Publications

5819088-1EN
Revision 1

User Guide
Part 3:
Clinical Scenarios
Volume Viewer
Dynamic Shuttle

0459

© 2019 General Electric Company. All rights reserved.

1
Table of Contents

Regulatory Requirements ............................................................................................................................. 3

Legal Notices ...................................................................................................................................................... 3

Introduction ......................................................................................................................................................... 4
User Interface Note ..................................................................................................................................................................... 4

Product Description ......................................................................................................................................... 5

Safety...................................................................................................................................................................... 6
Intended Use / Indications for Use ....................................................................................................................................... 7
Cautions and Warnings ............................................................................................................................................................. 7
Software Safety-Related Messages ..................................................................................................................................... 7

Privacy and Security Information ............................................................................................................. 8

CT Protocols......................................................................................................................................................... 9
Review CT liver multiphase exams ....................................................................................................................................... 9
Merge Multi-Phase CT VR........................................................................................................................................................10
Simple CT review with MR correlation ..............................................................................................................................13
Dual-Energy Review ..................................................................................................................................................................16
CT Multiple Trauma Review Protocol .................................................................................................................................18
CT Volume Shuttle Review......................................................................................................................................................21

MR Protocols .................................................................................................................................................... 24
MR Aorta Review.........................................................................................................................................................................24
MR IAC Review .............................................................................................................................................................................26
Review MR TRICKS multiphase exams ..............................................................................................................................28
Review MR Cardiac ....................................................................................................................................................................29

PET Protocols ................................................................................................................................................... 32

PET/CT Review .............................................................................................................................................................................32
Compare 2 PET/CT exams ......................................................................................................................................................36
Merge 3D PET/CT Volume Rendering ................................................................................................................................38
Create Time Activity Curves in PET 4D protocol ...........................................................................................................41

INNOVA 3D X-Ray Vascular Review ...................................................................................................... 42

Revision History .............................................................................................................................................. 44

2
Regulatory Requirements
Refer to Volume Viewer part1 user guide.

Legal Notices
Refer to Volume Viewer part1 user guide.

3
Introduction
This User Guide is a training material available on line on the workstation covering Volume
Viewer and Dynamic Shuttle. It can also be read from any PC using the Volume Viewer
installation DVD. Review operating procedures on a regular basis, paying special attention to the
Safety and Regulatory statements. Keep this User Guide available while using these products.

If you want to benefit from additional training, please contact your GE User Services
representative for assistance.

This User Guide is available in 3 parts.

You are now in Part 3: Clinical Scenarios, which is a step-by-step description of how to post
process the most common clinical exams.

Additional information on these products is also available in:

- Part 1: Overview of Volume Viewer which reviews the different functionalities of the
software user interface.
- Part 2: Deep Dive in Volume Viewer, which gives a detailed description of the main
functionalities.

As with any medical imaging process, only qualified personnel should use this equipment.
You must be aware of the limitations of the basic imaging modality and of ensuing image
processing. This includes understanding the limitations of the initial series acquisition, image
processing technology used, and image display methods.

User Interface Note

Please note that the screen captures in this document are intended for demonstration purposes
only and may not always be fully identical to the actual user interface (e.g., in color scheme). Use
these screen captures as guides.

4
Product Description
Refer to Volume Viewer part1 user guide.

5
Safety
To assure an efficient and safe use of Volume Viewer / Dynamic Shuttle, it is essential to read
this chapter before attempting to use the package.

The users of Volume Viewer software application will be CT, MR, nuclear medicine, and radiology
technologists, radiologists, cardiologists, or physicians qualified with advanced applications
training for software competencies or other personnel that the owner feels is properly trained
for this software use (radiology assistants, physician assistants, etc.).

The users of Dynamic Shuttle software application will be CT Angiography radiology

technologists, radiologists, cardiologists, or physicians qualified with advanced applications
training for software competencies or other personnel that the owner feels is properly trained
for this software use (radiology assistants, physician assistants, etc.).

