Mate-Fin

Diagnostic Software

 

InterView™ XP

Planar, SPECT and Whole Body Software

Introduction  

Interview™XP is a nuclear medical image evaluation workstation supporting the quantitative and 2D-3D presentation of time dependent, organ specific radio-pharmaceutical spatial distribution followed by the in-vivo bio-chemical processes. The system runs under MS Windows XP, Vista (32/64 bit), and Windows 7 (32/64bit) platforms, by well-known Windows based user-friendly interface. The high resolution true-colour display allows multiformat image presentation in excellent quality.

Main functions of the system are possible to access by pull-down menu structure (Fig.1.). Optionally, the most often used clinical procedures are available by “so called” quick access bar i.e. “Study Info Bar” (it is possible to activate/hide by the Option Menu item /Fig.3./) (Fig.2.).

The “Highly Automated Evaluations Procedures” are grouped by organs and acquisition modes (2D/3D, i.e. Planar /Fig.4./ or SPECT /Fig.5./). The evaluation tools of each procedure are organised by clinical tasks to be divided into logical steps. Each step corresponds to a page of a workbook, where the user may navigate among the steps in order to make the necessary modifications/corrections (Fig.6). 
The program leads the user along the logical steps with the necessary intervention.

Most of the default values of the evaluation procedures are user definable (filters, corrections, reconstruction mode, parameters, orientation, blowing up, palette, etc. /Fig.7./).  

Different reconstruction methods (FBP, iterative) are available for SPECT studies in the system (Fig.8.). They can be configured according to the clinical requirements. These reconstruction methods are fundamental elements of the organ specific clinical procedures. Additional configuration tools are also available for the user in order to create own dedicated procedure variants (see Fig.7.).

Reconstructed images can be co-registered with CT images and displayed with flexibly configurable color palettes.

Reports are formatted by applying user-definable templates allowing arbitrary combinations of picture and text in a simple informative way. These are complying with the recommendations of working group Standardized Documentation of the German Nuclear Medicine Society (DGNM). The software package supports data exchange with any nuclear medicine workstation using the industry standard DICOM protocol and Interfile.

 

TOMOGRAPHIC STUDIES

Reconstruction Methods

FBP           Filtered Back Projection
OS-EM       Ordered Subset Expectation Maximation
MOS-EM     Modified Ordered Subset Expectation Maximization
ML            Maximum Likelihood
OSEM-RR   Ordered Subset Expectation Maximation Resolution Recovery

SPECT filtering with the following Fourier filters

- Ramp
- Shepp-Logan
- Modified Shepp-Logan
- Parzen
- Linear
- Median
- Metz
- Wiener
- Butterworth
- Hanning
- Hamming
- Gauss (FFT)
- Gauss Smooth)
- FDR filters 
- User defined filters from the above types (Fig.9.)

Corrections

- Smooth                              linear + gauss
- Background subtraction        automatic
- Multiplication
- Activity correction
- Smoothing extreme pixels            
- Filters (see above)                
- Motion correction

Fusion/Coregistration

- Manual method      Free zoom/shift/rotate/shear;
- Landmark-based    Using user defined control point pairs in both modalities;
- Manual and Landmark methods can be freely mixed.

3D Studies

Three-dimensional image presentation. Volume and surface rendering, optional rotations and cine, also for motions in case of gated studies.

      

KIDNEY

Static Kidney
This procedure performs evaluation of the kidney functions on static images, and calculates geometric mean and various activity ratios.

Dynamic Kidney
Dynamic kidney scintigraphy is able to describe the the following properties: perfusion of kidney(s), extraction, clearance, excretion, obstruction and vesico-ureteral reflux. In most cases, automatic background correction and motion correction is allowed. Procedure variants available for:
- Perfusion analysis, relative perfusion, RBF/CO
- Function analysis, relative function
- Time activity curves and values: Tmax, T1/2, Wash-out T1/2, residual activity, etc
- Deconvolution
- Patlak method
- Diuretic response
- Output efficiency
- Micturition
- Transplanted kidney
- Clearance calculation:
- Gates (DTPA)
- noue (DTPA)
- Schegel ( I-131, I-123 hippuran)
- EC (blood sample)
- MAG3 (blood sample, standard and time method)
- MAG3 bloodless


Dynamic Kidney OSTNUCLINE version
Re-implements the majority of the calculations found in the application „OSTNUCLINE”. Contains perfusion, nephrographic, separated function, excretion fraction, global function and deconvolution routines.

