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<strong>syngo</strong>. <strong>via</strong> <strong>for</strong> <strong>Sustainable</strong> <strong>Cardiovascular</strong> <strong>Care</strong>.<br />

<strong>syngo</strong>. <strong>via</strong>. Images, my way.<br />

www.siemens.com/<strong>syngo</strong>.<strong>via</strong>-cardiovascular<br />

Answers <strong>for</strong> life.


<strong>syngo</strong>®. <strong>via</strong> enables me<br />

to diagnose and share<br />

results, my way.<br />

My cases are ready <strong>for</strong> reading. <strong>syngo</strong>.<strong>via</strong> 1 helps to<br />

analyze the individual case, prepares images, suggests an optimized<br />

workflow, and offers guidance when needed.<br />

My images are networked. And so am I.<br />

<strong>syngo</strong>. <strong>via</strong> speeds the way I connect and share in<strong>for</strong>mation with<br />

my clinical partners and patients – even on the go 2 .<br />

My needs are anticipated. The <strong>syngo</strong>. <strong>via</strong> service<br />

offering helps me keep up with innovations, get integrated services,<br />

and rely on predictable costs now and in the future.<br />

1<br />

<strong>syngo</strong>. <strong>via</strong> can be used as a stand-alone device or<br />

together with a variety of <strong>syngo</strong>. <strong>via</strong>-based software<br />

options, which are medical devices in their own rights.<br />

2<br />

Prerequisites include: Internet connection to clinical<br />

network, DICOM compliance, meeting of minimum<br />

hardware requirements, and adherence to local data<br />

security regulations.<br />

2


Index<br />

Intro 04<br />

Coronary Artery Disease (CAD) 06<br />

Heart Failure 12<br />

Valvular Heart Disease 16<br />

Vascular Disease 18<br />

More <strong>syngo</strong>. <strong>via</strong> features 22<br />

<strong>syngo</strong>. <strong>via</strong> is more than processing images 24<br />

<strong>syngo</strong>. <strong>via</strong> <strong>Cardiovascular</strong> Portfolio 26<br />

<strong>Siemens</strong> IT <strong>Care</strong> Plan TOP <strong>for</strong> <strong>syngo</strong>. <strong>via</strong> 30<br />

3


We can help you provide<br />

high-quality, sustainable<br />

cardiovascular care.<br />

The number of chronic cardiovascular disease patients is rising and cardiovascular<br />

diseases are the leading cause of death worldwide. The consequence is an<br />

increasing demand <strong>for</strong> high-quality, sustainable care in the most effective and<br />

efficient way. As one of the leading medical technology and service providers,<br />

we offer you a comprehensive portfolio along the entire cardiovascular care<br />

continuum, from prevention, early diagnosis, and acute care to follow-up.<br />

<strong>Healthcare</strong> facilities worldwide are faced with increased pressures and challenges<br />

both financial and clinical. To help, we offer sustainable and af<strong>for</strong>dable solutions<br />

that present an intuitive, optimized workflow from scanning, to processing, to<br />

reading. We provide you with technology and innovations that can support your<br />

ability to make sounder decisions, per<strong>for</strong>m safer and in many cases less invasive<br />

procedures, operate with better efficiency, and invest resources wisely.<br />

<strong>Sustainable</strong> care delivery throughout this continuum is a multifaceted topic and<br />

expected by all parties: the patient, the care provider, and the healthcare system.<br />

4


<strong>syngo</strong>. <strong>via</strong> helps make advanced<br />

reading an integral part of<br />

clinical routine – efficiently.<br />

In recent years, many advancements have taken place in cardiovascular care.<br />

New imaging modalities like CT and MRI have entered the field of cardiovascular<br />

diagnostics. Innovative technologies and applications have been developed <strong>for</strong><br />

them as well as <strong>for</strong> well established modalities such as coronary angiography<br />

and nuclear cardiology.<br />

<strong>syngo</strong>. <strong>via</strong> 1 is one of these innovations. <strong>syngo</strong>. <strong>via</strong> can help you improve cardiovascular<br />

care as it equips you with comprehensive cardiovascular workflows and<br />

applications <strong>for</strong> evaluating images from multiple modalities. It provides you<br />

with a broad variety of automated tools and processes to enable more efficient<br />

reading in your clinical routine. And clinical workflows are tightly integrated<br />

with RIS/PACS, of course.<br />

On the following pages, you will see how <strong>syngo</strong>. <strong>via</strong> can help you deliver<br />

sustainable, high quality cardiovascular care – and provide answers to many<br />

clinical questions.<br />

Rely on <strong>syngo</strong>. <strong>via</strong> to help establish:<br />

• Accelerated and high-per<strong>for</strong>mance reading and diagnosis in cardiovascular<br />

cases.<br />

• Increased productivity and reduced costs.<br />

• Easy results communication with referring physicians and patients.<br />

1<br />

<strong>syngo</strong>.<strong>via</strong> can be used as a stand-alone device or together with a variety of <strong>syngo</strong>.<strong>via</strong>-based<br />

software options, which are medical devices in their own rights.<br />

5


<strong>syngo</strong>. <strong>via</strong> <strong>for</strong> sustainable care<br />

of Coronary Artery Disease (CAD)<br />

Stephan Achenbach, MD,<br />

University of Gießen,<br />

Germany<br />

“<br />

I have to say that<br />

the advanced<br />

functions,<br />

such as the<br />

curved planar<br />

reconstructions,<br />

are extremely<br />

stable and the<br />

results are really<br />

good and reliable.<br />

”<br />

In<strong>for</strong>mation on the coronary status is of greatest importance<br />

<strong>for</strong> the management of patients with suspected<br />

or diagnosed Coronary Artery Disease (CAD), the largest<br />

patient group in cardiology. When diagnosing a patient,<br />

you want to know:<br />

• What is the risk <strong>for</strong> a future myocardial infarction?<br />

• Is the acute chest pain caused by CAD?<br />

• What is the severity of disease?<br />

• Is there a myocardial infarction?<br />

• Which treatment is appropriate?<br />

<strong>syngo</strong>. <strong>via</strong> offers you a variety of tools and applications to<br />

efficiently identify the answers during related readings<br />

and evaluations.<br />

6


<strong>syngo</strong>. CT CaScoring<br />

Quick and confident risk assessment and<br />

coronary age calculation with CT or SPECT<br />

Assessment of coronary artery calcium burden can be<br />

used as a prognostic indicator of the patient’s risk of<br />

morbidity from atherosclerotic coronary heart disease.<br />

Recent studies have indicated that calcium scoring<br />

shows promise as a good risk-assessment tool and it<br />

may be a better predictor of coronary heart disease<br />

compared to more traditional cardiac risk evaluation<br />

methods. Calcium scoring can also be used in a presurgical<br />

workup be<strong>for</strong>e per<strong>for</strong>ming cardiothoracic<br />

surgery.<br />

<strong>syngo</strong>. <strong>via</strong> with <strong>syngo</strong>. CT CaScoring allows accurate<br />

visualization and quick quantification of calcified<br />

coronary lesions, including number of lesions,<br />

volume, calcium mass, and Agatston Score. Scoring<br />

is easily per<strong>for</strong>med <strong>for</strong> the main coronary arteries<br />

(RCA, LM, LAD, CX). To finally yield a refined risk<br />

stratification, the patient’s score is compared to a<br />

reference group, <strong>for</strong> example the MESA study.<br />

When combining SPECT with a diagnostic CT exam, a<br />

perfusion scan and calcium scoring can be per<strong>for</strong>med<br />

in one examination. <strong>syngo</strong>. <strong>via</strong> with <strong>syngo</strong>. SPECT<br />

Cardiology Engine 4DM 1 or <strong>syngo</strong>. SPECT Cardiology<br />

Engine Cedars 1 will allow the quantification of the<br />

myocardial perfusion examination and comprehensive<br />

calcium scoring. When combining SPECT perfusion<br />

with CT calcium scoring on a SPECT/CT scanner, the<br />

risk stratification and subsequent patient management<br />

can be even more differentiated.<br />

1<br />

The product is pending 510(k) clearance, and is not yet commercially available in the U.S.<br />

7


<strong>syngo</strong>. CT Coronary Analysis<br />

<strong>syngo</strong>. MR General Engine<br />

Rule-out of coronary artery disease<br />

in less than a minute<br />

In<strong>for</strong>mation about the coronary status is of greatest<br />

importance <strong>for</strong> the management of patients with<br />

coronary artery disease. Due to the Automatic Pre-<br />

Processing in <strong>syngo</strong>. <strong>via</strong> with <strong>syngo</strong>. CT Coronary<br />

Analysis, a cardiac CTA case is ready <strong>for</strong> review as<br />

soon as it is opened. The table and rib cage are automatically<br />

removed and the main coronary arteries,<br />

major coronary branches, and SV grafts are automatically<br />

segmented and labeled. The centerlines<br />

are automatically computed and the comprehensive<br />

layout <strong>for</strong> display of multiple CPRs permits the review<br />

of the coronary tree with the blink of an eye. The<br />

Single Click Stenosis function 1 gives you all relevant<br />

in<strong>for</strong>mation at a glance, such as the diameter and<br />

area of the stenosis. The profile curve helps to locate<br />

other possible stenoses and the plaque lens visualizes<br />

plaque composition. <strong>syngo</strong>. <strong>via</strong> with <strong>syngo</strong>. CT Coronary<br />

