syngo.viaGet the full picture

Quantify the invisible.

The software delivers powerful quantitative reading functionality for oncology, cardiology and neurology cases and guides you through workflow.

Access Prior Findings, Virtually Anywhere²

Operational Return on Innovation
 

• syngo^®.via¹ offers up to 45% faster³ oncology reads compared to workstations. The RT export functionality now allows seamless collaboration with the oncology department.
• syngo.via as a multimodality client-server solution orches­trates the imaging workflow, from acquisition to reading and sharing. Working off of a single database, cases are instantly available from virtually anywhere², including PACS. Prior studies are automatically pre-fetched, results are available at the tumor board without extra preparation.
• VA20 supports collaboration for radiation oncology. PET-based segmentations can be exported as DICOM RT Structures for use in RT planning. PET-based RT planning allows for innovative patient-friendly therapies by focusing dose on residual viable tumor and sparing other tissue.

Cases are automatically prepared by syngo.via and are accessible from the Quick Worklist. Simply selecting the patient launches the case-specific reading environment.
 

Increased reading efficiency with automated case preparation

To help keep up with productivity gains during acquisition, syngo.via automates many manual and routine steps in the reading workflow.

In oncology, hybrid exams are commonplace, which doubles the available diagnostic information. In addition, the studies are often whole-body exams, further increasing the volume. And many patients have a history of prior studies for comparison. syngo.via automates necessary preparation steps so your workflow starts where it should: with reading. When selecting a patient, the system can be configured so syngo.via:

• has pre-fetched prior examinations.
• fuses hybrid studies and registers them across up to 8 time points.
• starts the appropriate reading environment: for example, the syngo.mCT Oncology Engine.
• displays prior findings.

In cardiology, hybrid scanners are becoming more utilized by the acquisition of CT calcium score and CTA examinations in parallel with the PET or SPECT study. When selecting a patient, the system can be configured so syngo.via:

• has pre-fetched prior examinations.
• starts the appropriate reading environment: for example, the syngo.mCT Cardiology Pro Engine.
• has already removed the rib cage, soft tissue and bloodpool.
• has tracked and labeled the coronary arteries.
• has performed a coronary lumen profile and plaque characterization.
• has selected the appropriate normals database for perfusion analysis.

In neurology, PET brain imaging is becoming more utilized due to the aging population and development of new biomarkers. Depending on the type of procedure performed, the system can be configured so syngo.via:

• starts the appropriate reading environment: for example, syngo^®.PET Database Comparison
• performs fusion to a CT and/or MR dataset
• performs fusion to a normals database for visual analysis
• performs registration to a reference brain template
• provides predefined regions of interest for quantification

With all preparation work being performed by syngo.via, the case interpretation can begin immediately upon launching. syngo.via increases reading efficiency and helps reduce report turnaround time.

Workflow integration from case preparation to results sharing
syngo.via is more than a diagnostic tool: it supports your workflow all the way to the tumor board presentation. From processing to diagnosis and sharing, syngo.via provides a single, common platform. Working on the same dataset preserves results and eliminates redundancies. First, the technologist can prepare the case. Next, the reading physician creates findings and documents the diagnosis. Finally, the case and its results can be elegantly presented in the tumor board meeting using the Findings Navigator.

RIS/PACS workplaces are often limited to 2D/3D image display and are not designed for hybrid reading or PET quantification. syngo.via overcomes these limitations through its advanced visualization and quantification functionality and can be fully integrated into the RIS/PACS workstation of all major vendors.
 

Reduced reading time
With a single database, your technologist can now prepare your cases before placing them in the reading worklist. Routine tasks will be completed, so more time is available for patient care and reading. All cases are available instantly, without sending studies across the network.

Advanced PET and CT reading on PACS
With syngo.via, you can freely navigate the entire dataset, use advanced PET and CT segmentation and quantification tools, and document your findings – right on the RIS/PACS reporting workplace. Cases can now be interpreted and reported with access to full clinical information, without depending on parallel ranges or switching between reporting and reading workplaces.

Live access anytime, virtually anywhere²
On your PACS, at the tumor board meeting, in the OR, or even from home, live access to all cases and tools is just a login away on any PC.* Referring physicians can access WebReports to review findings and related images. This creates new possibilities, like easy second opinions and on-call scenarios, using the Findings Navigator to elegantly present cases, or using 3D visualization for surgery planning and patient communication. syngo.via frees medical images from the local workstation to bring the power of hybrid imaging to clinical routine.
*with a network connection and meeting minimum hardware requirements.

One Platform for All Modalities and Needs

A department’s image management and reading solution is a key part of its infrastructure. As such, customers rely on uptime and state-of-the-art functionality to remain produc­tive and competitive. The syngo.via service offering helps customers keep up with innovations at a predictable cost.
The single-user syngo.via workstation, which does not require a server connection, runs all available syngo.via applications. Server clustering allows customers to go beyond five users, at a 60% discount.

 
Whether it is the CT or MR portion of a hybrid examination or a standalone CT or MR study in a shared service model, collaboration between the molecular imaging and radiology departments is greatly simplified when the same tools are used. Even a common syngo.via server can be shared across departments and their users, effectively extending the financial benefits of a shared service model from the scanner to the reading solution.

The syngo.via client-server architecture is a modular platform that is fully customizable with a large selection of advanced applications to match specific modalities and case mix requirements.
 

