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DICOM nD Presentation State Toshiba Cross-Sectional Imaging Use Cases

DICOM nD Presentation State Toshiba Cross-Sectional Imaging Use Cases. Updated 15 Feb, 2011. Modalities Considered. CT MR PET. Clinical Specialties Considered. Radiology Cardiology Gastroenterology. CT Coronary Artery Stenosis. Input is a gated, contrast-enhanced CT cardiac exam

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DICOM nD Presentation State Toshiba Cross-Sectional Imaging Use Cases

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  1. DICOMnD Presentation StateToshiba Cross-Sectional Imaging Use Cases Updated 15 Feb, 2011

  2. Modalities Considered • CT • MR • PET nD Presentation State Use Cases

  3. Clinical Specialties Considered • Radiology • Cardiology • Gastroenterology nD Presentation State Use Cases

  4. CT Coronary Artery Stenosis Input is a gated, contrast-enhanced CT cardiac exam • Device/user creating derived views and presentation states • CT technologist, radiologist or cardiologist using post-processing application • Automated / semi-automated segmentation of: • Heart / myocardium • Coronary arteries • Automated / semi-automated coronary artery centreline finding • Views saved: • Three MPRs aligned with the axes of the heart intersecting at the point of stenosis • Curved MPR following the centreline of the stenotic vessel with stenosis marked • Cross-curved MPR at the point of stenosis with % stenosis measurement • SVR and / or volumetric MIP, oriented to show stenosis • Device/user using presentation state to replicate derived views • Radiologist / cardiologist performing primary read after tech workup • Radiologist / cardiologist reviewing priors alongside follow-up exams • Need to reproduce: • Segmentation • Centrelines • Markers / measurements • Position and orientation of MPRs • Position of cross-curved MPR • Orientation and VOI for SVR / MIP • W/L for MPR and MIP views • Opacity for SVR views – accuracy of colour mapping unimportant nD Presentation State Use Cases

  5. CT Coronary Artery Plaque Evaluation Input is a gated, contrast-enhanced CT cardiac exam • Device/user creating derived views and presentation states • CT technologist, radiologist or cardiologist using post-processing application • Automated / semi-automated segmentation of: • Heart / myocardium • Coronary arteries • Automated / semi-automated coronary artery centreline finding • Views saved: • Slab MPR aligned with the affected vessel • 3-4 MPR views perpendicular to the above view demonstrating the extent of the plaque • Curved MPR following the centreline of the affected vessel • Set of cross-curved MPRs with colour-coded plaque burden • Device/user using presentation state to replicate derived views • Radiologist / cardiologist performing primary read after tech workup • Radiologist / cardiologist reviewing priors alongside follow-up exams • Need to reproduce: • Segmentation • Centrelines • Markers / measurements • Position and orientation of MPRs • Width and Intensity Projection of MPRs • Position of cross-curved MPRs • W/L for MPR views 9/20/2014 nD Presentation State Use Cases 5

  6. CT Coronary Artery Stent Evaluation Input is a gated, contrast-enhanced CT cardiac exam • Device/user creating derived views and presentation states • CT technologist, radiologist or cardiologist using post-processing application • Automated / semi-automated segmentation of: • Heart / myocardium • Coronary arteries • Automated / semi-automated coronary artery centreline finding • Views saved: • MPR aligned with the affected vessel • 3-4 MPR views perpendicular to the above along the length of the stent • Curved MPR following the centreline of the affected vessel • Set of cross-curved MPRs along the length of the stent • Device/user using presentation state to replicate derived views • Radiologist / cardiologist performing primary read after tech workup • Radiologist / cardiologist reviewing priors alongside follow-up exams • Need to reproduce: • Segmentation • Centrelines • Markers / measurements • Position and orientation of MPRs • Position of cross-curved MPRs • W/L for MPR views 9/20/2014 nD Presentation State Use Cases 6

  7. CT Coronary Artery Aneurysm Evaluation Input is a gated, contrast-enhanced CT cardiac exam • Device/user creating derived views and presentation states • CT technologist, radiologist or cardiologist using post-processing application • Automated / semi-automated segmentation of: • Heart / myocardium • Coronary arteries • Automated / semi-automated coronary artery centreline finding • Views saved: • Curved MPR following the centreline of the affected vessel • Cross-curved MPR at end-points of aneurysm and point of maximal diameter with measurements • Device/user using presentation state to replicate derived views • Radiologist / cardiologist performing primary read after tech workup • Radiologist / cardiologist reviewing priors alongside follow-up exams • Need to reproduce: • Segmentation • Centrelines • Markers / measurements • Position and orientation of MPRs • Position of cross-curved MPRs • W/L for MPR views 9/20/2014 nD Presentation State Use Cases 7