To avoid usability error, the user MUST have a good knowledge and understanding of both the
platform and its primary operating functions. This will be accomplished through applications
training and through the correct knowledge and application of User Guide content. Please
contact your GE representative to order and follow this mandatory training. The site determines
a qualified individual. The site is the owner of the program and can be located within a hospital,
a clinic, or a private office setting (fixed or mobile) or wherever this program is used.

Ensure that the correct versions of your User Guides are readily available at all times. Make a
point to review the procedures and safety precautions periodically. Additional safety concerns
are addressed in the AW VolumeShare/AW Server user documentation.

Safety notice legends:

THIS INDICATES A POTENTIALLY HAZARDOUS SITUATION, WHICH, IF NOT AVOIDED, COULD

RESULT IN DEATH OR SERIOUS INJURY.

This indicates a potentially hazardous situation, which, if not avoided, may result in minor or
moderate injury.
Notice
This indicates a non–hazardous situation, which, if not avoided, could result in equipment
damage, lost time, or reduced image quality.

6
Intended Use / Indications for Use
Refer to Volume Viewer part1 user guide.

Cautions and Warnings

Refer to Volume Viewer part1 user guide.

Software Safety-Related Messages

Refer to Volume Viewer part1 user guide.

7
Privacy and Security Information
Volume Viewer Application does not encrypt data that are stored locally and externally.

8
CT Protocols
Review CT liver multiphase exams
Step What you select How or Why you select it
REVIEW PROTOCOLS
1
1 exam:
Abdominal Dual Phase
Dual Phase Liver
MPVR and MIP - Liver
Three Phase Liver

2 exams:
Dual Phase Follow up

From the protocol page, select the

Abdomen anatomy, and the Fast
Reading or Oncology category.

Select the appropriate series from

the Series Selection panel.

2
Phase data is split automatically
upon loading based on acquisition
number DICOM field.
Select the phase from the Series
Description (Phase #) drop down list
on the viewports.

Note: if the merge option is activated in the loading

preferences, the 2 phases might be loaded into a
single volume. Uncheck this preference if only 1
volume is loaded, or adjust the maximum overlap
value for merge (see “Global Preferences” section in
“Volume Viewer part 1 – Overview” for more details).

9
Merge Multi-Phase CT VR
Volume Viewer provides the capability to merge 3D models created from different phases of a
multiphase CT exam. To begin, the data must be loaded to a multiphase Volume Viewer Protocol.

Step What you select How or Why you select it

1 Select a multiphase acquisition and
load it in a multiple volume protocol
(see above).

2 Set the upper left view to VR and

phase 1.

Set the lower left view to VR.

3 Use the AutoSelect tool from the

Segmentation tools to region-grow
the arterial structures of interest in the
upper left viewport (or use “Auto-
Remove Bone” button if AutoBoneTM
Xpress license is available).

10
Step What you select How or Why you select it
4 Ensure that the left mouse mode is set
to Select mode.

Left mouse click on the arterial model

in the upper left viewport and drag it
down to the lower left viewport (Drop
here to reassign).

You can also save temporarily the 3D

model via Save/Recall tool, available
in the Export tools.

5
Change the volume of the upper left
and upper right views to phase2.

Use the Advanced VR Settings tool to

assign color and opacity to structures
of interest (see Part 2 - “Advanced VR
Settings” for more information).

6 In the AutoSelect menu, clear the

upper left viewport. Then, use the
AutoSelect tool to region-grow the
venous structures of interest in the
upper left viewport (or use “Auto-
Remove Bones” button if AutoBone
Xpress license is available).

11
Step What you select How or Why you select it
7 Ensure that the left mouse mode is set
to Select mode.

Left mouse click on the model in the

upper left viewport and drag it down
to the arterial model in the lower left
viewport (Drop here to merge views).

You can continue this process to

merge up to 8 models.

