Zeego AX InSpace3D DynaCT

syngo Workplace - InSpace 3D/DynaCT
Operator Manual
www.siemens.com/healthcare
syngo InSpace 3D, DynaCT and DynaCT Cardiac
Legend
9 Prerequisites
Instructions
Text lists
Cross reference
Caution/
Warning
Cause
Possible consequences
Precautions or remedies
Usability
BEFORE USING THIS SYSTEM

This system should be used only by employees adequately trained in the use of
this equipment.
Before using this system, the operator should be thoroughly acquainted with the
instructions for use and safety recommendations provided in this manual.
Failure to follow the instructions for use and safety recommendations provided in
this manual can cause serious injury to the patient, to the operator or to other persons.
Original language
Version
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This Operator Manual was originally written in English.

This Operator Manual applies to software version VB14 and higher.
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Table of Contents
Part: syngo InSpace 3D, DynaCT and

DynaCT Cardiac
syngo InSpace 3D
InSpace 3D/Cardiac 3D workflow
Cardiac High Contrast 3D workflow
syngo DynaCT and syngo DynaCT Cardiac
DynaCT workflow
DynaCT Cardiac workflow
6
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7
7
9
10
Chapter: Cross-Sectional Image Reconstruction
11
Primary reconstruction
Offline reconstruction
Secondary reconstruction
The InSpace Reconstruction window
Volume data display
Defining the reconstruction volume
Setting parameters for reconstruction
Adjusting cardiac phases for DynaCT Cardiac
Additional functions
Starting reconstruction
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21
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Chapter: Viewing 3D Reconstructed Images
27
3D display techniques
Multiplanar reconstruction (MPR)
Maximum (MIP) and minimum (MinIP) intensity projection
Volume rendering technique (VRT)
Display in the InSpace task card
Rotating a volume
Changing 3D image display
Visualization of DynaCT images
Visualization of DynaCT Cardiac images
syngo iDentify: Dual volume display
Selecting and loading data sets for syngo iDentify
(dual volume display)
Optimizing dual volume display
Artis C-arm position data
C-arm symbol
Transferring and receiving position data to or from Artis (Automap)
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Chapter: Configuring Reconstruction
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Calling up the preset editor

Changing reconstruction presets
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Editing a preset
Creating a new preset
Deleting a preset
Defining defaults
Chapter: Touchscreen Operation (Artis)

Touchscreen control of the syngo Workplace
Activation of buttons
Selecting the image source
Mouse joystick
Transferring a 3D series for secondary reconstruction
3D image viewing and processing
Function overview
iPilot / iGuide / Adjust To Patient
Applying a modality preset
Working with viewing bookmarks
Measurements
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Operator Manual
Part: syngo InSpace 3D, DynaCT and DynaCT Cardiac

Introduction
syngo InSpace 3D, DynaCT and DynaCT Cardiac allow you to reconstruct a 3D data
set of cross-sectional images from projection images acquired on Artis systems.
2D image data suitable for processing with the syngo Workplace must have been
generated by a 3D acquisition program (i.e. acquisition with rotating C-arm and
acquisition parameters specifically set for processing with syngo InSpace 3D,
DynaCT or DynaCT Cardiac).
The resulting projection images are transferred from the Artis console to a
syngo Workplace and the InSpace Reconstruction application program for reconstruction and visualization.
Areas of application
syngo InSpace 3D, DynaCT and DynaCT Cardiac have been developed for diagnostic purposes in general and for interventional applications in particular.
3D volume data generated by syngo InSpace 3D, DynaCT or DynaCT Cardiac allow
multidirectional viewing of the reconstructed volume.
syngo InSpace 3D, DynaCT and DynaCT Cardiac data provide an additional image
basis for deciding on the therapeutic procedure to be performed immediately after the examination.
At a later stage, syngo InSpace 3D, DynaCT or DynaCT Cardiac data sets are also
excellently suited for the follow-up control of the interventional procedure.
Note
Diagnosis based on syngo Workplace images alone are not a sufficient basis.
Always use the original scenes on the Artis monitors as primary image source
on which any diagnosis must be based.
Note
Please note that a reconstruction of 3D data after a recalibration or with future

software versions may not be possible anymore.
(Also) Archive the reconstructed 3D volume data!
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syngo InSpace 3D
InSpace 3D is the basic technique from Siemens to reconstruct a 3D data set
of cross-sectional images from projection images acquired in a 3D acquisition

run on Artis.
InSpace 3D is used in the angio lab to create 3D images in endovascular and
non vascular procedures. The objects which are visible with InSpace 3D are always high contrast details like bones, clips, coils and vessel - filled with contrast
media. These are details of a contrast difference of down to 100 HU.
Cardiac 3D is the same technique as InSpace 3D used for cardiac applications.
Cardiac 3D is used in the EP lab to provide 3D images of contrast enhanced

heart chambers/vessels, especially in order to generate 3D visualizations of the
left atrial morphology.
InSpace 3D/Cardiac 3D workflow

An InSpace 3D or Cardiac 3D acquisition is performed in the following sequence:
1. Select a 3D acquisition program on the Artis.
2. Rotational acquisition which can be:
a native 3D DR acquisition without contrast medium
a 3D DR acquisition with contrast medium
a 3D DR - Large Volume acquisition with or without contrast medium
a 3D CARD acquisition with contrast medium
a 3D DSA acquisition with contrast medium and subtraction
See the Artis Operator Manual
3. Projection images are transferred to the syngo Workplace.
4. Slice reconstruction using InSpace Reconstruction 11
5. Visualization using the InSpace task card 31
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Introduction
Cardiac High Contrast 3D workflow

A Cardiac High Contrast 3D acquisition is performed in the following sequence:
1. Place the left atrium as exact as possible in the isocenter on Artis.
Since it may be difficult to place the left atrium exactly in the isocenter, especially with a 20 x20 flat detector, it might be beneficial to have a contrast enhanced catheter in the coronary sinus or in the pulmonary artery.
Having a contrast enhanced object within the field of view will simplify positioning, which is done by means of two orthogonal fluoro images, e.g. AP and
LAO 90.
2. Start acquisition (with low frame rate, e.g. 3 f/s) immediately after test bolus
injection in order to find the ideal scan delay for the subsequent acquisition.
3. Select a 3D acquisition program on the Artis.
4. Perform the test run.
5. Contrast medium injection, e.g. via pulmonary artery.
6. Perform 3D acquisition.
7. Projection images are transferred to the syngo Workplace.
9. Visualization using the InSpace task card 31
Optional: Segment the 3D volume using InSpace EP.
See the InSpace EP Operator Manual

Optional: Superimpose the reconstructed 3D volume or the segmentation re-
sult with the live fluoro image using iPilot.

See the iPilot/iGuide Operator Manual
Optional: Define 3D landmarks in the MPRs or in the 3D display of the recon-
structed volume. Those landmarks can be overlaid with the live fluoro image
using iGuide Toolbox.
See the iPilot/iGuide Operator Manual
syngo DynaCT and syngo DynaCT Cardiac

