Syngo - CT Dental IFU VB40 SAPEDM C2-via-DT.621.02.03.02 Online PDF

syngo.
via
Instructions for Use – syngo.CT Dental
VB40
siemens-healthineers.com
syngo.via
Instructions for Use – syngo.CT Dental
VB40
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CAUTION
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Used with the safety alert symbol, indicates a hazardous situation which, if not
avoided, could result in minor or moderate injury or material damage.
CAUTION consists of the following elements:
• Information about the nature of a hazardous situation
• Consequences of not avoiding a hazardous situation
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4 syngo.CT Dental | Instructions for Use

Print No. C2-via-DT.621.02.03.02
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WARNING
:$51,1*
Indicates a hazardous situation which, if not avoided, could result in death or serious
injury.
WARNING consists of the following elements:
• Information about the nature of a hazardous situation
• Consequences of not avoiding a hazardous situation
• Methods of avoiding a hazardous situation
syngo.via | VB40 5
Legend

Table of contents
1 syngo.CT Dental 9
1.1 Functionality of syngo.via 10
1.2 Safety information 11
1.2.1 General safety information 12
1.2.2 Safety information on training 13
1.2.3 Safety information on disposal 13
1.2.4 Safety information on patient data 14
1.2.5 Safety information on lossy compressed images 15
1.2.6 Safety information on algorithms 15
1.2.7 Safety information on the lingual marker 16
1.2.8 Safety information on true-size printing 16
1.2.9 Safety information on Rapid Results Technology 17
1.3 Image requirements of syngo.CT Dental 17
1.4 CT Dental tools and shortcuts 18
1.5 Layouts 21
1.6 Hiding and displaying the range parameter panel 23
2 The CT Dental workflow overview 25

2.1 Adjusting the dental range 26
2.2 Drawing the centerline 28
2.3 Correcting the centerline 28
2.4 Deleting and redrawing the centerline 29
2.5 Checking and positioning the lingual marker 30
2.6 Reviewing panoramic result images 31
2.7 Adjusting the parameters of the panoramic result
images 32
2.8 Reviewing paraxial result images 32
2.9 Defining the start and end point of the paraxial range 33
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Table of contents
2.10 Adjusting the parameters of the paraxial result images 34

2.10.1 Defining the distance or the number of the
paraxial result images 35
2.10.2 Locking and unlocking the number of
2.10.3 Defining the dimensions of the paraxial
result images 36
2.10.4 Defining the orientation of the paraxial
result images 37
2.10.5 Changing the numbering of the paraxial
result images 38
2.10.6 Changing the viewing direction of the
2.11 Defining the paraxial lines interactively 39
2.12 Resetting paraxial lines 40
2.13 Applying range presets 40
2.14 Saving user-specific range presets 41
2.15 Deleting user-specific range presets 41
2.16 Marking the mandibular canal 41
2.17 Removing the mandibular canal markers 43
2.18 Saving ranges 43
2.19 Saving and sending images for true size printing 44
2.20 Sending images for true size printing 45
3 Glossary 49
Index 51

syngo.CT Dental 1
1 syngo.CT Dental
In the following sections, you find procedural information and
background information on syngo.CT Dental.
Indications for use
syngo.CT Dental postprocessing image analysis software for CT
volume data sets that has been acquired continuously with
computed tomography (CT) systems. The software provides the
following digital image processing and visualization tools:
• Basic reading tools: Multiplanar Reconstruction (MPR), Maximum
Intensity Projection (MIP), Volume Rendering Technique (VRT),
Minimal Intensity Projection (MinIP).
• Basic geometric measurement tools: distance line, polyline,
marker, arrow, angle.
• Dedicated dental visualization tools: Dental panoramic views
(curved MPRs) and dental paraxial views (cross-section MPRs)
that are calculated based on a manually defined centerline.
• A tool to manually outline the mandibular canal.
• A tool that allows paraxial and panoramic result images to be
saved as dental range series.
• True Size (1:1) printing of panoramic and paraxial images to allow
anatomy to be printed in its actual size on the film sheet.
The specific visualization of panoramic and paraxial views of the
dental structures facilitates viewing, manual identification, and
marking of dental pathologies and anatomy (for example, the
position of the mandibular canal that needs to be preserved during
dental interventions, such as dental (implant) surgery).
Reporting and documentation of results is facilitated by the creation
of ranges and snapshots, True Size (1:1) printing on DICOM printers,
and by the use of a reporting tool.
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Intended use
syngo.CT Dental is used for diagnostic imaging of the mandible and
maxilla for 3D evaluation of dental anatomy, such as the planning
of dental (implant) surgery.
Contraindications
There are no known specific situations that contraindicate the use of
this device.
Legal notes
The functions described in this document are not commercially
available in all countries. Some functions may be protected by a
software license that is currently restricted for regulatory reasons.
Some functions may be available with an optional software license.
Please contact your local Siemens Healthineers representative for
further details.
1.1 Functionality of syngo.via

syngo.via is a software solution intended to be used for viewing,
manipulation, communication, and storage of medical images. It can
be used as a stand-alone device or together with a variety of cleared
and unmodified syngo based software options. The functionality of
the syngo.via software that is used in combination with a syngo.CT
medical device is described in the syngo.via Basic Operator Manual.
The syngo.via Basic Operator Manual and the syngo.via
Administrator Manual are the Instructions for Use of syngo.via.

syngo.CT Dental 1
 WARNING
Not observing the Instructions for Use and the safety

information of the medical device!
Injury to the patient.
◆ Always observe the Instructions for Use and follow the safety
instructions of the medical device.
◆ Always use this Instructions for Use document in conjunction
with all Instructions for Use documents provided.
1.2 Safety information

Follow the safety information in this document.