Analysis further provides the robust and intuitive<br />

VesselSURF tool, which allows <strong>for</strong> immediate 3D<br />

vessel assessment of axial slices, even without the<br />

existence of centerlines or in occluded vessels.<br />

All your findings and key images are collected on-thefly<br />

in the Findings Navigator as you read the case.<br />

Your result: Rule-out and reporting of coronary artery<br />

disease in less than a minute.<br />

Detect even minor abnormalities<br />

in MRI exams<br />

In MR exams, <strong>syngo</strong>.<strong>via</strong> combines images from functional<br />

data and dynamic signal assessment at rest and<br />

stress in the same view. When scrolling up and down<br />

within a series, you will see linked data from the<br />

other acquisitions displayed at the same anatomical<br />

position – making it easy to compare all available<br />

data and detect even minor abnormalities.<br />

1<br />

This functionality belongs to the <strong>syngo</strong>.<strong>via</strong>-based software application <strong>syngo</strong>.CT Coronary Analysis,<br />

which is a medical device in its own right.<br />

2<br />

The product is pending 510(k) clearance, and is not yet commercially available in the U.S.<br />

8


To take full advantage of the quantitative and dynamic<br />

imaging capabilities of PET, the <strong>syngo</strong>.PET Myocardial<br />

Blood Flow 2 application is available. It evaluates<br />

myocardial blood flow (MBF) during rest and peak<br />

stress (in ml/g/min) and calculates the resulting coronary<br />

flow reserve (CFR). This quantitative approach<br />

improves confidence in the evaluation of myocar<strong>syngo</strong>.PET<br />

Myocardial Blood Flow 2<br />

<strong>syngo</strong>. CT Cardiac Function<br />

Full spectrum of myocardial perfusion<br />

analysis in SPECT and PET exams<br />

In symptomatic patients, you need to determine<br />

whether a decrease in bloodflow is occurring at rest,<br />

stress, or both. Is there a perfusion defect? Is the<br />

damage reversible? <strong>syngo</strong>. <strong>via</strong> with <strong>syngo</strong>. SPECT<br />

Cardiology Engine 4DM 2 or <strong>syngo</strong>. SPECT Cardiology<br />

Engine Cedars 2 can answer these questions by automatically<br />

analyzing and quantifying the stress and<br />

rest myocardial perfusion and comparing the results<br />

to a normals database, also <strong>for</strong> gated datasets. Slice<br />

displays are customizable to provide visualization of<br />

the 2D cardiac slices in the desired layout. Polar plots<br />

(raw, normalized, blackout, severity) with segmental<br />

quantitative scores can also be displayed to help<br />

assess the severity of disease.<br />

Myocardial perfusion using PET has been shown to<br />

have high sensitivity and specificity <strong>for</strong> diagnosis<br />

and characterization of coronary artery disease. The<br />

<strong>syngo</strong>.mCT Cardiology Engine 4DM 2 and <strong>syngo</strong>.mCT<br />

Cardiology Engine Cedars 2 allow <strong>for</strong> comprehensive<br />

evaluation of PET perfusion and <strong>via</strong>bility studies.<br />

dial ischemia and functional estimation of coronary<br />

stenosis as well as the characterization of balanced or<br />

triple vessel disease. With <strong>syngo</strong>.PET Myocardial Blood<br />

Flow 2 , such quantitative evaluations can be per<strong>for</strong>med<br />

routinely as part of dynamic perfusion scans.<br />

9


<strong>syngo</strong>. MR General Engine<br />

<strong>syngo</strong>. Interventional QCA<br />

CT as a one-stop shop <strong>for</strong> assessment<br />

of myocardial perfusion<br />

In recent years, CT has been moving toward being a<br />

one-stop shop that allows <strong>for</strong> assessment of myocardial<br />

perfusion in addition to pure anatomy to analyze the<br />

hemodynamic relevance of a stenosis. <strong>syngo</strong>. <strong>via</strong> with<br />

<strong>syngo</strong>. CT Cardiac Function provides dedicated First<br />

Pass and Late Enhancement visualizations that facilitate<br />

the detection of myocardial perfusion defects.<br />

The Compare Layout easily allows users to differentiate<br />

between fixed and reversible defects by simultaneously<br />

displaying the rest against the stress scan.<br />

Alternatively, this mode may be used to distinguish<br />

scar tissue by loading a late enhancement scan.<br />

For dual energy scans, <strong>syngo</strong>.CT DE Heart PBV calculates<br />

material-specific iodine maps of the myocardium<br />

that also help in the detection and quantification<br />

of perfusion defects. Furthermore, <strong>syngo</strong>. <strong>via</strong> allows<br />

users to easily load dynamic myocardial perfusion<br />

data obtained with the SOMATOM® Definition Flash<br />

<strong>for</strong> the quantitative assessment of blood volume and<br />

blood flow.<br />

Simplified reading and analysis<br />

of cardiac MRI examinations<br />

Working with cardiac MRI data on a conventional<br />

workstation is challenging: Multiple applications are<br />

needed; synchronization and navigation capabilities<br />

may be insufficient. Cardiology-specific features may<br />

not be available. The <strong>syngo</strong>. <strong>via</strong>-based <strong>syngo</strong>. MR<br />

General Engine offers a rich suite of various functionalities<br />

to cover all of your routine reading and postprocessing<br />

needs. Be it managing images from different<br />

cardiac views, or phases or searching <strong>for</strong> useful<br />

in<strong>for</strong>mation from other acquisitions, the MR Cardiac<br />

Reading workflow of this Engine links all the images<br />

and in<strong>for</strong>mation to the series that is currently viewed.<br />

With its automatic layout <strong>for</strong>matting, the MR Cardiac<br />

Reading workflow ensures that a cardiac MR case is<br />

ready <strong>for</strong> review as soon as it is opened. Every detail is<br />

in the combined view. Images are presented by type<br />

or anatomical view. They are automatically recognized<br />

and sorted by order and location to provide a quick<br />

overview of even the tough cases. Through the guided<br />

approach, automated short and long axis contours are<br />

created and further parameter analysis is suggested.<br />

So your MR images are ready <strong>for</strong> reading.<br />

10


<strong>syngo</strong>. Interventional QCA Bifurcation<br />

<strong>syngo</strong>.Interventional IZ3D<br />

Optimal assistance <strong>for</strong> stent planning<br />

Once you detect a stenosis, imaging helps you plan<br />

the intervention. To close the gap between diagnosis<br />

and interventional procedure planning, <strong>syngo</strong>. <strong>via</strong><br />

with <strong>syngo</strong>. Interventional QCA supports you in the<br />

assessment of coronary artery dimensions. This<br />

scientifically validated 2D coronary quantification<br />

software provides quantitative coronary vessel analysis<br />

and is optimized <strong>for</strong> small vessels like coronary arteries.<br />

Featuring single vessel analysis including calibration,<br />

vessel border detection, and quantification of the<br />

severity of stenosis, it can assist you in the selection<br />

of the optimal balloon and stent. For CT datasets,<br />

<strong>syngo</strong>.<strong>via</strong> with <strong>syngo</strong>.CT Coronary Analysis assists<br />

you on the pre-procedural planning of the coronary<br />

stents as it provides the curved length, area, and<br />

diameter of a lesion <strong>for</strong> easy and efficient planning.<br />

Accurate analysis of bifurcation lesions<br />

A major challenge <strong>for</strong> interventional cardiologists is<br />

coronary artery bifurcation lesions. Using the conventional<br />

QCA without a dedicated bifurcation option<br />

<strong>for</strong> the evaluation of dedicated stenting devices has<br />

limitations due to vessel diameter changes over the<br />

bifurcation. Another complication lies in defining the<br />

true reference vessel size (healthy vessel) within the<br />

bifurcation area. <strong>syngo</strong>. <strong>via</strong> with <strong>syngo</strong>. Interventional<br />

QCA Bifurcation helps you to overcome these limitations<br />

and achieve the most accurate bifurcation<br />

analysis.<br />

3D reconstructions of the artery of interest help to<br />

eliminate <strong>for</strong>eshortening and out-of-plane magnification<br />

errors. <strong>syngo</strong>. <strong>via</strong> with <strong>syngo</strong>. Inter ventional<br />

