Advantage windows version 4

Manufactured by GE Healthcare

Sourced in United States, United Kingdom

Advantage Windows Version 4.5 is a software application developed by GE Healthcare for the analysis and management of medical imaging data. The software provides a user-friendly interface for viewing, manipulating, and sharing medical images acquired from various imaging modalities.

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Lab products found in correlation

Functool, by GE Healthcare (1 mentions) Functool software, by GE Healthcare (1 mentions) Light speed volume ct, by GE Healthcare (1 mentions) Smartscore 3, by GE Healthcare (1 mentions) Magnetom verio, by Siemens (1 mentions) Discovery mr750, by GE Healthcare (1 mentions)

14 protocols using advantage windows version 4

Multimodal MRI of Spinal Cord Injury

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All MRI data were acquired on a 3 T MR scanner (Signa; GE Medical Systems, Milwaukee, Wisconsin, USA) using a specialized coil designed for scanning rats. The rat was placed in the coil in a supine position to reduce the influence of respiratory movement on magnetic resonance artifacts of the spinal cord. Data acquisition was carried out on the region of interest, namely, the damaged area.
The relevant parameters of T1-weighted and T2-weighted images of the injured rats were as follows: TR=560 and 2600 ms, respectively; TE=11.3 and 120 ms, respectively; matrix size=320×224, FOV=8, and slice thickness=1.5 mm in both. The DTI was obtained in the sagittal view with b value=1000 s/mm², TR=3500 ms, TE=87.5 ms, 64×64 matrix, FOV=10, and slice thickness 2.4 mm in 15 diffusion gradient directions. When the scan of each rat was completed, the relevant parameters were transferred to a separate workstation (Advantage Windows, version 4.2; GE Healthcare, Waukesha, Wisconsin, USA) and the corresponding photographic images were then synthesized using FuncTool (GE Healthcare), a commercial software.

Wang F., Huang S.L., He X.J, & Li X.H. (2014). Determination of the ideal rat model for spinal cord injury by diffusion tensor imaging. Neuroreport, 25(17), 1386-1392.

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Spinal Cord MRI in Surgical Patients

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Prior to surgery (baseline), and 12 months after surgery, a 3.0 T MRI scanner (MAgnetom Verio) was used to image each participant. The T2WI data were recorded with a repetition time of 3000 ms and an echo time of 90 ms at a layer thickness of 3.5 mm in a 269 × 384 scan matrix with a field of view of 272 cm × 275 cm. In addition, a workstation (Advantage Windows, version 4.2; GE Healthcare, Waukesha, WI, USA) was used to capture diffusion tensor imaging (DTI) images with a repetition time of 6100 ms and echo time of 73 ms at a layer thickness of 1.5 mm in a 96 × 96 scan matrix with a field of view of 107 mm × 107 mm; the b-value was 600 s/mm². The image acquisitions were repeated six times. The apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values of the spinal cord segments were determined using FuncTool software (GE Healthcare). All MRIs were performed by the same radiologist, and the images were captured by a second radiologist.

Deng W.S., Ma K., Liang B., Liu X.Y., Xu H.Y., Zhang J., Shi H.Y., Sun H.T., Chen X.Y, & Zhang S. (2020). Collagen scaffold combined with human umbilical cord-mesenchymal stem cells transplantation for acute complete spinal cord injury. Neural Regeneration Research, 15(9), 1686-1700.

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Coronary Calcium Imaging and CTA Protocol

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For coronary calcium scan and CTA, we used a 64 multi-detector computed tomography scanner (Lightspeed Volume CT, GE Healthcare, Milwaukee, WI, USA). One hour prior to the CT scan, we administered 100 mg of atenolol to patients who had heart rates of more than 65 beats/min. Immediately before scanning, 0.6-mg sublingual nitroglycerin was given to all patients. Coronary calcium scan was performed before CTA scanning. The calcium scan parameters were as follows: prospective electrocardiogram-triggered at 70% of the R-R interval, 2.5-mm slice thickness, a gantry rotation time of 350 ms, a tube voltage of 120 kVp, and a tube current of 200–250 mA (depending on the patient's BMI). CAC score was calculated according to the Agatston method.6 (link) The analysis was performed using a commercially available external workstation (Advantage Windows, version 4.2, GE Healthcare, Milwaukee, WI, USA), as well as CAC scoring software (Smartscore 3.5, GE Healthcare, Milwaukee, WI, USA). Moderate and severe CAD were defined as having more than 50% or more than 70% stenosis in any of the major coronary arteries, respectively.

Park H.B., Jeong H., Lee J.H., Suh Y., Hwang E.S., Cho Y.H, & Cho D.K. (2019). Predictors of Severe or Moderate Coronary Artery Disease in Asymptomatic Individuals with Extremely Low Coronary Calcium Scores. Yonsei Medical Journal, 60(7), 619-625.

