Retrospective Spiral Respiratory Correlated Imaging with Varian RPM

Transcription

1 Retrospective Spiral Respiratory Correlated Imaging with Varian RPM This is a Quick Step Guide for Retrospective Spiral Respiratory Correlated Imaging (4D CT) using the Varian RPM device v1.7 with the Brilliance CT Big Bore v2.2.2 system and the Brilliance v For more detailed information, please refer to the Varian RPM operator manual and reference guide. Before starting, verify the following items are set correctly on the CT scanner and the RPM workstation. 1. Connect the Varian RPM Sensor Device to the gantry. 2. Ensure that the Varian RPM computer is turned on, is connected to the hospital network, and is fully booted up before logging in to the CT Host. 3. Wait at least 5 seconds after the login prompt appears before logging in to the CT Host. Note Restart the CT Host daily. 4. On the CT scanner, Select Preferences in the Directory tool panel. 5. Select Scanner from menu. 6. In the Pulmo Sensor Device option, select Varian. 7. Click OK to accept. 8. Place the marker block on the patient s chest or abdomen. 9. Review the procedure with the patient emphasizing the importance of maintaining a consistent breathing pattern. Refer to the Varian RPM reference guide for information about usage of Audio or Visual coaching. 1

2 Start Study on the CT scanner 1. Click Start Study to begin a new study. 2. Complete the patient data form. 3. Click Exam Protocol Groups. 4. Select the Thorax Protocol group. 5. Select Pulmo Retrospective Spiral Protocol. Launch the Varian RPM workstation 1. Login to the Varian RPM Workstation. 2. Double click the RPM Respiratory Gating Icon. 3. Close the Patient List. 4. Proceed with System Configuration. 5. Click on the View Menu. 6. Select System Configuration. 2

3 7. Click on the CT Interface Tab. CT Interface Tab 8. Select Trigger based on phase value. 9. Set Trigger At: to 0 degrees. 10. Set CT Trigger Length: to 0.50 sec. 11. Select Sensed via Digital I/O. 12. Set Binary Value indicating X-ray on: to [1] 13. Select No new pulse after and set to 180 sec. 14. Click File Export Tab 3

4 File Export Tab 1. Select Prompt to export a respiration data file after recording is finished. 2. Select Recalculate phase before respiration data export. Note Select Recalculate phase before respiration data export, only if you choose to recalculate phase before exporting. 3. Export filename format must be set to Patient ID_Exam Number_Series Number.vxp. 4. Export file location must be set to C:\Documents and Settings\VARIAN\Desktop\Gating\Breath (unless instructed otherwise by service or hospital personnel). 5. Click Chart Tab. Chart Tab 1. Set Recording Length to no higher than 9 minutes. Note Values greater than 9 minutes not supported. 2. Select Auto scale. 3. Click Tracking Options Tab. 4

5 Tracking Options Tab Note Options to be determined at installation by the field engineer (refer to the Varian manual for more information). 1. Once the System Configuration settings are confirmed click OK. Patient List 1. On the RPM System Click File. 2. Select Patient, patient list will open. 3. Click New Patient. 5

6 4. Complete the Patient Data Form, to match the CT scanner patient data form. 5. Click OK when complete. 6. Highlight the Patient Name. 7. Click Select. 8. In the New Treatment Field window, fill in the Treatment Field Label. 9. Select Appropriate Treatment Field. 10. Click OK. 6

7 Note A message will display: Do you want to create a reference session for selected option? 11. Click Yes. 12. RPM screen will display with Track Enabled. Learning Phase on the RPM System During the Learning Phase the RPM system will track the patient s respiratory motion and attempt to learn the patient s respiratory motion. Once the system has a good signal and learned the respiratory motion, the blue indicator bar at top left of the screen should display one or two bars. Acquiring Surview on the CT scanner On the CT scanner, acquire the Surview and any other preliminary scans desired. Note Some customers prefer a routine chest scan before the retrospective pulmonary acquisition. These must be completed before pressing the record button on the Varian RPM. 7

8 1. Confirm scan parameters. 2. Do not use Auto Voice. 3. Click Go to start the Surview. 4. On the CT set Scan Parameters. 5. On the Varian RPM computer Press Record. 6. On the RPM computer Click Enable Gating Button. Note Pulses will start to display on the RPM workstation after the enable gating is activated. 7. Use the table below to determine the pitch and rotation speed. Breath Rate (in breaths per minute) For 0.5 sec Rotation Time, use a pitch no higher than: For 0.44 sec Rotation Time, use a pitch no higher than: Once the parameters are set on the CT scanner click Go to start the scan. 8

9 9. Press Enable. 10. When patient s breathing is steady, press Manual to start the scan. Note The waveform displayed on the Varian system will turn green when x-rays are on and the Radiation On symbol will appear. Note Monitor the patient s breathing during the scanning process. You may choose to stop the scan if breathing is irregular through the area of interest. Note On the CT scanner you will be prompted to import the Varian File when the scan is completed. 11. Do Not click OK keep window open and proceed to the next step. Note The file has not been saved for export, it is still recording. 12. On the RPM Computer click the Stop button to save the file. 9

10 13. On the RPM Computer Type in 1 in the Exam Number field. 14. On the RPM Computer Type in 1 in the Series Number field. 15. On the RPM Computer click OK when complete. 16. On the RPM Computer click OK to New Export Step Verification. Note On the RPM Computer Respiration data file was exported successfully will display on the screen. 17. On the RPM Computer click OK. [again?] 18. On the CT scanner click OK on the Import Varian File window to complete the file import. 10

11 19. On the CT scanner review the wave form that was imported, and edit tags if desired. Note Tags represent where the reconstruction will define the beginning of the breath cycle (0%). Please be aware that there is no opportunity to edit tags sent from RPM TM during gated treatment. 20. On the CT scanner click OK to start the image reconstruction. Note May take up to 90 seconds for the first image 21. On the Varian RPM workstation click Close Patient. Philips Medical Systems is part of Royal Philips Electronics Philips Medical Systems Cleveland, Ohio Philips Medical Systems All rights reserved. (2007) Reproduction in whole or in part Is prohibited without prior consent of the copyright holder. Philips Medical Systems Printed in U.S.A. 11