2002 magnetom flash 1

No.1 . 2002s

An Applicat ions Reference for Siemens MAGNETOM Users

M A G N E T O MFlashFlashFlash

:In this issue:BEditorial . . . . . . . . . . . . . . . . . . .3

BAbdominal MRI . . . . . . . . . . . .4

BQuestions & Answers . . . . .0

BProduct News:Maestro Class . . . . . . . . . . . .14Ultra-High-Field . . . . . . . . . .21

BSeminars and Meetings . . . . . . . . . . . . . . . . .23

3T

M a e s t r o C l a s s

is in

?!Questions&Answers

A9

11

00

-M-Z

73

0-1

-76

00

Siemens Ultra High-Field

Programwww.SiemensMedical.com

The Siemens commitment to 3 Tesla can easily be seen in

our leading product line in the Ultra High-Field segment.

MAGNETOM® Allegra – See the Mind. Dedicated to brain

imaging, this most compact 3T scanner is equipped with

the strongest gradients in the market. MAGNETOM Trio –

See the Body. The Trio is your system for whole body

applications in the 3T Ultra High-Field sector. It offers a

full 40 cm Field of View and is the shortest 3T scanner

allowing clinical whole-body imaging at 3 Tesla.

Siemens Medical Solutions that help

smedical

MAGNETOM Flash – Reader ServiceLetters to the Editor – We welcome your com-ments about the content of MAGNETOM Flash.Please send comments to the Editor. Include yourname, address, and phone number or e-mail.

World Wide Web – Visit us atwww.siemensmedical.com. This site providesinformation about all Siemens medical products.

Publish articles? – You are invited to publisharticles in the newsletter to share your experiencewith MAGNETOM MR users all over the world.To submit an article please contact the Editor.

Subscription – You have seen the newsletter andwant to get it on a regular basis?In the US, please contact the ApplicationsHelpline (phone 800-888-SIEM) and give us yourname and business address (no home addresses,please). Outside the US,MAGNETOM Flash is distributed through the localSiemens offices. Please contact the Editor and wewill make sure that you are included on your localsupport office’s distribution list.

Editor

Ali Nejat Bengi, [email protected]

:From the Editor – Old and new faces at MAGNETOM Flash:

Some of these names will sound familiar to you. That is because they arecontributing authors to several medicaljournals.

The team approach will serve your wishto see the MAGNETOM Flash on a moreregular basis – you ask, we listen!

We hope you will enjoy this issue.Please send your comments to us!

Dagmar Thomsik-Schroepfer, PhD

3


For more than 6 years I've beencontributing ideas and content to theMAGNETOM Flash. For the past 3 yearsI have been editor, author, manager andcreative director of this newsletter,which is a lot of fun.

However, the increased interest in ournewsletter and the increased number ofinstalled systems require some changes.Beginning with this issue you will noticesome of these changes.

First, we introduce a new column called“Questions & Answers”. Here we askquestions regarding sequences and ap-plications and provide answers.

Second, we will publish articles that arealso available on the MAGNETOMWorld web site.

And, last but not least, we will changefrom a single person Editorial to anEditorial Board. I will step back a littleand will be a member of the editorial bo-ard, which gives me a more relaxedschedule to contribute content.

This MAGNETOM Flash Editorial Boardhas 110 years experience in MR. It is a group of health care professionals with international experience. They areclinical and technical experts, andmarketing, product, application as wellas business managers.

The Editor in Chief will be Nejat Bengi, M.D., a radiologistwith 9 years of clinical, technical,business and consulting experience.

The Editorial Board:Dagmar Thomsik-Schroepfer, PhD, abiologist with focus on medical writing,product and application marketing. I contribute another 10 years of experi-ence to the editorial board. OccasionallyI will provide information about our MAGNETOM products as well ascontribute Q&As.

continuation next page

Another medical professional with 8 years in application support, productand application development andtraining is Milind Dhamankar, M.D..

Laurie Fisher, BSRT, R, MR – iscurrently the MR Installed Base and e-Health Manager for the US. She brings 12 years of clinical, technical andmanagement experience.

Hands-on clinical and technical expertisecomes from Marion Hellinger,application specialist, radiographer andCoordinator of our Application Training,with 11 years of expertise.

Peter Kreisler, PhD, a physicist, brings17 years of expertise in product andapplication development, marketing andconsulting.

Business and product aspects are alsoadded to the team by Charles Collins,BSRT, with 14 years of clinical andapplication expertise, business consul-ting and product management.

Tony Enright, PhD, has been Collabo-rations Manager for the Asia-Pacificregion for the past 2 years and addsanother 4 years of medical researchexperience.

Michael Wendt, PhD, currently theManager of MR R&D and collaborationsin the USA, with 8 years of experience inMR. Before joining Siemens MedicalSolutions USA, Inc., Michael was anAssistant Professor of BiomedicalEngineering at Case Western ReserveUniversity in Cleveland.

Daniel Grosu, M.D., recently joined theUS MR Division as Manager of ResearchCollaborations. He brings 3 years ofexperience in medical practice andresearch, and in business development.

It is terrific to have Helmuth Schultze-Haakh, PhD, again as technical editor in the newsletter. He is MR Researchand Development CollaborationsManager USA for the Pacific Regionwith 12 years experience.

Finally we have Raya Dubner and AntjeHellwich as creative directors.

:Abdominal MRI – Case Studies from ShanghaiChanghai Hospital:Dr. Jianping LU, Department of Radiology, Shanghai, Peoples Republic of China

The Shanghai Changhai Hospital is a uni-versity teaching hospital, which is loca-ted in the northeast of Shanghai and has1600 beds. It provides medical cares forlocal patients and the whole of China.The Department of Radiology performsmore than 240000 exams annually. In1994 and 2000, 1.0T MAGNETOMImpact and 1.5T Symphony were instal-led. At present, they examine about 80patients every day. Abdominal MRI andcontrast-enhanced angiography withfast and ultrafast sequences wereroutinely performed and accounted for40 percent of all patients.