CT techniques
The step from high contrast imaging to a soft tissue imaging was possible by the
adaptation of CT techniques to the reconstruction.
The most important point is the increase of the number of projections that are acquired during a rotation around the patient and the application of CT reconstruction algorithms to create the volume.
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In order to follow the CT techniques, the angio equipment has to acquire in a short
amount of time as many images as possible. The processing step to create crosssectional images from the projection ones has to be adapted as well.
What is DynaCT?
DynaCT enables selected systems of the Artis family to create images that are CTlike images.
What is
DynaCT Cardiac?
DynaCT Cardiac creates cross-sectional 3D images of the beating heart/the left

atrium. It can be performed with or without ECG gating.
By using multiple, e.g. 2 - 4, C-arm runs with ECG gated acquisition and 3D reconstruction taking account of the cardiac phases, the temporal resolution of the 3D
volume is optimized. This results in high resolution visualization of moving cardiac
structures.
What is ACT?
DynaCT involves Angiographic Computed Tomography (ACT) utilizing images obtained through a rotational angiography run on an Artis system.
Image acquisition is performed with a C-arm rotation. The images are transferred
to the syngo Workplace and the 3D volume set is immediately reconstructed using
InSpace Reconstruction.
Soft tissue imaging
No patient transfers
DynaCT delivers soft tissue images that make it possible to visualize objects of
10 HU1 and 10 mm in size with a 16 cm CATPHAN phantom. A quality, that enables you to differentiate soft tissue such as hemorrhage and tumors.
Performing an ACT directly on an Artis system, DynaCT or DynaCT Cardiac eliminates unnecessary patient transfers to other modalities like CT or MRI.
In the event of a complication during an interventional procedure, time is of absolute essence for the safety of the patient. DynaCT allows you to perform ACT directly in the angio lab, thereby further supporting you in your decision-making.
DynaCT offers you additional information at the point of decision. Consequently,
the need to move the patient out of the sterile environment during the interventional procedure is greatly reduced.
Clinical scope
Neurovascular treatment always bears a risk for complications. The extend of a local bleeding as the result of an aneurysm rupture during a coiling procedure, for
example, is not visible on a conventional angiography system. With DynaCT, you
are able to detect the extend of hemorrhaging directly in the angio lab.
DynaCT allows you to visualize the ventricle system of the brain to aid in diagnosing pathologic processes or to guide and monitor placements during drainage procedures.
Capable of high quality examination without the use of contrast agents, DynaCT
also provides diagnostic and interventional support for a broad range of abdominal procedures, including punctures and drainages.
1
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HU is the shortcut for Hounsfield Units.

For example, water is defined as 0 HU, air as -1024 HU, fat has -100 to -20 HU, fresh blood is in the
range of +20 HU, soft tissue has +20 to +80 HU, and bones have > +500 HU.
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Introduction
For oncological applications, DynaCT has the potential to visualize tumors in

dense parts of the body, thereby enabling new methods for conducting biopsies
and treating tumors such as embolisation and RF ablations.
With DynaCT Cardiac a new dimension in DynaCT imaging is opened. Moving
cardiac structures can be visualized in high resolution.
Note
DynaCT is available for systems with FD 30x40 only.

However DynaCT Cardiac is available for systems with FD 20x20 and FD 30x40.
InSpace 3D and DynaCT
The basic difference between InSpace 3D imaging and DynaCT is the number of
projection images acquired and the reconstruction technique.
In InSpace 3D, typically up to 140 images are acquired in 4 to 8 seconds.
In DynaCT, typically 300 images or more are acquired in approximately 6 to 20
seconds.
This is also valid for DynaCT Cardiac with ECG gating.
DynaCT allows a better low contrast solution down to 10 HU.
Acquisition and
reconstruction times
A rotational run on the Artis takes about 5 - 20 seconds for InSpace 3D or DynaCT
and 4 - 8 seconds for DynaCT Cardiac.
The reconstruction on the syngo Workplace using InSpace 3D takes about 20 seconds for a high contrast and about 30 sec. to 1 min. (depending on the selected
acquisition program) for a DynaCT reconstruction.
A DynaCT Cardiac reconstruction takes about 30 seconds without ECG gating,
and about two and a half minutes with ECG gating.
DynaCT workflow
A DynaCT acquisition is performed in the same way as a InSpace 3D acquisition:
1. Selection of a DynaCT acquisition program on the Artis.
2. Rotational acquisition on the Artis.
DynaCT will be in most cases a non-subtracted acquisition.
3. Transfer of image data to the syngo Workplace.
5. Visualization using the InSpace or 3D task cards 34
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DynaCT Cardiac workflow

A DynaCT Cardiac acquisition is performed in the in the following sequence:
1. Selection of a DynaCT Cardiac acquisition program on the Artis.
2. Rotational acquisition of typically 2 to 4 runs on the Artis.
With ECG gating: Rotations are performed with respect to ECG synchronization, image acquisition is performed by ECG gating.
3. Transfer of image data to the syngo Workplace.
4. With ECG gating: Check the ECG R-peak detection and edit it, if required. 21
With ECG gating: Images of identical heart phases are selected for subsequent
reconstruction.
6. Visualization using the InSpace or 3D task cards 34
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Cross-Sectional Image Reconstruction
In principle, there are two possibilities of loading and processing 3D data on the
syngo Workplace:
After a 3D acquisition has been finished on the Artis the transfer of the acquired
data is either started automatically or initiated manually. The transfer of the data
is performed in the background.
When the transfer is started, reconstruction starts automatically on the
syngo Workplace using the reconstruction Preset that is linked to the 3D acquisition program on the Artis or the default reconstruction Preset configured on the
syngo Workplace.
Note
3D raw data (projection images) remain on the syngo Workplace until they are
overwritten by the next transfer from the acquisition system. You can re-process
these data as often as required.
If the security package has been activated, the screen saver must be set to its maximum value (9999 minutes). Thus it will only get activated if the system remains
untouched for more than 6.9 days, which is highly unlikely.
To activate the screen saver, select Options > Configuration from the main
menu and double-click the Screen Saver icon.

Risk that the images cannot be reconstructed and displayed during an
intervention
Note
Please take care when deleting 3D data on the acquisition system.

3D data transferred to syngo Workplace is overwritten by the next 3D data set.
Only reconstructed cross-sectional images remain stored in the local database of
syngo Workplace.
Archive data on the acquisition system before deleting it.
An offline reconstruction can be performed if the original 3D acquisition from the

acquisition system is stored in the local database of the syngo Workplace and the
calibration data is also available.
Offline reconstruction is possible on the syngo Workplace that is connected to
the Artis system where the original 3D acquisition was performed.

Offline reconstructions is also possible on a remote syngo Workplace if:
The licenses for syngo InSpace 3D, DynaCT or DynaCT Cardiac (depending
on the 3D acquisition run) are available.
A 3D realtime reconstruction board (Image ProX) is available on the
syngo Workplace.
Valid calibration data for the acquisition system where the 3D acquisition
run originates from are available.
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For offline reconstruction it is possible to export the calibration data of a

syngo Workplace and import it on a different syngo Workplace.
Once an image series has been loaded via transfer from the acquisition system,
several checks are performed and data is processed using default parameters.
During this time, a progress bar is displayed.

Then the reconstructed 3D image is displayed.
If the original 3D acquisition from the acquisition system is stored in the local database on your syngo Workplace and the calibration data is also available, you can
start a reconstruction from the Patient Browser:
Select the original 3D acquisition data in the Patient Browser window.
Click this icon in the tool bar of the Patient Browser window.
Or
Select Patient > Send To 3D in the menu of the Patient Browser window.
The data are loaded in the InSpace Reconstruction application.

The InSpace Reconstruction window is opened and a reconstruction like a
secondary reconstruction can be started.
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The InSpace Reconstruction window
In the InSpace Reconstruction window two images (two projections differing by
90) of a scene representing the collected 3D data are displayed.
You can select an image pair, select a Preset, choose the reconstruction volume
and change parameters for reconstruction.
(1)
(4)
(5)
(2)
(2)
(6)
(3)
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(1) Menu bar

(2) Image display in lateral and frontal views for VOI selection
(3) Scroll bar
(4) Image numbers and information about expected values of reconstructed volume
(5) Parameter selection subtask cards
(6) Icons for image reconstruction and transfer
Volume data display

Information on the selected 3D volume data is displayed in the upper right corner
of of the InSpace Reconstruction window.
Example
Images: <Image number of upper image> / <Image number of lower image>
The image numbers are the ones of the original scene.

