Siemens AG, Healthcare Sector. syngo MR D Operator Manual - System and data management

Transcription

1 Siemens AG, Healthcare Sector Cs2 syngo System Operator MR English 06/2012 n.a. Informatik and Manual D13 data management syngo MR D13 Operator Manual - System and data management syngo MR D13

2 Manufacturer's notes: This product bears a CE marking in accordance with the provisions of regulation 93/42/EEC of June 14, 1993 for medical products. The CE marking applies only to medico-technical products/ medical products introduced in connection with the above-mentioned comprehensive EC regulation.

3 Overview of Contents Advanced tasks and tools System administration and configuration Index A B C syngo MR D13 i

4 syngo System administration and configuration ii MR D13 - System and data management

5 Table of Contents A Advanced tasks and tools A.1MPPS A.2Camtasia A.3Correcting and assigning data (Patient Browser) B System administration and configuration B.1Managing the system B.2Managing measurement programs (Exam Explorer) B.3Creating AutoAlign programs B.4Creating a Dot Engine B.5Managing files (File Browser) B.6Managing voice outputs B.7Configuring reports B.8Adjusting the system manually B.9Expert-i B.10RemoteAssist C Index syngo MR D13 iii

6 syngo System administration and configuration iv MR D13 - System and data management

7 Introduction Introduction In order to operate the MR system accurately and safely, the operating personnel must have the necessary expertise as well as knowledge of the complete operator manual. The operator manual must be read carefully prior to using the MR system. Layout of the operator manual Your complete operator manual is split up into several volumes to improve readability. Each of these individual operator manuals covers a specific topic. Hardware components (system, coils, etc.) Software (measurement, evaluation, etc.) Another element of the complete operator manual is the information provided for the system owner of the MR system. The extent of the respective operator manual depends on the system configuration used and may vary. All components of the complete operator manual may include safety information that needs to be adhered to. The operator manuals for hardware and software address the authorized user. Basic knowledge in operating PCs and software is a prerequisite. syngo MR D13 v

8 syngo System administration and configurationintroduction The current operator manual This manual may include descriptions covering standard as well as optional hardware and software. Contact your Siemens Sales Organization with respect to the hardware and software available for your system. The description of an option does not infer a legal requirement to provide it. The graphics, figures, and medical images used in this operator manual are examples only. The actual display and design of these may be slightly different on your system. Male and female patients are referred to as the patient for the sake of simplicity. References to Siemens Service include service personnel authorized by Siemens. Configuration This manual consists of multiple parts (Part A, Part B, etc.). A comprehensive Table of Contents can be found at the beginning of each part. Part A Safety needs to be closely observed during your daily routine. vi MR D13 - System and data management

9 Introduction Important icons For readability, certain contents are highlighted. In the following sections, you will find the symbols and their contents used: Prerequisites for the operating steps to follow Request for action Item in list Notes for optimal use of the MR system. Remarks that facilitate work with the system. syngo MR D13 vii

10 syngo System administration and configurationintroduction Intended use Your MAGNETOM MR system is indicated for use as a magnetic resonance diagnostic device (MRDD) that produces transverse, sagittal, coronal and oblique cross sectional images, spectroscopic images and/or spectra, and that displays the internal structure and/or function of the head, body, or extremities. Other physical parameters derived from the images and/or spectra may also be produced. Depending on the region of interest, contrast agents may be used. These images and/or spectra and the physical parameters derived from the images and/or spectra when interpreted by a trained physician yield information that may assist in diagnosis. Your MAGNETOM MR system may also be used for imaging during interventional procedures when performed with MR compatible devices such as in-room displays and MR-safe biopsy needles. The MAGNETOM MR system is not a device with measuring function as defined in the Medical Device Directive (MDD). Quantitative measured values obtained are for informational purposes and cannot be used as the only basis for diagnosis. For the USA only: Federal law restricts this device to sale, distribution and use by or on the order of a physician. viii MR D13 - System and data management

11 Introduction Authorized operating personnel The MAGNETOM MR system must be operated according to the intended use and only by qualified persons with the necessary knowledge in accordance with country-specific regulations, e.g. physicians, trained radiological technicians or technologists, subsequent to the necessary user training. This user training must include basics in MR technology as well as safe handling of MR systems. The user must be familiar with potential hazard and safety guidelines the same way the user is familiar with emergency and rescue scenarios. In addition, the user has to have read and understood the contents of the operator manual. syngo MR D13 ix

12 syngo System administration and configurationintroduction Open source software included The software delivery volume includes a separate Open Source DVD. This DVD contains the Open Source software packages as well as the associated licensing information installed in this product. For additional information, please read the following files on DVD: release-notes.pdf release-notes-linux.pdf x MR D13 - System and data management

13 A Advanced tasks and tools A A.1 MPPS A.1-1 Controlling the MPPS Opening the MPPS dialog window Navigating between MPPS objects Saving an MPPS Finishing an MPPS Aborting an MPPS Sending information back to HIS/RIS Closing the MPPS dialog window without any changes Checking the MPPS information Completing the MPPS A.1-3 A.1-5 A.1-6 A.1-6 A.1-7 A.1-7 A.1-7 A.1-8 A.1-8 A.1-9 A.2 Camtasia A.2-1 Opening the Camtasia Recorder Capturing a video Selecting the capture area Starting capturing Pausing capturing Stopping capturing Deleting the current video Adding annotations and effects during recording Saving the video file Defining the output options Playing the video file Opening the AVI files Workflow example A.2-2 A.2-4 A.2-4 A.2-5 A.2-6 A.2-7 A.2-7 A.2-7 A.2-10 A.2-11 A.2-12 A.2-12 A.2-13 syngo MR D13 A-1

14 syngo System administration and configuration A.3 Correcting and assigning data (Patient Browser) General information Assignment of patients or studies Deleting data in the Patient Browser Tasks Splitting mosaic images Assigning patients or studies to patient groups Correcting data Deleting data manually Protecting data from deletion Removing delete protection Splitting studies in the Patient Browser UI explanation Study split A.3-1 A.3-1 A.3-1 A.3-3 A.3-5 A.3-5 A.3-6 A.3-8 A.3-12 A.3-12 A.3-13 A.3-13 A.3-15 A.3-15 A-2 MR D13 - System and data management

15 A.1 A.1 MPPS A.1 MPPS A.1 The exchange of information based on Modality Performed Procedure Step (MPPS) closes the gap between the modalities and the HIS/RIS. The information documents the actions being performed for a patient. A.1 The MPPS function is available with an optional software license. If this license is not available, only local MPPS management is possible, and no feedback is sent to the HIS. The MPPS component mainly handles the following: A.1 Creating MPPS during patient examination Passing information to the HIS/RIS Updating the MPPS status to the HIS/RIS based on user interaction and automatic procedures Thus a smooth clinical flow is ensured, billing, and other information are generated within the hospital system. A.1 The MR system generates entries automatically in the MPPS, for example, generated series and contrast media consumed. You can also add information manually (for example, contrast medium with flow, volume, kind of contrast medium). syngo MR D13 A.1-1

16 syngo A.1 System administration and configuration An MPPS is typically created as a part of the patient registration process in which: A.1 The HIS/RIS requests a worklist procedure. Alternatively, the workstep is created directly at the modality for the examination or image acquisition. During an examination, the modality sends a message indicating the start and the end of the examination. As a result, you can call up the status of the examination at any time. A.1 The following helpful features for integrating the modalities with the supervising information system in the hospital are provided: A.1 Displaying the patient information for MPPS Viewing the action items for MPPS Viewing the billing information for MPPS If you cannot edit the MPPS information, you do not have the relevant access rights. Security in syngo ensures that access to functions and data is always provided in accordance with the privileges and permissions granted to a user. A.1-2 MR D13 - System and data management

17 A.1 A.1 MPPS A.1 Controlling the MPPS A.1 The availability of buttons depends on the status of the MPPS. Layout of the MPPS dialog window A.1 The Modality Performed Procedure Step dialog window consists of three areas: A.1 syngo MR D13 A.1-3

18 syngo Information System administration and configuration (1) Patient and Study areas: Patient data A.1 Study description A.1 (2) Upper part of the MPPS area: Data of the selected MPPS A.1 Input field for comments to the MPPS A.1 (3) Lower part of the MPPS area: Examination data sorted by various aspects and displayed in three tab cards (not all of them may be available at your modality) A.1 Feedback to the HIS/RIS A.1 about status and changes of the MPPS is sent to the HIS/RIS every time you click one of the following buttons in the Modality Performed Procedure Step dialog window: A.1 Completed Discontinued Send A.1-4 MR D13 - System and data management

19 A.1 A.1 MPPS A.1 Opening the MPPS dialog window A.1 In the Patient Browser, the MPPS series are marked by the following flags: A.1 IN PROGRESS: series refers to MPPS which is in progress DISCONTINUED: series refers to MPPS which is discontinued HIS or LOC: series belongs to an examination planned by RIS or locally se: MPPS message acknowledged by IS The usage of the DICOM service MPPS depends on the availability of the corresponding RIS system. Even if no RIS with MPPS service is connected, the MPPS icon is displayed in the Patient Browser. Select the patient, the examination, or one of the associated series or images from the Patient Browser. Click the Show MPPS icon in the tool bar of the Patient Browser. The Modality Performed Procedure Step dialog window is opened. By default, the latest MPPS object is displayed. A.1 syngo MR D13 A.1-5

20 syngo A.1 System administration and configuration Navigating between MPPS objects A.1 Before you conclude your work on the examination by archiving, check and add missing entries to the performance report. A.1 Click the Next button to have the MPPS object displayed which is next in time. Click the Previous button to have the latest MPPS object displayed again. Saving an MPPS A.1 Click the Save button to save your changes of the document. Saving an MPPS does not complete the examination. No message is sent to the HIS/RIS. A.1-6 MR D13 - System and data management

21 A.1 A.1 MPPS A.1 Finishing an MPPS A.1 Click the Completed button to close the MPPS dialog window when all data shown in the performance document are correct, and complete the examination. The MPPS is closed. A corresponding message is forwarded to the HIS/RIS. A.1 If you are considering further steps, you can save the document first and close it later. Aborting an MPPS A.1 Click the Discontinued button if the examination is canceled. The MPPS is closed. A corresponding message is forwarded to the HIS/RIS. A.1 Sending information back to HIS/RIS A.1 Click the Send button to mark the MPPS as being processed and to inform the HIS/RIS about changes in the MPPS. The Send button is displayed only if an MPPS node is configured. syngo MR D13 A.1-7

22 syngo A.1 System administration and configuration Closing the MPPS dialog window without any changes A.1 Click the Cancel button to close the dialog window if you only opened the document for printing or viewing. Checking the MPPS information A.1 Click in the center of the status bar of the task card to check the corresponding entry in the History of Events. A list of events is displayed. A.1 Look for an entry in the list concerning the MPPS. If you do not find such an entry, it is already removed, because the information was sent successfully to the HIS/RIS. A.1 If you find an entry concerning the MPPS, click it. If an error occured, a message appears. Check also the status bar at the bottom of the task card for any error information. A.1-8 MR D13 - System and data management

23 In A.1 MPPS A.1 Completing the MPPS A.1 You can complete all MPPS of a patient or a study simultaneously. A.1 Automatic completion A.1 the Workflow tab card of the Examination Configuration dialog window, you can activate the checkbox Auto Complete MPPS. All MPPS are then automatically set to COMPLETED after all recon jobs were reconstructed and the patient was closed. A.1 Make sure that you printed all film sheets before closing the patient. Otherwise MPPS will not accept new film sheets. A.1 Manual completion A.1 Select the study or patient. Click the Complete MPPS icon in the Patient Browser. The status of all related MPPS is set to COMPLETED. A.1 syngo MR D13 A.1-9

24 syngo System administration and configuration A.1-10 MR D13 - System and data management

25 A.2 A.2 A.2 Camtasia A.2 Camtasia A.2 Camtasia is a separate software tool that allows you to film your desktop activities. A.2 You can save these recordings as AVI files for documentation and presentation purposes. A.2 Furthermore, you have the possibility within the Camtasia software to choose between several additional tools depending on your requirements. A.2 To ensure an accurate run of the single Camtasia functionality, only start one action at a time. You will find additional information about the Camtasia recorder by clicking the Help button. Availability on the consoles A.2 The recorder is available on both the syngo Acquisition Workplace and the syngo Workplace. A.2 After the installation of the Camtasia software, new menu entries are added to the main menu of any task card and the Patient Browser menu. syngo MR D13 A.2-1

26 syngo A.2 System administration and configuration The following tools are integrated in the Camtasia software: A.2 Recorder: to capture AVI files Player: to play AVI files Producer: to edit AVI files Effects: to add objects, such as callouts, arrows, text, and WMF images to an AVI video MenuMaker: to create an attractive menu where you can launch your files Opening the Camtasia Recorder A.2 Select Applications > Desktop > Camtasia Recorder. The Camtasia Recorder window opens. A.2 The entire Camtasia Recorder dialog window and the menu of the Camtasia Recorder dialog window is visible only if the Standard view is selected. By default, Minimal is selected and only the title bar and the icon bar are displayed. A.2-2 MR D13 - System and data management

27 A.2 A.2 A.2 Camtasia A.2 Click the Toggle View dropdown list and select Standard. Select the required tool from the Tools menu. The corresponding window of the selected tool opens. A.2 The Tools menu entries on the Camtasia Recorder window are only available on the syngo MR Workplace. syngo MR D13 A.2-3

28 syngo A.2 A.2 System administration and configuration Capturing a video A.2 For capturing a video, call up the Camtasia Recorder. Selecting the capture area A.2 You can select the capture area by clicking the arrow button next to the Record button. A.2 A bullet in the dropdown list shows you the capture area currently selected. When you pass over selectable areas, they are highlighted. Select Screen to capture the entire screen. or A.2 Select Window to capture a selected window. With the highlighter, select a window or any portion of a window to be captured. After clicking the Record button, click into a window to select it. or A.2 Select Region to capture a user-defined region. After clicking the Record button, click and drag the mouse cursor over the area you want to capture. or A.2 A.2-4 MR D13 - System and data management

29 A.2 A.2 Camtasia A.2 Select Fixed Region... to capture a pre-defined region. The Fixed Region dialog window is displayed. A.2 Define the size of the fixed region using the options in the Fixed Region dialog window. Starting capturing A.2 Click the Record button in the toolbar after selecting the capture area to start capturing. or A.2 Press F9. syngo MR D13 A.2-5

30 syngo A.2 A.2 System administration and configuration During the recording process, the Camtasia Recorder window is visible. You can move the window as far as possible out of the region of interest to make sure it is not captured in the video. A.2 Click the top of the window and keep the mouse button pressed while moving into another screen area. If you selected either Window or Region as your capture area, click the Record button and mark the area you want to capture. Calling up the minimized Camtasia window A.2 If you minimized the Camtasia window, you cannot reopen it as usual. A.2 Select Applications > Desktop > Camtasia Recorder to reopen Camtasia. Pausing capturing A.2 Click the Pause button in the toolbar to pause the capturing process. or A.2 Press F9. A.2-6 MR D13 - System and data management

31 A.2 A.2 A.2 Camtasia A.2 Stopping capturing A.2 Click the Stop button in the toolbar to stop capturing. or A.2 Press F10. Deleting the current video A.2 Click the Delete button in the toolbar to delete the video currently captured. The recording pauses and a message box are displayed. A.2 After confirming the message box, any captured frames are discarded. Adding annotations and effects during recording A.2 During AVI recording, you can add various annotations and effects to the file which is being recorded. A.2 syngo MR D13 A.2-7

32 syngo A.2 System administration and configuration Select Effects > Options to open the Effects Options window for defining the several options. Add the features you want to have displayed in your video. A.2-8 MR D13 - System and data management

33 A.2 A.2 Camtasia A.2 You can add following features to your video: Date and time Caption Watermarks Highlights/Autohighlights Cursor effects Audio effects Zoom & pan effects Select the corresponding menu entry in Effects to activate it. syngo MR D13 A.2-9

34 syngo Using A.2 Due A.2 Using A.2 A.2 A.2 A.2 System administration and configuration Saving the video file A.2 During recording, the video is stored as an AVI file. It is stored automatically in your offline file system under C:\Med- Com\temp\CDR_OFFLINE. A.2 CAUTION A.2 other than configured directory for Camtasia data files. Data disk is full and no further examination possible. Files can not be deleted by the user anymore. Use only the configured directory for saving the Camtasia data files. CAUTION A.2 to Camtasia screen capturing the data disk fills up. Examination is no longer possible or examination may be aborted. Only use Camtasia for short recording sequences. Don't use Camtasia for recording in parallel to the acquisition. CAUTION A.2 results from Camtasia for diagnosis or reading. Wrong diagnosis due to inadequate image quality. The results from Camtasia are only intended to be used for training and communication. A.2-10 MR D13 - System and data management

35 A.2 A.2 Camtasia A.2 Defining the output options A.2 Select Capture > Output > File to save the captured video as AVI (video) file. Select Tools > Options > File to set the name and the storage location of the video file. The AVI files you create can be imported or edited in any third-party application that supports the AVI format. or A.2 Select Capture > Output > Live to make the video available to any live encoding process running on your computer. syngo MR D13 A.2-11

36 syngo A.2 System administration and configuration Playing the video file A.2 With the Camtasia Player you can play the results of filming your desktop activities. A.2 Select Tools > Camtasia Player in the Camtasia Recorder window to open the Camtasia Player window. Opening the AVI files A.2 Select File > Open. A.2-12 MR D13 - System and data management

37 A.2 Camtasia A.2 Select the desired AVI file. Confirm the selection by clicking the Open button to start playing the movie. Workflow example A.2 You can record your desktop activities on any task card. A.2 Load a Head Angiography data set into the 3D task card. Apply a VRT preset on this data set. Select Applications > Desktop > Camtasia Recorder. The Camtasia Recorder window opens. A.2 Select the capture area. Click the Record button in the toolbar. Click into the segment you want to record your desktop activities in. Recording starts. A.2 syngo MR D13 A.2-13

38 syngo A.2 A.2 System administration and configuration Start working in this segment. When you have finished, click the Stop button in the toolbar to stop recording. A.2-14 MR D13 - System and data management

39 Rearrange A.3 A.3 A.3 Correcting and assigning data (Patient Browser) A.3 Correcting and assigning data (Patient Browser) A.3 General information A.3 Assignment of patients or studies A.3 In the Patient Browser, you can modify the assignment of patient groups or studies. A.3 This information applies to users performing daily routine operations with patient data protected by the Security Package (HIPAA). A.3 The Security Package must be installed on your system. CAUTION A.3 series/images to another series may lead to wrong image information if the selected images/series are not compatible. Wrong diagnosis caused by wrong image information. Correct the attributes which do not correspond first and then rearrange the series/images. syngo MR D13 A.3-1

40 syngo Correcting/rearranging A.3 If A.3 A.3 A.3 System administration and configuration CAUTION A.3 not all objects with references. References may be lost. Rearrange the entire hierarchical group containing all objects with references in order to maintain the references. Only references found within the selection will be adapted. CAUTION A.3 any Radiotherapy (RT) object is involved in a correction or rearrangement, the references to and from other objects are not updated. The Correct and Rearrange function checks if any Radiotherapy objects is involved and prompts for confirmation. References between images and Radiotherapy (RT) objects may be lost. Use the application(s) that was/were used to generate the Radiotherapy object for managing their references. First correct images (e.g. patient demographics) before using them within Radiotherapy. A.3-2 MR D13 - System and data management

41 Systems A.3 The A.3 A.3 A.3 Correcting and assigning data (Patient Browser) A.3 Deleting data in the Patient Browser A.3 CAUTION A.3 that do not use storage commitment only report back to the sending system when the data has been fully received (flags A and S). A user or a auto delete mechanism at the sending system might subsequently delete the sent data. However, this response does not imply that the data has already been stored at the receiving system. In the case that the receiving system cannot store the data, the data might irrevocably be lost. Cross-check if the data is actually stored on the receiving system. Use storage commitment whenever it is supported by the sending and receiving systems. CAUTION A.3 printed flag is set if the images are successfully transferred to the printer s control. Not all printers (e.g., paper printers) may be able to solve printing problems themselves. Image printout may be lost. Verify that the printouts are available before you delete images. syngo MR D13 A.3-3

42 syngo Deletion A.3 A.3 System administration and configuration CAUTION A.3 confirmation deactivated. Loss of data possible. The option in the General tab to configure the Delete Confirmation Dialog should not be switched off. Be careful when setting permissions to delete documents without check if flags are not set. A.3-4 MR D13 - System and data management

43 Correcting and assigning data (Patient Browser) A.3 Tasks A.3 Splitting mosaic images A.3 Some post-processing functions, e.g. 3D, cannot use mosaic images. In special cases, it may be necessary to split them into single images again. A.3 Splitting a mosaic image A.3 In the Patient Browser, select one mosaic image. Select Applications > Mosaic > Split to one Series. The images of the selected mosaic image are saved in a new series under the same study. A.3 Splitting several mosaic images A.3 Select several mosaic images or all mosaic images of a series in the Patient Browser. Select Applications > Mosaic > Split to one Series. The images of all select mosaic images are saved in one new series. A.3 Or A.3 Select Applications > Mosaic > Split to one Series per Mosaic. syngo MR D13 A.3-5