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Evaluating Hindlimb Recovery in Canine SCI

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In canines, the Olby scoring system was used to evaluate the movements of the hindlimbs before implantation and at 0.5, 1, 3, and 6 months after implantation. Two researchers blinded to the experimental groups observed the videos to give each canine a corresponding score.
At 6 months after SCI, the motor evoked potential (MEP) was measured in each canine as described previously, 24 The MEP signals of left and right hind limbs were recorded using Nicolet Viking Quest evoked potential equipment (Nicolet Biomedical Inc., San Carlos, CA, USA).
At 6 months after SCI, a 3.0T Magnetic resonance imaging (MRI) scanner (Magnetom Verio, Siemens, Germany) was performed in each canine. The workstation (Advantage Windows, version 4.2; GE Healthcare, Waukesha, Wisconsin, USA) was used to obtain diffusion tensor imaging (DTI).

Deng W.S., Yang K., Liang B., Liu Y.F., Chen X.Y, & Zhang S. (2021). Collagen/heparin sulfate scaffold combined with mesenchymal stem cells treatment for canines with spinal cord injury: A pilot feasibility study. Journal of orthopaedic surgery (Hong Kong), 29(2).

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Subjective PET/CT Image Quality Assessment

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Anonymized images were evaluated by two experienced readers (with 10 and 4 years of experience). Both readers blinded to patient data (i.e. glucose levels, reason of referral, dosage regimens) independently evaluated all studies in random order on a dedicated workstation (Advantage Windows, version 4.6; GE Healthcare).
Subjective IQ of axial and coronal PET/CT was rated on maximum intensity projection (MIP) of PET. Semi-quantitative assessment was performed with a 5-point Likert scale (9 (link)): score of 5, excellent IQ without any apprehensible image noise and with completely homogenous PET signal in the liver; score of 4, good IQ but locally non-uniform PET signal; score of 3, moderate IQ with image noise leading to a globally non-uniform signal reducing the confidence in the diagnostic assessment; score of 2, poor IQ with patchy signal interspaced with reduced background activity mimicking focal hepatic disease; score of 1, deficient IQ with massive signal inhomogeneity considered inadequate for any diagnostic use. Scores of 5 and 4 were considered valid for diagnostic purposes, whereas scores of 1–3 were considered of non-diagnostic quality. Exams were not repeated due to the retrospective nature of evaluation.

Geismar J.H., Stolzmann P., Sah B.R., Burger I.A., Seifert B., Delso G., von Schulthess G.K., Veit-Haibach P, & Husmann L. (2015). Intra-individual comparison of PET/CT with different body weight-adapted FDG dosage regimens. Acta Radiologica Open, 4(2), 2047981614560076.

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Quantitative Iodine Concentration Analysis

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All CT datasets were transferred to a commercially available workstation for analysis (Advantage Windows version 4.6; GE Healthcare). Subsequently, two experienced radiologists (with 25 and 5 years of abdominal CT experience, respectively), who were blinded to clinical data and pathological results, analyzed the images. According to a previous study (18 (link)), VMS images captured at 70 keV using 40% adaptive statistical reconstruction techniques exhibited decreased levels of image noise and high contrast-noise-ratio compared with 120 kVp images. The IC value (measured in 100 µg/ml, throughout the text) was then measured using axial iodine-based MD image at 1.25-mm thickness (Figs. 1A-D and 2A-D). The outline of the region of interest (ROI)-lesions encompassed the largest area of the lesion in 2 or 3 consecutive layers, while avoiding areas of necrosis, vessels, air and fat attenuation. ICs in the AP (IC_AP) and the VP (IC_VP) were measured separately. Circular ROI was assigned to the abdominal aorta in the same layer as the ROI-lesion for calculating the normalized IC (nIC); nIC=IC_lesion/IC_aorta (11 (link)). All of the IC_AP/VP and nIC_AP/VP data obtained from the ROIs of the same tumor were averaged and recorded (Table II).

Chen X., Ren K., Liang P., Li J., Chen K, & Gao J. (2017). Association between spectral computed tomography images and clinicopathological features in advanced gastric adenocarcinoma. Oncology Letters, 14(6), 6664-6670.

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MRI-Based Analysis of Cerebellar Tonsils

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MRIs were performed using a 1.5 Tesla (General Electric, GE Healthcare, Chicago, IL, USA) MRI device with the following features: coils, 8-channel neurovascular diffusion, perfusion, spectroscopy, and tractography. The DWIs and the ADC values were evaluated simultaneously by two radiologists and two neurosurgeons. DWIs were taken before and at 6 months after surgery for all 15 cases. For comparison, we used the data for 10 healthy individuals (controls) with normal cranial MRIs (1000 gradient b values). The obtained DWIs were processed on the MRI machines study station, using Advantage Windows, Version 4.6 (GE Medical Systems), and color ADC maps of the brain parenchyma were produced. Three regions of interest (ROIs) were placed, one each in the bilateral central parts of the cerebellar tonsils and one in the anterior part of the bulbus (Figure 2A-D). Mean ADC values were measured separately and automatically (s/mm²). We used the same ROI sizes in the patients and controls (30 mm 2 for the cerebellar tonsils, and 60 mm 2 for the bulbus). When considering the morphology of the tonsils, measurements were performed symmetrically from the central part of the tonsil parenchyma to reduce artifacts. When performing measurements of the bulbus, the anterior parts were preferred to avoid cerebrospinal fluid (CSF) artifacts.