Case Studies1. Duodenal Cancer

Patients History

A 38 year old women had occult upperabdominal pain with anorexia for half an year. All lab findings were normal.Gastroscope examination showednormal esophagus and stomach, butmissed duodenum. CT examination inlocal hospital showed the enlargementof pancreatic head and suspectedcancer of pancreatic head. 10 days later,the patient arrived in our department ofgeneral surgery because of ascites.

4

Editorial Board

Charles [email protected]

Milind Dhamankar, [email protected]

Tony Enright, [email protected]

Laurie [email protected]

Daniel [email protected]

Marion [email protected]

Peter Kreisler, [email protected]

Dagmar Thomsik-Schroepfer, [email protected]

Michael Wendt, [email protected]

Technical Editor

Helmuth Schultze Haakh, [email protected]

Creative Director

Raya [email protected]

Antje [email protected]

Published by

Siemens AG Medical SolutionsP.O.Box 3260D-91052 Erlangen

Correspondence and International Distribution

Ali Nejat Bengi, M.D., Editor in ChiefMAGNETOM FLASHSiemens AG Medical Solutions, MR MarketingAllee im Rötelheimpark 3D-91052 ErlangenPhone: 49 - 91 31 - 84 - 75 99Fax: 49 - 91 31 - 84 - 21 86

US Distribution

MR APPLICATIONS HELPLINESiemens Uptime Service Center110 MacAlyson CourtCary, NC 27511Phone: 800 - 888 - SIEMFax: 919 - 319 - 28 64

Internet: www.siemensmedical.comAll articles represent the techniques and opinions of the authors and may not represent specific recommendations or endorsements from Siemens Medical Solutions. Contact the authors directly for further information about their techniques and opinion.

continuation from last page

5


Fig. A

The coronal FLASH 2d fs shows dark ascitesaround the liver and slight enlargement ofwhole pancreas with normal signal intensity.The duodenum becomes burlier and solid,which margin is unclear.

Fig. B

The thick slice of HASTE MRCP shows milddilatation of both bile ducts and mainpancreatic duct. The point of obstruction islocated in ampulla of Vater without obviousmass.

Fig. C

The coronal TrueFISP also shows theenlargement of pancreatic head and milddilatation of both bile ducts and mainpancreatic duct, one cannot differentiatepancreatic head from duodenum.

Fig. D

The arterial phase image of 3D flash (VIBE)shows normal homogenous enhancement af-ter administration of 20ml Gd-DTPA. The so-lid duodenum has moderate enhancement.

Fig. E

The image of portal vein phase shows unclearduodenum and infiltration toward contiguousorgan.

Fig. F

The dorsal slice shows biliary obstruction atduodenal papilla.

The information presented in these case studies is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health carepractitioner reading this information is reminded that they must use their own learning, trainingand expertise in dealing with their individual patients. This material does not substitute for thatduty and is not intended by Siemens Medical Solutions to be used for any purpose in that regard.

6

Fig. A

The axial FLASH 2d fs shows enlargement ofpancreatic head and relative atrophy of bodyand tail. There is the low signal area withinenlarging head.

Fig. E

The margin of enlarging pancreatic uncinateprocess is unclear, but basically normal oncaudal slice of image D.

Fig. F

The image of FLASH 2D at phase of portalvein is same slice as image D.

Fig. G

The image of FLASH 2D at phase of portalvein is same slice as image E.

Fig. H

The thick slice of HASTE MRCP clearly showsmild enlargement of main pancreatic duct,abnormal confluence between the commonbile duct and main pancreatic duct, and somebranches encircled the duodenum.

Fig. B

The caudal slice of image A shows focal lowsignal area besieged by the enlargingpancreatic uncinate process of normal signal.

Fig. C

The same slice of image B with TSE T2-weighted sequence shows the enlargingpancreatic uncinate process whose signal is similar to body and tail.

Fig. D

The image of FLASH 2D at arterial phase sho-ws homogeneous enhancement of wholepancreas except the central area ofpancreatic head and mild enlargement ofmain pancreatic duct.

2. Annular Pancreas and Pancreatitis

Patients History

A 36 year old man had a history of acutepancreatitis three years ago. Recently,he felt mild pain in upper abdomen.Blood amylase increased by 261U (Somogyi). Clinically, he was suspectedto have acute episode of chronic panrea-titis. However, CT examination in localhospital revealed a mass of pancreatichead and could not exclude the neoplasm.

7


Fig. A

The axial image of FLASH 2D without FSshows the enlargement and deforming ofpancreatic uncinate process.

Fig. B

The signal of enlarging and deforming pan-creatic uncinate process is lower than theother parts of pancreas on FS-fl2d image.

Fig. C

The thick slice of HASTE MRCP showsinterruption of mildly dilated main pancreaticduct at uncinate process, but normalcommon bile duct.

Fig. D

The Sub-MIP image of thin slice of MRCPshows abruptly interruption of main pancrea-tic duct in detail.

Fig. E

The small mass within the uncinate processhas decreasing enhancement on 3D VIBEimage at arterial phase.

Fig. F

The caudal slice of image E shows the relationship between the mass andmesenterie vessels.

Fig. G

The enhancement of small mass within the uncinate process is still weaker thansurrounding normal pancreatic tissues.

3. Cancer of Pancreatic Uncinate Process

Patients History

A 49 year old man demanded imagingexamination because of only occultupper abdominal pain for a few days. Alllab findings were negative.

Results and DiscussionWe presented three cases with diseaseof pancreatic head and duodenum.These case reports indicate that thecombination of various MR sequences,including breath hold FLASH 2D T1weighted imaging with or without fatsuppression, Turbo Spin Echo T2waighted imaging, thick and thin slice ofMRCP, 2D FLASH and 3D FLASHdynamic scanning, can characterize thelesions in the regions of pancreatic headand duodenum. The combination caneffectively evaluate the mass,mesentery vessels, biliary system andpancreatic duct. It has potential advan-tages over CT and helps us to overcomedifficulties in differential diagnosis. TheMR examination always takes about 20minutes.

What is a DESS sequence?A 3D steady state gradient echo sequence.DESS stands for Dual Echo Steady State and is denoted by a de3d in thesequence file name. This sequenceacquires two signals, the FISP and PSIFgradient echo within the same repetitiontime. Both signals generate MR imagesof different contrast. The PSIF image ismore T2 weighted. During imagereconstruction, the strong T2 weightedPSIF images are added to the FISPimages which are more T1/T2 weightedin comparison.

