Siemens EMOTION 16-6 User Manual
SOMATOM
Emotion 6/16-slice
configuration
Application Guide
Protocols
Principles
Helpful Hints
Software Version syngo CT 2007E
The information presented in this application guide is
for illustration only and is not intended to be relied
upon by the reader for instruction as to the practice of
medicine. Any health care practitioner reading this
information is reminded that they must use their own
learning, training and expertise in dealing with their
individual patients.
This material does not substitute for that duty and is
not intended by Siemens Medical Solutions Inc., to be
used for any purpose in that regard. The drugs and
doses mentioned herein are consistent with the
approval labeling for uses and/or indications of the
drug. The treating physician bears the sole
responsibility for the diagnosis and treatment of
patients, including drugs and doses prescribed in
connection with such use. The Operating Instructions
must always be strictly followed when operating the
MR/CT System. The source for the technical data is the
corresponding data sheets.
The pertaining operating instructions must always be
strictly followed when operating the SOMATOM
Emotion 6/16-slice configuration. The statutory
source for the technical data are the corresponding
data sheets.
We express our sincere gratitude to the many
customers who contributed valuable input.
Special thanks to Christiane Bredenhoeller, Gabriel
Haras, Ute Feuerlein, Jessica Amberg, Thomas Flohr,
Rainer Raupach, Bettina Hinrichsen, Axel Barth,
Kristin Pacheco and the CT-Application Team for their
valuable assistance.
To improve future versions of this application guide,
we would highly appreciate your questions,
suggestions and comments.
Please contact us:
USC-Hotline:
Tel. no. +49-1803-112244
email ct-application.hotline@med.siemens.de
Editors: Wang Jian, Chen Ma Hao
Overview
User Documentation 16
Scan and Reconstruction 18
Dose Information 42
Workflow Information 64
Contrast Medium 122
Application Information 136
Head 162
Neck 204
Shoulder 218
Thorax 226
Abdomen 262
Spine 294
Pelvis 314
Upper Extremities 332
Lower Extremities 346
Vascular 360
Specials 416
Radiation Therapy 462
3
Overview
Respiratory Gating 484
Children 508
4
Overview
5
Contents
User Documentation 16
Scan and Reconstruction 18
• Concept of Scan Protocols 18
• Scan Set Up 19
• Feed in/Feed out 19
• Topo Length 20
• Scan Modes 21
- Sequential Scanning 21
- Spiral Scanning 21
-Quick Scan 22
- Dynamic Multiscan 22
- Dynamic Serioscan 22
• UFC detector 23
• Acquisition, Slice Collimation and Slice Width
- SOMATOM Emotion 16-slice configuration
- SOMATOM Emotion 6-slice configuration 26
• Increment 27
• Pitch 27
• Kernels 28
- Head Kernels 32
- Child Head Kernels 32
-Body Kernels 33
- Special Application Kernels 33
• Extended FoV 34
• Auto-FoV 35
• Neuro Modes 37
• Automatic Bone Correction 38
• Positioning 39
• Image Filters 40
24
25
Dose Information 42
• CTDI
and CTDI
W
• ImpactDose 44
• Effective mAs 45
Vol
6
42
Contents
• CARE Dose 4D 47
- How does CARE Dose 4D work? 49
- Special Modes of CARE Dose 4D 53
- Scanning with CARE Dose 4D 54
- Adjusting the Image Noise 58
- Activating and Deactivating 61
- Conversion of Old Protocols into Protocols
with CARE Dose 4D 61
- Additional Important Information 63
Workflow Information 64
• WorkStream4D 64
- Recon Jobs 64
- 3D Recon 65
- 1. Sagittal/Coronal Reconstructions 71
- 2. Oblique/Double-oblique Reconstructions
- Non-square Matrix for 3D Recon 76
- Case Examples for 3D Recon and Non-Square
Matrix 77
• Workflow 79
- Patient Position 79
- Auto Reference Lines 79
- Navigation within the Topogram 80
-API Language 81
• e - Logbook 83
- e- Logbook Configuration 83
- e- Logbook subtask card area 87
-e- Logbook Browser 88
- Study Continuation 91