To ensure the safe use of your product and the safety of people, you
must adhere to the safety information provided in the Instructions
for use documents. In addition, also observe your country-specific
regulations and guidelines.
Safety information is located in the safety section and repeated

within context where a hazardous situation may occur. To make sure
safety information is understood, always read it in context of the
situation.
WARNING and CAUTION are highlighted in the text:
Indicates a hazardous situation which, if not avoided, could result

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in death or serious injury.
Indicates a hazardous situation which, if not avoided, could result

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in minor or moderate injury.
WARNING and CAUTION have the same structure. The following

example CAUTION instructs you how to read a WARNING or a
CAUTION:
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 CAUTION
This text describes the hazardous situation: Images with lossy

compression are used for diagnosis!
This text describes the hazard: Wrong diagnosis.
◆ This text describes how to avoid the hazardous situation:
Always verify your evaluation results with the original
DICOM images (first reader duty).
◆ Never use lossy ...
1.2.1 General safety information

For the secure operation of your medical device, it is the
responsibility of the system owner to ensure that each person who
operates the system reads and understands the provided Instructions
for Use.
 WARNING
Not observing the Instructions for Use and the safety

information of the medical device!
◆ Always observe the Instructions for Use and follow the safety
instructions of the medical device.
◆ Always use this Instructions for Use document in conjunction
with all Instructions for Use documents provided.

syngo.CT Dental 1
1.2.2 Safety information on training

 WARNING
Operation of the medical device by non-trained users!

◆ Only trained and qualified users, certified in accordance with
country-specific regulations, are authorized to operate the
system. For example, physicians, radiologists, or
technologists.
For appropriate training, contact your Representative at
Siemens Healthineers.
 CAUTION
User is not instructed in how to operate the applications!

Wrong basis for diagnosis.
◆ The operator must be qualified to use the applications.
1.2.3 Safety information on disposal

 CAUTION
Incorrect disposal of the system or parts of the system!

Pollution of the environment.
◆ System components hazardous to persons or the
environment must be disposed of with care and in
compliance with legally binding ordinances.
Examples of environmentally relevant components are
accumulators and batteries, transformers, capacitors,
monitor picture tubes, and phantoms.
For details, contact your local Representative at Siemens
Healthineers.
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1.2.4 Safety information on patient data

 CAUTION
Displayed information about changed patient data is not

observed!
Wrong diagnosis due to patient data that has not been
updated.
◆ Always read and observe the displayed information about
changed patient data.
Follow the instructions provided with the displayed
information.
Check all results and delete results that include patient data
that has not been updated.
 CAUTION
Patient data is changed using the correct and rearrange

function while a time-critical workflow for this patient is in
progress!
Delayed diagnosis due to restart of workflow.
◆ Do not perform correct and rearrange actions while time-
critical cases are in progress. Always check the Workflows
section in the Job View for time-critical workflows.
 CAUTION
Loading image data sets of different patients!

Mix-up of patients and incorrect diagnosis possible.
◆ When loading reference and model series, make sure that
you select the data of the correct patient.

syngo.CT Dental 1
1.2.5 Safety information on lossy compressed images

 CAUTION
Images with lossy compression are used for diagnosis!

◆ Always verify your evaluation results with the original
DICOM images (first reader duty).
◆ Never use lossy compressed images for primary diagnosis.
◆ Check the image text for information on lossy compression
before starting an evaluation.
1.2.6 Safety information on algorithms

 CAUTION
Incorrect input data set used with algorithms leads to incorrect

results!
◆ Make sure that you use the specified input data.
◆ Verify algorithm results with the original data set.
 CAUTION
Algorithms may return inaccurate results or incomplete

anatomy information!
Wrong basis for diagnosis or treatment.
◆ Before diagnosis or further processing, check and correct
algorithm results. For example, results from segmentation or
masking.
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1.2.7 Safety information on the lingual marker

 CAUTION
Incorrect automatic positioning of the lingual marker!

◆ Check that the position of the lingual marker is correct.
1.2.8 Safety information on true-size printing

 CAUTION
True Size printouts depend on printer settings, calibration, or

other factors!
True Size printouts do not correlate to the real anatomic
dimensions.
◆ Check and validate the precision limitations when printing in
True Size.
Usage of True Size printouts is in your own responsibility.
Always compare the image scale bar on printed images with
a physical measurement unit, for example, a ruler.

syngo.CT Dental 1
1.2.9 Safety information on Rapid Results Technology

 CAUTION
Automatically saved results may be sent to another DICOM

node!
Wrong diagnosis due to wrong information.
◆ Check all results of the currently active workflow. If
applicable, remove intermediate or incorrect results.
Send only correct results to other DICOM nodes, such as
image viewers or PACS.
1.3 Image requirements of syngo.CT Dental

syngo.CT Dental images must meet the following image
requirements:
• Monochrome CT images of image type ORIGINAL and derived
secondary Dual Energy volumes (at least three slices)
• Equidistant slices (with a tolerance value of 0.31 mm) with
identical orientation
• Square images with a matrix size of 512 x 512 pixels and an
identical pixel size for x and y
• The following DICOM attributes must be valid:
– pixel representation = 0 or 1
– sample per pixel = 1
– bits allocated = 16 bit
– bits used = 12 bit or 16 bit
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If more than one series meets the image requirements, the series to
be loaded is selected according to the following criteria:
• Series description contains "DENTAL" or the modification string
"VIA dt" is used
• Sharpest kernel
• Latest series
• IMAR (Iterative Metal Artifact Reduction)
1.4 CT Dental tools and shortcuts

