Siemens SOMATOM Sensation Cardiac Version A60 Operations Instructions Page 1

SOMATOM Sensation 10Application GuideSpecial ProtocolsSoftware Version A60

10HeartView CTCoronary arteries:• Right coronary artery (RCA)Right coronary artery supplies blood to the rightatrium, right ventricle, a small part of

11HeartView CTCardiac Cycle and ECGThe heart contracts when pumping blood and restswhen receiving blood. This activity and lack of activityform a card

12HeartView CTTechnical PrinciplesBasically, there are two different technical approachesfor cardiac CT acquisition:• ECG triggered sequential scannin

13HeartView CTTimeTimeEstimated R-PeakECG (t)ECG (t)400 msec-400 msecScan/ ReconScan/ ReconFig. 11Fig. 12Absolute – delay: a fixed time delay after th

14HeartView CTFig. 13: Dose modulation with ECG pulsing.ECG Trace EditorThe ECG trace editor is used for adaptation of imagereconstruction to irregula

CardioCAREThis is a dedicated cardiac filter which reduces imagenoise thus provides the possibility of dose reduction. It isapplied in a pre-defined s

16HeartView CTHow to do itCalcium ScoringThis application is used for identification and quanti-fication of calcified lesions in the coronary arteries

17HeartView CTPlacement of ECG Electrodes:US Version (AHA standard)White Electrodeon the right mid-clavicular line, directly below the clavicleBlack E

18CaScoreSpiStdIndications:This is a standard spiral scanning protocol, using an ECG gating technique for coronary calcium scoringstudies, with a rota

19CaScoreSeqStdIndications:This is a sequential scanning protocol using an ECGtriggering technique for coronary calcium scoring studies.CaScoreSeqStdk

2The information presented in this application guide is for illustration only and is not intended to be reliedupon by the reader for instruction as to

20Coronary CTAThis is an application for imaging of the coronary arteries with contrast medium. It can be performedwith both ECG triggering and gating

21HeartView CT

22HeartView CTCoronaryStdIndications:This is a standard spiral scanning protocol, using arotation time of 0.5 s, with an ECG gating techniquefor coron

23HeartView CTCorStd_LowHeartRateIndications:This is a special spiral scanning protocol for coronaryCTA studies. It uses ECG gating technique and a 0.

24CoronaryCAREIndications:This is a spiral scanning protocol, using a rotation timeof 0.5 s, ECG gating technique and a dedicated cardiacfilter which

25HeartView CT

26HeartView CTCoronarySharpIndications:This is a spiral scanning protocol, using a rotation time of 0.5 s, ECG gating technique and a dedicatedcardiac

27HeartView CTImage reconstructionwith (b) and without (a) Cardio Sharp kernel.ab

HeartView CTECGTrigCTAIndications:This is a sequential scanning protocol with an ECG triggering technique for coronary CTA studies. It couldalso be ap

29HeartView CTECGTrigCTAkV 120Effective mAs 120Slice collimation 1.5 mmSlice width 1.5 mmFeed/Scan 12.0 mmRotation time 0.5 sec.Temporal resolution 25

33OverviewHeartViewCT 8Bolus Tracking 38Dental CT 46Osteo CT 52Pulmo CT 58Perfusion CT 62Dynamic Scanning 70Interventional CT 72Trauma 76LungCARE 80CT

30Aortic and Pulmonary StudiesThis application can be used for high-resolution inter-stitial lung studies with an ECG triggering technique,or when ima

31HeartView CTLungECGHiresIndications:This is a sequential scanning protocol with an ECG triggering technique for interstitial studies of the lungs,es

32HeartView CTPulmonaryECGIndications:This is a spiral scanning protocol with an ECG gatingtechnique for aortic and pulmonary studies, e. g. aorticdis

33HeartView CTAdditional Important InformationBy default, the “Synthetic Trigger” (ECG triggered scanning) or “Synthetic Sync” (ECG gated scanning) is

34HeartView CTACV (Adaptive Cardio Volume) (Fig. 3) is a dedicatedalgorithm for bi-phase image reconstruction. The imagetemporal resolution of 125 ms

35HeartView CTYou can activate the “Auto load in 3D” function on theExamination card/Auto Tasking and link it to a reconjob. If the postprocessing typ

36HeartView CTCalcium Scoring evaluation is performed on a separatesyngo task card:1. The threshold of 130 HU is applied for score calculation by defa