44 syngo A.3 A.3 A.3 System administration and configuration A new series is created with the split images for each mosaic image selected. A.3 Splitting images may take some time. The process runs in the background and is completed even if the current user logs off or another user logs on. Assigning patients or studies to patient groups A.3 You need the privilege Patient Browser > Edit > Modify Patient Groups to assign patients or studies to patient groups. A.3 Press the Browser key on the symbol keypad (Numeric:.). You must close the syngo Security Configuration window to work with the Browser key on the symbol keypad. Select the desired patient or study in the local database. A.3-6 MR D13 - System and data management

45 A.3 Correcting and assigning data (Patient Browser) A.3 Select Edit > Modify Patient Groups from the main menu of the Patient Browser. The Modify Patient Groups window is displayed. A.3 syngo MR D13 A.3-7

46 syngo System administration and configuration Select the group you want the patient or study currently selected to be assigned to. Confirm your selection with OK. Correcting data A.3 You can correct, add, or rearrange patient data and information already stored in the database. A.3 Using the Correct dialog window A.3 You use the Correct dialog window for correcting or modifying patient data and information. A.3 Select the patient, study, series, or images that you want to correct in the navigation or content area of the Patient Browser. Select Edit > Correct from the main menu of the Patient Browser. The Correct dialog window opens. A.3 A.3-8 MR D13 - System and data management

47 A.3 A.3 Correcting and assigning data (Patient Browser) A.3 Depending on the data level, some fields of the dialog window are dimmed. syngo MR D13 A.3-9

48 syngo A.3 System administration and configuration Select the required tab and correct the relevant data. Enter your name under Modifier s name or select your name from the selection list. Click OK to save the new data. If you want to correct data that is delete-protected, remove the delete-protection by selecting Edit > Remove Protection from the main menu. Displaying a history of changes A.3 You can view the modifications of the patient and the patient's examination data in the Patient Browser. A.3 Select the patient, study, series, or image stored in the local database whose history of changes you want to view. Select Edit > History from the main menu of the Patient Browser. A.3-10 MR D13 - System and data management

49 A.3 A.3 Correcting and assigning data (Patient Browser) A.3 The Correct & Rearrange History window is displayed. A.3 Click OK to close the history display. The entries in the Correct & Rearrange History window are generated by your system. You cannot make changes yourself. If an object was moved, the entry is marked with > under Attribute. syngo MR D13 A.3-11

50 syngo A.3 A.3 System administration and configuration Deleting data manually A.3 You can delete patient data in the Patient Browser only if no other application wants to access the same data. Select the data that you want to delete in the navigation area or content area. Select Edit > Delete from the main menu. Confirm with Yes in the dialog window displayed. You can turn off the confirmation dialog window when selecting Options > Configure Browser... from the main menu and deactivate the Confirm Deletion checkbox. Unprotected data is then always deleted immediately without confirmation. For this reason, this step is not recommended. Protecting data from deletion A.3 Select the data that you want to protect against deletion in the navigation or content area. Select Edit > Protect from the main menu. A.3-12 MR D13 - System and data management

51 A.3 A.3 A.3 Correcting and assigning data (Patient Browser) A.3 Removing delete protection A.3 Delete-protection always includes all lower data levels and the related entries of the higher data levels. Select the delete-protected data in the navigation or content area. Select Edit > Remove Protection from the main menu. Splitting studies in the Patient Browser A.3 You can assign series to different studies via the Patient Browser even after completing the examination. A.3 If the respective examination of the patient is terminated and the patient data is not loaded in any task card, you can only assign series via the Patient Browser. The series of sent, archived, exported, and printed image data can only be copied to a target study. Sent, archived, exported, and printed series are grayed and cannot be modified any more. Patient Browser is open syngo MR D13 A.3-13

52 syngo A.3 System administration and configuration Moving series to a different study A.3 In the Patient Browser, select Applications > Study Split. The Study Split dialog window opens. A.3 ( Page A.3-15 Study split) A.3 Moving series to a different study A.3 Drag & drop the series to the target study. Multiple series selection is possible. Copying series A.3 Drag & drop the series to the target study with the Ctrl key pressed down. A copy of the series is inserted in the target study. A.3 A.3-14 MR D13 - System and data management

53 A.3 Correcting and assigning data (Patient Browser) A.3 UI explanation A.3 Study split A.3 syngo MR D13 A.3-15

54 syngo Displays Displays Displays Defines Generates A.3 A.3 System administration and configuration (1) A.3 a series of the study described above. A.3 (2) A.3 a series of a different study. A.3 (3) A.3 the image stamp of the series. A.3 You can zoom an image stamp by moving the mouse pointer over it. (4) A.3 a new study. A.3 (5) A.3 a new study to the right of the dialog window. A.3 The input fields for entering the study description are not mandatory, but a Study Description is advisable. A.3-16 MR D13 - System and data management

55 B System administration and configuration B B.1 Managing the system B.1-1 General information System manager System control with syngo MR Tasks Controlling applications User administration Controlling the MARS processor Gathering diagnostic information Setting the language Configuring image text Configuring applications Viewing the Event Log UI explanation System manager - Host System manager - Meas & Recon System manager - Periphery System manager - Tools System Manager - Scanner StandBy B.2 Managing measurement programs (Exam Explorer) General information Working with the examination tree Searching for entries Protecting the customer tree Showing non-licensed measurement programs Printing and exporting protocol data B.1-1 B.1-1 B.1-1 B.1-2 B.1-2 B.1-3 B.1-5 B.1-6 B.1-7 B.1-9 B.1-10 B.1-11 B.1-12 B.1-12 B.1-14 B.1-17 B.1-19 B.1-21 B.2-1 B.2-1 B.2-4 B.2-4 B.2-6 B.2-7 B.2-8 syngo MR D13 B-1

56 syngo System administration and configuration Managing programs in the HIS/RIS Transmitting entries to the HIS/RIS Updating entries on the HIS/RIS Receiving entries from the HIS/RIS Deleting entries from the HIS/RIS and MR system Administering entries in the HIS/RIS system Creating regions, exams, programs, and steps Creating regions Creating examination folders Creating a measurement program Setting default parameter settings Changing default coil configuration Setting default protocol and pause properties Exporting / importing entries in the examination database Importing entries Exporting entries UI explanation Exam Explorer Program properties (Exam Explorer) Print dialog window B.2-9 B.2-9 B.2-10 B.2-11 B.2-12 B.2-13 B.2-14 B.2-14 B.2-15 B.2-16 B.2-18 B.2-19 B.2-21 B.2-22 B.2-22 B.2-25 B.2-27 B.2-27 B.2-30 B.2-31 B-2 MR D13 - System and data management

57 System administration and configuration B B.3 Creating AutoAlign programs B.3-1 General information AutoAlign AutoAlign Head AutoAlign Knee AutoAlign Shoulder AutoAlign Hip AutoAlign Spine LS AutoAlign Spine Interactive Tasks Creating and editing an AutoAlign program Importing an AutoAlign program from another system or software version B.3-1 B.3-1 B.3-6 B.3-16 B.3-32 B.3-39 B.3-49 B.3-58 B.3-60 B.3-60 B.3-64 B.4 Creating a Dot Engine B.4-1 General information Dot Engine examination Elements of a Dot Engine Common Dot add-ins Tips and tricks B.4-1 B.4-1 B.4-2 B.4-6 B.4-7 syngo MR D13 B-3

58 syngo System administration and configuration Tasks Setting up the Dot Engine Inserting and configuring a Dot Engine Step (Patient View) Renaming the slice groups of the MPR Planning Dot add-in Inserting a strategy branch (Exam strategy) Inserting a decision branch (Patient context decision) Inserting a decision step (Clinical decision point) Inserting a program step with Dot add-in Copying a Dot add-in to another protocol Copying settings between Dot add-ins Verifying a program in simulation mode B.4-8 B.4-8 B.4-10 B.4-11 B.4-12 B.4-13 B.4-14 B.4-15 B.4-17 B.4-18 B.4-19 B-4 MR D13 - System and data management

59 System administration and configuration B UI explanation Dot Engine Step properties Set-up tab card of the Dot Engine Step Protocol properties - Dot add-in Dot Add-In Configurator - Guidance Dot Add-In Configurator - Parameters Dot Add-In Configurator - Queue Dot Add-In Configurator - GSP Dot Add-In Configurator - Series Label Dot Add-In Configurator - Load to GSP Dot Add-In Configurator - Auto Coverage Dot Add-In Configurator - Auto Timing B.4-20 B.4-20 B.4-21 B.4-23 B.4-24 B.4-26 B.4-27 B.4-29 B.4-32 B.4-33 B.4-34 B.4-37 B.5 Managing files (File Browser) B.5-1 General information Tasks Working with the File Browser UI explanation File Browser B.5-1 B.5-2 B.5-2 B.5-3 B.5-3 syngo MR D13 B-5

60 syngo System administration and configuration B.6 Managing voice outputs B.6-1 General information Voice output management Voice outputs for unsupported languages Tasks Recording and editing voice outputs Changing voice outputs Deleting user-defined voice outputs UI explanation Organize Voice Output Exam UI Configuration - Voice Output Patient Comfort Configuration - Sound Volume B.6-1 B.6-1 B.6-2 B.6-3 B.6-3 B.6-5 B.6-6 B.6-8 B.6-8 B.6-10 B.6-12 B.7 Configuring reports B.7-1 General information Diagnostic codes Tasks Configuring reports B.7-1 B.7-1 B.7-4 B.7-4 B-6 MR D13 - System and data management

61 System administration and configuration B B.8 Adjusting the system manually B.8-1 General information Tasks Manual adjustment Determining the resonance frequency Calibrating the transmitter Performing 3D shim Performing interactive shim Optimizing water suppression Checking the resonance frequency after inline adjustment UI explanation Manual adjustments - Frequency Manual adjustments - Transmitter Manual adjustments - 3D shim Manual adjustments - Interactive shim Manual adjustments - Water suppression Manual adjustments - Show Confirm Frequency Adjustment B.8-1 B.8-1 B.8-2 B.8-2 B.8-3 B.8-4 B.8-5 B.8-7 B.8-8 B.8-9 B.8-9 B.8-14 B.8-19 B.8-24 B.8-29 B.8-33 B.8-35 syngo MR D13 B-7

62 syngo System administration and configuration B.9 Expert-i B.9-1 Safety General safety information Description Operation If you have problems connecting B.9-1 B.9-1 B.9-3 B.9-6 B.9-12 B.10 RemoteAssist B.10-1 Description Description Operation Restricting access Disconnecting Remote Assistance B.10-1 B.10-4 B.10-5 B.10-9 B.10-9 B-8 MR D13 - System and data management

63 B.1 Managing the system B.1 Managing the system B.1 General information B.1 System manager B.1 Your MR system comprises the following components: B.1 Magnetic resonance system (MR Scanner) MARS processor for measurement and image reconstruction syngo Acquisition Workplace for operating syngo MR Optional: the syngo MR Workplace MARS stands for Measurement and Reconstruction System. The following description refers to the MARS computer. The syngo MR System Manager is a module that allows you to monitor, as well as start and stop the individual components of the measurement system. B.1 System control with syngo MR B.1 You control and operate your MR system from the syngo Acquisition Workplace. For this purpose, syngo MR is available. The program runs under Windows XP. It comprises individual applications - for example, Examination. B.1 syngo MR D13 B.1-1

64 syngo System administration and configuration Tasks B.1 Controlling applications B.1 Select System > Control. The System Manager dialog window opens. B.1 Open the Host subtask card. Select the application from the list. Stopping an application B.1 Click Stop Application. Initially, the application shows the status Stop in progress. Then it changes to not running. B.1 Starting an application B.1 Click Start Application. Initially, the application shows the status Startup in progress. Then it changes to running. B.1 Restarting an application B.1 Click Restart Application. The selected application is shutting down and starts again without shutting down syngo MR or the operating system. B.1 B.1-2 MR D13 - System and data management

65 B.1 B.1 B.1 Managing the system B.1 User administration B.1 The End Session dialog window contains a number of additional functions when User Administration (HIPAA) is active. B.1 Select System > End Session. The End Session dialog window opens. B.1 Refer to the syngo Security Package brochure for detailed information regarding User Administration (HIPAA). Locking the computer B.1 Click this button. A registration window appears that covers the program surface.b.1 Logging off B.1 When a user logs off, unsaved data will be lost irretrievably. Always check for unsaved data and save any data you want to keep before logging off. syngo MR D13 B.1-3

66 syngo B.1 B.1 B.1 B.1 System administration and configuration Click this button. Opened patient data are unloaded. The log-off window is displayed. B.1 Logging on B.1 A new user can log on to the system even if the current user has not logged off. Click this button. The registration window is displayed. It hides the user interface of the program. B.1 Enter the new user name. If the new user has the same user rights as the previous user, the new user can continue working with the loaded data. If the new user has fewer rights, the data used by the previous user will be discarded. Unsaved data will be lost. If a measurement or image reconstruction of the previous user is still running in background, the new user cannot start until this process has finished. B.1-4 MR D13 - System and data management

67 B.1 B.1 Managing the system B.1 Changing your password B.1 Click this button. A dialog window opens. B.1 Enter the old password in the first field for authentication. Enter the new password in the next field. Enter the new password in the third field for verification. Remember, passwords are case sensitive! Controlling the MARS processor B.1 You can view status information of components required for measurement and image reconstruction. B.1 Select System > Control. The System Manager dialog window opens. B.1 Open the Meas & Recon subtask card. ( Page B.1-14 System manager - Meas & Recon) B.1 If required, restart the MARS software or selected components. or B.1 Reboot the operating system. syngo MR D13 B.1-5

68 syngo B.1 System administration and configuration Gathering diagnostic information B.1 In case of an error, it is useful to generate a MrLog data set for error analysis. B.1 Select System > Control. The System Manager dialog window opens. B.1 Open the Tools subtask card. ( Page B.1-19 System manager - Tools) B.1 Click Save System Log-Files. The MR system is collecting data for the MrLog data set. B.1 After a short time, the Save Log MrLog dialog window opens and displays additional error information: B.1 B.1-6 MR D13 - System and data management

69 B.1 B.1 Managing the system B.1 If desired, enter additional information into the fields of the User area. Click OK. Your additional information is added to the current MrLog data set and stored. B.1 Setting the language B.1 Select Options > Configuration... to open the NUMARIS/4 Configuration Panel. Double-click the Regional and Language Options icon in the NUMARIS/4 Configuration Panel to open the Regional and Language Options dialog window. syngo MR D13 B.1-7

70 syngo The B.1 B.1 System administration and configuration Select the language you require in the standards and formats area. Click the OK button to confirm the new language. Confirm with OK again to restart syngo with the new language. For further information on changing the language or the supported keyboard, contact Siemens Service. You must adjust the date format after each change of the Regional and Language Options settings. Adjusting the date format B.1 following date formats are recommended: B.1 For western languages: dd-mm-yyyy, For U.S. English: mm-dd-yyyy, For Chinese and Japanese: yyyy-mm-dd. Select Options > Configuration... from the main menu. Double-click the Regional and Language Options icon in the NUMARIS/4 Configuration Panel to open the Regional and Language Options dialog window. Click the Customize... button on the Regional Options tab card and select the Date tab card. Select the required entry from the Short date format selection list and confirm with OK. B.1-8 MR D13 - System and data management

71 You B.1 B.1 B.1 B.1 Managing the system B.1 Configuring image text B.1 You access the image text editor via the NUMARIS/4 Configuration Panel dialog window which you select with Options > Configuration... B.1 Highlighting image text B.1 can highlight selected image text. This can be helpful if the text would otherwise appear too small in certain layouts (20 and 35 layout). B.1 Click the required image text in the image text overview. The selected text is highlighted in gray and the B screen button is now active. B.1 Click this icon. The marked text is displayed in bold. B.1 Image texts can be highlighted only if the Customized Text option is selected. You can also cancel text highlighting in the same manner. Depending on your system configuration, it may not be possible to display some texts. If the orientation marks are deselected, the patient name is not displayed. syngo MR D13 B.1-9

72 syngo Native B.1 B.1 B.1 System administration and configuration Configuring applications B.1 Depending on the application, you can configure task cards, windows, and individual functions of the program i.e. adapt them to your requirements. B.1 CAUTION B.1 Windows configuration window does not disappear while examination is started. The window remains visible as it is a dialog displayed by Windows and not a syngo dialog. This may cause confusion. Avoid opening this dialog during examination. In any case, the computer and the syngo system should never be configured during an acquisition. Select Options > Configuration... from the main menu. The NUMARIS/4 Configuration Panel opens. B.1 Double-click the icon representing the desired application to open the corresponding configuration window. Adapt the functions of the application to your individual requirements. B.1-10 MR D13 - System and data management

73 B.1 B.1 Managing the system B.1 Viewing the Event Log B.1 Select Options > Service > Event Log... to display the Event Log dialog window. Enter the Time or Time Range and select additional filter parameters to specify your search for log entries. Click the Go button. syngo MR D13 B.1-11

74 syngo Lists B.1 System administration and configuration UI explanation B.1 System manager - Host B.1 System > Control B.1 (1) B.1 the applications that run under syngo MR on your syngo Acquisition Workplace. B.1 B.1-12 MR D13 - System and data management

75 Displays Status B.1 Running B.1 Not B.1 Waiting B.1 B.1 B.1 Stop B.1 Startup Comment The The B.1 Managing the system B.1 (2) B.1 the status of each listed application. B.1 Icon B.1 B.1 B.1 B.1 application is running B.1 running B.1 The application is not running B.1 B.1 application status is yet to be received shortly after starting the System Manager B.1 Not responding B.1 Unknown name B.1 in progress B.1 in progress B.1 It is not possible to communicate with the software components B.1 Certain components of the application are not available B.1 The application is being shut down B.1 The application is booting up B.1 syngo MR D13 B.1-13

76 syngo Displays Definition B.1 Component B.1 Component B.1 Component B.1 Component B.1 B.1 System administration and configuration System manager - Meas & Recon B.1 System > Control B.1 (1) B.1 the status of the MARS components: B.1 Icon B.1 B.1 is ready. B.1 is not ready. B.1 is operational to a limited extent. B.1 status is yet to be reported. B.1 B.1-14 MR D13 - System and data management

77 Restarts Restarts Reboots B.1 B.1 B.1 Managing the system B.1 (2) B.1 the software components selected in the Component Control area. B.1 (3) B.1 the overall software of MARS. B.1 This function terminates any running examination or image calculation without further warning! This can lead to data loss! (4) B.1 the operating system and the software of MARS. B.1 With the reboot function, you can eliminate system errors of MARS. This function terminates any running examination or image calculation without further warning! This can lead to data loss! syngo MR D13 B.1-15

78 syngo Switches Switches B.1 B.1 B.1 System administration and configuration (5) B.1 the measurement and image reconstruction system to standby. B.1 If the MARS processor does not contain jobs in the job list, it is immediately switched to standby followed by the MR Scanner. If the MARS processor contains jobs in the job list, the Scanner StandBy dialog window appears. ( Page B.1-21 System Manager - Scanner StandBy) B.1 Switching off the power supply to MARS during inactive times saves energy. In standby mode, you cannot perform measurements. (6) B.1 the system on. B.1 This button is only available for certain systems B.1-16 MR D13 - System and data management

79 B.1 Managing the system B.1 System manager - Periphery B.1 System > Control B.1 syngo MR D13 B.1-17

80 syngo Displays Displays Definition B.1 The B.1 The B.1 The B.1 Component B.1 B.1 System administration and configuration (1) B.1 the status of individual components of the MR Scanner. The main components include CANUnits, PALIs, and e.g. the Stimulation Monitor. B.1 Icon B.1 B.1 unit is ready. B.1 unit is not ready for operation. B.1 unit is operational within limits. B.1 status is yet to be reported. B.1 The list is updated automatically when a connection to MARS exists. (2) B.1 the helium fill level. B.1 B.1-18 MR D13 - System and data management

81 B.1 Managing the system B.1 System manager - Tools B.1 System > Control B.1 syngo MR D13 B.1-19

82 syngo Generates Displays B.1 B.1 System administration and configuration (1) B.1 a MrLog data set which can be used to locate an error. B.1 The MrLog data set contains information regarding the status and history of the MR system at the time of an error. The files of an MrLog data set are stored in the directory C:\MedCom\MriDiagnostic. They have a common name master: MrLog_Computername_Date_Time_Datatype.zip (or *.txt) (2) B.1 the content of the consistency log file in the Support & Diagnosis Tools area. B.1 The most important system files are checked for changes every time the system boots up. The results are saved in a log file. B.1-20 MR D13 - System and data management

