate Assist workflow features • Segmentation • Morphology - T2 Sagittal & T2 Transverse • Diffusion Weighted Imaging (DWI) • Morphology - T2 Coronal • Lymph Node Evaluation • 4D Imaging • Hints & Tips 2 Unrestricted © Siemens Healthineers, 2025 Notes 432 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist Objectives SIEMENS Healthineers ... At this end of this module, you should be able to: • Identify myExam Prostate Assist workflow features • Describe Segmentation • Recall the Morphology - T2 Sagittal & T2 Transverse imaging techniques • Recall the Diffusion Weighted Imaging (DWI) imaging techniques • Recall the Morphology - T2 Coronal imaging techniques • Summarize Lymph Node Evaluation • Describe 4D Imaging • Summarize the hints and tips for myExam Prostate Assist 3 Unrestricted © Siemens Healthineers, 2025 Notes 433 MR Protocol Building and Optimization- STEP Week 4 Disclaimers SIEMENS Healthineers ... The information presented in the myExam Prostate Assist course is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use their own learning, training, and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Medical Systems to be used for any purpose in that regard. 4 Unrestricted © Siemens Healthineers, 2025 Notes 434 MR Protocol Building and Optimization- STEP Week 4 Introduction: Prostate MRI before biopsy SIEMENS Healthineers ... Results of multi-center study Performance of mpMRI pathway in Comparison to PRECISION1 3 TRUS-bx pathway (500 men) MRI-FIRST2 4M Study BIDOC4 Avoid biopsy after negative mpMRI in [%] of patients 28% 18-21% 49% 30% Increase in detection of significant cancers [%] +12% +2% +2% +2% Diagnosis of insignificant -13% -14% -11% +8% cancers Reduction of Biopsy cores per patient (relevant for 11  4 12  3 12  3 infections and side effects) (= -64%) (= -75%) (= -75%) -23% 1 Kasivisvanathan V, et al. PRECISION Study Group Collaborators. MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis. N Engl J Med. 2018; 378(19):1767-1777 2 Rouvière O, Puech P, Renard-Penna R, et al. Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study. Lancet Oncol 2018; http://dx.doi.org/10.1016/S1470-2045(18)30569-2. 3 van der Leesta M, Cornelb E, Israëla B, et al. Head-to-head comparison of transrectal ultrasound guided prostate biopsy versus multi-parametric prostate resonance imaging with subsequent MR-guided biopsy in biopsy-naïve men with elevated PSA; a large prospective multicenter clinical study. Eur Urol 2018 in press 4 Boesen L, Nørgaard N, Løgager V, et al. Assessment of the Diagnostic Accuracy of Biparametric MRI for Prostate Cancer in Biopsy-Naive Men. The Biparametric MRI 5 for Detection of Prostate Cancer (BIDOC) Study. JAMA Network Open. 2018;1(2):e180219. Unrestricted © Siemens Healthineers, 2025 Notes 435 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers' ... Introduction myExam Prostate Assist provides Prostate Dot Engine TOIt PDE TOBE POE TOL POE fast, robust and standardized 1 IMA1 FRM 11/22 IMA1 FROM 9/17 2 AM_Prostate_Segm prostate MR examination for each 3 x 12_tse_sag_p2_fast 4 x_ 12_tse_tra_p3_352 02:07 patient’s anatomical status 5 % Air in rectum ? yes 6 % resolve_diff_b50_800_tra_p2 04:14 • Supports multi-parametric MR x 12_tse_cor_p3_352 02:07 8 % Lymph nodes eval ? yes imaging (mpMR) according to 9 x_ 11_vibe_dixon_tra_p2_352_lymph_n ... 01:10 10 x 4D Imaging ? yes latest guidelines (PIRADS 2.1) inject contrast after 3 measurements SP SP P13.5 11 SAMPINORMSHIFI/DIS20 OV 200"200 FoV 200-200 SAMP/NORM/SH/FIL/DIS2D Cor Workflow decisions, image 12 x 11_vibe-twist_dixon_tra_dyn_p4 04:36 Not for diagnostic use 1547 761 MA_Prostate_Segm_MPR_cor 1125 • 2 14:14 Not for diagnostic use guidance and text is available and Go Cancel & 1:03 min 4 Auto 2 @0.4x0.4x3.0 mm3 1.00 Parameters configurable by the user RESP Check slice positions and adjust If necessary. SAR Stimu 6 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 436 MR Protocol Building and Optimization- STEP Week 4 Introduction myExam Prostate Assist SIEMENS Healthineers' ... Introduction Inline processing functionalities: Prostate Dot Engine JOSEPDE 41 IMA 1 FRM 11/22 • Automatic segmentation of the 42 IMA 1 FRM 9/17 2 MA_Prostate_Segm x_ 12_tse_sag_p2_fast prostate 4 %_ 12_tse_tra_p3_352 Report generation containing 5 % Air in rectum ? • 6 76a resolve_diff_b50_800_tra_p2 04:14 prostate volume and PSA 7 x 12_tse_cor_03_352 02:07 % Lymph nodes eval ? density 9 x_ 11_vibe_dixon_tra_p2_352_lymph_n ... 01:10 10 x 4D Imaging ? SP 8220 SP P13.5 11 inject contrast after 3 measurements FoV 200 200 FoV 200-200 Sag SAMPINORM/SHFIL/DIS2D Cor 04:36 Not for diagnostic use AA_Prostate_Segm_MPR_cor 1125 AA_Prostate_Gegm_SEC Automatic coverage and slice 12 X 11_vibe-twist_dixon_tra_dyn_p4 1547 D2.MAGNINORM/SH/FIL/0820 2 14:14 Not for diagnosSc use 551 Not for diagnost Contoured Prostate positioning according to user Go Cancel Dot & 1:03 min 4 Auto 2 2 @ 0.4x0.4x3.0 mm) ? 1.00 Guidance Parameters preferred setup. RESP Check slice positions and adjust if necessary. 7 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 437 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... Strategy and Decision Steps One (1) Strategy that includes: Dot Prostate Dot Engine Prostate Patient View AutoAlign Prostate Segmentation V Standard localizer 00:12 • Scan is run after the 3-plane localizer Ganaric MiANIC AA_Prostate_Segm 00:41 • Automatically segments the prostate and allows Onco Auto Coverage Scout . t2_tse_sag_pz_fast 00:42 automatic coverage for protocols that use the Prostate Prostate t2_tse_tra_p3_368 02:22 Add-in Prostate Air in rectum ? Basic Decision Air in rectum ? Three (3) Decision Steps: yes no resolve_diff_b50_800_tra_p2 04:14 ep2d_diff_zoomit_b50_800_tra 03:30 1. Air in rectum? Prostate Prostate t2_tse_cor_p3_368 02:22 2. Lymph nodes evaluation? Prostate Lymph nodes eval ? 3. 4D Imaging? no Basic Decision Lymph nodes eval ? t1_vibe_dixon_tra_p2_352_lymph_nodes 01:10 Generic Views 4D Imaging ? yes Basic Decision 4D Imaging ? inject contrast after 3 measurements t1_vibe-twist _dixon_tra_dyn _p4 04:36 Prostate 8 Unrestricted © Siemens Healthineers, 2025 Notes 438 MR Protocol Building and Optimization- STEP Week 4 Workflow myExam Prostate Assist SIEMENS Healthineers ... Decision Steps 1. Air in rectum the user decides if the rectum contains a lot of air. This Dot Prostate Dot Engine Prostate Patient View decision influences the following diffusion weighted imaging sequence. V Standard localizer 00:12 a. Yes; the RESOLVE sequence is used. O Generic Views AA_Prostate_Segm 00:41 b. No, a ZOOMit single-shot EPI sequence is used C Onco Auto Coverage Scout t2_tse_sag_p2_fast 0042 Prostate t2_tse_tra_p3_368 02:22 2. Lymph nodes evaluation the user decides if a large Field-of-View (FoV) Prostate Air in rectum ? T1-weighted VIBE-Dixon sequence for lymph node evaluation should be no Rasic Decision Air in rectum ? performed. yes no resolve_diff_b50_800_tra_p2 04:14 ep2d_diff_zoomit_b50_800_tra 03:30 Prostate Prostate t2_tse_cor_p3_368 02:22 3. 4D Imaging the user decides if a perfusion weighted measurement Prostate Lymph nodes eval ? should be performed. & no Q Basic Decision Lymph nodes eval ? 11_vibe_dixon_tra_p2_352 lymph_nodes 01:10 Generic Views AD Imaging ? @ Racir Dericinn 4D Imaging ? inject contrast after 3 measurements yes t1_vibe-twist_dixon_tra_dyn_p4 04:36 Prostate 9 Unrestricted © Siemens Healthineers, 2025 Notes 439 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... Prostate Patient View One Standard Strategy is available. Anatomical Two (2) Slice Orientations are provided: General Parameters Prostate Parameters • Anatomical slices are perpendicular Exam Strategy Standard Slice Orientation Anatomical to the axis of the prostate PSA Value 6.00 - ng/ml • Axial true axial slice orientation PSA Value can be defined from which the PSA Density is automatically calculated. Axial 10 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 440 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... Prostate Anatomy and Slice Orientation Slice Orientation: Anatomical Slice Orientation Axial Slice group is auto-aligned using landmark detection Slice group is strictly Axial. (urethra in/outlet). Bladder Bladder Seminal vesicle Seminal vesicle Urethra inlet - Ejaculatory Urethra inlet Periurethral zone (PuZ)~ duct Periurethral zone (PUZ)~ Urethra inlet -Ejaculatory duct Transition zone (TZ) Transition zone (TZ) Central zone (CZ) Central zone (CZ) Anterior fibromuscular Urethra outle Peripheral zone (PZ) Anterior fibromuscular Peripheral zone (PZ) stroma (AFS) stroma (AFS) Urethra outlet Urethra outlet Urethra Urethra 11 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 441 MR Protocol Building and Optimization- STEP Week 4 Segmentation myExam Prostate Assist SIEMENS Healthineers ... Segmentation After the initial 3-plane localizer AA_Prostate_Segm 00:41 an AutoAlign Prostate Onco Auto Coverage Scout Segmentation scan is performed. This is a strict Axial T2 weighted low resolution TSE scan that must cover the entire prostate (as seen in these guidance images). From this measurement the prostate gland is automatically segmented using Artificial Intelligence (AI). 77 12 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 442 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... AA Prostate Segmentation Results 1. T2 weighted image with 1 2 4 Report overlay of prostate contours. CURRENT test_1/.12.2019_2 Hospital Anlagenzentrum MR ACQPrisma *1/23/1963, M, 56Y MAGNETOM Prisma 2. Segmentation mask is used to ETT CURRENT STUDY 12/17/2019 Prostate size Anterior >> Posterior = 37.03 mm calculate the prostate volume. ProstateSegReport latest 3. Sagittal and Coronal MPR’s are 48 52 PM Prostate size Right >> Left = 52.08 mm 8 IMA i FRM 1/1 used for planning subsequent Prostate size Foot >> Head = 42.81 mm LINE high-resolution scans. Segmentation contour Segmentation Mask Prostate volume = 44.80 ml 4. Report displays: 3 3 PSA= 0.00 ng/ml 1cm a. Prostate size in A/P, R/L and PSA Density = 0.13 ng/ml2 H/F directions. b. Volume of prostate. Computer estimated prostate volume may not be accurate. Check contours. Computer generated contours may not correspond to anatomy c. PSA density calculated from Inline MPR Sagittal Inline MPR Coronal the PSA value. 13 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 443 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers' ... Prostate Volume and PSA Density Calculation How was the prostate volume calculated prior to prostate segmentation algorithm? • Prostate volume (ml): AP x LR x HF x 0.52 • PSA-density (ng/ml2): PSA-value (ng/ml) / Prostate volume (ml) P 14 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 444 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... AA Prostate Segmentation Report AA Prostate Segmentation syngo MR XA30 results should be verified. test_17.12.2019_2 Hospital Anlagenzentrum MR Operator Manual - Oncologici ACQPrisma *1/23/1963, M, 56Y MAGNETOM Prisma CURRENT 3 Verify segmentation results. STUDY 12/17/2019 Disclaimer warns user that the Prostate size Anterior >> Posterior = 37.83 mm If segmentation could not be performed correctly, some of the ProstateSegReport values in the DICOM report will be incorrect. latest prostate volume may not be 12/17/2019 Prostate size Right >> Left = 52.08 mm 218-52 PM 8 IMA 1 FRM 11 i Please be aware of the fact that the prostate volume is a computer- estimated value and may not be accurate. accurate due to the last cranial Prostate size Foot >> Head = 42.81 mm Check contours. and caudal slices which may not Computer-generated contours may not correspond to anatomy. Prostate volume = 44.80 ml correspond to the anatomy. PSA - 6.00 ng/ml The segmentation cannot be PSA Density = 0.13 ng/ml2 edited. Computer estimated prostate volume may not be accurate. Check contours. Computer generated contours may not correspond to anatomy. If the segmentation is not Report Note: Check last cranial and caudal correct (e.g., due to motion slices. then the scan can be repeated which may improve the results). 