Akgun B., Ozturk S., Taskent I., Surme M.B., Erol F.S, & Yildirim H. (2017). Evaluation of Apparent Diffusion Coefficients in the Cerebellar Tonsils and Bulbus in Chiari Type I Malformations: Comparison Before and After Surgery. Turkish neurosurgery.

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Cardiac MRI Volumetric Analysis

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All CMR images were transported to an AW 4.3 work station (Advantage Windows version 4.3, GE Healthcare, Milwaukee, WI, United States). End-systolic frames and end-diastolic frames were identified by the smallest and largest cavity area using the cine images. Endocardial and epicardial contours were manually traced from base to apex for eight slices. The papillary muscles and trabeculae were excluded from myocardium. End-systolic volume (ESV), end-diastolic volume (EDV), stroke volume (SV), ejection fraction (EF) and cardiac output (CO) were measured and calculated by Report Card 3.7 software using Simpson’s rule.

Li J.H., Zhang H.D., Wang Z.Z., Lu Q.Q., Li D., Lian T.Y., Lv Z.C., Jiang X., Wu Y., Ye J., Zhao S, & Yang Z. (2019). Acute Iloprost Inhalation Improves Right Ventricle Function in Pulmonary Artery Hypertension: A Cardiac Magnetic Resonance Study. Frontiers in Pharmacology, 9, 1550.

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Evaluating Genitourinary Stone Detection Accuracy on CT

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Two board-certified genitourinary radiologists (T.J.V., M.L.W.), blinded to CT system and image type, evaluated images to detect stones by using a clinical workstation (Advantage Windows, Version 4.3; GE Healthcare, Waukesha, Wis). Four 5-mm image series were reconstructed (EID, low kilovolt and mixed kilovolt; PCD, bin 1 and T_L) and randomly displayed in the top row of the dual-monitor clinical workstation with 1-mm images randomly distributed across the lower row. Once a stone was seen, a confidence rating for that stone was assigned to each image series as follows: 1, definitely present; 2, probably present; 3, questionable if present; and 4, not seen. Disagreements were recorded and resolved by consensus. Each stone was rated as present if both radiologists gave a detection confidence rating of 1. Confidence ratings of 2–4 were considered as stone not definitively present. Artifacts were recorded.
Stone volume was measured by using in-house software and contrast-to-noise ratio was calculated for all stones rated as definitely present at both EID and PCD CT that were at least 3 mm³ (ie, > 10 pixels).

Marcus R.P., Fletcher J.G., Ferrero A., Leng S., Halaweish A.F., Gutjahr R., Vrtiska T.J., Wells M.L., Enders F.T, & McCollough C.H. (2018). Detection and Characterization of Renal Stones by Using Photon-Counting–based CT. Radiology, 289(2), 436-442.

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Harmonization of PET-CT Response Assessment Criteria

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All response assessment PET-CT studies were evaluated by a trainee radiologist under supervision of a dual-accredited Radiologist & Nuclear Medicine Physician with 15 years’ experience of reporting oncological PET-CT using specialised software (Advantage Windows Version 4.5, GE Healthcare, Chicago, Illinois, USA) and each of the four IC were applied. To accurately compare all four response assessment scales, each scale was re-classified into a 4-point scale as shown in Table 2 with complete response, partial response, indeterminate and progressive disease categories. Representative examples of these 4 categories are shown in Fig. 1.Table 2

Harmonisation process of each interpretative criteria into standardized 4-point scales.

Response category	NI-RADS	Porceddu	Hopkins	Deauville
1. Complete response	1	0	1 + 2	1 + 2
2. Indeterminate	2	1	3	3
3. Partial response	3	2	4	4
4. Progressive disease	4	3	5	5

Figure 1

Representative cases illustrating post-harmonisation interpretative categories (1 to 4) pre and post-treatment. Row 1 – Complete response, Row 2 – Indeterminate, Row 3 – Partial response, Row 4 – Progressive disease.

Zhong J., Sundersingh M., Dyker K., Currie S., Vaidyanathan S., Prestwich R, & Scarsbrook A. (2020). Post-treatment FDG PET-CT in head and neck carcinoma: comparative analysis of 4 qualitative interpretative criteria in a large patient cohort. Scientific Reports, 10, 4086.

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