Vision 6.0 Clinical Applications

1. Vision 6.0 Clinical Applications

2. Vision Power Station • Full panel cardiology software • Industry Standard Applications (Emory …) • Complete Clinical Software Library • Large panel of connectivity solutions • Fast processing

3. Vision Power StationCardiac SPECT Processing • Up to 3 simultaneous reconstruction (stress, rest, delay) • Any combination of gated and/or non-gated studies • Sinogram, Linogram and raw cine mode quality control • Fast assessment of wall motion, perfusion and thickening • Slices cine mode for Gated SPECT studies Read Master Display

4. Vision Power StationCircumferential Profiles Analysis • Stress and rest dual study comparison • Applicable to thallium or technetium agents • Circonferential profiles with expected redistribution • Perfusion and washout bullseyes • Adjustable distribution 3D map 3D perfusion map

5. Vision Power StationTARGET Bullseye • Perfusion bullseyes display • Thallium or technetium based perfusion agents • Cedars thallium reference database (option) • Multiple user-created databases • Quantitative patient/database comparison Patient bullseye Comparison bullseye

6. MultidimTM Comparative ProcessingOwnership gated tomography protocol • Up to 3 gated or non-gated datasets may be analysed • 4D cine of the endocardial wall (3D surface + wall motion) • Solid or wire-mesh display 4D cine and physiological indexes

7. MultidimTM Comparative ProcessingOwnership gated tomography protocol • LV EF and volume calculation • ES, ED and stroke volumes, EF and cardiac output computation • 3D mapping: • regional ejection fraction • regional perfusion • stress/rest subtraction (washout) 3D perfusion map

8. Vision Power Station Planar Gated Bloodpool • Automatic tail drop correction • Automatic or manual Region-Of-Interest • Left and right global ejection fraction • Exercise gated comparison with up to eight datasets • Fourier analysis • amplitude and phase image • contraction wave propagation • Regional and sectorial EF Functional images

9. Vision Power StationStasis Motion Correction • Correction for patient motion and cardiac creep • Vertical and horizontal shifts treated independently • Automated analysis of sinogram and linogram • Compatible with both gated and non-gated Linogram Sinogram

10. Standard Restore Restore reconstruction + TAC Vision Power StationRestore Resolution Recovery • Depth dependent resolution recovery • Scatter correction • Filter adjustement (maximum gain, cutoff, filter-shape) • Collimator and acquisition setting • Improves cardiac spect images quality: • enhances contrast between heart and background • gives better definition of ventricular cavity • leads to a more homogeneous visualization 3D map of Restore filter

11. Vision Power StationTACTM Transmission Attenuation Correction • Myocardial SPECT non-uniform attenuation correction • 153Gd or 99mTc as transmission source • 201Tl or 99mTc-sestamibi as radiotracer • Multi-iterative reconstruction optimization • Chang algorithm • Single or gated cardiac SPECT Transmission map

12. Standard Restore Restore reconstruction + TAC Vision Power StationTACTM Transmission Attenuation Correction • Eliminates non-uniform attenuation artifacts: • enhances activity in inferior / infero-spetal regions • decreases relative activity of antero-lateral region • decreases hyperactivity of apex

13. Vision Power StationSPECT reconstruction/ 3D package • Real time slice reconstruction for SPECT acquisition • Decay, COR, uniformity post-acquistion correction • Large choice of reconstructiuon filters • 3D volume rendering or iso-surface display Bone tomoscintigraphy

14. Vision Power StationCerebral Blood Flow • Regional brain flow quantification • Dual SPECT comparison • Automatic circumferential segmentation • Segmental left/right and early/delay analysis • Numeric and bar graphic display Cerebral stroke Circumferential analysis

15. Vision Power StationRenal Package • Automated processing • DTPA, MAG3 and IOH acquisitions • Renogram analysis • Effective Renal Plasma Flow (ERPF) • Glomerular Filtration Rate (GFR) • Renal uptake, clearance and excretion assessment MAG3 study

16. Vision Power StationLungs Ventilation /Perfusion • Analysis of pulmonary function • Automated processing • Global and segmental analysis • Ventilation and perfusion time activity curves • Functional images • Ventilation index • Perfusion index • Vent/Perf ratio • Mean transit time Vent/Perf ratio Image Histogram

17. Vision Power StationWhole Body Processing • Ant/Post single or dual study processing • Full 1024*1024 screen display • Hot spot masking • ROI counts statistics • Magnification tools Whole body scan

18. Tc-99m anterior bone scan Perfusion Mapping Vision POWERstation 6.0 New Clinical Appliation • PER (Scatter correction software) • BrainQuant (Stereotaxic Brain Quantification) • Myoflex (3D Myocarial Fuzzy Logic Expertise)

19. Tc-99m anterior bone scan PER™ - Scatter Correction • Objectives: • Improve the effective energy resolution of acquisition system, • Correct the images for • Compton scatter • Crosstalk down scatter contamination • => Multispectral analysis based on iterative energy spectrum deconvolution • Benefits • Better image contrast • Improved spatial resolution • More accurate quantification

20. PER™ - Scatter Correction Thallium Stress SPECT Scintigraphy Without correction With Scatter Correction Inf. wall Ant. wall Line profile through a middle VLA slice

21. MyoFLEX™ Processing steps       2D views 3D views

22. MyoFLEX™ • Automatic myocardial edge detection algorithm • Perfusion 3D Quantification (3D ROI) 3D automatic analysis

23. 18 Sectors Segmentation Normal Reference Databases available User-defined databases capability MyoFLEX™ Myocard segmentation

24. Color-coded perfusion scores Relative tracer uptake distribution Simultaneous Rest / Stress analysis Reversibility 3D map (Rest-Stress) MyoFLEX™ Perfusion Mapping

25. Automatic tail drop correction R-R waves histogram Automatic or manual Region-Of-Interest creation Left and right global ejection fraction calculation Multi-harmonic capability (1 or 3 harmonics) LV and RV percentile analysis LV percentile analysis LV percentile analysis XT-ERNA #2 Multi-harmonic Fourier Analysis

26. Exercise gated comparison with up to eight datasets Fourier analysis amplitude and phase image contraction wave propagation Sectorial EF Improved cine display Comprehensive result pages Standard display User-defined screens LV percentile analysis XT-ERNA #2

27. Scintigraphic scan Functional atlas BrainQuant™ Anatomical localization of functional abnormalities is difficult to implement in NM without MRI and CT scan images. ? Ability to identify cerebral structures by comparing functional images with a standard reference system (Talairach atlas).

28. BrainQuant™ AC-PC plane determination and Talairach grid applied on transverse cerebral slices Talairach grid AC-PC orientation

29. Patient Motion Correction (MoCo) • Can be launch from any SPECT Protocols • Fully Automatics • Support Gated SPECT

30. QGS / QPS Complementary (but similar) application referring to Myocardial SPECT

31. BPGS Recon Reformat uses eNTEGRA UI, BPGS uses UI of Cedars-Sinai.