Siemens MPI Processing Protocol

1. After selecting the patient and appropriate acquisitions the data above appears
   1. Settings
      1. Patient orientation is noted with the starting angle of -135^o with 180^o rotation
      2. Mask is applied which is the circle around the LV
      3. Filtered Back Projection (FBP) is selected for processing
   2. Reconstruction limits are set - correlate this to Philip's system
   1. Movement of the upper and lower red lines are adjusted to determine which area is going to be processed
      1. This tells the computer to process all the data between the two red lines and within the ellipse
      2. The yellow ellipse is displayed around the LV. This mask will cut out any outlining activity, such as unwanted GI
   3. The initial processed data is displayed allowing the technologist to
      1. Adjust/change the filter (current setting is Butterworth 0.557)
      2. Adjust the zoom and threshold data by moving the scale



2. Autocardiac program applied to the mask and filtered data display the cardiac cine
   1. Initial evaluate is to assess the raw data (cine) to determine
      1. Is there any attenuation artifacts that might adverse effect myocardial wall uptake?
      2. Is there patient motion? - Consider:
         1. Lining up the gal bladder, does it appear to bounce? Or stay in the same plane
         2. Linograms and sinograms display will also show patient movement by noting a disruption with the line. According the data display is there any patient movement?
         3. Summation image sums all the images collected during SPECT and displays it as one frame
   2. In the above images motion correction was applied and the pre-post results are displayed in the linogram/sinogram
   3. Histogram shows where the R waves were collected
      1. The role of the histogram to determine is there are too many irregular cardiac contractions
      2. A window should be set so that the extreme range of irregular beats are not acquired, but rejected



3. Images can then be adjusted in their three different projections: horizontal long, vertical long, and short axis
   1. Make sure that the LV is centering
   2. Confirm that GI activity has been eliminated
   3. Centering and masking can be re-adjusted at this point



4. Final step before displaying the processed images
   1. Just like before the red lines process all the data within their regions
   2. The mask is re-applied
   3. Results are show to the right
   4. Above images are only showing the processed stress data



5. Display the FBP data
   1. Vertical Long, Horizontal Long, and Short Axis
   2. Only the stress data is displayed, while normally both sets (stress and rest) are available for review
   3. This processed data is then sent for further quantifications via Cedars or Emory Toolbox software

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