The following table shows available tools and functions and
corresponding keyboard shortcuts:
Icon Description Available in Key-

board
Case Range Corner Context shortcut
Naviga- Parame- menu menu
tor ter Panel
Delete Yes Yes – Yes Alt + Del

Deletes the centerline and all In center-
result images and allows you line edit-
to start new dental ranges. ing
( Page 29 Deleting and mode:
redrawing the centerline) Del
Edit Yes Yes – Yes Alt + E

Starts the centerline editing
mode and allows you to move
or modify the centerline.
( Page 28 Correcting the cen-
terline)

syngo.CT Dental 1

board
tor ter Panel
Outline Canal Yes Yes – – Alt + M

Starts the mandibular canal
outline mode and allows you
to draw an orientation line in
the panoramic result images.
You can define the actual
mandibular canal by setting
markers on the paraxial result
images. ( Page 41 Marking
the mandibular canal)
Save and Print All Yes Yes – – Alt + P

Saves all result images, includ-
ing the reference images, and
sends them to the film sheet to
print in true size. You can
arrange the images on the film
sheet or apply another layout.
( Page 44 Saving and send-
ing images for true size print-
ing)
Save All Yes Yes – – Alt + S

Saves all result images, includ-
ing the reference images. Saved
images will be available in the
Results section of the Series
panel. ( Page 43 Saving
ranges)
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1 syngo.CT Dental

board
tor ter Panel
Hide Panel Yes Yes – – Alt + H

Hides or shows the range
parameter panel. Click the
Hide Panel icon to hide or
show the range parameter
panel and switch between the
With Parameters layout or
Without Parameters layout.
( Page 23 Hiding and dis-
playing the range parameter
panel)
Save Preset – Yes – – –

Opens the Save as Range Pre-
set dialog. ( Page 41 Saving
user-specific range presets)
Delete Preset – Yes – – –

Opens the Range Preset Dele-
tion dialog. ( Page 41 Delet-
ing user-specific range presets)
Swap Order – Yes – – –

Changes the numbering of the
paraxial result images from
the start marker to the end
maker and vice versa.
( Page 38 Changing the num-
bering of the paraxial result
images)

syngo.CT Dental 1

board
tor ter Panel
Swap View – Yes – – –

Changes the viewing direction
for the paraxial result images
from the start marker to the
end marker and vice versa.
( Page 38 Changing the view-
ing direction of the paraxial
result images)
Reset All – Yes – – –

Resets the paraxial result
images to the current parame-
ter settings. ( Page 40 Reset-
ting paraxial lines)
Delete All – Yes – – –

Deletes all paraxial result
images and allows you to add
paraxial result images man-
ually in the paraxial reference
segment. ( Page 39 Defining
the paraxial lines interactively)
1.5 Layouts
The layouts provided by syngo.CT Dental depend on your current
monitor configuration. There are dedicated layouts for single-
monitor and dual-monitor configurations and also for different
aspect ratios (landscape, portrait, and wide screen orientation).
For each monitor configuration, syngo.CT Dental provides a With
Parameters layout (default layout) and a Without Parameters
layout.
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In the Without Parameters layout, the range parameter panel is not

displayed.
The following example shows the With Parameters layout for a
single-monitor configuration. The images in segments (3), (4), and (5)
are displayed after the centerline has been defined.
(1) MIP segment

Displays a sagittal MIP image of the jaw on which you can
define the dental range, the orientation of the dental range, and
the height of the paraxial result images. You can also define the
position of the reference plane (red line) which is used for
panoramic and paraxial reference images.
(2) Panoramic reference segment
In the panoramic reference segment, you can define the
centerline. After the centerline is defined the workflow can
begin and the segment displays the panoramic reference image.
The panoramic reference image displays the panoramic lines on
the reference plane.

syngo.CT Dental 1
(3) Paraxial reference segment

Displays the paraxial reference image on which you can define
the paraxial range. The paraxial reference image displays the
paraxial lines along the centerline.
(4) Panoramic results segment
(5) Paraxial results segments
(6) Range parameter panel
In the range parameter panel, you can define the parameters of
the panoramic and paraxial result images and adjust range
presets. The CT Dental specific icons are also available in the
range parameter panel.
(7) Orthogonally synchronized MPR segments
The orthogonal MPR images display the currently selected
paraxial result image. You can perform measurements on these
MPR images.
(8) VRT segment
1.6 Hiding and displaying the range parameter

panel
You can hide or display the range parameter panel. If the range
parameter panel is displayed, the With Parameters layout is applied;
if it is not displayed, the Without Parameters layout is applied.
◆ In the Case Navigator, click the Hide Panel icon to hide or display
the range parameter panel.
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The CT Dental workflow overview 2
2 The CT Dental workflow

overview
The CT Dental workflow allows you to create panoramic range series
and paraxial range series of the jaw. The range series provide
information on the anatomical structure of the jaw that can be used,
for example, for presurgical planning purposes.

You can repeat the following steps to create several range series
from the same study, to cover single teeth or the upper and the lower
jaw successively.
The following steps represent a typical workflow:

1 Adjust the dental range and the orientation of the reference plane.
( Page 26 Adjusting the dental range)
2 Select the reference plane for the reference images and draw the
centerline. ( Page 28 Drawing the centerline)
3 Check and position the lingual marker. ( Page 30 Checking and
positioning the lingual marker)

You may skip steps 4 and 5 by applying a range preset.
( Page 40 Applying range presets)
4 Check and define the panoramic result images.

• ( Page 31 Reviewing panoramic result images)
• ( Page 32 Adjusting the parameters of the panoramic result
images)
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2 The CT Dental workflow overview
5 Check and define the paraxial result images.