Upper and lower images are from orthogonal views.
If the 3D scene consists of several acquisition runs, the image number are from
the first run.
Number of Slices: Expected number of slices in the reconstructed 3D volume
Voxel Size: Expected voxel size in the reconstructed 3D volume
Defining the reconstruction volume

In a first step you define the size of the VOI (Volume Of Interest). This can be done
in a pair of images displaying a lateral and a frontal view, for example.
Green rectangles in these images tell you which VOI is currently selected for 3D
reconstruction.
With the choice of the VOI you focus on the diagnostically relevant volume in the
displayed set of projections. All regions outside the VOI borders will be excluded
from the reconstruction.
For resetting and repositioning the VOI box you can either use the mouse, enter
numerical values or switch to a preset VOI size first.
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The selection can be done in several steps:

select the image pair
select the approximate VOI size
adjust/move the VOI
Selecting an image pair

Click the required image segment.
Scroll through the images using the scroll bar on the bottom.
Image numbers are displayed top right in the window.
Note
It is possible to window the projection images via the middle mouse button. 24
The windowing is performed onto one image and applied to all images.
Setting a pre-defined VOI

Click one of these icons for small, medium or large volume of interest.
Or
Select the VOI Size on the Recon subtask card.
The VOI is marked with green rectangles in the lateral and frontal views.
Setting a user-defined VOI

Moving a VOI
Move the mouse cursor on the green rectangle between the center of an edge
and a corner.
The cursor changes its shape.
Click and drag the rectangle to the required position.
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Adjusting a VOI
Move the mouse cursor on the green rectangle on the center of an edge or on
a corner.
Click and drag the rectangle to the required size.
Defining a VOI numerically
Click on the tab of the Num VOI subtask card.
Or
Select View > Numeric VOI in the menu of the InSpace Reconstruction win-
dow.
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Value
Description
LR
position of the VOI in direction Left-Right
PA
position of the VOI in direction Posterior-Anterior
HF
position of the VOI in direction Head-Feet
Width
width of the VOI
Height
height of the VOI
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Enter the required values or click on a spin button.
After a value has been modified - via the Return key or if the edit field is
looses the focus or by a click on a spin button - the VOI is updated.
The values are set according to the visible rectangles.
If the rectangle is modified, the values are updated.
Note
A numeric VOI makes sense in clinical studies, for example.
Setting parameters for reconstruction

The reconstruction parameters are displayed and can be changed on the Recon
subtask card.
Click on the tab of the Recon subtask card, if necessary.
Or
Select View > Reconstruction in the menu of the InSpace Reconstruction
window.
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The following parameter settings can be changed and are stored in a reconstruction preset:
Preset: Reconstruction preset 50
VOI Size: Small, Medium, or Full
Slice Matrix: resolution of the slices of the volume
Kernel Type: reconstruction kernel
(HU = Hounsfield Units or EE = Edge Enhanced)

Image Characteristics: Normal, Auto, Sharp, Smooth or Very Smooth
Reconstruction Mode: Nat Fill, Nat Mask, Subtracted or Dual Volume
Viewing Preset: default preset for 3D image display
Series Description: user part for series description
By default, the series description of a reconstructed volume starts with the

name of the used reconstruction preset followed by a string that summarizes
the used reconstruction parameters.
For a secondary reconstruction, you have the possibility to change the first part
of the series description that corresponds to the preset name.
The series description text is composed as follows:
<user part> or <preset name> and <technical parameters>
<technical parameters> are: <Reconstruction Mode> <Kernel Type> <Image
Characteristics> <cardiac data, if applicable (non-gated or Phase in %)>
[InSpace3D]
Example: Nat Full Bone Normal [InSpace3D]
The string length must not exeed 64 characters in total.
Select/enter the required parameters.
Working with presets

For your convenience InSpace Reconstruction offers predefined reconstruction
parameter sets in so-called reconstruction programs or presets.
Changing reconstruction presets 50
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Selecting the VOI size
Defining the reconstruction volume 14

Selecting the slice matrix
An important quality indicator for the spatial resolution of the reconstructed slices
is the voxel size. The voxel size depends on the size of the VOI box as displayed in
the projection images and the slice matrix.
The smaller the voxel size (the larger the slice matrix) the better the spatial resolution of the reconstruction and the longer the reconstruction and storage time
for this 3D volume will be.
Note
In high contrast applications, if spatial resolution is to be optimized, a voxel size

down to 0.2 mm is recommended. This may be achieved by selecting small VOIs
and/or a 512 slice matrix.
Selecting the reconstruction kernel
The reconstruction kernel is essential for the resulting 3D images. Depending on

the required examination, the corresponding kernel must be chosen.
The EE kernel is the basic recommendation for high contrast applications with
injection of iodine.
Otherwise, the HU kernel is recommended. Only the HU kernel results in gray
values that are proportional to X-ray absorption. The HU kernel shall be applied
for quantitative measurements, for data sets with metal (clips, coils), and for
DynaCT data.
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Changing the image characteristics
By default, all reconstruction programs (presets) are set to Auto sharpness.
With the setting Auto, the sharpness of the reconstruction algorithm is automatically adjusted. The Auto setting balances image quality and artifacts. Due
to the reconstruction principle, it is not possible to avoid artifacts completely.
A special algorithm smears out the artifacts in the Smooth setting. Artifacts
are suppressed, but spacial resolution is also reduced.

In the Sharp setting, spatial resolution is maximized, but this results in a higher
artifact level.
Normal is a compromise between Sharp and Smooth.
Very Smooth optimizes the image contrast.
Note
Do not change the Auto setting unless your specific diagnostic problem requires
sharper or smoother image quality.
Subtracted or unsubtracted reconstruction
In the Nat Fill setting, only the fill images are used for reconstruction.
The 3D image is displayed non-subtracted.

In the Nat Mask setting, only the mask images are used for reconstruction.
The 3D image is displayed non-subtracted.

In the Subtracted setting, both fill and mask images are used for reconstruc-
tion. This is especially useful for coil, stent or clips interventions.

The 3D image is displayed subtracted.
In the Dual-Volume setting a Native Mask run and a Subtracted run are recon-
structed and loaded into the InSpace Viewer. This technique, which we call
syngo iDentify, allows to visualize plaque and stents in the best way.
Note
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The settings can be selected only, if the series is available subtracted (mask and fill
images).
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Selecting a Viewing Preset
(Example)
You can use viewing presets for default display (windowing, segmentation, ...)
which are stored in the Preset Gallery.
Viewing presets 33
Resetting to Preset
If you want to discard your changes, you can reset all parameters to the values defined in the corresponding (reconstruction) Preset.
Select Reconstruction > Reset Preset in the menu of the InSpace Reconstruc-
tion window.
Note
You can select another preset in the preset editor. 50
Adjusting cardiac phases for DynaCT Cardiac

For reconstruction of a DynaCT Cardiac volume special parameters can be
changed on the 3D Card subtask card.
Click on the tab of the 3D Card subtask card, if necessary.
Or
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Select View > 3D Card in the menu of the InSpace Reconstruction window.
The following parameter settings can be changed:

Ungated: Use if reconstruction shall be performed without cardiac gating.
Cardiac Phase Center / Cardiac Phase Width: Cardiac phase range during ac-
quisition on Artis (display only)

Cardiac Phase 1 ... 10: One (default) or more (2 ... 10) relative cardiac phases
can be specified (0 ... 100% of the cardiac cycle), which will be used for cardiac
gating.
If more than one cardiac phases are specified, the number N of specified cardiac
phases results in N 3D volumes after the subsequent 3D reconstruction process.
The N 3D volumes cover N different cardiac phases and can be visualized as a 4D
volume.
If two cardiac phases have the same percentage only one volume is reconstructed.
If Ungated is checked only one (ungated) volume is reconstructed from the first
run.
The cardiac phase should be within the Acquired Phase.
Editing the R peaks

Initially the software identifies the R peaks as detected by the ECG recording system. You can verify the correct detection of the single cardiac cycles, i.e. of the single R peaks of the ECG waveform, respectively modify the detected R peaks.
Click this icon.
The ECG Curve window appears.
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Changing scale
You can adjust the scale of the X and the Y axis for better viewing.
Drag the respective slider to the required scale percentage.
Relocating R peaks
If a R peak has not been detected correctly:
Click a yellow line.
The line turns green.

Drag the line to the correct position.
Inserting additional R peaks

If a R peak is missing:
Double-click on the correct position.
Or
Select Add in the popup menu (right mouse button).
A new line appears.