37HeartView CTUser interface of syngo Calcium Scoring

38The BasicsThe administration of intravenous (IV) contrast material during spiral scanning improves the detectionand characterization of lesions, as

39Bolus TrackingAortic time-enhancement curves after i.v. contrastinjection (computer simulation*).All curves are based on the same patient parameters

4ContentHeartViewCT 8· The Basics 8– Important Anatomical Structures of the Heart 8– Cardiac Cycle and ECG 11– Temporal Resolution 11– Technical Princ

40Bolus TrackingHow to do itTo achieve optimal results in contrast studies, the useof CARE Bolus is recommended. In case it is not available,use Test

41Bolus Tracking– After the Topogram is performed, the predefined spiral scanning range and the optimal monitoringposition will be shown.– If you need

42TestBolusIndications:This mode can be used to test the start delay of anoptimal enhancement after the contrast mediuminjection.TestBoluskV 120Effect

43Application procedures:1. Select the spiral mode that you want to perform,and then “Append” the TestBolus mode under Specialprotocols.2. Insert the

44Additional Important Information1.The preset start delay time for monitoring scansdepends on whether the subsequent spiral scan willbe acquired duri

45Bolus Tracking5. If API is used in conjunction with CARE Bolus, theactual start delay time for the spiral will be as longas the length of API includ

46Dental CTThis is an application package for reformatting pano-ramic views and paraxial slices through the upper andlower jaw. It enables the display

47DentalkV 120Effective mAs 80Slice collimation 0.75 mmSlice width 0.75 mmFeed/Rotation 5.0 mmRotation time 0.75 sec.Kernel H60sIncrement 0.5 mmImage

48Dental CT• It is mandatory to position the patient head in thecenter of the scan field – use the lateral laser lightmarker for positioning.• Gantry

49Dental CTAdditional Important Information• This protocol delivers high resolution images for Dental CT evaluation, however, you can also recon-struc

5ContentBolus Tracking 38· The Basics 38· How to do it 40· CARE Bolus 40· TestBolus 42· Additional Important Information 44Dental CT 46· The Basics 46

50Dental CT• Multiple paraxial ranges can be defined on one reference image by “cluster & copy function”. I. e.,you can group a number of paraxial

51Dental CT

52Osteo CTThis is an application package for the quantitativeassessment of vertebral bone mineral density for the diagnosis and follow-up of osteopeni

53Osteo CTSiemens Reference Data:The Siemens reference data was acquired at threeEuropean centers, including 135 male and 139 femalesubjects, 20 to 80

54Osteo CTPatient positioning:• Set the table height at 125. The gantry tilt will beavailable from –22° to +22°.• Patients should be positioned so the

55Osteo CTFig. 2: Phantom inside the FoVFig. 1: TopographicAdditional Important Information• Fractured vertebrae are not suited for Osteo CT evaluatio

56Osteo CT• How to save the results on your PC?– Select Option/Configuration from the main menuand click icon ”CT Osteo”.– Activate the checkbox “Enab

57Osteo CTNote: it is not recommended to use filming setting of 4 x 5 segments since the image text elements of theresult image are overlapped and har

58Pulmo CTPulmo CTThis is an application package, which serves for quantitative evaluation of the lung density to aid thediagnosis and follow-up of di

59Pulmo CT• Examinations should be acquired at the same res-piratory level, usually at either full inspiration or fullexpiration. Studies had shown th

6ContentInterventional CT 72· The Basics 72· How to do it 73– Biopsy 73– BiopsyCombine 74· Additional Important Information 75Trauma 76· The Basics 76

60Pulmo CTAdditional Important Information• How to export the evaluation results to a floppy disc?– Select Option/Configuration from the main menuand

61Pulmo CTFig. 2: User interface of syngo Pulmo

62Perfusion CTThis is an application software package for the quan-titative evaluation of dynamic CT data of the brain following injection of a highly

63Perfusion CTThe CBF image shows a severe perfusion disturbance(flow close to zero) in the insular cortex and the poste-rior portion of the lentiform

64Perfusion CTHow to do itScan protocolsThere are two Scan protocols available:BrainPerfCT, a non contrast study and a DynamicSerio with 12 mm collima

