Siemens SOMATOM Sensation Cardiac Version A60 User guide

SOMATOM Sensation Cardiac
Application Guide
Software Version A60

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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 e pertise 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 were specified to the best of
our knowledge. We assume no responsibility what is
over for the correctness of this information. Variations
may prove necessary for individual patients.
The treating physician bears the sole responsibility
for all of the parameters selected. The pertaining oper-
ating instructions must always be strictly followed
when operating the SOMATOM Sensation Cardiac.
The statutory source for the technical data are the
corresponding data sheets. To improve future versions
of this application guide, we would highly appreciate
your questions, suggestions and comments.
Please contact us:
CT Application Hotline:
Tel. no. [phone] (outside Germany)
0130-18 53 91 (in Germany)
Fa no. [phone]
email: somatom.e aminationprot[email protected]
We e press our sincere gratitude to the many customers
who contributed valuable input.
In addition I would like to stress at this point that the
SOMATOM Sensation Cardiac Application Guide is
based very much on the other SOMATOM Application
Guides which have been written by Dr. Xiao-Yan Chen,
Loke-Gie Haw and Bettina Klingemann.
Special thanks to Dr. med. Martin Heuschmid,
Universitätsklinikum Tübingen.
Editor: Ute Feuerlein

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3
Overview
General 8
HeartView CT 22
Bolus Tracking 54
WholeBodyAngio 62
LungCARE 64
CT Colonography 66
Children 68
Head 88
Neck 98
Thora 102
Abdomen 112
E tremities 124

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Content
General 8
· Concept 8
· Scan Set Up 8
· Scan and Reconstruction 9
– Slice Collimation and Slice Width 9
– Pitch 10
– Recon Job 11
– Kernels 11
– Image Filter 11
· Effective mAs 12
· Dose Information 13
· CARE Dose 16
· How does it work 16
· Workflow 18
· Contrast Medium IV Injection 19
· How to Create your own Scan Protocols 20

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Content
HeartView CT 22
· The Basics 22
– Important Anatomical Structures
of the Heart 22
– Cardiac Cycle and ECG 25
– Temporal Resolution 25
– Technical Principles 26
– Preview Series Reconstruction 27
– ECG Trace Editor 28
– ECG Pulsing 28
– CardioCARE 29
– CardioSharp 29
· How to do it 30
– Calcium Scoring 30
– Hints in General 30
– Placement of ECG Electrodes 31
· CaScoreSpiStd 32
· CaScoreSpiStd0.5s 33
· CaScoreSeqStd 34
– Coronary CTA 35
– General Hints 36
· CoronaryStd 37
· CoronaryStd0.5s 38
· CorStd_LowHeartRate 39
· CoronaryCARE 40
· CoronaryCARE0.5s 41
· CoronarySharp 42
· CoronarySharp0.5s 44
· ECGTrigCTA 46
– Aortic and Pulmonary Studies 48
– General Hints 48
· PulmonaryECG 49
· Additional Important Information 50

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Content
Bolus Tracking 54
· The Basics 54
· How to do it 56
· CARE Bolus 56
– General Hints 56
· Test Bolus 58
– Application Procedures 59
· Additional Important Information 60
WholeBodyAngio 62
LungCARE 64
CT Colonography 66
Children 68
· Hints in General 69
· HeadSpi05s 72
· HeadSeq0.5s 74
· HeadAngio 76
· CarotidCTA 78
· NeonateBody 80
· ChestRoutine 82
· AbdPelRoutine 84
· AbdCTA 86
Head 88
· Overview 88
· Hints in General 89
· Angio Head 90
· AngioThinSlice 92
· HeadSeq0.5s 94
· HeadSpi0.5s 96
Neck 98
· Overview 98
· Hints in General 99
· AngioCarotid 100

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Content
Thora 102
· Overview 102
· Hints in General 103
· LungLowDose 104
· PulmonaryEmboli 106
· Thora Combi 108
· Thora Routine 110
Abdomen 112
· Overview 112
· Hints in General 113
· AbdRoutine 116
· AngioFast 118
· AngioRoutine 120
· AbdomenSeq 122
E tremities 124
· Overview 124
· Hints in General 125
· AngioRunOff 126