• ( Page 32 Reviewing paraxial result images)
• ( Page 33 Defining the start and end point of the paraxial
range)
• ( Page 34 Adjusting the parameters of the paraxial result
images)
• ( Page 39 Defining the paraxial lines interactively)
6 If required, mark the mandibular canal. ( Page 41 Marking the
mandibular canal)
7 Save the ranges or print the result images in true size.
• ( Page 43 Saving ranges)
• ( Page 44 Saving and sending images for true size printing)
• ( Page 45 Sending images for true size printing)
2.1 Adjusting the dental range

You can adjust the position of the dental range, as well as the
position and the orientation of the reference plane by using the hight
lines in the MIP segment.

(1) Height lines

The upper and the lower line define the upper and the lower
limit of the paraxial result images and are called height lines.
They are moved symmetrically.
(2) Range positioning line
The middle line represents the middle of the dental range and is
called the range positioning line.
(3) Reference plane
The red line is used as the panoramic and the paraxial reference
image.
The reference plane is initially positioned in the middle of the
dental range and is not visible as it is hidden under the range
positioning line.
1 In the MIP segment, click one of the height lines and drag the
mouse pointer up or down to adjust the height of the paraxial
result images.
The Image Height parameter in the Paraxial Images tab of the
range parameter panel is adapted accordingly.
2 In the MIP segment, click the pivot on the range positioning line
and drag the mouse pointer up or down to adjust the position of
the dental range.
The reference plane is initially positioned in the middle of the
dental range.
3 If required, click the pivot on the range positioning line and drag
the mouse pointer left or right to pan the image in the panoramic
reference segment.
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4 Click the range positioning line near the segment border and drag
the mouse pointer up or down to change the orientation of the
reference plane.
The position of the dental range, the initial position of the reference
plane, and the orientation of the reference plane are defined as
required.
2.2 Drawing the centerline

In the panoramic reference segment, you can draw the centerline
that is used as a base to define ranges of panoramic and paraxial
result images.
The centerline is always displayed on the reference plane which is
used as the panoramic and the paraxial reference image. The
position and the orientation of the reference plane is indicated by the
red reference plane line in the MIP segment.
Use the scroll wheel in the panoramic reference segment to adjust
the reference plane. The base points of the centerline are moved to
the new position of the reference plane and remain visible.
1 In the panoramic reference segment, click the jaw to set the start
point.
A magenta rubber band is displayed between the mouse pointer
and the start point.
2 Click consecutive base points along the jaw to draw the centerline
and double-click to finish the drawing.
The centerline is displayed in red. The start point of the centerline is
labeled with S (Start) and the end point is labeled with E (End). The
panoramic and paraxial result images are calculated according to
the current parameters in the range parameter panel and are
displayed in the panoramic and paraxial results segments.
2.3 Correcting the centerline

You can correct the centerline by modifying or moving it. This causes
a recalculation of the panoramic and paraxial result images.

✓ The centerline is defined.

1 In the range parameter panel, click the Edit icon.
– or –
In the panoramic reference segment or in the paraxial reference
segment, choose Edit Centerline from the context menu.
All unsaved result images and the mandibular canal markers will
be lost. The centerline is displayed in magenta and its base points
are displayed in white.
2 In the panoramic reference segment, click the centerline between
two base points and drag the mouse pointer to move the entire
centerline.
– or –
To modify the centerline, click one of the white base points and
drag it to the required position. It is also possible to move the start
or end point.
3 To finish editing, click on the area next to the centerline.
– or –
Click the Edit icon again.
The result images are recalculated accordingly.
2.4 Deleting and redrawing the centerline

You can delete and redraw the centerline to define new panoramic
and paraxial ranges. All unsaved result images and the mandibular
canal markers will be lost.

You can create successive range series from the same study. Save the
ranges then draw a new centerline to create a new range series.
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1 In the range parameter panel, click the Delete icon.
– or –
In the panoramic reference segment or in the paraxial reference
segment, choose Delete Centerline from the context menu.
The mouse pointer changes into a pen.
2 In the panoramic reference segment, draw a new centerline.
( Page 28 Drawing the centerline)
The result images are recalculated accordingly.
2.5 Checking and positioning the lingual marker

The lingual marker is displayed as a yellow cross in the reference
segments and defines the lingual side of the centerline. The position
of the lingual marker is synchronized between the reference
segments.
 CAUTION
Incorrect automatic positioning of the lingual marker!

◆ Check that the position of the lingual marker is correct.


1 Check the position of the lingual marker.
2 If required, click the lingual marker and drag it to the lingual side
of the centerline to reposition it.
On the paraxial result images, the orientation labels B (Buccal) and
L (Lingual) are defined according to the position of the lingual
marker.
2.6 Reviewing panoramic result images

After you have defined the centerline, the panoramic result images
are calculated according to the current parameters in the range
parameter panel.
In the panoramic reference segment, the position of the panoramic
result images is indicated by white panoramic lines. The
corresponding panoramic result images are displayed in the
panoramic results segment.
1 Click a panoramic line to display the corresponding panoramic
result image.
– or –
In the panoramic results segment, scroll through the panoramic
result images.
The red panoramic line indicates the position of the currently
displayed panoramic result image.
2 Modify the panoramic result images, if required.
( Page 32 Adjusting the parameters of the panoramic result
images)
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2.7 Adjusting the parameters of the panoramic

result images
In the Panoramic Images tab of the range parameter panel, you can
modify the parameters of the panoramic result images as required.
✓ The With Parameters layout is applied.
1 In the Panoramic Images tab of the range parameter panel, enter
an odd value in the Number of Images field.
2 Enter a value in the Distance between Images field.
The Image Thickness corresponds to the slice thickness that is
also indicated by the SL value on the panoramic result images.
3 Enter a value in the Image Thickness field.
The panoramic result images are recalculated accordingly.

