Digital-based full-length anteroposterior weight-bearing radiographs of both limbs were taken immediately prior to surgery and implant removal. Therefore, patients were positioned truly anteroposterior with the ankles hip-width. Radiographs were assembled using the Ysio system and Syngo Workplace (Siemens Healthcare, Erlangen, Germany). The applied reference guide was 25 mm in diameter. Radiographs were evaluated using the IMPAX EE R20 Release XIII software (Agfa Healthcare, Düsseldorf, Germany). The Z620 Workstations (Hewlett Packard, Böblingen, Germany) and 2 EIZO Radioforce RX 340 monitors (Mönchengladbach, Germany) were used.
Syngo workplace
Manufactured by Siemens
Sourced in Germany
Siemens' Syngo Workplace is a software platform designed for medical imaging and analysis. It provides a comprehensive suite of tools for healthcare professionals to manage, view, and interpret medical images from various modalities, including MRI, CT, PET, and X-ray. The Syngo Workplace offers a centralized interface for accessing and processing medical data, enabling efficient patient care and clinical decision-making.
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5 protocols using syngo workplace
1
Radiographic Assessment of Limb Alignment
2
3D-DSA Angiography Protocol for Vascular Evaluation
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Three-dimensional digital subtraction angiography (3D-DSA) was performed by femoral catheterization using the Seldinger technique with a biplane DSA unit with rotational capabilities (Axiom Artis dTA; Siemens Healthcare, Erlangen, Germany). Typically, 4–10 ml of nonionic contrast medium (Iopamidol, 300 mg of iodine per ml; Teva Takeda Pharma, Nagoya, Japan) was used per acquisition. The spatial resolution was 0.32 × 0.32 mm. Standard anteroposterior and lateral DSA images were obtained with the catheter in the four significant arteries (the common carotid arteries and vertebral arteries). The single 3D rotational angiographic acquisition is typically performed to evaluate aneurysm shape and surrounding blood vessels. Images were reconstructed using a 256 × 256 matrix. Rotational angiographic data were transferred to an independent workstation (Syngo Workplace; Siemens Healthcare, Erlangen, Germany) to generate 3D reformatted images. 3D-DSA data were immediately sent to an adjacent 3D workstation (Siemens Medical Solutions, Erlangen, Germany). An experienced endovascular staff reviewer evaluated the conventional DSA and discussed the operative strategy with the surgical intervention staff.
3
Angiographic Evaluation of Intracranial Aneurysms
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Angiographic examinations were performed using a biplane neuro-angiography unit (Siemens Artis Zee, Siemens Healthcare, Erlangen, Germany) with an image intensifier matrix of 2048 × 2048. Using a right femoral artery approach, conventional internal carotid angiograms were obtained after injection of 6-8 mL of iodinated contrast medium (Visipaque 270, GE Healthcare, Princeton, NJ) at a flow rate of 4-6 mL/sec.
For rotational angiography, after collimating the patient's head to isolate the aneurysmal region, the C-arm was rotated over a 200-degree range at a rate of 40 degrees/sec for 5 seconds. Contrast medium was injected at a flow rate of 2-3 mL/sec for 6 sec. Data obtained were then transferred to an external processing workstation (Syngo Workplace, Siemens Medical Solutions) to generate a volume rendering (VR) image using the vendor supplied 3D software (Inspace, Siemens Medical Solutions).
For rotational angiography, after collimating the patient's head to isolate the aneurysmal region, the C-arm was rotated over a 200-degree range at a rate of 40 degrees/sec for 5 seconds. Contrast medium was injected at a flow rate of 2-3 mL/sec for 6 sec. Data obtained were then transferred to an external processing workstation (Syngo Workplace, Siemens Medical Solutions) to generate a volume rendering (VR) image using the vendor supplied 3D software (Inspace, Siemens Medical Solutions).
4
ECG-Synchronized CT Imaging Protocols
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From the ECG-synchronized CT raw datasets, morphological images were generally reconstructed through the entire chest and abdomen at 70% of the R-R interval with 1-mm slice thickness, 0.7-mm increments, I26f reconstruction kernel and 32 cm FOV. Functional imaging was then reconstructed in 5% steps between 0 and 95% of the R-R interval from the ECG with 1-mm slice thickness, 0.7-mm increments, I26f reconstruction kernel and 24 cm FOV. All datasets were reconstructed with sinogram affirmed iterative reconstruction (SAFIRE, Siemens Healthcare, Forchheim, Germany) and a medium strength level of 3 was used in all patients. All datasets were transferred to a Siemens Workstation (Syngo Workplace; Siemens Medical Solutions) for image analysis.
5
Aneurysm Morphology Assessment via DSA Imaging
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The SR was considered a morphological characteristic, derived from intraoperative working angles useful for neck identification based on preoperative three-dimensional digital subtraction angiography (DSA) images, and as proposed by Dhar S et al.5 (link) The DSA images were acquired on a biplane Axiom Artis QBA angiography system (Siemens, Erlangen, Germany). Further, based on these images, measurements of aneurysm morphological factors were assessed using a Syngo Workplace (Siemens). Parent artery diameter was measured at the nearest region of all arteries that had direct contact with the aneurysm neck, and the average diameter of each of the involved parent arteries was calculated. The SR was calculated by dividing the maximum diameter of the aneurysm (mm) by the average diameter of the parent artery (mm). The details of the SR calculation method are shown in Fig. 1 . The correlation between SR and aneurysm size was also investigated.Fig. 1 ![]()
The SR was calculated as Hmax/DV. composite.
DV. composite = (DV1 + DV2 + DV3)/3.
DVi = (Dia + Dib)/2. i=1, 2, 3.
Hmax: maximum height.
Dv. composite: composite vessel diameter.
DV1, DV2, DV3: individual vessel diameter (average of two locations).
D1a, D2a, D3a: vessel diameter at neck or branching points.
D1b, D2b, D3b: vessel diameter 1.5 Da away from D1a, D2a, D3a.
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