15 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 445 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers' ... Segmentation (AI-based) – Numaris X versus syngo.via NUMARIS (XA30A) syngo.via (VB50) test_6.11.2019_13 test_6.11.2019_13 ACQAera MAGNETOMAera ACQAera MAGNETOM Aera *10/11/1953, M, 66Y MIR XA30 *10/11/1953, M, 66Y MR XA30 CURRENT FFS CURRENT 11/6/2019 11/6/2019 AA_Prostate_Segm_SEG 1,2 t2_tse_tra_p3_336 latest latest STUDY ID c91 cf2d0-4efa-44 STUDY ID c81 cf2d0-4efa-44 8:44:39 AM Volume: 40.50 cm3 8:47:23 AM Volume 14,53 cm3 3 IMAn.a. FRM n.a. 11 IMAn.a. FRM n.a. Min / Max: 0.00 /580.00 22.72 cm3 Mean/SD: 179.06 /65.42 LIL RHA RHA MPR MPR Gland Volume 5cm Volume 21 :41 cm3 , min SPC 1.0 SPC 0.3 VIII/ Max. 0.00 /020.08 Mean/SD: 195.44 /70.13 D TR 6800.0 TE 97.0 TP F27 SP F34.7 MPR : p2 MAGN/NORM/SHIFI/DIS2D MPR : p3 MAGN/NORMISHIFIL/DIS2D SP F34.7 538*672s | 127*192s Tra>Sag(-1)>Cor(1) 1014 BO1,2,SP5 Tra>Sag(-1)>Cor(1) 1157 tse201_25/160 W tse2d1_25/160 Not for diagnostic use 576 16 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 446 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... Segmentation (AI-based) – Numaris X versus syngo.via • The difference between the two algorithms is minor as seen on the previous slide, with syngo.via being slightly more accurate • Based on customer feedback if the difference is less than 10% then it is not significant • The aim is to have no differences between the left- and right-hand side and therefore this may change in the future NUMARIS (XA30A and future software): syngo.via (VB50 and future software): • Segmentation algorithm version 2.1 • Segmentation algorithm version 3.0 • Low resolution T2 images used for segmentation • High resolution T2 images used for segmentation • 2D slice data • 3D volume data generated from T2 images • Small training dataset used for algo • Large training dataset used for algo 17 Unrestricted © Siemens Healthineers, 2025 Notes 447 MR Protocol Building and Optimization- STEP Week 4 Morphology myExam Prostate Assist SIEMENS Healthineers ... Morphology: T2 Sagittal Coverage Sagittal T2 is scanned after the segmentation scan and a prostate add-in is attached to the protocol. Guidance Parameters Enable Prostate AutoCoverage Queue GSP Organ box Prostate Add-in configuration: Series Label V Propagate changes to all following protocols Enable Prostate AutoCoverage is activated, Auto Load • Keep FOV constant Prostate and the prostate organ box is selected. This Keep coverage constant ensures full coverage of the prostate, and the Additional coverage number of slices required to cover the Asymmetric Coverage prostate in the right-left direction are Additional coverage lateral 3 4 mm results in 1 additional slice on each side calculated in real time Apply cranial inplane shift • Propagate changes to all following protocols is also activated • By default, the coverage of the prostate is additionally symmetrically extended on both sides by 3mm which results in 1 additional slice each side, if 3mm slice thickness is used 18 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 448 MR Protocol Building and Optimization- STEP Week 4 T2 Sagittal myExam Prostate Assist SIEMENS Healthineers ... Morphology: T2 Sagittal Coverage A cranial shift has been implemented into the sagittal protocol by default. • This means that the sagittal slice group is shifted cranially so that the lower end of the field of view sits 5cm below the apex of the prostate • This enables coverage of the relevant anatomy superior to the prostate Not Shifted Additional coverage Asymmetric Coverage Additional coverage lateral 3 mm results in 1 additional slice on each side 5 cm Apply cranial inplane shift Shifted 19 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 449 MR Protocol Building and Optimization- STEP Week 4 T2 Transverse myExam Prostate Assist SIEMENS Healthineers ... Morphology: T2 Transversal Coverage The next scan is the high resolution T2 TSE Transverse. • By default, additional Asymmetric Coverage has been Enable Prostate AutoCoverage configured for this scan to extend the coverage of the Organ box Prostate prostate in the cranial and caudal directions. Propagate changes to all following protocols • Coverage is asymmetrical because when the slice group Keep FOV constant is centered on the prostate, 4 slices are added cranially Keep coverage constant compared to 2 slices caudally. This enables coverage of the seminal vesicles superiorly Additional coverage Asymmetric Coverage Note: The option Apply cranial in-plane shift Additional coverage cranial 12 - mm results in 4 additional slices implemented with the sagittal orientation is not visible Additional coverage caudal 6 - mm results in 2 additional slices here. This option is based on the slice orientation of the protocol. If the slice orientation is set to Transversal, the option is automatically deactivated and no longer visible. 20 Unrestricted © Siemens Healthineers, 2025 Notes 450 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... Morphology: T2 Transversals – Anatomical Slice Orientation Additional Coverage: Asymmetric Coverage Additional Coverage: None Additional coverage Asymmetric Coverage Additional coverage Additional coverage cranial 12 + mm results in 4 slices Asymmetric Coverage Additional coverage caudal 6 4 mm results in 2 slices Additional coverage transversal 0 4 mm results in 0 slices on each side 21 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 451 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... Morphology: T2 Transversals – Axial Slice Orientation Additional Coverage: Asymmetric Coverage Additional Coverage: None Additional coverage Additional coverage Asymmetric Coverage Asymmetric Coverage Additional coverage cranial 12 4 mm results in 4 slices Additional coverage transversal 0 4 mm results in 0 slices on each side Additional coverage caudal 6 mm results in 2 slices 22 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 452 MR Protocol Building and Optimization- STEP Week 4 Diffusion Weighted Imaging (DWI) myExam Prostate Assist SIEMENS Healthineers .. Diffusion Weighted Imaging (DWI) The next sequence is Diffusion weighted Imaging. Dot Prostate Dot Engine Prostate Patient View V Standard localizer 00:12 A workflow decision has been implemented allowing the user to decide Generic Views AA_Prostate_Segm between two DWI techniques depending on how much air is in the rectum. Onco Auto Coverage Scout t2_tse_sag_p2_fast 00:42 Excessive Air in the Rectum: select the RESOLVE sequence to help reduce O Prostate • t2_tse_tra_p3_368 02:22 the amount of distortion in the prostate Prostate Air in rectum ? • Minimal Air in the Rectum: select the ZOOMit EPI sequence for higher no Basic Decision Air in rectum ? signal-to-noise for the DWI measurement and ADC calculation yes no resolve_diff_b50_800_tra_p2 04:14 ep2d_diff_zoomit_b50_800_tra 03:30 Prostate Prostate t2_tse_cor_p3_368 If the conventional single-shot EPI sequence is the preferred then the Prostate Lymph nodes eval ? corresponding protocol in the Assist can be replaced with this protocol, but no Basic Decision Lymph nodes eval ? the Prostate add-in should be attached and configured properly. yes t1_vibe_dixon_tra_p2_352_lymph_nodes 01:10 Generic Views 4D Imaging ? yes Basic Decision 4D Imaging ? inject contrast after 3 measurements yes t1_vibe-twist_dixon_tra_dyn_p4 04:36 Prostate 23 Unrestricted © Siemens Healthineers, 2025 Notes 453 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... Diffusion Weighted Imaging (DWI) b800 Dot Prostate Dot Engine Prostate Patient View CURRENT 18.02-2021 ep2d_diff_zoomt_b30_000_tra_TRACEW V Standard latest/B-Value_02 00:12 STUDY D c5537218-200c-41 STUDY 10 €5537210-2506-41 localizer 15:36:39 Generic Views 11 MA 2 FFM 10/18 14 MA 2 FRM 1018 AA Prostate Segm 00:41 Onco Auto Coverage Scout t2_tse_sag_p2_fast 00:42 SPC 3,0 30 Prostate t2_tse_tra_p3_368 02:22 TR 4000,0 TR 4000,0 Prostate TE 72,0 TE 62,0 14 03:30 TA 04 14 Air in rectum ? BWV 1566,0 BW 963,0 MAGNCEFF/TRACEW/NORM/DFCMX DS2D p2 MAGNDFF/TRACEWINORMDIS2D A no Basic Decision ATOPIPES A2/SATAFS BY1,2, SP4 BY1,2 SP4 Air in rectum ? yes no ZOOMit Resolve resolve_diff_b50_800_tra_p2 04:14 ep2d_diff_zoomit_b50_800_tra 03:30 Prostate Prostate NOMETOM LUPINE [2_use_cor_p5_308 Prostate 77:20 Lymph nodes eval ? no Basic Decision STUDY O 65537218-2006-41 Lymph nodes eval ? 12 MA 1 FRM 10/18 ADC yes t1_vibe_dixon_tra_p2_352_lymph_nodes 01:10 Generic Views 4D Imaging ? 30 SPC 3,0 yes Basic Decision D Imaging ? TR 4000,0 TE 720 yes TA 03:30 BWV 1565,0 inject contrast after 3 measurements A10/PFPAS t1_vibe-twist_dixon_tra_dyn_p4 04:36 ZOOMit Resolve Prostate 24 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 454 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... Diffusion Weighted Imaging (DWI) – Resolve Planning (1 of 2) Resolve Planning: • Slice coverage and orientation are identical to previous T2-weighted Axial sequences • Due to Phase Encoding Direction, Sat Bands are required to suppress tissue outside the FoV • Sat bands are positioned automatically on the left and right side of the FoV due to the Prostate Add-in • Two sat bands are applied on each side and they have an overlap of 2cm to ensure sufficient suppression of tissue • No user interaction is required, if the position of the imaging volume is changed, then sat bands will follow • If the single-shot EPI sequence is used instead, then sat bands are positioned automatically as long as the Prostate add-in is attached and 4 sat bands are configured within the protocol 25 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 455 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... Diffusion Weighted Imaging (DWI) – Resolve Planning (2 of 2) Example: Anatomical Slice Orientation: Asymmetric Coverage AF test_17.12.2019_2 AT FRM 10/20 ACQPrisma TP H43 SP R4:4 FoV 220*220. P2 MAGN/NORMISHIFIL/DIS2D Sag 12_tse_sag_p2_fast W AFIU/DIS2D FIL/DIS2D 798 n_MPR_cor IL 26 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 456 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... Diffusion Weighted Imaging (DWI) – ZOOMit EPI Planning (1 of 2) ZOOMit EPI Planning: • ZOOMit Pro license is included with the Prostate Assist license • Slice coverage and orientation will be identical to previous T2-weighted axial scan • With this method, only the tissue inside the FoV is excited and therefore no sat bands are required • Left-Right phase encoding is implemented to avoid bladder and rectum artifacts over the prostate 27 Unrestricted © Siemens Healthineers, 2025 Notes 457 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers' ... Diffusion Weighted Imaging (DWI) – ZOOMit EPI Planning (2 of 2) Example: Anatomical Slice Orientation: Asymmetric Coverage H test_17.12.2019 2 test_17.12.2019_2 test_17.12.2019_2 ACQPrisma ACQPrisma ACQPrisma 10 IMA1 FRM 10/20 7 IMA 1 FRM 8/16 11 IMA 1 FRM 14/22 LIS LA TP H43 TP H8 SP R4:4 SP A7.3 FoV 220*220 FoV 200*200 P2 MAGN/NORMISHIFIL/DIS2D ov 200 12_tse_sag_p2_fast Sag ... SAMP/NORM/SH/FIL/DIS2D Cor 798 AA_Prostate_Segm_MPR_cor p3 MAGN/NORM/SH/FIL/DIS2D W 1278 t2 tse_tra_p3 368 1066 385 C 640 14-1 777 28 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 458 MR Protocol Building and Optimization- STEP Week 4 Morphology - T2 Coronal myExam Prostate Assist SIEMENS Healthineers ... Morphology: T2 Coronal Coverage Coronal T2 is acquired after the Diffusion Weighted Imaging (DWI). Enable Prostate AutoCoverage • Coronal orientation is always perpendicular to the selected Transversal Slice Orientation (i.e., Anatomical or Axial) Organ box Prostate Propagate changes to all following protocols • Transversal protocol, Asymmetric Coverage is configured by default to extend the