83 Shuts Immediately B.1 B.1 B.1 Managing the system B.1 System Manager - Scanner StandBy B.1 (1) B.1 down the MARS processor after reconstructing all current jobs. B.1 The shutdown can take several minutes. There is no associated loss in data. (2) B.1 ends image reconstruction in progress. B.1 Data can be lost. syngo MR D13 B.1-21

84 syngo System administration and configuration B.1-22 MR D13 - System and data management

85 B.2 Managing measurement programs (Exam Explorer) B.2 Managing measurement programs (Exam Explorer) B.2 General information B.2 The sequences and parameter settings of frequently performed MR examinations are stored in your system as scan programs. The Exam Explorer provides you with an overview of the measurement programs available. B.2 The programs are subdivided into two groups: Siemens programs and customer programs, each with a subdirectory (tree). The SIEMENS tree also contains libraries Siemens created for specific clinical questions. From these, you can compose your own measurement programs. B.2 Measurement programs offered as defaults in the SIEMENS tree cannot be changed. syngo MR D13 B.2-1

86 syngo B.2 System administration and configuration Purpose of the Exam Explorer B.2 The Exam Explorer allows you to manage and maintain your measurement programs. B.2 Usually you do not work directly in the Exam Explorer during the examination in progress. In some cases, you may use the Exam Explorer to search for measurement programs or protocols during an examination and transfer them directly to the queue. B.2 The Exam Explorer is primarily a tool for managing and maintaining your measurement programs. If you want to change a measurement program immediately prior to an examination (and for this particular examination only), use the queue in the program control instead. B.2 Dot add-ins cannot be configured using the queue. They can only be configured using the Exam Explorer. The Exam Explorer provides functions for printing out tables of contents as well as individual protocols including an overview of the parameter settings. Furthermore, password protection can be configured for customer protocols. B.2 ( Page B.2-8 Printing and exporting protocol data) B.2 B.2-2 MR D13 - System and data management

87 The The You Managing measurement programs (Exam Explorer) B.2 Non licensed measurement programs B.2 Measurement programs that include non-licensed protocols or non-licensed Dot add-ins are normally not displayed in the Exam Explorer. However, you may display non-licensed measurement programs and protocols. B.2 ( Page B.2-7 Showing non-licensed measurement programs) B.2 Password protection B.2 customer tree can be protected with a password. This must be enabled by a service technician. When the customer tree is password protected, the user must enter the password before changes are saved. B.2 Examination database B.2 Siemens and the customer tree are stored in the examination database on your system. You may also access examination regions, examinations, measurement programs and protocols stored on external data media (disk, CD ROM etc.) or on your hospital-wide data network. B.2 You can also export objects from your database to external data media or network addresses - for example, to make your examinations and measurement programs available to other syngo MR users. B.2 Print protocols B.2 can either print out the parameter overview of protocols, contents of measurement programs, examinations and regions, or write them to a text file or XML file. B.2 The parameter overview enables you to compare the parameters of the protocols directly. B.2 The lists of contents provide you with an overview of the available examinations and scan programs, making selection easier. B.2 syngo MR D13 B.2-3

88 syngo B.2 B.2 B.2 System administration and configuration Working with the examination treeb.2 Searching for entries B.2 If you know the name of a specific region, examination, measurement program, protocol, or pause, you may search for the exact name. B.2 Exam Explorer is open Select Edit > Find. The Find object in data base dialog window opens. B.2 In the Name input field, enter the name of the object you are looking for. The following characters are not allowed: ^ \. You can use the following wildcards: * stands for an indefinite number of unknown characters.? stands for one unknown character. Click Find. B.2-4 MR D13 - System and data management

89 B.2 Managing measurement programs (Exam Explorer) B.2 A list of the found objects is shown B.2 Double-click the desired entry to display the entry in the Exam Explorer. or B.2 Select Properties to edit the properties of the entry. ( Operator Manual - Scanning and postprocessing: C.2 Composing a measurement program) B.2 syngo MR D13 B.2-5

90 syngo B.2 B.2 System administration and configuration Protecting the customer tree B.2 You can write-protect the USER tree to avoid accidental changes to the customer measurement program. B.2 This write-protection can be switched on and off without a password. B.2 You can also protect the customer tree with a password. This must be enabled by the service technician. Exam Explorer is open Select Tools > Protect USER tree. You cannot change the measurement programs. B.2 You have to deselect the write protection if you want to work on the customer measurement programs. B.2 Deselect Tools > Protect USER tree. B.2-6 MR D13 - System and data management

91 B.2 B.2 Managing measurement programs (Exam Explorer) B.2 Showing non-licensed measurement programs B.2 Measurement programs that include non-licensed protocols are normally not displayed in the Exam Explorer. B.2 Exam Explorer is open Select Tools > Show Unlicensed Items. Non-licensed measurement programs, protocols, and Dot add-ins are now shown as additional gray items in the Exam Explorer. B.2 For an individual, non-licensed measurement program, you can establish that it is visible at all times in the directory structure, independent of the setting in the main menu. ( Page B.2-30 Program properties (Exam Explorer)) syngo MR D13 B.2-7

92 syngo B.2 B.2 System administration and configuration Printing and exporting protocol data B.2 You may select one or more protocols, measurement programs, examinations, or regions for printing or exporting to a text, XML, or PDF file. B.2 Since printing this data is time-consuming, it is generally not used during clinical examinations. Exam Explorer is open Select the requested objects under the Exam Explorer. Select Object > Print in the Exam Explorer. The Print dialog window opens. B.2 Define the printing settings on the Print dialog window. ( Page B.2-31 Print dialog window) B.2 Start printing with OK. B.2-8 MR D13 - System and data management

93 B.2 B.2 B.2 B.2 Managing measurement programs (Exam Explorer) B.2 Managing programs in the HIS/RIS B.2 Transmitting entries to the HIS/RIS B.2 You can send entries from the customer tree to the HIS/RIS. It is therefore possible to make measurements which have been designed by you available to all MAGNETOMS connected to the HIS/RIS. B.2 Exam Explorer is open Your HIS/RIS supports transmitting Select the entry you would like to send. Select Edit > Exam Explorer Upload to RIS. The Exam Explorer Upload to RIS dialog window opens. B.2 Do not use the following characters for RIS file names: \, *,?, ^. Refer to the documentation for your HIS/RIS for further details. syngo MR D13 B.2-9

94 syngo B.2 System administration and configuration Updating entries on the HIS/RIS B.2 Modified single objects or entries (with DICOM code) can be reloaded into the HIS/RIS by a simplified loading process. The corresponding data are thereby updated within the HIS/RIS. B.2 Exam Explorer is open Protocol update function is activated The same data were previously sent to the HIS/RIS. Select the entry (or entries) that you want to send. Call up Object > Update on RIS... The data are updated within the HIS/RIS. B.2 B.2-10 MR D13 - System and data management

95 B.2 B.2 B.2 Managing measurement programs (Exam Explorer) B.2 Receiving entries from the HIS/RIS B.2 You can load entries from the HIS/RIS to your customer tree. B.2 Exam Explorer is open Your HIS/RIS supports transmitting Select Edit > Download from RIS. The Exam Explorer Download from RIS dialog window opens. B.2 Refer to the documentation for your HIS/RIS for further details. syngo MR D13 B.2-11

96 syngo B.2 System administration and configuration Deleting entries from the HIS/RIS and MR system B.2 Entries with DICOM code cannot be deleted directly from the MR system as long as they are still stored in the HIS/RIS. These entries can only be deleted from the HIS/RIS and the MR system at the same time. B.2 Otherwise inconsistencies between the data of the HIS/RIS and the MR system may occur. While entries (with DICOM code) are being deleted from the HIS/RIS, they are still available in your MR system. B.2 You can delete these entries manually from the MR system to clear the inconsistencies with the HIS/RIS. B.2 Exam Explorer is open Select the entry (the entries) that you want to delete from the MR system. Select Edit > Delete RIS objects. A warning message is displayed. B.2 Confirm this message with OK. The entries are deleted from the MR system. B.2 B.2-12 MR D13 - System and data management

97 B.2 B.2 B.2 Managing measurement programs (Exam Explorer) B.2 Administering entries in the HIS/RIS system B.2 You can also delete entries in the HIS/RIS or distribute them to other MR systems from the syngo Acquisition Workplace. B.2 Exam Explorer is open Your HIS/RIS supports this type of administrative task Select Edit > Administrating objects on RIS. The Exam Explorer Administrating objects on RIS dialog window opens. B.2 Refer to the documentation for your HIS/RIS for further details. syngo MR D13 B.2-13

98 syngo B.2 System administration and configuration Creating regions, exams, programs, and steps B.2 Creating regions B.2 You may create regions in your customer tree. B.2 Exam Explorer is open Select the customer tree (USER). Select Object > New. The Add New Region dialog window opens. B.2 Enter a name for the examination region. Click OK. The dialog window is closed and the region is appended at the end of the list. B.2 Select the region in the customer tree. Select Edit > Properties. The Region properties dialog window is displayed. B.2 On the Region subtask card, set the Body Part Examined. Click OK. B.2-14 MR D13 - System and data management

99 B.2 Managing measurement programs (Exam Explorer) B.2 Creating examination folders B.2 You may create examination folders in your customer tree. B.2 Exam Explorer is open Select the region for which you want to create an examination. Select Object > New. or B.2 Select New in the context menu. The Add New Exam dialog window opens. B.2 Enter a designation in the Name input field. Click OK. The examination is appended at the end of the examination list of the respective region. B.2 syngo MR D13 B.2-15

100 syngo System administration and configuration Creating a measurement program B.2 Exam Explorer is open Examination folder is selected Create new Program B.2 Select Object > New. The Add New Program dialog window opens. B.2 Enter a designation in the Name input field. Click OK. The new program is appended to the list of measurement programs of the open examination folder. B.2 Inserting program steps B.2 Select Insert > Program Step. The Insert Program Steps dialog window opens. B.2 Select the program step you want to transfer to your measurement program. Click Insert. The selected program step is copied into the measurement program. B.2 B.2-16 MR D13 - System and data management

101 Managing measurement programs (Exam Explorer) B.2 Inserting a sequence as a protocol B.2 Select Insert > Sequence. The Insert Sequences dialog window opens. B.2 Mark the desired sequence in the list. Click Insert. The sequence selected is transferred as a protocol to the measurement program. B.2 Inserting a measurement pause B.2 You insert a pause, for example, to administer contrast medium to the patient prior to the measurement or to provide him with instructions. B.2 Select Paste > Pause. The pause is inserted into the measurement program. B.2 The Pause properties dialog window opens. B.2 ( Operator Manual - Scanning and postprocessing: C.2 Composing a measurement program) B.2 Storing the measurement programs B.2 Select Object > Save. syngo MR D13 B.2-17

102 syngo B.2 B.2 System administration and configuration Setting default parameter settings B.2 You can change the default parameter setting of a protocol in the Exam Explorer. B.2 Exam Explorer is open Examination folder is selected Select the desired protocol. Select Edit > Protocol. The Protocol Editor opens. B.2 You work in the Protocol Editor as you would in the parameter card stack of the Exam task card. B.2-18 MR D13 - System and data management

103 If B.2 Managing measurement programs (Exam Explorer) B.2 Changing default coil configuration B.2 You can change the default coil configuration of a protocol in the Exam Explorer. B.2 Exam Explorer is open Protocol is opened via the Exam Explorer Changing coil usage B.2 On the System - Coils parameter card, define the coil elements required for the measurement protocol. Selecting virtual coils B.2 you want to select coils different from the ones stored in the protocol, open the Virtual Coils dialog window. B.2 Click Virtual Coils... The Virtual Coils dialog window is shown. B.2 syngo MR D13 B.2-19

104 syngo B.2 System administration and configuration Set the required coil configuration. Click Apply. If you selected array coils as virtual coils, you must still set the coil elements on the System - Coils parameter card (see Parameters and Image Text documentation for details). End the dialog window with Close. Accept the protocol changes in the Protocol Editor with OK. All parameter changes are accepted by the protocol and the Protocol Editor is closed. B.2 B.2-20 MR D13 - System and data management

105 B.2 Managing measurement programs (Exam Explorer) B.2 Setting default protocol and pause properties B.2 You can change the default properties of a protocol or pause in the Exam Explorer. B.2 Exam Explorer is open Protocol is opened via the Exam Explorer Select required protocol or pause. Select Edit > Properties. The Protocol properties or Pause properties dialog window opens: B.2 ( Operator Manual - Scanning and postprocessing: C.2 Composing a measurement program) B.2 Change the desired settings. Click OK. The changes are applied and the dialog window closes. B.2 syngo MR D13 B.2-21

106 syngo B.2 B.2 B.2 System administration and configuration Exporting / importing entries in the examination database B.2 Importing entries B.2 Using the Exam Explorer, you can import the examinations, measurement programs or protocols from a network address or an external data carrier. B.2 Note that you cannot perform any other actions during import. Exam Explorer is open Select the entry where you would like to import data. When importing a whole tree, the customer tree must be selected. Select Object > Import. The Exam Explorer Import message box is displayed. B.2 B.2-22 MR D13 - System and data management

107 B.2 Managing measurement programs (Exam Explorer) B.2 Confirm with OK. The Import Object dialog window opens. B.2 Set the Drives, Folder and File Name. Click Import. The system will now check whether importing is possible at the selected position in the navigation area of the Exam Explorer. B.2 syngo MR D13 B.2-23

108 syngo B.2 B.2 System administration and configuration The Programs to be imported dialog window opens. B.2 It shows the measurement programs or protocols contained in the read edx file. B.2 The Convert button is active for non-executable measurement programs. These programs must be converted before they can be imported. Import the selected measurement program or protocol with Import. The imported measurement programs are appended in the Exam Explorer to the end of the directory selected. B.2 B.2-24 MR D13 - System and data management

109 B.2 B.2 Managing measurement programs (Exam Explorer) B.2 Exporting entries B.2 You can export examination regions, examinations, and measurement programs from your examination database to a network address or to an external data carrier. B.2 The exported objects are retained on your system. The export function only copies the objects to the target drive or network address. Exam Explorer is open Select the entry you want to export. Select Object > Export. The Export Object dialog window opens. B.2 syngo MR D13 B.2-25

110 syngo B.2 System administration and configuration Set the Drives, Folder and File Name. Export the selected objects with Export. B.2-26 MR D13 - System and data management

111 B.2 Managing measurement programs (Exam Explorer) B.2 UI explanation B.2 Exam Explorer B.2 View > Exam Explorer B.2 syngo MR D13 B.2-27

112 syngo Customer Region Examination Measurement Protocol Decision System administration and configuration (1) B.2 tree/siemens tree B.2 The Siemens tree contains a palette of clinically tested measurement programs installed on your system by Siemens Service. They serve as a basis for preparing your own selection of frequently used measurement programs in the customer tree. B.2 (2) B.2 (Body Part Examined) B.2 All examinations for a certain region of the body are grouped into an examination region. B.2 (3) B.2 folder B.2 An Examination Folder contains all measurement programs for a certain part of the body or for an anatomical structure of a body region. B.2 (4) B.2 program B.2 A measurement program (program) contains a sequence of optimized program steps suitable for clarifying clinical questions. B.2 (5) B.2 B.2 (6) B.2 step (only for Dot Engines) B.2 B.2-28 MR D13 - System and data management

113 Decision Program Function B.2 B.2 B.2 B.2 B.2 B.2 B.2 B.2 B.2 B.2 B.2 B.2 B.2 B.2 B.2 Managing measurement programs (Exam Explorer) B.2 (7) B.2 branch (only for Dot Engines) B.2 (8) B.2 steps and branches B.2 Program steps may be a measurement protocol (protocol), a measurement pause (pause) or a decision step. B.2 Branches are decision or strategy branches. B.2 The sequence of protocols and pauses in a measurement program determines the course of the examination. B.2 Toolbar B.2 Icon B.2 B.2 Move up one directory level B.2 Copy B.2 Paste B.2 Delete B.2 Move selection up B.2 Move selection down B.2 Edit protocol B.2 Display property window B.2 Insert measurement pause B.2 Insert steps (not active if no program is displayed) B.2 Store the measurement program in the examination database B.2 Transmit entries to the HIS/RIS B.2 Receive entries from the HIS/RIS B.2 Activate the simulation mode for Dot Engines B.2 syngo MR D13 B.2-29

114 syngo If When B.2 System administration and configuration Program properties (Exam Explorer) B.2 (1) B.2 the Archive option is enabled, you may restore measurement programs in case of data recovery or software updates. Measurement programs for which the Archive option has not been set are usually replaced by original Siemens programs. B.2 (2) B.2 you activate the Visibility - Irrespective of licensing checkbox, the measurement program is available in the directory structure of the Exam Explorer, even if it is a non-licensed measurement program. B.2 ( Page B.2-7 Showing non-licensed measurement programs) B.2 B.2-30 MR D13 - System and data management

115 Sets Effect An A B.2 B.2 Managing measurement programs (Exam Explorer) B.2 Print dialog window B.2 (1) B.2 the print options B.2 Print option B.2 Protocols B.2 Table of contents B.2 B.2 overview of the parameter settings is printed for all selected protocols. The settings are listed in the same way as on the parameter cards. B.2 list of contents is printed for the selected measurement programs, examinations, or regions. B.2 Protocols and table of contents B.2 Both the parameter overview and the list of contents are printed. B.2 syngo MR D13 B.2-31

116 syngo System administration and configuration B.2-32 MR D13 - System and data management

117 B.3 Creating AutoAlign programs B.3 Creating AutoAlign programs B.3 General information B.3 AutoAlign B.3 AutoAlign assists the user in positioning the slices in a robust and reliable way regarding positioning standards and arbitrary patient positions, different patient ages, pathologies, and interventions. B.3 Within a special 3D scout volume, AutoAlign detects the position and orientation of the predefined AutoAlign sub-regions in the individual patient anatomy. This information is available in following protocols. B.3 For information on scanning with AutoAlign protocols, refer to the application-specific Operator Manuals. syngo MR D13 B.3-1

118 syngo The Within B.3 AutoAlign AutoAlign B.3 B.3 B.3 System administration and configuration Definition B.3 AutoAlign region B.3 AutoAlign feature is available for several anatomical AutoAlign regions like head, knee, hip shoulder or spine. B.3 Some AutoAlign regions are only available in combination with the corresponding Dot Engine. AutoAlign reference B.3 one AutoAlign region, the position and orientation of multiple so-called AutoAlign references are detected. For example, Head > Basis (which provides the midsagittal plane), Head > Optic nerves, Head > Inner ear, Head > Temporal lobe and others. B.3 (1) B.3 region B.3 (2) B.3 reference B.3 On the Routine parameter card of clinical protocols, all AutoAlign references are listed in the AutoAlign combo box. B.3 B.3-2 MR D13 - System and data management

119 Except After B.3 Creating AutoAlign programs B.3 Usage B.3 AutoAlign scout B.3 AutoAlign Spine Interactive, all other AutoAlign techniques are landmark based. The scouts for these technique uses the VIBE technique to scan a T1-weighted 3D volume. B.3 Based on a landmark detection, several AutoAlign references (anatomical positions and orientations) are computed from the 3D volume. Also, several MPR localizer images are reconstructed from this 3D volume and automatically loaded into the planning segments of the Exam task card. B.3 AutoAlign Info Dialog B.3 the AutoAlign scout is done, all computed AutoAlign references and their category of alignment (aligned, to-be-checked, failed) are listed in the AutoAlign Info Dialog. This dialog can be opened via the main menu (Queue > AutoAlign Info Dialog). B.3 If one or more AutoAlign references are not in the category aligned, the user is asked via a pop-up window to check and correct the positioning of all clinical protocols that use these AutoAlign references. The AutoAlign verification icon marks the clinical protocols that need to be checked by the user. B.3 syngo MR D13 B.3-3

120 syngo B.3 B.3 B.3 System administration and configuration Usage of AutoAlign B.3 An AutoAlign scan program starts with an AutoAlign scout. After this AutoAlign scout is done, the AutoAlign references are available in the following clinical protocols. Each protocol can use one of these AutoAlign references e.g. a sagittal head protocol uses Head > Basis and a transversal head protocol uses Head > Brain. B.3 As long as an aligned clinical protocol is not running, the user can subsequently change the resulting position and orientation of this protocol. B.3 Working-man icon B.3 Even with AutoAlign, the user is responsible for scanning with the right alignment and the right coverage of the anatomical region of interest. Therefore, it is recommended to apply a working-man icon to clinical protocols where the coverage could be critical even if AutoAlign is used. B.3-4 MR D13 - System and data management

121 The B.3 Creating AutoAlign programs B.3 Follow-Up B.3 user can apply patient-specific, individual adaptations to the aligned slice positions. For improved alignment of follow-up examinations, it is recommended to avoid individual modifications if not absolutely necessary. B.3 If individual adaptations were performed during a prior examination, these changes must be recalled via Phoenix Zip to obtain the same parameters in the follow-up exam. B.3 Phoenix Zip contains the whole study information. When reconstructing single protocols with Phoenix the AddIn is not applied to the protocol. Therefore the behavour of the protocol may change! syngo MR D13 B.3-5