8 After the models are merged, the

objects within the merged model can
be manipulated with VR Multi Objects
panel, available in the Visualization
tools.

Click on the object name to select a

volume.
Click the eye (eye will close) to hide the
volume.
Adjust the Transparency with the
slider.

12
Simple CT review with MR correlation
Step What you select How and/or Why you select it
1 Load CT exam

[AW and AW Server]

Select a CT exam and click VV General
Review to launch the review.

[Seamless Integration]
Select the CT exam viewport and load it in
Reformat protocol via the 3D Applications
list.

2 Review & Measure on CT

From the Measure/Annotate tools, select a

tool to use for measuring.

For example:
Use the Distance tool to measure a
structure on CT.

Results are displayed on screen and in the

Summary Table under CT date column, as
Finding 1.

13
Step What you select How and/or Why you select it
3 Correlate with MR exam (registration)

Use the Dynamic Load panel* or the Series

Navigator** to drag and drop
morphological MR series into a viewport.
If the Integrated Registration license is
available, the MR series will be loaded and
registered to the CT on the fly (see the
Integrated Registration User Guide for more
information).
If necessary, adjust the registration of MR
(a)
to CT (a).
Once the registration is acceptable, load
the functional map of the MR exam (e.g.
ADC) via Dynamic Load* or the Series
Navigator**. Confirm when IR asks for
validation in order to propagate the
registration to the functional map. (b)
Now all series (CT, MR morphological, and
functional) are registered.
If no Integrated Registration license is
(b)
present, you can drag and drop functional
MR series and perform a manual link/unlink
to align it to the CT exam.

4 Perform measurement on functional MR

From the Measure/Annotate tools, select a

tool to use for measuring.

For example:
Use the 2D ROI to compute the average
ADC value of the lesion.

* [AW and AW Server]

** [Seamless Integration only]

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 5 Review measurements
(a)
If not displayed, open the Summary table
from the Export tools and click to
expand the table.

Measurements performed on CT and MR

exams are displayed in the table. If exams
were performed on the same day,
measures will be displayed under the same
column, otherwise they will be displayed in
(b)
2 columns and you need to expand the
Summary Table to see them both.
If measurements are not displayed in the
same finding (a) (i.e. the MR measurement
is under Finding 2), link it manually to
Finding 1 by drag & drop. (b)

6 Save State

Click the icon, type a name to the Save

State series, select under which exam to
save it and click (Save).

15
Dual-Energy Review
Volume Viewer provides the capabilities to generate material maps based on dual energy CT
acquisitions.
Select exam containing dual energy series and select Volume Viewer [AW only] or 3D Viewer
[AW Server and Seamless Integration]. From the protocol page, select General anatomy, then
Dual Energy category.

Note: Dual-Energy protocols do not support intra-venous contrast images and require the exact
same geometries (slice thickness, image location, FOV, reconstruction filters, etc.) between
the two kVp series. Thus when acquiring dual energy images:
- Do not use IV contrast.
- Avoid manual retro-reconstructions, and prefer prospective reconstructions instead.

Step What you select How or Why you select it

VOLUME REGISTRATION
1
The first step to perform is to review and
adjust the registration between 80/140 kVp
(or Low/High kVp).
If patient motion is observed between the 2
series, adjust the registration using
automatic, manual or regional registration
tools. Refer to “Integrated Registration” User
Guide for detailed explanations.

MATERIAL SEGMENTATION MAP

2
DE Uric Acid – DE Calcium

The software automatically computes maps

based on ratio values between 80 kVp and
140 kVp.

It is possible to threshold the HU of interest

that are used for map segmentation, e.g.
150<HU<500, from the dedicated sliders on
the wizard panel.

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Step What you select How or Why you select it
Click Compute to re-generate material
maps.
For DE Uric Acid (respectively DE Calcium)
ratio value is set to maximum of 1.25
(respectively minimum of 1.25) and cannot
be adjusted.

DE Custom

The software automatically computes maps

based on ratio values between low kVp and
high kVp.