coverage in the anterior-posterior direction Keep FOV constant Keep coverage constant • Extra coverage is configured posteriorly compared to anteriorly to ensure that the seminal vesicles are included Additional coverage Sagittal T2, a cranial in-plane shift is applied by default. This Asymmetric Coverage • moves the FoV towards the head to cover more anatomy Additional coverage posterior 12 4 mm results in 4 additional slices superiorly to the prostate Additional coverage anterior 6 4 mm results in 2 additional slices Apply cranial inplane shift 29 Unrestricted © Siemens Healthineers, 2025 Notes 459 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... Morphology: T2 Coronal – Anatomical Slice Orientation No Cranial in-plane Shift Cranial In-plane Shift Asymmetric Coverage None Asymmetric Coverage Asymmetric Coverage None None 30 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 460 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... Morphology: T2 Coronal – Axial Slice Orientation No Cranial in-plane Shift Cranial In-plane Shift Asymmetric Coverage None Asymmetric Coverage None 31 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 461 MR Protocol Building and Optimization- STEP Week 4 Lymph Node Evaluation myExam Prostate Assist SIEMENS Healthineers .. Lymph Node Evaluation – Positioning In the Lymph Node Evaluation workflow decision step decide if you Dot Prostate Dot Engine Prostate Patient View want to acquire a large FoV T1-weighted scan. Standard localizer 00:12 • Yes selected, then a T1 VIBE Dixon sequence is applied Generic Views AA_Prostate_Segm 00:41 • No auto coverage is provided for this protocol and a Generic Views Onco Auto Coverage Scout t2_tse_sag_p2_fast 00:42 Add-in is attached Prostate t2_tse_tra_p3_368 02:22 • The protocol is programmed to position the center of the FoV Prostate Air in rectum ? 75mm above the center of the prostate, with the lower end of the no Basic Decision Air in rectum ? FoV on the symphysis pubis yes no resolve_diff_b50_800_tra_p2 04:14 ep2d_diff_zoomit_b50_800_tra 03:30 Prostate • Since we do not have segmentation of whole body, we do not Prostate t2_tse_cor_p3_368 02:22 know if the patient is shifted in the Right-Left direction, so you Prostate Lymph nodes eval ? may need to shift the FOV Lymph nodes eval ? yes t1_vibe_dixon_tra_p2_352_lymph_nodes 01:10 Generic Views 4D Imaging ? yes Basic Decision 4D Imaging ? yes inject contrast after 3 measurements t1_vibe-twist_dixon_tra_dyn_p4 04:36 Prostate 32 Unrestricted © Siemens Healthineers, 2025 Notes 462 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers' ... Lymph Node Evaluation – Positioning test_17.12.2019_2 test_17.12.2019_2 test_17.12.2019_2 ACQPrisma ACQPrisma ACQPrisma 1 IMA 1 FRM 5/18 1 IMA 1 FRM 10/18 1 IMA 2 FRM 6/13 75mm R 10cm 10cm 100m AJ TP O TP O P SP 0.0 FoV 300*300 SP A10.0 SP H8.8 FoV 300*300 FoV 300*300 p2 MAGN/NORM/SH/FIL/DIS2D Sag p2 MAGN/NORM/SH/FIL/DIS2D localizer 958 958 p2 MAGN/NORM/SH/FIU/DIS2D Tra 958 460 localizer W localizer C 460 460 33 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 463 MR Protocol Building and Optimization- STEP Week 4 4D Imaging myExam Prostate Assist SIEMENS Healthineers ... 4D Imaging – Coverage Final decision step within the Prostate Assist workflow is 4D Imaging. Dor Prostate Dot Engine Prostate Patient View • The user can decide whether dynamic contrast enhanced imaging V Standard localizer 00:12 should be acquired Generic Views AA_Prostate_Segm 00:41 Onco Auto Coverage Scout • The decision is set to Yes by default t2_tse_sag_p2_fast 00:42 The TWIST-VIBE protocol is used and the license for the TWIST-VIBE Prostate • t2_tse_tra_p3_368 02:22 is included in the Prostate Assist license Prostate Air in rectum ? • The slice orientation and position of imaging volume is identical to no Basic Decision Air in rectum ? the T2 tra and DWI measurements, however the number of slices yes no resolve_diff_b50_800_tra_p2 04:14 ep2d_diff_zoomit_b50_800_tra 03:30 are fixed Prostate Prostate t2_tse_cor_p3_368 02:22 Prostate Lymph nodes eval ? no Basic Decision Lymph nodes eval ? yes t1_vibe_dixon_tra_p2_352_lymph_nodes 01:10 Generic Views 4D Imaging ? yes Basic Decision 4D Imaging yes inject contrast after 3 measurements t1_vibe-twist_dixon_tra_dyn_p4 04:36 Prostate 34 Unrestricted © Siemens Healthineers, 2025 Notes 464 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... 4D Imaging – Coverage Enable Prostate AutoCoverage is Routine Contrast Resolution Geometry activated to ensure that the Enable Prostate AutoCoverage Slab Group Organ box Prostate 1 position and angulation of the V Propagate changes to all following protocols. Slabs imaging volume is identical to the T2 tra and DWI imaging volume. Keep FOV constant Slices per Slab 26 + Keep coverage constant Keep coverage constant : Additional coverage Constant coverage = number of slices from Asymmetric Coverage protocol guarantees constant temporal • Number of slices remains Additional coverage transversal 0 4 mm results in 0 additional slices on each side resolution for dynamic scans: constant • Ensures a constant temporal Total Measurement Time: 4:36 min resolution for all patients Temporal resolution: 3.33 s Number of slices and coverage Whole matrix: 8.26 s • may differ to the t2 tra and DWI protocols 35 Unrestricted © Siemens Healthineers, 2025 Notes 465 MR Protocol Building and Optimization- STEP Week 4 Hints & Tips myExam Prostate Assist SIEMENS Healthineers ... Hint and Tips – Propagate Changes Any changes made to the positioning, angulation and coverage are propagated to protocols of the same orientation that have VEnable Prostate AutoCoverage not yet been applied in the queue (they are still pending). Organ box Prostate Propagate changes to all following protocols If the protocols have already been applied, they need to be Keep FOV constant reopened for these changes to be propagated. This means that Keep coverage constant sagittal, transversal and coronal orientations are handled Additional coverage independently from each other. Asymmetric Coverage Additional coverage cranial 12 - mm results in 4 additional slices Additional coverage caudal 6 mm results in 2 additional slices 36 Unrestricted © Siemens Healthineers, 2025 Notes 466 MR Protocol Building and Optimization- STEP Week 4 myExam Prostate Assist SIEMENS Healthineers ... Hint and Tips – Assist Library All Protocols within the Prostate Assist are saved with An Assist Library was added under the Pelvis Male guidance images using the Anatomical Slice region. Here, all the protocols with guidance images for Orientation. the Axial Slice Orientation are found. If the user prefers If the user wants to use Axial Slice Orientation, then this orientation, then protocols in the Prostate Assist can the Guidance images are not updated automatically. be exchanged with these. Parameters Parameters SIEMENS SIEMENS [ pelvis male [ pelvis male Check slice positions and adjust If necessary. Prostate Assist Check slice positions and adjust if necessary. Prostate Assist Parameters prostate program Parameters prostate program > [ library library library Assist library Assist E T2 E T2 E diffusion E diffusion El dynamic Check slice positions and adjust If necessary. El dynamic heck slice positions and adjust if necessary. 37 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 467 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers myExam Autopilot STEP - MR Protocol Building with myExam Cockpit & myExam Assist Unrestricted © Siemens Healthineers, 2025 Effective date: 5 August 2025 - QR700026089 Notes 468 MR Protocol Building and Optimization- STEP Week 4 Agenda SIEMENS Healthineers ... myExam Autopilot • Introduction • Autopilot User Interface (UI) • Autopilot workflow setup • Summary • myExam Brain Autopilot • myExam Knee Autopilot 2 Unrestricted © Siemens Healthineers, 2025 Notes 469 MR Protocol Building and Optimization- STEP Week 4 Objectives SIEMENS Healthineers ... At this end of this module, you should be able to: • Recognize the Autopilot User Interface (UI) • Explain the Autopilot workflow setup • Summarize the myExam Autopilot and features • Recall the features myExam Brain Autopilot • Describe myExam Knee Autopilot 3 Unrestricted © Siemens Healthineers, 2025 Notes 470 MR Protocol Building and Optimization- STEP Week 4 Disclaimers SIEMENS Healthineers ... The information presented in the myExam Autopilot course is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use their own learning, training, and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Medical Systems to be used for any purpose in that regard. Please refer to a Contrast Agent manufacturer's labeling, and instructions for use, for use of that Contrast Agent with an MRI exam. 4 Unrestricted © Siemens Healthineers, 2025 Notes 471 MR Protocol Building and Optimization- STEP Week 4 Introduction myExam Autopilot SIEMENS Healthineers ... Introduction myExam Autopilot myExam Assist myExam Cockpit 0000000 ----- ................................................................................................................................... .................................................................................................................................. ................................................................................................................................. Automate intelligently Flexible and guided Customize intuitively ....................................................................................................................... ............................................................................................................ Tailored user assistance enabling consistent results 5 Unrestricted © Siemens Healthineers, 2025 Notes 472 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Introduction Fully automated workflow for core applications (brain, knee). Scanning may be performed with limited experience and/or reduced workload. • Workflow automation: less user interaction • Simplified and intuitive User Interface (UI) • User Interface (UI) guidance with focus-attracting design 000000000 • Novel touch or click interaction Classic Numaris X interface and workflows are still available. ...... Embedded remote operation capabilities with syngo Virtual Cockpit 6 Unrestricted © Siemens Healthineers, 2025 Notes 473 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Introduction Fast, reproducible and standardized MRI examinations. Advanced workflow automation: • AutoPosition • AutoAlign • AutoCoverage 000000000 • SAR Assistant Multiple Exam Strategies are supported, and adaption is possible during examination. ...... Exam settings are available: • Decisions (e.g., Contrast Agent injection, no decision steps) • Languages • Patient comfort settings 7 Unrestricted © Siemens Healthineers, 2025 Notes 474 MR Protocol Building and Optimization- STEP Week 4 Autopilot User Interface myExam Autopilot SIEMENS Healthineers ... Autopilot View Autopilot View is initiated only via the selection of a Patient Registration Program selection myExam Autopilot program at patient registration Test, Autopilot All Programs Examination Information • Load Program to Queue must be selected Last Name |Test SIEMENS Procedure First Name Autopilot Accession Nr. • If above conditions are not met, it is not possible Middle Name Req. Proc. ID * Patient ID 01 head Study Description head Brain Autopilot to switch to Autopilot View during the Date of Birth |8/8/1982 [M/d/yyyy! Brain Assist Study Comment * Age |40 Year(s) [ Brain Autopilot examination * Sex |M (Male) program clinical libranes * Height |170 cm > [ advanced applications libraries Weight |70 kg › LIGOBrain library Medical Information angiography angiography ce Admitting Diagnosis Lc-spine Implant Scanning > [t-spine Alerts No Implant > [ l-spine whole spine Medical Alerts Program Selection neck soft tissue Allergies › thorax SIEMENS >> head >> Brain Autopilot > program › heart VLoad Program to Queue breast RF Transmit Mode abdomen Any Polarization > [ pelvis female > [ pelvis male Body Part and Laterality > [ tmj › shoulder Brain Unpaired elbow Patient Orientation > wrist Head First Supin ISafety relevant information needs to be validated and confirmed . Mandatory information Autopilot View Save Cancel Delete Local Data Prior Studies Exam EN 2:31:04 PM 8 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 475 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Autopilot View & Expert View Autopilot View Expert View  Simplified User Interface (UI) The Classic Numaris X interface and workflows (Numaris X  Autopilot workflow is customized in myExam Cockpit scan UI, MR View&GO, advanced post-processing) are still  Supports basic image distribution accessible for conventional and experienced operators in  Released for brain and knee Autopilot workflows Expert View. Switch between Autopilot View and Expert View during examination. Hint: the user cannot switch back to Autopilot View if an incompatible feature was added/changed in Expert View. (e.g., adding working man). 