The viewing direction of the panoramic result images is indicated by
small white arrows in the panoramic reference segment and cannot
be changed.
2.8 Reviewing paraxial result images

After you have defined the centerline, the paraxial result images are
calculated according to the parameters in the range parameter
panel.
In the paraxial reference segment and in the panoramic results
segment, the position of the paraxial result images is indicated by
white paraxial lines. By default, the paraxial lines are distributed
equidistantly.
The corresponding paraxial result images are displayed in the
paraxial results segments.


1 In the paraxial reference segment, click a paraxial line to display
the corresponding paraxial result image.
– or –
Scroll through the paraxial result images and click a paraxial
result image.
The red paraxial line indicates the position of the currently
selected paraxial result image. A white line indicates which
paraxial result images are currently visible in the paraxial results
segments.
The position of the currently selected paraxial result image is
zoomed and displayed in the orthogonally synchronized MPR
segments, in which you can perform measurements.
2 Modify the paraxial result images, if required.
• ( Page 33 Defining the start and end point of the paraxial
range)
• ( Page 34 Adjusting the parameters of the paraxial result
images)
• ( Page 39 Defining the paraxial lines interactively)
2.9 Defining the start and end point of the

paraxial range
In the paraxial reference segment, the first and last paraxial result
image are represented by a yellow start marker and a yellow end
marker.
You can move the start marker and the end marker to limit the
paraxial range to the area of interest in the jaw. For example, you
can cover a single tooth only.
When you move the start marker or the end marker, the paraxial
result images are distributed equidistantly. All manual interactions
that you have performed on the paraxial range will be lost.
( Page 39 Defining the paraxial lines interactively)
syngo.via | VB40 33

1 Lock or unlock the Number of Images. ( Page 36 Locking and
unlocking the number of paraxial result images)
2 Click and drag the yellow start marker or the yellow end marker
along the centerline to the required position.
The paraxial result images are recalculated accordingly.
2.10 Adjusting the parameters of the paraxial

result images
In the Paraxial Images tab of the range parameter panel, you can
define parameters for the calculation of the paraxial result images.
✓ The Number of Images is unlocked.
◆ Define the distance or the total number of the paraxial result
images. ( Page 35 Defining the distance or the number of the
paraxial result images)
– or –
Lock or unlock the number of paraxial result images.
( Page 36 Locking and unlocking the number of paraxial result
images)
– or –
Define the dimensions of the paraxial result images.
( Page 36 Defining the dimensions of the paraxial result images)
– or –
Define the orientation of the paraxial result images.
( Page 37 Defining the orientation of the paraxial result images)

– or –
Change the numbering of the paraxial result images.
( Page 38 Changing the numbering of the paraxial result
images)
– or –
Change the viewing direction of the paraxial result images.
( Page 38 Changing the viewing direction of the paraxial result
images)
2.10.1 Defining the distance or the number of the paraxial

result images
You can either specify the total number of paraxial result images
between the start marker and the end marker or you can specify the
distance between the paraxial result images.
All manual interactions that you have performed on the paraxial
range will be lost. ( Page 39 Defining the paraxial lines
interactively)
✓ The Number of Images is unlocked.
◆ In the Paraxial Images tab of the range parameter panel, enter a
value in the Number of Images field.
The specified number of paraxial result images is distributed
equidistantly between the start marker and the end marker. The
Distance between Images parameter is adapted accordingly.
– or –
Enter a value in the Distance between Images field.
The paraxial result images are distributed according to the
specified distance. The Number of Images parameter is adapted
accordingly.
syngo.via | VB40 35
2.10.2 Locking and unlocking the number of paraxial result

images
You can lock or unlock the Number of Images.
When the Number of Images is unlocked, you can edit the values in
the Number of Images field and in the Distance between Images
field. When you move the start marker or the end marker in the
paraxial reference segment, the number of paraxial result images
changes according to the specified distance between the paraxial
result images. ( Page 33 Defining the start and end point of the
paraxial range)
When the Number of Images is locked, you cannot edit the values in
the Number of Images field and in the Distance between Images
field. When you move the start marker or the end marker in the
paraxial reference segment, the distance between the paraxial result
images changes according to the specified number of paraxial result
images. ( Page 33 Defining the start and end point of the paraxial
range)
The Number of Images is unlocked by default.
◆ In the Paraxial Images tab of the range parameter panel, click the
Lock number of images icon.
– or –
Click the Unlock number of images icon.
2.10.3 Defining the dimensions of the paraxial result images

You can define the Image Thickness, the Image Height, and the
Image Width of the paraxial result images.


The Image Thickness corresponds to the slice thickness that is
also indicated by the SL value on the paraxial result images.
1 In the Paraxial Images tab of the range parameter panel, enter a
value in the Image Thickness field.
The Image Height corresponds to the distance between the height
lines in the MIP segment and the green dotted lines in the
panoramic results segment.
You can roughly define the Image Height by moving the height
lines in the MIP segment. In the range parameter panel, you can
define the Image Height in a more precise way.
When you adjust the Image Height, the paraxial result images are
zoomed automatically to fit in the paraxial result segments.
2 In the MIP segment, click one of the height lines and drag the
mouse pointer up or down.
– or –
In the Paraxial Images tab of the range parameter panel, enter a
value in the Image Height field.
The Image Width is indicated by the length of the paraxial lines in
the paraxial reference segment.
3 In the Paraxial Images tab of the range parameter panel, enter a
value in the Image Width field.
2.10.4 Defining the orientation of the paraxial result images