It is possible to threshold the HU of interest

that are used for map segmentation, e.g.
150<HU<500, from the dedicated sliders on
wizard panel.
It is also possible to adjust the ratio value
and display material map below or above
this ratio, via dedicated sliders on wizard
panel.
Click (Compute) to re-generate material
maps.

IMAGE FUSION

Material segmented maps can be merged

with other images in 2D, 3D, or mixing 2D
and 3D.
Refer to the Integrated Registration User
Guide for detailed explanations.

17
CT Multiple Trauma Review Protocol
Introduction
Multiple Trauma exams require complex, fast, and exhaustive review of multiple series. This
review protocol is designed to optimize review and post-processing of this type of exam by:
• Single loading of all series together in 3D in compare mode.
• One dedicated general layout preset optimized for multiple trauma fast and easy review
of vital structures.
• Several dedicated layout presets of each anatomical region.
• Providing a scenario of multiple trauma review.

I. Protocol Selection

Step What you select How or why you select it

1
Select Compare Multiple
Trauma Protocol

[AW and AW Server]

Select the Compare
Multiple Trauma button
from the protocol list under
the General anatomy and
Fast Reading category.
This protocol can be set as
a Favorite by clicking on
the star button.

[Seamless Integration]
Select Compare Multiple
Trauma from the Basics
menu in the 3D
Applications list.

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II. Series Flagging and acquisition recommendations for optimal use
of layout presets
Step How or why you select
What you select
it
2
Select Series
a Select a desired series
and flag each series with
the corresponding
scanned anatomy. (a)

Available anatomies are:

• Head
• Neck
• Chest
• Cardiac
• Abdomen
• Spine
• Upper Extr.
• Lower Extr.

Click [OK].

Table summarizing CT series to acquire and their anatomical flagging:

Acquired Series Recon Filter Anatomical flag in panel of Step II
Head or BONE and/or HEAD
Head together with face STANDARD
Cervical Spine BONE and/or NECK
STANDARD
Chest/Abdomen/Pelvis STANDARD ABDOMEN
injected series LUNG CHEST
Hand, arm, shoulder BONE and/or Upper Extremity
STANDARD
Foot, Ankle, Knee, Leg BONE and/or Lower Extremity
STANDARD

Note: The BONEPLUS reconstruction is handled the same way as BONE reconstruction by the
protocol.

19
III. General Overview of Vital Structures
How or why
What you select
you select it
Once each series is
flagged with the
corresponding
anatomy, click (OK) to
begin the review. A
list of layout presets is
available in Review
Steps to provide a
scenario for multiple
trauma review. The
layouts have dedicated
window/level and
rendering modes for
each anatomical area.

20
CT Volume Shuttle Review
This section describes the protocols available to review 4D head and body CT datasets acquired
in the Volume Shuttle mode.

The following 4D review protocols provide visualization tools for vascular kinetics. These
protocols offer the ability to dynamically display multiple contrast phases of a CT dataset,
enabling the visualization of contrast flow through the tissue, and arterial and venous
vasculatures.

Baseline Arterial Venous Wash out

phase phase

Time

The 4D Shuttle Review protocol offers the ability to load a

multi-phase head CT dataset and to dynamically display
the phases with the use of a cine tool.
Anatomy: General

4D Neuro DSA offers dynamic review capabilities of the

4D Shuttle Review protocol after image registration and
bone removal. The bone is removed using Digital
Subtraction Angiography (DSA), which subtracts the bone
mask from every contrast phase of the dataset. This
technique is well adapted to those neuro cases in which
patient motion does not introduce bone deformation.
Anatomy: Head

The 4D Body Shuttle protocol offers the ability to load and

dynamically review a multi-phase body CT dataset after
bone removal. The bone removal can be achieved using
Bone Subtraction (DSA) or AutoBone protocols. Note that
in case of non-rigid bone deformation (e.g. deformation of
the ribs in presence of respiratory motion), Bone
Subtraction may not succeed at completely removing the
bone.
Anatomy: Abdomen

21
4D Shuttle Review/Neuro DSA/Body Shuttle protocols shall be used exclusively with the GE
Volume Shuttle (axial) and Volume Helical Shuttle datasets.

