Frequently Asked Questions

Transcription

1 Frequently Asked Questions Answers to 4DM questions. Products Product Offerings CT Options Coronary Flow Reserve (CFR) Option Reconstruction Option 4DM Personal Licensing 4DM Personal Sales and Purchasing Network Design Floating Licenses Compatibility With other nuclear cardiology review software With mixed camera environments With earlier 4DM versions With 4DM Personal and a vendor workstation with 4DM Installed 4DM Features 4DM Reporting Multi-Monitor Support Upgrades Upgrades 4DM Functionality Functionality International INVIA Services Training Customer Support

2 Products Product Offerings Q: What products and services does INVIA offer? A: Products 4DM Integrated Application 4DM Personal Application Services Application Packages & License Types Options Essentials: SPECT PET SPECT + PET Advanced: SPECT + Hybrid-CT PET + Hybrid-CT SPECT + PET + Hybrid-CT Premium: SPECT + CFR PET + CFR SPECT + PET + Hybrid-CT + CFR SPECT + Hybrid-CT + CFR PET + Hybrid-CT + CFR 4DM Application Features: Fixed and floating license configurations Reconstruction add-on available for SPECT Packages Nuclear cardiac reporting engine - 4DM Reporting Multi-monitor displays 4DM is translated into over 20 languages On-site installation and training Workshops held at INVIA headquarters Web demonstrations of the 4DM application Assistance with report customization and site specific configurations (Product Features and Services may vary with Reseller) 2

3 Products Product Offerings Q: Can I try 4DM before purchasing? A: Yes, there are two options for users looking to try 4DM prior to purchasing it. 1. The fast and easy way to try 4DM is to download the 4DM Demo Application from the INVIA website. The 4DM Demo contains the fully-functional 4DM application with sample patient data pre-installed. Learn how to navigate the application, watch videos to see product overviews and a sample SPECT workflow, or simply install 4DM and explore the full application at your leisure. To download the 4DM Demo Application, request access to the Prospect Center: 2. Alternatively, you can request a free 60-day trial license, which allows you to install 4DM and import your patient imaging files into the application. Contact INVIA or visit the Reseller section of our website to find the best reseller partner who can provide you a free trial license: CT Options Q: What CT Options do you have available? A: 4DM contains three review screens for CT images: CT Viewer, Ca Scoring and Fusion. 1. CT Viewer screen allows the user to review the CT in Transverse, Coronal and Sagittal viewports. Each viewport provides the user the ability to display MPR, MIP and Thin MIP displays, draw measurements with a ruler, draw regions of interest, and the ability to scroll through the slice display. 2. Ca Scoring screen provides the ability to score individual vessels for calcium, displays the number of lesions as well as the Agatston Score for diagnostic interpretation, and quantifies calcium percentile. 3. The Fusion screen provides a way to review the co-registration of SPECT/PET Myocardial Perfusion Images with CTA, CaSc and Attenuation Correction maps (both mu Maps and CT maps) as well as MIP co-registration. If SPECT/CT is being performed for Attenuation Correction only, the Fusion page can be viewed without purchasing the CT option. Fusion includes a Nine Panel Layout, Contours, a Transparent Viewer Tool, an Orientation Toggle and the ability to display a 3D or Slice object while aligning CTA or Ca Scoring overlays. With v2013 and higher, 4DM also supports whole body PET studies. 4DM v2017 and higher includes a two study comparison layout. Review the co-registration utilized during image reconstruction of both Stress and Rest datasets at the same time. Q: Will my CTA vessels appear on 3D objects? A: It depends. If the camera vendor provides the necessary CTA vessel files in a supported file format, they will display as expected in the 4DM application. Contact INVIA for information on supported cameras. Q: If my NM and CTAC maps are mis-registered, can I fix them inside 4DM? A: No. You will be able to review the mis-registered display and manipulate the alignment to demonstrate proper alignment, but the changes needed to correct the mis-registration MUST be done on the vendor reconstruction workstation. 3