If you have rotated the reference plane, you can decide whether to
calculate the paraxial result images orthogonal to the reference
plane or orthogonal to the scan direction. Depending on your
selection, the paraxial lines in the panoramic results segment are
displayed orthogonal or skewed.
If the reference plane is not rotated, the two options will produce
identical paraxial result images.
syngo.via | VB40 37

◆ In the Paraxial Images tab of the range parameter panel, select
the Orthogonal to Reference Plane option.
The paraxial result images are calculated orthogonal to the
reference plane and the panoramic result images, even if the
reference plane is rotated.
– or –
Select the Orthogonal to Scan Direction option.
The paraxial result images are calculated orthogonal to the scan
direction.
2.10.5 Changing the numbering of the paraxial result images

Numbers are displayed on the paraxial result images and in the
paraxial reference segment. By default, the paraxial result images
are numbered from the start marker to the end marker. You can
reverse the numbering of the paraxial result images.
Swap Order icon.
2.10.6 Changing the viewing direction of the paraxial result

images
The viewing direction of the paraxial result images is indicated by the
small white arrows in the paraxial reference segment. By default, the
viewing direction goes from the start marker to the end marker. You
can change the viewing direction of the paraxial result images. The
orientation labels B (Buccal) and L (Lingual) on the paraxial result
images are adapted accordingly.


Swap View icon.
2.11 Defining the paraxial lines interactively

In the paraxial reference segment, you can interactively modify the
position of the paraxial result images by deleting, adding, or moving
the paraxial lines until the paraxial reference segment displays
paraxial lines at all required positions.
You can either modify the current paraxial range, or you can start to
define a new paraxial range by deleting all paraxial lines.
When you delete or add paraxial lines, the value of the Number of
Images field in the range parameter panel is adapted accordingly.
You cannot delete the start marker and the end marker.

You can expand a segment by double-clicking it.
1 To delete a single paraxial line, click and drag the paraxial line
away from the centerline. When the color of the line changes to
red, release the mouse button.
– or –
To delete all paraxial lines, click the Delete All icon in the
Paraxial Images tab of the range parameter panel.
2 To add a paraxial line, right-click the centerline between two
existing paraxial lines and choose Add Paraxial from the context
menu.
3 To move a paraxial line within the start marker and the end
marker, click and drag it to the required position on the centerline.
syngo.via | VB40 39
2.12 Resetting paraxial lines

You can discard all manual interactions that you have performed on
the paraxial range. ( Page 39 Defining the paraxial lines
interactively)
✓ Manual interactions have been performed on the paraxial range.
◆ In the range parameter panel, click the Reset icon.
The paraxial result images are recalculated according to the
currently displayed parameters in the range parameter panel.
– or –
In the Preset list of the range parameter panel, select a range
preset.
The paraxial result images are recalculated according to the
parameters of the selected preset.
2.13 Applying range presets

Range presets are specific sets of parameters for the calculation of
panoramic and paraxial result images.
You can apply the default range preset provided by Siemens
Healthineers or your own user-specific range presets.
( Page 41 Saving user-specific range presets)
◆ In the range parameter panel, select the required range preset
from the Preset list.
The recalculation starts according to the parameters of the selected
range preset.

2.14 Saving user-specific range presets

You can create your own presets with adapted parameters for the
calculation of the panoramic and paraxial result images.
To modify an existing user-specific preset, save the edited
parameters with the same name.
1 In the range parameter panel, edit the parameters of an existing
range preset as required and click the Save Preset icon.
The Save as Range Preset dialog box opens.
2 Enter a Preset Name and click OK.
Your user-specific range preset is saved and available in the Preset
list.
2.15 Deleting user-specific range presets

You can only delete your own user-specific range presets. Default
presets cannot be deleted.
1 In the range parameter panel, select a range preset from the
Preset list and click the Delete Preset icon.
2 In the Range Preset Deletion dialog box, click Yes to confirm the
deletion.
2.16 Marking the mandibular canal

You can mark the mandibular canal on the paraxial result images.
For example, this supports you in presurgical implant planning.
Only markers that have been defined and accepted on the paraxial
result images will be saved and sent to print. Help lines on the
panoramic result images and the corresponding preliminary markers
in the paraxial result images will not be saved and sent to print.
syngo.via | VB40 41

1 In the range parameter panel, click the Outline Canal icon.
The mouse pointer changes into a pen.
For overview purposes, you can draw help lines on the panoramic
result images.
2 Click and drag the mouse pointer to draw the mandibular canal
where it enters the jawbone and follow it. You can draw several
help lines and scroll through the panoramic result images to mark
the mandibular canal on different panoramic result images.
The course of the mandibular canal is displayed on the panoramic
result images as blue help lines. The points of intersection of the
help lines are displayed on the paraxial result images as blue
preliminary markers.
3 Scroll to a paraxial result image that displays the mandibular
canal clearly and click the position of the mandibular canal.
A red marker is set at the position of the mandibular canal on the
paraxial result images.
4 To correct the position of a marker, click another position on the
same paraxial result image.
5 Repeat steps 3 and 4 as often as necessary for further paraxial
result images.

You can skip paraxial result images that do not show the canal
clearly. syngo.CT Dental interpolates the position of the mandibular
canal and sets red markers on these images.
6 Right-click a red marker and choose Accept Mandibular Canal

from the context menu to confirm all set markers.
The color of the markers changes from red to green.
7 To finish marking the mandibular canal, click the Outline Canal
icon again.
The accepted mandibular canal markers that are displayed on the
paraxial result images and on the orthogonal MPR images describe
the course of the mandibular canal.

