SYNAPSE  3D    
TRAINING  COURSE  
SYLLABUS  
 

Revision  2.0  
February,  2014  
   
      
   

  2  
      

 
TABLE  OF  CONTENTS  
Course  Description  ..........................................................................................................................................................................................  5  
Intended  Audience  ......................................................................................................................................................................................  5  
Goals  And  Objectives  .................................................................................................................................................................................  5  
Course  Outline  ...................................................................................................................................................................................................  6  
General  Applications  .......................................................................................................................................................................................  6  
Introduction  to  Synapse  3D  ....................................................................................................................................................................  6  
2D  Viewer  .......................................................................................................................................................................................................  7  
3D  Viewer  .......................................................................................................................................................................................................  7  
Advanced  3D  Viewer  ............................................................................................................................................................................  8  
Fusion  and  PET/CT  Viewer  ....................................................................................................................................................................  9  
3D  Comparison  .............................................................................................................................................................................................  9  
3D  Compositor  .............................................................................................................................................................................................  9  
Combination  ...............................................................................................................................................................................................  10  
4D  Viewer  ....................................................................................................................................................................................................  10  
Sector  MPR  ..................................................................................................................................................................................................  10  
Dynamic  Data  .............................................................................................................................................................................................  11  
Dental  Analysis  ..........................................................................................................................................................................................  11  
Slicer  ..............................................................................................................................................................................................................  11  
RECIST  &  PERCIST  Tracker  .................................................................................................................................................................  12  
Advanced  Radiology  .....................................................................................................................................................................................  13  
Neurology  ....................................................................................................................................................................................................  13  
Brain  Perfusion  ....................................................................................................................................................................................  13  
ADC  VIEWER  .........................................................................................................................................................................................  13  
Brain  Vessel  Analysis  ........................................................................................................................................................................  14  
Advanced  3D  Viewer  –  Neurology  ...............................................................................................................................................  14  
2D/3D  Fat  Analysis  .................................................................................................................................................................................  15  
Lung  Analysis  .............................................................................................................................................................................................  15  
Liver  Analysis  .............................................................................................................................................................................................  16  
Cardiac  Applications  ....................................................................................................................................................................................  17  
Calcium  Scoring  ........................................................................................................................................................................................  17  
Coronary  Artery  Analysis  (CT  &  MR)  ..............................................................................................................................................  17  
Cardiac  Functional  Analysis  (CT)  ......................................................................................................................................................  18  
Cardiac  Functional  Analysis  (MRI)  ...................................................................................................................................................  18  

  3  
      
Myocardial  Delayed  Enhancement  ...................................................................................................................................................  19  
Aortic  Valve  Analysis  ..............................................................................................................................................................................  19  

 
   

  4  
      

COURSE  DESCRIPTION  
This  course  is  designed  to  be  an  introduction  to  Synapse  3D  clinically.  The  basics  of  advanced  visualisation  and  
multi   planar   reformatting   will   be   explored   and   specifically   how   to   use   Synapse   3D   to   enhance   clinical  
workflow  within  a  radiology  and  cardiology  department.  

INTENDED  AUDIENCE  
This   course   is   intended   for   new   and   current   users   of   Synapse   3D.     Fujifilm   Applications   Specialists,  
radiologists,   cardiologists,   radiographers   and   other   medical   professionals   interested   in   advanced   visualisation  
will  benefit  from  this  course.    Different  focus  will  be  placed  on  goals  and  objectives  to  meet  the  end  needs  of  
the  student.  

GOALS  AND  OBJECTIVES  

After  completion  of  this  course,  the  participant  should  be  able  to:  

1. Understand  and  demonstrate  integration  with  Synapse  PACS.  

2. Evaluate  and  choose  correct  studies  to  load  into  correct  applications.  
3. Understand  snapshots,  optimal  workflow  and  reports.  
4. Be  able  to  import,  export  and  save  images.  
5. Demonstrate  use  of  keyboard  shortcuts  and  mouse  actions.  
6. Demonstrate  use  of  basic  tools  and  shortcut  bars.  
7. Select  templates  and  rendering  techniques  appropriate  to  the  study.  
8. Gain  understanding  of  all  applications  included  in  course  list.  
9. Learn  methods  to  effectively  demonstrate  Synapse  3D  to  customers.  
10. Be  able  to  train  customers  in  Synapse  3D  Applications  
11. Be  able  to  clinically  troubleshoot  Synapse  3D  Applications  during  an  install.  
12. Know  how  to  access  web  sites  for  continuing  professional  development.  
 

