multimodality image processing workstation Visualizing your SPECT-CT-PET-MRI images

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1 multimodality image processing workstation Visualizing your SPECT-CT-PET-MRI images

FUSION FUSION is a new visualization and evaluation software developed by Mediso built on state of the art technology, novel image processing algorithms and

It provides multimodality registration and fusion of SPECT, PET, CT and MRI studies via several specialized viewers and auto-registration algorithms.

A wide range of function-specialized toolboxes provide a well-detailed, fast and easy evaluation of medical images combining with advanced visualizations

Basic arithmetic operations for image comparisons are supported.

2 FUSION FUSION is a new visualization and evaluation software developed by Mediso built on state of the art technology, novel image processing algorithms and tools to provide an effective and fully flexible way in order to evaluate different medical imaging modalities. It provides multimodality registration and fusion of SPECT, PET, CT and MRI studies via several specialized viewers and auto-registration algorithms. Statistical measurements by ROIs, VOIs are present as well just as SUV representations for PET images. A wide range of function-specialized toolboxes provide a well-detailed, fast and easy evaluation of medical images combining with advanced visualizations and interactions with flexible workspaces. Special segmentation methods are provided to easily extract organs/regions from images. Basic arithmetic operations for image comparisons are supported. Direct reading and recognition of different image modalities from DICOM files, saving processed images and studies in DICOM is provided. FUSION supports operating with workspaces that enclose different layouts for providing logical separation of the data and this way it helps the user focusing on the actual work. With workspaces as many virtual screens are possible as required.

Choosing the study FUSION facilitates loading DICOM files from both DICOM server and local or network drives through the Patient Selector which helps finding the desired studies via several filtering

3 Choosing the study FUSION facilitates loading DICOM files from both DICOM server and local or network drives through the Patient Selector which helps finding the desired studies via several filtering options. Based on the opened study FUSION offers a specified layout for re-presenting the data, although role assigning in case of ambiguity is possible as well. Image loading - Patient selector to find studies or series - Filtering possibility on patient name, date of acquisition, descriptors - Supported file formats: - DICOM 3.0 images from RIS/PACS/DICOM server - DICOM 3.0 images from file - RTSS DICOM RT files - Analyze RAW data - Multiple study selection for comparison - Auto-layout for opened studies - Single and comparative predefined layouts - Supported modalities: SPECT, CT, PET, MRI, SC (Secondary Capture) Patient Selector

4 Visualize, Manage and Evaluate Workspaces Layout Viewers - Add / Remove workspace - Switch between workspaces - Custom layout generation for every workspace - Custom and pre-defined layouts to represent images on workspace - Grid size (rows / columns) definition - Viewer type, modality, palette and orientation preferences - Manipulation - Accurate, fast navigation - Movie functionality with adjustable speed and direction - Moving (translate and zooming in the views) - Common 3D cursor among the same images - Adjustable slice thickness - Zoom any viewer to full screen - Common zoom for all viewers - Free 3D navigation for 3D viewers - Hot keys for special modes - Various viewers for visualization: - Volume viewer: representing volume from a given direction (Axial, Coronal, Sagittal) - Tiled viewer: representing volume slices in row/column format from a given direction (Axial,... Coronal, Sagittal) - Orthogonal viewer: Viewing of slices from the three main orientations (Axial + Coronal + Sagittal) - MIP viewer: Maximum Intensity Projection view of up to 4 volumes - Rendered volume viewer: 3D volume rendering of up to 4 volumes - Chart viewer for ROI/VOI representation - Labels - Histogram viewer to represent volume density functions - Representing DICOM tag information for given image - Displayed PET unit is changeable (SUV modes) - Cursor positions - Modality specific voxel values (HU, Counts, SUV depending on modality) - Customizable level of details (All, Less, None, Custom) 4

5 Fused volume viewer of FDG-PET/CT in axial direction An orthogonal volume viewer in fusion mode A tiled fusion viewer Histogram viewer representing the density function of whole body CT in range -96, 997 HU Chart viewer representing ROI/VOI statistics drawn on attenuation corrected whole body PET

(green) - non-attenuation corrected PET (red) - CT Left: CT Volume Rendering with skin