Clearence (blood sample)
This procedure performs evaluation of the kidney clearance, based on user-entered numerical input values. Available variants:
- DTPA clearence
- MAG3 clearence (standard method)
- MAG3 clearence (time method)
- Tc-EC-clearence – children

RESPIRATORY

Quantitative 6-Part Lung Analysis
Used for quantitative examination of lung segments. Lungs are investigated from anterior (AP) and posterior (PA) view. Each lung is divided into top, middle and bottom part segments at both anterior (AP) and posterior (PA) view. Counts and maximum counts in the regions are calculated at every segment and compared to each other.

Combined Lung

For combined inhalation-perfusion lung studies. Ventilation and perfusion lung scintigraphy is an established noninvasive technique which is used to establish the diagnosis of pulmonary embolism. The ventilation and perfusion images may be acquired by two ways: either at the same time with different radiopharmaceuticals, or at different times with the same tracer. Both protocols may require a special image correction method. The diagnosis is based on the displayed ventilation and perfusion images, which are properly corrected.

 

CARDIOLOGY

Cardiac First Pass
The First Pass procedure contains L-R Shunt, Cardiac output and Mean pulmonary transit time examinations.

Gated RNV
This procedure is for the diagnosis the function and productivity of left ventricle. Displays heart wall movements, so that analyzing of the phase and amplitude images can be performed, with images taken from up to 9 directions. Global and partial EF and parameters of volume curve also calculated. + phase histogram

Static Myocardial Perfusion (work in progress)

The procedure uses either Rest or Stress+Rest static planar cardiac images, and calculates circumferential profile curves. In case of S+R studies, also the redistribution and washout profile curves are computed.

 

ENDOCRYNOLOGY

Thyroid Tc-99m Uptake
For routine processing of thyroid scintigrams acquired using Tc-99m Pertechnetate. The procedure displays raw and/or filtered images, performs thyroid uptake calculation, estimates of thyroid size and weight (by various formulas). The measurement protocol may be either syringe-based or dose calibrator-based.

Thyroid Iodine (I-131)

Displays thyroidal radioiodide uptake curves from several measurement points of phantom and patient thyroid image pairs. Calculates uptake ratios, biological half-life, geomatrical values, thyroid weight with several estimation methods, and optionally I-131 therapy parameters. The Simple scintigraphy variant is able to provide thyroid weight estimates from several methods, regardless of the applied isotope.

Thyroid I-123 Clearance 
Calculates the clearance of I-123 from thyroid lobes. The measurement protocol may be either syringe-based or dose calibrator-based. The activity of the blood sample may be originated either from estimation, or from a well counter.

Parathyroid Dual Label 
The aim of this procedure is localization and rough estimation of parathyroid adenoma through subtraction of parathyroid and thyroid organ images acquired using different radiopharmaceuticals (dual label). The procedure provides appropriately scaled difference images for evaluation.

 

GASTROENTEROLOGY

Gallbladder (Hepatobiliary)
The aim of the procedure is to derive various quantitative functional parameters from hepatobiliary studies acquired using different protocols, with or without provocations. Calculates EF, as well as Tmax, T1/2 values of Liver, Hilus, Hilus-Liver, Gallbladder-Liver and Choledocus time-activity curves.

Oesophago – Gastric Motility procedure

Provides Oesophagus and gastric emptying examinations. For gastric emptying and oesophagus studies calculates and displays activity curves, Tmax, effective T1/2 and biological T1/2 values. Moreover, for oesophagus, displays passage, functional delayed or both curves, calculates transport speed, and creates condensed image for reflux determination.

Salivary Glands
Determines possible functional disturbs after inflammations and radioiodine therapies. Calculates time-activity curves, relative secretion and uptake values for parotides, sublinguales and submandibulares. Creates subtracted image for displaying activity loss by secretion.

 

LIVER

Static Liver
Performs simple evaluation of static kidney images. Calculates basic ROI statistics, activity ratios and geometric means of activities of the two kidneys, geometric mean ratios, estimates depth difference of the kidneys.

Liver / HIDA Evaluation

Evaluates liver perfusion function or HIDA on dynamic and/or static images. The liver perfusion variant displays perfusion activity curves of aorta, heart, peripheral parenhima and spleen, and calculates mean activity, Tmax, HPI, PHF values. HIDA variant display peripheral parenhima, choledocal, cyst, intestine, parenhima, hilus, duedonum curves, and calculates max activity, EF, Tmax, biological T1/2 parameters.