   

  5  
      

COURSE  OUTLINE  
Specific  modules  included  in  this  course  are  listed  below:  
 

General  Applications     Advanced  Radiology     Cardiology    

2D  Viewer   3D  Compositor   Liver  Analysis   Calcium  Scoring  

3D  Viewer   Slicer   Lung  Analysis   CT  Functional  Analysis  

4D  Viewer   Combination   2D  Fat  Analysis   MR  Functional  Analysis  

3D  Comparison   Dental     3D  Fat  Analysis   Cardiac  Fusion  

Dynamic  Data   Sector  MPR   CT  Brain  Perfusion   CT  Coronary  Analysis    

Fusion   RECIST   MR  Brain  Perfusion   MR  Coronary  Analysis    

PET-­‐CT  Viewer   PERCIST     CT  Brain  Vessels     MR  Delayed  Enhancement    

    ADC  Mapping   Aortic  Valve  Analysis  

Further  education  will  be  provided  via  written  material,  manuals,  help  files  and  online,  including  web-­‐ex  and  
computer  based  learning.  

GENERAL  APPLICATIONS  
INTRODUCTION  TO  SYNAPSE  3D  
1. User  Guides  and  Online  Documents  
2. Integration  
a. Synapse  PACS  
b. Synapse  Cardiovascular  
3. Launching  Synapse  3D  and  Users  
4. Study  Screen  
a. Search  
b. Study  List  and  Series  List  
c. Import,  export  and  send  studies  
d. Delete  and  anonymise  studies  
e. Image  Preview  settings  
f. Image  Input  List  
g. System  Frame  
h. Online  Help  
i. System  Settings  
j. Shutdown  
5. Snapshots  
6. Reports  

   

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2D  VIEWER  
1. Main  Functions  
2. Compatible  SOP  classes  
3. 2D  Tools  
a. Home  Button  
b. Window  Level  /  Window  Width  
c. Zoom  and  Pan  
d. Measurement  
e. Text  Annotation  and  Arrows  
f. SUV  
4. Shortcut  Bar  
5. Layout  Changes  
6. Synchronise  Cine  Images  
7. Create  Additional  Planes  
8. 2D  Localiser  
 

3D  VIEWER  
1. Main  Functions  
a. 3D  Visualisation  /  Rendering  
b. Bone,  vessel  and  organ  extraction    
c. Curved  Planar  Reconstructions  (CPR)  
d. Masks  
e. Create  reformatted  images    
2. Layout  Options  
3. 3D  Viewer  Tools  
a. Home  Button  
b. Window  Level/Window  Width  
c. Zoom/Pan  
d. Measurements  
e. Annotations  
f. SUV  evaluation  
g. 3D  Object  Extraction  and  Deletion  
h. 3D  Clip  
i. Organ  Extraction  and  Deletion  
j. Position  and  Rotation  
k. Reformat  Images  
l. Movie  Creation  

   

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ADVANCED  3D  VIEWER  

Advanced   functionality   of   3D   Viewer   includes   Curved   Planar   Reconstruction   (CPR)   tools,   Mask   Editing,  
templates,  presets  and  advanced  render  functions.  
1. Renders  
a. Volume  Render  
b. MIP  
c. MinIP  
d. SSD  
e. Ray-­‐Sum  
2. Templates  
a. Editing  Templates  
b. Saving  Templates  
c. Displaying  template  options  
3. CPR  
a. Creating  CPR  
b. Editing  CPR  
c. Viewing  CPR  
d. CPR  Layout  Options  
e. Graphs  
f. Stenosis  Measurements  
g. Plaque  Analysis  
h. Virtual  Stents  –  Aorta  and  Other  
4. Masks  
a. Creating  Masks  
b. Viewing  Multiple  Masks  
c. Editing  Masks  
5. Extraction  and  Removal  
a. Presets  
6. STL  files  and  surface  renders  