  8. CT Coronary Artery Anomalous Vessel Evaluation Input is a gated, contrast-enhanced CT cardiac exam • Device/user creating derived views and presentation states • CT technologist, radiologist or cardiologist using post-processing application • Automated / semi-automated segmentation of: • Heart / myocardium • Coronary arteries • Automated / semi-automated coronary artery centreline finding • Views saved: • Three MPRs intersecting at the vessel origin • Slab MPR demonstrating the vessel anomaly • Device/user using presentation state to replicate derived views • Radiologist / cardiologist performing primary read after tech workup • Radiologist / cardiologist reviewing priors alongside follow-up exams • Need to reproduce: • Segmentation • Centrelines • Markers / measurements • Position and orientation of MPRs • Width and Intensity Projection of MPRs • W/L for MPR views 9/20/2014 nD Presentation State Use Cases 8

  9. CT Coronary Artery CABG Evaluation Input is a gated, contrast-enhanced CT cardiac exam • Device/user creating derived views and presentation states • CT technologist, radiologist or cardiologist using post-processing application • Automated / semi-automated segmentation of: • Heart / myocardium • Coronary arteries • Automated / semi-automated coronary artery centreline finding • Views saved: • Curved MPR following the centreline of the bypass graft • SVR views oriented to show junction of bypass graft and coronary artery with different VOIs (survey and focused on junction) • Device/user using presentation state to replicate derived views • Radiologist / cardiologist performing primary read after tech workup • Radiologist / cardiologist reviewing priors alongside follow-up exams • Need to reproduce: • Segmentation • Centrelines • Markers / measurements • Position and orientation of MPRs • Orientation and VOI for SVR / MIP • W/L for MPR views • Opacity for SVR views – accuracy of colour mapping unimportant 9/20/2014 nD Presentation State Use Cases 9

  10. CT Cardiac 4D Valve Evaluation Input is a retrospectively gated, contrast-enhanced CT cardiac exam • Device/user creating derived views and presentation states • CT technologist, radiologist or cardiologist using post-processing application • Automated / semi-automated segmentation of: • Left ventricle endocardium • Left ventricle epicardium • Views saved: • Three MPRs aligned with the axes of the heart intersecting at the aortic valve cycling through cardiac phases • SVR view oriented to show the aortic valve cycling through cardiac phases • Three MPRs aligned with the axes of the heart intersecting at the mitral valve cycling through cardiac phases • SVR view oriented to show the mitral valve cycling through cardiac phases • Device/user using presentation state to replicate derived views • Radiologist / cardiologist performing primary read after tech workup • Radiologist / cardiologist reviewing priors alongside follow-up exams • Need to reproduce: • Segmentation • Position and orientation of MPRs • Cine details? • Orientation and VOI for SVR • W/L for MPR views • Colour / opacity guideline – accuracy of colour and opacity mapping unimportant 9/20/2014 nD Presentation State Use Cases 10

  11. CT Cardiac 4D Myocardial Contractility Input is a retrospectively gated, contrast-enhanced CT cardiac exam • Device/user creating derived views and presentation states • CT technologist, radiologist or cardiologist using post-processing application • Automated / semi-automated segmentation of: • Left ventricle endocardium • Left ventricle epicardium • Views saved: • Three MPRs aligned with the axes of the heart intersecting at the left ventricle cycling through cardiac phases • SVR view oriented to show the left ventricle valve cycling through cardiac phases • Device/user using presentation state to replicate derived views • Radiologist / cardiologist performing primary read after tech workup • Radiologist / cardiologist reviewing priors alongside follow-up exams • Need to reproduce: • Segmentation • Position and orientation of MPRs • Orientation and VOI for SVR • W/L for MPR views • Colour / opacity guideline – accuracy of colour and opacity mapping unimportant 9/20/2014 nD Presentation State Use Cases 11

  12. CT Calcium Scoring Input is a retrospectively gated, non-enhanced CT cardiac phase • Device/user creating derived views and presentation states • CT technologist, radiologist or cardiologist using post-processing application • Automated / semi-automated segmentation of: • Coronary artery calcification • Output saved: • Assignment of calcification to coronary arteries • Device/user using presentation state to replicate derived views • Radiologist / cardiologist performing primary read after tech workup • Radiologist / cardiologist reviewing priors alongside follow-up exams • Need to reproduce: • Segmentation • Assignment of calcification to coronary arteries • Use case may be more appropriate to a CAD-like object than to an nD PS 9/20/2014 nD Presentation State Use Cases 12