Drag the line to the correct position.
Removing wrong R peaks

If a R peak has been detected while there is none:
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Click the line.

Press the Del key.
Or
Select Delete in the popup menu (right mouse button).
The line is removed.

Saving changes
Click Save to save or OK to save and quit.
After ECG editing the identified R peaks will be the base for the subsequent cardiac
gating process.
Additional functions
You can adopt image display in the InSpace Reconstruction window by changing
the window values of the images.
For documentation of the selected VOI, it is possible to store or film an image.
Windowing images
Click in the required image with the middle mouse key.
Hold the mouse key pressed and move the mouse up or down to change the
window level.
Or
Hold the mouse key pressed and move the mouse to the right or left to change
the window width.

As soon as you release the mouse key, the window settings will change in
all loaded images.
Saving a single image

It is possible to save a single selected image in a new series. An append to an existing series is not possible.
The images are stored with the VOI rectangle and current windowing.
Click on the required image.
The image is marked with a dotted blue frame.

Click this icon.
Or
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Select Patient > Save As... in the menu of the InSpace Reconstruction win-
dow.
The Save As window appears.
Enter a new series description.

Click on OK to save the image.
The image is saved in the original resolution including the VOI graphics.
Filming the current image

Click on the required image.
The image is marked with a dotted blue frame.

Click this icon.
Or
Select Patient > Copy To Film Sheet in the menu of the InSpace Reconstruc-
tion window.
The image is passed to the virtual film sheet.
Closing the InSpace Reconstruction window

Click the Close icon.
Or
Select Patient > Close InSpace Reconstruction in the menu of the InSpace
Reconstruction window.
Note
Once the window has been closed, its status remains available until new images
are transferred (or the syngo Workplace is shut down or restarted). You can return
to InSpace Reconstruction at any time:
In the main menu, select Patient > InSpace Reconstruction.
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Setting automatic close

It is possible to close the InSpace Reconstruction window automatically when a
reconstruction has been performed.
Select Options > Close after sending in the menu of the InSpace Reconstruc-
tion window.
Note
You can use this option during examinations when image data is sent from the acquisition system to the syngo Workplace.
In this case the InSpace Reconstruction window will not appear but the reconstructed image is displayed immediately in the InSpace task card.
Starting reconstruction
Note
It is possible to perfom a reconstruction if up to three volumes are opened in the

InSpace task card and one volume in the 3D task card.
With all reconstruction parameters set as required:
Click this icon in the InSpace Reconstruction window.
Or
Select Reconstruction > Run in the menu of the InSpace Reconstruction win-
dow.
Reconstruction is started.
During reconstruction a progress bar is displayed.
Note
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When you click on Cancel it will take the program a few seconds to be ready again.
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Viewing 3D Reconstructed Images
syngo InSpace 3D, DynaCT and DynaCT Cardiac create stacks of axial cross-sectional images. A stack of images is called volume.
3D display techniques
There are several techniques of displaying volumes:
MultiPlanar Reconstruction (MPR) is used to place the slices in various orienta-
tions through the region of interest. The resulting images are two-dimensional.
Maximum Intensity Projection (MIP) is used for the display of contrast medium
examinations or especially for angiography.

Volume Rendering Technique (VRT) is used, for example, to differentiate be-
tween organs and tissue structures, and for colored, three-dimensional display
of bone, tissue, and organs.
Multiplanar reconstruction (MPR)
(1) Transversal/axial
(2) Coronal
(3) Paraxial
(4) Sagittal
(5) Paraxial
(6) Sagittal
In MPR, two-dimensional images are always calculated from the volume. However, you can move through the representation quickly using the 3D cross-hair or the
mouse to gain a three-dimensional impression.
The smaller the distance between the slices or the larger the degree of overlap of
the original images, the greater the resolution in the examination direction.
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The minimum slice thickness of an MPR image is one voxel. But you can generate
thicker slices (MPR Thick). The gray-scale mean values are calculated for voxels located one behind the other.
(1) MPR: 1 voxel slice thickness

(2) MPR Thick: slice thickness can be set
Only with MPR Thick, the small differences in the density can be seen.
Both the syngo InSpace and the syngo 3D task card provide visualization with MPR
Thick.
Maximum (MIP) and minimum (MinIP) intensity

projection
In the selected view through the volume elements (called voxels) with the greatest/least intensity are determined and projected onto a surface irrespective of
whether they are at the front or further back in the stack. This gives you the maximum/minimum intensity projection.
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MIP
The voxel with the maximum intensity is displayed in the MIP image.
(1) Voxels in MIP images

(2) Most intensive gray scale value
Some structures, especially bones, cause interference in the projections. Where
bones and blood vessels are superimposed on one another on the MIP projection,
the voxels of the (denser) bones can cover the voxels of the blood vessels. In this
case, reduce the target volume using the VOIs (Volumes of Interest) until it only
contains the vessels to be projected.
MinIP
You can use this method, for example, for examinations of the lung as the structures with the least intensive gray-scale values.
In the MinIP image the voxels with the minimum intensity are displayed.
In order to gain a three-dimensional impression you can generate several MIP/
MinIP images from different viewing directions or rotate the projection using the
mouse or the 3D cross-hair.
MIP Thin / MinIP Thin
You can limit the volume for a projection to a partial area of the volume data set.
In the output type MIP Thin/MinIP Thin you define which expansion the volume
used for the projection should have.
(1) Normal MIP or MinIP Thin, whole volume

(2) MIP Thin or MinIP Thin, only partial volume (slice) is used for projection
(3) Part used
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Volume rendering technique (VRT)

The Volume Rendering Technique (VRT) is a way of creating color images in which
a 3D effect is achieved with such parameters as transparency, shading, and color
transition.
The entire volume data set is included in the image. Areas of interest such as bone
and blood vessels can be emphasized interactively by assigning appropriate color
and transparency values.
The VRT method is based on the idea that defined rendering properties (color,
brightness, contrast, and transparency) are assigned to the voxels of the volume
data set depending on the initial pixel value (HU value). In practice, pixel input value ranges are assigned to specific tissue classes.
This technique works optimal when the object of interest is visible and nothing
with the same density is located close to it.
The display of DynaCT images with VRT will be limited to areas where air - like in
the lungs - is present.
The InSpace and the 3D task cards provide VRT visualization.
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Display in the InSpace task card
InSpace task card
When reconstruction is completed, image data is transferred to the InSpace task

card and is displayed there.
For general information, please refer to the InSpace online help.
Note
When image data is loaded into a task card and this data is simultaneously altered
using Correct, a refresh is not performed by the task card. Therefore an inconsistent state can arise.
Do not change image information using Correct while image data is loaded.
Note
Patient position on Artis was changed.

If the VRT image has to match the acquired image you may freely rotate the VRT
to any desired projection.
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There are several specialities with X-ray 3D images acquired on an angiography

system:
C-arm display
Functions for transferring and receiving position data to or from Artis
Special presets and bookmarks for image display of X-ray images
Rotating a volume
Activate the Manipulate All Objects mode by clicking this icon, if the mode is
not set by default.

Rotate the volume by left-clicking on the volume and drag it in any direction.
The mouse cursor shape changes to a rotation indicator.

Keep the mouse button pressed and rotate the volume into the required posi-
tion.
Or
Click this icon.
Keep the mouse button pressed and rotate the volume.
Note
If you release the mouse button while you are rotating the volume, it will continue
to rotate automatically.
Click on the view to stop the volume rotating.
If you want to disable this feature permanently:

Select Orientation > Volume Rotation in the main menu.
Remove the selection of Auto Rotate.

For segmentation purposes (e.g. vessels or bones), one or more windows using
the Table subtask card can be set.
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Note
Segmentation is essentially based on correct window settings. Measurements

may get wrong due to wrong segmentation.
Choose the window setting carefully.
Viewing presets
It is also possible to use the preset gallery.