   

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FUSION  AND  PET/CT  VIEWER  

Fusion  includes  MRI,  CT,  NM  and  PET  studies  and  can  be  fused  in  any  combination  thereof.    
The   PET/CT   Viewer   is   also   Fusion   but   is   used   specifically   for   viewing   of   PET   and   CT   fused  
studies.  

1. Selecting  Studies  for  Fusion  

2. Loading  Studies  
3. Registration  –  manual  and  automatic  
4. Fusion  Ratio  
5. Reconstruction  Options  
6. Layout  Options  
7. Display  Planes  
8. Colour  Templates  
9. SUV  
10. MPR  Reading  
11. Reference  Reading  
12. Comparison  Reading  
 

3D  COMPARISON  
Synapse   3D   Comparison   Viewer   enables   up   to   six   studies   from   the   same   or   from   different  
patient   to   be   loaded   into   a   viewer   and   comparisons   made.   CT/MRI   and   PET   images   can   all   be  
registered   via   table   location   data,   DICOM   referencing   of   images   or   through   the   Fujifilm   Image  
Intelligence  system  comparing  and  mapping  actual  anatomy.  

1.  Choose  Studies  
2. Registration  
3. ROI  Functions  
4. Viewer  Layouts  
 

3D  COMPOSITOR  
3D  compositor  allows  anatomy  from  different  modalities  to  be  extracted  and  then  loaded  back  
together.     This   function   is   accessible   through   the   3D   viewer   tab   or   directly   by   directly  
launching  the  Compositor  Application.  

1. Choosing  Optimal  Studies  for  best  demonstration  of  anatomy  and  pathology  
2. Creating  Extractions  
3. Creating  Compositions  
a. One  Modality  
b. Multiple  Modalities  
4. Display  Options  
a. Show  extractions  individually  or  combined  
 

   

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COMBINATION  
Combination   application   allows   you   to   adjust   positions   and   orientations   of   images   that   are  
captured   over   a   long   field   of   view   and   separated   as   different   series.   Combination   is   able   to  
merge,   display,   and   save   multiple   series   like   a   single   image.   The   images   do   not   need   to   be  
overlapped,   but   needed   to   be   captured   at   continuing   positions.   The   connected   or   combined  
image  can  be  used  with  other  applications.    

1. Select  correct  series  

2. Adjust  the  WW  and  WL  
3. Adjust  overlap  or  orientation  manually  
4. Display  the  orthogonal  section  and  MIP  that  are  created  by  combining  different  series.  
5. Save  DICOM  images  after  combining  
6. Open  3D  Viewer  

4D  VIEWER  
4D  Viewer  enables  viewing  of  multiples  series  across  a  period  of  time.  The  series  must  be  from  
the  same  modality  and  have  a  minimum  of  five  slices.  

1. Orthogonal  and  Oblique  Views  

2. Main  Frame  Layout  
3. Edit  Mask  
4. Playback  Order  and  Duration  
5. Create  a  4D  Movie  

SECTOR  MPR  
Sector  MPR  is  a  virtualised  ultrasound  module  that  allows  CT  images  to  be  viewed  as  if  from  
an  ultrasound  probe.    Clinically  it  is  used  for  education  of  sonographers  and  radiographers.    

1. Set  Location  
2. Operation  of  View  Plane  
3. Choose  Virtual  Probe  
a. Sector  
b. Rectangle  
4. Choose  Target  Organ  
5. Reference  Surface  
6. Reverse  and  Invert  
7. Consider  bone  and  water  
8. Centesis  View  
9. Adjust  Slab  Thickness  
10. Distance  Measurement  

   

  10  
      

DYNAMIC  DATA  
Dynamic  Data  In  Dynamic  Data,  a  time  intensity  (time-­‐density)  curve  of  each  pixel  can  be  
created  from  an  image  exposed  for  a  period  of  time  with  CT  or  MR.    