- Reconstruction on the syngo CT Workplace
- Examination Job Status 93
- Auto Load in 3D and Postprocessing Presets
• Scan Protocol Creation 96
- Edit/Save Scan Protocol 96
- Scan Protocol Assistant 98
- Manipulate scan protocols 100
71
92
94
7
Contents
- Change parameters 103
- Import scan protocols from SOMATOM
LifeNet/CD 117
Contrast Medium 122
• Contrast Medium 122
- The Basics 122
- IV Injection 125
• Bolus Tracking 126
• Test Bolus using CARE Bolus 128
• Test Bolus 129
- CARE Contrast 130
Application Information 136
• SOMATOM LifeNet 136
- General Information 136
- Key Features 137
- SOMATOM LifeNet offline 138
- SOMATOM LifeNet online 140
• Image Converter 147
• Report Template Configuration 150
• File Browser 151
• Camtasia 155
- Key features 155
- Additional Important Information 159
• Patient Protocol 160
Head 162
• Overview 162
- General Hints 165
- Head Kernels 166
• Scan Protocols 168
- HeadRoutine 168
- HeadNeuro 172
- HeadSeq 174
- InnerEarHR 177
8
Contents
- InnerEarHRVol 180
- InnerEar 184
- InnerEarSeq 188
- Sinus 192
- SinusVol 196
- Orbit 198
- Dental 200
Neck 204
• Overview 204
- General Hints 206
- Body Kernels 207
• Scan Protocols 208
- NeckRoutine 208
- NeckThinSlice 212
- NeckVol 214
Shoulder 218
• Overview 218
- General Hints 219
- Body Kernels 219
• Scan Protocols 220
- Shoulder 220
- ShoulderVol 224
Thorax 226
• Overview 226
- General Hints 229
- Body Kernels 231
• Scan Protocols 232
- ThoraxRoutine/
ThoraxRoutine06s 232
- ThoraxCombi/
ThoraxCombi06s 235
- ThoraxVol 240
-ThoraxFast/
9
Contents
ThoraxFast06s 244
- ThoraxHR 246
- ThoraxHRSeq 250
- ThoraxECGHRSeq 252
-LungLowDose/
LungLowDose06s 254
-LungCARE/
LungCARE06s 258
Abdomen 262
• Overview 262
- General Hints 264
- Body Kernels 265
• Scan Protocols 266
- AbdomenRoutine/
AbdomenRoutine06s 266
- AbdomenCombi/
AbdomenCombi06s 270
- AbdomenVol 274
- AbdomenFast/
AbdomenFast06s 278
- AbdMultiPhase/
AbdMultiPhase06s 280
- AbdomenSeq 288
- Colonography/
Colonography06s 290
Spine 294
• Overview 294
- General Hints 296
- Body Kernels 297
• Scan Protocols 298
- C-Spine 298
- C-SpineVol 300
- SpineRoutine 302
- SpineThinSlice 304
- SpineVol 305
10
Contents
- SpineSeq 308
- Osteo 312
Pelvis 314
• Overview 314
- General Hints 316
- Body Kernels 317
• Scan Protocols 318
- Pelvis 318
- PelvisVol 322
- Hip 324
- HipVol 328
- SI_Joints 330
Upper Extremities 332
• Overview 332
- General Hints 334
- Body Kernels 335
• Scan Protocols 336
- WristHR 336
- ExtrRoutineHR 340
- ExtrCombi 344
Lower Extremities 346
• Overview 346
- General Hints 348
- Body Kernels 349
• Scan Protocols 350
- Knee 350
- Foot 352
- ExtrRoutineHR 354
- ExtrCombi 358
11
Contents
Vascular 360
• Overview 360
- General Hints 363
- Head Kernels 364
- Body Kernels 365
• Scan Protocols 366
- HeadAngio/
HeadAngio06s 366
- HeadAngioVol 370
-CarotidAngio/
CarotidAngio06s 372
- CarotidAngioVol 376
- ThorAngioRoutine/
ThorAngioRoutine06s 380
- ThorAngioVol 384
- ThorAngioECG/
ThorAngioECG06s 388
- ThorAngioECGSeq 392
- Embolism/
Embolism06s 394
- BodyAngioRoutine/
BodyAngioRoutine06s 398
- BodyAngioVol 402
-BodyAngioFast/
BodyAngioFast06s 406
- AngioRunOff/
AngioRunOff06s 410
- WholeBodyAngio 414
Specials 416
• Overview 416
- Trauma 416
- Interventional CT 418
- Test Bolus 420
• Trauma Protocols 422
- General Information 422
- Trauma 424
- TraumaVol 425
12
Contents
-PolyTrauma/
PolyTrauma06s 426
- HeadTrauma 430
- HeadTraumaSeq 432
- Additional Important Information 434
• Interventional CT - Biopsy 436
- Biopsy 437
- Biopsy Single 438
• Interventional CT - CARE Vision 439
- The Basics 439
- CAREVision 440
- CAREVisionSingle 441
- CAREVisionBone 442
- HandCARE 443
- Additional Important Information 447
• General Information for Biopsy and CARE
Vision 450
- Interventional Toolbar 450
- CAREView 453
- Configuration 456
