Nodule Detection process: 1. Click on the patient study to be loaded 2. Click the drop down arrow next to the analysis button and select LNA

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1 Application Guide Lung Nodule Assessment Post Processing Portal version 2.5 This is an application guide for Lung Nodule Post Processing on version 2.5. For more detailed information, please refer to the Philips instruction for use manual. Nodule Detection process: 1. Click on the patient study to be loaded 2. Click the drop down arrow next to the analysis button and select LNA 3. Once the study is loaded; scroll through images to locate the nodule(s). 4. Click the Mark Nodule button and the pencil cursor appears Page 1 of 9

2 5. Click on the nodule to mark it. A blue bounding box appears around the nodule. Note: The mark nodule button is deactivated after marking a nodule and the last tool used will be active again. 6. Repeat steps 4 through 5 as many times as necessary until are lesions are marked. 7. Review segmentation of nodules by selecting the Show axial inspection button. A pink overlay will appear on the segmented nodules and the editing tools will become available. 8. If it is necessary to correct the overlay, click the Add slice by slice or Remove slice by slice button and the pencil icon appears. 9. Click at the edge of area identified for editing and drag the pencil to encircle the area. Once you release the mouse, the system will recalculate and add or subtract from the nodule overlay. 10. Repeat steps 8 and 9 as many times as necessary until all lesions are properly segmented. Note: To turn off the editing tool select another tool such as scroll Page 2 of 9

3 11. Once you have completed the study, save the nodules using the Save Nodule(s) or Save nodule(s) as options. 12. Select Assessment from the dropdown or click the forward arrow to proceed to the final workflow stage. 13. The Assessment stage displays the list of accepted nodules along with the following information: Name of the Lesion Maximum Diameter Max D (mm) Study Date Hounsfield Numbers HU Volume +/- error (mm3) Mean/Max/Min Effective Diameter ED Percentage of Growth (mm) Doubling days Maximum Area Max Area (mm2) 14. Click on the lesion in the list to display it in the viewport. 15. Verify that the information in the assessment table is correct Page 3 of 9

4 Note: To enlarge the assessment table; click on the assessment table and then on the Enlarge button. 16. Select Send results to Report from the Report dropdown list Page 4 of 9

5 17. The Patient History and Follow Up dialog box opens. Fill in patient specific data and click OK to send the data and images to the report. There will be three images sent to the report for every accepted nodule: slab, volume and MIP image. 18. Click the Report button located at the top of the screen to review and complete the patient s report Page 5 of 9

6 Follow the steps below to perform nodule matching on two studies: Nodule Matching Process: 1. Load the original study along with the saved nodules and the follow-up study. 2. The Launch Application dialog box prompts the user to verify that the studies selected are from the same patient. Click OK to proceed. 3. The LNA analysis package will load with the follow-up study in the Nodule Detection stage and is labeled Primary. 4. Follow steps 3 through 11 above for detecting nodules for the follow-up study. 5. Select the Nodule Matching stage from the workflow dropdown, or click the forward button to move to the next workflow stage Page 6 of 9

7 6. The Nodule Matching workflow stage opens with the Set Series tab active. The Primary study is at the top of the viewport and the Secondary is at the bottom. Note: The system recognizes the Follow-up study as the Primary and the Original study as the Secondary. The system will allow you to change them, but it is not recommended as this will produce inappropriate results. 7. Click the Match tab to open the list of nodules and detection tools Page 7 of 9

8 8. Click on the lesions in the list and as matching nodules are identified, click the Match button. A green bounding box will appear around both lesions; the individual lesion names are removed from the Primary and Secondary list and the name Matched Lesion 1, etc. will be added to the bottom of the list. 9. Repeat step 8 until all lesions are matched. Note: There maybe lesions that have no matches. 10. Select Assessment from the workflow dropdown or click the forward button to move to the next workflow stage Page 8 of 9

9 11. The Assessment workflow stage opens. To display the matched nodules in the viewport, click on the lesion(s) in the Select Nodules list. Note: You can click a lesion in the assessment table and it will automatically be highlighted along with the matched nodule. The images in the viewport will not update when selecting them from the table. They are only changed by selecting the lesions in the Select Nodules list. 12. Follow steps 15 to 18 from above in the Nodule Detection Process section to complete the analysis Page 9 of 9

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