Click this icon.
Or
Select InSpace > Load Modality Preset... in the main menu.
Use presets located in the AX section there.
There you will find several (viewing) presets useful for InSpace 3D / DynaCT /
DynaCT Cardiac images.
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Visualization of DynaCT images

Displaying DynaCT images with VRT
When reconstruction is completed, image data is automatically transferred to the
InSpace task card and is displayed there.
Displaying DynaCT images with MPR Thick
Reconstructed DynaCT images are not automatically displayed with MPR Thick.
With the MPR for thick slices, you can define the thickness of the original slice from
which the image is to be reconstructed. The program calculates an average from
several gray-scale values and uses these averages to build up the image.
Click this icon on the Type subtask card of the InSpace task card.
The selected segment is set to type MPR.

Click this icon on the Type subtask card with the right mouse button.
Or
Select a segment and then right-click on it.
Choose MPR in the function menu (right mouse button).

Select the segment again and right-click on it.
Choose Slice Properties in the function menu.

The Slice Properties dialog box appears.
Click Thick MPR.

Enter an MPR thickness (in mm) or adjust the slider.
Recommendation: 3 mm
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Further settings:
Disable the Auto-hide MPR lines after delay checkbox if you want to always
display the reference lines.

If Window all MPR views together is set, all the MPR views will be windowed
simultaneously.
If Maintain orthogonal MPR views is set, changing the orientation of one
MPR plane will also change the other two planes to keep them mutually orthogonal.
If this option is not checked, each MPR plane can be rotated to any desired angulation without affecting the other MPR planes.
Close the dialog box.
The selected setting is applied to all MPR Thick reconstructions.
Note
The value for MPR image thickness is displayed in the image and always also
filmed and stored.
Visualization of DynaCT Cardiac images

The 3D morphology of cardiac chambers or vessels can be extracted interactively
(using the default InSpace punching functionality) or by using advanced segmentation functionality of InSpace EP. When using InSpace EP, also endoscopic view
(Fly) visualizations of cardiac chambers can be displayed.
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InSpace EP
It is also possible to visualize several reconstructed volumes as a movie (4D), e.g.

if each of the volumes contains images of a certain cardiac phase.
syngo iDentify: Dual volume display

It is possible to reconstruct two volumes from a 3D data set and display them simultaneously.
You can use different reconstruction modes and/or viewing presets for best reconstruction of vessels and bones, for example.
Prerequisites
Dual volume reconstruction is only possible under certain conditions:

The two volumes must be reconstructed from the same 3D data set.
Or
A 3D/3D registration has been performed for two 3D data sets.
Please refer to the syngo InSpace 3D/3D Fusion Operator Manual.
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Preparing dual volume display

Dual volume display needs a lot of memory. To prevent any problems, unload any
other studies or volumes first.
Click this icon.
Selecting and loading data sets for syngo iDentify

(dual volume display)
The required data sets should already be available on your local data base.
Open the Patient Browser.
Select the required patient and study.
Click the first series.
Press the Ctrl key.
Ctrl
Click the second series.
Drag the selected series into the InSpace task card.
The Volume Selector window appears.
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Click on Load Merged.
The Apply Modality Preset window appears.
Select a modality preset.
Both volumes are displayed overlaid to each other.
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Optimizing dual volume display

The Dual-Volume Properties window opens automatically when reconstructing
a dual volume data set.
To reopen it when closed:
Select Tools > Dual-Volume Properties in the main menu.
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You can select the following merging methods of the two volumes:
Addition A+B: Volume A is added to volume B. The two volumes are overlaid
to each other.
Subtraction A-B: Volume B is subtracted from volume A.
Embedded MPR (B+ A MPR): Embed volume A as MPR to volume B.
Clipped (B + A Clipped): The two volumes are overlaid to each other, volume
A is clipped.
Side by Side: The two volumes are displayed side by side in MPR view.
Note
Ensure that the volumes are registered correctly before having confidence to the
ghost cursor of the Side by Side mode!
A Only, B Only: Only one volume is displayed.
Reverse A & B in Merging: Reverse volume A and volume B.
You can window the two volumes separately or together:

Windowing: A Only, B Only, Both
Windowing
For best display, you should adjust image display of the two volumes separately.
For example, you can use a bones preset for the mask images and a vessel preset
for the fill images of a 3D DSA series.
Optimizing the first/second volume
Click Windowing: A Only/B Only.
Or
Select Volumes > [Your first/second volume] in the main menu.
Only the first/second volume is displayed, e.g. bones/vessels.
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Select InSpace > Load Modality Preset... in the main menu to check/select a
suitable modality preset.
Adjust the ramp for best display (of bones, for example).
Displaying both volumes

Select Volumes > Dual [Your volumes] in the main menu.
Both volumes are displayed.
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Changing the merging method and ratio of the volumes

Changing the merging method
Click A Only/B Only/Addition A+B or Subtraction A-B.
Example of a subtracted volume A (vessels) and a non-subtracted volume B (bones)

From left to right: A, A+B, B
Changing the ratio of the two volumes

The displayed portion of each volume can be changed.
Click and drag the slider or enter a percentage.
Image display changes immediately.
Example of a subtracted volume A (vessels) and a non-subtracted volume B (bones)

From left to right: more A (slider to the left), equal portions, more B (slider to the right)
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Embedded MPR
Click Embedded MPR (B+ A MPR).
Display changes to MPR display.
You can adjust the MPR segments.

Double-click the lower right-hand segment.
Display changes to fullscreen.
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You can rotate the view and adjust the MPR plane.
The embedded MPR plane behaves like a clip plane. The thickness of the MPR can
be changed by adjusting the Slab Thickness.
Click this icon on the Clip subtask card with the right mouse button.
Or
Select Type > Set Slab Thickness... from the main menu.
The Slab Thickness dialog box opens.

For more information, please refer to the InSpace online help.
Artis C-arm position data

Artis 3D data sets in VRT or MIP display are shown with a rotating C-arm symbol.
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C-arm symbol
When you rotate the image, the C-arm displayed in the top right corner performs
the rotation correspondingly. It moves to all positions, although the C-arm may
not be able to rotate to that position in reality.
In images from biplane systems two C-arms are shown. If plane B is in parking position only the C-arm of plane A is shown.
Angulation data are displayed next to the C-arm (of plane A only).
C-arm display
Description
Single plane configuration:

C-arm and table, both have blue color:
C-arm position is reachable.
C-arm has red color and table has blue color:

C-arm position is not reachable.
C-arm and table, both have red color:

C-arm collides with the patient table.
Biplane configuration:
C-arm of plane A and table, both have blue color:
C-arm position is reachable.
C-arm of plane A has red color and table has blue color:
C-arm of plane B has red color and table has blue color:
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C-arm display
Description
Both C-arms have red color:
C-arms collide with each other.
C-arm of plane A and table, both have red color:

C-arm of plane A collides with the patient table.
C-arm of plane B and table, both have red color:

C-arm of plane B collides with the patient table.
Hiding the C-arm display

Click this icon on the X-Ray subtask card.
Showing the C-arm display

Transferring and receiving position data to or from

Artis (Automap)
On the X-Ray subtask card there are two icon buttons providing position data
transfer from or to Artis.
Adjusting image display corresponding to C-arm position

Especially during examinations, it may be useful to see the 3D image in exactly the
current position the C-arm.
syngo Workplace
Artis touchscreen
Press this icon.
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The 3D image is rotated corresponding to the current C-arm position.
Adjusting the C-arm position corresponding to image display

(single plane)
To acquire an image corresponding to the current 3D image displayed on the
syngo Workplace, it is necessary to rotate the C-arm to this position (only for possible positions).
Note
The patient must be registered in the same position as has been during the acquisition of the 3D volume data set.
Note
If the current 3D image display is not in the possible range of C-arm positions (red
C-arm display) the following situations may occur:
The system tries to move the C-arm near to the required position.
If the required position is too far away, the position data transfer is rejected.
syngo Workplace
9 The C-arm is displayed in blue color (no collision).

Artis touchscreen
Press this icon.
Perform automatic movement on Artis:

Press the stand joystick (of plane A) down and deflect it forward until the tar-
get position is reached.