4 Products Coronary Flow Reserve (CFR) Option Q: Is the 4DM CFR option FDA-approved? The 4DM CFR option is FDA-approved and validated. CFR is for use with Rubidium-82 and N-13 Ammonia PET perfusion imaging agents. Q: What method is 4DM using to calculate Coronary Flow Reserve? A: 4DM uses these algorithms: Patented Brigham and Women s GFADS algorithm Factor Analysis-Hybrid (FAH) algorithm Region of Interest (ROI) Compartment algorithm Region of Interest (FixedDV) algorithm developed out of Ottawa Heart to automatically calculate CFR Q: What are the advantages of the 4DM CFR option over other commercially available methods? A: There are several advantages FDA approved. All methods are automated. 4DM provides options for selecting the processing flow model. Choose from the Factor Analysis (FA) model, FAH model, ROI Compartment model, or ROI (FixedDV) model to process the dynamic study. INVIA continuously researches and improves upon CFR quantification. With v2017 and higher, streamline the reviewing process with the new QA and Results Modes. Q: Does 4DM quantify SPECT-CFR patient datasets? 4DM Integrated v2016 and higher provides the ability to quantify and review SPECT Coronary Flow Reserve (CFR) datasets from certain camera systems. Currently, datasets must be acquired from the GE Discovery 530c Alycone or Spectrum Dynamics DSPECT cameras. Reconstruction Option Q: Does the 4DM Reconstruction option include Motion Correction? With 4DM v2013 and higher, Motion Correction is part of the SPECT Reconstruction option. Technologists can perform all processing from within 4DM for SPECT datasets, eliminating the need for the technologist to switch programs, to help streamline the workflow. Q: What type of motion can be corrected? A: You can correct for patient axial motion during acquisition, slight shifts between detectors, and cardiac creep. 4

5 Products Reconstruction Option Q: Will the program reconstruct any SPECT data? A: 4DM can reconstruct these type of SPECT patient datasets: 4DM reconstructs volumetric images from nuclear medicine tomographic and gated tomographic datasets. Q: What reconstruction methods does 4DM provide? A: Filtered Back Projection (FBP) Currently, 4DM only offers the Filtered Back Projection (FBP) method of reconstruction. Therefore, 4DM can only reconstruct non-attenuation Corrected volumetric images. Q: What reconstruction tools does 4DM provide? A: The Reconstruction screen allows users to perform standard SPECT reconstruction processing for one-to-four datasets on a single screen and includes: 1. Slice Selection: Slice plane indicators on the Tomo viewport determine which slices to include in the reconstructed volume. 2. Reconstruction Filter Adjustments: Select Butterworth, Hanning, Hamming, Parzen, Shepp, or Gaussian as the filter; adjust cutoff and order (Butterworth only) settings. 3. Reorientation Controls: Adjust reconstructed cardiac volumes along the long axis of the heart by clicking and dragging the circular control on the SA, HLA, and VLA slices. 4. Multiple Image Displays: A Splash object displays for visualization of the reconstructed volume when one dataset is displayed on the Reconstruction screen. 4DM Personal 4DM Personal Q: What is 4DM Personal? A: 4DM Personal is stand-alone software that has the complete functionality of 4DM. Instead of requiring a fixed installation on your PACS, camera, or integrated workstation, 4DM Personal has the ability to install on any Windows laptop or workstation creating a portable and convenient nuclear review and reporting environment, or supplementing your 4DM Integrated installation. Q: Will 4DM Personal work with my camera or PACS manufacturer s workstation? A: 4DM Personal is ideal for a clinical environment with workstations from multiple manufacturers. With 4DM Personal s built-in browser (DICOM file manager), you can store, import, receive, query/retrieve, and transfer DICOM image files across the local area network from a variety of sources. Once a file is ready for review, select the patient using the browser and launch 4DM. 5