9 Unrestricted © Siemens Healthineers, 2025 Notes 476 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers' ... Autopilot View & Expert View ------- Autopilot View Expert View 10 Images on file Unrestricted © Siemen Unrestricted © Siemens Healthineers, 2025 s Healthineers, 2025 Notes 477 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Autopilot User Interface (UI) – Overview 7 8 1. Image viewing area Healthingers à ¡ R 6 2. Details area Anatomic regions wer AAHead_Scout 3. Workflow & exam information detected successfully 2 Scan Time 4. Workline with illustrated 1 0:32 min Repeat Stop workflow steps 5. Workflow control 6. Access bar 7. sVC (syngo Virtual Cockpit) 8. Switch UI Brain Autopilot | StaHard 6:56 Remaining Time SAR 6:56 Check Image Que. 114 Stimu NM 3 4 AAHead_Scout Check Image t1_se_sag 12_tse_dark ep2d_diff_ 12_tse_tra 12_hemo Check Image Inject contrast t1_mprage_ 5 Quality huid_tra_p2 4scan brace. Quality seg_bo 10: 42:23 AM 11 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 478 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Image Viewing Area Depending on the execution state of each Healthineers Workline Step the following is displayed in t1_se_sag Scan Time the Image Viewing area: 2:50 min Repeat Stop • Show Scan Preview button: No images available (Pending/Preparing) • Scanning: Running • Loading image: Recon • Image preview: Done/Viewed Basic image information provided: • Scale bar • Window & Center OF windowing ₩ 2986 • Orientation cube Brain Autopilot | Standard | 6:56 Remaining Time SAP O OOOO Continue Stimu NM Available tools: • Scroll bar for image navigation • Basic image viewing tools 12 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 479 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers' ... Image Viewing Area – AutoAlign Localizer AutoAlign Check: Healthineers> • System checks if all AutoAlign @ Anatomic regions were AAHead_Scout references and organ boxes for this detected successfully Series Scan Time 0:32 min specific workflow are available Repeat Stop • User is informed if anatomical regions required for workflow can’t be detected • User can repeat the localizer step or request support from an experienced Anatomic regions could not be X detected Multi-series Technologists selector Failed to detect the following anatomic regions: Head_Localizer, Brain_tra Multi-series Selector: Repeat the Localizer or contact support for further assistance.  View different series within a step Brain Autopilot | Standald (e.g., Inline MPRs) SAR O 2:58 6:56 check Image Ou .. ... 114 Continue Stimu NM AAHead_Scout Check Image t1_se_sag 2 8 0 IN 10:42:23 AM Quality 13 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 480 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Image Viewing Area – Image Viewing Tools Reset (left menu) resets image to original view. Reset Rotate CW Rotate CW 90º Rotate CW 90° (center menu) 90º 90 Rotate CCW 90º • Three lines indicate further functions Rotate 90° clockwise or counter-clockwise R : A Flip Horizontal • R • Flip horizontal or vertical K Flip Vertical 2:58 Windowing (right menu) G • Triangle symbol indicates further functions Reset Rotate CW | Windowing -O- Windowing 90º • Windowing/Zoom/Pan (standard mouse operation Zoom works for these functions) > Pan • Rotate Rotate 2:58 4:28 14 Unrestricted © Siemens Healthineers, 2025 Notes 481 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Details Area The Details Area provides information about the Workline Step that is currently selected. AAHead_Scout (e.g., Step Name). IL Series Scan Time 0:32 min Repeat Stop The selected step can be any step in the workline and may not be the step currently running. In the Details Area, you can Delete or Repeat a Step in the workline. 87 . AMHead SCOUR MPR, cor OOOOOOO bring Time Check image Que .. 114 Continue 15 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 482 MR Protocol Building and Optimization- STEP Week 4 Workflow myExam Autopilot SIEMENS Healthineers ... Workflow and Exam Information Displays current measurement Program Name, Exam The user is always informed about current workflow Mode (Strategy), and remaining measurement time. scenarios with pop-up windows and messages. Access to Exam Settings (i.e., left-gear-scanner-icon). SAR and Stimulation information (i.e., click icon to Switch to Expert View open the detailed window). ) Only switch to Expert View if you had X Ul training or with expert O There are currently dialogs open. These dialogs wil be closed and canceled Rotate CW Zoom / Pan Proceed Cancel Brain Autopilot | Standard | 6:56 Remaining Time Automatic Table Movement Further measurements could SAR OOO AutoAlign failed X automatically move the table. The following scanregions were not detected: Ensure that the patient is prepared for Brain_tra, Head_Localizer table movement. Stimu NM Repeat the localizer or contact your support to Cancel Ok AAHead_Scout 12_tse_dark huid tra p2 ep2d_dift_ Brain Autopilot | Standard switch to Expert Mode. t1_se_sag 4scan_trace. SAR O O 1:56 2:32 4:58 6:56 Stimu NM AAHead_Scout Check Image t1_se_sag 12_tse_dark- ep2d_diff_ 12_tse_tra ep_seg_srl Inject contrast t1_mprage_ Quality fluid tra_p2 4scan troce ... sag_iso 16 Unrestricted © Siemens Healthineers, 2025 Notes 483 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Exam Settings Window Editing Exam Settings: Exam Settings Exams can be edited if the measurement has Patient Language Patient Comfort not been started, paused, or stopped. speakers Exam Mode Exams cannot be edited while a measurement 1 Exam Mode" can only be changed before start of first measurement. A) Headphones step is running. Standard Ventilation @ Bore Light Edit exam settings: Click Exam Settings icon. Click Lock icon to edit settings 1. Patient Comfort settings can be 2. Click Lock icon, activates Exam Settings A click on the lock to activate the edit modo. changed at any time edit mode. Brain Autopilot | Standard | 23:51 Remaining Theme OO o weck Image Que .. 114 c Exam Mode (Strategy) cannot be changed once the scan has been started. Exam Settings icon Patient Comfort Settings can be changed at anytime. 17 Unrestricted © Siemens Healthineers, 2025 Notes 484 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Workline Steps Each Measurement Step of the current program is visualized in the Workline as circles. @ Anatomic regions were AAHead_Scout Scan Time 0:32 min Repeat Stop Pending 0:57 Done Preparing 2:20 Viewed Running 2:20 Images Viewing Area (Selected & Displayed) Recon Brain Autopilot | Standard | 6:56_Rem SAR Check Image Que. 114 Continue Stimu NM 18 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 485 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Workline Steps – Visualization States Recon in progress Active Step, action button in control area refers to the Continue Step Step complete & viewed (no green ring) Scan aborted Summary Step Head | Standard Scan | 1:00 remaining time SAR NM X O 0:30 0:30 Stimu NM Check Image Qua ... 114 Continua Localizer Huid 12 tra quid 11 tra Quality Check Contrast Settings Pending steps (dotted green line) Interaction step (requires user User interaction required Current Selected Step (bright ring) interaction) to continue workflow (orange badge marks) 19 Unrestricted © Siemens Healthineers, 2025 Notes 486 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers' ... Scan Preview A preview of the image volume of a pending step is available but not automatically loaded into the image detected successfully Attend Scout viewer. Repeat Stap 1. Select a pending step in the Workline. 2. Click Show Scan Preview in the image viewing area to display a preview. The image area is surrounded by a gray frame and Hocm displays localizer images and FoV/coverage of the selected protocol. Brain Autopilot | Standard 1 18:08 Formahing Theme Only localizer results can be loaded for preview. EN 2:46:58 PM 20 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 487 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Workflow Control Area Workflow Control Area enables: HealthMENS> • Start button, starts workflow and is only Anatomic regions Series AAHead Scon active if no step is running 0:32 min • Stop button, stops workflow/measurement Repeat Step immediately and is only active when a step is running • Pause • Continue the workflow The name of the step to which the action refers is displayed. The current orange button guides through the Brain Autopilot | Standard 1 6:56 Remaining Time Check Image Que ... Continue workflow and shows how to proceed. 2 68 0 EN 10:42:23 AM If the workline is long a scroll bar is available. 21 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 488 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers' ... Workflow Control Area – Pause The Pause button halts the workflow at the next possible point in time. (e.g., when the current AAHead Scout Scan Time measurement has finished). • Orange color indicates pause is active • Allows interaction with patient and/or workflow (e.g., delete step) or requesting assistance Deactivate the pause to resume the workflow (click on orange pause button). If a workflow is switched to the Expert View while it is Brain Autopilot | Standard | 6:56 Remaining Time SAR paused, the pause is automatically deactivated, and OOOOOOO 6:56 Check Image Que. 114 Continue Stimu NM Check Image Inject contrant 11_mprage_ Summary the workflow resumed. Quality R 8 0 IN 10:42:23 AM 12_tse_tr Start 22 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 489 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Image Quality Check Image Quality Check is an interaction step and Brain Autopilot 4 Neuro Patient View included with the myExam Autopilot Image V Standard Quality Assurance (QA) Add-in. AAhead_scout 00:19 AutoAlign Scout • Workflow pauses automatically when Check Image Quality Autopilot Image QA Autopilot Image QA step is reached to t1_se_sag 03:07 review acquired images (Optional Step) Generic Views t2_tse_tra_512 03:37 Generic Views • Check acquired images in the image viewing t2_tse_dark-fluid_tra O 04:50 area by selecting scanned steps in the Generic Views ep2d_diff_3scan_trace_p2 01:47 workline Generic Views Click Continue to confirm sufficient image t1_se_tra 02:25 • Generic Views quality and continue the measurement Check Image Quality Autopilot Image QA • User must manually resume the workflow contrast agent with contrast agent when ready Inject contrast agent. t1_se_tra 02:25 Generic Views Steps can be renamed (e.g., Talk to patient, t1_se_cor 02:27 Senior tech to check images, etc.). Generic Views t1_se_sa 03:07 Generic Views ----- 23 Unrestricted © Siemens Healthineers, 2025 Notes 490 