IZ3D offers automated detection and 3D analysis of<br />

single and bifurcated coronary arteries from angiographic<br />

X-ray projection images. Multiple X-ray<br />

projections are used to calculate the true geometric<br />

shape in 3D space and create an interactive 3D view<br />

of the artery of interest. This way, it enables improved<br />

analysis results and a clear visualization of the<br />

geometry of difficult lesions and segment anatomy.<br />

Sharper images of calcified<br />

lesions and stents<br />

Even though a stenting procedure was successful,<br />

patients might get symptomatic again over time. So<br />

you need to follow-up on the patency of the stents.<br />

Evaluating stent patency or possible occlusions is<br />

facilitated by the Image Sharpening Tool of <strong>syngo</strong>. <strong>via</strong><br />

with <strong>syngo</strong>. CT Coronary Analysis. Blooming artifacts<br />

that often appear around small, high-contrast objects<br />

are reduced without the need <strong>for</strong> an additional sharp<br />

reconstruction. The image is displayed as if it was<br />

reconstructed with a sharp reconstruction kernel thus<br />

saving valuable time.<br />

11


Award-winning<br />

cardiac segmentation<br />

solution <strong>for</strong> MRI<br />

In 2009 and 2011, <strong>Siemens</strong> won<br />

a competition <strong>for</strong> segmentation<br />

algorithms arranged by the Medical<br />

Image Computing and Computer<br />

Assisted Intervention (MICCAI)<br />

Society. The society had invited<br />

universities and companies to<br />

compete in a challenge on segmentation<br />

algorithms.<br />

<strong>Siemens</strong> was able to achieve the<br />

best results with a registration-based<br />

segmentation technique to fully<br />

automated segment the left ventricle<br />

in cardiac cine MRI studies, in all<br />

slices and all phases of such a study.<br />

A derivation of this technique has<br />

been implemented in the <strong>syngo</strong>. <strong>via</strong>based<br />

software option <strong>syngo</strong>. MR<br />

Cardiac 4D Ventricular Function.<br />

<strong>syngo</strong>. <strong>via</strong> <strong>for</strong> sustainable<br />

care of Heart Failure<br />

Heart failure is one of the most common diseases in<br />

Western civilizations. It is a syndrome that may be caused<br />

by other heart diseases such as coronary artery disease<br />

or different <strong>for</strong>ms of cardiomyopathies. Its treatment<br />

depends on the underlying disease. There<strong>for</strong>e, finding<br />

the cause of heart failure and an exact diagnosis and<br />

follow-up are a must to assure optimized treatment.<br />

12


<strong>syngo</strong>. MR Cardiac 4D Ventricular Function<br />

Comprehensive functionalities <strong>for</strong><br />

ventricular analysis of MRI data<br />

Functional and volumetric evaluations are the cornerstone<br />

of every cardiac MRI examination in ischaemic<br />

heart disease as well as in cardiomyopathies and<br />

myocarditis. Precise analysis of all relevant volumetric<br />

parameters such as ejection fraction, stroke volume<br />

and segmental analysis of wall thickening needs to<br />

be per<strong>for</strong>med. <strong>syngo</strong>. <strong>via</strong> with <strong>syngo</strong>. MR Cardiac 4D<br />

Ventricular Function processes MR cine images of the<br />

heart and generates the required quantitative results<br />

<strong>for</strong> the diagnostic process. It loads the entire dataset<br />

and sorts it automatically, allowing you to see immediate<br />

results when you open the case. Additionally,<br />

the preprocessed segmentation of the left ventricle,<br />

which is based on an award-winning algorithm, is<br />

instantly displayed. Ventricular volumes, ejection<br />

fraction, and myocardial mass, as well as myocardial<br />

thickening <strong>for</strong> all myocardial segments are calculated<br />

automatically and displayed in standardized graphs<br />

and tables. All data are structured into workflow steps<br />

with dedicated reading layouts. These workflow steps<br />

also guide you through the MR cardiac function analysis<br />

<strong>for</strong> the left and right ventricle. As an example,<br />

<strong>syngo</strong>. MR Cardiac 4D Ventricular Function includes an<br />

interactive reporting template.<br />

Low-dose evaluation of ischemia or<br />

cardiomyopathy with CTA<br />

<strong>syngo</strong>. <strong>via</strong> with <strong>syngo</strong>. CT Cardiac Function allows you<br />

to read and diagnose CT angiography images of the<br />

left and right 1 heart <strong>for</strong> the evaluation of ischemia or<br />

cardiomyopathy. Usually the evaluation is based on<br />

ECG gated spiral CT data, which is relatively doseintensive.<br />

The smart segmentation algorithms of<br />

<strong>syngo</strong>. CT Cardiac Function can manage SOMATOM®<br />

Definition CT’s MinDose ECG data, which allow <strong>for</strong><br />

functional evaluation on top of the coronary assessment.<br />

This saves up to 50% of dose <strong>for</strong> full functional<br />

assessment, in other words it reduces the dose from<br />

8-12 mSv down to ~4 mSv. With the Automated Case<br />

1<br />

Optional feature. Available in <strong>syngo</strong>. CT Cardio-Vascular Engine Pro.<br />

13


<strong>syngo</strong>. CT Cardiac Function<br />

<strong>syngo</strong>. Interventional LVA<br />

Preparation, all the relevant data <strong>for</strong> cardiac function<br />

are presented when opening the case: Global functional<br />

parameters such as endsystolic and enddiastolic<br />

volume, myocardial mass, and ejection fraction are<br />

automatically calculated <strong>for</strong> both the left and the<br />

right 1 ventricle. Local left ventricular functional<br />

parameters such as wall motion, wall thickening,<br />

and wall thickness are displayed in easy to read AHA<br />

con<strong>for</strong>m 17 segment 2D polar plots.<br />

Fast and intuitive assessment of left<br />

ventricular function within XA studies<br />

You might need to validate the diagnosis that was<br />

done based on CT or MR data within an additional<br />

XA study, complemented by a hemodynamic measurement<br />

at this modality to evaluate the severity<br />

of CAD. The <strong>syngo</strong>. <strong>via</strong> client-server architecture<br />

helps to ensure that the previous images as well<br />

as measurements will be at hand in the lab where<br />

this XA exam ultimately takes place. <strong>syngo</strong>. <strong>via</strong> with<br />

<strong>syngo</strong>. Interventional LVA then offers fast and intuitive<br />

assessment of left ventricular function within the<br />

XA study. The software provides automated contour<br />

detection of the left ventricle, automatic end-diastole/<br />

end-systole detection, volume calculation, and wall<br />

motion analysis.<br />

1<br />

Optional feature. Available in <strong>syngo</strong>. CT Cardio-Vascular Engine Pro.<br />

2<br />

The product is pending 510(k) clearance, and is not yet commercially available in the U.S.<br />

14


<strong>syngo</strong>. SPECT Corridor4DM 2 <strong>syngo</strong>.PET Myocardial Bloodflow 2<br />

Revascularization decision based on<br />

PET myocardial <strong>via</strong>bility examinations<br />

A myocardial <strong>via</strong>bility examination helps determine if<br />

a patient could benefit from revascularization despite<br />

non reversible perfusion defects. An 18 F-FDG PET<br />

study helps differentiate hibernating from non-<strong>via</strong>ble<br />

myocardium by showing glucose metabolism of <strong>via</strong>ble<br />

tissue. Through the use of <strong>syngo</strong>. mCT Cardiology<br />

Engine 4DM 2 or <strong>syngo</strong>.mCT Cardiology Engine Cedars 2<br />

on <strong>syngo</strong>. <strong>via</strong>, the myocardial <strong>via</strong>bility exam can easily<br />

be visualized and immediately compared to the SPECT<br />

or PET myocardial perfusion examination.<br />

Other parameters that aid in the assessment of<br />

<strong>via</strong>bility and patient prognosis are ejection fraction,<br />

wall thickening, and wall motion, which are calculated<br />

in the <strong>syngo</strong>.mCT Cardiology Engine 4DM 2 and<br />

<strong>syngo</strong>.mCT Cardiology Engine Cedars 2 .<br />

15


“<br />

Tobias Pflederer, MD,<br />

University of Erlangen-Nuremberg,<br />

Germany<br />

<strong>syngo</strong>.<strong>via</strong><br />

combines all<br />

evaluation tools<br />

in one single<br />

workflow.<br />

This is a real<br />

ad vantage because<br />

we need less time<br />

to evaluate all<br />

anatomic structures<br />

relevant <strong>for</strong> the<br />

TAVI procedure.<br />

”<br />

<strong>syngo</strong>. <strong>via</strong> <strong>for</strong> sustainable<br />

care of Valvular Heart<br />

Disease<br />

Imaging is of key importance to assess suspicions of<br />

valvular heart disease such as valvular stenosis or<br />

valvular insufficiency, to grade the disease, to decide<br />

on the treatment of choice to prevent manifestations<br />

of heart failure, and <strong>for</strong> appropriate treatment planning<br />

and evaluation. <strong>syngo</strong>. <strong>via</strong> guides you through all these<br />

steps.<br />

16


<strong>syngo</strong>. CT Vascular Analysis <strong>syngo</strong>. MR Cardiac Flow 1<br />

Streamlined CT TAVI Planning<br />

<strong>syngo</strong>. <strong>via</strong>’s CT Cardio-Vascular Engine provides a<br />

dedicated workflow <strong>for</strong> CT TAVI Planning. In a first step,<br />

the smallest diameter of the iliac arteries is visualized<br />

with a single click so you are able to determine the<br />

access route <strong>for</strong> the catheter. The Single Energy Calcification<br />