6 4DM Personal 4DM Personal Q: Can I install 4DM Personal on any computer? A: No. 4DM Personal is compatible with desktop and laptop computers running a Windows operating system. In order to communicate with other site workstations, it needs to be installed on a computer within the same local area network (LAN). Additionally, it is not recommended for vendor acquisition, processing, or review workstations. Below is a list of minimum system requirements: Supported Operating Systems: Windows 7; Windows 8; Windows 10; Windows Server 2008 R2, 2012 R2, 2016 Processor Speed: Dual Core 2.0 GHz or greater Memory: 3 GB minimum, 4-6 GB recommended Disk Space: 1 GB required for installation; 2-4 GB additional for image files Display: 24 bit color; 1280x1024 or higher 3D Graphics Card: 256 MB or higher; 3D graphics card supporting OpenGL 3.0 Networking: Networking adapter card (Ethernet or wifi) required Q: How do I buy 4DM Personal? A: You can purchase 4DM Personal directly from INVIA or from some of our reseller partners. Contact an INVIA sales representative for more information or for a list of reseller partners offering 4DM Personal. 6 Q: Why should I buy the Personal version of 4DM? A: 4DM Personal is cost-effective and flexible, it includes installation and training, as well as maintenance: Cost Effective: Software-Only version of 4DM Does not require you to purchase additional hardware Supplements 4DM integrated on your PACS, camera, or workstation Flexible: Flexible Workflow: Receive reconstructed data from multiple cameras or workstations Flexible Scheduling: Process and review patients studies at any time day or night Flexible Licensing: Purchase licenses based on the number of simultaneous users anticipated Installation & Training: 8 hours of on-site installation and training included at no additional cost Personalized training designed for your staff International users receive installation and training remotely and scheduled at your convenience Maintenance Included: 1 year of support and upgrades included with each license at no additional cost INVIA automatically sends you the newest release of 4DM (targeted at one release per year) or phone INVIA for technical support during standard business hours

7 4DM Personal 4DM Personal Q: How do I locate patients on my network and launch them when using Personal? A: Within the 4DM Personal Patient Browser. 4DM Personal has a built-in browser that provides direct DICOM connectivity from the technologist processing workstation to the 4DM Personal PC. It also acts as the gateway to launching patients into the 4DM Personal software for quantification and interpretation. With 4DM v2017 and higher, view the status of the patients report before launching into 4DM. Q: Can I use 4DM Personal to query/retrieve patients from a processing workstation? Most facilities typically transfer the data (also called pushing ) to the built-in browser. However, the browser also includes the capability to query/retrieve (also called pulling ) as long as the processing workstation allows this. Q: Does the built-in browser allow me to launch more than one patient at a time into 4DM Personal? Users can launch up to 250 patients into 4DM Personal by clicking the CTRL key as they select patients. Q: If I have multiple 4DM Personal workstations, can I set up one centralized patient database for them to pull the data from? The built-in browser can be configured on each computer to pull patient studies from one centralized database. This saves substantial time when this workflow eliminates the need for duplicative data transfers from the technologist processing workstation. Sales and Purchasing Q: What is included with my purchase of 4DM Personal? A: All purchases of 4DM Personal include: Permanent license of the software (no annual licenses fees) The browser screen directly connects your PC to the vendor processing workstation so DICOM files can be transferred seamlessly The 4DM Reporting application for generation of reports The 4DM Administration application for customization of 4DM Additional purchases: One year of maintenance and technical support One year of upgrades (for all features purchased) 1-day on-site installation, configuration, and training by an INVIA specialist 7

8 4DM Personal Sales and Purchasing Q: Are there options to extend the maintenance and support beyond the one year included with purchase? INVIA encourages 4DM Personal customers to take advantage of our extended maintenance plans (one- and threeyear options) that provide support and FREE upgrades (for all features purchased) for the length of the agreement. Q: Do I need to purchase special hardware in order to use 4DM Personal? A: No. 4DM Personal is a cost-effective, software-only solution that can be installed on your existing Windows desktop or laptop PCs. Be sure to check that your system meets the requirements specified above. Q: Does 4DM Personal provide the capability to review PET and CT data? 4DM Personal PET licenses are available with the CT option added as an adjunct. The CT option provides Review of volumetric CT data (including CTAs and calcium scoring CTs) Fusion review screen Dedicated CT Viewer Calcium Scoring screen (quantifies Agatston calcium scores) Ability to overlay 2D/3D coronary trees and 4DM-quantified calcium deposits Licensing Network Design Q: We want our technologists to have uninterrupted access to 4DM throughout the day. We have three physicians who interpret, and they would each like it on their office PC s. However, only one physician needs access on a daily basis. Is there a cost efficient solution to provide such flexibility? The technologists can have their own fixed license, while the physicians can use a 1-seat floating license for 4DM Personal amongst them. 4DM Personal is a software only version of 4DM compatible with Windows PCs. Install 4DM Personal on an unlimited number of PCs, but only pay for the number of simultaneous users (seats) needed. Q: I want to utilize a single seat floating license for both the technologist and the physician but their systems are on separate subnets. Will 4DM support this configuration? 4DM can support separate subnets through the use of manual definition of the network pathway. This configuration setting is implemented by INVIA during the onsite installation and configuration visit. 8