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Contrast Agent Contrast Step enables the user to Brain Autopilot Neuro Patient View administer a contrast agent while the Standard workflow is paused. AAhead_scout AutoAlign Scout • Contrast agent administered enter Check Image Quality Autopilot Image QA required information t1_se_sag 03:07 Generic Views • Contrast Agent admission t2_tse_tra_512 03:37 Generic Views checkmark must be activated when t2_tse_dark-fluid_tra 04:50 configuring the Autopilot program Generic Views ep2d_diff_3scan_trace_p2 01:47 Name Inject contrast Generic Views Description 1_se_tra 02:25 Generic Views Check Image Quality Contrast agent admission Autopilot Image QA Agent Name Catalog ... contrast agent Active Ingredient with contrast agent Dilution Inject contrast agent. Concentration Open Injector Control t1_se_tra 02:25 Generic Views t1_se_cor 02:27 Generic Views t1_se_sag 03:07 Generic Views 24 Unrestricted © Siemens Healthineers, 2025 Notes 491 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Contrast Agent Details of the Contrast Step open automatically Brain Autopilot Neuro Patient View when the workflow reaches this step. Standard AAhead_scout 00:19 AutoAlign Scout Edit Contrast Settings: Check Image Quality Autopilot Image QA 1. Select Contrast Medium used from the list t1_se_sag 03:07 Generic Views (configured in Expert View). t2_tse_tra 512 03:37 Generic Views 2. Enter Volume [ml]. t2_tse_dark-fluid_tra 04:50 3. Click Confirm to continue workflow. Generic Views ep2d_diff_3scan_trace_p2 01:47 -or- Generic Views t1_se_tra 02:25 4. Click Abort Contrast to cancel the contrast Generic Views settings. (steps following contrast injection Check Image Quality Autopilot Image QA are removed from the workline). contrast agent with contrast agent Inject contrast agent. t1_se_tra 02:25 Generic Views t1_se_cor 02:27 Generic Views ------- t1_se_sag o O 03:07 --- Generic Views 25 Unrestricted © Siemens Healthineers, 2025 Notes 492 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Action Badges If user interaction is required to continue the workflow, an orange Action Badge ● marks the step in where an interaction is required. Badges are only displayed if the step is not selected. Badges can mark any of the following: • Exam Settings icon • Quality Check Step • Contrast Step Brain Autopilot | Standard 1 6:05 Remaining Time o Mised_Scout Check image Qualityr fud_va_pz 26 Unrestricted © Siemens Healthineers, 2025 Notes 493 MR Protocol Building and Optimization- STEP Week 4 Summary myExam Autopilot SIEMENS Healthineers ... Summary Step Summary Step opens automatically after workflow finishes. • Select the Summary Step at any time to select, send images • Finalize image selection, send images to archive, and close the examination Summary • Select or Deselect thumbnails of required series, choose a destination from the Send To list and click Send to send images Printer is in status Error Mint Layout If Auto-routing is configured, series are automatically sent to the configured destination. Sent series status is indicated. Brain Autopilot | Standard | 6:05 Remaining Time So O O Misead_Scout Check image Quality fuid_la_p2 Ched Inage Inject contrest Ascan_trace Quality 27 Unrestricted © Siemens Healthineers, 2025 Notes 494 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Summary Step Click on a series to enlarge the view. • An enlarged view allows the user to view individual series frames • Rotate, window, zoom/pan tools are available 12_the_tra for viewing only Brain Autopilot | Standard | 6:56 Remaining Time KAR O OOOOO o Stimu Nu AMPlead Scout Check image 12 hemo Check Inage 28 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 495 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Switching Views Autopilot View opens automatically if a myExam Autopilot workflow was selected Scan Preview during patient registration. User can switch between Autopilot View and witch to Expert View Expert View. 1. Click Toggle button to open a window (note information) 2. Click Proceed to agree and Switch Views 1065 Brain Autopilot | Standard | 12:03 Remaking Tome O O Ouch inage 29 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 496 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Unsupported Scenario Unsupported scenario has occurred! Unsupported scenario has occured • Message indicates a non-supported Workflow Step, or situation cannot be solved in Autopilot View . Steps with a working man are not supported. Contact support for further assistance. • Workflow contains elements that do not meet the restrictions of a myExam Autopilot workflow or AutoAlign has failed Anatomic regions could not be X detected Failed to detect the following anatomic regions: Head_Localizer, Brain_tra Repeat the Localizer or contact support for further assistance. Unsupported scenario has occurred The Spine planning step requires a subsequent User can switch to Expert View and adjust workflow steps decision with the following name: 'Spine scan mode decision' Contact support for further assistance. or protocols before returning to the Autopilot View C-Spine Autopilot | Sindund 1 4:49 working time (i.e., request support from Senior Technologists). 30 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 497 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Autopilot Workflow Setup – myExam Cockpit Configuration myExam Autopilot Check Box function marks the program myExam Cockpit - Program Editor (Program Path - USER/Head/AutoPilot/New program) Explorer Program Editor as an Autopilot workflow. Browse Import Export Edit Simulate X ... Standard USER >> Head >> AutoPilot >> New program myExam Autopilot Registering a patient with this program and with Load Brain Assist Neuro Patient View Standard Speed focu program to queue selected automatically launches the AAhead_scou 00:19 AAhead_scout 00:19 AutoAlign Scout AutoAlign Scout Autopilot UI. t1_sc_sag 03:07 t1_f12d_sag Generic Views Generic Views 12_tse_tra_517 03:37 t2_haste_tra_p2 00:57 Generic Views Generic Views t2 tse dark-fluid tra 04:50 ep2d_dark-fluid tra_p2 01:47 An internal check for compliance with the Autopilot rules Generic Views Generic Views ep2d_diff_3sc _trace_p 01:47 p2d_diff_3scan_trace_p2 00:52 is performed in the background. An error report is Generic Views Generic Views 11_se_tra 02:25 1_120_tra 01:08 Generic Views Generic Views displayed with a note next to the check box if conditions contrast agent contrast agent with contrast agent with contrast agent are not met. Inject contrast agent. Inject contrast agent. t1_se_tra 02:25 1_f12d_tra 01:08 myExam Autopilot 41 Generic Views Generic Views × t1_sc_co 02:27 1_12d_cor 01:15 Generic Views Generic Views 31 Unrestricted © Siemens Healthineers, 2025 Notes 498 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Autopilot Workflow Setup – myExam Cockpit Configuration Configuration is basically the same as other . Standard workflows. (e.g., myExam Assist workflows). USER > Head > AutoPilot > program myExam Autopilot Brain Autopilot Neuro Patient View Program structure builds on established Stor hard • Resolution focus Speed focus elements (e.g., Strategies, Decisions, Steps AAhead_scout 00:19 AAhead_scout 00:19 AAhead_scout 00:19 AutoAlign Scout AutoAlign Scout AutoAlign Scout and Add-ins) t1_se_sag 03:07 t1_space_fs_sag_p2_iso 05:34 t1_f12d_sag 01:03 Generic Views Autopilot MPR Generation Generic Views Autopilot functionality may be configured t2_tse_tra_512 03:37 t2_space_sag_p2_iso 04:37 t2_haste_tra_p2 00:52 • Generic Views Autopilot MPR Assignment Generic Views using specific Add-ins and/or Add-in t2_tse_dark-fluid_tra 04:50 t2_space_dark-fluid_sag_p2_ns-t2prep 06:06 ep2d_dark-fluid_tra_p2 01:47 Generic Views Autopilot MPR Assignment Generic Views combinations and a specific naming of ep2d_diff_3scan_trace_p2 01:47 ep2d_diff_4scan_trace_p2 02:49 ep2d_diff_3scan_trace_p2 00:52 Generic Views Generic Views Generic Views elements t1_se_tra 02:25 t1_f12d_tra 01:08 Generic Views Generic Views Programs must comply with a set of rules contrast agent contrast agent contrast agent • with contrast agent with contrast agent with contrast agent to become an Autopilot workflow used in Inject contrast agent. Inject contrast agent. Inject contrast agent. 02:25 t1_space_fs_sag_p2 50 01:08 the new Autopilot UI t1_se_tra Generic Views Autopilot MPR Assign ... t1_f12d_tra Generic Views 02:27 t1_f12d_cor 01:15 • Rules are necessary to create easy-to-use t1_se_cor Generic Views Generic Views and robust workflows that require less user interaction 32 Unrestricted © Siemens Healthineers, 2025 Notes 499 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Autopilot Workflow Setup – myExam Cockpit Configuration Configuration Guidelines (must be ensured) The following configurations (Cannot be used) 1. Program must be configured as an myExam Autopilot 1. Copy References. workflow (check mark activated in program editor). 2. Add-ins (except Generic Views and dedicated myExam 2. AutoAlign is mandatory. Autopilot Add-ins). 3. Scout Step must have an assigned AutoAlign region 3. Working Man. (AutoAlign provider). 4. Step Types: Pause step, Decision step, Interaction step 4. Measurement Step must have an assigned AutoAlign (except in combination with special myExam Autopilot reference (AutoAlign consumer). Add-ins). 5. SAR Assistant and Charge Balance Model (CBM) Solver must always be enabled. 6. Boost Assistant must be enabled if Gradient Mode > Boost selected. myExam Cockpit Editor checks compliance for rules set. 1. Provides help notifications 2. Non-compliant programs cannot be saved 33 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 500 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Restrictions Restrictions Comments Program-related Program must be configured as an Autopilot workflow Copy references are not supported Step-related Only Autopilot workflow supported Add-ins are allowed Pause steps are not supported Exception: ‘Contrast agent admission’ checked ‘Wait for user to start’ single or multi-load is not supported Decision steps (workflow decisions) are not supported Exception: Spine scan mode decision Interaction steps are not supported Exceptions: Autopilot Image QA ‘Working man’ is not supported Manual voice commands are not supported Use automatic voice commands. Automatic voice commands are only supported if available for selected language Only single slice/slab groups allowed (AA & Auto Coverage only Exception: MSMA & Spine Positioning work for one) Add-in 34 Unrestricted © Siemens Healthineers, 2025 Notes 501 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Restrictions Restrictions Comments Protocol-related Inline Composing is not supported Set-n-Go is not supported SAR Assistant must be enabled Boost Assistant must be enabled if Gradient Mode ‘Boost’ is activated System frequency confirmation must not be used Note: step does not turn red in myExam Cockpit Reference amplitude confirmation must not be used AutoAlign Reference amplitude cannot be changed A scout or localizer step must have an AA region assigned (AA provider step) A measurement step must have an AA reference assigned Note: step does not turn red in myExam (AA consumer step) Cockpit The AA reference of an AA consumer step must have an AA provider step which provides the required AA reference 35 Unrestricted © Siemens Healthineers, 2025 Notes 502 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Add-ins Four Autopilot Add-ins Browse Search Default Autopilot Image QA Patient View Addins [13] • Default AddIns [48] • Autopilot MPR Assignment Abdomen Bolus Timing Autopilot MPR Generation ABLE • Access-i • Autopilot Spine Planning Advanced Application Angio Advanced Bolus Timing Angio Advanced Planning Add-ins must be attached to an interaction step. Angio Bolus Timing AutoAlign G AutoAlian Scout Autopilot Image QA Autopilot MPR Assignment Autopilot MPR Generation O Autopilot Spine Planning Basic Decision BOLD Breast Auto Coverage Scout Breast Basic Breast Dynamic Breast Implant Selection Cardiac Basic Default Sequences [134] 36 Unrestricted © Siemens Healthineers, 2025 Notes 503 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... MPR Generation & Assignment Autopilot MPR Generation and Autopilot MPR Assignment Add-ins Brain Autopilot Neuro Patient View • Contains both MPR Planning and MPR Assignment functionality to generate MPR images for several protocol steps within one V Resolution focus AAhead_scout 00:19 program AutoAlign Scout • Autopilot MPR Generation Add-in is used once it adds the t1_space_fs_sag_p2_iso 05:34 Autopilot MPR Assignment Add-in to all other measurement steps Autopilot MPR Generation that require MPRs t2_space_sag_p2_iso 04:37 Manual MPR Planning in Autopilot isn't required to activate the Autopilot MPR Assignment • AutoAlign Organ Box for MPR Planning t2_space_dark-fluid_sag_p2_ns-t2prep 06:06 Autopilot MPR Planning is based on AutoAlign and available for 4 Autopilot MPR Assignment • the AutoAlign Organ boxes ep2d_diff_4scan_trace_p2 02:49 Generic Views • MPRs are generated automatically without any User Interaction contrast agent with contrast agent Inject contrast agent. t1_space_fs_sag_p2_iso 05:3 Autopilot MPR Assign ... 