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Visage 7 Web Client Online Guide

1. 1 Drop down the list of available color palettes 2 Select one of the predefined palettes All loaded images are now no longer displayed as grayscale images but with this color palette Toggling single view and split screen You can always switch back and forth between a single viewer window and com pare mode even after you have started processing the loaded images Click on one of these icons to change views Displays viewer 1 and viewer 2 side by side Displays viewer 1 and viewer 2 one above the other Displays only viewer 1 Displays only viewer 2 150 Visage 7 Web Client Reviewing Images BEJ Scrolling through the loaded images Displays viewer 1 and the study report if available Scrolling through the loaded images Position indicator bar You will usually have loaded more images of a patient into one of the viewers than can be displayed in the image area at a time All the images that cannot be dis played due to lack of space are placed in the background You can scroll through the loaded images to obtain an overview and to select imag es that you then want to process and evaluate Visage 7 Web Client offers a range of options for scrolling image by image More over an automatic fast scrolling function is available that gives you the impression of a movie being played back Cine mode has advantages when viewing dynamic series because it displayes pro cesses that change over time espec
2. Note Access to other data sources may be disabled for some user groups Please ask your system administrator to help you if you find only the web server in the data source list Querying a network node 1 Select a network node as the data source 2 Enter further filter criteria such as the patient name and patient ID The Modality box is inactive and therefore dimmed when you search a network node When searching in the network you should always be as precise as possible with the search criteria you enter Otherwise the number of hits you will obtain could be very high 3 Click the Start Data Query icon on the toolbar The response list from the network node shows all the patients found If searching a network node takes too long you might want to cancel the search and specify your search and filter criteria more precisely 1 Click this icon to stop the database query Now only those patients who have been found so far are listed 2 Enter more precise filter search criteria 3 Start the database query again Shortcut to querying network nodes If a patient s current examination is available on the web server but you would also like to load a previous study for comparison Visage 7 Web Client offers you a par ticularly straightforward way of doing so 1 Click on an entry in the local patient list Visage 7 Web Client Loading Image Data ME Visage 7 Web Client 2 Finding patients and transferrin
3. Presentation state label as entered on the diagnostic workstation where the presentation state was created Descriptive text for this presentation state Name of the user who created the presentation state object Date and time when the presentation state was created in the format YYYY MM DD and hh mm ss 24 hour clock 56 Visage 7 Web Client The Visage 7 Web Client Window Study series window No of ref imag es Number of referenced images in this presentation state object Image preview Visage 7 Web Client The image preview of the study series window shows the images of the selected study or series as miniature images thumbnails You use the preview area to select images or series You can select an entire study complete series a presentation state or individual images from one or several se ries and then load them into a viewer With large series that contain a large number of images and slow data transmission lines selecting and loading only those imag es that are relevant to your diagnostic problem will save time Moreover the image preview contains information about the study series and the images they contain Refer to the preview window for details about e Information about the study e Information about a series e Thumbnails e Image preview popup menu 57 Preview window The Visage 7 Web Client Window Preview window The preview window shows the images of the selected study or series
4. Study Date Time Indicates whether a procedure step exists for this study Indicates the status of the procedure step scheduled in progress discontinued or com pleted Indicated the name of the Visage 7 Web Client user who is currently reviewing the images of this study or who completed a procedure step Low medium or high You can use this column to sort the study list for example Date and time of the study in the format YYYY MM DD and hh mm ss 24 hour clock Visage 7 Web Client 95 Worklist Expert Reading The Visage 7 Web Client Window Modalities in Modalities used to examine the patient Study Image Series Number of series in this study Study Descrip Description of the study tion Referring Physi Name of the referring physician cian Accession Num Job number of the patient in the HIS RIS hospital or radiology information system ber Study ID Study s identification number Reading Physi Name of the physician who read this study on the system that sent the data to Visage 7 cian Study Comment Comment text about the study 96 Visage 7 Web Client The Visage 7 Web Client Window Display Protocol Viewer Expert Reading Display Protocol Viewer Expert Reading EE Toolbar display protocol viewer Thumbnail browser Navigation bar Image area with viewports In client type Expert Reading the display protocol viewer replaces the viewer and report windows of the other