- Routine Subtask card 458
- Additional Important Information 459
• TestBolus Protocol 460
- TestBolus 460
Radiation Therapy 462
• Radiation Therapy Planning 462
- Benefits 465
• Workflow 468
• Scan Protocols 470
- Overview 470
- RT_Head 472
- RT_Thorax 474
- RT_Breast 476
- RT_Abdomen 478
- RT_Pelvis 480
- Additional Important Information 482
13
Contents
Respiratory Gating 484
• Key Features 486
- Respiratory Gating 486
- Respiration Monitoring 486
- Respiration Synchronization 487
• Positioning of the respiratory sensor belt 488
• Scanning Information 490
- Scan Parameters 490
- Temporal Resolution 491
- Technical Principles 491
- Respiratory Triggering 491
- Respiratory gating 492
- Prospective respiratory triggering versus
retrospective respiratory gating 494
- Curve Editor 495
- Synthetic Trigger/Sync 497
• Workflow 498
- Reconstruction and Post processing 498
• Additional important Information 499
• Scan Protocol 500
- RespSeq 500
- Resp 502
- RespModBreathRate 504
- RespLowBreathRate 506
Children 508
• Overview 508
- General Hints 512
- Head Kernels 515
- Body Kernels 516
• Scan Protocols 518
- HeadRoutine 518
- HeadSeq 522
- InnerEarHR 526
- InnerEar 530
- InnerEarSeq 534
- SinusOrbit 538
- NeckRoutine 542
14
Contents
- ThoraxRoutine/
ThoraxRoutine06s 546
- ThoraxCombi/
ThoraxCombi06s 550
- ThoraxHRSeq 554
- AbdomenRoutine/
AbdomenRoutine06s 558
- Spine/
SpineRoutine 562
- SpineThinSlice 566
- ExtrRoutineHR 568
- ExtrCombi 570
- HeadAngio/
HeadAngio06s 574
-CarotidAngio/
CarotidAngio06s 578
- BodyAngioRoutine/
BodyAngioRoutine06s 582
-BodyAngioFast/
BodyAngioFast06s 586
- NeonateBody/
NeonateBody06s 587
15
User Documentation
For further information about the basic operation,
please refer to the corresponding syngo CT Operator
Manual:
syngo CT Operator Manual Volume 1:
syngo Security Package
Siemens Virus Protection
Basics
SOMATOM LifeNet
syngo Patient Browser
syngo Data Set Conversion
Camtasia
SaveLog
E-Logbook
syngo Viewing
syngo Filming
syngo CT Operator Manual Volume 2:
Preparations
Examination
MPPS
HeartView CT
Respiratory Gating CT
CARE Bolus CT
CARE Vision CT
syngo CT Operator Manual Volume 3:
syngo 3D
syngo Dental CT
syngo Osteo CT
16
User Documentation
syngo CT Operator Manual Volume 4:
syngo LungCARE CT
syngo Pulmo CT
syngo Neuro Perfusion CT
syngo Body Perfusion CT
syngo CT Operator Manual Volume 5:
syngo Calcium Scoring
syngo Circulation
syngo Volume Calculation
syngo Dynamic Evaluation
syngo Neuro DSA CT
syngo CT Operator Manual Volume 6:
syngo InSpace 4D CT
syngo Colonography
17
Scan and Reconstruction
Concept of Scan Protocols
The scan protocols for adult and children are defined
according to body regions - Head, Neck, Shoulder,
Thorax, Abdomen, Pelvis, Spine, Upper Extremities,
Lower Extremities, Vascular, RT, Specials and
optional Cardiac, PET, SPECT and Private.
The protocols for special applications are defined in the
Application Guide “Clinical Applications” or in the
case of a Heart View examination, in the Application
Guide “Cardiac CT“.
The general concept is as follows: All protocols without
a suffix are standard spiral modes. For example,
“Sinus” means the spiral mode for the sinus.
The suffixes of the protocol name are follows:
“Routine“: for routine studies
“Seq”: for sequence studies
“Fast“: use a higher pitch for fast acquisition
“ThinSlice“: use a thinner slice collimation
“Combi“: use a thinner and a thicker slice collimation
“05s”: use the rotation time of 0.5 seconds
“ECG“: use a ECG-gated or triggered mode
“Neuro“: for neurologicial examinations with a special
mode
“Vol“: use the 3D Recon workflow
“HR“: use a thin slice width for High Resolution studies
A prefix of the protocol name is as follows:
“RT”: for radio therapy studies
The availability of scan protocols depends on the sys-
tem configuration.