Removal helps to visualize calcifications<br />

in the entire aorta. With <strong>syngo</strong>. CT Vascular Analysis,<br />

the curvature of the aortic arch is easily assessed.<br />

The short and long axis of the aortic annulus as well<br />

as its area are crucial to an optimal implant device<br />

size. <strong>syngo</strong>. CT Cardiac Function provides a single-click<br />

navigation to the aortic valve plane, which greatly<br />

facilitates the quantitative assessment of the annulus.<br />

The length of the device is determined by the distance<br />

of the coronary ostia, which is obtained in a matter<br />

of seconds. The sinotubular junction and the left ventricular<br />

outflow tract are also easily assessed. Finally,<br />

<strong>syngo</strong>. <strong>via</strong> automatically calculates the angulation <strong>for</strong><br />

the C-arm intervention to help save contrast agent in<br />

the cath lab. In addition, the angulation predicted can<br />

be transferred to guide the C-arm positioning.<br />

Quick and easy evaluation of<br />

blood flow dynamics with MRI<br />

Functional and flow evaluation are important keys<br />

of cardiac MR examination in valvular diseases as<br />

well as hydrocephalus. With the <strong>syngo</strong>. <strong>via</strong>-based<br />

application <strong>syngo</strong>. MR Cardiac Flow 1 , the evaluation<br />

of blood flow dynamics is quick and easy. It processes<br />

velocity-encoded MR images to evaluate<br />

blood flow dynamics, e.g., in the heart and the great<br />

vessels. The flow analysis determines the mean<br />

and maximum velocity of blood flow and the vessel<br />

cross-sections according to the trigger time, e.g., in<br />

various cardiac phases. Special features of <strong>syngo</strong>.MR<br />

Cardiac Flow 1 include the “one-click” vessel segmentation,<br />

background phase adjustment and VENC<br />

anti-aliasing.<br />

The detection and evaluation of vascular diseases<br />

such as aortic stenosis and aneurisms is possible.<br />

The application generates quantitative results <strong>for</strong><br />

physicians in the diagnostic process <strong>for</strong> example in<br />

the heart and the great vessels.<br />

An MR cardiac interactive reporting template is also<br />

included.<br />

1<br />

Under development. Not available <strong>for</strong> sale in the U.S.<br />

17


<strong>syngo</strong>. <strong>via</strong> <strong>for</strong> sustainable<br />

care of Vascular Disease<br />

“<br />

Roberto Maroldi, MD,<br />

University of Brescia,<br />

Italy<br />

<strong>syngo</strong>.<strong>via</strong> is an<br />

excellent tool<br />

<strong>for</strong> planning the<br />

placement of<br />

prosthesis <strong>for</strong><br />

abdominal<br />

aneurysms.<br />

”<br />

In addition to diseases of the heart, cardiovascular care<br />

also covers the management of diseases of the great<br />

vessels like aortic dissection or pulmonary embolism.<br />

Furthermore, Cerebrovascular Disease or Peripheral<br />

Artery Disease often manifest in CAD patients. For vascular<br />

reading, you need not only visualizations of the<br />

vessel lumen but also analysis of the vessel wall. And,<br />

you need accurate in<strong>for</strong>mation to guide the treatment<br />

decision and to evaluate its sustainable success.<br />

<strong>syngo</strong>. <strong>via</strong> provides powerful functionalities to help<br />

you leverage your potential.<br />

18


<strong>syngo</strong>. CT PE CAD 2<br />

<strong>syngo</strong>. CT Vascular Analysis<br />

Fast and comprehensive triple<br />

rule-out when every second counts<br />

Guidance <strong>for</strong> AAA stent planning<br />

<strong>syngo</strong>. <strong>via</strong> with the <strong>syngo</strong>. CT Acute <strong>Care</strong> Engine<br />

provides clinical functionality to deliver reliable and<br />

fast results in triple rule-out examinations. <strong>syngo</strong>. CT<br />

Coronary Analysis automatically segments and labels<br />

the main coronary arteries, major coronary branches,<br />

and SV grafts. It further provides the Single Click<br />

Stenosis function to rule-out coronary artery disease<br />

in less than a minute. Similarly, <strong>syngo</strong>. CT Vascular<br />

Analysis automatically removes the bone and displays<br />

the vessels in a dedicated layout <strong>for</strong> straight<strong>for</strong>ward<br />

diagnosis of aortic dissections. The Autotracer 1<br />

automatically calculates centerlines <strong>for</strong> the aorta,<br />

left and right run-offs, and renal arteries. In addition<br />

to an automatic calculation of CPRs, these vessels<br />

are automatically labeled. When ruling out pulmonary<br />

embolism, <strong>for</strong> example, in patients with acute chest<br />

pain, the optional feature <strong>syngo</strong>.CT PE CAD 2 helps as<br />

a second reader to detect segmental and subsegmental<br />

filling defects and it also provides an automatic<br />

lesion zoom view <strong>for</strong> easy lesion classification. Finally,<br />

<strong>syngo</strong>. CT Vascular Analysis provides the intuitive<br />

and robust VesselSURF function <strong>for</strong> the evaluation of<br />

peripheral vessels throughout the body. Herein vessel<br />

paths can be assessed along axial slices without centerlines<br />

even in case of a total occlusion. VesselSURF<br />

simultaneously presents you with the corresponding<br />

perpendicular and longitudinal cross sections. As you<br />

see, all these <strong>syngo</strong>. <strong>via</strong>-based workflows are designed<br />

to bring more efficiency into daily clinical routine.<br />

<strong>syngo</strong>. <strong>via</strong> with the <strong>syngo</strong>. CT Acute <strong>Care</strong> Engine or<br />

the <strong>syngo</strong>. CT Cardio-Vascular Engine also offers the<br />

means to assess abdominal aortic aneurysms (AAA).<br />

Due to several automatic pre-processing steps, like<br />

automatic bone and table removal, an immediate<br />

vascular-only view is provided. The aorta is displayed<br />

in a curved planar re<strong>for</strong>mation and the centerline<br />

is automatically created, providing the grounds <strong>for</strong><br />

important length measurements 1 . If Dual Energy data<br />

is available, <strong>syngo</strong>.CT Vascular Analysis also offers a<br />

Dual-Energy based bone and calcium removal, which<br />

provides even greater accuracy, especially in very<br />

small vessels and in vessels that are close to bones 3 .<br />

1<br />

Optional Feature. Available in the <strong>syngo</strong>.CT Cardio-Vascular Engine Pro and <strong>syngo</strong>. CT Acute <strong>Care</strong><br />

Engine Pro.<br />

2<br />

Not available <strong>for</strong> sale in the U.S.<br />

3<br />

Requires at least one user license of <strong>syngo</strong>.CT DE Direct Angio.<br />

19


<strong>syngo</strong>. CT Vascular Analysis <strong>syngo</strong>. CT Dynamic Angio 1<br />

Dynamic vessel evaluation, extended phase handling,<br />

and advanced bolus analysis<br />

Since 95% of aortic aneurysms are located below the<br />

ostia of the renal arteries, <strong>syngo</strong>. <strong>via</strong> with <strong>syngo</strong>. CT<br />

Vascular Analysis provides a dedicated stent planning<br />

template <strong>for</strong> these cases. This template guides you<br />

through all important measurements. In addition to<br />

the registration of all measurements in the Findings<br />

Navigator, all diameter measurements are automatically<br />

saved in the stent planning template. The automation<br />

greatly facilitates the workflow and allows <strong>for</strong> a reliable<br />

assessment of abdominal aortic stent parameters<br />

thus providing a sound basis <strong>for</strong> EVAR procedures.<br />

For patients showing TIA symptoms, <strong>syngo</strong>. <strong>via</strong> with<br />

<strong>syngo</strong>. CT Dynamic Angio 1 helps to inspect time-resolved<br />

CT images reconstructed from dynamic CT data. It<br />

supports the visualization of the vessel enhancement<br />

over time and can be used to create CT volumes of,<br />

e.g., arterial or venous phase. Additionally, it allows<br />

the evaluation of regions of interest and the visual<br />

inspection of time attenuation curves. As soon as<br />

the dataset is loaded, the case is ready <strong>for</strong> review:<br />

<strong>syngo</strong>. CT Dynamic Angio 1 automatically calculates a<br />

Temporal Maximum Intensity Projection (tMIP) and<br />

Temporal Average Volume (tAVG) <strong>for</strong> enhanced vessel<br />

and soft tissue visualization. For a phase-specific<br />

evaluation, <strong>for</strong> example of the arterial phase, the<br />

Twin Slider allows you to restrict the calculation<br />

of new CT volumes to any user-defined time range<br />

within the dynamic scan. For an evaluation of local<br />

vessel or tissue enhancement, <strong>syngo</strong>. CT Dynamic<br />

Angio 1 displays ROI-specific time attenuation curves,<br />

as well as curve and statistical parameters, <strong>for</strong><br />

example time-to-peak and peak enhancement.<br />

Finally, <strong>syngo</strong>. <strong>via</strong> with <strong>syngo</strong>. CT Neuro DSA and its<br />

guided workflow support the evaluation of complex<br />

intracranial vascular structures and delineation of<br />

aneurysms and other vascular diseases with zero<br />

delay. CT DSA data are immediately pre-processed<br />

and ready <strong>for</strong> evaluation. When opening a case, bones<br />

of the head and neck are automatically removed as<br />

low-dose native head CT scan and contrast-enhanced<br />

CTA data are automatically subtracted. Fast toggling<br />

between the bone removed and bony structures gives<br />

you a full and constant control of the data, allowing a<br />

separate view of bone or vessels, with all in<strong>for</strong>mation<br />

provided and presented in one place.<br />

1<br />

The product is pending 510(k) clearance, and is not yet commercially available in the U.S.<br />