  13. CT Colonography Input is a combination of prone, supine and decubitus CT volumes, with or without contrast • Device/user creating derived views and presentation states • CT technologist, radiologist or gastroenterologist using post-processing application • Automated / semi-automated segmentation of: • Luminal surface of colon • Colonic centerline • Air in small intestine • Polyps/flat lesions • Contrast tagged stool • Residual fluid • Views saved: • SVR of air in colon • MPR/slab views to illustrate individual lesions • Endoscopic (SVR/SSD) of colon • Dissected SVR view • Device/user using presentation state to replicate derived views • Radiologist / gastroenterologist performing primary read after tech workup • Radiologist / gastroenterologist reviewing priors alongside follow-up exams • Need to reproduce: • Segmentation • Centrelines • Position and orientation of MPRs • Orientation and VOI for SVR • W/L for MPR views • Opacity /threshold for SVR/SSD views – accuracy of colour mapping unimportant 9/20/2014 nD Presentation State Use Cases 13

  14. CT Angiography Input is a contrast-enhanced CT angiography exam • Device/user creating derived views and presentation states • CT technologist or radiologist using post-processing application • Automated / semi-automated segmentation of: • Arteries to be analyzed • Bone adjacent to arteries of interest • Automated / semi-automated artery centreline finding • Views saved: • Three MPRs aligned with the artery intersecting at the point of stenosis • Curved MPR following the centreline of the stenotic vessel with stenosis marked • Cross-curved MPR at the point of stenosis with % stenosis measurement • SVR and / or boneless volumetric MIP, oriented to show stenosis • Device/user using presentation state to replicate derived views • Radiologist performing primary read after tech workup • Radiologist reviewing priors alongside follow-up exams • Need to reproduce: • Segmentation • Centrelines • Markers / measurements • Position and orientation of MPRs • Position of cross-curved MPR • Orientation and VOI for SVR / MIP • W/L for MPR and MIP views • Opacity for SVR views – accuracy of colour mapping unimportant 9/20/2014 nD Presentation State Use Cases 14

  15. MR Cardiac LV Analysis Input is a gated, contrast-enhanced MR cardiac exam • Device/user creating derived views and presentation states • MR technologist, radiologist or cardiologist using post-processing application • Automated / semi-automated segmentation of: • Left ventricle endocardium • Left ventricle epicardium • Views saved: • Set of LV short axis views with overlaid segmentation • Device/user using presentation state to replicate derived views • Radiologist / cardiologist performing primary read after tech workup • Radiologist / cardiologist reviewing priors alongside follow-up exams • Need to reproduce: • Segmentation • W/L for MPR views 9/20/2014 nD Presentation State Use Cases 15

  16. MR Cardiac Perfusion Input is a contrast-enhanced MR cardiac perfusion exam • Device/user creating derived views and presentation states • MR technologist, radiologist or cardiologist using post-processing application • Automated / semi-automated segmentation of: • Left ventricle endocardium • Left ventricle epicardium • Views saved: • Set of LV short axis views with functional overlays – stress and rest acquisitions • Device/user using presentation state to replicate derived views • Radiologist / cardiologist performing primary read after tech workup • Radiologist / cardiologist reviewing priors alongside follow-up exams • Need to reproduce: • Segmentation • W/L for MPR views 9/20/2014 nD Presentation State Use Cases 16

  17. MR Cardiac Delayed Enhancement Input is a delayed-enhancement MR cardiac exam • Device/user creating derived views and presentation states • MR technologist, radiologist or cardiologist using post-processing application • Automated / semi-automated determination of infarct enhancement threshold • Automated / semi-automated segmentation of infarct • Views saved: • Cross-sectional view highlighting infarct with overlays and measurements • Device/user using presentation state to replicate derived views • Radiologist / cardiologist performing primary read after tech workup • Radiologist / cardiologist reviewing priors alongside follow-up exams • Need to reproduce: • Segmentation • Signal intensity threshold used to perform infarct segmentation 9/20/2014 nD Presentation State Use Cases 17

  18. PET / CT Fusion – Added 15 Feb Input is a set of registered PET /CT exams, typically from a combined PET / CT scanner. A set of prior exams may also be loaded. • Device/user creating derived views and presentation states • Technologist or radiologist using post-processing application • If views are not already registered, registration is performed • Views saved: • Blended CT / PET MIP views demonstrating areas of interest with measurement overlays (point measurements or ROIs) • 3D MIP view with an inverted W/L • Device/user using presentation state to replicate derived views • Radiologist performing primary read after tech workup • Radiologist reviewing priors alongside follow-up exams • Need to reproduce: • MPR positions • Blending function • W/L and or color maps • Measurement position and ROI details 9/20/2014 nD Presentation State Use Cases 18

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