Phase time is displayed on the views for each phase and is relative to the time of the first
selected phase.

It is possible to merge phases (peak arterial and peak venous for example): Refer to section
Merge Multi-Phase CT VR above. However please note that merge views will not support cine
looping.

4D Neuro DSA
This protocol is fully automated. It loads all phases of a dynamic head CT dataset, performs
image registration, and removes the bone using DSA. This protocol can be initiated as follows:

• Select a dynamic head CT dataset acquired in Volume Shuttle mode from the patient list.
• Click (Volume Viewer) [AW] / (3D Viewer) [AW Server and Seamless Integration] and
select (4D Neuro DSA) in the Head protocol list.

The segmented head volume is then displayed in the top left viewport in MIP mode. Three
remaining viewports display original images in Axial, Sagittal, and Coronal orientations. The Cine
tool panel is active to initiate dynamic visualization of the dataset of interest.

22
4D Body Shuttle
The workflow of this protocol is similar to 4D Neuro DSA, but it offers a choice of bone removal
method: AutoBone or Bone Subtraction. This protocol can be initiated as follows:
• Select a dynamic body CT dataset acquired in Volume Shuttle mode from the patient list.
• Click (Volume Viewer) [AW] / (3D Viewer) [AW Server and Seamless Integration] and select
(4D Body Shuttle) in Abdomen protocol list.
• Choose (AutoBone Shuttle) or (Bone Subtraction) from the control panel.

Tip on Selecting Bone Removal Method

Generally, in the absence of bone deformation due to patient motion, or in the absence of
patient motion the Bone Subtraction technique will effectively remove the bone. However,
AutoBone may produce better results when non-rigid bone motion is encountered (e.g.
deformation of the ribs in presence of respiratory motion).

CINE Review With Bones

Non-Rigid
Bone Motion ?
No Yes

Bone removal by DSA Bone removal by AutoBone

23
MR Protocols
MR Aorta Review
Step What you select How or why you select it
1 Selecting Protocol

Select the 3D MIP protocol from the

Protocol page.

2 View vessels

1. From the Segmentation tools, select

the AutoSelect tool.
2. Click (Small Vessels) or (Any Structure)
from the AutoSelect panel ((Add) is
automatically selected). Click (Yes) to
clear the upper left viewport.
3. Scroll through the 2D views at their
minimum slice thickness and place the
3D cursor in center of the aorta.
4. Click and hold to fill the vessel.
5. Release the left mouse button to stop
filling.
6. Repeat the operation in order to
display all vessels of interest in the 3D
MIP viewport.

24
Step What you select How or why you select it
3 Quick Export

1. From the Export tools, select the

Quick Export tool.

2. Select an output mode:

• Save as new series
• Send to the Filmer as a video*

3. If needed, set the number of 3D

frames to be saved.

4. Click the 3D viewport to export a

rotating 3D.

* [AW and AW Server only]

25
MR IAC Review
Step What you select How or why you select it
1 Select a 3D exam
Select exam and series
Select an exam and load it in Reformat
protocol.

2 Film/Save oblique planes

1. Click on the Axial viewport to select

it.

2. From the Export tools, open the

Batch tool and select Oblique.

3. Adjust the oblique plane for the left

IAC. (a)

4. From the Batch Film panel, the

following parameters can be set:
- Number of views
- Spacing
a - Slice Thickness
- FOV
- Output (e.g. “Save”)
Enter a series description then click
(OK) to save a new series.

5. Repeat the operation for the right

IAC.

26
Step What you select How or why you select it
3 Double Oblique

Select the Multiple Oblique button

from the Visualization tools.

Adjust oblique planes on the top
viewports (a) (b).