Or press the hands free foot pedal.
The C-arm is rotated corresponding to the current 3D image display.
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Adjusting the C-arm position corresponding to image display

(biplane)
X-Ray task card/
Status
C-arm display
Monitor
icon
Touchscreen
icon
Action
To adjust C-arm of plane A:

Click/press this icon.
Perform automatic movement on
Artis: 47
To activate C-arm of plane B:

Plane A is active.
(blue C-arm)
To adjust C-arm of plane B:

Artis: 47
To activate C-arm of plane A:

Plane B is active.
(orange C-arm)
To activate C-arms of both planes:

Plane A or plane B is active. (not affected)

To adjust both C-arms:
Artis: 47
To activate C-arm of a single plane:

Both planes are active.
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(no red C-arm)
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Configuring Reconstruction
For your convenience, the syngo Workplace offers predefined reconstruction parameter sets in so-called reconstruction programs or presets.
You can easily redefine these presets by choosing one, altering its reconstruction
parameter settings and saving the changes.
Using these presets you need not make any further settings after acquisition on
the syngo Workplace.
The 3D data set is automatically reconstructed and visualized in the InSpace task
card.
This way you can customize 3D reconstruction with the syngo Workplace by creating standard reconstruction parameter sets that will produce the best results in
your area of application.
Calling up the preset editor

9 InSpace Reconstruction window is on top.
Select Reconstruction > Edit Preset in the menu of the InSpace Reconstruc-
tion window.
Or
9 InSpace task card is on top.
Select Options > Configuration from the main menu.
The Configuration Panel appears.

Double-click the InSpace Reconstruction icon.
The InSpace Reconstruction configuration window is displayed.
This window displays a list of all reconstruction presets and shows its parameters.
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Note
The number of entries in the list is limited to 12. If the list is full and you want to
create a new entry, you need to delete an entry first.
It is not possible to delete all entries of the list. At least one entry remains.
Note
The default reconstruction preset DynaCT modified performs a special correction

to ease the visualizations of hemorrhage near the skull.
If this preset is deleted it is not possible for the user to create a new reconstruction
preset, that uses this algorithm!
Changing reconstruction presets

You can edit, delete and create new reconstruction presets.
Editing a preset
Click the required preset line in the InSpace Reconstruction window.
Double-click an entry.
Or
Select an entry and click on Edit Entry.
The InSpace Reconstruction Editor window is displayed.
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The parameters of the selected preset are displayed.

Preset Name:
Name of the preset

Modify the preset-name, if required.
Organ Program Number

Identifier for this reconstruction preset to be used as a reference in the Artis Exam
Set Editor (3D Recon Preset in ACQUISITION TYPE) - number between 1 and 12.
Select the required number used by the acquisition program.
Reconstruction parameters
See Setting parameters for reconstruction 17
Automatic reconstruction
Automatic Reconstruction: Yes
3D reconstruction is started automatically after image transfer.

Automatic Reconstruction: No
3D reconstruction is not started automatically.
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Automatic visualization
Automatic Visualization: Yes
3D data is visualized immediately after reconstruction in the InSpace task card.

Automatic Visualization: No
The data is stored to database only.

Window values
The cross sectional images created by InSpace 3D, DynaCT and DynaCT Cardiac
contain two pairs of window values. This makes it easier to find the appropriate
window values when reviewing the data.
You can then use the functions Window 1 and Window 2 which are available in
the syngo Viewing, 3D and InSpace task cards to switch between the two window values with a single mouse click.
Viewing Preset
See Viewing presets 33
Change the settings and click on Apply to keep the changes.
Creating a new preset

Click on New Entry.
To create a new preset type in the requested preset-name. The other data
fields are initialized with default values for the parameters.
For example:
VOI Size = Medium
Slice Matrix = 512 x 512,
Kernel Type = HU,
Image Characteristics = Auto,
Automatic Visualization = Yes,
Reconstruction Mode = Subtracted
Window1 Center = 0
Window1 Width = 1000
Window2 Center = 0
Window2 Width = 300
Viewing Preset = <first entry in the list of viewing presets>
Click on Apply to store the setting.
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Deleting a preset
Click the required preset line in the InSpace Reconstruction window.
Click on Delete Entry.
The preset is deleted immediately.
Defining defaults
The InSpace Reconstruction Preset to be used is configured in the 3D DR, 3D
DSA or 3D CARD acquisition program on the Artis.
The Organ Program Number of the InSpace Reconstruction Preset is used as a
reference for this purpose in the Artis Exam Set Editor (3D Recon Preset in
ACQUISITION TYPE).
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Touchscreen Operation (Artis)
Various functions of the syngo Workplace can be operated using the Artis touchscreen and mouse joystick.
If Inroom Control has been purchased, the additional InSpace task card is available.
(Example, configurable)
Operation works in the same way since the Artis Imaging System can be controlled
by pressing the buttons on the touchscreen and deflecting the joystick.
Refer the Artis Operator Manual for more details.
Most of these functions can also be operated from the syngo Workplace.
If necessary, activate the InSpace task card.
Touchscreen control of the

syngo Workplace
Normally the touchscreen joystick operates the Artis Imaging System. It is also
possible to take control of the syngo Workplace in the examination room using the
Artis mouse joystick.
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(1)
(2)
(1) Touchscreen
(2) Mouse joystick
For your convenience, some important functions have been mapped to buttons
on the touchscreen with slightly different mouse (joystick) operation.
Activation of buttons
Functions of syngo Workplace, which are explicitly available on the touchscreen
can be activated both on the syngo Workplace and the touchscreen control.
The button of a function which is not active has a gray background.
Press, to activate it.
The button of a function which has been activated on syngo Workplace, has a
white background.
Press, to take control in the examination room.
The button of a function which is active in the examination room has a white
background with a green joystick.

Perform your operation using the mouse joystick.
Press, to deactivate it.
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Selecting the image source

The Artis additional color display can be used for displaying images from other
equipment such as
syngo Workplace
Endoscopy
Ultrasound
Patient monitoring, etc.
Artis touchscreen
9 Settings task card
Example
Press the button for the required image source.
The image in the additional color display is switched over immediately.
Mouse joystick
Using the mouse joystick you can execute all the mouse functions of the
syngo Workplace.
syngo Workplace mouse control
If you want to take control of the syngo Workplace in the examination room:
Press this icon.
Now you can move the mouse pointer on the monitor of the syngo Workplace
by deflecting the mouse joystick.
You can also press the buttons like on a normal mouse.
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Artis mouse control

If you want to redirect the functions of the IS-Joystick to control the Artis Imaging
System:
Press this icon again.
Transferring a 3D series for secondary reconstruction

Artis console
9 PostProc task card

Press the Patient Browser key (Num .) on the symbol keypad.
Select the 3D series in the Patient Browser and load it by drag & drop or by
double-clicking.
Select Image > Send to 3D in the main menu.
Artis touchscreen
9 InSpace task card

Press this icon.
If a 3D DSA scene is viewed in subtracted mode:
The mask and all fill images will be transferred.

If a 3D DSA scene is viewed in native mode, or if a 3D DR scene is being re-
viewed:
All fill images of the acquired scene will be transferred.
If a 3D CARD series is viewed:
The images of all acquisition runs will be transferred.