20


<strong>syngo</strong>. MR General Engine<br />

<strong>syngo</strong>. MR General Engine<br />

Take full advantage of in<strong>for</strong>mation<br />

from MR angiography<br />

Whether it is the 3D Reference Point, the Auto zooming<br />

functionality in multi-stage exams, or subtraction,<br />

the <strong>syngo</strong>. MR General Engine acts as an extension<br />

<strong>for</strong> <strong>syngo</strong>. <strong>via</strong> by adding software <strong>for</strong> advanced and<br />

routine MR radiology usage. This rich suite of various<br />

functionalities includes workflows <strong>for</strong> dedicated MRI<br />

examinations that load and structure examination<br />

results automatically into meaningful layouts,<br />

including user support to make sure that no data is<br />

missed. The perfect match <strong>for</strong> applications such<br />

as <strong>syngo</strong> TWIST and TimCT Angio (Continuous Table<br />

move), the <strong>syngo</strong>. MR General Engine enables an<br />

optimized workflow from scanning, to processing,<br />

to reading.<br />

With the cardiovascular MR workflows on the<br />

<strong>syngo</strong>. MR General Engine – Single Station Angio,<br />

Multi Station Angio, Angio TimCT, and Angio TWIST –<br />

you can take full advantage of the in<strong>for</strong>mation<br />

generated in MR angiography. <strong>syngo</strong>.<strong>via</strong> automatically<br />

recognizes the acquisition method <strong>for</strong> TimCT,<br />

multi-station, or <strong>syngo</strong> TWIST and matches the layout.<br />

Images are organized automatically with MPR and 3D<br />

MIP views displayed next to each other, based on<br />

preferences the user can define, so that reading and<br />

evaluation begins as soon as the case is opened.<br />

Auto zooming on the region of interest across planes,<br />

rotating around the point of interest and a 3D reference<br />

point synchronized in all of the images, as<br />

well as easy drag-and-drop functionality enhance the<br />

reading experience.<br />

Accurate and reproducible vessel<br />

evaluation in XA studies<br />

XA studies offer diagnostic in<strong>for</strong>mation as well as<br />

interventional opportunities in vessel examinations.<br />

And, they can be used to validate the diagnosis that<br />

was done based on CT or MR data within an additional<br />

XA study. The <strong>syngo</strong>. <strong>via</strong> client-server architecture<br />

helps to ensure that the previous images as well as<br />

measurements will be at hand in the lab where the XA<br />

exam and XA-guided procedure ultimately take place.<br />

Furthermore, <strong>syngo</strong>. <strong>via</strong> with <strong>syngo</strong>. Interventional<br />

QVA (Quantitative Vascular Analysis) offers fast and<br />

intuitive analysis and 2D quantification of peripheral<br />

vessels such as the abdominal aorta and the carotid,<br />

renal, iliac, and femoral arteries. It features single<br />

vessel analysis including calibration, vessel border<br />

detection, and quantification of severity of stenosis.<br />

Its algorithm is validated <strong>for</strong> vessels from 5 mm to<br />

50 mm. The result? An objective, accurate, and reproducible<br />

vessel evaluation.<br />

21


More <strong>syngo</strong>. <strong>via</strong><br />

features <strong>for</strong> sustainable<br />

cardiovascular reading<br />

<strong>syngo</strong>. MR Cardiac 4D Ventricular Function<br />

Multimodality reading, immediate case<br />

review, and insightful disease orientation<br />

Since <strong>syngo</strong>. <strong>via</strong> provides multimodality reading, it can give you additional and<br />

potentially decisive diagnostic in<strong>for</strong>mation in your cardiovascular workup. Should<br />

any additional image data from, <strong>for</strong> example, MRI, Ultrasound, Angiography,<br />

Dual Energy or CT Perfusion be available <strong>for</strong> your patient, you can easily drag and<br />

drop the data into your cardiovascular reading layout. <strong>syngo</strong>. <strong>via</strong> preprocesses the<br />

images and lets you start reading your case immediately. Your cardiovascular case<br />

automatically loads into the appropriate reading environment, including the right<br />

application, layout, and tools. All user interface elements can be hidden so you<br />

can focus on the case. And when you need to change to a different tool, it’s where<br />

you need it: on the image, in the corner menus, and on your configurable context<br />

menu. Last but not least, with <strong>syngo</strong>. <strong>via</strong>, you can create disease-specific reports right<br />

away 1 . They visualize the diagnosis and provide important facts and results from<br />

your evaluation at a glance – including key images and findings details, such as<br />

calcium score, ejection fraction, stroke volume, and LV and RV volumes.<br />

On-the-fly collection of your<br />

findings and key images<br />

All your findings and key images are collected on-the-fly in <strong>syngo</strong>. <strong>via</strong>’s unique<br />

Findings Navigator while you read the case. You never need to repeat what<br />

you have already finished. With the Findings Navigator, retrieving and toggling<br />

between findings <strong>for</strong> detailed in<strong>for</strong>mation is as easy as a single click. It will always<br />

bring you back to the same context as when you first collected the finding: the<br />

same 2D or 3D image, the same layout, and the same window. The Findings<br />

Navigator facilitates accelerated reading and your list of findings can be elegantly<br />

used as bookmarks <strong>for</strong> easy sharing and presentation of your results during<br />

clinical demonstrations.<br />

1<br />

The disease-specific report created in <strong>syngo</strong>. <strong>via</strong> is not the final diagnostic report. The final<br />

diagnostic report is generated and signed off within the RIS. Archiving of diagnostic reports<br />

is the responsibility of the RIS.<br />

2<br />

<strong>syngo</strong>. <strong>via</strong> Mobile Applications, i.e., <strong>syngo</strong>. <strong>via</strong> WebViewer and <strong>syngo</strong>. <strong>via</strong> WebReport, are optional<br />

components of <strong>syngo</strong>. <strong>via</strong>. For further in<strong>for</strong>mation about availability or restrictions refer to the<br />

<strong>syngo</strong>. <strong>via</strong> Overview Brochure.<br />

22


Unique in<strong>for</strong>mation sharing and effective<br />

communication with colleagues and patients<br />

<strong>Cardiovascular</strong> imaging is a team ef<strong>for</strong>t. Whether it is in the 3D laboratories, at the<br />

scanner, or workspace in the cardiologist’s office, multiple users need to be able to<br />

access and manipulate cardiac datasets concurrently. For instance, when a cardiac<br />

CT scan is per<strong>for</strong>med, the technologist at the scanner can prepare the calcium<br />

score. At the same time, the reading physician can take care of the vascular and<br />

functional evaluation and can confidently confirm the findings. Furthermore,<br />

MR Cardiac data can be pulled up easily in order to support the diagnosis and to<br />

plan future treatment. Sharing results with colleagues and referrers is easy. The<br />

client server architecture enables real time second opinion and on-call support<br />

remotely. Using the Findings Navigator or the Collaboration Mode allows the<br />

physician the ability to discuss or present a case quickly and efficiently – and all<br />

of the in<strong>for</strong>mation is then automatically dropped into dedicated cardiac reporting<br />

templates. Finally, <strong>syngo</strong>.<strong>via</strong> Mobile Applications 2 allow new ways to discuss the<br />

case with colleagues, referrers, and even patients. For example, surgeons can<br />

plan an intervention by navigating through the case in 3D, instead of looking at<br />

static 2D images. Physicians and referrers within and outside the hospital can review<br />

findings, related images, and reports.<br />

For iPhone and iPad country specific laws may apply. Please refer to these laws be<strong>for</strong>e using <strong>for</strong><br />

diagnostic reading/viewing.<br />

23


<strong>syngo</strong>. <strong>via</strong> is more than<br />

processing images.<br />

Live access anytime, anywhere 1 <strong>via</strong> client-server architecture<br />

Innovative integration with modalities and RIS/PACS<br />

<strong>syngo</strong>. <strong>via</strong> is based on a client-server architecture and represents a complete departure<br />

from the workstation paradigm: The server processes and renders the data from<br />

the connected modalities. The client provides the user interface. Since the majority<br />

of the data processing is per<strong>for</strong>med by the server, the client can run on standard offthe-shelf<br />

computers 2 . This means you can access <strong>syngo</strong>. <strong>via</strong> from virtually anywhere<br />

within the network infrastructure and per<strong>for</strong>m your tasks. There<strong>for</strong>e, <strong>for</strong> example,<br />

pre-interventional 2D and 3D images as well as measurements and treatment planning<br />

data can be at hand in any 1 lab where an intervention ultimately takes place.<br />

Up to five concurrent readers can even use the same applications enabling fast parallel<br />

reading. Workplaces are not “bound” to a physical location, but virtually “follow”<br />

you. Whether at the reading physician’s office, at a workstation in a different department,<br />

reporting from PACS, at a case demonstration, or even at home 1 , you benefit<br />

from <strong>syngo</strong>. <strong>via</strong>’s client-server technology and get quick multimodality in<strong>for</strong>mation.<br />