Supported modalities include:
 

• Positron Emission Tomography
• Single Photon Emission Computed Tomography
• General Nuclear Medicine
• Computed Tomography
• Magnetic Resonance
• Angiography
• Radiography and Fluoroscopy
• Ultrasound

Image management and visualization solutions are part of the infrastructure of the department. Uptime and state-of-the-art functionality are required to remain productive and competitive. And, the infrastructure has to grow with future needs.
 

The number of syngo.via client licenses, applications and engines can be configured independently with regard to timing and quantity.⁴

Investment protection with cost-effective scalability and maintenance
The syngo.via service agreement keeps the system state-of-the-art with automatic remote updates. Uptime is improved with server-grade hardware that is remotely monitored and centrally managed. And with the flexible licensing model, additional user and application licenses can be configured as needed.

State-of-the-art applications
Remote updates become automatically available on the server and ready for installation by the local administrator. All users can immediately benefit from the continuous innovations.

Improved uptime
Server-grade hardware in a controlled server room can be centrally managed and remotely monitored. Siemens Remote Service monitors the server continuously for preventative maintenance to ensure system performance.

Cost-effective scalability
The flexible licensing model of concurrent users allows additional users and application licenses to be configured at any time.⁴ Existing computers can also be used as syngo.via clients, which can run on any standard PC meeting minimum requirements.

Quantify the invisible.

The software¹ guides you through the entire workflow - it automatically pre-processes images and delivers powerful quantitative reading functionality.

Due to its unique capability of imaging and quantifying biological processes, molecular imaging is the modality of choice for many complex clinical questions in the areas of oncology, cardiology and neurology.
To fully exploit the quantitative capabilities of recent scanner innovations, such as Biograph™ mCT, advanced applications are available from Siemens that can be configured on syngo.via.

The most recent innovations allow for confident and efficient quantitative assessment of:
 

• blood flow in cardiology
• therapy response in oncology
• dementia in neurology
   

The complete overview of molecular imaging applications on syngo.via can be found under Technical Details.

With its unique capability to accurately detect metabolic changes before anatomical changes are visualized, PET/CT has become instrumental for early detection and staging, as well as therapy response assessment. Quantitative therapy response criteria are well established in CT with RECIST and WHO. In PET, current practice incorporates SUV_max as the major quantitative parameter. However, since SUV_max is essentially a single voxel volume of interest (VOI), it is subject to larger statistical variation compared to other SUV measurement criteria. SUV_peak offers a metric that is reproducible while also being robust to noise.

SUV_max is subject to significant statistical variation, where SUV_peak is the mean value of the voxels within a fixed sphere of one cubic cm volume, centered on the hottest area of the tumor. This makes it close to SUV_max in terms of its representation of the maximum tumor metabolism, yet it avoids the statistical fluctuations of SUV_max due to incorporation of a larger number of voxels within the hottest tumor area. SUV_peak is easy to obtain in routine clinical use; the SUV_peak alogorithm automatically identifies the hottest 1 cm³ sphere within a VOI, which ensures reproducibility.

Quantification of SUV ratio for Amyloid Plaque

Several studies have illustrated that in certain clinical cases, visual assessment alone may lead to inconclusive or false reports which can be a source of risk to practices and patients. In specific, borderline cases and those where the intensity of amyloid uptake is insufficient, it may become challenging to accurately interpret based on visual assessment alone.

Quantify the invisible.

The software¹ delivers powerful quantitative reading functionality for oncology, cardiology and neurology cases and guides you through the workflow.

Clinical Return on Innovation
 

• Oncology: Reproducible PERCIST metrics for confi­dent therapy response assessment, allowing for early therapy adjustment.
• Neurology: Reproducible SUVratio and database comparison aids PET amyloid exams in providing appropriate diagnostic evaluations and therapy planning.
• Cardiology: Reproducible blood flow in ml/min supports detection of triple vessel disease for possible intervention.

The new syngo.via version VA20 adds features to oncology that complete the quantitative trending workflow: The SUV_peak metric is complemented with automatic detection of liver and blood pool background SUV, providing PET response criteria in solid tumors (PERCIST). Second, the new trending graph capability plots quantification metrics over time for quick visual therapy response assessment — a great addition to the display of up to eight time points and the quantification table. Together with the reproduc­ible quantification capabilities of Biograph mCT, follow-up studies can now be evaluated with confidence. Further, dynamic studies can be evaluated with time activity curves.

Quantitative assessment of amyloid PET studies with SUVr are further enhanced in VA20 with a dedicated amyloid normals database. With a clear dedication to quantitative assessments, VA20 further offers the opportunity to create custom normal databases to match an institution’s patient population. Biograph mCT’s finest volumetric resolution⁶ of 87mm⁷, based on 400x400 matrix recon, and Neuro AC capabilities match the requirements for the quantitative assessment of amyloid scans.

For cardiology, VA20 introduces the hybrid coronary view. A correlative view of stenotic areas on the CTA together with any hemodynamic impact based on PET results can be displayed. Myocardial surface projections can be selected from quantitative parameters including perfusion, blood flow, flow reserve, wall thickening and wall motion. Combined with the SMART Cardiac registration and single injection blood flow capabilities of Biograph mCT, a comprehensive solution for routine quantitative cardiac assessment is now available.