FAQ
What tomographic myocardial
studies can Toolbox 4.0 Process
and Review?
What tomographic myocardial studies can Toolbox 4.0 Process
and Review?
SPECT: Tc-99m sestamibi, Tc-99m tetrofosmin, Tl-201, I-123 mIBG
PET: Rb-82, N-13 ammonia, F-18 FDG
The input data must consist of at least one set of short axis myocardial slices.
What quantitative methodology
analysis are available?
What quantitative methodology analysis are available?
The extent and severity of stress perfusion defects
The percent of defect that is reversible
The estimated viability of resting perfusion defects
Myocaridal wall motion and estimated wall thickening, if the study was acquired with ECG-gating.
Re-written from the ground up- A Microsoft.net re-write.
Dynamic, flexible display
Dynamic display architecture allowing for real time screen resizing. Flexible display providing the ability to view multiple studies (prone/supine, AC non-AC, etc.), in a single display simultaneously, or toggle studies.
Smarter and more efficient
Smarter processing, allowing the user to see results as soon as they are available while longer running tasks continue to run in the background. Parallel processing, allowing the system to take advantage of multi-core and multi-processor hardware.
Enhanced slices page to include perfusion slices, functional gated study, quantitative results, polar maps, and AC transmission images in a single display resulting in increased user efficiency and reducing review time.
Improved processing functionality allows for gated and non-gated parameters to be reviewed on a single screen with real time updates of perfusion and functional quantitative results resulting in reduced processing and interpretation time.
New Normal DBs, optimized and DNM530c.
Ability to show borders on all Param screens (Gated , Ungated)
Comprehensive, interactive 3D display including perfusion, extent, reversibility, and coronary overlay.
Automatic interpretation using a decision support system (IDS) to provide an interpretation (2nd opinion) in SmartReport. System provides over 230 rules used to evaluate perfusion, reversibility, viability, function, & clinical findings.
Integrated, automated reporting, powered by Syntermed IDS and SmartReport.
Enhanced quality control providing gated QC, count statistics, patient motion, and imaging artifacts.
Display of indexed functional values (if height and weight are provided).
Memory - when navigating around the app, it remembers the state of all your controls (e.g. Color Bar, toolbars, etc...).
Diastolic dysfunction
Simultaneous Stress/Rest LV Dyssynchrony display
17 segment % uptake
It allows you to identify/verify the various images used, as well as normal file and patient gender.
It allows you to set parameters for quantitative analysis of ungated data: center, radius, apex, base.
It allows you to set parameters for functional images: center, radius, apex, base for each gate.
It allows you to review LV slices in various formats, along with planar images and segmental perfusion scores.
It allows you to review polar map display of perfusion. If you have selected a PET study with rubidium and FDG images, this button will be replaced with a Match/Mismatch button.
It allows you to review quantitative perfusion defect extent.
It allows you to review results of functional analysis: volumes, ejection fraction and wall thickening. Cine of beating slices is also available.
It is a tool for assessing LV viability using the polar maps.
The 3D page is much improved, what
does it show me?
The 3D page is much improved, what does it show me?
It allows you review 3-dimensional display of perfusion, with optional coronary artery overlays. It also allows you to asses wall motion if you play the cine. There are multiple overlays that can be selected from the dropdown menus. Blackout and Blackout Reversibilty maps for example. Left Click and hold to drag the image around to see all the walls of the ventricle.
It allows you to review phase analysis and LV synchrony, derived from functional analysis using SyncTool™.
Yes, Smart Report is our innovative industry leading Myocardial Perfusion reporting tool. It works seemlessly with Toolbox integreating the results into a natural langauge report. Free trials are available.
All the selections on the Verify page for data type and normal file. Also the parameters set for the ungated and gated data.
Can I see the Dicom Header
information on each of data sets?
Can I see the Dicom Header information on each of data sets?
Yes, on the Verify page, left click on File Description on any of the files available. The dicom header information will populate the table in the lower half of the page.
If I make changes to the Params or
the Gated Params limits, when do
the results update?
If I make changes to the Params or the Gated Params limits,
when do the results update?
When you make a change, the results will update when you leave that page. For example, if a change in gated parameters occurs, the EF will not be updated until the user navigates away from the Gated Params screen. If values are changed that require the study to be reprocessed, the reprocessing will automatically be triggered when the user navigates away from the screen.
TID is used as an index of possible Transient Ischemic Dilatation.
It is calculated by dividing the stress ungated endocardial volume by the rest endocardial volume. Values significantly greater than 1.0 may indicate the presence of TID.
Note: For the ECToolbox application, the accuracy and clinical value of this ratio has only been validated for the Dual-Isotope protocol. You should consult the literature regarding the potential clinical value of this ratio.
The QC (Quality Control) button is available at the bottom of this and every screen in the application. Click this button to display a screen of QC findings that have been automatically performed. The color of this button indicates the outcome of QC analysis, in particular the assessment of ECG-gating (if a gated study is present).
green: no gating error was found.
yellow: a minor gating error was found (usually a drop off in counts in the last frame of the gate).
red: a serious gating error was found, one that could potentially affect the functional results.
You should review the results of automatic Gated Quality Control for any study for which the indicator button is red, since certain types of gating errors may compromise the diagnostic value of functional results.
AC means Attenuation Corrected. MC means Motion Corrected. Dyn means a dynamic study.
Some of the Normal Files have an
asterisk beside them, what does
that mean?
Some of the Normal Files have an asterisk beside them, what
does that mean?
An asterisk beside a name indicates a database that has been optimized for use with the Syntermed IDS decision support system.
What is the Ht / Wt in blue at the
top of every page used for?
What is the Ht / Wt in blue at the top of every page used for?
The patient's height and weight can be entered which will be used to calculate the indexed values for ventricular volumes based on Body Surface Area.
Numerical scores representing regional perfusion are shown within segmental boundaries on the Stress, Rest and Reversibility polar maps. Segmental boundaries only are displayed on the other polar maps. The scoring system is a five-point scale:
0 = Normal
1 = Equivocal
2 = Moderate Reduction in perfusion
3 = Severe Reduction in perfusion
4 = Absent perfusion
By default, the scores that are displayed are generated automatically by the application, based on two types of analysis. First, the patient is compared to the selected normal file on a regional basis. The image counts are then analyzed by IDS (Intelligent Decision Support), an artificial intelligence program, which may modify one or more of the initial scores.
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