By using common IT standards, <strong>syngo</strong>. <strong>via</strong> connects to RIS/PACS and modalities of<br />

all major vendors. Hence, you can freely navigate the entire dataset, use advanced<br />

segmentation and quantification tools, and document findings – right on the<br />

RIS/PACS reporting workplace. Cases can now be interpreted and reported with<br />

access to full clinical in<strong>for</strong>mation, without depending on secondary captures or<br />

switching between reporting and reading workplaces. Even greater synergies can<br />

be achieved by connecting <strong>syngo</strong>. <strong>via</strong> to RIS/PACS and modalities from <strong>Siemens</strong>:<br />

Instant data-streaming allows a faster modality connection, and thus faster availability<br />

of images. When using <strong>syngo</strong>. plaza (<strong>Siemens</strong> PACS), images are displayed<br />

simultaneously in <strong>syngo</strong>. <strong>via</strong> – without additional clicks. Last but not least,<br />

the unified <strong>syngo</strong> user interface makes it easy to work with <strong>Siemens</strong> systems.<br />

1<br />

Prerequisites include: Internet connection to clinical network, DICOM compliance, meeting<br />

of minimum hardware requirements, and adherence to local data security regulations.<br />

2<br />

If minimum hardware requirements are met.<br />

3<br />

This feature is only available in English; there<strong>for</strong>e it is only sold in countries/regions where<br />

the regulatory competent authorities allow <strong>for</strong> English language-based medical devices to be<br />

delivered to customers.<br />

4<br />

The <strong>syngo</strong>. <strong>via</strong> software applications are medical devices in their own rights.<br />

24


Capability to combine advanced visualization,<br />

quantification tools, and structured reporting<br />

The capability to combine <strong>syngo</strong>. <strong>via</strong> with <strong>syngo</strong> Dynamics <strong>Cardiovascular</strong> Imaging<br />

and In<strong>for</strong>mation Solution (CVIIS) continues the <strong>Siemens</strong> <strong>Healthcare</strong> philosophy<br />

to provide comprehensive and innovative solutions to cardiovascular specialists<br />

through a single point of control. <strong>syngo</strong>. <strong>via</strong> automatically prepares multimodality<br />

cases <strong>for</strong> reading, provides insightful disease-specific step-by-step guidance, and<br />

comes with advanced visualization tools. <strong>syngo</strong> Dynamics CVIIS is used <strong>for</strong> the<br />

acceptance, transfer, display, storage, archive, and manipulation of digital medical<br />

images from echocardiography, cardiac catheterization, nuclear medicine, OB,<br />

and ultrasound departments, as well as <strong>for</strong> quantification and report generation.<br />

It also provides the ability to manage patient in<strong>for</strong>mation, order entry, whiteboard<br />

scheduling and business analytics 3 . A personalized workspace offers a flexible<br />

monitor configuration with access to additional workflow-enhancing software<br />

and networked applications.<br />

The integration of both products thus offers cardiovascular specialists a natural<br />

transition between advanced visualization software and quantification tools combined<br />

with structured reporting in the department and enterprise environment.<br />

<strong>syngo</strong>. <strong>via</strong> – a modular, multimodality solution<br />

<strong>syngo</strong>. <strong>via</strong> is a modular solution combining client-server architecture and a variety of<br />

standard and optional software applications. Every <strong>syngo</strong>. <strong>via</strong> configuration includes<br />

applications that provide an extensive range of functions and tools required<br />

<strong>for</strong> a variety of clinical fields. <strong>syngo</strong>. <strong>via</strong> includes what you need to read and share<br />

images and results. Additionally, a broad variety of optional clinical applications 4<br />

<strong>for</strong> a higher level of automation and quantification is available <strong>for</strong> <strong>syngo</strong>. <strong>via</strong>.<br />

These applications are commercially available either as single applications or as<br />

Engines – sets of applications <strong>for</strong> the specific imaging technologies. There are two<br />

levels of Engines: Engine and Engine Pro. The Engine level addresses the needs<br />

of users who regularly work in a specific clinical field. The Engine Pro level can<br />

be ordered on top of the Engine level, and provides advanced functionality and<br />

automated workflows <strong>for</strong> high-end reading and processing. The result is a reading<br />

and evaluation solution tailored to your workflow requirements, installed modalities,<br />

and clinical focus. The powerful applications and engines can be purchased at<br />

any time – making <strong>syngo</strong>. <strong>via</strong> a modular, multimodality, client-server solution that<br />

can grow with you today, as well as tomorrow.<br />

25


<strong>syngo</strong>.<strong>via</strong> <strong>Cardiovascular</strong><br />

Portfolio<br />

A large selection of standard functionality, clinical applications<br />

and engines <strong>for</strong> diagnostic CT, MRI, XA, PET, and SPECT as well<br />

as interventional procedures is available to cover your basic and<br />

advanced reading needs <strong>for</strong> cardiovascular care.<br />

<strong>syngo</strong>.<strong>via</strong> Standard Functionality and Applications 1<br />

included with every <strong>syngo</strong>.<strong>via</strong> system<br />

<strong>syngo</strong>.<strong>via</strong> <strong>Cardiovascular</strong><br />

Applications<br />

<strong>syngo</strong>.CT CaScoring<br />

<strong>syngo</strong>.CT Cardiac Function<br />

<strong>syngo</strong>.CT Coronary Analysis<br />

<strong>syngo</strong>.CT Vascular Analysis<br />

<strong>syngo</strong>.CT Cardiac Function -<br />

Enhancement<br />

Features<br />

Total & relative Calcium Scoring with Coronary Age calculation based on trial data, e.g.,<br />

MESA Trial and more.<br />

Automatic Left Ventricular Analysis (LVA) <strong>for</strong> evaluation of global and local left ventricular<br />

function, visualization of left ventricular wall motion, thickness, and thickening in 17-segment<br />

polar plots, single-click display of the aortic valve plane, workflow CT TAVI Planning <strong>for</strong><br />

streamlined assessment of parameters necessary <strong>for</strong> implant device selection.<br />

Curved & cross-sectional ranges, AngioView, VesselSURF, automatic tracking and labeling (zero-click)<br />

of the main coronaries (RCA, LAD, CX), major coronary branches and SV grafts, single-click<br />

stenosis measurement, image sharpening <strong>for</strong> stent and calcified lesion evaluation, profile curve.<br />

Curved & cross-sectional ranges, VesselSURF and Best Plane, 2-click vessel tracking,<br />

measurement, and reporting tools <strong>for</strong> stent planning in case of AAA, single energy<br />

calcification removal, stenosis measurement, profile curve. Dual Energy bone & calcium<br />

removal. 3, 8<br />

Visualization of first pass and late enhancement myocardial perfusion based on single<br />

energy CT data.<br />

Multi-modality<br />

2D/3D Reading<br />

Reading 2D and 3D multimodality images,<br />

processing and evaluation of examinations.<br />

<strong>syngo</strong>.<strong>via</strong> supports: CT, MR, PET, CR, digital X-ray,<br />

X-ray angiographic 2 , X-ray radio-flouroscopic,<br />

ultra sound, and secondary capture images as<br />

well as encapsulated PDFs. Optimized and customizable<br />

reading layouts, multi-monitor reading<br />

(dual monitor), table removal, bone removal<br />

<strong>syngo</strong>.CT Cardiac Function -<br />

Right Ventricle<br />

<strong>syngo</strong>.CT Vascular Analysis -<br />

Autotracer<br />

<strong>syngo</strong> Volume Perfusion CT Body -<br />

Myocardium 4, 5<br />

<strong>syngo</strong>.CT PE CAD 6<br />

Automatic Right Ventricular Analysis (RVA) <strong>for</strong> evaluation of right ventricular function.<br />

Automatic tracking and labeling of main vessels (zero-click).<br />

Dynamic assessment of volumetric myocardial perfusion yielding quantitative values <strong>for</strong><br />

myocardial blood flow and blood volume.<br />

Automatic detection of filling defects, overview layout, automatic lesion center zoom,<br />

automatic transfer of confirmed findings to the Findings Navigator.<br />

MultiModality<br />

Compare<br />

<strong>syngo</strong>.<strong>via</strong><br />

Common<br />

Features<br />

<strong>syngo</strong>.CT<br />

Cardiac<br />

<strong>syngo</strong>.CT<br />

Vascular<br />

<strong>syngo</strong>.MR<br />

Reading<br />

<strong>syngo</strong>.CT Dual<br />

Energy<br />

Allows flexible comparison of 2D and 3D patient<br />

datasets (follow-up, multimodality data),<br />

synchronization of two phases<br />

AutoProcessing, AutoSorting, AutoLayouts,<br />

Case Navigator, Findings Navigator, contextspecific<br />

reports, customizable worklist<br />

Review marker, plaque visualization, heart<br />

isolation, movie (beating heart), manual<br />

coronary tracking, cardiac planes, curved &<br />

cross-section MPR, integrated reporting<br />

Bone removal, table removal, review marker,<br />

manual vessel tracking, MPR, thin MIP ranges,<br />

curved & cross-section MPR, integrated reporting<br />

Basic workflow, workflow customization,<br />

follow-up support, re-scan handling<br />

Preparing and viewing of Dual Energy data 3<br />

<strong>syngo</strong>.CT Dynamic Angio 9<br />

<strong>syngo</strong>.PET Myocardial Blood Flow 9<br />

<strong>syngo</strong>.PET Corridor4DM 9<br />

<strong>syngo</strong>.SPECT Corridor4DM 9<br />

<strong>syngo</strong>.CT Extension Corridor4DM 9<br />

Inspection of time-resolved CT images reconstructed from dynamic CT data, visualization of<br />

the vessel enhancement over time, creation of CT volumes of, e.g., arterial or venous phase,<br />

evaluation of regions of interest, and visual inspection of time attenuation curves.<br />