2.17 Removing the mandibular canal markers

You can remove the accepted mandibular canal markers that are
displayed on the paraxial result images. This allows you to redefine
the mandibular canal.
✓ Mandibular canal markers are set and accepted on the paraxial
result images.
◆ On one of the paraxial result images, right-click a green
mandibular canal marker and choose Delete Mandibular Canal
from the context menu.
All mandibular canal markers that were accepted at the same time
are removed.
2.18 Saving ranges

You can either save the panoramic range or the paraxial range
separately or both ranges at the same time.
Each range is saved as a range series that contains all the
corresponding result images and the corresponding reference image.
All accepted mandibular canal markers are displayed on the images.
You can open the range series in other workflows, for example, MM
Reading, export them to a disc, or send them to print.
◆ In the range parameter panel, click the Save All icon to save both
ranges at the same time.
– or –
In the panoramic reference segment, choose Save Panoramic
Range from the upper left corner menu to save the panoramic
range separately.
syngo.via | VB40 43
– or –
In the paraxial reference segment, choose Save Paraxial Range
from the upper left corner menu to save the paraxial range
separately.
Depending on your selection, either a panoramic range series, a
paraxial range series, or both, are displayed in the Results section of
the Series panel.
2.19 Saving and sending images for true size

printing
You can save and send all panoramic and paraxial result images to
print in one step.
The following images are sent to the film sheet in the specified order:
• Panoramic reference image
• Paraxial reference image
• All panoramic result images in true size
• All paraxial result images in true size
1 In the range parameter panel, click the Save and Print All icon.

If you use other syngo.via print functions, the result images are not
sent in true size to the Print workflow step. To print the images in
true size, right-click the images on the film sheet and choose
Zoom/Pan > True Size from the context menu.
2 Click the Print workflow step and select a suitable layout for each
film sheet from the Layout list.


You can create layouts that are optimized according to your needs,
for example, according to the size of your print sheets and the size of
the panoramic and the paraxial result images. Contact your clinical
administrator to create specific print layouts with the Print Layout
Editor. For more information on the Print Layout Editor, see the
syngo.via Instructions for Use.
3 Adjust the images on the film sheet.

You cannot zoom an image that is displayed in true size.
To be able to zoom the image, right-click the image on the film sheet
and choose Zoom/Pan > Clip Document or Zoom/Pan > Fit to
Segment from the context menu.
4 Click the Print icon.

The images are printed as specified on the film sheet.
 CAUTION

other factors!
dimensions.
True Size.
2.20 Sending images for true size printing

You can append all panoramic result images, all paraxial result
images, or the currently displayed paraxial result images (including
the corresponding reference image) to the film sheet.
syngo.via | VB40 45

1 In the panoramic results segment, from the upper left corner
menu, choose True Size Print All Panoramic Images.
– or –
In one of the paraxial results segments,from the upper left corner
menu, choose True Size Print All Paraxial Images.
– or –
In one of the paraxial results segments, from the upper left corner
menu, choose True Size Print Visible Paraxial Images.

If you use other syngo.via print functions, the result images are not
sent in true size to the Print workflow step. To print the images in
true size, right-click the images on the film sheet and choose
Zoom/Pan > True Size from the context menu.
2 Click the Print workflow step and select a suitable layout for each
film sheet from the Layout list.

You can create layouts that are optimized according to your needs,
for example, according to the size of your print sheets and the size of
the panoramic and the paraxial result images. Contact your clinical
administrator to create specific print layouts with the Print Layout
Editor. For more information on the Print Layout Editor, see the
syngo.via Instructions for Use.
3 Adjust the images on the film sheet.

You cannot zoom an image that is displayed in true size.
To be able to zoom the image, right-click the image on the film sheet
and choose Zoom/Pan > Clip Document or Zoom/Pan > Fit to
Segment from the context menu.
4 Click the Print icon.

The images are printed as specified on the film sheet.
 CAUTION

other factors!
dimensions.
True Size.
syngo.via | VB40 47

Glossary 3
3 Glossary
dental range A series of panoramic result images and paraxial result images of
the jaw are created along a predefined centerline.
lingual marker A marker (yellow cross) that defines the lingual side of the centerline
in the reference segments.
panoramic range A series of panoramic result images of the jaw are created along a
predefined centerline.
panoramic reference segment A reference segment that shows a multi-planar reconstruction (MPR)
image of the reference plane. To begin the workflow, the user defines
the reference line on the panoramic reference segment. Once the
reference line has been defined, the panoramic reference image
displays the panoramic reference lines on the reference plane.
paraxial range A series of paraxial result images of the jaw are created orthogonally
to the predefined centerline and the reference plane.
paraxial reference segment A reference segment that shows a multi-planar reconstruction (MPR)
image of the reference plane and displays the paraxial reference
lines along the centerline of the jaw.
syngo.via | VB40 49
3 Glossary

Index
B L deleting 39
end marker 33
basic workflow 25 layouts
highlighting 32
buccal orientation label (B) 30, 38 With Parameters layout 21, 23
moving 39
Without Parameters layout 21, 23
navigating 32
C legal notes 9 resetting 40
centerline lingual marker 30 start marker 33
base points 28 lingual orientation label (L) 30, 38 synchronization 32
correcting 28 loading criteria 17 paraxial range
deleting 29 end marker 33
loading images 17
drawing 28 start marker 33
modifying 28 locking number of images 33, 36
paraxial reference segment 21, 33, 39
moving 28 lossy compression 15
paraxial result images 21, 32, 43
redrawing 29
dimensions 36
centerline editing mode 28 M distance 35
contraindications 9 mandibular canal equal distances 35
CT Dental accepting 41 height 26, 36
basic workflow 25 deleting 43 locking number of images 36
contraindications 9 drawing 41 number of images 35
indications for use 9 interpolating 41 numbering 38
intended use 9 removing 43 order 38
parameters 34
mandibular canal markers 41, 43
plane orientation 37
D mapping criteria 17 thickness 36
dental range 26 MIP segment 21, 26, 36 unlocking number of images 36
MPR segments 21, 32 viewing direction 38
F width 36
function overview 18 O paraxial results segments 21, 32
orthogonally synchronized MPR printing