1. Main  Frame  Layout    

2. Slice  Selection  
3. Phase  Settings  –  Time  Interval    
4. Measurement  Settings    
a. Parameter  Range  
5. Overlay  Ratio  
6. Dynamic  Data  Operations  
a. Difference,  TTP,  Max-­‐min,  Area  Underneath  Curve  
7. Create  a  ROI    
a. ROI  SHAPES  
b. Manipulate  a  ROI    
8. Time  Intensity  Curve    
 

DENTAL  ANALYSIS  
Dental   Analysis   MPR   is   used   to   create   panorama   and   cross   sectional   images   of   the   mandible,  
teeth  and  alveolar  bones  using  spiral  CT  images.    

1. Display  cross  sections    

2. Create  and  display  panorama  images  of  alveolar  bones  
a. Editing  Control  Points  
b. Change  Image  Thickness  and  Interval  
3. Demonstrate  Virtual  Implants  
4. Output  to  DICOM  or  windows  printer  
 

SLICER  
The  Slicer  application  is  used  for  observing  cross-­‐sectional  and  reconstructed  slice  images  in  any  
plane.  It  is  primarily  for  use  in  orthopaedic  regions  such  as  vertebrae  and  complicated  fractures  
in  extremities.  Single,  multi  and  curved  slices  can  be  produced.    

1. Loading  the  correct  series  

2. Auto-­‐detection  of  spine  curvature  and  generation  of  slices  
a. Setting  the  vertebral  level  
b. Labelling  of  vertebrae  
c. Manual  Adjustments  –  angles  of  axial,  coronal  and  sagittal  images  
3. Display  slice  images  
4. Understand  different  layouts  for  observing  a  large  number  of  slice  images  
5. Create  CPR  images  
6. Modify  CPR  
7. Switch  to  3D  Viewer  application  
8. Output  slice  images  to  DICOM  systems  or  Windows  printers  
 

   

  11  
      

RECIST  &  PERCIST  TRACKER  

Response   Evaluation   Criteria   in   Solid   Tumours   (RECIST)   measures   and   assesses  
tumour   lesions   and   changes   according   to   WHO,   RECIST   1.0   and   RECIST   1.1  
regulations.     Positron   Emission   Response   Criteria   in   Solid   Tumours   (PERCIST)  
measures   and   assesses   PET   tumour   lesions   and   changes   according   to   PERCIST   1.0  
or  1.1  regulations.    In  order  for  RECIST  or  PERCIST  to  be  used  in  evaluation  multiple  
studies  of  the  same  area  or  past  snapshots  must  be  present.  

1. Understanding  RECIST,  PERCIST  and  WHO  criteria  

2. Understand  the  difference  between  RECIST  and  PERCIST  
3. Selecting  Appropriate  Studies  
4. Following  appropriate  protocols  
5. Identifying  target  lesions  
6. Creating  a  baseline  and  target  lesions  
7. Accepting  and  categorising  lesions  
8. Understanding  snapshots  and  workflow  of  RECIST  studies  
9. Undertaking  follow-­‐up  studies  
10. Creating  Reports  
11. Accepting  reports  and  final  evaluation  of  a  study.  
12. Know  where  to  access  more  information  on  RECIST  and  PERCIST  
   

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ADVANCED  RADIOLOGY  
NEUROLOGY  
Modules   covered   in   the   neurology   section   include   Brain   Perfusion,   Brain   Vessel   Analysis   and   advanced  
functionality  of  3D  viewer  in  relation  to  neurology.  