5. Transferring patient data to the study series window The patient list as a rule contains only one entry for each patient even if several studies exist for a patient Once you have found the patient in the local database transfer the data to the study series window Double click the patient entry The data of the selected patient is transferred to the study series window The study series window opens Note On rare occasions it may not be possible to load a patient into the study series window because the patient s data are currently being updated from the HIS RIS In this case a message is displayed informaing you that the patient is temporarily locked Try again later Selecting series and images ma Checking if a series is complete 116 Once you have found the patient you were looking for the next step will be to select the images you wish to review You use the study series window for this Double clicking on a patient in the patient window automatically displays the study series window It contains all examinations and series of the patient selected in the patient list Here you can select the study series or images you want to review in one of the viewers If you are reviewing images very shortly after or even while the examination is still in progress not all images may have been transferred to the web server yet You can tell whether a series is complete by comparing the Number of Images and the High
6. Use these icons on the navigation bar to switch to the report window or report with image view The icons are active if you have selected a study for which a report is available in the study series window Tip You must first load images into viewer 1 or viewer 2 before switching over to the report with image view Otherwise the image section of this view will remain blank and only the report text will be shown Or Click the Edit Report icon in the toolbar of one of the viewer windows to create a new report Visage 7 Web Client now shows the report with image window whose report section is in editing mode Tip If your hospital works with a HIS RIS and normally uses this system to create and manage reports the Edit Report icon will most likely not be available in your client installation Instead the system will automatically query the report node for the lat est report version and display it view only every time you load images Consult your system administrator for details about how your system has been configured with respect to report handling Visage 7 Web Client The Visage 7 Web Client Window Report window Dual monitor Information area viewer Viewer toolbar Report text Image display Navigation bar Report text Visage 7 Web Client Dual monitor operation does not support the text only view When you call the report with image view in dual monitor mode the left monitor shows the image wind
7. Visage 7 Web Client Managing the Diagnostic Reading Workflow Procedure step creation Patient list filter Mark as read Procedure step management in the study list Visage 7 Web Client The system helps you with managing the diagnostic reading workflow by supporting procedure steps Visage 7 can be configured to create a new procedure step for every study that is sent to the Visage 7 server from a particular network node For network nodes for which this feature has not been configured you can create a procedure step in Visage 7 Web Client Tip Talk to your system administrator to find out how procedure step creation is config ured in your system One of the filter criteria available in the patient list is the interpretation status of pro cedure steps Filter the patient list so that it only shows patients whose study data contain a proce dure step with status scheduled for example This filter setting can be stored in your user profile so that every time you log on to Visage 7 Web Client you will find only those patients and studies that are scheduled for interpretation Tip Talk to your system administrator to find out if filter settings are configured to be stored in user profiles In all Visage 7 Web Client viewers physicians can mark a study as read This sets the status of the associated procedure step to completed and lists the name of the reading physician as performer If a reporting physicia
8. off x ggg ggg a Truncate Thumbnails for Large Series x Deselect all previews x B DICOM Information x Launching Application ce x A DICOM Send x DICOM Quick Send s Display as 3D volume x 3D A 258 Visage 7 Web Client Appendix Overview of functionality supported by client types Synchronize with 3D volume 3D Show Hide Thin Slice Series Marked images filter All hd Client type View x x Client type Classic Client type Expert Client type Expert Reading x Viewers Change Toolbar Loca tion Auto Hide Toolbar Lock Toolbar Previous Patient hi Next Patient i Previous Study Client type View x Client type Classic Client type Expert Client type Expert Reading Visage 7 Web Client 259 Overview of functionality supported by client types Appendix Client type View Client type Classic Client type Expert Client type Expert Reading Next Study x x x Previous Series x x x T Next Series x x x a Previous Scene x x x x fa Next Scene x x x x a Previous Presentation x x x State H Next Presentation State x x x H Previous Annotated Im x x x x age A Next Annotated Image x x x x i Cancel loading x x x x 260 Visage 7 Web Client Appendix Overview of functionality supported by client types Client type View Client type Classic Client type Expert Client type E