Advantages:

• Improved SNR due to the acquisitionof two raw data matrices

• Strong T2 contrast with T1/T2weighting, this helps Fluid-cartilagedifferentiation

MPR is used for post-processing. TheDESS sequence is especially suitable fororthopedic series requiring gooddifferentiation between synovial fluidand cartilaginous structures.

8

Double Echo Steady State : DESS sequence Separate acquisition and calculation of both SSFP signals. Addition of FISP and PSIF resultsin an enhanced T2 contrast due to the strong contribution of the T2 weighted PSIF signal

Q&A:Questions & Answers:Dagmar Thomsik-Schröpfer, PhD Market Segment Manager High Field, Siemens Medical Solutions

DESS

What is a CISS sequence?A 3D steady state gradient echo sequen-ce. CISS stands for Constructive Interfe-rence in the Steady State and is denotedby a ci3d in the sequence file name. This sequence offers rapid, high reso-lution T1/T2 weighted imaging. Thesequence scheme is based on True-FISP. Each image is generated by thecombination of two separately acquiredTrueFISP images that differ only inTHEIR RF pulse scheme. This helps toavoid interference streaks.

Advantages:

• Very high SNR of fluid and

sub-millimeter resolution

• Strong T1/T2 contrast

• Robust

The 3D implementation of CISS providesT2 weighted sub-millimeter resolutionimaging. Typical applications are theinner ear (cochlea, labyrinth), cranialnerve imaging, imaging of the cerebello-pontile angle, and the cerebellum. MPRor MIP is used for post-processing.

9


Constructive Interference Steady State: CISS 3D Sequence Diagram

Phase cycled 3D True FISP

10

What is a HASTE sequence?HASTE is a Half Fourier single shotTurbo Spin Echo technique. HASTEstands for Half Acquisition Single shotTurbo Spin Echo and is denoted by thenomenclature haste in the sequence filename. HASTE is used for sequentialacquisition of high resolution T2weighted images. The sequence utilizesthe longitudinal magnetization of thefully relaxed spin system.

This sequence utilizes a single 90°excitation pulse followed by an echotrain of up to 512 RF refocused echoes.Only 53% of the total number ofrequested phase encoding lines areacquired with a k-space reorderingtechnique. This allows the placement ofa moderately T2 weighted TE at theeffective echo time. All data for a singleslice are acquired in a single shot beforemoving on to the next slice. The data arethen reconstructed with a Half Fourieralgorithm to achieve the final resolution.

This sequence is useful in the entirebody for fast T2 weighted imaging.

Advantages:

• Reduces TEeff to less than 100 ms

• Even tissue with a short T2 can bedisplayed

• Robust single-shot technique notsensitive to motion artifacts

Because of the short acquisition timeper image, the HASTE sequence is notsensitive to patient movement orrespiratory artifacts. Thus, HASTE issuitable for use not only in abdominalimaging, but also for examinations of uncooperative or pediatric patients.

Changing the echo time

If you change the echo time TE, thenumber of lines measured before thecentral echo will also be changed. Thus,the actual Phase Partial Fourier factor isset with the parameter TE. At minimumTE, a Half Fourier measurement isperformed; at maximum TE, a single-shot TSE measurement is performed,measuring the entire raw data space.The latter is used, for example, incholangiography.

:Questions & Answers:

HASTE Sequence Diagram Half Fourier Single Shot Turbo Spin Echo:HASTE Sequence Diagram

Single shot multi echo sequencewith half Fourier reconstruction:TAHASTE ~ TARARE / 2

mild medium strong T2 weighting

HASTE T2 contrast variation by different k-space data filling

11

M A G N E T O MFlashFlashFlashWhat is a VIBE sequence?A T1 weighted 3D FLASH breath-holdtechnique. This sequence utilizes isotro-pic resolution, a frequency selected fatsaturation pulse prior to each partitionloop, thinner slices than a fl2d sequence,and extended FoV coverage. VIBE standsfor Volumetric Interpolated Breath-hold Examination and is denoted by thenomenclature fl3dv or d1 in the sequence file name. In addition FS isselected.

Advantages:

• 3D dynamic imaging of the abdomenwith isotropic voxels

• High spatial resolution

• MIP to obtain vessel informationwithout additional exam

Applications for this sequence besidesdynamic liver and pancreas imaging arealso the orbits, chest and pelvis. Postprocessing the same data set can alsobe used to provide high quality vascularinformation and you can separate the ar-terial, portal-venous and equilibrium pha-ses. It can also be used for MR colonos-copy providing high resolution imagesshowing presence of polyps and tu-mors, non-invasively.

12

What is a MEDIC sequence?The MEDIC (Multi Echo Data ImageCombination) sequence is a multi-echogradient echo sequence with flow com-pensation with each echo. It is denotedwith me in the sequence file name. MEDIC sequence combines multipleimages with different T2 weighting.

T2*-weighted imaging with good signal-to-noise ratio for spine (especially trans-verse cervical and thoracic spine) andjoint (knee and shoulder) imaging.

T2*-weighted 3D imaging of the cervicalspine with small flip angle and adjustedTR.

When Combined Echoes = 1, thissequence behaves like a FLASHsequence with flow compensation.

Advantages:

• Minimize chemical shift artefacts

• Minimal flow artefacts

• T2* contrast

• Better resolution compared to a singleecho low band width sequence

Applications for this sequences are C-Spine and orthopedic imaging.

MEDIC: Multi Echo Data ImageCombination

Unipolar “high bandwidth” multigradient echo sequence with GMR.Features: reduced chemical shift-,susceptibility-, flow- artifacts.Data postprocessing possible.

:Questions & Answers:

:Tp:AXX

13

M A G N E T O MFlashFlashFlash “I need an MR systemthat provides

perfect all-around support”MAGNETOM Maestro Class –a new degree of perfection

MAGNETOM® Maestro Class – an MR system that offers you

everything you need for a fast and comfortable workflow:

intelligence – MAGNETOM Maestro Class thinks with you!