“Resp”: for respiratory gated studies
The availability of scan protocols depends on the sys-
tem configuration.
18
Scan and Reconstruction
Scan Set Up
Scans can be simply set up by selecting a predefined
examination protocol. To repeat any mode, just click
the chronicle with the right mouse button for repeat.
To delete it, select cut. Each range name in the chronicle can be easily changed before load.
Multiple ranges can be run either automatically with
auto range, which is denoted by a bracket connecting
the two ranges, or separately with a pause in
between.
Feed in/Feed out
The performance of the different buttons (soft buttons, gantry buttons, control box buttons) is standardized as follows:
•in NOT loaded modes
1 mm
•in loaded Biopsy mode:
Feed In/Out = slice width x No. slice positions per scan
2
19
Scan and Reconstruction
Topo Length
SOMATOM
Emotion 16
Length [mm] 128, 256, 512, 768, 1024,
1500
Slice width [mm] 4x0.6
Angle Top, Bottom, Lateral
SOMATOM
Emotion 6
Length [mm] 128, 256, 512, 768, 1024,
1500, 1536*, 2000**,
2048***
Slice width [mm] 3x1
Angle AP, PA, Lateral
* only in combination with PET and SPECT, option
** only in combination with SPECT, option
*** only in combination with PET, option
20
Scan and Reconstruction
Scan Modes
Sequential Scanning
This is an incremental, slice-by-slice imaging mode in
which there is no table movement during data acquisition. A minimum interscan delay in between each
acquisition is required to move the table to the next
slice position.
Spiral Scanning
Spiral scanning is a continuous volume imaging mode.
The data acquisition and table movements are performed simultaneously for the entire scan duration.
There is no inter-scan delay and a typical range can be
acquired in a single breath hold.
Each acquisition provides a complete volume data set,
from which images with overlapping can be reconstructed at any arbitrary slice position. Unlike the
sequence mode, spiral scanning does not require additional radiation to obtain overlapping slices.
21
Scan and Reconstruction
Quick Scan
The data is usually acquired during a full 360° rotation
– this is a Full scan. Data acquisition not using a full
360° rotation is called a “Quick scan”. Quick scans are
employed to reduce motion artifacts and improve the
temporal resolution.
Dynamic Multiscan
Multiple continuous rotations at the same table position are performed for data acquisition. Normally, it is
applied for fast dynamic contrast studies, such as
syngo Neuro Perfusion CT.
Dynamic Serioscan
Dynamic serial scanning mode without table feed.
Dynamic serio can still be used for dynamic evaluation
such as Test Bolus. The image order can be defined on
the Recon subtask card.
22
Scan and Reconstruction
UFC detector
Siemens’ proprietary, high-speed Ultra Fast Ceramic
(UFC) detector enables a virtually simultaneous readout of two projections for each detector element.
The detector configuration with the routine acquisition
of the Emotion 6/16-slice configuration:
SOMATOM Emotion 16-slice configuration:
SOMATOM Emotion 6-slice configuration:
23
Scan and Reconstruction
Acquisition, Slice Collimation and Slice Width
Slice collimation is the slice thickness resulting from
the effect of the tube-side collimator and the adaptive
detector array design. In Multislice CT, the Z-coverage
per rotation is given by the product of the number of
active detector slices and the collimation (e.g. 6 x
1.0mm for the SOMATOM Emotion 6-slice configuration or 16 x 0.6mm for the SOMATOM Emotion 16slice configuration ).
Slice width is the FWHM (full width at half maximum)
of the reconstructed image.
With the SOMATOM Emotion 6/16-slice configuration,
you select the slice collimation together with the slice
width desired. The slice width is independent of pitch,
i.e. what you select is always what you get. Actually,
you do not need to care about the algorithm any more;
the software does it for you.
If Metrorecon/Fastrecon is not selected you will routinely get “Real Time” images. The Recon icon on the
chronicle will be labeled with “RT”. After the scan the
Real Time displayed image series has to be reconstructed.
In some cases – this depends also on Scan pitch and
Reconstruction increment – the Recon icon on the
chronicle will be labeled with “RT”. This indicates the
Real Time display of images during scanning. The Real
Time displayed image series has to be reconstructed
after completion of spiral.
The Acq (Acquisition) is displayed on the Examination
task card. The Acquisition is simply "number of slices
acquired per rotation" x "width of one slice".