1. From the Export tools, select the

a b
QuickExport tool.

2. Select Save as a new series and

click on the double-oblique
viewport (green border in the
example shown).

3. Enter a series description when

prompted and press (OK) to
confirm.

4. Repeat double oblique

adjustments and export for the
right IAC and press (Exit) then (OK)
to close Volume Viewer.

27
Review MR TRICKS multiphase exams
Step What you select How or Why you select it
1 Protocol: TRICKS

Select an MR TRICKS exam from the Patient List

and click on the Volume Viewer shortcut [AW
only] or on (3D Review) [AW Server and Seamless
Integration].

In the protocol page, select General anatomy and

Vascular category. Select the TRICKS protocol.

Select the phases to load from the Series Selection

panel.

2 Default layouts are available in the Review Steps

list.

Additional layouts are available in the Protocol

List via the (+) icon.

3 Phases are split into individual volumes and

available from the active annotation.

28
Review MR Cardiac
"MR Cardiac AutoCine" is the MR Cardiac review protocol in Volume Viewer. It allows the
dynamic review (Cine) of typical MR cardiac exams (FIESTA, MDE, etc.).

MR Cardiac AutoCine
Launching the “MR Cardiac AutoCine” protocol will display the series selection panel and
automatically check the appropriate series for loading. Localizers will not be checked. You can
make changes to the selection if needed.

Clicking (OK) will load the selected series and automatically display the following square layouts:

One screen configuration

Displays the series with the maximum number of slices (priority to Fiesta multiphase series)

Dual screen configuration

Right screen: the series with the maximum number of slices (priority to Fiesta multiphase series)
Left screen: second series with the maximum number of slices

If the different series do not have the same number of phases then the cine mode will be based
on the series with the largest number of phases.
29
Using the Review steps
You can take advantage of the review steps for this protocol, which are described below.

Time course VS MDE

"MR Cardiac Time Course vs MDE" allows side-by-side display of myocardium contrast uptake in
Cine mode as well as the contrast myocardium delayed acquisition. It can be used to assess
contrast uptake of an infarcted area.

30
Fiesta VS MDE
"MR Cardiac FIESTA vs MDE" displays side-by-side FIESTA short axis in Cine mode and delayed
acquisition of contrasted myocardium. It can be used to assess myocardium motion on an
infarcted area.

Time Course Stress/Rest

"MR Cardiac Time Course Stress/Rest" displays side-by-side contrast uptake of pharmaceutical
induced stress acquisition and rest acquisition. It can be used to assess ischemic areas in the
myocardium.

31
PET Protocols
PET/CT Review
Step What you select How or why you select it
1 Select a PET/CT exam

Select a PET/CT exam and load it in PET/CT

Single Review from the General anatomy
and PET category in Volume Viewer protocol
page.

2 Exporting 3D rotating weighted MIP

1. From the Export tools, select the

Quick Export tool.
2. Select (Save as a new series) and
click on the upper left viewport,
which contains the 3D weighted MIP.
Set the number of views in 3D Views.
3. Enter a series description (preference
to ask for series description is Global
Preference) and click (OK) to save the
new series.
4. [AW and AW Server only] Click again
on the Quick Export tool and select
(Send to the Filmer as a video).
Click again on the upper left
viewport. The 3D rotating MIP will be
sent to the Filmer as a movie.

32
Step What you select How or why you select it
3 Changing the layout

1. Select a layout from the Review

b a
Steps list. (a)
OR
2. Click (+) next to the Review Steps
to display the Protocol List (b),
click to select a layout or drag &
drop a layout to the Review Steps
list.

For example, select (2 Planes PET) from

the Review Steps list.

