Post-Facto Reorientation Module

A new tool to save time and increase accuracy in Emory Toolbox version 4.0

Post-facto Reorientation can be accessed from any page in the Emory Toolbox 4.0 with the PF Reorient button in the left-hand panel.

Post-Facto Reorientation Page

The Post-Facto Reorientation screen allows the user to adjust the angle of the short axis images from both the HLA and VLA planes. This feature is designed to allow the user to make changes in the SA angle, within ECTb4, without having to re-visit the acquisition computer and subsequently re-send corrected data back to ECTb4.


Stress Images

The top row of images represent a reference HLA and reference VLA from the incoming (original) data.  On these, the user positions a center marker and sets a reorientation angle.


The bottom row of images are resultant HLA, VLA, and SA images.  These are a preview of the reorientation represented by the markers on the reference slices.  Green overlay lines (useful for verifying the correct orientation) exist on each preview slice and do not persist beyond the reorientation page.


Correct alignment would have the apex of the heart for the HLA image pointing at 12 o'clock and the apex of the VLA image  pointing to 3 o'clock as shown in these stress images.


Rest Images



The Rest images are shown with the top/bottom rows flipped such that the resultant HLA, VLA, and SA slices from each acquisition can be compared more easily with the Stress images.


In the images above (left), the HLA image does not have its apex at 12 o'clock and the VLA apex is not at 3 o'clock.  To make this adjustment, grab the top of the line in each of the HLA and VLA images (text will pop up indicating angle and the degree of line tilt) and rotate it left or right so that the line is parallel to the long axis walls of the myocardium.  To move the center so the crosshairs fall in the center of the short axis image (labeled SA), grab the circle (text will pop up indicating center and the coordinates) and move the center point.  Compare the alignment to the Stress images for accuracy.


A looping video of this process is shown below.


Reorientation will only be saved if the Apply to All button in the left-hand column of the PF Reorientation page is selected.  


Watch the looped video below of the reorientation process:

Post Reorientation Changes

Before PF Reorient

After PF Reorient

After selecting Apply to All, you will be redirected to the Params page. 


Notice the Rest HLA and VLA images are now oriented similar to the Stress HLA and VLA images.


Before PF Reorient

After PF Reorient

Notice the basal inferoseptal defect at rest that normalizes after the long-axis orientation of the heart has been corrected with PF Reorient.