Enables computation of myocardial blood flow (MBF) during rest and peak stress<br />

(in terms of ml/g/min) and calculation of coronary flow reserve (CFR) , <strong>for</strong> both Ammonia<br />

and Rubidium scans. Validated on Biograph.<br />

Provides multiple 2D and 3D displays <strong>for</strong> assessment of myocardial perfusion. Polar plots (raw,<br />

normalized, blackout, severity) with segmental quan titative scores in 17, 19, or 20 segments<br />

are available to help assess the severity of disease. Functional evaluation provided with ejection<br />

fraction, wall thickening and wall motion is available. Normal databases <strong>for</strong> perfusion included.<br />

Provides multiple 2D and 3D displays <strong>for</strong> assessment of myocardial perfusion. Polar plots (raw,<br />

normalized, blackout, severity) with segmental quantitative scores in 17, 19, or 20 segments<br />

are available to help assess the severity of disease. Functional evaluation provided with ejection<br />

fraction, wall thickening and wall motion is available. Normal databases <strong>for</strong> perfusion included.<br />

Option available <strong>for</strong> Corridor4DM PET and SPECT. Volumetric registration of hybrid or stand-alone<br />

CT to PET and SPECT. Fusion allows <strong>for</strong> physician QC of attenuation correction. CT cardiac review,<br />

calcium scoring, and fusion display. Enables CT cardiac and further incidental finding reporting.<br />

26<br />

Annotations:<br />

Pro Engines are optional additions to Engines.


Available Engine Configurations<br />

<strong>syngo</strong>.CT<br />

Cardio-Vascular<br />

Engine<br />

<strong>syngo</strong>.CT<br />

Cardio-Vascular<br />

Engine Pro<br />

<strong>syngo</strong>.CT<br />

Acute <strong>Care</strong><br />

Engine<br />

<strong>syngo</strong>.CT<br />

Acute <strong>Care</strong><br />

Engine Pro<br />

<strong>syngo</strong>.mCT<br />

Cardiology<br />

Engine 4DM<br />

<strong>syngo</strong>.mCT<br />

Cardiology<br />

Engine Pro 4DM<br />

<strong>syngo</strong>.mCT<br />

Cardiology<br />

Engine Cedars<br />

<strong>syngo</strong>.mCT<br />

Cardiology<br />

Engine Pro Cedars<br />

<strong>syngo</strong>.SPECT<br />

Cardiology<br />

Engine 4DM<br />

<strong>syngo</strong>.SPECT<br />

Cardiology<br />

Engine Pro 4DM<br />

• • • • •<br />

• • • •<br />

• • • •<br />

• •<br />

• •<br />

• •<br />

• •<br />

•<br />

• •<br />

•<br />

•<br />

• •<br />

1<br />

Application features are part of medical products in their own right and fully compatible with <strong>syngo</strong>.<strong>via</strong>.<br />

2<br />

Only ready-processed DSA scenes can be reviewed.<br />

3<br />

For SOMATOM Definition and<br />

Definition Flash data.<br />

4<br />

For SOMATOM Definition Flash only.<br />

5<br />

Available as one user license on MMWP (MultiModality Workplace) 6 Not available <strong>for</strong> sale in the U.S.<br />

7<br />

The product is still under<br />

development and not commercially available yet. Its future availability cannot be ensured.<br />

8<br />

Requires at least one user license of <strong>syngo</strong>.CT DE Direct Angio.<br />

9<br />

The product is pending 510(k)<br />

clearance, and is not yet commercially available in the U.S.<br />

27


<strong>syngo</strong>.<strong>via</strong> <strong>Cardiovascular</strong><br />

Portfolio<br />

A large selection of standard functionality, clinical applications<br />

and engines <strong>for</strong> diagnostic CT, MRI, XA, PET, and SPECT as well<br />

as interventional procedures is available to cover your basic and<br />

advanced reading needs <strong>for</strong> cardiovascular care.<br />

<strong>syngo</strong>.<strong>via</strong> Standard Functionality and Applications 1<br />

included with every <strong>syngo</strong>.<strong>via</strong> system<br />

<strong>syngo</strong>.<strong>via</strong> <strong>Cardiovascular</strong><br />

Applications<br />

<strong>syngo</strong>.PET Corridor4DM CFR 9<br />

<strong>syngo</strong>.PET Cedars 9<br />

<strong>syngo</strong>.SPECT Cedars 9<br />

<strong>syngo</strong>.CT Extension Cedars 9<br />

<strong>syngo</strong>.Interventional Viewer<br />

<strong>syngo</strong>.Interventional QCA<br />

Features<br />

Enables computation of myocardial blood flow (MBF) during rest and peak stress<br />

(in terms of ml/g/min) and calculation of coronary flow reserve (CFR) <strong>for</strong> Rubidium studies.<br />

Provides multiple 2D and 3D displays <strong>for</strong> assessment of myocardial perfusion. Polar plots (raw,<br />

normalized, blackout, severity) with segmental quantitative scores in 17 and 19 segments are<br />

available to help assess the severity of disease. Functional evaluation provided with ejection<br />

fraction, wall thickening and wall motion is available. Normal databases <strong>for</strong> perfusion included.<br />

Provides multiple 2D and 3D displays <strong>for</strong> assessment of myocardial perfusion. Polar plots (raw,<br />

normalized, blackout, severity) with segmental quantitative scores in 17 and 19 segments are<br />

available to help assess the severity of disease. Functional evaluation provided with ejection<br />

fraction, wall thickening and wall motion is available. Normal databases <strong>for</strong> perfusion included.<br />

Volumetric registration of hybrid or stand alone CT to PET and SPECT. Fusion allows <strong>for</strong> physician QC<br />

of attenuation correction. CT cardiac review, calcium scoring, and fusion display. Enables CT cardiac<br />

and further incidental finding reporting.<br />

Software package consisting of DSA Angio Viewer <strong>for</strong> real-time display of native and subtracted<br />

angiography images.<br />

Scientific analysis of the coronary vessels with determination of degree of stenosis, distance<br />

measurement, and calibration.<br />

Multi-Modality<br />

2D/3D Reading<br />

MultiModality<br />

Compare<br />

<strong>syngo</strong>.<strong>via</strong><br />

Common<br />

Features<br />

<strong>syngo</strong>.CT<br />

Cardiac<br />

<strong>syngo</strong>.CT<br />

Vascular<br />

<strong>syngo</strong>.MR<br />

Reading<br />

<strong>syngo</strong>.CT Dual<br />

Energy<br />

28<br />

Reading 2D and 3D multimodality images,<br />

processing and evaluation of examinations.<br />

<strong>syngo</strong>.<strong>via</strong> supports: CT, MR, PET, CR, digital<br />

X-ray, X-ray angiographic 2 , X-ray radio-flouroscopic,<br />

ultra sound, and secondary capture images as<br />

well as encapsulated PDFs. Optimized and customizable<br />

reading layouts, multi-monitor reading<br />

(dual monitor), table removal, bone removal<br />

Allows flexible comparison of 2D and 3D patient<br />

datasets (follow-up, multimodality data),<br />

synchronization of two phases<br />

AutoProcessing, AutoSorting, AutoLayouts,<br />

Case Navigator, Findings Navigator, contextspecific<br />

reports, customizable worklist<br />

Review marker, plaque visualization, heart<br />

isolation, movie (beating heart), manual<br />

coronary tracking, cardiac planes, curved &<br />

cross-section MPR, integrated reporting<br />

Bone removal, table removal, review marker,<br />

manual vessel tracking, MPR, thin MIP ranges,<br />

curved & cross-section MPR, integrated reporting<br />

Basic workflow, workflow customization,<br />

follow-up support, re-scan handling<br />

Preparing and viewing of Dual Energy data 3<br />

<strong>syngo</strong>.Interventional QCA<br />

Bifurcation<br />

<strong>syngo</strong>.Interventional IZ3D<br />

<strong>syngo</strong>.Interventional LVA<br />

<strong>syngo</strong>.Interventional QVA<br />

<strong>syngo</strong>.MR Cardiac 4D Ventricular<br />

Function<br />

<strong>syngo</strong>.MR Cardiac Flow 6, 7<br />

<strong>syngo</strong>.MR Composing<br />

<strong>syngo</strong>.MR General Engine<br />

<strong>syngo</strong>.mMR General<br />

Annotations:<br />

Pro Engines are optional additions to Engines.<br />

Enhances the scientific cardiovascular analysis with an evaluation of bifurcations.<br />