G segments 21, 32 true-size 16
general safety 12 printing in true size 44, 45
P
H panoramic lines R
height lines 26, 36 highlighting 31 range parameter panel 21
navigating 31 hiding/showing 23
synchronization 31 panoramic result images 32
I
panoramic reference segment 21, 28, paraxial result images 34, 35, 36,
icons 18 37, 38, 38
28
image compression 15 range presets
panoramic result images 21, 31
image requirements 17 distance 32 applying 40
indications for use 9 number of images 32 default presets 40
slice thickness 32 deleting 41
intended use 9
saving 41
panoramic results segment 21, 31
user-specific presets 40
K paraxial lines
Rapid Results Technology
keyboard shortcuts 18 adding 39
Safety information 17
syngo.via | VB40 51
reference plane
adjusting 28
initial position 26
orientation 26
S
safety advice 12
Safety information 11
algorithm 15
disposal 13
lingual marker 16
lossy compression 15
patient data 14
printing 16
Rapid Results Technology 17
training 13
saving and printing images 44
saving ranges
panoramic range 43
paraxial range 43
syngo.CT Dental
contraindications 9
indications for use 9
intended use 9
layouts 21
T
tools and shortcuts 18
true size printing
order of images on the film
sheets 44
panoramic result images 44, 45
paraxial result images 44, 45
Print Layout Editor 44, 45
true-size printing 16
U
unlocking number of images 33, 36
V
VRT image 21
VRT segment 21

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syngo.via | VB40 53
This page has been intentionally left blank.

Unauthorized changes to this product are not covered by the CE
mark and the related Declaration of Conformity.
Caution: Federal law restricts this device to sale by or on the

order of a physician, dentist, or veterinarian (21 CFR 801.109(b)
Manufacturer’s note: (1)).
This device bears a CE mark in accordance with the provisions The original language of this document is English.
of Council Directive 93/42/EEC of June 14th 1993, concerning
medical devices.
The CE marking applies only to Medical Devices which have

been put on the market according to the above-mentioned EC
Directive.
Siemens Healthineers Legal Manufacturer

Headquarters Siemens Healthcare GmbH
Siemens Healthcare GmbH Henkestr. 127
Henkestr. 127 91052 Erlangen
91052 Erlangen Germany
Germany
Phone: +49 9131 84-0
siemens-healthineers.com
Published by Siemens Healthcare GmbH / Print No. C2-via-DT.621.02.03.02 / © Siemens Healthcare GmbH, 2015 – 2019
Date of first issue: 2019-03 / Revision date: 2019-07

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syngo.

Indicates the solution of a problem

Indicates a list item

Indicates a one-step operation

Indicates steps within operating sequences

Italic Is used for references and for table or figure titles

Is used to identify a link to related information as well as previous or next steps

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Courier Is used to identify inputs you need to provide

<variable> Is used to identify variables or parameters, for example, within a string

• Consequences of not avoiding a hazardous situation

• Methods of avoiding a hazardous situation

4 syngo.CT Dental | Instructions for Use

• Consequences of not avoiding a hazardous situation

• Methods of avoiding a hazardous situation

6 syngo.CT Dental | Instructions for Use

2 The CT Dental workflow overview 25

2.10 Adjusting the parameters of the paraxial result images 34

8 syngo.CT Dental | Instructions for Use

1.1 Functionality of syngo.via

10 syngo.CT Dental | Instructions for Use

Not observing the Instructions for Use and the safety

1.2 Safety information

Safety information is located in the safety section and repeated

Indicates a hazardous situation which, if not avoided, could result

Indicates a hazardous situation which, if not avoided, could result

WARNING and CAUTION have the same structure. The following

This text describes the hazardous situation: Images with lossy

1.2.1 General safety information

Not observing the Instructions for Use and the safety

12 syngo.CT Dental | Instructions for Use

1.2.2 Safety information on training

Operation of the medical device by non-trained users!

User is not instructed in how to operate the applications!

1.2.3 Safety information on disposal

Incorrect disposal of the system or parts of the system!

1.2.4 Safety information on patient data

Displayed information about changed patient data is not

Patient data is changed using the correct and rearrange

Loading image data sets of different patients!

14 syngo.CT Dental | Instructions for Use

1.2.5 Safety information on lossy compressed images

Images with lossy compression are used for diagnosis!

1.2.6 Safety information on algorithms

Incorrect input data set used with algorithms leads to incorrect

Algorithms may return inaccurate results or incomplete

1.2.7 Safety information on the lingual marker

Incorrect automatic positioning of the lingual marker!

1.2.8 Safety information on true-size printing

True Size printouts depend on printer settings, calibration, or

16 syngo.CT Dental | Instructions for Use

1.2.9 Safety information on Rapid Results Technology

Automatically saved results may be sent to another DICOM

1.3 Image requirements of syngo.CT Dental

1.4 CT Dental tools and shortcuts

Icon Description Available in Key-

Delete Yes Yes – Yes Alt + Del

Edit Yes Yes – Yes Alt + E

18 syngo.CT Dental | Instructions for Use

Icon Description Available in Key-

Outline Canal Yes Yes – – Alt + M

Save and Print All Yes Yes – – Alt + P

Save All Yes Yes – – Alt + S