It automates processes, making them faster and simpler.

increased speed – MAGNETOM Maestro Class saves time!

Experience new dimensions in acquisition speed and

resolution.

SiemensMedical.com

innovative applications – MAGNETOM Maestro Class is

setting the standard! You’ll be able to expand your appli-

cation spectrum from cardiology, oncology and neurology

all the way to surgery. From the clinical routine up to

research applications.

Maestro Class

is inintelligence

increased speed

innovative applications

A9

11

00

-M-Z

71

6-1

5-7

60

0

At the RSNA 2001 Siemens MedicalSolutions introduced the next step indevelopment for their main product lineMAGNETOM Harmony, Symphony andSonata: the Maestro Class. Newsystems are delivered with MaestroClass already. And it is available for thealready existing systems as an upgrade.The obvious change are new covers.

Within the soul of Maestro Class youfind intelligence, speed and innovativeapplications.

We use technology in an intelligent wayto make MR even easier to use. Many routine processes are automated,making them faster and simpler.

Inline Technology – Processinginstead of Post-processingThe complete exam is finished as soonas image acquisition is finished. Inlinetechnology uses an intelligent on-the-flyfeedback loop to control scanning,reconstruction and processing. Thusmotion is detected and corrected on theacquired image and unwanted

information is no longer filling up yourharddisk.

PACE Prospective Acquisition and CorrEction – Motion under control!

1D PACE allows exams with freebreathing and is the perfect alternative

to breath hold scanning. The userdefines the expiration phase in whichdata are accepted. The Inline displayshows the diaphragm position. Thusrespiratory motion is detected. Forimaging only the selected phases aretaken resulting in high image quality infree breathing.

14

PRODUCT NEWS:MAGNETOM Harmony, Symphony, Sonata Maestro Class – A New Degree of Perfection:Dagmar Thomsik-Schröpfer, PhD, Siemens Medical Solution, Market Segment Manager High Field

Inline display of diaphragm positon

Define expiration phase to accept data


is into make MR easier!

telligence –

2D PACE improves selectivity andprecision in abdominal MRI. It is arobust technique that automaticallyaligns each multi breath hold.2D PACE compensates unwantedpatient movement.

15


None 3D PACE

Processing Plug-ins – provide unmatched flexibility

Simplifly routine procedures byselecting various checkboxes on theaccording syngo task cards (e.g.Subtraction, MIP, SuperMIP, t-test) orby creating own macros.

Maestro UI – Your cockpit for dynamic MRI

This ergonomic and easy-to-use interfacesupports the clinical workflow. A quickoverview is provided by Image Stamps.

The Phoenix* feature is a drag and dropfunction. An existing image is selectedvia the Browser and simply placed intothe measurement queue. All imageparameters are extracted and placedinto the exam task card.

syngo scan assistant

Changing one MR parameter inevitablymeans adjusting other parameters. Thesyngo Scan Assistant makes the effectvisible and suggests further parametersin case of conflict.

Multi breath holding with 2D PACE control

Maestro user Interface

Inline Movie for cine studies

Inline PhysioMonitor

ImageStamps

3D PACE* virtually freezes patientmotion. It improves selectivity and increases selectivity. This is beneficiale.g. in functional MRI for preciseneurosurgical planning.

The Solution to speed upacquisition times is iPAT –Integrated Parallel AcquisitionTechniques.

• Integrated feature

• Integrated into the MAGNETOM IPAcoil concept, use up to 8 independentchannels

• Integrated Auto-calibration

• Combines the convenience of IPA andiPAT for many applications

PAT factor 2 is Standard!

Maestro Class for MAGNETOMHarmony, Symphony and Sonatafeatures iPAT with a speed factor of 2 as standard and is IPA compatible. The benefits are:

• Higher patient comfort – Shorterbreath holds in abdominal imagingincrease patient comfort; due to theshort acquisition times

• Higher temporal resolution – in abdominal and cardiac MRI, e.g.dynamic 3D VIBE liver imaging, cinecardiac imaging

• Less blurring artifacts through thewhole body due to shorter measure-ment times

• Improved diagnostic confidence instroke imaging - shorter measurementtimes possible, higher resolution,FEWER distortion artifacts in single-shot EPI

PAT Plus* – iPAT factor 4

iPAT-Plus with speed factor 4 combineshigh speed imaging with the 8 channelneuro array coil and the 6 channel bodyarray coil to push demandingapplications, e.g. stroke imaging, evenfurther.

16

Siemens iPAT techniques

com

ple

te e

xam

inat

ion

tim

e

Scan

approx1 Minute

Scan

Requiredcalibration afterevery patientmovement

Initialcalibration

1 sec.

Scan

Scan

Scan

other iPATtechniques

Scan

1 sec.

1 sec.

1 sec.

approx1 Minute

:Product News:


is into make MR faster!

creased speed

without iPAT, TA 1:24 min. PAT factor 4, 24 s.

PAT factor 3, 16 s.without iPAT, 20 s.

novative applicationsExpand MR and open new application areas

Neuro MRI – One-stop stroke examination in less than 5 minutes

17


Easy patient set-up with high comfortfor the patient

High resolution imaging withvarious contrast provides: perfect anatomical images, visualiz ation of pathological tissue.

MR Angiography is an easyadd-on to show details invessels according to tissue/pathology

Diffusion-weightedMRI (DWI) in combina-tion with Perfusion-weighted MRI is highlysensitive to early cere-bral ischemia (withinthe first 30 minutes to 6 hours). It may predictthe severity of thestroke and the outcomeof the recovery.

The ADC (ApparentDiffusion Coefficient)map helps to estimatethe age of stroke lesi-ons. Calculate ADCmaps automaticallywith Inline Technologyat the end of the scan.

Trace-weighted imageshelp to differentiateinfarcted regions com-pared to normal tissue.They can be acquireddirectly in a single-shotexam or by combiningindividual diffusion-weighted images.

Parameter mapcalculations*, such astime to peak as well asrelative MTT*, relativeCBF*, relative CBV* aredone automaticallyusing Inline Technology.


is in

MR Spectroscopy is gettingeasier keeping the high flexibilityfor research

• Easy and efficient “single-button”Spectroscopy, with spectra annotationand quantification at a mouse-click.