BRAIN  PERFUSION  
Perfusion   CT   is   a   relatively   new   technique   that   allows   rapid   qualitative   and   quantitative  
evaluation   of   cerebral   perfusion   by   generating   maps   of   Cerebral   Blood   Flow   (CBF),   Cerebral  
Blood  Volume  (CBV),  and  Mean  Transit  Time  (MTT)  and  Time  To  Peak  (TTP).  The  technique  is  
based   on   the   central   volume   principle   (CBF   =   CBV/MTT)   uses   complex   de-­‐convolution  
algorithms   to   produce   perfusion   maps.   Perfusion   CT   has   been   found   to   be   useful   for   non-­‐
invasive   diagnosis   of   cerebral   ischemia   and   infarction   and   for   evaluation   of   vasospasm   after   subarachnoid  
haemorrhage.    

1. Select  correct  study  

2. Ensure  brain  vessels  are  labelled  correctly  
3. Screen  Layout  Options  
4. ROI  
a. Shape  Selection  
b. Hemisphere  Comparison  
5. Results  

ADC  VIEWER  
The  ADC  (Attenuation  Diffusion  Co-­‐efficient)  Viewer  enables  mapping  of  MRI  diffusion  images  
and  allows  measurements  of  these  images.  In  neurology  both  perfusion  and  diffusion  studies  
can  give  valuable  information  to  decide  on  the  best  treatment  for  stroke  patients.    ADC  Viewer  
can  also  be  used  for  analyses  of  the  liver  and  prostate.  

1. Selecting  correct  series  

2. b-­‐Values  
3. Registration  of  series  
4. Display  ADC  Map  and  eADC  Map  images  
5. Calculation  Methods  
6. Setting  appropriate  thresholds  
7. Setting  WW  and  WL  
8. Gradations  
9. Measure  ADC  values  in  ROIs  
10. Pseudo-­‐colour  display  of  ADC  Map  images  
11. Blending  display  of  ADC  Map  images  and  background  images  
12. Automatic/Manual  registration  of  ADC  Map  images  and  background  images  
 

   

  13  
      

BRAIN  VESSEL  ANALYSIS  

Brain  vessel  analysis  requires  both  pre  and  post  contrast  studies  to  extract  brain  vessels.    The  
vessels   are   extracted   via   fusing   both   sets   of   data   together   and   comparing   the   pre   and   post  
contrast  studies.  

1. Choose  correct  Study  and  Series  

2. Ensure  pre  and  post  contrast  series  are  correctly  labelled.  
3. Register  Studies  
4. Brain  Vessel  Tab  
5. Image  Display  
a. Brain  Vessel  3D  
b. Pre-­‐contrast  
c. Fusion  Image  
d. Brain  Vessel  MIP  
e. Brain  Vessel  and  Bone  
6. Fusion  Options  
7. Open  3D  Viewer  

ADVANCED  3D  VIEWER  –  NEUROLOGY  

3D  Viewer  can  be  used  as  an  alternative  to  Brain  Vessel  Analysis  for  studies  that  do  not  include  both  pre  and  
post  contrast  data  or  as  a  quicker  method  for  follow  up  or  studies  that  do  not  require  in  depth  clinical  analysis.  

1. Selecting  Studies  
2. Bone  Removal  
3. 3D  Clip  Tool  
a. Clipping  Range  
b. Clipping  Operation  
4. Special  Clipping  
a. Arbitrary  Plane  Clipping  
b. Face  Clipping  
c. Sphere  Clipping  
d. VOI  Clipping  

   

  14  
      

2D/3D  FAT  ANALYSIS  

1. Select  correct  studies  
2. Identify  base  of  liver  and  top  of  symphysis  pubis  
3. Results  Tab  
a. Visceral  and  Interstitial  Fat  calculated  
b. BMI  Calculation  
4. Report  Creation  

LUNG  ANALYSIS  
Lung   Analysis   utilizes   CT   volume   date   to   analyse   lung   nodules,   bronchi,   lower   attenuation  
areas,  etc.  can  be  performed  using  the  volume  data  collected  by  CT.    