ADDITIONAL TOOLS

Interfile – DICOM conversion.
Operations on Multiple Images.
Calibration tools.
Scatter correction
CLEAR Filters

These Resolution Recovery filters are proprietary to Mediso and can be applied both to projection (SPECT) and planar images. The filters can be run in the background (using the dedicated Mediso Application Server accompanied with InterView™ XP), while performing another evaluation or presentation function of the program, as usual.

CARDIAC SPECT

Cardiac Stress 
5 different reports from analysis of single phase myocardiac tomographic images.
Reports provide long and short axis images and 
Bull’s-eyes with quantitative polar map analysis (region distribution, circumferential profile curve, defective areas, ROI analysis).

Tl-201 stress-redistribution
Parallel analysis of two phases of image series. 6 different reports are obtained from analysis of 201Tl stress-redistribution tomographic images with quantitative polar map analysis.
Reports provide long and short axis slices and stress- redistribution Bull’s-eyes, quantitative polar map analysis, wash-out, subtraction image, 3D cine.

Tc-99m Stress-Rest

Parallel analysis of two phases of image series. 6 different reports are obtained from analysis of 99mTc-Sestamibi tomographic images with reorientation. Reports provide long axis, short axis, subtraction Bull’s-eyes, quantitative polar map analysis, 3D cine.

ECG gated blood-pool SPECT and perfusion SPECT
9 different  reports from gated SPECT processing with quantitative analysis (volume curve, EF, regional EF and perfusion, wall motion, thickening, phase-histogram, phase and amplitude images, ED/ES, evaluation of summation image, 3D cine).

Different polar maps for perfusion and blood-pool:
Perfusion: regional perfusion, wall thickening 
Blood-pool: phase, amplitude

The results can be compared with the international cardiologic database as the Emory Cardiac Toolbox or Cedars-Sinai Cardiac Suite can be on-line connected to InterView.

 

BRAIN SPECT

Brain SPECT
4 different reports from analysis of (rCBF) brain tomographic images with attenuation correction and reorientation.
Reports provide coronal, sagittal and transversal slices.

Brain Stress-Rest SPECT
Parallel analysis of two phases image series, 5 different reports are obtained from the analysis of brain tomographic images.
Reports provide coronal, sagittal and transversal slices,
from each phases (S, R, S-R and R-S images). Different types of 3D cine are also available (volume rendering, surface rendering, combined, etc).
Movement of patient’s head can be corrected.

Quantitative Brain region analysis

Automatic contour determination.
All slices are divided into 8-segments with quantitative determination.
Right-left hemisphere analysis.

 

USER DEFINED SPECT

 

According to the clinical requirements the user can also define by his own of processing procedure, based on the above mentioned  clinical programs (i.e. Tl-201 rest-re-injection; liver SPECT, etc.)

 

BONE

3-Phase Bone Scintigraphy
Compare Examined to Reference areas is the base of evaluation of 3 phase bone scintigraphy. Acquisitions are made from a paired organ or bone and the program determines them ratio.

Sacroiliacalis Index
Sacroiliac index is the sacroiliac joint-to-sacrum ratio. It is calculated as the quotient of the maximum counts in the sacroiliac joint and the maximum counts in the sacrum. Using median filter can help to eliminate unreliable maximum count values. Software uses the maximum point of the selected areas for the calculation of Sacroiliacal Index.

Simple Whole Body

Provides visual examination of whole body images.
Display and zoom multiplied AP and PA images and additional static views. Multilevel display:
display whole-body images at two brightness levels

 
 

BRAIN ANALYSIS

DaTSCAN
Calculates activity ratios over selected brain regions, which may be defined over transaxial image slices (or on sum of slices) of the brain.

Brain Perfusion
Determines possible functional disturbs after inflammations and radioiodine therapies. Calculated results include bolus appearing time, statistical properties of time-activity curves, perfusion rate, Fits gamma curves to hemisphere or user-defined region TACs’ of the brain, displays fitted gamma parameters, MTT value, T0, Tmax, T1/2 and other activity statistics.

 

DACRYO SCINTIGRAPHY

This program is used for dynamic analysis of the lacrimal apparatus function. Dacryo Scintigraphy enables the control of activity changes in the regions defined by the user for which the procedure finds Tmax and T1/2.

 
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