4 Creating a coronal contiguous slabs

series

1. Put the mouse cursor over the

slice thickness yellow annotation
and right/left click to
increase/decrease the slice
thickness. (a)
2. Click on the rendering yellow
annotation and select the desired
mode (Average, MIP, minIP, VR).
(b)
3. Put the mouse cursor next to the
Sp. yellow annotation and
right/left click to
increase/decrease slice spacing.
(c)
Note: the spacing cannot exceed
the slice thickness
c 4. From the Export tools, select the
Quick Export tool.
a b
5. Select (Save as a new series) and
click on any PET coronal view.
6. Enter a series description if
needed and click (OK) to save the
new series.

33
Step What you select How or why you select it
5 Quantifying lesion SUV

Move the 3D cursor on the lesion by

pressing the <Shift> key while the
mouse is over the lesion.

Deposit a bookmark:
1. Press the <Insert> key while the
mouse is over the lesion.
or
2. Select the AutoContour tool from
the Segmentation tools and click on
the lesion to analyze.
Check that the rectangular ROI
encompasses the lesion on the 3
orthogonal planes. If necessary, you
can resize the 3D ROI by dragging
the corners of the 3D ROI.
Click (Accept and Measure) to
validate the contour and display the
statistics.

Statistics and the estimated volume are

displayed on the viewport.

Lesions may also be identified by using

the Deposit Bookmark tool from
the PET tools.

When more than one ROI is deposited,

use Next Bookmark to navigate
through the bookmarks.

Save state

1. From the Export tools, select

(Save State).

2. Enter a description for the save

state series and click (OK) to
confirm. Layout, Review Steps,
ROIs, and segmentation
operations will be saved.

34
Step What you select How or why you select it
3. To re-load the results:

[AW and AW Server]

Select the exam from the Patient
List and double click on save
state series you want to load
(“3D Saved state – xxxx”).

[Seamless Integration]
Load the exam in a 3D protocol
then drag and drop the Save
State series from the Navigator
window to the 3D window, and
select (Load).

35
Compare 2 PET/CT exams
Step What you select How or Why you select it
1 Select PET/CT exams

Select 2 PET/CT exams and load

them in PET/CT Follow-up from the
General anatomy and PET category
in Volume Viewer protocol page.

Select series to load from the Series

Selection panel.
It is recommended to select 1 CT and
1 PET per exam.

2 PET/CT Follow up

The most recent exam will

Most Recent automatically display in the upper
exam
viewports while the older exam will
display in lower viewports.
Identical view types are displayed for
each exam to facilitate the
comparison.
Older exam

36
Step What you select How or Why you select it
3
Use the Link/Unlink icons
available in the Visualization tools to
adjust synchronization of volumes
(PET and CT volumes from same
exams cannot be unlinked).

Content of the views can be

customized using yellow annotations
(see “Customize your display” section
in Volume Viewer part2 User Guide).

To perform a more accurate

registration, you can use the
Integrated Registration application
(for more information, refer to the
Integrated Registration User Guide).

37
Merge 3D PET/CT Volume Rendering
Volume Viewer provides the capability to merge 3D models created from PET and CT series from
a PET/CT exam. To begin, the data must be loaded to a Volume Viewer PET Protocol.

Step What you select How or Why you select it

1 Select a PET/CT exam and load it into
a dedicated PET/CT protocol.

2 Change the display mode of the PET

Volume on upper left view to VR.

Change the display mode of the CT

Volume on upper right view to VR.

Change the display mode of the CT

Volume on lower left view to VR.

3 Click on the lower left viewport to

select it.
From the Visualization tools, select
the VR Basic Settings tool and apply
the Air Structure preset (from the
Chest anatomy).

38
Step What you select How or Why you select it
4 To remove undesired structures in the
lower left CT view and keep only lung
structures:
- Set the mouse mode to Select
mode and double-click on the
lower left viewport.
- Use the Scalpel tool from the
Segmentation tools.

5 Select the PET VR in the upper left

view.

From the Visualization tools, select

the VR Basic Settings tool and apply
the PET Color Lesions preset (from the
General anatomy).

Use the middle mouse mode to modify

the VR opacity setting.