6 Left: Maximum Intensity Projection (MIP) of whole body PET. Middle: Dual fusion MIP of PET/CT Right: Triple fusion MIP of attenuation corrected PET (green) - non-attenuation corrected PET (red) - CT Left: CT Volume Rendering with skin gradient surface and a cutting plane Middle: CT Volume Rendering and gradient surface of bones. Right: Fused SPECT/CT Volume Rendering 6

palettes in triple fusion: AC PET (green), NAC PET (Red), CT (gray) Whole Body bone SPECT AP - PA

7 18 Melanoma malingnum FDG PET/CT study representation Top row: Attenuation corrected (AC) PET and Non-attenuation corrected (NAC) PET Bottom row: CT and triple fusion of AC PET / NAC PET and CT Color palettes in triple fusion: AC PET (green), NAC PET (Red), CT (gray) Whole Body bone SPECT AP - PA acquititions and their corresponding reconstructed SPECT/CT fusion with spatially aligned synchronized cursors 7

8 Displaying images - Dual / Triple / Quad fusion display of images in all type of image viewers - Support of more monitors / more workspaces - More types of available interpolations (nearest, bilinear, spline, bicubic) - More cursor shapes (none, crosshair, fixed crosshair, side lines, full lines) - 2D or 3D image visualization Paletting - Color schemes / palette windows / alpha functions / non-linear color scaling (log/exp) capabilities - Various factory-default color palettes - Pre-defined palette windows for CT - Custom palettes /palette windows / color scaling parameters / alpha functions given by user - Palette manager to handle factory-default/ user-defines palette presets - Changeable palette preferences for all modalities (default palettes for CT/MRI/PET/SPECT) in both single and fusion viewers - User defined favorite palette for quick accessing Handling image volumes - Extracting and displaying DICOM data - Toggling between Attenuation-Corrected and Non-Attenuation-Corrected PET images - Registration of images: automated / semi-automated / manual registration of images with rigid / affine / non-linear transformations - Object manager tool to easily find and use loaded images - Segmentation of images (lung, lymph-node (optional), cardiac (optional), bone, threshold, ROI based) - Arithmetic manipulations (add, subtract, multiply, minimum, maximum, mean value, absolute difference) Registration - Flexible role selection to register up to 4 images at the same time - Rigid / Affine / Non-linear transformation support - Manual registration: rigid / affine transformations - Semi-automated registration: determining optimal non-linear transformation based on manually given initial point pairs - Automated registration: rigid / affine / non-linear transformations with various optimal parameters - Hiving transformations (several transformations for the same image, one after another) - Saving / Reloading / Showing registration parameters - Saving / Retrieving / registrated images - Real time observing of automated registration process

9 A SPECT/CT dual fusion before and after automated affine registration m I-Na/CT TC-MDP SPECT before and after automated rigid triple fusion 9

10 10 18 Quad fusion of an FDG whole body PET/CT study pair acquired at different time before and after automated non-linear registration

for setting scope for segmentation - Saving segmented and optionally binary results Top row: Original prostate SLN SPECT/CT Bottom row:

11 Segmentation - Manual, semi-automatic and automatic methods: - Roi based segmentation - Threshold segmentation - Bone (CT) segmentation - Lung (CT) semi-automatic segmentation - Automatic lymph-node segmentation - Automatic cardiac segmentation (optional) - Bounding Box for setting scope for segmentation - Saving segmented and optionally binary results Top row: Original prostate SLN SPECT/CT Bottom row: SLN SPECT/CT after automatic sentinel lymph node segmentation Top row: Original CT before segmentation. Bottom row: Bone segmented CT 11

12 Arithmetic operations - Various arithmetic operations performed on chosen images - Add - Subtract - Multiply - Minimum - Maximum - Mean value - Absolute difference - Saving result image Top row: Reference FDG PET Middle row: Follow-up FDG PET Bottom row: Subtraction of first and second row 12

Measurements and ROI - Ruler for measuring distances (more rulers at a time) - 3D (orthogonal plane) distance measuring - Bevel tool for measuring angles (more bevels at a time) - 3D (orthogonal