37 Unrestricted © Siemens Healthineers, 2025 Notes 504 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... MPR Generation & Assignment Brain Autopilot Neuro Patient View MPR Planning is configured in the Autopilot MPR Generation Add-in. • Resolution focus Applied to all steps with an MPR Assignment Add-in configured in V AAhead_scout 00:19 myExam Cockpit AutoAlign Scout • Individual selection/setup of MPRs can be generated for each step t1_space_fs_sag_p2_iso 05:34 • MPRs are created as soon as the measurement step is completed Autopilot MPR Generation and appears in the Summary Step t2_space_sag_p2_iso 04:37 4 Autopilot MPR Assignment myExam Add-In Configurator t2_space_dark-fluid_sag_p2_ns-t2prep 06:06 Autopilot MPR Assignment Guidance Parameters Generate the following selected MPRs ep2d_diff_4scan_trace_p2 02:49 Queue GSP Generic Views Series Label Auto Load AutoCoverage contrast agent AutoTiming MPR Planning with contrast agent MPR Assignment Inject contrast agent. t1_space_fs_sag_p2_iso 05:34 4 Autopilot MPR Assign ... 38 Unrestricted © Siemens Healthineers, 2025 Notes 505 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Configuration Hints – SAR Assistant (1 of 2) SAR Assistant parameter defines the Strategy to Routine Contrast Resolution Geometry System Physio Inline Sequence avoid exceeding the SAR limits. Part 1 Part 2 Assistant System manipulates the selected parameter SAR Assistant Flip Angle • A combination of up to three (3) parameters can Min Flip Angle 30 - deg • be changed (Flip Angle, TR, and RF Pulse Type) Allowed Delay 30 OS • Parameter list defines if a parameter is used and in what order Boost Assistant Example: Flip Angle > TR> RF Pulse Type. First the Flip Angle is reduced, if this modification doesn’t lead to a resolution, the system continues and increases the TR without resetting the Flip Angle, if necessary, then the RF Pulse Type is changed. 39 Reference: N10VA61A_AM_MR_References_MR-03007G.622.21.02.02 Unrestricted © Siemens Healthineers, 2025 Notes 506 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... Configuration Hints – SAR Assistant (2 of 2) Modification Limits. Routine Contrast Resolution Geometry System Physio Inline Sequence Part 1 Part 2 Assistant Flip Angle: SAR Assistant Flip Angle Maximum possible value for the modification Min Flip Angle 30 - deg corresponds to the defined minimum Flip Angle. Allowed Delay 30 OS TR Boost Assistant Maximum possible value for the modification corresponds to the defined maximum TR. RF Pulse Type • Limit for the RF Pulse Type cannot be specified • Possible Settings (Fast, Normal, or Low SAR) depends on sequence • Maximum TR is relevant for RF Pulse Type, if changed, then the TR can also be changed automatically to the maximum 40 Reference: N10VA61A_AM_MR_References_MR-03007G.622.21.02.02 Unrestricted © Siemens Healthineers, 2025 Notes 507 MR Protocol Building and Optimization- STEP Week 4 myExam Brain Autopilot myExam Autopilot SIEMENS Healthineers ... myExam Brain Autopilot myExam Brain Autopilot enables a less experienced/trained staff to perform high quality Brain MRI exams. By using automation, it takes away burdensome routine tasks for all technologists. Automation features: • AutoPosition • AutoAlign Head LS AutoCoverage : 000000000 • • Inline MPRs • Inline Diffusion 41 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 508 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers' ... myExam Brain Autopilot Pre-defined protocols allow users to scan with minimal manual interactions. L Switch to myExam Assist (Expert View) at any time to further personalize scan settings. Switch to Expert View lealthineers Brain Autopilot >LOC . + AAHead_Scout myExam Brain Autopilot my Exam Brain Autopilot myExam Brain Autopilot myExam Brain Autopilot myExam Brain Autopilot myExam Brain Autopilot 2 Check Image Quality OID OtherPat OID OtherPat .. OID OtherPat 2 IMA1 FRM 3/5 3 IMA 1 FRM 20 4 IMA1 FRM 2/3 3 11_se_sag t2_tse_dark-fluid_tra_p2 04:28 5 ep2d_diff_4scan_trace_p2 02:02 6 12_tse_tra 02:35 7 Check Image Quality RFA RFA 2:31 o Scen 5cm A TP O TP O TP O SP RO.4 SPA51.1 SP F10.0 Expert View IMPPIRESAMPINORMDIS30 FoV 259 259 FOV 259-259 FoV 259-259 AMHead_Scout MPR_899 >Tra[.4).Con(-1) JMPRIRESAMP/NORMDIS3 Cor>Tra(-20)>Sag(2) 1062 540 Mitess_Scout MPR_ra Cor(5)>Sag(3) MAHead_Scout_MPR_cor 1159 568 2 09:05 Go Cancel 42 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 509 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Brain Autopilot – Protocols and Workflow One Strategy (Standard) is provided. SIEMENS > head > Brain Autopilot > program IEMENS > head > Brain Assist + program Brain Autopilot Neuro Patient View AutoAlign and AutoCoverage are configured for full V Standard V Standard AAhead_scout 00:19 automation (AutoAlign is mandatory). AutoAlign Scout AAhead_scout 00:19 Check Image Quality AutoAlign Scout Autopilot Image QA t1_qse_sag 03:07 O With Contrast Agent is a Patient View Decision t1_qse_sag 03:07 Generic Views Generic Views t2_tse_tra_512 03:37 (no decision steps) t2_tse_tra_512 03:37 Generic Views Generic Views t2_qtse_dark-fluid_tra 04:32 t2_qtse_dark-fluid_tra 04:32 Generic Views Pre-configured myExam Brain Autopilot workflow: Generic Views ep2d_diff_3scan_trace_p2 01:44 ep2d_diff_3scan_trace_p2 01:44 C Generic Views Generic Views • Users can configure their own Strategies and Decisions t1_qse_tra 02:25 • MPR Generation and MPR Assignment are available Generic Views Check Image Quality t1_qse_tra 02:25 Generic Views Autopilot Image QA contrast agent contrast agent with contrast agent with contrast agent Inject contrast agent. Inject contrast agent. t1_qse_tra 02:25 t1_qse_tra 02:25 Generic Views 1 Generic Views t1_se_ Brain Autopilot t1_se_cc Brain Assist VS 43 Unrestricted © Siemens Healthineers, 2025 Notes 510 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Brain Autopilot – Workflow Start 1. Select the myExam Brain Autopilot Program to start the workflow. Examination Information 2. In the Registration > Program Selection MRI BRAIN 3D WIO CONTRAST Accession Nr. RS-AN_000015 window, select Load Program to Queue. Req. Proc. ID RS-RP_000015 Study Description head Brain Autopilot 3. Click Exam, a new patient tab opens, and the Study Comment --- workflow is loaded into the workline. Implant Scanning No Implant Program Selection WorkflowSimulation2 >> head >> Brain Autopilot >> program Load Program to Queue RF Transmit Mode Any Polarization Body Part and Laterality Brain Unpaired Patient Orientation Head First Supine bam 44 Unrestricted © Siemens Healthineers, 2025 Notes 511 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Brain Autopilot – Workflow Start 4. Exam Settings, Check and adjust as needed. (e.g., adapt contrast agent administration decision) 5. Click Start, begins examination Exam Settings Alerts: \Not knownl \Claustrophobict; Please contact Dr. Smith after examination Patient Language English (United States) Exam Mode "Exam Mode" can only be changed before start of first measurement. Standard contrast ag with contrast agent with contrast agent You can change the settings now. Cancel Apply Brain Autopilot 1 Standard 1 12:46 Remaining Time O 2:58 O AAHead_Scout start Ouch Inage Des Image Quilty full_tre_p2 4scan track Quality 45 Unrestricted © Siemens Healthineers, 2025 Notes 512 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Brain Autopilot – Localizer & Image Quality Check 1. AAHead_Scout step (AutoAlign localizer) HealthMENS runs after starting the examination. 1 Brain Autopilot 1 Stunded 1 12:03 amswing Time So O O Ched image Que. Dreck image Oto inagt Summary Quality 46 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 513 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers' ... myExam Brain Autopilot – Localizer & Image Quality Check 2. Once the AAHead_Scout step finishes, the Check Image Quality Step opens. 3 IL Serles a. Click on the AAHead_Scout step icon in the Repeat Stop workline to check image quality. 3. Message in the upper left corner of the image area indicates if AutoAlign was successful. 4. Click on the different Orientations in the Series Navigator to view. 5. Use the Slider to scroll through image frames. 5 Brain Autopilot : Handed | 1203 margine 4 --- 2 47 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 514 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Brain Autopilot – Show Scan Preview Show Scan Preview Preview scanned area for next steps by selecting the respective step in the workline 1. Open Check Image Quality Step. 2. Click Continue to proceed with the examination. 2 1 Brain Autopilot : Sanded 1 12:03 -org - Go POOO 48 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 515 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Brain Autopilot – Workline Workline scanning can be performed without further user interaction. • Sequence running the workline displays the current step in progress, this same step is displayed in the workflow control • Scanned steps are displayed with a different color and a thumbnail in the workline • Completed sequences, click on the step icon in the workline to open and check the image quality at any time Brain Autopilot | Standard | 9:05 Remaining Time O 0:04 4:28 2:02 2:35 O t1_se_sag 114 Stop AAHead_Scout Check Ima Quality 11_se_sag Muid_tra_p2 4scan_trace_ .. 12_tse_tra Check Image Quality Summary Brain Autopilot | Standard | 2:35 Remaining Time O 0:04 2:35 o ep2d_diff_4scan _ ... Stop AAHead_Scout Check Imag t2 tse dark - 12_tse_tra Quality t1_se_sag fluid_tra_p2 epad_dift- iscan_trace_ .. Check Imag Quality Summary 49 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 516 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers' ... myExam Brain Autopilot – Image Quality Check In the With Contrast Agent workflow, the Check Image Quality step opens prior to the Contrast step. - Before proceeding, review the non-contrast images for image quality. 1. To review the images, click on the icon for the respective sequence step in the workline. 2. Steps with insufficient image quality (e.g., due to patient motion) can be repeated using the Repeat Step button a. During review: orange badge in the Check Image Brain Autopilot | Standard | 4:50 herwining Twe Quality step icon indicates that user action is So o -- --- - required for this step. 3. After reviewing the images, go back to the Check Image Quality step and click Continue. Then the Contrast step will open. 50 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 517 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Brain Autopilot – Contrast Agent Injection Edit the Contrast Setting Healthincers> 1. Select the Contrast Medium from the list Contrast Agent (configured in Expert view). 