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General
Concept
The scan protocols for adult are defined according
to body regions – Head, Neck,Thorax, Abdomen,
Extremities.
The pediatric scan protocols are defined under the
folder Children”.
The protocols for special applications are defined
under Special”.
The general concept is as follows:
Fast”: uses 1.5 mm slice collimation and a higher
pitch for fast acquisition for CT Angios or trauma cases.
Routine”: uses either 0.75 mm or 1.5 mm slice
collimation depending on the region of interest for
routine studies.
ThinSlice”: uses 0.75 mm slice collimation for
thin slice studies.
Combi”: uses 0.75 mm as slice collimation and
reconstruct images as both thinner slice width for
HiRes or CTA and thicker slice width for soft tissue
studies.
Seq”: stands for Sequence. E. g. “HeadSeq” means
the sequence mode for the head;
Spi” stands for “Spiral”. E. g. “HeadSpi” means the
spiral mode for the head.
Scan Set Up
Scans can be simply set up by selecting a predefined
e amination protocol. To repeat any mode, just click
the chronicle with the right mouse button for “repeat”.
To delete it, select “cut”. Each chronicle is rewriteable
before “load”.
Multiple ranges can be run either automatically with
“auto range”, or separately with a “pause” in between.

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General
Scan and Reconstruction
Slice Collimation and Slice Width
Slice collimation is the slice thickness collimated by
the tube collimator, which determines the Z-coverage
per rotation. In Multislice CT, this is divided by the
number of active detector channels (e. g. 16 0.75 mm).
Slice width is the true thickness of the reconstructed
image.
With the SOMATOM Sensation Cardiac, you select the
slice collimation together with the slice width desired,
the slice width is independent of pitch and algorithm,
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.
On the SOMATOM Sensation Cardiac some slice widths
are marked as “fast” (blue background). These images
will be reconstructed with highest performance (up
to 6-10 images per second). All others will be recon-
structed with up to 3 images per second.
The reconstruction time depends on slice collimation
and the reconstructed slice width. To get the fast
performance, slice width has to be at least 3 times the
slice collimation.
During scanning the user normally will get “real time”
reconstructed images in full image quality, if the “fast”
slice has been selected.
In some cases – this depends also on Scan range, Feed/
Rotation and Reconstruction increment – the Recon
icon on the chronicle will be labeled with “RT”. This indi-
cates the real time display of images during scanning.
The real time displayed image series has to be recon-
structed afterwards.

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General
The following tables show you the possibilities of image
reconstruction in spiral and sequential scanning.
Slice Collimation and Slice Width for Spiral Mode
0.75 mm 0.75, 1, 1.5, 2, 3, 4, 5, 6, 7, 8, 10 mm
1.5 mm 2, 3, 4, 5, 6, 7, 8, 10 mm
Cardio Spiral Modes
0.75 mm 0.75, 1.0, 1.5, 2,3 mm
1.5 mm 2, 3, 4, 5 mm
Slice Collimation and Slice Width for Sequence Mode
0.75 mm 0.75, 1.5, 3, 4.5, 9 mm
1.5 mm 1.5, 3, 4.5, 6, 9 mm
5 mm 5, 10 mm
ECG triggered Modes
0.75 mm 0.75, 1.5, 3 mm
1.5 mm 1.5, 3, 6 mm
Pitch
In single slice CT:
Pitch = table movement per rotation/slice collimation
E. g.: slice collimation = 5 mm,
table moves 5 mm per rotation, then pitch = 1.
With the SOMATOM Sensation Cardiac, in Siemens
Multislice CT, we differentiate between:
Feed/Rotation, the table movement per rotation
Volume Pitch, the table movement per rotation/single
slice collimation
E. g.: single slice collimation = 1.5 mm, table moves
24 mm per rotation, then the Volume Pitch = 16
Pitch Factor, the table movement per rotation/
collimation
E. g.: slice collimation = 16 1.5 mm, table moves
24 mm per rotation, then the Pitch Factor = 1
With the SOMATOM Sensation Cardiac, you do not
need to select pitch. Once the scan range, scan time,
slice collimation, and rotation time is defined, the
software will adapt the table feed per rotation accor-
dingly. The Pitch Factor can be freely adapted from
0.5 to 1.5.