9 Licensing Network Design Q: Can I have multiple license types on a single license manager? A: Yes, with variable licensing. Each 4DM License Manager can control multiple 4DM License Types, and each Type can contain varying number of seats. This enables End-users to purchase the optimal number of seats to most economically meet their needs. The License Manager checks out the License Type and number of seats used, notifying the next-user when all seats have been checked-out. License types include SPECT, PET, Hybrid-CT, CFR, and SPECT Reconstruction. Example: A site with three imaging systems (two SPECT and one PET-CT) could order multiple License Types with a varying numbers of seats (such as 2 SPECT Essentials and 1 PET with Hybrid-CT Advanced) and check-out the License Types on various workstations as needed. Floating Licenses Q: What is a floating license? A: Floating licenses, also known as concurrent licenses, allow a customer to install 4DM on a greater number of computers than the number of floating license seats purchased. The maximum number of individuals using 4DM simultaneously is limited to the number of seats purchased. Q: How do floating licenses work? A: When an individual tries to launch 4DM from an available workstation, the application requests a seat via the license manager. If a seat is available, the application launches. When the application is closed, the seat becomes available to other 4DM workstations. Example: A site purchases 1 floating seat. The 4DM software is installed on 2 workstations. There is currently one user using 4DM. A 2nd user wants to launch 4DM but is unable to because there are no available seats. Q: How do I know if a floating license configuration is right for me? A: Floating licenses are great for sites with: Multiple physicians reading studies at varying times Physicians who want greater flexibility when reading within the network Administrators looking to save money by streamlining software expenses or workflows An INVIA Product Specialist can help identify the optimal number of seats for your hospital or clinic. Compatibility With other nuclear cardiology review software (previous and current studies) Q: How will the quantification values generated by 4DM compare to the values previously generated by my non-4dm quantification package? A: 4DM s quantification values have been compared to competitive quantification values and show equivalence. For more information see 4DM validation papers posted at 9

10 Compatibility With other nuclear cardiology review software (previous and current studies) Q: Can 4DM provide a quantitative comparison between previous and current studies? Through the utilization of the polar map difference option (DIFF1-2), users can normalize and review a quantitative comparison between the two studies. With mixed camera environments Q: Do I need separate versions of 4DM to review SPECT/CT datasets in same setting that I review SPECT-only studies? A: No. 4DM provides a single user interface for review of SPECT, SPECT/CT, PET, PET/CT, SPECT/CFR, PET/CFR and MUGA studies within a single review session. Q: Will 4DM purchased from one vendor differ from that purchased from another vendor? A: In most cases, no. If you purchase the same version of 4DM from multiple vendors, they will provide the same quantification values, supported datasets, screens, and preferences. Some features, like 4DM s integrated reporting, may not be available with all of INVIA s reseller partners. With earlier 4DM versions Q: Are results generated on 4DM-SPECT v5.2 compatible with results generated in the newest version of 4DM? 4DM results files are compatible across the different versions of 4DM. With 4DM Personal and a vendor workstation with 4DM installed Q: Can I use 4DM Personal with the copy of 4DM Integrated purchased with my vendor workstation? 4DM Personal is compatible with all 4DM installations, including those integrated with one of our many reseller partners workstations and PACS systems. 10