24
Scan and Reconstruction
SOMATOM Emotion 16-slice configuration
Spiral Mode
Collimation/
Acquisition
16 x 0.6 mm 0.75, 1.0, 1.5, 2.0, 3.0, 4.0, 5.0 mm
16 x 1.2 mm 1.5, 2.0, 3.0, 4.0, 5.0, 6.0, 8.0,
HR/Neuro Spiral Mode
Collimation/
Acquisition
4 x 0.6 mm 0.6, 0.75, 1.0, 1.5, 2.0, 3.0, 4.0,
Sequence Mode
Collimation/
Acquisition
4 x 0.6 mm 0.6, 1.2, 2.4 mm
12 x 0.6 mm 0.6, 2.4, 7.2 mm
16 x 0.6 mm 1.2, 2.4, 4.8, 9.6 mm
Slice width
10.0 mm
Slice width
5.0 mm
Slice width
2 x 5 mm 5.0, 10.0 mm
12 x 1.2mm 1.2, 3.6, 4.8 mm
2 x 8 mm 8.0, 16.0 mm
16 x 1.2 mm 2.4, 4.8, 9.6, 19.2 mm
25
Scan and Reconstruction
SOMATOM Emotion 6-slice configuration
Spiral Mode
Collimation Slice width
1 mm 1,1.25,2,2.5,3,4,5,6,8,10mm
2 mm 2.5, 3, 4, 5, 6, 8, 10 mm
3 mm 4, 5, 6, 8, 10 mm
Sequence Mode
Collimation Slice width
1 mm 1, 2, 3 mm
2 mm 2, 4, 6, 12 mm
3 mm 3, 6, 9, 18 mm
5 mm 5, 10 mm
HR Spiral Mode
Collimation Slice width
0.5 mm 0.63, 0.75, 1, 1.25, 2, 2.5, 3, 4,
5mm
HR Sequence Mode
Collimation Slice width
1 mm 1 mm
26
Scan and Reconstruction
Increment
The increment is the distance between the reconstructed images in Z direction. When the chosen increment is smaller than the slice thickness, the images are
created with an overlap. This technique is useful for
reducing partial volume effect, giving you better detail
of the anatomy and high quality 2D and 3D postprocessing.
The increment can be freely adapted from 0.1 - 10
mm.
Pitch
Pitch = feed per rotation
z-coverage
z-coverage = detector rows x collimated slice width
Feed/Rotation = table movement per rotation
The Pitch Factor can be freely adapted from 0.45 – 2.0,
in Cardio, there is a fixed pitch down to 0.1.
With the SOMATOM Emotion 6/16-slice configuration,
you select the slice collimation together with the slice
width desired.
The slice width is independent of pitch, i.e. what you
select is always what you get. Actually, you do not
need to be concerned about the algorithm any more;
the software does it for you.
Pitch values with a step width of 0.05 can be selected
for all modes.
We recommend to use a Pitch Factor of 0.45 for MPR
reconstructions.
27
Scan and Reconstruction
Kernels
There are 4 different types of kernels: “H“ stands for
Head, “B“ stands for Body, “C“ stands for ChildHead and
”S” stands for Special Application, e.g. syngo Osteo CT.
The image sharpness is defined by the numbers – the
higher the number, the sharper the image; the lower
the number, the smoother the image.
Head Kernels:
Kernel description
H10s very smooth
H19s very smooth
H20s smooth
H21s smooth +
H22s smooth FR +
H29s smooth +
H30s medium smooth
H31s medium smooth +
H32s medium smooth FR +
H37s medium smooth (Emotion 16-slice
configuration only)
H39s medium smooth
H40s medium
H41s medium +
H42s medium FR
H45s medium
H47s medium smooth (Emotion 16-slice
configuration only)
H48s medium smooth (Emotion 16-slice
configuration only)
H50s sharp
H60s medium
H70s very sharp
H80s inner ear
H90s inner ear
28
Scan and Reconstruction
Body Kernels:
Kernel description
B08s very smooth
B10s very smooth
B19s very smooth
B20s smooth
B29s smooth
B30s medium smooth
B31s medium smooth +
B35s HeartView medium
B39f HeartView medium
B40s medium
B41s medium+
B46s medium
B50s medium sharp
B60s sharp
B65s sharp
B70s very sharp
B75s very sharp (Emotion 16-slice configu-
ration only)
B80s ultra sharp
B90s ultra sharp
Child Head Kernels:
Kernel description
C20s smooth
C30s medium smooth
C60s sharp
29
Scan and Reconstruction
Topogram Kernels:
Kernel description
T10s smooth
T20s standard
T21s standard
T80s sharp
T81s sharp
T90s ultra sharp
Special Application:
Kernel description
S30s Shepp-Logan
S80s Shepp-Logan with notch filter
S90s Shepp-Logan without notch filter
U90s specification kernel
30
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