• Free slice positioning – tailor sliceposition and orientation to your patient!

• High research flexibility – allows tointeract with the whole procedure forthe research approach

• 3D CSI for complete anatomicalcoverage. For faster 3D CSI weightedencoding can be chosen

• Fully automated post-processing ofdata with instant display, e.g.

- Spectral maps displaying spectra in the selected voxels

- Metabolite images* are showing the voxel dependent peak intensitiesor peak ratios as grayscale or coloroverlay onto a reference image

- Table of metabolites for simplereporting

• 31P and multi nuclear* spectroscopydo benefit from the post processingfunctionality in the same extent

18

:Product News:

MR Angiography – Easy and completely automated – High resolution peripheral MRA from diaphragmatic level to distal vessels

19


Watch the inflow enhancementusing Care Bolus Online! Noguess,no calculation! Youdecide when to start the scan!Maestro Class InlineTechnology automates thecalculation of MaximumIntensity Projection (MIP) foreach anatomical level. Get theresults while the patient is stillon the table with subtraction onthe fly. MIP is instantaneouslydisplayed on the Maestro userinterface.

or

Switch to 3D

Combination of Body Coil and CP Head Array Coil

allows to get a vesseloverview and can be usedfor post operative exams

Get a maximum coverageof 1.5 m (5 feet) in 4 steps by combining our PeripheralCP Angio Array Coil, the CPBody Array Flex Coil and the Large Field of View Adapter.Used e.g. for pre-operativeplanning

Use Body and CP Head Array Coil or a set up of multiple CP array coils with automated table movement using Integrated Panoramic Array (IPA) and Integrated Panoramic Positioning (IPP).

Optimized workflow is only a mouse click away!

Care Bolus 1

…

Care Bolus …

1st step

2nd step

3rd step

The scan program for the whole examination is already programmed using

the Maestro User Interface with its multi level scouts, automatic table travel

and pre and post contrast scanning. Each mearsurement (no. of slices, matrix)

can be individually adjusted to the patient anatomy

Body MRI – VIBE and iPAT – Expand your diagnosis

Combine VIBE and iPAT to speed upyour body exams by a factor of 2 stan-dard. This ultra fast imaging techniqueallows to visualize even earlier arterialphase in liver imaging which may openthe way to new diagnoses.

Cardiac MRI – One-stop shop cardiac examination in just 16 Minutes

20

Morphology

• Display your results automaticallywith the Auto Movie function

• Image stamps can be loaded into the movie function, the postprocessing card or into themeasurement queue

Function

Real time TrueFISP allows rapidassessment of ventricular function

* Information about features with syngo MR2002B is being provided for planningpurposes. The product requires 510(k) reviewand is not commercially available in the U.S.

:Product News:

Hepato cellular carcinomaCourtesy of University Erlangen

:The Siemens Ultra High-Field ProgramMAGNETOM Allegra and Trio 3T MR The Next Dimension in Clinical and ResearchMR Systems:Cécile Mohr, PhD, Market Segment Manager Ultra High-Field, Siemens Medical Solutions

3T Magnetic Resonance forthe futureOver the past 20 years, MR has made its way into the clinical world. This wasachieved by first developing technicalaspects of MR scanners and then byimproving patient comfort and userfriendliness. 1.5T is now the standardclinical field strength of today’s MR.This is reflected in the success of theMAGNETOM Symphony and Sonata1.5T platforms.

But good is not good enough! Higherfield strengths offer more SNR, moreBOLD effect and greater chemical shift.This benefits especially functional MR,MR spectroscopy examinations, andmore generally whole-body techniquesthat require greater spatial resolution orspeed.

“Making Research Clinical”Siemens is the only manufacturer tooffer two 3T products, both FDA-cleared, the MAGNETOM Allegra andMAGNETOM Trio. The MAGNETOMUltra High-Field systems have beendeveloped to take advantage of theincreased SNR, BOLD effect andincreased chemical shift available at 3 Tesla.

In 2000, Siemens launched the most-compact 3 Tesla MR scanner, theMAGNETOM Allegra. With a 1.25 mlong magnet, the Allegra has revolutio-nized the Ultra High-Field MR Market byproviding the first patient-friendly UltraHigh-Field MR. Dedicated to neuro-imaging, the gradient power unleashedallows the fastest 3T image acquisition.There are now 15 Allegras installed inthe USA but also in Turkey, Sweden,Japan to name just a few.

Fig.1.: High-resolution T2-weighted brain image (MAGNETOM Allegra)(courtesy of Dr. K. Wicklow, WashingtonUniversity, Saint Louis, USA)

21


Based on this success, in 2001, theMAGNETOM Trio extended thisrevolution to whole-body imaging. TheMAGNETOM Trio is a 3T MR-scanneroffering a full 40 cm FoV. It opens newdoors to clinical research in applicationssuch as cardiac, spine, orthopedic MRand many more MR applications. Thefirst Trio was installed in Boston, at theMassachusetts General Hospital (MGH)NMR center in the USA in November2001 and was completed in only 6 days.The next installations were carried out atthe University of Tübingen in Germany(December 2001) and at FC Donders,Nijmegen in the Netherlands (January2002). The pace of installations is nowincreasing and the Trio installed baseshould reach 15 units by the end of theyear.

Continuing its tradition of innovation,Siemens is proud to offer these 2 unique3T MR systems to its customers.

System DescriptionThe MAGNETOM Allegra is the ultimatebrain machine. This 3T MR scanner hasbeen optimized for best image qualityand fastest imaging of the brain, all in ahighly compact design. These featuresprovide best imaging to the physician forthe diagnosis of stroke, epilepsy, tumorand multiple sclerosis. In addition, MA-GNETOM Allegra provides the ultimateperformance for neuro cognitive functio-nal MRI research.

Leading gradient powerLeader in the design of gradient coilsand amplifiers, Siemens is the first to of-fer the performance of the Allegra gradi-ents. Just imagine 40 mT/m and a slewrate of 400 mT/m/ms! This allows per-forming EPI with echo-spacing down to360 MICRO sec.