11 Features 4DM Reporting Q: Will I be able to use 4DM for reporting? If so, can I add our logo or a Physician s signature? Reporting is integrated into the 4DM Personal application and sometimes comes included with 4DM Integration installations. 4DM Reporting can be accessed from 4DM Personal s Patient Browser or from within the 4DM application. Exporting reports is now easier than ever. Customization of report templates can be done by following steps in the Help Sheets provided on our website or by ordering template customization through INVIA (ask an INVIA specialist for prices). Q: What formats can 4DM export a report into? A: Reports can be exported to XML, RTF, PDF, Encapsulated PDF, HL7 V2, and HL7 V2 Referenced PDF formats. Q: Can I open 4DM reports from v2015 and prior in the new 4DM reporting engine? 4DM report files from older versions of 4DM are compatible with the new reporting engine included in 4DM v2016 and newer. However, report files saved in the new reporting engine cannot be opened in the old reporting engine. Q: How do I select a 4DM report template? A: With v2013 and higher, it is automatic. 4DM automatically matches study protocol to the appropriate report template, so you don t have to manually select your templates. If you want to select a different template, use the Template Selector tool in 4DM Reporting. Q: Can I use speech-to-text software with 4DM Reporting? 4DM v2016 and higher includes the ability to use Dragon Nuance dictation software for speech-to-text input. Q: How does using 4DM Reporting save me time? A: With 4DM v2016 and higher, 4DM Reporting was overhauled to provide more efficient reviewing. 4DM Reporting includes features such as automatic-sentence generation, real-time report preview and editing capability, and drop-downs and check-boxes to make reporting convenient and efficient. Q: Can I enter patient information into their report before acquiring their patient study? With 4DM v2016 and higher, reports can be started or edited independently from 4DM, and prior to images being acquired. Fill-in patient information and EKG results in advance of imaging your patient. 11

12 Features Multi-Monitor Support Q: What is multi-monitor support? A: With 4DM v2012 and higher, you can read a patient study across multiple monitors, displaying various 4DM screens on each monitor. Q: How many monitors can be used? A: 4DM supports up to four displays. Q: Why would I use multiple monitors to review a patient study? A: There are many benefits to using multiple monitors: Multi-monitor review can improve your organization s workflow, from processing to reporting Compare images, quantifications, and reports side-by-side for thorough study interpretation Increase efficiency in reading studies by viewing any combination of 4DM screens at one time Input report information while reviewing study result screens for improved report generation Q: How do I receive 4DM upgrades with a purchase made through a camera or workstation manufacturer? A: If you purchased an integrated version of 4DM (one that is installed on the manufacturer s workstation), 4DM upgrades are managed by that manufacturer. Most often, the details can be found within your service maintenance agreement. Speak to your sales representative for more information. Upgrades Upgrades Q: How do I receive 4DM upgrades with a purchase of 4DM Personal? A: All customers who have a maintenance agreement direct from INVIA automatically receive the latest version of 4DM Personal with its annual release. Q: I do not have an active maintenance agreement but want to upgrade my version of 4DM Personal. How is that done? A: 4DM Personal upgrades are available for purchase. Contact an INVIA Product Specialist for pricing. 12

13 4DM Functionality Functionality Q: Where does 4DM display % defect, both regionally and globally? A: 4DM provides this information on our Polar Maps screen, which can easily be added to your list of active screens. Also, a custom screen can be built for the customer including this information. Q: Can 4DM provide Transient Ischemic Dilation (TID) ratios? TID ratios are automatically calculated and displayed for ungated stress datasets when a rest dataset is also present. Q: Can 4DM support the review and quantification of gated planar (MUGA) data? 4DM includes a MUGA processing screen, at no additional charge, which will process both RV and LV EF s. It also includes automatic and manual methods. With v2017 and higher, MUGA screen includes regional EF and the ability to interpolate the ROI s during editing mode. Q: Does 4DM support prone imaging? 4DM configures the dataset matching strings in preferences to add Prone to the Attenuation Correction strings. The dataset layout for the Images Screen is also configured in preferences to use the NC/AC Perfusion dataset layout to display Stress and Prone datasets. Q: I am used to masking extra-cardiac activity - does 4DM provide this tool as well? A: 4DM has a similar tool called Constraints. This allows the algorithm contours to be set manually. Yes, you will still see the extra-cardiac activity; however constraints will not truncate the heart. Q: Does 4DM measure inflammation of the heart? With 4DM PET licenses, 4DM provides an Inflammatory screen, which displays regional and global results to identify normal, infarct, and mixed tissue versus inflamed tissue. Q: How does 4DM provide consistent results? A: The 4DM application provides a streamlined workflow for reconstruction, quality assurance, and review. INVIA provides training, collateral, and user preferences to help users conduct the necessary steps to provide reproducible results. Q: Has the 4DM application ever been validated? Extensive validation testing is performed with every release. Validation papers are posted on the INVIA website: 13

