syngo.via MR Cardiac Reading Job Aid

SIEMENS Healthineers syngo.via MR Cardiac Reading Template Effective Date: 10 Aug 2021 | HILS 2223 Job Aid Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022 syngo.via MR Cardiac Reading SIEMENS Healthineers Table of Contents MR Cardiac Analysis Real-time Segmented AHR AHR Overview 3 MR Cardiac Reading Steps 5 Learn Create RFA RFA RFA Creating Findings 13 Overview Functional Dynamic Data Classification 15 Tissue Characterization Combined .............................. ............................................ AHR Flow AHR AHR Myomaps ........ Findings REA REA RFA .................................................... Real-time F Segmented AF Tools RHA RHA Synch Align Custom Hide Graphics Reset Text Edit Snapshot Print Undo Redo Layout Export Image Image 2:09 AM syngo.via MR Cardiac Reading requires an additional license and is not available in all countries, e.g., the US. 2 There might be slight changes between software versions. Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022 syngo.via MR Cardiac Reading SIEMENS Healthineers Overview (1/2) MR Cardiac Reading enables you to view and evaluate different kinds of cardiac images using the common tools. The focus of the reading is ischemic heart disease. Therefore, this task comprises the MR Cardiac Analysis + following preconfigured steps: MR Cardiac Reading • Overview • Functional Learn Segments Findings • Dynamic Overview • Tissue Characterization Functional • Combined Dynamic • Flow Tissue Characterization • Myomaps Combined Flow Myomaps The following tasks are available in the workflow if the license is purchased: • The MR Cardiac Function step allows for a quantitative assessment of the function of the ventricles, including the wall thickening analysis of the left ventricle. • The MR Flow Quantification step is used to quantitatively assess flow acquisitions. • The focus of the MR Cardiac Perfusion step is ischemic heart disease. You can read cardiac images in order to diagnose focal lesions of hypoperfusion. syngo.via MR Cardiac Reading requires an additional license and is not available in all countries, e.g., the US. 3 There might be slight changes between software versions. Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022 syngo.via MR Cardiac Reading SIEMENS Healthineers Overview (2/2) In the Overview step the user can see MR Cardiac Analysis AF HLP an overview of all the scanned images MR Cardiac Reading loaded in chronological order. E Learn Create Segments Findings Overview Functional RHA AL Dynamic Tissue Characterization Combined Flow Myomaps Findings AHR AHR PDF RFA RFA Tools Et= L Synch Lock Hide Hide Lines Reset Navigati ... Graphics Timepoi ... EP Edit Snapshot Print Export Undo Redo KU Layout Image Image 2:05 AM syngo.via MR Cardiac Reading requires an additional license and is not available in all countries, e.g., the US. 4 There might be slight changes between software versions. Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022 syngo.via MR Cardiac Reading SIEMENS Healthineers Functional (1/2) The layout is divided into the short- MR Cardiac Analysis Real-time H Segmented AHR AHR axis and long-axis regions. In the first MR Cardiac Reading SAX segment of each of these regions, E Learn Create Segments Findings buttons are provided to switch RFA RFA RFA Overview between functional Real-time and Functional Dynamic Segmented images. By default, Tissue Characterization segmented images are displayed. Combined Flow AHR AHR AHR Myomaps The buttons act only on the region 11 with which they are associated. For Findings RFA RFA RFA example, a switch from Segmented to Real-time in the short-axis region only results in switching the short-axis Real-time Segmented AF HLP region and not the long-axis region. LAX Tools L RHA RHA AL Synch Align Custom Hide Hide Lines Reset Graphics Timepoi ... Edit Snapshot Print port Undo Redo KU Layout mage 2:06 AM syngo.via MR Cardiac Reading requires an additional license and is not available in all countries, e.g., the US. 5 There might be slight changes between software versions. Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022 syngo.via MR Cardiac Reading SIEMENS Healthineers Functional (2/2) All segments in both regions are synchronized Real-time Segmented by phase. When scrolling in one segment, the other segments are updated accordingly. This synchronization is also active when the Movie tool is activated. Zoom/Pan AHR 30 Reference Point 2,1 Rotate Windowing 100 10 400% RT Correlated Cursors Il Movie Scroll Save as Series R A Flip Horizontal Fit to Segment AF syngo.via MR Cardiac Reading requires an additional license and is not available in all countries, e.g., the US. 6 There might be slight changes between software versions. Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022 syngo.via MR Cardiac Reading SIEMENS Healthineers Dynamic The left side of the layout displays MR Cardiac Analysis Dynamic Stress images; the right-side MR Cardiac Reading Stress Rest displays Dynamic Rest images. The large E Learn Create Segments Findings viewing segments are for the clinical Overview reading. Functional Dynamic Tissue Characterization Combined The small gallery segments are used for Flow Myomaps selection of the data. When clicking on a gallery segment, the large viewing Findings segment is updated to display those images. The large viewing segments are 3,2 3,2 14,2 3,2 3,2 4,2 synchronized by the cardiac phase. This synchronization is also active when the Tools TT 97.50 SP A36.0 TT 257.50 TT 97.50 SP A55.2 SP A36.0 TT 257.50 TT 580.00 SP A55.2 SP L4.4 L Synch Lock Hide Movie tool is activated. Custom Hide Lines Reset Navigati Text Graphics Timepoi ... 3,2 3,2 ent.MR.Dynamic.Dynamic_Stress.SA_01. la rent.MR.Dynamic.Dynamic_Stress.LA .** Jat rent.MR.Dynamic.Dynamic_Rest.SA_01 .** la prrent.MR.Dynamic.Dynamic_Rest.LA .** late Edit Snapshot Print Undo Redo Layout Image Image TT 420.00 TT 420.00 SP A74.4 SP A74.4 2:11 AM syngo.via MR Cardiac Reading requires an additional license and is not available in all countries, e.g., the US. 7 There might be slight changes between software versions. Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022 syngo.via MR Cardiac Reading SIEMENS Healthineers Tissue Characterization The layout is divided into four regions MR Cardiac Analysis MAG-Overvi ... IIPSIR-Overview HL SAX HL HL 1,2 displaying tissue characterization MR Cardiac Reading images: E ARH ARH ARH ARH Create Segments Findings Overview • The upper row displays short-axis. Functional Dynamic MAG-Overvi .. PSIR-Overview LAX • The second area displays long-axis. Tissue Characterization The third area displays short-axis Combined • Flow Myomaps Current.MR.DE.DE_Overview_PSIR.LA .** latest Current.MR.DE.DE_Overview_PSIR.LA .** latest Current.MR.DE.DE_Overview_PSIR.LA .** latest Current.MR.DE.DE_Overview_PSIR.LA .** latest high-resolution. • The bottom area displays long-axis. Findings MAG-HighRes - PSIR-HighRes) HLP In the segment, buttons are provided to High Res HLP switch between magnitude MAG and ARH ARH ARH Current.MR.DE.DE_high-res_PSIR.SA_01 .** latest phase sensitive PSIR images. By default, PSIR is displayed. The buttons act only on the region with MAG-HighRes It PSIR-HighRes AFR MAG / PSIR HL Tools 4,5 which they are associated. Synch Align Full Text Hide Hide Lines Reset Graphics Timepoi ... AHL ALF Current.MR.DE.DE_high-res_PSIR.L.A .** latest Edit Snapshot Print Export Undo Redo Layout Image Image 2:12 AM syngo.via MR Cardiac Reading requires an additional license and is not available in all countries, e.g., the US. 8 There might be slight changes between software versions. Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022 syngo.via MR Cardiac Reading SIEMENS Healthineers Combined The Combined step displays all different image MR Cardiac Analysis Segmented Q. + Real-time MAG-Overvi ... PSIR-Overview MAG-HighRes PSIR-HighRes types in a 2x2 layout. MR Cardiac Reading Functional Tissue Characterization Learn Segments Finding The upper left segment displays the functional Overview Functional images, the upper right segment the tissue Dynami Tissue Characterization characterization images, and the lower segments 0000 Combined OH Flow displays the Dynamic Stress and Rest images. Myomaps In each of the four segments, the corresponding Findings ..................................... Original Moco Original Moco buttons are provided to allow for switching to the Dynamic Stress Dynamic Rest corresponding image type (for example, Real-time /Segmented). To allow for a combined viewing of the image Tools types, all four segments are spatially synchronized. Synch Align Text Hide Hide Lines Reset Graphics Timepoi. For example, when scrolling to another slice EP Edit Snapshot Print Export Undo Redo KU Image Image position or slice orientation in any of the segments, 2:18 AM the other segments are updated accordingly. syngo.via MR Cardiac Reading requires an additional license and is not available in all countries, e.g., the US. 9 There might be slight changes between software versions. Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022 syngo.via MR Cardiac Reading SIEMENS Healthineers Flow The layout displays on the left phase contrast images MR Cardiac Analysis PCA Anatomical (PCA), on the right the corresponding anatomical MR Cardiac Reading images. The gallery segments are intended for data Create Segment Findings selection. When clicking on a gallery segment, the large Overview Functional viewing segment is updated to display those images. Dynamic Tissue Characterization Combined RFP Flow The first segment of the right gallery segments shows Myomaps the anatomical images. In this first II Findings segment, buttons allow for switching between standard magnitude images (MAG) and phase-contrast, angio-like images (PCA). Magni PCA Current.MR.FlowReading .**. latest.PC Current.MR.FlowReading .** Jatest.PC Current.MR.FlowReading .** latest.MAG Current.MR.FlowReading .** latest.MAG By default, magnitude images are displayed. The large Tools TT-0:00 TT 0.00 SP H56.9 SP H56.9 L viewing segments are synchronized by phase and Synch Align Custom Hide Hide Lines Reset Text Graphics Timepoi ... display the same phase. Edit Redo Current.MR.FlowReading .** latest.PC Current.MR.FlowReading .** latest.PC Current.MR.FlowReading .** latest.PC Current.MR.FlowReading .** latest.MAG Current.MR.FlowReading .** latest.MAG Current.MR.FlowReading .** latest.MAG Layout Snapshot Print Export Image mage 2:19 AM This synchronization is also active when the Movie tool is activated. syngo.via MR Cardiac Reading requires an additional license and is not available in all countries, e.g., the US. 10 There might be slight changes between software versions. Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022 syngo.via MR Cardiac Reading SIEMENS Healthineers Myomaps The layout displays short-axis or long-axis images on the MR Cardiac Analysis Q + Anatomical Myomaps left. The right segments display the colored, parametric Learn Segments FSreste Myomaps. T1 overview 12 Functional T2Star Dynamic The lower area shows the corresponding gallery Tissue Characterization Combined segments of the available images. The gallery segments Flow ARH TARH Myomaps are not intended for clinical reading, but rather for data MR Cardiac Function O selection. When you click on a gallery segment, the large Findings viewing segment is updated to display those images. The first gallery segments provide buttons to switch between MoCo (motion corrected) and Original images. 2000 ms ent.MR.Myormaps. TINative_MoCo.SA_01 .** Jarent MR.Myomaps.T1Native_MoCo.SA_01." la Lo ma ent.MR.Myomaps.T1Native_TIMap.SA_01 .** Jent.MR.Myomaps.Ti Native_T1Map.SA_01 ... le For appropriate side-by-side viewing, the large viewing Tools L segments are synchronized for zoom pan. Synch Align Full Text Hide Hide Lines Rezet Graphics Timepoi ... irrent.MR.Myomaps. Ti Native_MoCo.LA." laterrent MR.Myomeps.T1Netive_MoCo.LA .** lateurrent.MR.Myomaps.T1Native_MoCo.LA .. A." laterrent.MR.Myomaps.T1Native_T1Map LA .** Jaterrent.MR.Mymaps.TiNative_T1Mep.LA." late Edit Snapshot Print Export Unde Redo Image Image There is also a new Combined layout to compare 2:20 AM Myomaps with functional, late enhanced and dynamic images. syngo.via MR Cardiac Reading requires an additional license and is not available in all countries, e.g., the US. 11 There might be slight changes between software versions. Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022 syngo.via MR Cardiac Reading SIEMENS Healthineers Volume Quantification For MR Cardiac Reading, you can measure the scar tissue with Volume Quantification. Distance Line ROI Freehand The tool is accessible in the upper right corner menu. The tool provides a freehand ROI that can be used in several slices. The images need to be parallel. Pixel Lens Marker - it VolumeQuant – Mini tool bar VolumeQuant – ROI text Arrow New: Discard ROIs of current lesion: If no finding was Lesion identifier. Angle • • created before, these ROIs are lost. T • Area corresponding ROI. Text • Type: Clinical classification of lesion: By selecting the • Pixel statistics of current ROI. Volume Quant type in mini-tool bar new types can be added by the • Total volume of complete lesion. user. • % of LV myocardium according to LV_EF finding created. This is • Create: Create a finding for current lesion: Finding only displayed if a finding was created in the Cardiac Function includes snapshots of all images on which ROIs for this step. lesion were drawn. Lesion 1 Fat Area: 3.79 cm2 Edema Mean/SD: 2121.27 /69.16 Lesion TotalVolume: 3.03 cm3 CALL %Myocardium: 2 % New esion Create LinkedTo: LV EF1 syngo.via MR Cardiac Reading requires an additional license and is not available in all countries, e.g., the US. 12 There might be slight changes between software versions. Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022 syngo.via MR Cardiac Reading SIEMENS Healthineers Creating Findings (1/2) For MR Cardiac Reading, you can create findings MR Cardiac Analysis with the standard tools and document the results in MR Cardiac Reading an AHA-conforming segment model. E Create Segments Findings In the Case Navigator, click the Create Findings button. Tabs are provided to allow for switching Create Findings Create Findings Create Findings Patient Name MR_Cardiac_Analysis Patient Name MR_Cardiac_Analysis Patient Name MR_Cardiac_Analysis Patien between segment models for Functional, Dynamic, 69 Years Age 69 Year Age 69 Years Height 66.92914 inches Weight Create Findings Height 56.92914 inches Create Findings Height 66.92914 inches Create Findings 171.0062 lbs Weight 171.8062 1bs Weight 171.8062 lbs and Tissue Characterization. Functional Dynamic DE Functional Dynamic DE Functional Dynamic DE Stress Rest Combined Alinehe Hypokinche Normal Each tab card comprises an AHA-conforming Norma Hyperkinetic Subendocordial 26-50% Dyskinstic Transeural 51-75% Not Applicable 76-100% segment model. Each segment can be filled out Tissue Cherscterization Not Applicabie Strees interactively by selecting it and then assigning a value via the context menu. Findings Findings Finding 2 Multi1 1.41 c ... You can select several segments by keeping the Ctrl Finding 3 key pressed. The segments are colored according to DE_AHA the severity. After creating a finding, it is added to the finding's navigator as a snapshot. PDF syngo.via MR Cardiac Reading requires an additional license and is not available in all countries, e.g., the US. 13 There might be slight changes between software versions. Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022 syngo.via MR Cardiac Reading SIEMENS Healthineers Creating Findings (2/2) For correct loading in all the steps of MR Cardiac Analysis, the system cine_segmented_LAX_4K-chamber . DE_high-res_Moco_AVG_PS ... uses data classification. cine_segmented_LAX_3K-chamber cine_segmented_LAX_2K-chamber DE_high-res_Moco_AVG_M ... cine_segmented_SAX › DE_high-res_PSIR_LA For the data classification certain identifiers need to be included in cine_segmented_SAX › DE_high-res_MAG_LA cine_segmented_SAX 84 DE_Overview_PSIR_SA_01 the series name. It is recommended to follow these identifiers. cine_segmented_SAX cine_segmented_SAX 83 DE Overview_MAG_SA_ 01 cine_segmented_SAX 75 > Dynamic_Rest_MOCO_LA In the patient browser, the scanned image data is displayed