122 syngo B.3 A AutoAlign System administration and configuration AutoAlign Head B.3 Introduction B.3 The specific AutoAlign Head scout scans a sagittal, T1-weighted 3D volume in the isocenter and computes the AutoAlign Head references. The resulting MPR localizer images are automatically loaded into the graphic segments of the Exam task card. B.3 AAHead_Scout protocol B.3 collection of AutoAlign Head scout protocols one for each head coil can be found in the following protocol tree: B.3 \Siemens\head\library\localizer B.3 It is recommended to copy the most relevant one into your scan program. B.3 AutoAlign Head references B.3 Head computes the following AutoAlign references: B.3 Head > Basis Head > Brain Head > Inner ear Head > Orbits Head > Optic nerves Head > Optic nerve L Head > Optic nerve R Head > Temporal lobe B.3-6 MR D13 - System and data management

123 This B.3 Creating AutoAlign programs B.3 All references are designed to provide high reliability (good alignment in the clinical routine) across patient ages, for a variety of diseases, and in problem cases. B.3 Some of the AutoAlign references provide high reproducibility (for example for re-scanning or follow-up examinations of the same individual). B.3 Head > Basis B.3 Head > Basis B.3 AutoAlign reference provides a reproducible symmetry of the whole head. It uses bony landmarks on the scull to define a robust midsagittal plane which is independent of disease-related deformations in the brain area. B.3 syngo MR D13 B.3-7

124 syngo B.3 System administration and configuration Application: B.3 Standard sagittal head protocols Brainstem imaging (with offset) Pituitary transversal/coronal (with offset) Alignment: B.3 Inplane Orientation: parallel to the brainstem Center: 10 mm offset posterior from the sella Head > Brain B.3 B.3-8 MR D13 - System and data management

125 The Creating AutoAlign programs B.3 Head > Brain B.3 most common views of the brain in Neuro MR imaging are provided for morphology, diffusion, perfusion, fmri, etc. B.3 Application: B.3 Standard transversal view of the brain Standard coronal views of the brain Alignment: B.3 Perpendicular to the midsagittal plane that is provided by the AutoAlign reference Head > Basis Tilted Tra > Cor along the corpus callosum contour If the following two landmarks are not covered by a clinical standard protocol with a thickness of 150 mm, all clinical protocols affected are marked with a special AutoAlign symbol to indicate a necessary user interaction: - Superior frontal gyrus - Center of the foramen magnum Tips: B.3 The Dot AutoCoverage functionality can be used to let the system adapt the number of slices and field of view of a clinical protocol If the Dot AutoCoverage functionality is not available in a clinical protocol, the protocol should be set up with a working man icon to provide a quick coverage check of the whole brain with the given parameters. The following protocols with the same slice orientation should be linked with a copy reference to simplify the correct positioning in a full scan program. syngo MR D13 B.3-9

126 syngo Application: B.3 System administration and configuration Head > Inner ear B.3 Head > Inner ear B.3 B.3 Provides robust views of the inner ears Used e.g. to examine for acoustic neuroma Alignment: B.3 Orientation: along the internal acoustic meatus The intersection point of the inner ear axis with the midsagittal plane defines the center point. B.3-10 MR D13 - System and data management

127 This B.3 Creating AutoAlign programs B.3 Head > Orbits B.3 Head > Orbits B.3 AutoAlign reference provides a highly reproducible view of the orbits by using several bony landmarks. B.3 Application: B.3 Provides reproducible sag / cor / tra views for follow-up examination of the optic nerve system Based on bony landmarks and therefore unaffected by - Eye position/movement - Orbital or optic nerve tumors and diseases syngo MR D13 B.3-11

128 syngo B.3 System administration and configuration Alignment: B.3 Tilted Cor > Sag to be parallel to the lateral optic bones This AutoAlign reference is therefore not perpendicular to the AutoAlign reference Head > Basis. B.3 Tilted Tra > Cor: derived from bony landmarks around the optic nerves Center: fixed offset from landmark sella Head > Optic nerves B.3 This AutoAlign reference provides a symmetric and robust view of the two optic nerves. In contrast to the AutoAlign reference Head > Orbits, soft landmarks are used on the two nerves and the optic chiasm. B.3 B.3-12 MR D13 - System and data management

129 Application: Creating AutoAlign programs B.3 Head > Optic nerves B.3 B.3 Alignment to the contours of the optic nerves Provides robust and symmetric intracranial view of the two optic nerves Mainly based on the intracranial part of the optic nerves and on the optic chiasm Special features: If the clinical protocol defines exactly two sagittal slice groups, the following automatism is applied: The first slice group is aligned by Head > Optic nerve L, the second one by Head > Optic nerve R. Alignment: B.3 Tilt Tra > Sag: tilted to view the two nerves in one plane Tilt Tra > Cor: derived from landmarks Center: optic chiasm syngo MR D13 B.3-13

130 syngo Application: B.3 System administration and configuration Head > Optic nerve L / Head > Optic nerve R B.3 Head > Optic nerve L / R B.3 B.3 Provides robust and symmetric sagittal views of the left (resp. right) optic nerve Based on the optic nerves and the optic chiasm Alignment: B.3 Alignment to the contours of the optic nerves Perpendicular to Head > Optic nerves B.3-14 MR D13 - System and data management

131 The B.3 Creating AutoAlign programs B.3 Head > Temporal lobe B.3 Head > Temporal lobe B.3 transversal orientation is derived from the lateral fissure line above the temporal lobe. The center is located in the center of a bounding box which encloses the examined temporal lobe.b.3 Application: B.3 Provides robust transversal and coronal views of the temporal lobe Used e.g. for temporal lobe epilepsy studies syngo MR D13 B.3-15

132 syngo B.3 A System administration and configuration Alignment: B.3 Orientation: parallel / perpendicular to the lateral fissure line Center: geometrical center between anterior border of the temporal lobe and the posterior border of the hippocampus If the detected size of the temporal lobe is greater than 55 mm (in F-H direction) or 85 mm (in A-P direction), all clinical protocols are marked with a special AutoAlign symbol to indicate a necessary user interaction. AutoAlign Knee B.3 Introduction B.3 The specific AutoAlign Knee scout scans a transversal, T1-weighted 3D volume in the isocenter and computes the AutoAlign Knee references. The resulting MPR images are automatically loaded into the graphic segments of the Exam task card. B.3 AAKnee_Scout protocol B.3 collection of AutoAlign Knee scout protocols one for each knee coil can be found in the following protocol tree: B.3 \Siemens\knee\library\localizer B.3 It is recommended to copy the relevant protocols into your scan program. B.3 B.3-16 MR D13 - System and data management

133 Creating AutoAlign programs B.3 AutoAlign Knee references B.3 AutoAlign Knee computes the following AutoAlign references in the knee joint: B.3 Knee > Standard Knee > Meniscus Knee > Patella routine Knee > Patella cartilage Knee > Femur cartilage Knee > ACL Knee > PCL The AutoAlign references Knee > Meniscus, Knee > Patella cartilage and Knee > Femur cartilage are designed for high reproducibility in follow-up examinations. B.3 Depending on the purpose of a clinical protocol, the user selects the corresponding AutoAlign reference via the AutoAlign parameter on the Routine parameter card. B.3 syngo MR D13 B.3-17

134 syngo Depending B.3 System administration and configuration Knee > Standard B.3 Knee > Standard B.3 on the main orientation of a clinical protocol, Knee > Standard adapts the positions by one of the following AutoAlign references: B.3 Knee > Sagittal Knee > Coronal Knee > Transversal These AutoAlign references are described in detail in the following paragraphs. B.3 Knee > Standard (Transversal) B.3 B.3-18 MR D13 - System and data management

135 Creating AutoAlign programs B.3 Knee > Standard (Transversal) B.3 This AutoAlign reference provides robust transversal coverage of the knee joint. B.3 Application: B.3 Standard transversal scans of the whole knee joint Alignment: B.3 Parallel to the meniscus plane (mainly defined by the tibial plateau) Centered F-H so that the patella and as much of the tibia growth plate as possible are included in a standard protocol with a thickness of 99 mm Centered A-P so that the patella (+patella ligament) and as much of the muscle as possible are included in a standard protocol with a field of view of 140 mm If either the tibia growth plate or the patella ligament tibia connection are not covered in a protocol with a thickness of 99 mm, all affected clinical protocols are marked with a special AutoAlign symbol to indicate a necessary user interaction. syngo MR D13 B.3-19

136 syngo This B.3 System administration and configuration Knee > Standard (Coronal) B.3 Knee > Standard (Coronal) B.3 AutoAlign reference provides robust positioning within coronal knee protocols. B.3 Application: B.3 Standard coronal scans of the knee joint Alignment: B.3 Same F-H center point as Knee > Standard (Transversal) Centered A-P so that the femur, the tibia, as much of the fibula as possible and, if applicable, the patella are included in the field of view of a standard protocol with a thickness of 90 mm If parts of the femur or the tibia are not covered within the field of view of a protocol with a thickness of 90 mm, all affected clinical protocols are marked with a special AutoAlign symbol to indicate a necessary user interaction. B.3-20 MR D13 - System and data management

137 This B.3 Creating AutoAlign programs B.3 Knee > Standard (Sagittal) B.3 Knee > Standard (Sagittal) B.3 AutoAlign reference provides robust positioning within sagittal knee protocols. B.3 Application: B.3 Standard sagittal scans of the knee joint Alignment: B.3 Same F-H center point as Knee > Standard (Transversal) Centered R-L so that the femur, the tibia, and as much of the fibula as possible are included in a standard protocol with a thickness of 90 mm Centered A-P so that the patella (+patella ligament) and as much of the muscle as possible are included in a standard protocol with a field of view of 140 mm If parts of the femur or the tibia are not covered within the field of view of a protocol with a thickness of 90 mm,all affected clinical protocols are marked with a special AutoAlign symbol to indicate a neccessary user interaction. syngo MR D13 B.3-21

138 syngo This B.3 System administration and configuration Knee > Meniscus B.3 Left image: Application1; Right image: Application 2 (1) Knee > Meniscus B.3 AutoAlign reference provides a robust and reproducible view of the knee meniscus plane for special meniscus examinations and follow-ups. B.3 Application: B.3 sagittal/coronal meniscus imaging with a group of parallel slices. meniscus 2D imaging with a radial slice group. meniscus 3D imaging with an additional radial MPR reconstruction. B.3-22 MR D13 - System and data management

139 Creating AutoAlign programs B.3 Alignment: B.3 Parallel to the medial tibia plateau (therefore quite independent of different tibia-femur angulations in follow-ups). Fixly centered in the center of the two menisci (no auto-adaptation to cover the whole knee joint as available in Knee > Standard or Knee > Transversal). syngo MR D13 B.3-23

140 syngo This B.3 System administration and configuration Knee > Patella routine B.3 Knee > Patella routine B.3 AutoAlign reference provides robust positioning for straight transversal patella scans. B.3 Application: B.3 Standard patella imaging (not focusing on high reproducibility of the patellar cartilage). Supports a small field of view (without offset) and a large field of view (with offset towards posterior) because the A-P center point is fixed in the joint space between patella and femur. Alignment: B.3 Parallel to the meniscus plane (Knee > Meniscus) F-H center shifted so that the patella (with margin) and as much of the tibia plateau as possible are covered by a standard protocol with a thickness of 80 mm. A-P center lies in the joint space between the patella and the femur. B.3-24 MR D13 - System and data management

141 This B.3 Creating AutoAlign programs B.3 Knee > Patella cartilage B.3 Knee > Patella cartilage B.3 AutoAlign reference provides reproducible views of the patella cartilage for special cartilage examinations and follow-ups. B.3 Application: B.3 Special patella cartilage imaging Supports a small field of view (without offset) and a large field of view (with offset towards posterior) because the A-P center point is fixed in the joint space between the patella and the femur Alignment: B.3 Perpendicular to the patella disk The center lies in the center of the patella cartilage. syngo MR D13 B.3-25

142 syngo This B.3 B.3 System administration and configuration Knee > Femur cartilage B.3 Knee > Femur cartilage B.3 AutoAlign reference provides reproducible views of the femur cartilage and condyles for special cartilage examinations and follow-ups. B.3 Application: B.3 Special femur cartilage imaging Used e.g. for monitoring an arthritic process or the progress of a knee therapy Alignment: B.3 The center point lies in the intercondylar pit. The orientation is derived from the Blumensaat line. The AutoAlign reference Knee > Femur Cartilage can serve as a basis for semi-automated positioning of individual slice groups in the medial or lateral condyle. B.3-26 MR D13 - System and data management

143 B.3 Creating AutoAlign programs B.3 Knee > ACL (Sag > Cor) / ACL (Sag > Tra) B.3 This AutoAlign reference provides a robust, sagittal standard view of the anterior cruciate ligament (ACL) with a fixed tilt starting from the Knee midsagittal plane (Knee > Meniscus). B.3 Knee > ACL (Sag > Cor) B.3 Application: B.3 Sagittal imaging of the anterior cruciate ligament. Sagittal slices are tilted towards Cor. Based on bony landmarks, therefore independent of the status or existence of the anterior ligament itself. Used, for example, in the suspected case of a cruciate ligament rupture or post-surgery scans after a cruciate ligament replacement. Detects laterality and applies the tilt (+/-) accordingly. syngo MR D13 B.3-27

144 syngo System administration and configuration Alignment: B.3 Tilted Sag > Cor by 15 degrees (+/-), starting from the midsagittal plane that is provided by the AutoAlign reference Knee > Standard (Sagittal). In the right knee, a positive tilt Sag > Cor is applied. In the left knee, a negative tilt Sag > Cor is applied. B.3-28 MR D13 - System and data management

145 B.3 Creating AutoAlign programs B.3 Knee > ACL (Sag > Tra) B.3 Application: B.3 Sagittal imaging of the anterior cruciate ligament. Sagittal slices are tilted towards Tra. Based on bony landmarks, therefore independent of the status or existence of the anterior ligament itself. Used e.g. in the suspected case of a cruciate ligament rupture or post-surgery scans after a cruciate ligament replacement. Detects laterality and applies the tilt (+/-) accordingly. syngo MR D13 B.3-29

146 syngo This B.3 System administration and configuration Alignment: B.3 Tilted Sag > Tra by 8 degrees (+/-), starting from the midsagittal plane that is provided by the AutoAlign reference Knee > Standard (Sagittal). In the right knee, a negative tilt Sag > Tra is applied. In the left knee, a positive tilt Sag > Tra is applied. Knee > PCL B.3 Knee > PCL B.3 AutoAlign reference provides a robust, sagittal standard view of the posterior cruciate ligament (PCL) with a fixed tilt starting from the knee midsagittal plane (Knee > Standard). B.3 B.3-30 MR D13 - System and data management

147 Creating AutoAlign programs B.3 Application: B.3 Sagittal imaging of the posterior cruciate ligament. Based on bony landmarks, therefore independent of the status or existence of the posterior ligament itself. Used e.g. in the suspected case of a cruciate ligament rupture or post-surgery scans after a cruciate ligament replacement. Detects laterality and applies the tilt (+/-) accordingly. Alignment: B.3 Tilted Sag > Tra by 15 degrees (+/-), starting from the midsagittal plane that is provided by the AutoAlign reference Knee > Standard (Sagittal). B.3 In the right knee, a positive tilt Sag > Tra is applied. In the left knee, a negative tilt Sag > Tra is applied. syngo MR D13 B.3-31

148 syngo B.3 System administration and configuration AutoAlign Shoulder B.3 Introduction B.3 The AutoAlign Shoulder scout scans a volume in the isocenter and computes the AutoAlign Shoulder landmarks. B.3 The resulting localizer images in coronal, sagittal, and transversal orientation are auto-loaded into the image segments of the Exam task card. B.3 AAShoulder_Scout protocol B.3 The AutoAlign Shoulder scout protocol can be found in the following protocol tree: B.3 \Siemens\shoulder\library\localizer B.3 It is recommended to copy the relevant protocols into your scan program. B.3 AutoAlign Shoulder References B.3 AutoAlign Shoulder computes the following AutoAlign references of the shoulder: B.3 Shoulder > Paratransversal Shoulder > Paracoronal Shoulder > Parasagittal B.3-32 MR D13 - System and data management

149 B.3 Creating AutoAlign programs B.3 Shoulder > Paratransversal B.3 Application B.3 Basic alignment for visualizing the following: B.3 Overall shoulder anatomy Acromioclavicular (ac) joint Rotator cuff (all tendons and ligaments around humerus head) Glenoid Humerus head Tip of scapula syngo MR D13 B.3-33

150 syngo System administration and configuration Alignment: B.3 Orientation: - Single oblique tra>sag rotation - To be aligned with axis defined by glenoid center and ac joint center (yellow dashed line) Positioning: - Initially centered by the glenoid center - Shift in head/feet direction to center the organ box - Shift in medial/lateral direction to center the organ box laterally B.3-34 MR D13 - System and data management

151 B.3 Creating AutoAlign programs B.3 Shoulder > Paracoronal B.3 Application B.3 Visualizing the following: B.3 Labrum Glenoid cavity/humerus head interface, along with the rotator cuff muscles syngo MR D13 B.3-35

152 syngo System administration and configuration Alignment B.3 Orientation: - Single oblique cor>sag rotation - To be aligned with scapula Positioning: - Initially centered by the center of humerus head (AP) and glenoid cavity (LR and FH) - Shift in medial/lateral direction to include a maximum gap of 1cm laterally - Shift in FH direction for positioning cranial edge of the slice group to maximum 15 mm above organ box B.3-36 MR D13 - System and data management

153 B.3 Creating AutoAlign programs B.3 Shoulder > Parasagittal B.3 Application B.3 Basic alignment for visualizing the following: B.3 Labrum Glenoid cavity/humerus head interface, along with the rotator cuff muscles syngo MR D13 B.3-37

154 syngo System administration and configuration Alignment B.3 Orientation - Single oblique Sag > Cor rotation - To be aligned with scapula (as for Paracoronal but 90 degrees rotated) Positioning - Initially centered by the center of humerus head - Shift in medial/lateral direction to center the organ box - Shift in FH direction same as in Shoulder > Paracoronal B.3-38 MR D13 - System and data management

155 B.3 The Creating AutoAlign programs B.3 AutoAlign Hip B.3 Introduction B.3 The AutoAlign Hip scout scans a volume in the isocenter and computes the AutoAlign Hip landmarks. B.3 The resulting localizer images are auto-loaded into the image segments of the Exam task card. For bilateral hip scans, MPRs with coronal and transversal orientation are calculated. For unilateral hip scans, MPRs in sagittal, coronal, and transversal orientation are presented. B.3 AAHip_Scout protocol B.3 AutoAlign Hip scout protocols can be found in the following protocol tree: B.3 \Siemens\Hip\library\localizer B.3 It is recommended that you copy the relevant protocols into your scan program. B.3 syngo MR D13 B.3-39

156 syngo AutoAlign System administration and configuration AutoAlign Hip References B.3 Spine computes the following AutoAlign references of the shoulder: B.3 Hip (Both) Transversal Hip (Both) Paracoronal Hip (Single) Paratransversal Hip (Single) Transversal Hip (Single) Paracoronal Hip (Single) Parasagittal Hip (Single) Femur Axis B.3-40 MR D13 - System and data management

157 B.3 Creating AutoAlign programs B.3 Hip > (Both) Transversal B.3 Standard transversal imaging of both hips B.3 Application B.3 Visualizes the following: B.3 Femur head Acetabulum Trochanter minor and major Alignment B.3 Orientation: - Inplane rotation - To be aligned with axis connecting the centers of two femur heads (Pure transversal orientation) Positioning - Centered by the medial points between centers of two femur heads syngo MR D13 B.3-41

158 syngo B.3 System administration and configuration Hip > (Both) Paracoronal B.3 Standard coronal imaging of both hips. B.3 Application B.3 Visualizes the following: B.3 Femur head Acetabulum Trochanter major Alignment B.3 Orientation: - Single oblique cor>sag rotation - To be aligned with axis connecting two centers of femur heads Positioning: - FH centered by the medial points between tops of two femur heads. - LR, AP centered by the medial points between tops of two femur heads B.3-42 MR D13 - System and data management

159 B.3 Creating AutoAlign programs B.3 Hip > (Single) Paratransversal B.3 Standard paratransversal imaging of a single hip. B.3 Application: B.3 Visualizes the following: B.3 Femur head Acetabulum Trochanter major and minor Alignment B.3 Orientation: - Single oblique Tra > Sag rotation - To be aligned with femoral neck Positioning: - Organ box centered syngo MR D13 B.3-43

160 syngo B.3 System administration and configuration Hip > (Single) Transversal B.3 Standard transversal imaging of a single hip. B.3 Application B.3 Visualizes the following: B.3 Femur head Acetabulum Trochanter major and minor Alignment B.3 Orientation: - No rotation. Pure transversal Positioning: - Initially centered by the femoral head center - Organ box center B.3-44 MR D13 - System and data management