14 4DM Functionality Functionality Q: Does 4DM provide Standard Uptake Value Calculation? A: Yes, with 4DM v2013 and higher. FDG PET Standard Uptake Value (SUV) calculation displays as a 2D/3D Polar Map distribution of the LV on any quantification screen and is also included in the information for any manually defined ROI of the body on the Fusion screen. International Q: Is 4DM translated into languages other than English? The current 4DM user Interface is translated into 20 languages: Chinese, Czech, Danish, Finnish, French, German, Hungarian, Indonesian, Italian, Japanese, Korean, Norwegian, Polsih, Portuguese, Romanian, Russian, Spanish, Swedish, and Turkish. Q: Does INVIA provide installation and training for international users? For our international customers who purchase 4DM Personal, an INVIA Product Specialist will install 4DM Personal using remote access software and provide web-based training scheduled at your convenience. To ease the transition to 4DM, your INVIA Product Specialist can also set 4DM to display in your native language. INVIA Services Training Q: I have new physicians who joined my practice, they are new to 4DM and have requested software training. Can INVIA provide on-site training for 4DM software previously purchased through our camera vendor? INVIA can come directly to your site and provide site-specific, version-specific training, in a format that best fits your patient scheduling to avoid costly downtime. Order additional training by a 4DM Product Specialist directly from INVIA, or through your camera or PACS vendor. Q: I have a large, multi-center site. What are my options to ensure that my staff gets the appropriate training they need? A: INVIA can provide a classroom-style training session, rotating groups through to leverage our time at your site. If you want to avoid any patient scheduling downtime, and prefer a one-on-one approach, we can accomodate you. An INVIA Product Specialist can assist you in determining how many days you need, based on the type of training requested, the total number of attendees and the number of locations. 14

15 INVIA Services Customer Support Q: Where can I look for more help with using the 4DM application? A: There are several ways to obtain help with the 4DM application. Users Guide: Available by clicking Help within 4DM or online in User Center Website: Available online in User Center are step-by-step help sheets and other support material Vendor Support Desk: If you purchased 4DM from one of our many reseller partners, you should contact their support specialists OR if you have an active Maintenance Agreement with INVIA, contact us directly via (support@inviasolutions.com) Q: I heard you have an informative Users Center site, containing lots of useful reference material and downloads. How do I obtain a log-on? A: To gain access to the User Center go to You must be a current 4DM user to gain access to the User Center. If you are not currently using 4DM and would like to know about the software request access to the Prospect Center, Q: What information should I have ready when contacting product support? A: When contacting either vendor or INVIA support personnel, it is important that you have the following information on hand: Software Version Camera and Workstation Manufacturer(s) Version of any manufacturer s or third-party software (e.g., Microsoft) Your Maintenance Agreement Number Q: What type of experience do the 4DM support personnel have? A: INVIA s support staff are all experienced Nuclear Medicine Technologists who understand your environment and have become experts in most facets of 4DM. Q: Do you have specific hours for 4DM Support? INVIA is located in the East Standard Time zone in Ann Arbor, Michigan. Business hours are 8:30 a.m. to 5 p.m. EST. Support voic and are available 24 hours a day, 7 days a week. Leave a detailed message, including the information provided above, your call will be returned as soon as possible. 15

16 Our mission is to develop advanced imaging software for medical professionals to optimize patient care. PC_ A INVIA, LLC