13 Measurements and ROI - Ruler for measuring distances (more rulers at a time) - 3D (orthogonal plane) distance measuring - Bevel tool for measuring angles (more bevels at a time) - 3D (orthogonal plane) angle measuring - ROIs - Various types ( ellipse, rectangle, polygon, freehand) - Manipulating (moving, rotating, scaling, mirroring) and managing ( copy to other slice, delete) ROIs - VOIs (3D ROIs) - Various types (rectangular, parallelepiped, ellipsoid) - Manipulating (moving, scaling) VOIs - Computing statistics (min, max, mean, volume, standard deviation) - SUV values for PET images - HU values for CT images - Counts values for SPECT / NM images - ROI / VOI table - Detailed ROI / VOI table statistics - Excel compatible calculation board definition based on calculated statistics - Saving / Loading calculation board and ROI / VOI statistics - Daily QC (Quality Check) support Excel compatible calculation board based on the calculated ROI / VOI statistics Exporting - Exporting into various formats: - CD (writing selected DICOM images onto CD-ROM) - Secondary Capture (capturing selected slices / viewers) - Processed (fused, segmented, etc.) DICOM images (CT, PET, SPECT, NM, MRI) - DICOM RT (exporting ROIs into standard DICOM RT format) - AVI, BMP (slices along a direction / MIP rotations / Volume rendering rotations) - Exporting DICOM files to PACS or local directory 13

14 Design and Share FUSION is built on the philosophy of full flexibility enhancing the workflow of all levels of institutions ranging from private labs to academic sites hence it provides customizing the whole view by the user. Whenever the operator wants to create custom layouts with manually defined viewers in them or wants to show and align only those toolboxes needed for the actual work, FUSION will give free hands to build up custom workplaces for the actual needs. Saving and sharing the custom view templates is a basic feature of FUSION. Any time when recovery of predefined views for the particular evaluations, or sharing them on other FUSION workstations are necessary this feature is fully supported. Summary of features - Dual / triple / quad fusion of multimodal images - Layout customization on all workspaces - Define and dock necessary toolboxes for the given workspace - Save/Load customized workspace templates with customized layouts and toolboxes - DICOM communication - Automated rigid / affine / non-linear registration - ROI / VOI statistics and excel compatible calculation table saving / loading Report After finishing the evaluation FUSION provides a report creation including several editing options like zooming, windowing or adding ROI and arrow to the report. Archiving the report to CD or printing it to printer or DICOM printer is supported just as exporting to PDF of HL or secondary capture DICOM format. Summary of features - Live reporting on the fly WYSIWYG report page - All program functionalities on Report page - Editing option after planning in the filmer - Adjust pan&zoom, windowing, etc. - Add ROIs, markers, etc. to images to mark certain areas or points - Burn CD/DVD with selected studies and a viewer version of the program - Support of DICOMDIR format (also DICOM RT Structure optional) - Filmer toolbox to plan the printout - Grid layout for images - Drag & drop images - Batch drop to Filmer toolbox (drops every n slice from a position to a position) - Exchange or delete images easily - Postscript and DICOM printer support - Exporting printout to Secondary Capture 14

Environment In order to give as much details for the study visualizations and evaluation processes as it is possible, FUSION workspace is delivered with

This way the user will never be forced to switch between windows and to loose the focus of his or her work.

8 GHz CPU - nvidia GeForce GTX 460-12 GB RAM - 4 TB HDD - Windows 7 64 bit Ultimate operating system Optional accessories: - nvidia GeForce GTX 480 - Lite

15 Environment In order to give as much details for the study visualizations and evaluation processes as it is possible, FUSION workspace is delivered with extra large 30" + 20" dual monitor. During the evaluation of study on the extra large screen the operator creates report on the side screen in parallel. This way the user will never be forced to switch between windows and to loose the focus of his or her work dual monitor with SPECT/CT study and report - Dual monitor: Intel Core i7 2.8 GHz CPU - nvidia GeForce GTX GB RAM - 4 TB HDD - Windows 7 64 bit Ultimate operating system Optional accessories: - nvidia GeForce GTX Lite Viewer software for CD/DVD reporting - One touch printing, publishing and archiving - Dedicated server with improved performance - Online image archiving with fast Raid connected 4 TB HDD - CD/DVD burner/labeler - Codonics printer for reporting to film or paper 15

16 Conformance Statement Product design, development, production and services comply with ISO 9001:2001 and with ISO 13485:2004. The supplied software conforms to DICOM standard. The technical information provided here is not a detailed specification. For exact details and up to date information please contact your local distributor or Mediso Medical Imaging Systems. Trademarks: FUSION is trademark of MEDISO Medical Imaging Systems. MEDISO Medical Imaging Systems 1022 Budapest, Alsótörökvész 14. Hungary Phone.: Fax.: info@mediso.com Web: MEDISO reserves the right to change data without notice MEDISO Printed in Hungary INTF 08/10

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