161 B.3 Creating AutoAlign programs B.3 Hip > (Single) Paracoronal B.3 Standard paracoronal imaging of a single hip. B.3 Application B.3 Visualizes the following: B.3 Femur head Acetabulum Trochanter major and minor Alignment B.3 Orientation: - No rotation - Single oblique Cor > Sag rotation - To be aligned with femoral neck Positioning: - To optimally cover femoral head, acetabulum, trochanter major and minor syngo MR D13 B.3-45

162 syngo B.3 System administration and configuration Hip > (Single) Parasagittal B.3 Standard parasagittal imaging of a single hip. B.3 Application B.3 Visualizes the following: B.3 Femur head Acetabulum Trochanter major and minor Alignment B.3 Orientation: - Single oblique Cor > Sag rotation - To be aligned with femoral neck (as for Paracoronal but 90 degrees rotated). Positioning: - To optimally cover femoral head, acetabulum, trochanter major and minor B.3-46 MR D13 - System and data management

163 B.3 Creating AutoAlign programs B.3 Hip > (Single) Femur Axis B.3 Rotating slice group for visualizing anatomies in a single hip with respect to the femoral neck axis B.3 Application B.3 For example: B.3 Femoral head Femoral neck Acetabulum syngo MR D13 B.3-47

164 syngo System administration and configuration Alignment B.3 Rotation axis: Femoral neck axis. B.3 Positioning: Center of femoral head. B.3 First slice: Parallel to femoral shaft. B.3 Other slices: Are generated by rotation clockwise with respect to the femoral neck axis. B.3 B.3-48 MR D13 - System and data management

165 B.3 AutoAlign B.3 B.3 B.3 Creating AutoAlign programs B.3 AutoAlign Spine LS B.3 Introduction B.3 AutoAlign Spine LS is part of the Spine Dot Engine. For further information on using the Spine Dot Engine refer to: ( Operator Manual Neuro) CAUTION B.3 Spine may result in wrong mapping of anatomical data (for example, mismatch of vertebras) due to different distortions! Incorrect diagnosis or wrong therapy planning If you use AutoAlign Spine, always check the anatomy and be aware of possible wrong mapping. The AutoAlign Spine scout scans a volume in the isocenter and computes the AutoAlign Spine LS landmarks. B.3 The field of view (FoV) of the scout is large enough to cover the L-spine or the C-spine. To scan the entire spine of an average sized adult, three scouts are necessary. B.3 syngo MR D13 B.3-49

166 syngo System administration and configuration AutoAlign Spine supports: B.3 Detection and identification of the vertebra bodies and disks Prescription of sagittal, coronal, and double-oblique axial slices in the spine Prescription of an anterior regular saturation region Labeling of axial slices with the vertebrae and vertebra disk labels The resulting MPR localizer images are loaded into the image segments of the Exam task card. B.3 AutoAlign scout (AASpine_Scout) B.3 Stationary Spine scout (C-Spine, L-Spine): The scout scans the local spine on the current table position starting at the light marker position. B.3 Whole-Spine Scout (e.g. C-T-Spine, T-L-Spine, Whole-Spine): B.3-50 MR D13 - System and data management

167 The B.3 B.3 Creating AutoAlign programs B.3 The scout scans the whole spine at 2 to 3 table positions starting at the light marker position. B.3 AASpine_Scout protocols can be found in the c-/t-/l-spine protocol libraries of the SIEMENS protocol tree. B.3 Scan duration B.3 average scan duration of an AutoAlign Spine LS scout is about 20 seconds measurement time plus 10 seconds AutoAlign computing and reconstruction time per table position. B.3 Thickness of the AA scout volume B.3 The number of slices of the scout can be increased. This may be suitable for patients with strong kyphosis. B.3 For this purpose, the Slices per slab and TR parameters can be adapted. B.3 Clinical protocols B.3 A clinical protocol can reference one of the following AutoAlign Reference values: B.3 Spine > Cervical Spine > Thoracic Spine > Lumbar AutoAlign suggests the positioning of the slices/slabs and saturation regions of the protocol in the center of the corresponding part of the spine. B.3 syngo MR D13 B.3-51

168 syngo B.3 System administration and configuration Offset of the saturation region B.3 The offset of the saturation region can be defined by the user within the extended configuration of the linked Spine Positioning AddIn. B.3 AutoAlign landmarks B.3 AutoAlign Spine LS derives the spine geometry from multiple landmarks: B.3 B.3-52 MR D13 - System and data management

169 So Anterior Posterior Spinous Left Vertebra Disk B.3 Creating AutoAlign programs B.3 (1) B.3 spine geometry line B.3 (spline through all A-points.) B.3 (2) B.3 spine geometry line B.3 (spline through all P-points.) B.3 (3) B.3 process geometry line B.3 (spline through all P'-points.) B.3 (4), (5) B.3 and right spine geometry line B.3 (spline through all R- or L-points.) B.3 (6) B.3 body B.3 (7) B.3 cartridge B.3 A disk cartridge is computed as the mid-plane between the lower plate of the upper vertebra body and the upper plate of the lower vertebra body. B.3 Minimal Bounding Box B.3 called MBBs are used to help determining the final positioning of the protocol geometry like, for example, the slices. The minimal bounding box embraces all vertebras and vertebral disks within the spine part of interest. B.3 syngo MR D13 B.3-53

170 syngo Linear Linear B.3 B.3 System administration and configuration The left and right borders of the MBB (linear fitting slice box in the following image) are parallel to a linear fitting line which connects the given landmarks. B.3 (1) B.3 fitting line B.3 (2) B.3 fitting slice box B.3 B.3-54 MR D13 - System and data management

171 B.3 B.3 Creating AutoAlign programs B.3 AutoAlign Spine Scenarios B.3 Axial slices B.3 Axial slices are positioned in the disk cartridge plane. B.3 The tilt is double-oblique. It is derived from the averaged lower and upper plate of the adjacent vertebrae. B.3 The slice group center lies on the posterior spine geometry line. The axial slices are not in-plane rotated. B.3 A saturation region is positioned tangential to the anterior spine geometry line with a user-configurable gap. The end user can adapt the positioning of the saturation region to avoid artefacts. B.3 Axial slabs B.3 Axial slabs (slice groups of 9 or more slices) are positioned perpendicular to the posterior spine geometry line. B.3 The slice group center lies on the posterior spine geometry line. The tilt is double-oblique. The axial slices are not inplane rotated. B.3 A saturation region is positioned tangential to the anterior spine geometry line with a user-configurable gap. The end user can adapt the positioning of the saturation region to avoid artefacts. B.3 syngo MR D13 B.3-55

172 syngo B.3 System administration and configuration Sagittal protocols B.3 The position and orientation of sagittal protocols is derived from the left and right spine geometry line in the focused spine part (here C2/C7.. T1). The tilt is single-oblique. B.3 In combination with the Spine Dot engine, the necessary number of slices is suggested. B.3 The slice group center lies on the posterior spine geometry line. The sagittal slices are not in-plane rotated. B.3 A saturation region is positioned tangential to the anterior spine geometry line with a user-configurable gap. The end user can adapt the positioning of the saturation region to avoid artefacts. B.3 B.3-56 MR D13 - System and data management

173 B.3 Creating AutoAlign programs B.3 Coronal Slabs B.3 The position and orientation of coronal protocols is derived from the anterior and posterior spine geometry line in the focused spine part. B.3 In combination with the Spine Dot engine, the necessary number of slices is suggested. B.3 The center lies on the posterior spine geometry line and in the common center of the left and right spine geometry line. B.3 The tilt is single-oblique. The slices have no in-plane rotation. B.3 syngo MR D13 B.3-57

174 syngo B.3 B.3 System administration and configuration AutoAlign Spine Interactive B.3 AutoAlign Spine automatically positions and orients transverse slice groups to intervertebral disk layers. The correction for the scoliosis angle is taken into account for the entire spine. B.3 To use AutoAlign Spine during interactive slice positioning in all clinical protocols, the AutoAlign parameter Spine > Interactive must be selected. B.3 For open clinical protocols, the interactive Autolign Spine assistant can also be switched on and off via the main menu entry Tools > AutoAlign Spine. B.3 If the user drags a slice group in AutoAlign Spine mode, a cross-hair symbol appears at the mouse cursor position while dragging. If the mouse button is released in a vertebra disk, the dragged slice is aligned (double-oblique). B.3 If the protocol contains a sat region, its position and angulation (coronal) are also adapted. B.3 B.3-58 MR D13 - System and data management

175 AutoAlign The Creating AutoAlign programs B.3 Prerequisites B.3 Spine uses a search algorithm based on a parallel stack of high-quality, T2-weighted sagittal images. These images must be loaded into the graphic segments of the exam task card first. B.3 Algorithm B.3 algorithm is based on a 3D segmentation of the vertebrae in the given stack of T2-weighted images. The final slice group position is determined from the mouse-button release position: If the slice group has fewer than 9 slices, it is positioned on the geometric midplane between the neighboring vertebral plates. Otherwise the slice group is positioned perpendicular to the myeloma. The status line displays a message if the alignment was not found. B.3 syngo MR D13 B.3-59

176 syngo B.3 B.3 System administration and configuration Tasks B.3 Creating and editing an AutoAlign program B.3 This procedure is not applicable with the following AutoAlign programs: AutoAlign Spine Interactive AutoAlign Spine LS For detailed information on creating an AutoAlign Spine LS program refer to: ( Operator Manual - Neuro) 1st: Run AutoAlign Scout B.3 Register a volunteer. Start the AutoAlign scout. Only use predefined AutoAlign scouts from the Siemens localizer libraries, e.g. \\SIEMENS\head\library\localizer\AAHScout \\SIEMENS\knee\library\localizer\AAKScout The user can combine AutoAlign with scan@center. Therefore the parameters Positioning mode and Distortion correction can be edited and adapted accordingly. Wait until the AutoAlign scout is done. B.3-60 MR D13 - System and data management

177 During B.3 Creating AutoAlign programs B.3 2nd: Adapting the protocols B.3 Open your clinical protocol. Reset the AutoAlign reference to none (---). Predefine the main orientation (Sagittal, Coronal, Transversal) and reset the position to Isocenter. Set the required AutoAlign matrix in the field AutoAlign of the Routine parameter card. Position the slices as required. If required, define an offset for Position and Orientation. When planning the slices, make sure that the effective thickness of your slice group / slab is large enough to cover the typical anatomical variances within your patients. 3rd: Deleting inaccuracies B.3 slice positioning you might have changed aspects of the orientation or slice position accidentally. For example, the field of view has become off-center in the left-right direction. B.3 For the definition of a good standard, we recommend rounding the offset values in the Position and Orientation parameters and to remove undesired asymmetries as follows: B.3 Open the Routine parameter card. Reset the AutoAlign reference to none (---). syngo MR D13 B.3-61

178 syngo System administration and configuration The volunteer-specific alignment is removed. The protocol parameters Position and Orientation show the offset values. B.3 Simplify the values of the Position parameter, e.g. L2.3 H34.8 P9.3 -> L0 H35 P9. Simplify the values of the Orientation parameter, e.g. Tra > Cor 11.2 > Sag > Tra > Cor 11. Make sure that there is no remaining inplane rotation. Re-apply the correct AutoAlign reference and check the adapted offsets visually on the volunteer images. Apply the protocol to the queue and run a control scan. 4th: Saving the queue as a new program B.3 Save the protocols as a new program in the Exam Explorer with Queue > Save as program. ( Operator Manual - Scanning and postprocessing: C.2 Composing a measurement program) B.3 5th: Optimizing the workflow parameters B.3 Set Copy references between the protocols where necessary. ( Operator Manual - Scanning and postprocessing: C.2 Composing a measurement program) B.3 Set the execution settings of the protocol as required (working man, Auto load, Inline Position Display, and so on). ( Operator Manual - Scanning and postprocessing: C.2 Composing a measurement program) B.3 B.3-62 MR D13 - System and data management

179 B.3 Creating AutoAlign programs B.3 Even with the use of the correct AutoAlign reference and with well-defined Position and Orientation offsets, some clinical protocols might need user interaction before scanning, e.g. the user needs to decide on additional slices for a good coverage or to adapt a sat band in addition to the well-aligned slice group. Protocols that might need a user interaction should be set up with a working-man icon. Protocols that are well-aligned and need no user interaction can be set up without a working-man icon. These protocols should run first. In the meantime, the user prepares/adapts the semi-automated protocols. 6th: Testing the program B.3 Test the new Auto Align program with different volunteers to optimize the program or the initial values for position and orientation (if necessary). syngo MR D13 B.3-63

180 syngo B.3 System administration and configuration Importing an AutoAlign program from another system or software version B.3 An AutoAlign program which is based on an older software version must usually be adjusted before its first use. B.3 From Atlas-based to Landmark-based AutoAlign Head B.3 If the imported scan program previously used the atlas-based AutoAlign (AAScout) Head principle, adapt the scan program as follows: B.3 Insert the landmark-based AutoAlign scout AAHScout where previously an atlas-based AAScout was used. Remove any additional standard localizers. These localizers are not needed anymore as several MPR localizer images are generated from the landmark-based AutoAlign scout. To get a positioning as similar to the old AutoAlign principle as possible, set the AutoAlign reference parameter to Head > Brain in all clinical AutoAlign protocols. or B.3 Use the new, more specialized AutoAlign references like Head > Basis, Head > IAC, Head > Orbits or Head > Temporal lobe where possible. Since these AutoAlign references might require other Position and Orientation offsets, start with a zero offset. B.3-64 MR D13 - System and data management

181 B.3 Creating AutoAlign programs B.3 From syngo MR B17 to syngo MR D11 or higher B.3 A scan program that is based on the software version syngo MR B17 might already be set up with a landmark-based AutoAlign scout. In this case, the user can execute the scan program without adaptions. B.3 However, the imported scan program can still be optimized. B.3 Use the extended AutoAlign functionality. Adapt and test the protocols. ( Page B.3-60 Creating and editing an AutoAlign program) AutoAlign Head In syngo MR B17, only the AutoAlign references Head > Basis and Head > Brain were available. Scan protocols, e.g. for the inner ear, were set up with an offset based on the given AutoAlign reference. It is recommended to adapt such protocols to take full advantage of the new AutoAlign references of syngo MR D11 like Head > Inner ear, Head > Orbits, Head > Optic nerves and Head > Temporal lobe. ( Page B.3-60 Creating and editing an AutoAlign program) syngo MR D13 B.3-65

182 syngo B.3 System administration and configuration AutoAlign Knee In syngo MR B17, only the AutoAlign reference Knee > Basis was available. In all imported protocols which used this reference, the new AutoAlign reference Knee > Standard is applied. It is recommended to remove any previous Position and Orientation offsets and to employ the new AutoAlign references like Knee > Meniscus, Knee > Patella routine, Knee > Patella cartilage, and Knee > PCL. ( Page B.3-60 Creating and editing an AutoAlign program) B.3-66 MR D13 - System and data management

183 Creating a Dot Engine B.4 Creating a Dot Engine B.4 General information B.4 Dot Engine examination B.4 Examinations powered by a Dot Engine offer user guidance, patient personalization and process automation. With the Dot technology, alternative decisions and strategies can be configured for measurement programs. B.4 The context of a patient requires certain decisions (e.g. Are CM measurements possible? - yes/no) before the examination. The user also chooses the strategy for an examination according to the patient s capabilities. B.4 During the examination, clinical findings (e.g. tumor yes/no) can necessitate further decisions by the user. If the condition of a patient changes during an examination, a different strategy (e.g. reducing the length of the examination or considering limited patient capability) might be necessary for the examination. These patient-specific and examination-specific requirements result in a complex tree-like structure when illustrating the course of an examination. B.4 The Dot Engine serves as an answer to this complexity. It provides the tools and elements to facilitate the examination process. In addition, the Dot Engine offers a user guidance with tips and instructions for the user. Important measurement parameters can be displayed to lead the user through an examination. B.4 syngo MR D13 B.4-1

184 syngo Dot Strategy Decision Decision B.4 B.4 System administration and configuration Elements of a Dot Engine B.4 The elements of a Dot Engine are visible in the Exam Explorer: B.4 (1) B.4 Engine Step B.4 (2) B.4 branch with four strategies B.4 (3) B.4 step B.4 (4) B.4 branch with two alternative program paths B.4 B.4-2 MR D13 - System and data management

185 Dot The B.4 Creating a Dot Engine B.4 Dot add-in B.4 add-ins are auxiliary objects for Dot Engine Steps and program steps. They enhance the Dot Engine Step, pauses, and programs with indication-specific automation. B.4 Features of Dot add-ins are: B.4 Dedicated UI (Dot View) Internal logic with parameters and algorithms Configurable via the Exam Explorer Application-specific Stored with the protocol step or program step Add-in functionality is solely intended to be used in the context defined by a Siemens Dot Workflow. Other combinations of add-ins may not provide the desired result, due to unresolved dependencies. Dot Engine Step B.4 Dot Engine Step is what distinguishes the Dot Engine from a conventional measurement program. Each Dot Engine has exactly one Dot Engine Step. Using a Dot add-in, this Dot Engine Step defines the strategies, decisions, and patient-specific or examination-specific settings of the Dot Engine. B.4 Each application (e.g. Brain Dot Engine, Abdomen Dot Engine) has a unique Dot add-in. B.4 syngo MR D13 B.4-3

186 syngo System administration and configuration The Patient View shows the following details of the Dot Engine Step: B.4 Strategies Patient context decisions Application-specific information e.g. breathhold duration of an abdomen examination The Patient View can be accessed via Dot button on the Exam task card. B.4 Dot decisions and decision steps B.4 Decisions are defined in the Dot Engine Step and only have the states with or without [decision]. They build the structure of an examination by offering different paths. B.4 There are two kinds of decisions: B.4 Patient context decisions are set initially in the Patient view of the Dot Engine Step. For example: Should contrast agent be used for the patient? Patient context decisions are designed with the decision branch element. Clinical decisions are made during examination. For example: Is there a finding in the images? Clinical decision points are designed with the decision step element followed by the decision branch element. Decision steps can press for a decision by the user (indicated by a working man icon) or can be optional. Clinical decisions require decision steps. B.4 B.4-4 MR D13 - System and data management

187 Strategies Any Creating a Dot Engine B.4 Dot strategies B.4 are defined in the Dot Engine Step. They are used to adapt the examination to the patient capability (e.g. Standard, Limited patient capabilities, Resolution focus, Speed focus). Strategies can be changed at any time during the examination. They are always valid, irrespective of decisions. B.4 Typically, strategies do not change the structure of an examination. They only describe different techniques for a certain part of the examination e.g. how to acquire the contrasts. B.4 Examination parts depending on strategies are designed with the strategy branch element. B.4 Pauses and protocols B.4 pause or protocol can be part of a Dot Engine examination. B.4 Protocols should have a Dot add-in assigned. Only protocols with assigned Dot add-ins have a Dot view user guidance. B.4 syngo MR D13 B.4-5

188 syngo Features B.4 B.4 B.4 System administration and configuration Common Dot add-ins B.4 Protocols with unlicensed Dot add-ins are handled the same way as unlicensed sequences. ( Page B.2-7 Showing non-licensed measurement programs) Dot add-in B.4 Generic Views B.4 MPR Planning B.4 MPR Assignment B.4 Basic Decision B.4 Basic Patient View B.4 B.4 User guidance (text, images) Reduced protocol parameter selection Definition of MPR reconstruction Set-up of user guidance possible Used for 3D protocols which are a basis for MPR reconstruction User guidance and reduced parameter selection User guidance for decision steps Automatically selected for decision steps Basic add-in for Dot Engine Steps Definition of strategies and decisions Naming of Patient view For some combinations of add-ins, full functionality cannot be guaranteed. ABLE and AutoAlignScout cause trouble when combined with views and add-ins outside their Dot Engine. It is not recommended to use them outside their respective Dot Engine. B.4-6 MR D13 - System and data management

189 B.4 Creating a Dot Engine B.4 Tips and tricks B.4 Strategies and strategy branches B.4 Sort the strategies according to their importance. ( Page B.4-21 Set-up tab card of the Dot Engine Step) B.4 Name strategy branches according to the logical grouping, e.g., MR contrast behavior, pre-contrast/post-contrast. Pool protocols which should be measured together in a strategy branch. Allocate protocols which should be measured independently to separate strategy branches. If the strategy changes during examination, all protocols of unfinished strategy branches are inserted in the queue. Reuse programs B.4 If applicable, reuse the skeleton of an existing program (strategies / decisions). syngo MR D13 B.4-7