3D analysis of single and bifurcated coronary arteries based on conventional X-ray acquisitions from<br />

two projections.<br />

Assessment of left ventricular function.<br />

Vessel analysis with determination of degree of stenosis, distance measurement, and calibration.<br />

4D ventricular function evaluations; completely automatic segmentation of LV, semiautomatic<br />

segmentation of RV. The automatic pre-processing allows to see immediate results when<br />

the case is opened. The step by step user interface allows intuitive editing as needed.<br />

Processing of velocity-encoded MR images to evaluate blood flow dynamics e.g., in the heart<br />

and the great vessels. Generation of quantitative results <strong>for</strong> physicians in the diagnostic<br />

process. Includes the MR cardiac interactive reporting template.<br />

Composing of images from different body regions to see the complete anatomy (also automated<br />

as Inline functionality). Dedicated offline application <strong>for</strong> creation of full-<strong>for</strong>mat images<br />

from overlapping MR volume datasets acquired at multiple stages. Can be used to compose<br />

images in any of the other <strong>syngo</strong>.<strong>via</strong> workflows.<br />

Software <strong>for</strong> professional and routine MR radiology usage. Includes workflows <strong>for</strong> dedicated MR<br />

examinations that load and structure examination results automatically into meaningful layouts<br />

including user support to make sure that no data is missed. Contains several MR Radiology workflows,<br />

cardiovascular workflows (angio reading, cardiac reading), and MR Evaluation features.<br />

Software <strong>for</strong> professional MR radiology and PET nuclear medicine usage. Includes workflows<br />

<strong>for</strong> dedicated MR-PET examinations that load and structure examination results into meaningful<br />

layouts including user support to make sure that no data is missed. Focuses also on lesion<br />

detection, staging, and follow-up by enabling the registration visualization and quantitative<br />

analysis of MR-PET studies acquired across multiple time points.


Available Engine Configurations<br />

<strong>syngo</strong>.mCT<br />

Cardiology<br />

Engine Cedars<br />

<strong>syngo</strong>.mCT<br />

Cardiology<br />

Engine Pro Cedars<br />

<strong>syngo</strong>.SPECT<br />

Cardiology<br />

Engine Cedars<br />

<strong>syngo</strong>.SPECT<br />

Cardiology<br />

Engine Pro Cedars<br />

<strong>syngo</strong>.MR<br />

Cardiology<br />

Engine<br />

<strong>syngo</strong>.Interventional<br />

Cardiology<br />

Engine<br />

<strong>syngo</strong>.Interventional<br />

Cardiology<br />

Engine Pro<br />

<strong>syngo</strong>.Interventional<br />

Radiology<br />

Engine<br />

•<br />

•<br />

• •<br />

• •<br />

•<br />

•<br />

•<br />

•<br />

•<br />

•<br />

•<br />

1<br />

Application features are part of medical products in their own right and fully compatible with <strong>syngo</strong>.<strong>via</strong>.<br />

2<br />

Only ready-processed DSA scenes can be reviewed.<br />

3<br />

For SOMATOM Definition and Definition Flash data.<br />

4<br />

For SOMATOM Definition Flash only.<br />

5<br />

Available as one user license on MMWP (MultiModality Workplace) 6 Not available <strong>for</strong> sale in the U.S.<br />

7<br />

The product is still under development and not commercially available yet. Its future availability cannot be ensured.<br />

8<br />

Requires at least one user license of <strong>syngo</strong>.CT DE Direct Angio.<br />

9<br />

The product is pending 510(k) clearance, and is not yet commercially available in the U.S.<br />

29


<strong>Siemens</strong> IT <strong>Care</strong> Plan <strong>for</strong><br />

<strong>syngo</strong>. <strong>via</strong> – taking care of your<br />

investment and innovations<br />

Whatever your application, workflow, or IT requirements<br />

are – with <strong>Siemens</strong> IT <strong>Care</strong> Plan <strong>for</strong> <strong>syngo</strong>. <strong>via</strong>, you receive<br />

service and support that mirrors your needs and workflows<br />

to help you tap the full potential of your <strong>syngo</strong>. <strong>via</strong>.<br />

You can benefit from services such as:<br />

Remote Assist<br />

• Let your experts talk to ours – and get high-quality service.<br />

• Our experts can answer even rarely occurring application questions and<br />

provide support <strong>via</strong> desktop sharing in real-time.<br />

• Your administrators receive training tools that are based on our experience<br />

and comprehensive expertise.<br />

Administrator Training<br />

• Web-based training with special administrator focus.<br />

• Knowledge-base access with in<strong>for</strong>mation regarding the collection of<br />

questions/answers.<br />

• Ask-the-expert teaching session, training on current topics provided by<br />

<strong>Siemens</strong> experts.<br />

30


<strong>Siemens</strong> IT <strong>Care</strong> Plan<br />

Remote Connection and Administrator are prerequisite<br />

TOP<br />

Standard<br />

Modules<br />

Hotline Service<br />

Software<br />

Updates<br />

Incident<br />

Application Support<br />

Software<br />

Upgrades<br />

Primary<br />

Contact<br />

System<br />

Monitoring<br />

Administrator<br />

Assistance<br />

Hardware Call<br />

Management<br />

Standard Service Level<br />

Principal Coverage Period<br />

Remote Response Time<br />

PRO<br />

Standard<br />

Modules<br />

Hotline Service<br />

Software<br />

Updates<br />

not part of the contract<br />

Administrator<br />

Assistance<br />

Hardware Call<br />

Management<br />

Standard Service Level<br />

Principal Coverage Period<br />

Remote Response Time<br />

Primary Contact<br />

• A primary contact who has in-depth knowledge of your installation and<br />

working environment.<br />

• Quick initiation of required measures thanks to direct contact.<br />

• A partnership based on certified processes in your sensitive patient data<br />

environment.<br />

System Monitoring<br />

• Proactively avoid malfunctions or unplanned system downtime.<br />

• Early recognition of potential system errors and unplanned system downtimes.<br />

• The ability to stay on schedule, as costly workflow interruptions are kept to a<br />

minimum.<br />

Software Updates and Upgrades<br />

• <strong>syngo</strong>. <strong>via</strong> is automatically kept up-to-date – future applications will<br />

smoothly integrate.<br />

• Delivery initiated by Customer Services (Regional Support Center – RSC)<br />

as push or pull service.<br />

• Latest image management and reporting software help to optimize your<br />

workflow.<br />

• Greater profitability, increased efficiency, and productivity.<br />

• Longer investment cycles – financial resources can be saved.<br />

Hardware Call Management<br />

• Management of OEM hardware service provider.<br />

• OEM support is engaged and dispatched on-site when required.<br />

Incident Management<br />

• Technical specialist support <strong>for</strong> incident and ticket management <strong>via</strong><br />

<strong>Siemens</strong> Remote Service (SRS).<br />

31


On account of certain regional limitations of sales<br />

rights and service availability, we cannot guarantee<br />

that all products included in this brochure are available<br />

through the <strong>Siemens</strong> sales organization worldwide.<br />

Availability and packaging may vary by country and are<br />

subject to change without prior notice. Some/all of<br />

the features and products described herein may not be<br />

available in the United States or Japan.<br />

The in<strong>for</strong>mation in this document contains general<br />

technical descriptions of specifications and options as<br />

well as standard and optional features which do not<br />

always have to be present in individual cases.<br />

<strong>Siemens</strong> reserves the right to modify the design,<br />

packaging, specifications, and options described herein<br />

without prior notice. Please contact your local <strong>Siemens</strong><br />

sales representative <strong>for</strong> the most current in<strong>for</strong>mation.<br />

All product names and company names are trademarks<br />

or registered trademarks of the corresponding<br />

companies.<br />

Note: Any technical data contained in this document<br />

may vary within defined tolerances. Original images<br />

always lose a certain amount of detail when reproduced.<br />

Global Business Unit<br />

<strong>Siemens</strong> AG<br />

Medical Solutions<br />

SYNGO<br />

Henkestr. 127<br />

DE-91052 Erlangen<br />

Germany<br />

Phone: +49 9131 84-0<br />

www.siemens.com/<strong>syngo</strong><br />

Global <strong>Siemens</strong> Headquarters<br />

<strong>Siemens</strong> AG<br />

Wittelsbacherplatz 2<br />

80333 Muenchen<br />

Germany<br />

Global <strong>Siemens</strong> <strong>Healthcare</strong><br />

Headquarters<br />

<strong>Siemens</strong> AG<br />

<strong>Healthcare</strong> Sector<br />

Henkestrasse 127<br />

91052 Erlangen<br />

Germany<br />

Phone: +49 9131 84-0<br />

www.siemens.com/healthcare<br />

Legal Manufacturer<br />

<strong>Siemens</strong> AG<br />

Wittelsbacherplatz 2<br />

DE-80333 Muenchen<br />

Germany<br />

A91001- M2040- G800-1-7600 | Printed in Germany | CC SY WS 11116. | © 11.2011, <strong>Siemens</strong> AG<br />

www.siemens.com/healthcare

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