22

MAGNETOM Allegra

MAGNETOM TrioSystem DescriptionThe MAGNETOM Trio consists of a 3Tesla superconductive Actively Shielded(AS) magnet equipped with the EISsystem. With only 2 m length, homo-geneity guaranteed for full 40 cm FoVand a full 60 cm patient opening, theMAGNETOM Trio is the shortest MRscanner allowing true clinical whole-bo-dy imaging at 3 Tesla.

Easy sitingThe stray field (5 Gauss line) of the Trioextends to only 3.4 m in the x and ydirection and 5.9 m in the z direction. Inaddition, electrical and cooling require-ments are similar to those of the 1.5TMAGNETOM Sonata. These make the3T Trio very easy to site.

Easy siting in a 1.5T suit!

We at Siemens Medical Solutions USAInc., would like to invite all of our CT, MRand NM users to participate in our 2002Multi-Modality Technologist Seminar inSan Antonio, Texas.

We are excited to present our first multi-modality seminar with topicsencompassing the most cutting edgetechnology to satisfy all of youreducational needs. As CT, MR and NMTechnologists, you will increase yourknowledge in our general technologistsession with topics such as theCorrelation of CT, MR, NM and PET inOncological Diseases and modalityspecific topics including Applications inCardiac Imaging. In addition, you willlearn to evaluate and identify anatomyand pathology.

Please come and join us! Our goal is toprovide the opportunity for ourcolleagues and Siemens personnel toshare experiences in CT, MR and NMimaging.

General InformationRegistration

Registration will be held on Wednesdayevening, May 1st from 7:00 PM – 9:00PM at a designated registration desk atthe Hyatt. Registration will also be heldon Thursday, May 2nd from 7:00 AM -8:00 AM prior to the start of the pro-gram.

Registration Fee: $ 450.00

Early Registration Fee: $ 400.00 (paid no later than April 1, 2002)

All cancellations must be submitted inwriting to Traveltrust. An administrativefee of $ 25.00 is retained on all refunds.Foreign payments must be made in U.S.currency.

Siemens reserves the right to cancel atany time. If this should occur, all registra-tion fees will be refunded.

Information

For further information please contact the Applications Group at

1-732-321-32 70

Area Attractions and Hotel Accommodations

The Hyatt Regency is a 12 - mile taxi ridefrom the San Antonio InternationalAirport and is located on the renownedSan Antonio River Walk. Hotel facilitiesinclude heated outdoor swimming andwhirlpool and a new complimentaryhealth club. Golf and tennis accommo-dations are located nearby.

Area points of interest include theAlamo, the San Antonio Riverwalk, SixFlags, Sea World and the San AntonioZoo.

Please call the Conference ReservationCenter if you have any questions at:

1-800-792-46 62 (Nationwide)

1-760-635-17 00 (Canada)

or

E-mail - [email protected]

Please do not call the hotel directly.

Meals

Siemens will host a Cocktail Receptionon Thursday, May 2nd at 7:00 PM. A continental breakfast will be providedeach morning of the seminar along withmidmorning and afternoon coffeebreaks.

AIRLINES

San Antonio International Airport is a 15 - minute cab ride from the Hyatt Regency.

A special discount on airfare is offeredby calling our Conference ReservationsCenter. Our Reservations Center will save you money on your travel expenses.

Ground Transportation

Taxis to and from the airport costapproximately $ 12 one-way.

Rental Cars

A special discount has been arranged forparticipants of this meeting. Pleasecontact our Conference ReservationsCenter for this discount.

Credit

Evidence of continuing education, ECE points, have been applied for withthe A.S.R.T. Check with the SiemensApplications group to verify credit on thestate level.

23

M A G N E T O MFlashFlashFlashSEMINAR:Siemens CT, MR and NM TECHNOLOGIST SEMINAR:Hyatt Regency, On the River Walk, San Antonio, TX, May 2-4, 2002

Please complete and mail or FAX directly to:Siemens Medical Systems, Inc.c/o Traveltrust374 North Coast Highway 101, Suite FEncinitas. CA 92024FAX 1-760-635-33 43

Or Register online at:www.traveltrust.com

Login: SiemensPassword: Siemens

Please Check Modality CT____ MR____ NM____

First Name Middle Initial Last Name

Site Name (must be filled in)

Address

City State Zip Code

Social Security Number Telephone Number

Email Address

Please complete and mail or FAX directly to:Siemens Medical Systems, Inc.c/o Traveltrust374 North Coast Highway 101, Suite FEncinitas. CA 92024FAX 1-760-635-3343

Or make Reservations online at:www.traveltrust.com

Login: SiemensPassword: Siemens

Arrival Date:___________________ Departure Date:___________________

____Single ____Double $ 109 per night-does not include (16.75% occ. Tax)*This group rate is offered from Wed May 1st - Sunday May 5th.


Site Name (must be filled in)

Address

City State Zip Code

Roommate’s Name

24

Meeting Registration Form

Hotel Registration Form

Registration Fee: $ 450.00Early Reg. Fee: $ 400.00

Make check payable to Traveltrust.(Visa, MasterCard & American Express accepted for $ 11.00 surcharge)Note: Sign up for the breakout sessionswill occur at the meeting.

Reservations must be received no laterthan 15 days prior to the conference.Deposits will be refunded if cancellati-ons are received prior to 7 days inadvance of the conference.

_____Hotel reservation guaranteed byenclosed check

_____Hotel reservation guaranteed bycredit card:

Please circle:■ AMEX ■ MasterCard ■ VISA

Card Number Expiration Date

Signature

Siemens CT, MR and NM Technologist Seminar, May 2-4, 2002

:Technologist Seminar:

General Session CT/MR/NM 8:00 – 12:15

Thursday May 2, 20027:00 – 8:00 REGISTRATION

8:00 - 8:30 Welcome & Introduction

Doug LaVigne

8:30 - 9:00 Applications – From Training to Education

Mollie Beaver R.T. (R ) (CT)

9:00 - 10:00 Are You Safe? Is Your Patient Safe?