1. Lung  Extraction    
a. Lung  Separation  
b. Bronchus  Extraction  
2. Lobe  Segmentation  
a. Segmentation  Results  
b. Modifications  
3. Nodules  
a. Extraction  
b. Modification  of  Nodule  
4. Bronchial  Analysis  
5. Lung  Attenuation  Absorption  
6. Cluster  Analysis  
a. 2D  Analysis  
b. 3D  Analysis  
7. Goddard’s  Score  

   

  15  
      

LIVER  ANALYSIS  
Liver   Analysis   extracts   liver   and   blood   vessel   regions   from   contrast   radiography   CT   images,  
and   displays   the   result   as   3D   images.   In   addition,   the   dominant   region   of   the   extracted   liver  
region,   portal   vein,   and   veins   can   be   extracted   and   divided   into   areas,   and   a   hepatectomy  
simulation  can  be  performed.    

9. Liver  Anatomy  
10. Selection  of  series;  Tri-­‐phasic  –  confirm  each  series  
11. Registration  
12. Automatic  Extraction  of  Liver  
13. Extract  Surrounding  Organs  and  Vessels  
a. IVC  
b. Arterial  Phase  –  early  and  late  
c. Portal  Vein  
d. Hepatic  Vein  
e. Tumour  
f. Biliary  Tree  
g. Gall  bladder  
14. Set  Root  Node  
15. Display  Options  
a. Show  
b. Sheer    
c. Hide  
16. Volume  calculation  for  liver,  blood  vessels,  bile  duct,  tumours,  bladder,  and  other  regions.  
17. Display  Settings  
a. Smooth  
b. Surface  
c. Cut-­‐plane  
d. Observe  
e. Pre-­‐set  
18. Extract  Region  
a. Divide  
b. Extract  
c. Territory  
d. Drill  
e. Length  
19. Insert  Plane  

   

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CARDIAC  APPLICATIONS  
CALCIUM  SCORING  
Calcium  scoring  displays  the  plaque  area  of  the  coronary  artery  by  colour  and  calculates  the  
quantitative  value  of  the  plaque  by  using  the  Agatston  score  method.    

1. Scan  Requirements  
2. Agatston  Score  
3. Automatic  Extraction  of  the  Heart  
4. Display  single  frame  
5. Scoring  Tab  
6. Display  Options  
7. Selection  Mode  –  ROI  or  Click  
8. Selection  of  Calcium  and  Assign  to  artery  
9. Add  new  artery  
10. Workstation  Settings  

CORONARY  ARTERY  ANALYSIS  (CT  &  MR)  

1. Slice  View  (Optional)  
2. Heart  Extraction  
3. Classifying  (Automated  CT)  
4. Manual  Extraction  (MR)  
5. General  Observation  Tab  
a. Verify  correct  orientation  
b. Coronary  Artery  selection  
c. Editing  and  Relabeling  
d. Viewing  Options  
e. Stenosis  Tools  
f. Plaque  Measurement  
g. Plaque  Thresholds  
h. Modification  Options  
i. Virtual  Stent  
6. Path  Observation  Tab  
7. XA  Observation  Tab  (CT)  
a. Linking  CTA  and  XA  Images  
8. Cardiac  Fusion  (CT  &  NM)  
a. Assign  Stress  and  Rest  NM  correctly  
b. Overlay  Options  
c. MPR  Observation  
d. CPR  Observation  

   

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CARDIAC  FUNCTIONAL  ANALYSIS  (CT)  

CT  Cardiac  Functional  Analysis  requires  a  multi-­‐phase  cardiac  CTA  exam.    Normally  ten  phases  
are   acquired   in   line   with   cardiac   gating.   Functional   Analysis   provides   the   ability   to   view   the  
heart   dynamically.   Synapse   3D   enables   visualisation   of   the   chambers   of   a   beating   heart,   and  
allows   accurate   functional   measurements   to   be   automatically   generated   including   ejection  
fraction  and  cardiac  output  for  the  left  ventricle.  
 