as cine_segmented_SAX Dynamic_Rest_MOCO_SA_01 scanned. When opening the images with MR Cardiac Analysis, with cine_segmented_SAX 71 + Dynamic_Rest_LA cine_segmented_SAX the help of the identifiers, the image data is re-sorted and some cine_segmented_SAX Dynamic_Rest_SA_01 67 > Dynamic_Stress_MOCO_LA naming paradigm identifiers are added to the name, which is used for cine_segmented_SAX_InlineVF cine_segmented_SAX_InlineVF > Dynamic_Stress_MOCO_SA ... the loading into the corresponding segments. Inline_VF_Results 63 > Dynamic_Stress_LA Inline VF_Results cine_realtime_trufi_cs_rt_4K-chamber_INTP Dynamic_Stress_SA_01 cine_realtime_trufi_cs_rt_3K-chamber INTP 57 Inline_VF_Results_1 cine_realtime_trufi_cs_rt_2K-chamber INTP 55 cine_realtime_trufi_es_rt_a ... cine_realtime_trufi_cs_rt_adapt_trig_SAX_INTP cine_realtime_trufi_cs_rt_adapt_trig_SAX_INTP › Cine_Realtime_INT SA_01 cine_realtime_trufi_cs_rt_adapt_trig_SAX_INTP Cine_Realtime_INT_LA cine_realtime_trufi_cs_rt_adapt_trig_SAX_INTP 23 Inline_VF_Results cine_realtime_trufi_cs_rt_adapt_trig_SAX_INTP 21 cine_segmented_SAX_Inlin ... cine_realtime_trufi_cs_rt_adapt_trig_SAX_INTP cine_realtime_trufi_cs_rt_adapt_trig_SAX_INTP Cine_Segmented_SA_01 cine realtime trufi_cs_rt_adapt trig_SAX INTP Cine_Segmented_LA syngo.via MR Cardiac Reading requires an additional license and is not available in all countries, e.g., the US. 14 There might be slight changes between software versions. Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022 SIEMENS Healthineers Real-time H co Segmented AHR AHR RFA RFA -------- RFA ................................... syngo.via MR Cardiac Analysis AHR AHR AHR Image Data RFA RFA RFA Classification Real-time F Segmented AF HLP RHA RHA AL syngo.via MR Cardiac Reading requires an additional license and is not available in all countries, e.g., the US. 15 Click to add footnote There might be slight changes between software versions. Effective Date: 04 Oct 2022 | HOOD05162003305349 second line Unrestricted © Siemens Healthineers, 2022 Data Classification Customizing Protocol Names SIEMENS Healthineers For Siemensimage data The identifier after xyz can be added For Other vendors image data The naming has to be followed cine segmented to “xyz_cine” cine segmented short axis to “cine_short-axis” cine realtime to “xyz_cine_realtime” cine segmented long axis to “cine_-chamber” perfusion test to “xyz_dynamic_test” cine real time short axis to “cine_realtime_short-axis” perfusion stress to “xyz_dynamic_stress” cine real time long axis to “cine_realtime_-chamber” perfusion rest to “xyz_dynamic_rest” perfusion test to “dynamic_test” perfusion stress_MOCO to “xyz_dynamic_stress_MOCO perfusion stress to “dynamic_stress” perfusion rest_MOCO To “xyz_dynamic_rest_MOCO perfusion rest to “dynamic_rest” perfusion rest_MAP_SLOPE to “xyz_dynamic_rest_MAP_SLOPE” perfusion stress MOCO to “dynamic_stress_MOCO” perfusion stress_MAP_SLOPE to “xyz_dynamic_stress_MAP_SLOPE” perfusion rest MOCO to “dynamic_rest_MOCO” viability overview_MAG to “xyz_de_overview_MAG” perfusion stress upslope map to “dynamic_stress_MAP_SLOPE” viability overview_PSIR to “xyz_de_overview_PSIR” perfusion rest upslope map to “dynamic_rest_MAP_SLOPE” viability high-res_MAG to “xyz_de_high-res_MAG” viability overview MAG short axis to “DE_overview_short-axis_MAG” viability high-res_PSIR to “xyz_de_high-res_PSIR” viability overview PSIR short axis to “DE_overview_short-axis_PSIR” flow_P to “flow_xyz_P“ viability overview MAG long axis to “DE_overview_-chamber_MAG” flow_MAG to “flow_xyz_MAG” viability overview PSIR long axis to “DE_overview_-chamber_PSIR” 16 Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022 SIEMENS Healthineers 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 collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Please note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. © Siemens Healthcare GmbH 2022 Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Telephone: +49 9131 84-0 siemens-healthineers.com 17 Effective Date: 04 Oct 2022 | HOOD05162003305349 Unrestricted © Siemens Healthineers, 2022