David T. Nixon MS, R.T.(R) (CT)

10:00 - 10:15 BREAK

10:15- 11:15 Are You Safe? Is Your Patient Safe? (Con’t)

David T. Nixon MS, R.T. (R) (CT)

11:15 - 12:15 Correlation MR/CT/NM and PET in Oncological Diseases

Joseph Busch M.D.

12:15 – 1:30 PM LUNCH sponsored by Mallinckrodt

25

M A G N E T O MFlashFlashFlashCT AGENDA

Thursday May 2, 20021:30 -2:30 Dose and the Pediatric Patient

David Bradley BS,R.T. (R ) (CT)

2:30-3:30 CT Fluoro – Appendicitis in CT

Joseph Busch M.D.

3:30 – 3:45 BREAK

3:45 – 4:45 Post Processing / 3 D

Sean Mahan M.D.

7:00 – 9:00 PM WELCOME DINNER

Fr iday, May 3, 20028:00 – 9:00 Cardiac CT Imaging:

An Overview

Chad DeGraaf R.T. (R ) (CT)

9:00 – 10:00 Cardiac CT Imaging: Part I

Loke-Gie Haw

10:00 - 10:15 BREAK

10:15- 11:15 Cardiac CT Imaging: Part II

Christoph Becker M.D.

11:15 - 12:15 Basics of Multislice

William Davros Ph.D

12:15 – 1:30 PM LUNCH on your own

1:30 -2:30 Coronary CT Angiography: Imaging Strategy & Postprocessing

Loke-Gie Haw

2:30-3:30 Perfusion

Alexander G. Khandji M.D.

3:30 – 3:45 BREAK

3:45 – 4:45 Artifacts

Claudia Lindner

26

Saturday May 4, 20028:00 – 9:00 Neuro Angiography

Alexander G. Khandji M.D.

9:00 – 10:00 Trauma CT

Michael Lundgren R.T. (R ) (CT)

10:00 - 10:15 BREAK

10:15- 11:15 Sex, Embryos, and Stem Cells: Medical Ethics

William B. Bondeson Ph.D.

11:15 - 12:15 The Future of CT

Bappa Choudury

MR AGENDA

Thursday May 2, 20011:30 -2:30 CE MRA Techniques

David J. Fisher M.D., Ph.D.

2:30-3:30 Tech Tips and Hints

Margaret King R.T. (R) (MR)

3:30 – 3:45 BREAK

3:45 – 4:45 Image Artifacts

John Kirsch Ph.D.


Fr iday, May 3, 20028:00 – 9:00 Advanced Abdominal and

Pelvic MRI

Glenn Coates M.D.

9:00 – 10:00 Advanced Neuro MRI Techniques

Leo Czervionke M.D.

10:00 - 10:15 BREAK

10:15- 11:15 Dynamic 3D MR of the Breast: Current Status and Technological Advances

Bruce Porter M.D.

11:15 - 12:15 Real World Cardiac MRI Cases

Glenn Coates M.D.


BREAKOUT SESSIONS

1:30 -3:30 Advanced Protocol Programming

Abraham Padua R.T. (R) (MR)

3:30 – 3:45 BREAK

3:45 – 4:45 Making Cardiac Imaging Fun!

Stuart Schmeets/Brian DeSouza

3:45 – 4:45 Low Field Techniques

Stephen Rigsby/Thomas Minahan/Jeff Zimmers

Saturday May 4, 20028:00 – 9:00 MR Staging of Advanced

Lymphatic Spread of Breast Cancer: Current Status and Technological Advances

Bruce Porter M.D.

9:00 – 10:00 Basic Cardiac Hints

John Anastos D.O.

10:00 - 10:15 BREAK

10:15- 11:15 MR Contrast Agents

Val M. Runge M.D.

11:15 - 12:15 The Future of Siemens MR

Nancy Gillen

NM AGENDA

Thursday May 2, 20021:30 -2:30 ESOFT: Where are we at?

Where are we going?

Brad Pratt and David Hashimoto

2:30-3:30 Coincidence and High Energy Imaging with the DUET

James O’Donnell M.D.

3:30 – 3:45 BREAK

3:45 – 4:45 New Technologies in PET

Sylke Grootoonk Ph.D.


Fr iday, May 3, 20028:00 – 9:00 PET: Protocols and Daily

Operations

Steven Wozniak B.S., CNMT, RT(N)

9:00 – 10:00 Clinical PET

Paul Shreve M.D.

10:00 - 10:15 BREAK

10:15- 11:15 3D Fusion

Vilim Simcic Ph.D.

11:15 - 12:15 Gated Bloodpool SPECT Imaging

Serge Van Kriekinge M.S.


1:30 -2:30 Cardiac Quantification: 4DMSPECT

James Kritzman B.S.

2:30-3:30 Cardiac Quantification: QGS & QPS

Serge Van Kriekinge M.S.

3:30 – 3:45 BREAK

3:45 – 4:45 Profile Attenuation Correction

James Kritzman B.S.

27

M A G N E T O MFlashFlashFlashSaturday May 4, 20028:00 – 9:00 The Easy Way to ROI’s and Curves

Kevin Romine B.S., CNMT, RT(N)

9:00 – 10:00 PET Physics: Radiation Safety, QA

John Gochoco M.S., DABR

10:00 - 10:15 BREAK

10:15- 11:15 Reconstruction Capabilities with ESOFT

Jane Popov-Dadiani CNMT, RT(N)

11:15 - 12:15 The Future of NM

Kerry Mowry

NUCLEAR MEDICINE BREAK

OUT SESSIONS:

The following interactive, hands on breakout sessions are designed to increase

competency and strengthen skills on the functionality ofESOFT:

• Workflow Organization

• Organ Specific Processing

• Cardiac Processing

• Flexible Display Building

Attendees will sign up for break out sessions at registration.