6 Colors can be modified via the

Advanced VR Settings tool in the
Visualization tools.
Select the color cursor to modify (a)
and click (Active Color) (b) to modify
color.

a
b

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Step What you select How or Why you select it
7 To Merge PET VR and Bone CT VR:

1. Set the left mouse mode to Select

mode.

2. While on the upper left viewport,

hold the left mouse button to drag
the PET model to the CT VR bone
model in the upper right viewport.
Drop it in the upper white square
(Drop here to merge views) to
merge.

8 To Merge the CT Lung model VR and

merged PET/CT VR:
1. Check that Select mode is the
active left mouse button mode
2. While on the lower left viewport,
hold down the left mouse button to
drag the model to the PET/CT VR in
the upper right viewport.
Drop it in the white square (Drop
here to merge views) to merge.

You can continue this process to

merge up to eight models.

9 After the models are merged, the

objects within the merged models can
be shown or hidden from the Multi
Objects window.
From the Visualization tools, select
(Multi Objects).
Click on the object name and adjust
the transparency with the slider.
Click on the eye to show/hide the
volume.

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Create Time Activity Curves in PET 4D protocol
Volume Viewer provides the capability to create Time Activity Curves for overview of tracer
uptake. To begin, the data must be loaded in 4D PET protocol.

Step What you select How or Why you select it

1 Select a PET/CT exam containing a
dynamic or gated PET series and load
desired PET phases in PET 4D protocol
(Anatomy: General, Category: PET).
Use Movie tool to check visually the
dynamic uptake.

2
Set any viewport to Graph view.

By default, the curve corresponding to

the 3D cursor is displayed, and
updated when moving the 3D cursor.

Deposit a 2D or 3D ROI on a PET

viewport. The graph view will be
updated with as many ROIs as
deposited.

Scale can be changed to Absolute,

Relative, Percentage or Shape
Comparison value.

Statistics plot (stats type) can be

changed to Average, Max or min.

Min/Max values and last phase can be

adjusted as well directly on the graph
view.

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INNOVA 3D X-Ray Vascular Review
Innova 3D XR produces XA CT images (512 images 512x512 or 256 images 256x256 depending
on user settings). This format will give access to Volume Viewer workflow features including:
Review Steps, Protocol Creation, One Touch Protocols, etc. Please refer to part1 & part2 of the
User Guide for more information on Volume Viewer workflow features.

Step What you select How or why you select it

1 Load the pre-intervention 3D series

[AW]
Double-click on the first 3D vascular
series (Type “Axial”, modality “XA”) to
launch the “Innova3D NOSUB” protocol.

[AW Server]
Click the 3D Viewer button and select
the Innova protocol from protocol
page.

[Seamless Integration]
Once the series is loaded, open 3D
Viewer from More protocols in the 3D
Applications list and select the Innova
3D NOSUB protocol from the protocol
page.

2 Adjust VR display

a 1. Select a VR Preset in the VR

Basic Settings tool, from
Visualization tools.
2. Adjust VR opacity with the
middle mouse button. (a)

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Step What you select How or why you select it

3 [AW only]
Checking DSA

1. Open the mini-patient list. All

non-3D images such as DSA are
listed with a (2D) button next to
them.
2. Click on the (2D) button to load
the desired DSA series in a mini-
Viewer on the bottom left.

4 Comparing pre/post intervention

1. Open the mini-patient list [AW

and AW Server] (a1), or the
Series Navigator [Seamless
Integration] (a2).
2. Drag the post intervention series
and drop it over a desired
viewport.
a1
Note: registration can be
automatically processed at
loading with the Integrated
Registration option. See Volume
Viewer part 1 – Overview for
more information about this
a2 global preference.
3. From the (+) icon next to review
steps, click the Protocol Page
button and select the Compare
Sub protocol.
Pre-intervention Post-intervention

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 Revision History
Revision Date Reason for change Pages
1 2019-02 Initial release based on 5789073 rev1 44

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