2. Enter Volume [ml]. 3. Click Confirm colthinters > The next Step pending in the workline opens but Contrast Agent does not start automatically. (Allows time to inject 24.50 kg contrast agent). 1. Click Start to continue the workflow (i.e., starts measurement with contrast agent injected) -or- 2. Alternatively: Click Abort Contrast in the Contrast step to cancel the contrast settings. The steps following contrast injection are removed from the workline. 51 Unrestricted © Siemens Healthineers, 2025 Notes 518 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Brain Autopilot – Summary Step Summary step, series can be selected manually SIEMENS oithincers ABR and sent to PACS (e.g., if auto-routing is disabled). Send Select/Deselect all Series button, click to JustDicomPrint deselect or select all series. Printer is in status Ready Paper Sar Inch Bx10 Individual Series check box, click box to 29 Min sheet(d) will be printed deselect or select individual series. Ol Export a series 1. Check that all required series were selected. 2. Select network node from Send drop-down menu. 3. Click Send. Brain Autopilot 1 Standard O Summary 114 Alired Scout Oled inage Sent/Exported images are marked with a green check icon. 52 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 519 MR Protocol Building and Optimization- STEP Week 4 myExam Knee Autopilot myExam Autopilot SIEMENS Healthineers ... myExam Knee Autopilot myExam Knee Autopilot enables a less experienced/trained staff to perform high quality Knee MRI exams. By using automation, it takes away burdensome routine tasks for all technologists. Automation features: • AutoPosition • AutoAlign Knee LS AutoCoverage 000000000 • • Inline MPRs 53 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 520 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers' ... myExam Knee Autopilot Pre-defined protocols allow users to scan with minimal ABR manual interactions. F Dotate Stop Switch to myExam Assist (Expert View) at any time to further personalize scan settings. Switch to Expert View SIEMENS Healthineers mybam Knee Autopilot . 1/1/2000 M 2022.10.10-1_ 00:02 MR ViewSGO MR Basic my Bam Brain .. Knee Autopilot LOC AAKnee_Scout 2022 10:06- 18 51 34-DST 0 3 12 2 1107 5 99 3 2022:0010-00 31 36 DST-1 3 12 21107 593 3 2022.10.10-18 51 34 DST-1 3.122.1107.5.993 2 Check Image Quality SIMAI FRM BUTS 3 pd_tse_fs_tra pd_tse_cor 04:15 15 pd_tse_fs_cor 06:02 6 t1_tse_sag 04:31 LLU 7 pd_tse_sag 04:15 RAH RAH o 8 t2_tse_fs_sag 05:06 5cm 5cm 9 Check Image Quality A TPO TP O Expert View SP L76 7 SP P12.0 FOV 400*240 FoV 400*240 Aknee_ ScoLL. MPR_699 Sag.Cor(-7).Tra(2) 1628 JMPRIRESAMPINORM/DISJO ag(7)>Tra(-5) 756 AAKnee_Scout_MPR_cor 2029 JMPRIRESAMPINORMDIS3D 912 MAKnee_Scout_MPR_tra 1 24:09 Cancel 54 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 521 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Knee Autopilot – Protocols and Workflow One Strategy (Standard) is provided. . >> knee . Knee Autopilot |> general 2D SIEMENS > knee >> Knee Assist >> general 2D Knee Autopilot Ortho Patient View AutoAlign and AutoCoverage are configured for full V Standard V Standard automation (AutoAlign is mandatory). AAknee scout 00:18 AAknee_scout AutoAlign Scout Automatic positioning of a single saturation band Check Image Quality Autopilot Image QA supported (not visible or adjustable in Autopilot pd_tse_fs_tra_384 04:14 pd_tse_fs_tra_384 04:14 View). Generic Views Generic Views pd_tse_cor_448 03:41 pd_tse_cor_512 04:02 Generic Views Generic Views Pre-configured myExam Knee Autopilot workflow: pd_tse_fs_cor_320 03:48 pd_tse_fs_cor_352 03:56 Generic Views 1 • Users can configure their own Strategies and Generic Views Decisions t1_se_sag_320 03:53 t1_se_sag_320 03:33 Generic Views 2 Generic Views • MPR Generation and MPR Assignment are pd_tse_sag_432 04:29 pd_tse_sag_432 04:17 available Generic Views 2 Generic Views t2_tse_fs_sag_320 03:52 t2_tse_fs_sag_320 03:45 Generic Views Generic Views Check In Knee Autopilot age QA Knee Assist 55 Unrestricted © Siemens Healthineers, 2025 Notes 522 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Knee Autopilot – Workflow Start 1. Select the myExam Knee Autopilot Program to start the workflow. Examination Information 2. In the Registration > Program Selection Procedure Accession Nr. window, select Load Program to Queue. Req. Proc. ID Study Description knee Knee Autopilot 3. Click Exam, a new patient tab opens, and the Study Comment workflow is loaded into the workline. Implant Scanning | No Implant Program Selection WorkflowSimulation2 >> knee >> Knee Autopilot >> program ¥Load Program to Queue RF Transmit Mode Any Polarization Body Part and Laterality Knee Left Patient Orientation Feet First Supine Gam 56 Unrestricted © Siemens Healthineers, 2025 Notes 523 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Knee Autopilot – Workflow Start 4. Exam Settings, Check and adjust as needed. 5. Click Start, begins examination Exam Setting Patient Comfort Patient Language English (United States) Exam Mode "Exam Mode" can only be changed before start of first measurem Standard u can change the settings now. Cancel Apply Knee Autopilot | Simdend | 31:09 humani Ine o c ----- ------- 57 Unrestricted © Siemens Healthineers, 2025 Notes 524 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Knee Autopilot – Localizer & Image Quality Check 1. AAKnee_Scout step (AutoAlign localizer) runs after starting the examination. and press Continue to Continue 1 Knee Autopilot | Standard | 30:11 Rom So O 6:02 401 5:06 O Dreck mage Que. 114 ---- --- --- Onk Ings Quality 58 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 525 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Knee Autopilot – Localizer & Image Quality Check 2. Once the AAKnee_Scout step finishes, the Healthineen > Check Image Quality Step opens. 3 Series AMknee Scout a. Click on the AAKnee_Scout step icon in the workline to check image quality. 3. Message in the upper left corner of the image area indicates if AutoAlign was successful. 4. Click on the different Orientations in the Series Navigator to view. 5. Use the Slider to scroll through image frames. 5 Knee Autopilot | Standard 1 30:11 Running Time 4 So O O --- ---- --- 2 59 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 526 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Knee Autopilot – Show Scan Preview Show Scan Preview Healthineers Preview scanned area for next steps by selecting the respective step in the workline 1. Open Check Image Quality Step. 2. Click Continue to proceed with the examination. 2 1 Knee Autopilot 1 sentes 1 30:15 mm ---------- 60 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 527 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Knee Autopilot – Workline Workline scanning can be performed without further user interaction. • Sequence running the workline displays the current step in progress, this same step is displayed in the workflow control • Scanned steps are displayed with a different color and a thumbnail in the workline • Completed sequences, click on the step icon in the workline to open and check the image quality at any time Knee Autopilot | Standard | 13:52 Remaining Time O 0:04 4:31 4:15 5:06 O pd_tse_fs_cor 114 Stop AAknee_Scout Check Image pd_tse_Is_tr po_use_cor pd_tse_is_cor 11_tse_sag pd_tse_sag t2 tse_is_sag quality Summary 61 Images on file Unrestricted © Siemens Healthineers, 2025 Notes 528 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers' ... myExam Brain Autopilot – Image Quality Check In the With Contrast Agent workflow, the Check Image Quality step opens. LI Before proceeding, review the images for image quality. 1. To review the images, click on the icon for the respective sequence step in the workline. 2. Steps with insufficient image quality (e.g., due to patient motion) can be repeated using the Repeat Step button a. During review: orange badge in the Check Image Knee Autopilot | Mendes Quality step icon indicates that user action is O required for this step. 3. After reviewing the images, go back to the Check Image Quality step and click Continue. Then the Summary Step will open. 62 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 529 MR Protocol Building and Optimization- STEP Week 4 myExam Autopilot SIEMENS Healthineers ... myExam Knee Autopilot – Summary Step Summary step, series can be selected manually and SIEMENS Healthineers sent to PACS (e.g., if auto-routing is disabled). Select / Deselect all Series WORDPACS Select/Deselect all Series button, click to deselect AntDicomPrint or select all series. Printer is in status Ready inch Beto Individual Series check box, click box to deselect or 3) Sims chested) will be printed select individual series. Export a series 1. Check that all required series were selected. 2. Select network node from Send drop-down menu. Knee Autopilot 1 Semdes Click Send. ® 3. Sent/Exported images are marked with a green check icon. 63 Images on file Unrestricted © Siemens Healthineers, 2025 Unrestricted © Siemen s Healthineers, 2025 Notes 530 MR Protocol Building and Optimization- STEP Week 4 Daily Hands-on Exercises STEP – MR Protocol Building Exercises STEP – MR Protocol Building with myExam Cockpit and myExam Assist exercises. These Instructor-led demo excercises are performed by the participant in the classroom on a Siemens SmartSimulator. Day 1 pm – Exercises myExam Cockpit 1. Open myExam Cockpit 2. Search for seqeunces (e.g., Deep Resolve, T2, HASTE) 3. Create a new User Tree a. Add a Region, Exam, Program, and multiple Strategy’s b. Add Decisions c. Add sequences to the program d. Create Copy References e. Add post contrast sequences myExam Assist Configuration 1. Add to the new User Tree created a. Add additional Regions, Exams, Programs, and multiple Strategy’s b. Add Decisions c. Add Interactions (MPR Planning and MPR Assignment) d. Add sequences to the additional programs e. Create Copy References f. Expand the scout across strategies 2. Simulation Mode – review created protocol 3. Addin Configurator – Generic View Add-ins and define the following; a. Guidance View i. Preview images and/or create new guidance images using the Camera Icon. ii. Review Guidance text options b. Parameters View i. Review the pre-defined parameters. ii. Search for a parameter iii. Add/edit parameters iv. Queue - Review options and edit as needed c. GSP - Review options and edit as needed d. Series Label - Review options and edit as needed e. Audio Load - Review options and edit as needed f. Auto Coverage - Review options and edit as needed g. Auto Timing - Review options and edit as needed h. Preview the Generic View Addins 4. Simulation Mode – review created protocol Unrestricted | Published by Siemens Healthineers AG, 2025 531 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/2025 | QR70000xxxx MR Protocol Building and Optimization- STEP Week 4 Day 2 am – Exercises myExam Brain Assist 1. Add a Region, Exam, Program, and multiple Strategy’s 2. Add Decisions (Contrast with/without) 3. Add Interactions (MPR Planning and MPR Assignment) 4. Add a AutoAlign Head Scout 5. Add sequences to the program strategy’s 6. Define parameters for each sequence in the protocol 7. Create Copy References 8. Expand the scout across strategies 9. Simulation Mode – review created protocol 10. Review the AutoAlign Head localizer features and options myExam Spine Assist 1. Add a Region, Exam, Program, and multiple Strategy’s 2. Add Decisions 3. Add Interactions (MPR Planning and MPR Assignment) 4. Add sequences to the program strategy’s 5. Define parameters for each sequence in the protocol 6. Create Copy References 7. Expand the scout across strategies 8. Simulation Mode – review created protocol 9. Review the AA Spine scout features and options 10. Review AutoAlign Verification features and options Day 2 pm – Exercises myExam Abdomen Assist 1. Add a Region, Exam, Program, and multiple Strategy’s 2. Add Decisions 3. Add Interactions (MPR Planning and MPR Assignment) 4. Add sequences to the program strategy’s 5. Define parameters for each sequence in the protocol 6. Create Copy References 7. Expand the scout across strategies 8. Simulation Mode – review created protocol 9. Review the Automatic Breath-hold commands, languages, and pause before breath-hold 10. Review Auto ROI and Auto Bolus Detecion features 11. Revew ABLE Add-ins, options, and features 12. Review AutoTiming and AutoCoverage options, and features Unrestricted | Published by Siemens Healthineers AG, 2025 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/2025 | QR70000xxxx Healthineers Page 2 of 6 532 MR Protocol Building and Optimization- STEP Week 4 Day 2 am – Exercises Day 3 am – Exercises myExam Brain Assist myExam Cardiac Assist 1. Add a Region, Exam, Program, and multiple Strategy’s 1. Add a Region, Exam, and a Program 2. Add Decisions (Contrast with/without) 2. Add multiple Strategy’s 3. Add Interactions (MPR Planning and MPR Assignment) 3. Add Decisions 4. Add a AutoAlign Head Scout 4. Add Interactions (MPR Planning and MPR Assignment) 5. Add sequences to the program strategy’s 5. Add sequences to the program strategy’s Define parameters for each sequence in the protocol 6. 