190 syngo B.4 System administration and configuration Tasks B.4 Setting up the Dot Engine B.4 The following workflow describes how to create Dot engines. Individual tasks are described in separate chapters. B.4 We recommend drawing a sketch of the program on paper prior to setting up the Dot Engine. Exam Explorer is open Create a program. ( Page B.2-16 Creating a measurement program) B.4 Insert a Dot Engine Step. ( Page B.4-10 Inserting and configuring a Dot Engine Step (Patient View)) B.4 Create skeleton of the program consisting of Strategy branches( Page B.4-12 Inserting a strategy branch (Exam strategy)) B.4 Decision branches (for patient context decisions) ( Page B.4-13 Inserting a decision branch (Patient context decision)) B.4 Decision steps (for clinical decisions) ( Page B.4-14 Inserting a decision step (Clinical decision point)) B.4 B.4-8 MR D13 - System and data management

191 Creating a Dot Engine B.4 Fill up the skeleton with program steps and attach Dot add-ins (if required). ( Page B.4-15 Inserting a program step with Dot add-in) B.4 Review complete program in simulation mode. ( Page B.4-19 Verifying a program in simulation mode) B.4 syngo MR D13 B.4-9

192 syngo System administration and configuration Inserting and configuring a Dot Engine Step (Patient View) B.4 The Dot Engine Step is inserted on the highest hierarchic level into a Dot Engine examination via the menu or the context menu like normal program and pause steps in the Exam Explorer. B.4 Exam Explorer is open Select Insert > Patient View. The Dot Engine Step properties dialog window opens. B.4 ( Page B.4-20 Dot Engine Step properties) B.4 Name the Dot Engine Step. Select a Dot add-in (Basic Patient View or an application-specific Dot add-in). Open the configuration page of the Dot Engine Step with Edit Configuration. Define strategies, decisions (patient context decision and clinical decision point) and application-specific workflow data. Confirm with OK. You can insert program steps, pauses, strategy branches, decision branches, and decision steps below the Dot Engine Step. B.4 B.4-10 MR D13 - System and data management

193 Creating a Dot Engine B.4 Renaming the slice groups of the MPR Planning Dot add-in B.4 The slice groups of the MPR Planning Dot add-in can be renamed using the Exam Explorer. B.4 Exam Explorer is open Right-click MPR Planning... in the Exam Explorer and select Properties in the context menu. The Decision Step properties dialog window opens. B.4 Select the Dot add-in subtask card. Click the Edit Configuration... button. Select the Set-up subtask card. Double-click the Add / Remove button. Right-click the view to be renamed. Rename the selected view. syngo MR D13 B.4-11

194 syngo B.4 System administration and configuration Inserting a strategy branch (Exam strategy) B.4 Exam Explorer is open Dot Engine Step is configured with strategies Select Insert > Exam strategy. The Strategy Branch properties dialog window opens. B.4 Enter the name of the strategy branch on the Standard tab card. Confirm with OK. The system automatically generates the strategies predefined in the Dot Engine Step. B.4 The Strategy branch displays the strategies of the examination in the configuration view of the Exam Explorer. You can insert program steps, decision steps, and decision branches below each strategy. B.4 Once a strategy branch has been inserted, the strategy cannot be changed (e.g. deleted) within the Dot Engine Step and new strategies cannot be added. B.4-12 MR D13 - System and data management

195 B.4 Creating a Dot Engine B.4 Inserting a decision branch (Patient context decision) B.4 Exam Explorer is open Dot Engine Step is configured with patient context decision Select Insert > Patient context decision. The Decision Branch properties dialog window opens. B.4 Name the decision branch on the Standard tab card. Select the decision on the Decision tab card. Confirm with OK. The system automatically generates subfolders for with and without [decision]. B.4 A decision branch always has two program paths. Program steps, strategy branches, decision steps, and decision branches can be inserted below the program path. Furthermore, decision branches can be nested i.e. strategy or decision branches can be inserted within a decision branch. B.4 Once a decision branch has been inserted, the decision cannot be deleted. syngo MR D13 B.4-13

196 syngo B.4 System administration and configuration Inserting a decision step (Clinical decision point) B.4 Exam Explorer is open Dot Engine Step is configured with clinical decision point Select Insert > Clinical decision point. The Decision Step properties dialog window opens. B.4 Name the Decision step on the Standard tab card. Select the Decision on the Decision tab card. Select the required Dot add-in on the Dot add-in tab card. The Basic Decision add-in is selected by default. Define the Guidance Text for the decision with Edit Configuration. Confirm the changes with OK. A decision branch is automatically inserted below the decision step. B.4 B.4-14 MR D13 - System and data management

197 Creating a Dot Engine B.4 Inserting a program step with Dot add-in B.4 Program steps with Dot add-in are not mandatory for a Dot Engine. A Dot Engine can comprise only program steps without a Dot add-in. But then program steps with Dot add-in can be part of a conventional measurement program. B.4 Exam Explorer is open Select Insert > Program Steps. The Insert Program Steps dialog window opens. B.4 Select the desired program step(s) and click Insert. Select the program step in the Exam Explorer and select Edit > Properties. Select the required Dot add-in on the Dot add-in tab card of the Protocol properties. ( Page B.4-23 Protocol properties - Dot add-in) B.4 Configure the parameters of the Dot add-in with the Edit Configuration button. ( Page B.4-24 Dot Add-In Configurator - Guidance) B.4 ( Page B.4-26 Dot Add-In Configurator - Parameters) B.4 ( Page B.4-29 Dot Add-In Configurator - GSP) B.4 ( Page B.4-27 Dot Add-In Configurator - Queue) B.4 syngo MR D13 B.4-15

198 syngo B.4 System administration and configuration ( Page B.4-32 Dot Add-In Configurator - Series Label) B.4 ( Page B.4-33 Dot Add-In Configurator - Load to GSP) B.4 ( Page B.4-34 Dot Add-In Configurator - Auto Coverage) B.4 ( Page B.4-37 Dot Add-In Configurator - Auto Timing) B.4 Set the desired protocol properties. ( Operator Manual - Scanning and postprocessing: C.2 Composing a measurement program) B.4 Copy References can only be applied within the same strategy. This functionality is only offered for protocols which are displayed on the right side of the Exam Explorer. To apply Copy References between different decision branches, switch to simulation mode. ( Page B.4-19 Verifying a program in simulation mode) Confirm the changes with OK. B.4-16 MR D13 - System and data management

199 Creating a Dot Engine B.4 Copying a Dot add-in to another protocol B.4 Exam Explorer is open Source protocol is selected in the sequence of program steps on the right side Select Edit > Copy Dot add-in. Select the target protocol and select Edit > Paste. The Dot add-in is attached to the target protocol. The name of the Dot add-in is displayed to the right of the protocol name. B.4 syngo MR D13 B.4-17

200 syngo B.4 System administration and configuration Copying settings between Dot add-ins B.4 You can copy settings between Dot add-ins. B.4 With this procedure the content of one card of the source Dot add-in is copied into the card of the target Dot add-in. B.4 The card must be available on the target Dot add-in B.4 Exam Explorer is open Source protocol is selected in the sequence of program steps on the right-hand side Open the Dot Add-in Configurator. Select the card you want to copy the content from. Click the Copy button. B.4-18 MR D13 - System and data management

201 B.4 B.4 Creating a Dot Engine B.4 Close the Dot Add-in Configurator. Select the target protocol. Open the Dot Add-in Configurator. Select the card you want to paste the content to. Click the Paste button. The content is copied into the card of the target Dot add-in. B.4 Verifying a program in simulation mode B.4 Exam Explorer is open Measurement program is selected in customer tree Switch to simulation mode with this icon. On the right side, the Exam Explorer simulates the display in the queue. B.4 In simulation mode, the functionality of the Exam Explorer is limited. Not all menu items are available. Furthermore, the tree view on the left side differs from the tree view in configuration mode. Change strategy or decision values via the Edit icon to the right of the name of the Dot Engine Step. The status bar of the Exam Explorer indicates the strategy currently selected. B.4 Switch back to Configuration Mode. syngo MR D13 B.4-19

202 syngo Selects Opens Resets B.4 System administration and configuration UI explanation B.4 Dot Engine Step properties B.4 Dot Engine Step is selected; Properties B.4 (1) B.4 the Dot add-in for the Dot Engine Step. B.4 (2) B.4 the Parameter Configuration card. B.4 (3) B.4 the Siemens default configuration for the Dot add-in. B.4 B.4-20 MR D13 - System and data management

203 B.4 Creating a Dot Engine B.4 Set-up tab card of the Dot Engine Step B.4 Dot Engine Step is selected; Properties > Exam add-in > Edit Configuration B.4 syngo MR D13 B.4-21

204 syngo Defines, Defines, Defines, B.4 System administration and configuration (1) B.4 deletes, and organizes the strategies of a Dot Engine. B.4 It is recommended to sort the strategies according to their importance e.g. to position the default strategy on top of the Strategies list. Use the arrow buttons to the right to move a list entry up or down. (2) B.4 deletes, and organizes the patient context decisions of a Dot Engine. B.4 (3) B.4 deletes, and organizes the clinical decision points of a Dot Engine. B.4 B.4-22 MR D13 - System and data management

205 Selects B.4 Creating a Dot Engine B.4 Protocol properties - Dot add-in B.4 Insert > Protocol > Dot add-in B.4 (1) B.4 a preconfigured Dot add-in for the protocol. B.4 syngo MR D13 B.4-23

206 syngo Allows Sets B.4 System administration and configuration Dot Add-In Configurator - Guidance B.4 Program step is selected; Properties > Dot add-in > Configuration B.4 (1) B.4 capture of guidance images from the image segments of the Exam task card. B.4 (2) B.4 the guiding text for the user. B.4 B.4-24 MR D13 - System and data management

207 Allows Sets B.4 B.4 B.4 Creating a Dot Engine B.4 When the cursor is placed in the text field, the toolbox for standard text formatting appears. (3) B.4 loading of a guidance image in the respective image display. B.4 You can select image files in JPG (recommended) or BMP format. Note that larger files use more memory capacity, which influences the system performance. To ensure high performance, choose the file format and size accordingly. Image data is saved in the configuration. The displayed path only indicates the original location of an image. (4) B.4 the tooltip for the image. B.4 syngo MR D13 B.4-25

208 syngo Slot Slot Slot B.4 B.4 B.4 System administration and configuration Dot Add-In Configurator - Parameters B.4 Program step is selected; Properties > Dot add-in > Configuration B.4 (1) B.4 to display parameter or text. B.4 To search for a parameter, insert the beginning of the parameter name, for example, the first letter. Only parameters that match the inserted text are displayed for selection. (2) B.4 P B.4 displays corresponding parameter B.4 T B.4 displays user-defined text B.4 B.4-26 MR D13 - System and data management

209 Defines B.4 Creating a Dot Engine B.4 Dot Add-In Configurator - Queue B.4 Program step is selected; Properties > Dot add-in > Configuration B.4 (1) B.4 availability of the Scan button. B.4 syngo MR D13 B.4-27

210 syngo The User B.4 B.4 System administration and configuration (2) B.4 Default B.4 next protocol is opened as soon as this protocol is started. B.4 On Image Reconstruction... B.4 The next protocol is opened as soon as the image reconstruction of this protocol is completed. B.4 (3) B.4 Default B.4 can open the protocol manually. B.4 When previous step has finished B.4 Protocol is opened immediately after the images of the previous step are reconstructed. B.4 Opening the protocol manually is suppressed. B.4 B.4-28 MR D13 - System and data management

211 Defines B.4 Creating a Dot Engine B.4 Dot Add-In Configurator - GSP B.4 Program step is selected; Properties > Dot add-in > Configuration B.4 (1) B.4 automatic execution of the following functions of the GSP menu View when the Add-in UI is opened from the measurement queue: B.4 syngo MR D13 B.4-29

212 syngo Defines Description Defines Shows Displays Displays Displays Displays Description Defines Hides Switches Displays B.4 B.4 System administration and configuration Item B.4 B.4 GSP Layout B.4 the layout of the reference images (2 Segments, 3 Segments, Maestro UI, Tim Planning UI). B.4 Image Text B.4 (On) or hides (Off) image text. B.4 Reference Lines B.4 the reference lines which show the positions of other reference images and facilitate spatial orientation. B.4 Protocol Table Position B.4 the table position of the isocenter protocol as a blue line. B.4 Coil Positions B.4 the coils and the coil elements that have been connected for the examination. B.4 Adjust Volume B.4 the adjustment volume in the reference images. B.4 (2) B.4 automatic execution of the following functions of the GSP menu View-Graphics: B.4 Item B.4 B.4 Line / Box Mode B.4 the intersection display: B.4 Line Mode Displays the center line of the intersection area B.4 Box Mode Shows the actual intersection surface and therefore the anatomical region covered by the slice B.4 Package Mode B.4 the individual intersections of a slice group. B.4 Projection B.4 on the projection display of slices/slabs. B.4 Shadow B.4 the shadow lines to improve the visibility of graphic objects in light images. B.4 B.4-30 MR D13 - System and data management

213 Defines Defines Defines Description Activates Transfers Activates Description Activates Activates Groups Description Defines B.4 B.4 B.4 Creating a Dot Engine B.4 (3) B.4 automatic execution of the following functions of the GSP menu Image: B.4 Item B.4 B.4 Windowing On Series B.4 windowing on complete series. B.4 Zoom/Pan On Series B.4 changes in one image to all images of the respective series. B.4 Zoom/Pan B.4 the Zoom/Pan mode. B.4 (4) B.4 automatic execution of the following functions of the GSP menu Tools: B.4 Item B.4 B.4 Extent Mode B.4 the mode to change the extent of slices/slabs (e.g. distance, thickness, slice oversampling). B.4 Extent Phase Oversampling B.4 the mode for changing phase oversampling. B.4 Coupled Graphics B.4 graphic objects in order to rotate or move them together. B.4 (5) B.4 automatic execution of the following functions of the GSP menu Scroll: B.4 Item B.4 B.4 Display Order B.4 a scheme for sorting images within a series. B.4 When set to Userdefined, three selection lists for defining the sort criteria are displayed. B.4 syngo MR D13 B.4-31

214 syngo Defines Selected B.4 System administration and configuration Dot Add-In Configurator - Series Label B.4 Program step is selected; Properties > Dot add-in > Configuration B.4 (1) B.4 the set of provided labels B.4 (2) B.4 labels for this series. B.4 If matching labels are defined in the Load to GSP card of a subsequent protocol, images of this protocol are loaded into the image segments. B.4 B.4-32 MR D13 - System and data management

215 Defines Selected B.4 Creating a Dot Engine B.4 Dot Add-In Configurator - Load to GSP B.4 Program step is selected; Properties > Dot add-in > Configuration B.4 (1) B.4 the set of provided labels B.4 (2) B.4 labels for this image segment. B.4 If matching labels are defined in the Series Label card of a previous protocol, the latest images of this protocol are loaded. B.4 syngo MR D13 B.4-33

216 syngo Sets B.4 B.4 System administration and configuration Dot Add-In Configurator - Auto Coverage B.4 Program step is selected; Properties > Dot add-in > Configuration B.4 (1) B.4 the organ box. B.4 This organ box will be covered by the defined manipulation routines. B.4 If Empty is selected, no auto coverage is performed. B.4-34 MR D13 - System and data management

217 The The Defines B.4 Permitted Increment B.4 B.4 Creating a Dot Engine B.4 (2) B.4 Propagate changes to all following protocols B.4 If the organ box is manipulated manually, these changes are propagated to all following protocols that use the same organ box. B.4 Keep center of FOV B.4 Keep FOV constant B.4 field of view is not adapted by the system. B.4 Manual changes to the field of view are still permitted. B.4 size of the field of view is not adapted by the system. B.4 Manual changes to the field of view are still permitted. B.4 (3) B.4 the manipulation steps for auto coverage. B.4 Value will be increased / decreased B.4 Limit B.4 minimum / maximum of the value B.4 Increment B.4 of the manipulation step B.4 The defined manipulation steps are executed one after another until the organ box is ompletely covered. B.4 syngo MR D13 B.4-35

218 syngo Mode No TR Flip B.4 System administration and configuration (4) B.4 B.4 Defines the strategy to avoid exceeding the SAR limit. Therefore the system manipulates the selected parameter. B.4 Off B.4 SAR assistant functionality B.4 TR B.4 Min flip angle B.4 is increased by the system to avoid exceeding the SAR limit B.4 angle is reduced by the system to avoid exceeding the SAR limit B.4 Min flip angle B.4 Sets the permitted minimum value for the flip angle. B.4 Max. TR B.4 Sets the permitted maximum value for the TR. B.4 B.4-36 MR D13 - System and data management

219 Defines B.4 B.4 Creating a Dot Engine B.4 Dot Add-In Configurator - Auto Timing B.4 Program step is selected; Properties > Dot add-in > Configuration B.4 (1) B.4 conditions for the auto timing. B.4 It is not necessary to define a condition to use the auto timing functionality. syngo MR D13 B.4-37

220 syngo Defines B.4 Permitted Increment B.4 System administration and configuration (2) B.4 the manipulation steps for auto timing. B.4 Value will be increased / decreased B.4 Limit B.4 minimum / maximum of the value B.4 Increment B.4 of the manipulation step B.4 Goal B.4 <Number> The goal of the manipulation step must meet the assigned condition. B.4 All The goal of the manipulation step must meet all conditions. B.4 None The goal of the manipulation step must meet the value defined in Limit. B.4 The defined manipulation steps are executed one after another until the conditions are met. B.4 B.4-38 MR D13 - System and data management

221 B.5 Managing files (File Browser) B.5 Managing files (File Browser) B.5 General information B.5 The File Browser provides access and manages a clearly defined portion of the NUMARIS/4 file system. B.5 The File Browser enables: B.5 Copying or moving files (DICOM image data) i.e. to the CD folder for export Access to generated reports and AVI files Access to files downloaded via NUMARIS life If Security (HIPAA) is activated, you need export authorization for the File Browser. Detailed information regarding all security settings in syngo is included in the syngo Security Package brochure. syngo MR D13 B.5-1

222 syngo B.5 System administration and configuration Tasks B.5 Working with the File Browser B.5 File Browser is opened Opening files and folders B.5 Double-click the desired file or folder. Exporting files and folders B.5 Select a file or folder. Select the export destination under File > Send to. The file or folder is copied to the export target. B.5 Managing files and folders B.5 Select files or folders. Select the desired function from the File or Edit menu. When creating or renaming a file or folder, enter a new name. Preinstalled folders and files cannot be deleted, moved, or renamed. B.5-2 MR D13 - System and data management

223 Options B.5 Managing files (File Browser) B.5 UI explanation B.5 File Browser B.5 Selection of the File Browser B.5 > File Browser B.5 syngo MR D13 B.5-3

224 syngo Menu View Directory Status System administration and configuration (1) B.5 bar B.5 (2) B.5 of the directory B.5 (3) B.5 view with subdirectories and files B.5 (4) B.5 bar with display of free disk space B.5 B.5-4 MR D13 - System and data management

225 B.6 Managing voice outputs B.6 Managing voice outputs B.6 General information B.6 Voice output management B.6 You can record or edit patient instructions to optimize the communication with the patient. B.6 To ensure the quality of your recording, we recommend starting recording in a normal voice at 30 cm from the intercom. The volume slider in the exam room does not affect the recording volume. ( Page B.6-10 Exam UI Configuration - Voice Output) syngo MR D13 B.6-1

226 syngo B.6 System administration and configuration Voice outputs for unsupported languages B.6 If you want to use voice outputs for languages that are not provided by Siemens the following commands have to be recorded:b.6 Hold breath (inhaled) Short: Hold breath (inhaled) Hold breath (exhaled) Continue breathing If these voice outputs do not exist in your language, no voice output of this language can be used in Dot Engines. B.6 These voice outputs must exist even if none of them are used by the Dot Engine. B.6-2 MR D13 - System and data management

227 B.6 B.6 Managing voice outputs B.6 Tasks B.6 Recording and editing voice outputs B.6 No patient is registered Select Queue > Voice Output > Organize. The Organize Voice Output dialog window opens. B.6 Establishing labels B.6 Select the language for the new instructions in the Organize Voice Output dialog window. Click New... The Edit Label dialog window opens. B.6 Enter a label for the new voice output and click OK. The new label is appended at the end of the list. It is available in all languages. B.6 The label cannot contain more than 31 characters and has to start with a letter. The following characters cannot be used:?, ", *,, :, \, /, >, <. syngo MR D13 B.6-3

228 syngo B.6 B.6 B.6 B.6 B.6 System administration and configuration Recording new voice outputs B.6 Intercom is selected Click this button on the Organize Voice Output dialog window. The Record Voice dialog window opens. B.6 The dialog window shows the selected language and the label for the voice output. B.6 If your syngo Acquisition Workplace includes a volume display, the dialog includes a bar to monitor the volume. To start recording, click this button in the Record Voice dialog window. Record your new instructions via the microphone of the intercom. The duration of the recording is displayed (max. 30 s). B.6 End recording with this button in the Record Voice dialog window. B.6-4 MR D13 - System and data management

229 B.6 B.6 B.6 Managing voice outputs B.6 Testing voice output B.6 Check the voice output with this button. Identical to examinations, the voice outputs are played back via the loudspeaker or the headphones. B.6 Changing voice outputs B.6 On the Instruction selection list of the Organize Voice Output dialog window, select the instructions you want to change. ( Page B.6-8 Organize Voice Output) Click this button. The Confirm Record dialog window is displayed. B.6 Open the Record Voice dialog window with Yes. You can now record the patient instructions. B.6 ( Page B.6-4 Recording new voice outputs) B.6 syngo MR D13 B.6-5