A progress bar indicating the running reconstruction is displayed on the monitor
of the syngo Workplace.
3D image viewing and processing

Function overview
The following InSpace functions are supported on the Artis touchscreen:
For more information, please refer to the respective operator manuals and online
help.
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Function
Monitor
icon/Key
Touchscreen
icon
Image display
Short description
Manipulation mode (default)

In the manipulate all objects mode, whatever object
is behind the cursor, will be selected.
Switch to rotate volume mode
Zoom/pan volume
No mouse joystick button pressed:
Up/down: increase/decrease zoom

Left mouse joystick button pressed:
Left/right: Pan left/right

Up/down: Pan up/down
-
Middle mouse (joystick) button pressed:
Left/right: Decrease/increase window width

Up/down: Increase/decrease window center
Window center (WC) - (Num)

(Brightness -)
Window center (WC) + (Num /)

(Brightness +)
Window Width (WW) - (Num *)

(Contrast -)
Window Width (WW) + (Num -)

(Contrast +)
Adjust window center/width
Up/down: increase/decrease window center

Left/right: increase/decrease window width
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Function
Monitor
icon/Key
Touchscreen
icon
Short description
Adjust brightness/opacity
Up/down: increase/decrease brightness

Left/right: increase/decrease opacity
Reset visualization to the loaded preset
Select orientation
Open Orientation popup

Selecting the standard view 65
Adjust view
Open View popup
Selecting Full Screen mode 63
Switching between 1/1 VRT and 4/1 MPR display

64
InSpace > Load Modality

Preset...
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Function
Monitor
icon/Key
InSpace > Save Series Bookmark
Touchscreen
icon
Short description
Saving a bookmark 68
(right mouse button)
InSpace > Load Series Bookmark
Loading a bookmark 68
(left mouse button)
Measurements
Open Measure popup
Measuring distances 70
Using a grid 69
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Function
Monitor
icon/Key
Touchscreen
icon
C-arm position
Short description
Adjusting image display corresponding to C-arm position 46

Adjusting the C-arm position corresponding to image
display (single plane) 47
Adjusting the C-arm position corresponding to image
display (biplane) 48
AXIOM Sensis
Copy image data to Sensis Report

iPilot / iGuide / Adjust To Patient

The following touchscreen functions are described in detail in the iPilot/iGuide Operator Manual.
Function
syngo iPilot
Monitor
icon
Touchscreen
icon
Short description
iPilot Live: The 2D projection of the latest 3D volume

on syngo Workplace will be displayed on the active
Artis reference screen and overlaid to the Artis live image.
iPilot Dynamic (3D Roadmap): The Artis live image is
overlaid to the 3D image on syngo Workplace.
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Function
Monitor
icon
Touchscreen
icon
syngo iGuide Toolbox
Short description
Open iGuide Toolbox popup
Linked Marker: Place points/lines in the latest 3D image on syngo Workplace.

The 2D projections of the points/lines will be displayed
in the Artis live image.
Linked Pointer: Position/move the mouse pointer in

the latest MPR image on syngo Workplace.
The mouse cursor will be positioned at the corresponding point in the 2D Artis live image.
Linked Contour: Automatically draw contours in the
latest 3D image on syngo Workplace.
The 2D projections of the contours will be displayed in
the Artis live image.
syngo iGuide Needle
Guidance
syngo Adjust To Patient
Plan a needle path for interventional procedures.
Align a 3D volume on syngo Workplace to the current

Artis live image, e.g. after a patient movement.

Selecting Full Screen mode
For better image viewing, it is possible to hide the tab cards with icons, etc. and
display the image of the syngo Workplace in full screen mode.
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syngo Workplace
Click on the arrow top right.
Artis touchscreen
Press this icon.
Press this icon.
Only the image area is shown on the syngo Workplace monitor.

To show the tab cards again, press the button again.
Switching between 1/1 VRT and 4/1 MPR display

In InSpace various display modes are available. Using the touchscreen control it is
possible to switch between the following display modes:
Volume Rendering Technique (VRT)

MultiPlanar Reconstruction (MPR)
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syngo Workplace
Click the Type subtask card to the front, if necessary.

Click one of these icons (bottom left).
Image display is switched to single/dual/quad VRT display.

Click on this icon (bottom right).
Image display is switched MPR/MPR/MPR/VRT display.

Artis touchscreen
Press this icon.
Press this icon.
Image display on the syngo Workplace monitor is switched from single VRT
to MPR/MPR/MPR/VRT display.
To switch back to VRT only display, press the button again.
Selecting the standard view

It possible to rotate the 3D image to one of the following standard views:
button
View
Ant
from anterior
Post
from posterior
Left
from left
Right
from right
Feet
from feet
Head
from head
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syngo Workplace
Click the Orient subtask card to the front, if necessary.

Click on the orientation button you require.
Artis touchscreen
Press this icon.
Select the view you require.
Applying a modality preset

Select InSpace > Load Modality Preset... in the main menu.
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syngo Workplace
Select a preset located in the AX section.
There you will find several (viewing) presets useful for InSpace 3D / DynaCT /
DynaCT Cardiac images.
Artis touchscreen
Press this icon.
The preset gallery is displayed.

Choose a bookmark.
Click Apply.
Working with viewing bookmarks

Viewing bookmarks for the 3D image can be stored and reloaded via the
Bookmark function.
Note
Bookmarks are assigned to the current study and can only be recalled when the
same study is active again.
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Saving a bookmark
Display the image in the way you require.
syngo Workplace
Click on this icon (bottom right) using the right mouse button.
Artis touchscreen
Press this icon.
The image display is saved in the bookmark gallery.

The bookmark is automatically named bookmark 1, bookmark 2 and so
on.
Loading a bookmark
syngo Workplace
Click on this icon (bottom right) using the left mouse button.
Artis touchscreen
Press this icon.
The bookmark gallery is displayed.
Choose a bookmark.
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Operator Manual
Click Ok.
The image is displayed corresponding to the loaded bookmark.
Measurements
syngo Workplace
Click the Measure subtask card to the front, if necessary.
Artis touchscreen
Press this icon.
Select the function you require.

When finished, close the window via X.
Using a grid
It is possible to overlay a grid pattern on the 3D image which makes it possible to
estimate distances between points in the volume.
syngo Workplace
Click on this icon.
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Artis touchscreen
Press this icon.
A grid is displayed.
Rotating the grid
Deflect the mouse joystick to move the cursor over a grid axis.

Press the left mouse joystick button and hold it pressed while deflecting the
mouse joystick to rotate the grid.
Note
Make sure to move the cursor over a grid axis. Otherwise you will rotate the image.
Panning the grid

Deflect the mouse joystick to move the mouse cursor over the grid center.