65Perfusion CTIV injection protocolContrast medium Non-ionicConcentration 300 – 370 mlInjection rate 8 ml/sec.Total volume 40 mlTotal injection time ~

66Perfusion CT• The standard examination slice is best positionedsuch that it cuts through the basal ganglia at the levelof the inner capsule. This se

67Perfusion CTAdditional Important Information1. Why short injection times are necessary?The brain has a very short transit time (approx. 3 to 5 secon

68Perfusion CT3. What do pixel values mean in the Perfusion CT images?It is very important to realize that pixel values nowhave a different meaning, w

69Perfusion CTAfter adjustment (use non-ischemic hemisphere asguideline) ischemic areas will therefore be displayedeither in violet (very low flow) or

7Content

Dynamic ScanningThese are protocols templates for the analysis of contrast enhancement dynamics in the body. Scanparameter details such as mAs, slice

Dynamic Scanning71BodyDynCTkV 120Effective mAs 100Slice collimation 12.0 mmSlice width 12.0 mmFeed/Scan 0 mmRotation time 0.5 sec.Cycle time 1.0/5.0 s

72Interventional CTTo facilitate CT interventional procedures, we createddedicated multislice and single slice sequential modes. • BiopsyThis is the m

73Interventional CTHow to do itBiopsyIndications: This is the multislice biopsy mode. 6 slices,3.0 mm each, will be reconstructed and displayed foreac

74Interventional CT5. Click “Load” and then “Cancel move”. Press the“Start” button and 6 images will be displayed.6. Press “Start” again, you’ll get a

75Interventional CTAdditional Important Information• In the BiopsyCombine mode, the slice position, tableposition, table begin and table end are all t

TraumaIn any trauma situation, time means life and the quality of life for the survivor. In order to facilitate theexaminations, two protocols are pro

TraumaTraumakV 120Effective mAs 140Slice collimation 1.5 mmSlice width 7.0 mmFeed/Rotation 15.0 mmRotation time 0.5 sec.Kernel B31fIncrement 7.0 mmIma

78TraumaPolyTraumaScan Protocol:PolyTrauma HeadFastSpi NeckFastspikV 120 120Effective mAs 260 150Slice collimation 1.5 mm 1.5 mmSlice width 6.0 mm 5.0

79TraumaAdditional Important Information• For long range scanning, please pay attention to themark of scannable range on the table mattress whileposit

8HeartView CTHeartView CTHeartView CT is a clinical application package specifi-cally tailored to cardiovascular CT studies.The BasicsImportant Anatom

80LungCAREA dedicated low dose Spiral mode for the syngoLungCARE evaluation.Indications:Lung studies with low dose setting, e. g. early visuali-zation

81LungCAREFig. 1: User interface of syngo LungCAREsyngo LungCARE is a dedicated software for visuali-zation and evaluation of pulmonary nodules using

82CT ColonographyFor Colonography studies.A typically range of 40 cm can be covered in 22.4 s.CT Colonography 2ndreconstr.kV 120Effective mAs 100Slice

83CT ColonographyWe recommend using a tube voltage of at least 120 kV.A comprehensive study consists of four sections:Preparation, examination in supi

AppendixOsteo CTExample for one patient with three Osteo tomograms:PATIENT; John Smith; 007; 64; MaleIMAGE; L2; 234; 2; 27-JAN-1998; 11:12:17; 61.7;48

Appendix85Abbreviations:TML Trabecular Mean LeftTMR Trabecular Mean RightTMT Trabecular Mean TotalTSL Trabecular Standard Deviation LeftTSR Trabecular

86AppendixPulmo CTExample of result file:START; 20-FEB-1998 12:01:17PATIENT; John Smith; 007; 64; MaleIMAGE; 234; 21; 27-JAN-1998 11:12:17;-200;1RESUL

87AppendixData structure of the result file:START; <Date and Time of the evaluation start>PATIENT; <Patient name>; <Patient ID>; <

88AppendixMANSEGMENT; <LEFT/RIGHT>;<Image number>; <Segmentation number, always 1>;<Number of segments>;<Mean value first s

89Appendix

9HeartView CTFig. 1: Blood fills both atriaFig. 2: Atria contract, bloodenters ventriclesA: AortaP: Pulmonary ArteryRV: Right VentricleLV: Left Ventri

Siemens reserves the right to modify the design and specifications containedherein without prior notice. Please contact your local Siemens Sales Repre