Loke-Gie HawSiemens – Forchheim Germany

Alexander G. Khandji M.D.Columbia University

Margaret King R.T. (R) (MR)Manager Raleigh MRI Center

John Kirsch Ph. D.Siemens MR R&D Collaborations Manager

Serge Van Kriekinge M.S.Cedars-Sinai Medical Center

James Kritzman B.S.University of Michigan Health Systems

J. Douglas LaVigneSiemens Vice President of Logistics

Claudia LindnerSiemens – Forchheim, Germany

Michael Lundgren R.T. (R) (CT)Siemens CT Applications Specialist

Sean Mahan M.D.Chesapeake General Hospital

Thomas Minahan R.T. (R) (MR)Siemens MR Applications Specialist

Kerry MowrySiemens Division Manager, NM

David T. Nixon MS, R.T.(R) (CT)Mercy Hospital

James K. O’Donnell M.D.University Hospitals of Cleveland

Abraham Padua R.T. (R) (MR)Siemens Advanced Applications Specialist

Jane Popov-Dadiani, CNMT, R.T. (N)Siemens NM Applications Specialist

Bruce A. Porter MD, FACRMedical Director – First Hill Diagnostic Imaging

Brad PrattSiemens Product Manager, NM

Facu l ty

John Anastos D.O.Parkside Magnetic Resonance Center

Mollie Beaver R.T. (R) (CT)Siemens Applications Education Specialist

Christoph Becker M.D.Grosshadern University Hospital

William B. Bondeson Ph.D.University of Missouri

David Bradley B.S. R.T. (R), (CT) Siemens Advanced Applications Specialist

Joseph Busch M.D.Director of Radiology -Hutcheson MedicalCenter

Bappa ChoudurySiemens Division Vice President CT

G. Glenn Coates M.S., M.D.Director Raleigh MRI Center

Leo Czervionke M.D.Mayo Clinic Jacksonville, Florida

William Davros Ph.D.Cleveland Clinic Foundation

Chad DeGraaff R.T. (R) (CT)Siemens CT Applications Specialist

Brian DeSouzaSiemens MR Applications Specialist

David J. Fisher M.D., Ph.D.Skagit Valley Hospital

Nancy GillenSiemens Division Vice President, MR

John Gochoco M.S., DABRSaint Barnabas Medical Center

Sylke Grootoonk Ph.D.Siemens Medical Solutions, Inc.

David HashimotoSiemens Product Manager, NM

28

Kevin Romine B.S., CNMT, R.T.(N)Siemens NM Applications Specialist

Val M. Runge M.D.Robert and Alma Moreton Centennial Chair inRadiology

Stuart Schmeets R.T. (R) (MR)Siemens MR Applications Specialist

Paul Shrieve M. D.VA Medical Center, Ann Arbor, MI

Vilim Simcic Ph.D.VP NM Product & Clinical Collaborations

Steven Wozniak B.S., CNMT, R.T. (N)St. Barnabas Ambulatory Care Center

Jeff Zimmers R.T. ( R ) (MR)Siemens MR Applications Specialist

Special thanks to Mallinckrodt Inc.

29


Monday, May 20, 2002, 7:00 pm

at the Hilton Hawaiian Village

2005 Kalia Road Honolulu, HawaiiUSA

Phone: 1-808-949-43 21Fax: 1-808-947-78 98

Room: Cocktail Hour on the Lagoon GreenDinner in the Tapa I & II

Cocktail Reception 7:00 - 8:00 pm

Welcome and Introduction 8:00 - 9:00 pm

Dinner and Networking 9:30 - 11:00 pm

Please respond before May 3, 2002 by sending an e-mail [email protected]

MEETING:Siemens User Meeting:at the Hilton Hawaiian Village, Monday, May 20, 2002, 7:00 pm

Experience the MAGNETOM World

30

Please complete and mail directly to:Siemens Medical SolutionsRaya Dubner186 Wood Ave. South

Iselin, New Jersey, USA

e-mail: [email protected]


Site Name

Address

City State Zip Code

Telephone Number

e-mail Address

Siemens User Meeting, Hilton Hawaiian Village, Monday, May 20, 2002

Meeting Registration Form

For further informations:

Internet: SiemensMedical.com/MR

MAGNETOM ConcertoWe’ve brought power to low field MRI

Open to EveryoneMAGNETOM®Concerto

It delivers competitive applicationsMAGNETOM Concerto goes beyond typical low-field applications and runs, for example, contrast-enhanced MRA in surprisinglyshort acquisition times.

It enjoys highest patient comfortThe open C-shaped design allows horizontal patient loading andmaximum visual contact ensuring greatest acceptance by claustro-phobic patients.

It fits your space These days space is at a premium and every inch matters.MAGNETOM Concerto nestles into only 30 m2 (325 square feet).

It promotes cost effectivenessThe new permanent magnet saves substantial running costs.With the EVOLVE program Siemens will replace the host compu-ter and image reconstruction system every thirty-six months.*

It embodies ease of use the common system platform sets new standards forsimple and intuitive operations.

* a continuous Performance TOP service agreement must be maintained.

Alexander CzervinskiCurrent World champion-Sumo wrestling “Open Class” Dec. 2000

A91

100-

M-Z

691-

30-4

A00

Sie

men

s A

ktie

nges

ells

chaf

t · M

edic

al S

olut

ions

· H

enke

stra

sse

127

· 910

52 E

rlang

en ·

Ger

man

y · T

el.+

+49

-91

31 8

4-0

Inte

rnet

: Sie

men

sMed

ical

.com

Siemens medicalSolutions that help

Please contactSiemens Medical Systems, Inc.186 Wood Avenue SouthIselin, NJ 08830-2770Phone (732) 321-45 00

Siemens AG, Medical Solutions Computed TomographySiemensstr. 1, D-91301 ForchheimGermanyTelephone: ++49 9191 18-0

Siemens reserves the right to modify the design and

specifications contained herein without prior notice.

Please contact your local Siemens Sales representative

for the most current information.

Note:

Original images always lose a certain amount of detail

when reproduced.

Siemens AG, Medical SolutionsHenkestr. 127, D-91052 ErlangenGermanyTelefon: ++49 9131 84-0Internet: SiemensMedical.com

Order No. A91100-M2220-F-691-2-7600

Printed in Germany

CCA 62691 WS 030220.

2002 magnetom flash 1

Documents

hilton hawaiian village

main pancreatic duct

siemens medical solutions

shanghai changhai hospital

maestro user interface

nm technologist seminar

siemens medical systems

conference reservations center