230 syngo B.6 B.6 B.6 B.6 B.6 System administration and configuration Deleting user-defined voice outputs B.6 You can delete voice outputs that are no longer required. B.6 If you delete a voice output needed for the automatic instruction of program steps, you must give the patient instructions via the intercom while processing the respective program steps. Default voice output may not be deleted. The changes you make in the Organize Voice Output dialog window are implemented immediately. It is not possible to undo them. Deleting a voice output from the current language B.6 On the Instruction selection list of the Organize Voice Output dialog window, select the instructions you want to delete. ( Page B.6-8 Organize Voice Output) Click this button. The Confirm Delete dialog window opens. B.6 The button is active only when you locate a voice output for the respective instruction. Click Yes. B.6-6 MR D13 - System and data management

231 B.6 Managing voice outputs B.6 The loudspeaker icon in front of the label disappears and the voice output is no longer available in the selected language. Deleting voice outputs in the current language does not automatically delete them in other languages. B.6 Deleting a voice output from all languages B.6 On the Instruction selection list of the Organize Voice Output dialog window, select the instructions you want to delete. ( Page B.6-8 Organize Voice Output) Click Delete. The Confirm Delete dialog window opens. B.6 The button is not active if a default instruction is selected. Click Yes. The voice output is deleted from all languages and the label is removed from the instruction list. B.6 syngo MR D13 B.6-7

232 syngo B.6 System administration and configuration UI explanation B.6 Organize Voice Output B.6 The Instruction selection list of the Organize Voice Output dialog window uses a loudspeaker symbol to identify files that are available on your MR system. You can now record additional commands. B.6 Queue > Voice Output > Organize B.6 B.6-8 MR D13 - System and data management

233 Default User-defined Manages Managing voice outputs B.6 (1) B.6 voice output (black) B.6 (2) B.6 voice output (blue) B.6 (3) B.6 voice outputs. B.6 syngo MR D13 B.6-9

234 syngo The B.6 B.6 System administration and configuration Exam UI Configuration - Voice Output B.6 NUMARIS/4 - Configuration Panel > Patient Comfort > Voice Output B.6 (1) B.6 Patient Primary Language selection list determines the language of the voice output. B.6 Select languages only if your MR system contains at least one patient instruction in this language. B.6-10 MR D13 - System and data management

235 The The The Managing voice outputs B.6 (2) B.6 Playback Volume slider increases/decreases the volume of the voice output in the examination room. B.6 (3) B.6 Test selection list determines the voice output for testing. B.6 (4) B.6 Record Volume slider increases/decreases the volume of the voice outputs. B.6 syngo MR D13 B.6-11

236 syngo Regulates Regulates B.6 System administration and configuration Patient Comfort Configuration - Sound Volume B.6 NUMARIS/4 - Configuration Panel > Patient Comfort B.6 (1) B.6 the volume of the ECG sound B.6 (2) B.6 the volume between patient and operator B.6 B.6-12 MR D13 - System and data management

237 Regulates Adjusts Regulates Regulates Managing voice outputs B.6 (3) B.6 the volume between operator and patient B.6 (4) B.6 the balance between the inroom loudspeaker and the headphone of the patient B.6 (5) B.6 the volume of the music (inroom loudspeaker) B.6 (6) B.6 the volume of the music (headphone) B.6 syngo MR D13 B.6-13

238 syngo System administration and configuration B.6-14 MR D13 - System and data management

239 Diagnostic Configuring reports B.7 Configuring reports B.7 General information B.7 For a report, you use defaults on two subtask cards for generating reports via the configuration dialog window: B.7 General settings (language/user logo) Code catalogs (diagnostic code catalog for Argus or Mean Curve reports) Diagnostic codes B.7 Diagnostic code B.7 codes are used in the Conclusion part of the report. B.7 The complete code consists of the code value (N11.1) followed by a colon and a short description of the code (chronic obstructive pyelonephritis). B.7 Input example: B.7 N11.1:chronic obstructive pyelonephritis B.7 syngo MR D13 B.7-1

240 syngo The Identifier B.7 System administration and configuration Display format B.7 display format specifies how the diagnostic codes are displayed in the report. It is defined in the lookup table ( Example). B.7 Input example: B.7 DisplayFormat = 2 B.7 Display format B.7 B.7 Code value and code description e.g. B.7 N11.1:Chronic obstructive pyelonephritis B.7 0 B.7 Code value only e.g. B.7 N11.1 B.7 1 B.7 Code description only e.g. B.7 Chronic obstructive pyelonephritis B.7 2 B.7 B.7-2 MR D13 - System and data management

241 Entering B.7 Configuring reports B.7 Example B.7 a diagnostic code and a display identifier in the lookup table: B.7 Lines preceded by a # are comment lines. In all other lines, you can define the required codes - one code per line. B.7 To activate the settings, save the changes in the text editor (not to be confused with the Report - Configuration dialog window). B.7 syngo MR D13 B.7-3

242 syngo System administration and configuration Tasks B.7 Configuring reports B.7 Patient Browser is open Select Applications > Report Tools > Report Configuration. The Report Configuration dialog window opens. B.7 Setting the language B.7 Select the language from the Report Language selection list on the General Settings tab card. Setting the logo of your institution B.7 The logo is used for all saved reports. B.7 Logo is stored as Logo.gif on CD Insert this data medium into the appropriate drive on your station. Install the logo with the Install Logo from... button on the General Settings tab card. The logo is read in and you receive a message about successful installation. B.7 B.7-4 MR D13 - System and data management

243 Configuring reports B.7 Changing or creating a new diagnostic code B.7 A code catalog may contain different diagnostic codes. This enables you to select diagnostic codes in the report quickly. B.7 Select the code catalog you want to edit. Click Edit Codes. The text editor for the codes of the active catalog opens. You can define the codes you require. B.7 Open File > Save in the text editor. The inputs are saved and you can close the text editor. B.7 syngo MR D13 B.7-5

244 syngo System administration and configuration B.7-6 MR D13 - System and data management

245 B.8 Adjusting the system manually B.8 Adjusting the system manually B.8 General information B.8 Manual adjustment B.8 Manual adjustments of the MR system prior to the application measurement are intended primarily for test purposes, for error analysis, or for special applications such as Spectroscopy. Through manual shimming, experienced users can compensate for magnetic field inhomogeneities. B.8 Manual adjustment of the system should only be performed by experienced users and should not be performed during routine operation. syngo MR D13 B.8-1

246 syngo System administration and configuration Tasks B.8 Determining the resonance frequency B.8 With this optimizing process, you determine the exact proton resonance frequency. For this purpose, you enter various parameters and accept the frequency calculated for the MR system following the adjustment. B.8 No other protocols are planned or running before this protocol. Open the protocol in the program control. The parameters of the protocol are shown. B.8 Select Options > Adjustments. The Manual adjustments dialog window opens. B.8 Open the Frequency parameter card. Define the parameters to optimize the frequency. ( Page B.8-9 Manual adjustments - Frequency) Start the measurement with Go. The numeric results are listed beside the running numbers. B.8 The results are displayed graphically in both the time and the frequency domain. B.8 B.8-2 MR D13 - System and data management

247 Adjusting the system manually B.8 Calibrating the transmitter B.8 The transmitter calibration process refers to a range at the isocenter. The reference amplitude is continuously varied until the spins are rotated by 180 (flip angle) by the RF pulse. Two echoes are generated, one normal echo and one stimulated echo. The magnitude and the phase relation of both echoes are directly related to the flip angle. B.8 No other protocols are planned or running before this protocol. Open the protocol in the program control. The parameters of the protocol are shown. B.8 Select Options > Adjustments. The Manual adjustments dialog window opens. B.8 Open the Transmitter parameter card. Define the parameters to calibrate the transmitter. ( Page B.8-14 Manual adjustments - Transmitter) Start the measurement with Go. The numeric results are listed below the running numbers. B.8 The results are displayed graphically in both the time and the frequency domain. B.8 syngo MR D13 B.8-3

248 syngo B.8 B.8 System administration and configuration Performing 3D shim B.8 With the 3D shim you can correct inhomogeneities of the magnetic field. B.8 No other protocols are planned or running before this protocol. Open the protocol in the program control. Select Options > Adjustments. The Manual adjustments dialog window opens. B.8 Open the 3D Shim parameter card. Select a field map sequence and resolution. ( Page B.8-19 Manual adjustments - 3D shim) Create a three-dimensional field map with Measure. The magnitude and phase values are graphically displayed. B.8 Depending on the sequence and resolution, the measurement can take more than 10 s. Calculate the new shim parameters with Calculate. The numeric results are listed beside the running numbers. B.8 The results are stored as temporary values and are used as the basis for the next field map measurement. B.8-4 MR D13 - System and data management

249 B.8 Adjusting the system manually B.8 To accept the temporary parameters for the MR system, click Apply in the lower part of the 3D-Shim parameter card. After changing the shim setting, readjust the frequency. If skipped, the system adjusts the frequency automatically. Performing interactive shim B.8 During interactive shim, inhomogeneities of the magnetic field are compensated for. You can enter the shim parameters and monitor the measurement of the MR signal in real time. B.8 Changes of the parameters are reflected in the results of the following MR signal measurement. You can continue shimming the magnetic field until it meets your requirements. B.8 No other protocols are planned or running before this protocol. Open the protocol in the program control. Select Options > Adjustments. The Manual adjustments dialog window opens. B.8 Open the Interactive Shim parameter card. Define the parameters for the interactive shim. ( Page B.8-24 Manual adjustments - Interactive shim) Start the measurement with Measure. syngo MR D13 B.8-5

250 syngo B.8 B.8 System administration and configuration The numeric results are listed beside the running numbers. B.8 The results are displayed graphically in both the time and the frequency domain. B.8 The measurement is performed continuously with the current parameters (endless loop measurement). The parameters can be changed while the measurement is in progress. Stop the measurement with Stop. To accept the temporary parameters for the MR system, click Apply in the lower part of the Interactive-Shim parameter card. After changing the shim setting, readjust the frequency. If skipped, the system adjusts the frequency automatically. B.8-6 MR D13 - System and data management

251 Adjusting the system manually B.8 Optimizing water suppression B.8 There are special RF pulses used for water suppression during measurements. With this adjustment, you determine a correction factor for the transmitter amplitude of these RF pulses. Within the adjustment volume, the flip angles are set for optimal suppression of the water signal. B.8 No other protocols are planned or running before this protocol. Open the protocol in the program control. Select Options > Adjustments. The Manual adjustments dialog window opens. B.8 Open the Water suppression parameter card. Define the parameters for the water suppression. ( Page B.8-29 Manual adjustments - Water suppression) Start the measurement with Go. Depending on the system configuration, the measurement can take more than 10 s. B.8 The results are displayed graphically in both the time and the frequency domain. B.8 syngo MR D13 B.8-7

252 syngo System administration and configuration Checking the resonance frequency after inline adjustment B.8 Inline frequency adjustment is performed automatically before each measurement. The user has no influence on this adjustment. However, the user can configure the system to stop and open a dialog window after each inline frequency adjustment. In the Confirm Frequency Adjustment dialog window, the user can confirm or change the resonance frequency calculated by the adjustment. B.8 Open the requested protocol in the program control area. Select the System - Adjustments parameter card. Activate the Confirm frequency adjustment checkbox. After the final inline frequency adjustment, the Confirm Frequency Adjustment dialog window opens. ( Page B.8-35 Confirm Frequency Adjustment) B.8 Enter the new resonance frequency in the Frequency (temp) field. Accept the new resonance frequency for the MR system with Apply. Start the measurement with Continue. B.8-8 MR D13 - System and data management

253 B.8 Adjusting the system manually B.8 UI explanation B.8 Manual adjustments - Frequency B.8 Options > Adjustments B.8 syngo MR D13 B.8-9

254 syngo Lists Defines Displays Description Running Transmitter Old Difference New New B.8 B.8 System administration and configuration (1) B.8 numeric results of the adjustment. B.8 Column B.8 B.8 No B.8 number of the adjustment measurement B.8 Amplitude [V] B.8 Frequency (old) [Hz] B.8 Delta [Hz] B.8 Frequency (new) [Hz] B.8 Converged B.8 amplitude of the adjustment measurement B.8 resonance frequency B.8 between the old resonance frequency and the new calculated frequency B.8 calculated resonance frequency B.8 resonance frequency was successfully calculated and(!) is suitable for the application measurement. B.8 (2) B.8 the coil element and receiver channel (ADC) for the graphic displays. B.8 The Combined entry is used to select the combined signal of all measurement signals. This signal is actually evaluated during the adjustment. (3) B.8 the real part of the selected measurement signal in the time domain. B.8 Displays the maximum magnitude of all measurement signals (MAX) and the selected measurement signal (Max) in the time domain numerically. B.8 If a new resonance frequency was successfully calculated, it is highlighted by a marker at the top of the display. B.8 B.8-10 MR D13 - System and data management

255 Displays Displays Displays B.8 B.8 Adjusting the system manually B.8 (4) B.8 the imaginary part of the selected measurement signal in the time domain. B.8 (5) B.8 the amplitude of the selected measurement signal in the frequency domain. B.8 Displays the maximum magnitude of all measurement signals (MAX) and the selected measurement signal (Max) in the frequency domain numerically. B.8 (6) B.8 the phase of the selected measurement signal in the frequency domain. B.8 You can invert the direction of the frequency axes or zoom into details of the frequency domain via the context menu of the display. It is possible to graphically select a frequency. For this purpose, a vertical cursor is shown when the mouse pointer is positioned inside the display of the frequency domain. A tooltip indicates the difference between the cursor position and the marked frequency. syngo MR D13 B.8-11

256 syngo Applies Starts Displays Defines Defines Defines B.8 B.8 System administration and configuration (7) B.8 the current temporary resonance frequency as the system frequency. B.8 A manually applied system frequency is highlighted by a red vertical line in the display of the frequency domain. (8) B.8 the adjustment measurement. B.8 (9) B.8 the system resonance frequency used for the application measurement. B.8 (10) B.8 the temporary resonance frequency used for the adjustment measurement. B.8 If a new resonance frequency was calculated successfully, it is automatically stored as the temporary frequency. If the new resonance frequency is also suitable for the application measurement and(!) the final shim has been determined, it is automatically stored as the system frequency. (11) B.8 the transmitter amplitude for the adjustment. B.8 (12) B.8 the sequence and resolution. B.8 The selection list contains the following options: B.8 Narrowband volume-selective (STEAM 10 Hz) Narrowband not volume-selective (FID 10 Hz) Broadband not volume-selective (FID 400 Hz) B.8-12 MR D13 - System and data management

257 Defines Defines B.8 B.8 B.8 Adjusting the system manually B.8 If the resonance frequency lies outside the narrowband range (no resonance line in the spectrum), it is recommended to search a broad frequency band first. To adjust the frequency in detail, you must work with a narrowband sequence afterwards. For safety reasons, the system frequency must be determined by a volume-selective adjustment sequence if it is not applied manually. (13) B.8 the receiver gain during the acquisition of the measurement signal. B.8 Low Reduces the amplitude of the measurement signal. B.8 High Increases the amplitude of the measurement signal. B.8 If necessary, the system adjusts this setting automatically. (14) B.8 if the adjustment uses the same physiological triggering as the application measurement. B.8 syngo MR D13 B.8-13

258 syngo B.8 System administration and configuration Manual adjustments - Transmitter B.8 Options > Adjustments B.8 B.8-14 MR D13 - System and data management

259 Lists Defines Displays Description Running Receiver Old Integral Phase Integral Phase Projection Calculated New New B.8 Adjusting the system manually B.8 (1) B.8 numeric results of the adjustment. B.8 Column B.8 B.8 No B.8 number of the adjustment measurement B.8 ADC B.8 channel of subresults B.8 Ampl (old) [V] B.8 Int1 B.8 Pha1 B.8 Int2 B.8 Pha2 B.8 Int2 Int1 B.8 Angle [deg] B.8 Ampl (new) [V] B.8 Converged B.8 transmitter reference amplitude B.8 of the first echo in the frequency domain B.8 of the first echo in the frequency domain B.8 of the second echo in the frequency domain B.8 of the second echo in the frequency domain B.8 of the second on the first integral B.8 flip angle B.8 calculated transmitter reference amplitude B.8 transmitter amplitude was successfully calculated and(!) is suitable for the application measurement. B.8 (2) B.8 the coil element and receiver channel (ADC) for the graphic displays. B.8 (3) B.8 the real part of the selected measurement signal in the time domain. B.8 Displays the maximum magnitude of all measurement signals (MAX) and the selected measurement signal (Max) in the time domain numerically. B.8 syngo MR D13 B.8-15

260 syngo Displays Displays Displays Applies Starts B.8 System administration and configuration (4) B.8 the imaginary part of the selected measurement signal in the time domain. B.8 (5) B.8 the amplitude of the selected measurement signal in the frequency domain. B.8 Displays the maximum magnitude of all measurement signals (MAX) and the selected measurement signal (Max) in the frequency domain numerically. B.8 (6) B.8 the phase of the selected measurement signal in the frequency domain. B.8 You can invert the direction of the frequency axes or zoom into details of the frequency domain via the context menu of the display. (7) B.8 the current temporary reference amplitude as the system reference amplitude. B.8 (8) B.8 the adjustment measurement. B.8 B.8-16 MR D13 - System and data management

261 Displays Defines Displays Defines B.8 Adjusting the system manually B.8 (9) B.8 the system reference amplitude used for the application measurement. B.8 (10) B.8 the temporary reference amplitude used for the adjustment measurement. B.8 If a new reference amplitude was calculated successfully, it is automatically stored as a temporary reference amplitude. If the new reference amplitude is also suitable for the application measurement, it is automatically stored as the system reference amplitude. (11) B.8 the transmitter amplitude (specific parameter of the transmitter coil) used for the first inline adjustment iteration. B.8 (12) B.8 sequence and resolution. B.8 The selection list contains the following options: B.8 Double echo (DblEcho) Double Echo with enhanced 1D resolution (DblEcho1D) syngo MR D13 B.8-17

262 syngo Defines B.8 System administration and configuration (13) B.8 the receiver gain during the acquisition of the measurement signal. B.8 Low Reduces the amplitude of the measurement signal. B.8 High Increases the amplitude of the measurement signal. B.8 If necessary, the system adjusts this setting automatically. B.8-18 MR D13 - System and data management

263 B.8 Adjusting the system manually B.8 Manual adjustments - 3D shim B.8 Options > Adjustments B.8 syngo MR D13 B.8-19

264 syngo Lists Defines Displays Description Running First New B.8 B.8 B.8 System administration and configuration (1) B.8 numeric results of the adjustment. B.8 Column B.8 No B.8 B.8 number of the adjustment measurement or calculation B.8 A11, B11 A10 [µt/m] B.8 order (linear) gradients from adjustment calculation B.8 A20, A21, B21, A22, B22 B.8 Second order shim currents from adjustment calculation B.8 [µt/m 2 ] B.8 Converged B.8 field map was successfully measured or new shim parameters were successfully calculated. B.8 (2) B.8 the coil element and receiver channel (ADC) for the graphic displays. B.8 The Combined entry is used to select the combined signal of all measurement signals. This signal is actually evaluated during the adjustment. (3) B.8 the magnitude and phase information of the selected measurement signal composed in a 2D image. B.8 The brightness and contrast of the magnitude and phase images can be modified interactively. Keep the middle mouse button pressed in the display and use horizontal movements to change the brightness and vertical movements to change the contrast. A double-click with the middle mouse button restores the default settings. B.8-20 MR D13 - System and data management

265 Displays Displays Applies Starts Defines Defines B.8 Adjusting the system manually B.8 (4) B.8 the system field map used for the application measurement. B.8 (5) B.8 the temporary field map used for the adjustment calculation. B.8 (6) B.8 the current temporary field map as system field map. B.8 If a new field map was measured successfully, it is automatically stored as a temporary field map. (7) B.8 the adjustment measurement. B.8 (8) B.8 the transmitter amplitude for the adjustment measurement. B.8 (9) B.8 the sequence and resolution. B.8 The selection list contains the following options: B.8 Double Echo Steady State Standard (DESS Std) Double Echo Steady State Advanced (DESS Adv) Gradient Echo Standard (GRE Std) syngo MR D13 B.8-21

266 syngo Defines Applies Calculates Loads Loads B.8 System administration and configuration (10) B.8 the receiver gain during the acquisition of the measurement signal. B.8 Low Reduces the amplitude of the measurement signal. B.8 High Increases the amplitude of the measurement signal. B.8 If necessary, the system adjusts this setting automatically. (11) B.8 the current temporary shim parameters as system shim parameters. B.8 (12) B.8 new temporary shim parameters from the current temporary field map. B.8 (13) B.8 the shim parameters determined by the system tune-up as temporary shim parameters. B.8 (14) B.8 the system shim parameters as temporary shim parameters. B.8 B.8-22 MR D13 - System and data management