Press the left mouse joystick button and hold it pressed while deflecting the
mouse joystick to pan the grid.
Measuring distances
It is possible to measure the distance between two points in the display plane.
syngo Workplace
To measure the distance between two points in the displayed plane in 2D, i.e. stay
although the object turns:
Click on this icon.
To measure the distance between two points in the displayed plane in 3D, i.e. turn
with the object:
Click on this icon.
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Artis touchscreen
To measure the distance between two points in the displayed plane in 3D:
Press this icon.
Deflect the mouse joystick to move the cursor to the first point.
Press the left mouse joystick button to mark the start point of the distance line.
Deflect the mouse joystick to move the cursor to the second point.
Press the left mouse joystick button to mark the second point of the distance
line.
The distance line is drawn in.
The distance is calculated and displayed.
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Operator Manual
Index
3D
display techniques 27
load and process data 11
A
Acquisition times 9
ACT 8
Additional color display
selecting the image source 57
Adjust To Patient 63
touchscreen 62
Adjusting cardiac phases 21
Angiographic Computed Tomography
(ACT) 8
Application 5
Artis
C-arm position data 44
touchscreen 55
Auto Rotate 32
Automap 46
Automatic reconstruction
configuring 51
Automatic visualization
configuring 52
B
Bookmarks
touchscreen 67
Brightness
touchscreen 60
C
Cardiac 3D 6
workflow 6
Cardiac High Contrast 3D
workflow 7
C-arm position
touchscreen 62
C-arm position data 44
C-arm symbol 45
Clinical scope 8
Closing
reconstruction 25
Configuring
InSpace Reconstruction 49
Cross-sectional image Reconstruction 11
CT techniques 7
Display
of volume data 14
Distance
touchscreen 70
Dual volume display 36
Dual-volume
windowing 40
Dual-Volume Properties 39
DynaCT 8
visualization 34
with MPR Thick 34
with VRT 34
workflow 9
DynaCT Cardiac 8
cardiac phases 21
visualization 35
workflow 10
E
Editing
R peaks 22
Embedded MPR 43
F
Filming
in InSpace Reconstruction 25
Full screen mode
touchscreen 63
G
Grid
touchscreen 69
I
iGuide
touchscreen 62
iGuide Needle Guidance 63
iGuide Toolbox 63
Image
filming in InSpace Reconstruction 25
saving in InSpace Reconstruction 24
Image characteristics
for reconstruction 20
Image display
touchscreen 59
Image reconstruction 11
InSpace
task card 31
InSpace 3D 6
workflow 6
InSpace Reconstruction
configuring 49
window 13
iPilot 62
touchscreen 62
iPilot Dynamic 62
iPilot Live 62
K
Kernel
L
Linked Contour 63
Linked Marker 63
Linked Pointer 63
Loading a bookmark
touchscreen 68
M
Manipulation mode
touchscreen 59
Maximum Intensity Projection
(MIP) 27, 28
Measurements
touchscreen 61, 69
Minimum Intensity Projection (MinIP) 28
MinIP 29
MinIP Thin 29
MIP 29
display technique 27
MIP Thin 29
Modality preset 33
touchscreen 66
Mouse joystick 55, 57
MPR 27, 28
touchscreen 64
MPR Thick 28
DynaCT 34
Multimodality
image source 57
Multiplanar reconstruction (MPR) 27
N
Needle Guidance 63
O
Offline reconstruction 11
performing 12
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Opacity
touchscreen 60
Orientation
touchscreen 60, 65
P
Pan volume
touchscreen 59
Position data
transferring 46
Preset editor 49
Preset gallery 33
Primary reconstruction 11
performing 12
R
R peaks
editing 22
Reconstruction 11
closing 25
filming 25
image characteristics 20
parameters 17
saving 24
slice matrix 19
starting 26
subtracted or unsubtracted 20
viewing 27
windowing 24
Reconstruction kernel 19
Reconstruction presets 50
Reconstruction times 9
Reconstruction volume 14
Resetting visualization
touchscreen 60
Rotate volume
touchscreen 59
Rotating a volume 32
S
Saving
Saving a bookmark
touchscreen 68
Secondary reconstruction 11, 58
performing 13
Sensis Report
touchscreen 62
Slice matrix
Soft tissue imaging 8
Standard view
touchscreen 65
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Subtracted reconstruction 20
syngo Adjust To Patient 63
syngo iDentify 36
syngo iGuide Needle Guidance 63
syngo iGuide Toolbox 63
syngo iPilot 62
T
Task card
InSpace 31
Touchscreen 56
Artis 55
C-arm position 62
function overview 58
image display 59
measurements 61, 69
orientation 60
view 60
Transferring
for secondary reconstruction 58
W
Window
InSpace Reconstruction 13
Window 1 52
Window 2 52
Window values 52
Windowing
dual-volume 40
touchscreen 59
Workflow
Cardiac 3D 6
Cardiac High Contrast 3D 7
DynaCT 9
DynaCT Cardiac 10
InSpace 3D 6
Z
Zoom volume
touchscreen 59
U
Unsubtracted reconstruction 20
V
View
touchscreen 60
Viewing
in InSpace task card 27
Viewing bookmarks
touchscreen 67
Viewing preset 33
configuring 52
Visualization 27
of DynaCT Cardiac images 35
of DynaCT images 34
VOI
numerical 16
pre-defined 15
user-defined 15
VOI (Volume Of Interest) 14
Volume 27
Volume data
display 14
Volume Rendering Technique (VRT) 27
Volume rendering technique (VRT) 30
Volume rotation 32
VRT 30
DynaCT 34
touchscreen 64
AX42-010.621.63.01.02
Operator Manual
Notes
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Global Business Unit

Siemens AG
Medical Solutions
Angiography, Fluoroscopic and
Radiographic Systems
Siemensstr. 1
DE-91301 Forchheim
Germany
Phone: +49 9191 18-0
www.siemens.com/medical
Local Contact Information

In Germany
Siemens AG
Medical Solutions
Angiography, Fluoroscopic and
Radiographic Systems
Siemensstr. 1
DE-91301 Forchheim
Germany
Phone: +49 9191 18-0
www.siemens.com/medical
Global Siemens Headquarters

Siemens AG
Wittelsbacherplatz 2
80333 Muenchen
Germany
Global Siemens
Healthcare Headquarters
Siemens AG
Healthcare Sector
Henkestrasse 127
91052 Erlangen
Germany
Phone: +49 9131 84-0
www.siemens.de/healthcare
www.siemens.de/healthcare
Order No.: AX42-010.621.63.01.02 | Printed in Germany | 04.2009, Siemens AG
Legal Manufacturer
Siemens AG
Wittelsbacherplatz 2
DE-80333 Muenchen
Germany

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syngo Workplace - InSpace 3D/DynaCT

syngo InSpace 3D, DynaCT and DynaCT Cardiac

BEFORE USING THIS SYSTEM

This Operator Manual was originally written in English.

Part: syngo InSpace 3D, DynaCT and

Chapter: Cross-Sectional Image Reconstruction

Chapter: Viewing 3D Reconstructed Images

Chapter: Configuring Reconstruction

Calling up the preset editor

syngo Workplace - InSpace 3D/DynaCT (VB14)AX42-010.621.63.01.02

syngo InSpace 3D, DynaCT and DynaCT Cardiac

Chapter: Touchscreen Operation (Artis)

Part: syngo InSpace 3D, DynaCT and DynaCT Cardiac

on which any diagnosis must be based.

Please note that a reconstruction of 3D data after a recalibration or with future

syngo Workplace - InSpace 3D/DynaCT (VB14)AX42-010.621.63.01.02

syngo InSpace 3D, DynaCT and DynaCT Cardiac

of cross-sectional images from projection images acquired in a 3D acquisition

Cardiac 3D is used in the EP lab to provide 3D images of contrast enhanced

InSpace 3D/Cardiac 3D workflow

Cardiac High Contrast 3D workflow

See the InSpace EP Operator Manual

sult with the live fluoro image using iPilot.

syngo DynaCT and syngo DynaCT Cardiac

syngo Workplace - InSpace 3D/DynaCT (VB14)AX42-010.621.63.01.02

syngo InSpace 3D, DynaCT and DynaCT Cardiac

DynaCT Cardiac creates cross-sectional 3D images of the beating heart/the left

Soft tissue imaging

HU is the shortcut for Hounsfield Units.

For oncological applications, DynaCT has the potential to visualize tumors in

DynaCT is available for systems with FD 30x40 only.

InSpace 3D and DynaCT

syngo Workplace - InSpace 3D/DynaCT (VB14)AX42-010.621.63.01.02

syngo InSpace 3D, DynaCT and DynaCT Cardiac

DynaCT Cardiac workflow

syngo InSpace 3D, DynaCT and DynaCT Cardiac

menu and double-click the Screen Saver icon.

Please take care when deleting 3D data on the acquisition system.

An offline reconstruction can be performed if the original 3D acquisition from the

the Artis system where the original 3D acquisition was performed.

syngo Workplace - InSpace 3D/DynaCT (VB14)AX42-010.621.63.01.02

syngo InSpace 3D, DynaCT and DynaCT Cardiac

For offline reconstruction it is possible to export the calibration data of a

During this time, a progress bar is displayed.

The data are loaded in the InSpace Reconstruction application.

Cross-Sectional Image Reconstruction

syngo Workplace - InSpace 3D/DynaCT (VB14)AX42-010.621.63.01.02

syngo InSpace 3D, DynaCT and DynaCT Cardiac

(1) Menu bar

Volume data display

Images: <Image number of upper image> / <Image number of lower image>

The image numbers are the ones of the original scene.

Defining the reconstruction volume

Cross-Sectional Image Reconstruction

The selection can be done in several steps:

Selecting an image pair

Image numbers are displayed top right in the window.

Setting a pre-defined VOI

Setting a user-defined VOI

Click and drag the rectangle to the required position.

syngo Workplace - InSpace 3D/DynaCT (VB14)AX42-010.621.63.01.02

syngo InSpace 3D, DynaCT and DynaCT Cardiac

Click and drag the rectangle to the required size.

Changing reconstruction presets 50

Defining the reconstruction volume 14

You can select another preset in the preset editor. 50