6. Define parameters for each sequence in the protocol Create Copy References 7. 7. Create Copy References 8. Expand the scout across strategies 8. Expand the scout across strategies 9. Simulation Mode – review created protocol 9. Simulation Mode – review created protocol 10. Review the AutoAlign Head localizer features and options 10. Review the AA Heart scout features and options 11. Review Physio Parameters and options myExam Spine Assist 12. Review Breath-hold parameters Add a Region, Exam, Program, and multiple Strategy’s 1. 13. Review the options in Cardiac Configuration Add Decisions 2. 3. Add Interactions (MPR Planning and MPR Assignment) Add sequences to the program strategy’s 4. Day 3 pm – Exercises 5. Define parameters for each sequence in the protocol myExam Angio Assist Create Copy References 6. 1. Add a Region, Exam, and a Program Expand the scout across strategies 7. 2. Add multiple Strategy’s Simulation Mode – review created protocol 8. 3. Add Decisions Review the AA Spine scout features and options 9. 4. Add Interactions (MPR Planning and MPR Assignment) 10. Review AutoAlign Verification features and options 5. Add sequences to the program strategy’s 6. Define parameters for each sequence in the protocol 7. Create Copy References Day 2 pm – Exercises 8. Expand the scout across strategies myExam Abdomen Assist 9. Simulation Mode – review created protocol Add a Region, Exam, Program, and multiple Strategy’s 1. 10. Reviwe Angio Assist Test Bolus and Care Bolus options and features Add Decisions 2. 11. Review Automatic Breath-hold commands and parameters Add Interactions (MPR Planning and MPR Assignment) 3. 12. Review the Angio Bolus timing configuration options and features Add sequences to the program strategy’s 4. Define parameters for each sequence in the protocol 5. myExam Breast Assist Create Copy References 6. 1. Add a Region, Exam, and a Program 7. Expand the scout across strategies 2. Add multiple Strategy’s 8. Simulation Mode – review created protocol 3. Add Decisions Review the Automatic Breath-hold commands, languages, and pause before breath-hold 9. 4. Add Interactions (MPR Planning and MPR Assignment) 10. Review Auto ROI and Auto Bolus Detecion features 5. Add sequences to the program strategy’s 11. Revew ABLE Add-ins, options, and features 6. Define parameters for each sequence in the protocol 12. Review AutoTiming and AutoCoverage options, and features 7. Create Copy References 8. Expand the scout across strategies Unrestricted | Published by Siemens Healthineers AG, 2025 Unrestricted | Published by Siemens Healthineers AG, 2025 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/2025 | QR70000xxxx Job Aid Effective Date: XX/XX/2025 | QR70000xxxx Healthineers Page 2 of 6 Page 3 of 6 533 MR Protocol Building and Optimization- STEP Week 4 9. Simulation Mode – review created protocol 10. Review Breat Implant Selection Add-in Simulation Mode – review created protocol 9. 11. Review AutoCoverage options and features 10. Review Decision Steps options and features 12. Review Confirm Frequency Adjustment options and features 11. Review Prostate Patient view options and features 13. Review Auto Adjust Volume options and features 12. Review AA Prostate Segmentation 14. Review Implant Type Confirmation options and features 15. Review Inline MPR options and features myExam Autopilot 16. Review AutoCoverage Add-in options and features 1. Create an Brain Autopilot protocol and add to the User tree created 17. Review Breast Dynamic Add-in options and features Add sequences to the program strategy’s 2. 18. Review Care Bolus Add-in options and features Define parameters for each sequence in the protocol 3. Simulation Mode – review created protocol 4. 5. Register a patient for a Brain Simulation Scan Review the Exam Settings in a Autopilot workflow 6. Day 4 am – Exercises Run the protocol and recognize the workflow steps 7. myExam Whole Body Assist 8. Review the Sumary Step. 1. Add a Region, Exam, and a Program 2. Add multiple Strategy’s 3. Add Decisions 4. Add Interactions (MPR Planning and MPR Assignment) 5. Add sequences to the program strategy’s 6. Define parameters for each sequence in the protocol 7. Create Copy References 8. Expand the scout across strategies 9. Simulation Mode – review created protocol 19. Review FastView Local and coverage range 20. Review Focus Adaption options and features 21. Review Auto Bolus Detection options and features 22. Review Auto ROI, and Breath-hold parameters, options and features 10. Review Automatic Inline Segmentation 11. Review Focus Scans and Coverage Mode myExam Prostate Assist 1. Add a Region, Exam, and a Program 2. Add multiple Strategy’s 3. Add Decisions 4. Add Interactions (MPR Planning and MPR Assignment) 5. Add sequences to the program strategy’s 6. Define parameters for each sequence in the protocol 7. Create Copy References 8. Expand the scout across strategies Unrestricted | Published by Siemens Healthineers AG, 2025 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Unrestricted | Published by Siemens Healthineers AG, 2025 Job Aid Effective Date: XX/XX/2025 | QR70000xxxx Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Healthineers Job Aid Effective Date: XX/XX/2025 | QR70000xxxx Page 4 of 6 Page 5 of 6 534 MR Protocol Building and Optimization- STEP Week 4 9. Simulation Mode – review created protocol 9. 10. Review Breat Implant Selection Add-in Simulation Mode – review created protocol 11. Review AutoCoverage options and features 10. Review Decision Steps options and features 12. Review Confirm Frequency Adjustment options and features 11. Review Prostate Patient view options and features 13. Review Auto Adjust Volume options and features 12. Review AA Prostate Segmentation 14. Review Implant Type Confirmation options and features 15. Review Inline MPR options and features myExam Autopilot 16. Review AutoCoverage Add-in options and features 1. Create an Brain Autopilot protocol and add to the User tree created 17. Review Breast Dynamic Add-in options and features 2. Add sequences to the program strategy’s 18. Review Care Bolus Add-in options and features 3. Define parameters for each sequence in the protocol 4. Simulation Mode – review created protocol 5. Register a patient for a Brain Simulation Scan 6. Review the Exam Settings in a Autopilot workflow Day 4 am – Exercises 7. Run the protocol and recognize the workflow steps myExam Whole Body Assist 8. Review the Sumary Step. 1. Add a Region, Exam, and a Program 2. Add multiple Strategy’s 3. Add Decisions 4. Add Interactions (MPR Planning and MPR Assignment) Add sequences to the program strategy’s 5. 6. Define parameters for each sequence in the protocol 7. Create Copy References 8. Expand the scout across strategies 9. Simulation Mode – review created protocol 19. Review FastView Local and coverage range 20. Review Focus Adaption options and features 21. Review Auto Bolus Detection options and features 22. Review Auto ROI, and Breath-hold parameters, options and features 10. Review Automatic Inline Segmentation 11. Review Focus Scans and Coverage Mode myExam Prostate Assist 1. Add a Region, Exam, and a Program 2. Add multiple Strategy’s 3. Add Decisions Add Interactions (MPR Planning and MPR Assignment) 4. Add sequences to the program strategy’s 5. 6. Define parameters for each sequence in the protocol 7. Create Copy References 8. Expand the scout across strategies Unrestricted | Published by Siemens Healthineers AG, 2025 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Unrestricted | Published by Siemens Healthineers AG, 2025 SIEMENS Job Aid Effective Date: XX/XX/2025 | QR70000xxxx Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/2025 | QR70000xxxx Page 4 of 6 Healthineers Page 5 of 6 535 MR Protocol Building and Optimization- STEP Week 4 Please note that the 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 collec- tively “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 neces- sarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. 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. Copyright © Siemens Healthineers AG 2025 Siemens Healthineers Headquarters Local Contact Information Legal Manufacturer Siemens Healthineers AG Siemens Medical Solutions USA, Inc. Imaging & Therapy Systems Siemensstraße 3 40 Liberty Blvd. Magnetic Resonance 91301 Forcheim, Germany Malvern, PA 19355-9998 USA Henkestr. 127 Phone: +49 9191 18-0 Telephone: +1-888-826-9702 DE-91052 Erlangen siemens-healthineers.com Customer Care Telephone: Germany +1-800-888-7436 Telephone: +49 9191 18-0 Unrestricted | Published by Siemens Healthineers AG, 2025 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/2025 | QR70000xxxx Healthineers Page 6 of 6 536 MR Protocol Building and Optimization- STEP Week 4 Please note that the 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 collec- On account of certain regional tively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no limitations of sales rights and means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not neces- service availability, we cannot sarily reflect the latest version of the software and hardware available at the time of the training. guarantee that all products The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. included in this brochure are available through the Siemens Note: Some functions shown in this material are optional and might not be part of your system. sales organization worldwide. Availability and packaging may 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 vary by country and is subject to guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. change without prior notice. Some/All of the features and The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. products described herein may Offenders will be liable for damages. not be available in the United Local Contact Information All names and data of patients, parameters and configuration dependent designations are fictional and examples only. States. Siemens Medical Solutions USA, Inc. 40 Liberty Blvd. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. 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Phone: +49 9131 84-0 +1-800-888-7436 Telephone: +49 9191 18-0 https://www.siemens-healthineers.com Unrestricted | Published by Siemens Healthineers AG, 2025 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/2025 | QR70000xxxx Page 6 of 6 Published by Siemens Healthcare GmbH · QR700021234· · ©Siemens Healthcare GmbH, 2025 537