Hermia | Pneumology

Hermia applications for Pneumology

1. Hermia Lung Lobe Quantification
Improve outcomes for patients undergoing lung volume reduction surgery with accurate lung lobe quantification method.

2. Hermia Lung SPECT V/Q
Navigate, co-register, and analyse ventilation and perfusion data quickly and with ease.

Hermia Lung Lobe Quantification

Hermia Lung Lobe Quantification* achieves quick and precise prediction of function in each lobe by combining computer-assisted CT segmentation of lung, airway, and lobar anatomy with functional image data.

PRE-OPERATIVE EVALUATION OF REGIONAL LUNG FUNCTION
Hermia Lung Lobe Quantification provides powerful and versatile tools for reliable surgical planning. Pre-operative evaluation of regional lung function is crucial for planning and predicting the outcomes of surgery.¹ Identification of the most affected lobe in pulmonary emphysema before volume reduction procedures is essential to optimize the respiratory pump function² and prevents mistargeting a lobe that makes a significant contribution to lung function.³

FAST AND RELIABLE RESULTS EVEN FOR SEVERE EMPHYSEMA 
Processing is very fast and provides a complete evaluation. A robust algorithm segments the lungs automatically followed by an easy-to-use fissure drawing tool. Save, reload, edit and redraw regions as needed; the full Hermia region creation toolbox is at your disposal, enabling analysis even for the most challenging cases.

EXTERNAL CT FOR ANATOMICAL DEFINITION
Combine an existing diagnostic CT with the SPECT data to provide reliable lobar perfusion and ventilation results without the need for additional radiation exposure to the patient. Automatic alignment on load is followed by linear deformation of the CT image: shrink it to fit the SPECT in all three dimensions.

PRESENT CLEAR AND VISUALLY IMPRESSIVE RESULTS TO THE SURGICAL TEAM
Save results as a DICOM encapsulated PDF to send to PACS. Rotating, 3D volume rendered lobes and fused slices may be saved as DICOM multi-frame secondary captures to aid surgical interpretation and promote nuclear medicine imaging.

V/Q RATIO IMAGES TO HIGHLIGHT PERFUSION DEFECTS
Automatically create, display and synchronously navigate parametric normalized V/Q ratio images together with ventilation and ventilation-subtracted perfusion data. V/Q ratio (or ‘quotient’) images highlight areas of mismatch between ventilation and perfusion, indicating possible pulmonary embolism. 

SUBTRACTION IMAGES TO CORRECT FOR OVER-VENTILATION
Ventilation counts are automatically subtracted from perfusion SPECT for clearer visualization. Ventilation counts are decay corrected to account for the difference between acquisition times and then subtracted from the perfusion image when both are acquired with ^99mTc. Subtraction is not performed when ^81mKr ventilation images are loaded. 

V/Q SPECT/CT DISPLAY FOR INCREASED REPORTING CONFIDENCE
Combine information from multiple modalities to increase reporting confidence: fuse lung SPECT with local or external chest CT to correlate functional defects with anatomical information. Use the CT from a simultaneous SPECT/CT acquisition or import an external CT and automatically align it with the SPECT data.

References

1. Wechalekar K, Garner J, Gregg S. Pre-surgical Evaluation of Lung Function. Seminars in Nuclear Medicine (2018) 49:22-30  
2. Schaefer W, Knollmann D, Avondo J, Meyer A. Volume/perfusion ratio from lung SPECT/CT. Nuklearmedizin (2018) vol: 57 (01) pp: 31-34 
3. Trahair E, Nowosinska E, Sizer N, Burniston M, Balan A, Lau K, O’Shaughnessy T, Sotiropoulos G, Waller D. Does 99mTc-MAA SPECT/CT have a role in evaluation of lung lobar perfusion in patients with chronic obstructive airway disease (COPD) prior to lung volume reduction surgery (LVRS). Nuclear Medicine Communications (2019) 40:393-453 

*May be subject to regulatory clearance in your market. Not for sale in the USA.