267 Defines Defines B.8 Adjusting the system manually B.8 (15) B.8 the temporary shim parameters used for the adjustment measurement. B.8 A00 Transmitter frequency. B.8 A11, B11, and A10 First order (linear) gradients. B.8 A20, A21, B21, A22, and B22 Second order shim currents. B.8 If new shim parameters were calculated successfully, they are automatically stored as temporary shim parameters. (16) B.8 the system shim parameters used for the application measurement. B.8 syngo MR D13 B.8-23

268 syngo B.8 System administration and configuration Manual adjustments - Interactive shim B.8 Options > Adjustments B.8 B.8-24 MR D13 - System and data management

269 Lists Defines Description Running Transmitter Integral Transverse Width Indicates The B.8 B.8 Adjusting the system manually B.8 (1) B.8 numeric results of the adjustment. B.8 Column B.8 B.8 No B.8 number of the adjustment iteration B.8 Amplitude [V] B.8 Int P B.8 T2* [ms] B.8 FWHM [Hz] B.8 Tendency B.8 Best Shim B.8 amplitude of the adjustment measurement B.8 of the amplitude of the combined signal in the time domain B.8 relaxation time (approximation) B.8 of the frequency peak at half of its maximum amplitude (Full Width Half Maximum) B.8 whether the shim parameter changes result in shim improvement (+) or degradation (-) or whether the status remains the same (o). B.8 bottom line represents the best shim parameters, yielding the longest T2* time. B.8 (2) B.8 the coil element and receiver channel (ADC) for the graphic displays. B.8 The Combined entry is used to select the combined signal of all measurement signals. This signal is actually evaluated during the adjustment. syngo MR D13 B.8-25

270 syngo Displays Displays Displays Displays Defines System administration and configuration (3) B.8 the amplitude of the selected measurement signal in the time domain. B.8 Displays the maximum magnitude of all measurement signals (MAX) and the selected measurement signal (Max) in the time domain numerically. B.8 (4) B.8 the real part of the selected measurement signal in the time domain. B.8 (5) B.8 the amplitude of the selected measurement signal in the frequency domain. B.8 Displays the maximum magnitude of all measurement signals (MAX) and the selected measurement signal (Max) in the frequency domain numerically. B.8 (6) B.8 the phase of the selected measurement signal in the frequency domain. B.8 (7) B.8 the transmitter amplitude for the adjustment. B.8 B.8-26 MR D13 - System and data management

271 Defines Defines Starts Defines Applies Loads Loads B.8 Adjusting the system manually B.8 (8) B.8 the receiver gain during the acquisition of the measurement signal. B.8 Low Reduces the amplitude of the measurement signal. B.8 High Increases the amplitude of the measurement signal. B.8 If necessary, the system adjusts this setting automatically. (9) B.8 if the adjustment uses the same physiological triggering as the application measurement. B.8 (10) B.8 the adjustment measurement. B.8 (11) B.8 the size of increments to the shim parameters. B.8 (12) B.8 the current temporary shim parameters as system shim parameters. B.8 (13) B.8 the shim parameters determined by the system tune-up as temporary shim parameters. B.8 (14) B.8 the system shim parameters as temporary shim parameters. B.8 syngo MR D13 B.8-27

272 syngo Loads Resets Defines Defines B.8 B.8 System administration and configuration (15) B.8 the current best shim parameters as temporary shim parameters. B.8 (16) B.8 the current best shim parameters. B.8 (17) B.8 the temporary shim parameters used for the adjustment measurement. B.8 A00 Transmitter frequency. B.8 A11, B11, and A10 First order (linear) gradients. B.8 A20, A21, B21, A22, and B22 Second order shim currents. B.8 If new shim parameters were calculated successfully, they are automatically stored as temporary shim parameters. (18) B.8 the system shim parameters used for the application measurement. B.8 Changes of the shim parameters and their increments are possible while the measurement is in progress. B.8-28 MR D13 - System and data management

273 B.8 Adjusting the system manually B.8 Manual adjustments - Water suppression B.8 Options > Adjustments B.8 syngo MR D13 B.8-29

274 syngo Lists Defines Defines Displays Description Running Transmitter Old Signal Signal Signal New New B.8 System administration and configuration (1) B.8 numeric results of the adjustment. B.8 Column B.8 B.8 No B.8 number of the adjustment measurement B.8 Amplitude [V] B.8 Factor (old) B.8 Signal - B.8 Signal ± 0 B.8 Signal + B.8 Factor (new) B.8 Converged B.8 amplitude of the adjustment measurement B.8 correction factor B.8 strength of repetition using best correction factor minus one increment B.8 strength of repetition using best correction factor B.8 strength of repetition using best correction factor plus one increment B.8 calculated correction factor B.8 correction factor was successfully calculated and(!) is suitable for the application measurement B.8 (2) B.8 the coil element and receiver channel (ADC) for the graphic displays. B.8 (3) B.8 the repetition for the graphics display. B.8 (4) B.8 the amplitude of the selected measurement signal and repetition in the time domain. B.8 Displays the maximum magnitude of all measurement signals (MAX) and the selected measurement signal (Max) in the time domain numerically. B.8 B.8-30 MR D13 - System and data management

275 Displays Displays Displays Defines Displays B.8 Adjusting the system manually B.8 (5) B.8 the phase of the selected measurement signal and repetition in the time domain. B.8 (6) B.8 the amplitude of the selected measurement signal and repetition in the frequency domain. B.8 Displays the maximum magnitude of all measurement signals (MAX) and the selected measurement signal (Max) in the frequency domain numerically. B.8 (7) B.8 the phase of the selected measurement signal and repetition in the frequency domain. B.8 (8) B.8 the temporary correction factor used for the adjustment measurement. B.8 (9) B.8 the system correction factor used for the application measurement. B.8 If a new correction factor was calculated successfully, it is automatically stored as a temporary correction factor. If the new correction factor is also suitable for the application measurement, it is automatically stored as the system correction factor. syngo MR D13 B.8-31

276 syngo Applies Starts Displays Defines Defines B.8 B.8 B.8 System administration and configuration (10) B.8 the current temporary correction factor as the system correction factor. B.8 (11) B.8 the adjustment measurement. B.8 The adjustment measurement is only possible after a transmitter reference amplitude has been determined. (12) B.8 the system reference amplitude used for the application measurement. B.8 (13) B.8 the receiver gain during the acquisition of the measurement signal. B.8 Low Reduces the amplitude of the measurement signal. B.8 High Increases the amplitude of the measurement signal. B.8 If necessary, the system adjusts this setting automatically. (14) B.8 the increment for the correction factor during the repetitions of the adjustment measurement. B.8 By modifying the increment, you can change the resolution of the adjustment. B.8-32 MR D13 - System and data management

277 B.8 B.8 Adjusting the system manually B.8 Manual adjustments - Show B.8 Options > Adjustments B.8 This information is primarily intended for diagnostic purposes. It is always displayed in English. syngo MR D13 B.8-33

278 syngo Displays Selects Starts Invalidates System administration and configuration (1) B.8 all adjustment results for the selected application protocol. B.8 (2) B.8 the displayed depth of information. B.8 (3) B.8 all inline adjustments for the selected application protocol. B.8 (4) B.8 all adjustment results stored in the system. B.8 B.8-34 MR D13 - System and data management

279 Displays B.8 B.8 Adjusting the system manually B.8 Confirm Frequency Adjustment B.8 (1) B.8 the amplitude of the selected measurement signal in the frequency domain. B.8 It is possible to graphically select a frequency. For this purpose, a vertical cursor is shown when the mouse pointer is positioned inside the display of the frequency domain. A tooltip indicates the difference between the cursor position and the marked calculated new resonance frequency. syngo MR D13 B.8-35

280 syngo Defines Displays Defines Starts Applies B.8 B.8 System administration and configuration (2) B.8 the coil element and receiver channel (ADC) for the graphic displays. B.8 The Combined entry is used to select the combined signal of all measurement signals. This signal is actually evaluated during the adjustment. (3) B.8 the system resonance frequency used for the application measurement. B.8 (4) B.8 the temporary resonance frequency used for the adjustment measurement. B.8 (5) B.8 the application measurement. B.8 (6) B.8 the current temporary resonance frequency as system frequency. B.8 The system frequency manipulation via Apply could cause an unknown slice shift. A note to that effect in the Confirm Frequency Adjustment dialog window informs you about this. B.8-36 MR D13 - System and data management

281 Insuffienct B.9 B.9 B.9 Expert-i B.9 Expert-i B.9 Safety B.9 General safety information B.9 During examinations, you are required to adhere to the safety measures as described in the Safety chapter of the system manual. CAUTION B.9 image quality of the remote computer! Incorrect interpretation of the MR images Do not use the remote computer for diagnoses or reports. syngo MR D13 B.9-1

282 syngo Remote B.9 B.9 System administration and configuration CAUTION B.9 user does not adhere to the currently valid safety guidelines! Hazard. Patient injury due to uncontrolled actions of the remote user. Possible injury to patient due to missing control or absence of local user. As the local user, you are responsible for the patient during the entire examination. Remain continuously at the MR console and monitor the actions of the remote user. Remain continuously in touch with the remote user via telephone. Stop the patient table if hazardous conditions are present for the patient or terminate the entire measurement sesquence (e.g. via the table STOP /sequence termination at the intercom). Interrupt the remote connection in case of uncontrolled actions by the remote user. B.9-2 MR D13 - System and data management

283 Remote Each Expert-i B.9 Description B.9 The syngo Expert i software supports local users at the MR console via experts (e.g. physicians) outside the examination room (for example, at a remote networked PC). B.9 Functionality B.9 access is handled via a suitable computer (remote computer) connected to the local network. B.9 For remote access, the remote user has to register at the MR console. For this purpose, he needs a password. B.9 This password is generated by the syngo Expert i software and is only applicable for the registration planned. B.9 In this case, the system can be operated at the MR console as well as the remote computer. B.9 HIPAA audit trail B.9 time you use the syngo Expert i software, the protocol inputs are entered into the HIPAA audit trail. B.9 The inputs are generated when you perform the following actions: B.9 The local user syngo Expert i activates the software. The remote user successfully established the remote connection. The remote connection was not established within the time reserved for this purpose. The local user or the remote user disconnected the remote connection. syngo MR D13 B.9-3

284 syngo The System administration and configuration Software installation B.9 syngo Expert i software can only be used in conjunction with the released versions of the syngo software. B.9 The released versions are listed on the front page of this document. B.9 The syngo Expert i software needs to be installed and configured by Siemens Service on the MR system as well as the designated remote computer. The syngo Expert i software is integrated in the MR system by Numaris/4 installation. B.9 B.9-4 MR D13 - System and data management

285 The Current 850 Windows x > <30 B.9 B.9 B.9 Expert-i B.9 Minimum requirements B.9 following minimum requirements must be met for the remote computer and the local network: B.9 Computer hardware B.9 standard hardware B.9 Processor B.9 MHz B.9 Operating system B.9 NT4.0, XP B.9 Primary storage B.9 MB B.9 Network card B.9 Mbit/s B.9 Graphic card, monitor B.9 B.9 Color B.9 bit B.9 Local network B.9 Mbit/s or higher B.9 Min. transfer rate B kb/s B.9 Response time B.9 ms B.9 When falling beyond the minimum requirements, the performance and display of the remote computer may be adversely affected. syngo MR D13 B.9-5

286 syngo B.9 System administration and configuration Operation B.9 Perform the following steps to access the MR console: syngo Expert i B.9 Activate the syngo Expert i software at the MR console Transfer the password to the remote user Establish a connection at the remote computer. As the local user, you are responsible for the patient during the entire examination. Do not leave the MR console at any time during remote connection and monitor the actions of the remote user. Local user: Activate software B.9 To ensure that the remote user can access the MR console, the local user must first activate the syngo Expert i software at the MR console. B.9 The syngo Expert i software is installed on the MR system. Call the remote user to request the initiation of a remote connection. B.9-6 MR D13 - System and data management

287 B.9 B.9 B.9 B.9 Expert-i B.9 Activate the syngo Expert i software by clicking the tray icon. The syngo Expert i dialog window is opened; a four-digit password is displayed. B.9 Dialog window of the MR console (2) The password displayed is only valid once - for the next registration. The syngo Expert i software generates a new password for every registration. Local user: Transferring the password B.9 Confirm the message with OK and activate the syngo Expert i software with this message. Communicate the generated password to the remote user. While the local user is waiting for registration of the remote user, the tray icon is changing. B.9 syngo MR D13 B.9-7

288 syngo B.9 B.9 System administration and configuration Local user: Establishing the connection B.9 After the local user has activated the syngo Expert i software at the MR console, the remote user has 2 minutes to establish the remote connection. B.9 The local user must select whether the remote user should have Full Access or View Only access to the MR console. B.9 If he exceeds the allocated time, the local user has to request a new password. In this case, you have to start the syngo Expert i software again. The syngo Expert i software is installed at the remote computer. You received the password from the local user. Start the syngo Expert i software via the program icon or a link at the remote computer. The location of the link depends on the installation of the software on the remote computer. B.9-8 MR D13 - System and data management

289 B.9 B.9 Expert-i B.9 Remote user: Entering a password and registering at the MR system B.9 Entering the password at the remote computer (3) Enter the password and click Log On. The active connection is shown by the tray icon of the syngo Expert i software at the MR console. B.9 The screen of the remote computer shows the user interface of the MR console. The remote user is now able to access the MR console. B.9 Local user: Disconnecting the remote connection B.9 The local user can disconnect the remote connection at any time. B.9 Press the key combination Ctrl+Alt+Del to disconnect the remote connection immediately. or B.9 Click the tray icon of the syngo Expert i software to display the dialog window. Click syngo Expert i in the dialog window and press Terminate. The remote connection is disconnected. The tray icon shows that the connection is down. B.9 syngo MR D13 B.9-9

290 syngo B.9 System administration and configuration Remote user: Disconnecting the active connection B.9 The remote user can disconnect the active connection at any time. B.9 Click the symbol to close the window which is shown when you move the mouse in the upper right corner of the screen. or B.9 Click the tray icon of the syngo Expert i software to display the dialog window. Click syngo Expert i in the dialog window and press Terminate. The remote connection is disconnected. B.9 Local user: Installing Expert-i Viewer B.9 The local user can also install the Expert-i Viewer B.9 Click the Expert-i client link in the Expert-i entry in the programs menu. The installation dialog windows opens. B.9 Click Next. The dialog window for the user opens. You can browse to the right directory or type into the entry field. B.9 Click Next after the configuration. The installation is done. B.9 B.9-10 MR D13 - System and data management

291 B.9 Expert-i B.9 Remote user: Using the Expert-i Remote Client B.9 The remote user can use the Expert-i Remote Client to connect to a specific workplace. B.9 Click the Expert-i client link in the startup menu. The syngo Expert-i - Remote Client dialog window opens. B.9 Select New Connection and click Setup to create a new connection. or B.9 Select an existing connection and click Setup to edit an existing connection. syngo MR D13 B.9-11

292 syngo System administration and configuration If you have problems connecting B.9 If the connection on the remote computer fails, the reasons for it may be as follows: B.9 The local user did not activate the syngo Expert i software at the MR console. The following message appears at the remote computer: "Your connection has been rejected. Please contact local user first.". B.9 The remote user entered the wrong password or the time allowed for entering the password exceeded: The following message appears at the remote computer: "Authentication failed!". B.9 The remote computer is unable to establish a connection to the MR console. The following message appears at the remote computer: "Failed to connect to server.". B.9 Check the error sources described and repeat the registration. B.9-12 MR D13 - System and data management

293 B.9 B.9 B.9 B.9 Expert-i B.9 Establishing a connection at the remote computer failed. B.9 The remote user entered the wrong password or he exceeded the time for registration: B.9 Get in touch with the local user and request a new password. Repeat your registration. Establishing a connection at the remote computer failed. B.9 The local user did not activate the syngo Expert i software at the MR console. B.9 Ensure that the local user activated access to the syngo Expert i software. Request that the local user provide you with a new password. Repeat your registration. syngo MR D13 B.9-13

294 syngo B.9 B.9 B.9 System administration and configuration Establishing a connection at the remote computer failed. B.9 The remote computer is unable to establish a connection to the MR console. B.9 Check the network connection from the remote computer to the MR console. Get in touch with your system administrator. If it is still not possible to establish a connection, get in touch with your system administrator or Siemens Service. B.9-14 MR D13 - System and data management

295 Remote B.10 RemoteAssist B.10 RemoteAssist B.10 Description B.10 The syngo RemoteAssist software supports local users at the MR console via Siemens Customer Service. B.10 Do not use the syngo RemoteAssist software function Take over remote control during patient examination! During patient clinical routine it is not allowed to let 3rd persons take over control via the syngo RemoteAssist software. Functionality B.10 access is handled via a suitable computer (remote computer) connected to the local network. B.10 For remote access, the remote user has to register at the MR console. For this purpose, he needs a password. B.10 This password is generated by the syngo RemoteAssist software and is only applicable for the registration planned. B.10 In this case, the system can be operated at the MR console as well as the remote computer. B.10 syngo MR D13 B.10-1

296 syngo Each The HIPAA audit trail B.10 time you use the syngo RemoteAssist software, the protocol inputs are entered into the HIPAA audit trail. B.10 The inputs are generated when you perform the following actions: B.10 The local user syngo RemoteAssist activates the software. The remote user successfully established the remote connection. The remote connection was not established within the time reserved for this purpose. The local user or the remote user disconnected the remote connection. Software installation B.10 syngo RemoteAssist software can only be used in conjunction with the released versions of the syngo software. B.10 The released versions are listed on the front page of this document. B.10 The syngo RemoteAssist software is installed and configured by Siemens Service on the MR system as well as the respective remote computer. B.10 B.10-2 MR D13 - System and data management

297 The Current 850 Windows x > <30 B.10 B.10 B.10 RemoteAssist B.10 Minimum requirements B.10 following minimum requirements must be met for the remote computer and the local network: B.10 Computer hardware B.10 standard hardware B.10 Processor B.10 MHz B.10 Operating system B.10 NT4.0, XP B.10 Primary storage B.10 MB B.10 Network card B.10 Mbit/s B.10 Graphic card, monitor B.10 B.10 Color B.10 bit B.10 Local network B.10 Mbit/s or higher B.10 Min. transfer rate B kb/s B.10 Response time B.10 ms B.10 On failing to meet the minimum requirements, the performance and display of the remote computer may be adversely affected. syngo MR D13 B.10-3

298 syngo B.10 Description B.10 The Remote Assistance Software must be installed on your MR system. Siemens service technicians can support the local user at the MR system e.g. if problems arise or new software has to be installed. B.10 A service technician can acess your system only if you enable him to do so. Unauthorized access is blocked. B.10 B.10-4 MR D13 - System and data management

299 B.10 RemoteAssist B.10 Operation B.10 Usually your service technician informs you if he wants to access your MR system. B.10 You can activate a single connection with a service technician via a menu. B.10 Activating a single connection B.10 Call up Options > Service > Remote Assistance. The following dialog window is displayed: B.10 In this dialog window, you enter a non-assigned session number. B.10 Enter the session number in the input field. If there are sensitive data on your system, a corresponding message is displayed, referring to privacy rules for these data. B.10 Click the Logon button to activate the connection syngo MR D13 B.10-5

300 syngo If B.10 B.10 If remote assistance has been successfully started, the icon (single connection) appears in the status bar. Remote user access to your MR system is in View Only mode with another cursor. The remote user cannot operate your MR system. B.10 If a remote connection could not be established, a corresponding message is displayed on your screen. In this case, contact your service technician. Activate third-party access B.10 another service technician wants to access your MR system, the remote assistance icon in the status bar blinks. B.10 Click the Remote Assistance icon. A corresponding request appears in this dialog window: B.10 B.10-6 MR D13 - System and data management

301 RemoteAssist B.10 If you agree to further access, click OK. or B.10 Click Cancel to cancel the dialog and refuse the request. If remote assistance is started successfully, an icon (multiple connections) is displayed in the status bar. A third party can access your MR system in View Only mode with another cursor and cannot operate your MR system. B.10 Transferring Remote Assistance B.10 Even if several service technicians can access your workstation, there are - at most - two remote users who can access your MR system and you can control the system all the time. If any technician wants to take control of your system, the Remote Assistance icon in the status bar blinks. B.10 Click the Remote Assistance icon in the status bar. The following request is displayed in this dialog window: B.10 syngo MR D13 B.10-7

302 syngo B.10 If you agree to transfer control, click OK. or B.10 Click Cancel to cancel the dialog and refuse the request. If transferring control access is started successfully, the remote user can operate on the MR system. At the same time, there is only one remote user who can operate the MR system. If one remote user is allowed to operate the MR system, another remote user who is operating the MR system will lose control automatically. B.10 B.10-8 MR D13 - System and data management