1. Cardiac  Anatomy  
2. Selection  of  Study  and  Functional  CT  Series  
3. 4D  Cine  Play  
4. Ventricle  Tab  -­‐  Automatic  Extraction  
5. Results  
6. Viewing  Options  
a. Ejection  Fraction  
b. Wall  thickness  
c. Wall  thickening  rate  
7. Manual  Edit  
a. Short  Axis  
b. Long  Axis  
c. Series  Edit  
8. Workstation  Settings  
a. Papillary  Muscle  
b. Ventricular  Threshold  
9. Views  
a. Chamber  Views  
b. Bulls  Eye  
c. Mesh  Displays  
10. Reports  
 

CARDIAC  FUNCTIONAL  ANALYSIS  (MRI)  

Cardiac   Function   MR   is   an   application   for   cardiac   function   evaluation,   which   obtains   the   contour  
of   ventricle   and   myocardium   from   MR   images   constructed   by   the   multiple   time   phases,   and  
calculates   ejection   fraction,   end-­‐diastolic   volume,   end-­‐systolic   volume,   stroke   volume,   etc. The  
contour   of   the   ventricle   and   the   contour   of   the   cardiac   wall   can   be   set   by   automatic   extraction  
based  on  the  image  information  or  by  user  input  or  modification.    

Main  functions  are  as  follows:  

1. Cardiac  MRI  Functional  Series  Selection  

2. Semi-­‐automatic   extraction   of   the   contours   of   ventricle   and   myocardium   which   are   required   cardiac  
function  analysis  
3. Display  the  long  axis  and  short  axis  images  of  the  heart  
4. 3D  mapping  display  of  the  result  data  
5. Volume  measurement  and  display  of  the  bull's  eye  for  ventricle  and  myocardium  
6. Short  Axis  Modification  
7. Long  Axis  Modification  
8. Measuring  of  various  cardiac  function  evaluations  
9. Calculation  of  the  ventricle  capacity  from  a  long  axis  image  with  the  Area-­‐Length  method  
10. Output  cine  movies  
 
   

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MYOCARDIAL  DELAYED  ENHANCEMENT  

Delayed  enhancement  of  the  myocardium  application  allows  images  from  2D  and  3D  MR  scans  of  
the  left  ventricle  to  be  analysed.    Images  are  typically  acquired  10  to  30  minutes  post  injection  of  
contrast  media.  

1. Cardiac  anatomy  of  the  myocardium  and  surrounding  heart  

2. Correct  selection  of  series  
a) 3D  Analysis  
b) 2D  Analysis  
3. Contour  Setting  
a) Myocardial  inner  and  outer  wall  
b) Setting  the  normal  region  
c) Interpolation  of  contours  
d) Editing  contours  
4. Bulls-­‐eyes  
a) Understanding  different  types  of  bulls-­‐eyes  
b) Editing  Bulls-­‐eyes  
c) Assessing  slice  levels  
d) Bulls-­‐eye  numbers  
5. Display   of   area   and   volume   of   the   enhanced   area   within   both   the   inner   side   and   outer   side   of   the  
myocardium  
6. Display  of  the  surface  ratio  and  the  volume  occupancy  ratio  of  the  enhanced  area  and  overlays  
7. Create  3D  map  of  myocardium.  
a) Viewing  3D  Map  
b) Understanding  Histograms  

AORTIC  VALVE  ANALYSIS  

Aortic   Valve   Analysis   is   an   application   for   measuring   all   regions   of   the   aortic   valve   to   select   the  
correct   size   implant   for   valve   replacement.   Images   are   obtained   from   CT   series   of   the   entire   heart  
with   cardiac   gating.   This   application   allows   the   confirmation   of   the   size   of   the   aorta,   and   the  
performance  and  calcification  levels  of  the  aortic  valve  to  be  determined.  

1. Gain  an  understanding  of  TAVI/TAVR  procedure  

2. Anatomy  of  Heart  Valves  and  related  vessels  and  chambers  
3. Select  the  correct  dataset  
4. Modifications  
a) Point  of  coronary  vessel  origins  
b) Aortic  outline  
c) Centreline  of  aorta  
d) Change  Valve  Cusp  Positions  
5. Insert  Image  Plane  
6. Insert  Virtual  Valve  
7. Plaque  Regions  
a) Alter  thresholds  
b) Alter  blend  ratios  
c) Show/Hide/Sheer  options  
8. Insert  Virtual  Catheter  

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