9. 2 Monitors Landscape 2 Monitors Portrait Depending on your monitor configuration Visage 7 Web Client will suggest a num ber of suitable display protocols Select the monitor configuration you are working with Once you have done so Visage 7 updates the display protocols list Only those pro tocols are now shown that have been configured for this monitor configuration Or Select All Protocols to show the display protocols list unfiltered Tip You will only have to select your monitor configuration once as the system stores this information in your user profile The next time you log on to Visage 7 Web Cli ent with Expert Reading this monitor selection will be immediately active again Interpreting the display protocols list Display protocol concept Suitability ranking Visage 7 Web Client In Visage 7 the term display protocol is used in the sense of hanging protocol ac cording to the DICOM standard A display protocol defines the screen layout in the display protocol viewer of the Ex pert Reading client type This includes how many viewports or viewer segments are shown for comparing series and studies the size of viewports and how they are ar ranged on your monitor or on dual monitors and how images are displayed in each of these viewports A set of factory default display protocols come with your system These display pro tocols have been optimized for typical image types combinations of im
10. Drop down icon Some icons on the toolbar of the viewer windows represent a drop down icon bar bars This is indicated by a small black triangle pointing downwards El 1 Click on the icon on the toolbar with the left mouse button and keep the mouse Bal button pressed 2x1 3 Release the mouse button while the cursor is still pointing to the option or func tion you wish to activate Ea 2 Select a function or option by moving the mouse pointer down the icon bar until it points to the relevant sub icon x2 xs anal Tool Tips All the icons in the navigation bar and on the toolbars are assigned tool tips a Position the mouse pointer on an icon and let it rest there for a short time A brief explanation of this icon appears 36 Visage 7 Web Client Getting Started with Visage 7 Web Client Scrolling through images Popup menus Apply to All v Windowing Zoom Pan SliceShift SliceThickness View b v MPR MIP Reset Unload In the image preview viewer and basic MIP MPR viewer windows a number of im age selection and processing options are also available from a popup menu which you can call up in the workspace area In the viewer windows many image display functions are available from both the toolbar and popup menu Only a few functions are available from the popup menu only The basic MIP MPR viewer has no toolbar All image display and processing func tions are available from the popup menu here or as
11. Participants in a net conference can communicate with one another over video and sound channels as long as their computers are equipped with the necessary hard ware of course If you want to set up communication in the form of an audio conference a sound card must be installed in your PC You will also need loudspeakers and a micro phone both of which must be installed and switched on In order to be able to make use of the video functions of NetMeeting you will need a video capture card and camera or a video camera which is connected to the paral lel port print authorization of your computer Application sharing 236 So called application sharing allows you to let the participants in a net conference participate in your work with Visage 7 Web Client The parties to the conference can view your activities in Visage 7 Web Client and see the images you are working with Visage 7 Web Client Setting up an Online Conference Connecting to an interlocutor With this application the participants in the net conference can follow your work without having installed the program themselves and without having specific knowl edge of how to handle this program Connecting to an interlocutor 1 Launch the NetMeeting Client program 2 Log onto the NetMeeting server with your email address or IP address 3 Call your interlocutor with the NetMeeting button If the interlocutor confirms your call the connection has been established and
12. Selecting encrypted transfer 5 Selecting non encrypted transfer Selecting data compression 1 Right click an image from a series in the image preview 2 Select Image Info from the popup menu The Image Info box informs you about the compression level settings for this im age type Image Info x Secondary Capture Image Image Number 1 Number of Frames 1 Compression Info levelA LevelB lossless lossy 95 227 0 kB 66 0 kB 1 Click one of these icons on the toolbar of the study series window to select the appropriate compression level Selecting data encryption Click Encrypted Data Transfer on the toolbar of the study series window Click Non encrypted Data Transfer on the toolbar of the study series window Loading thick or thin slice series 126 If your Visage 7 receives CT or MR series with very thin slice thicknesses and very large image numbers which is usually the case if these series are to be used in high quality 3D reconstruction then loading and viewing large thin slice series would slow down the system performance in Visage 7 Web Client Your system ad ministrator can therefore configure the Visage 7 server to automatically compile thick slice images from such thin slice series The thick slice series will have fast download times and still provide sufficient image quality for an overview of a situa tion Nevertheless you may be able to view the original thin slice images as well
13. With the icons of the navigation bar you can switch back and forth between the var ious Visage 7 Web Client windows call up status information or online help or log off from the web server Click this icon to display the study series window for example If one particular operating step does not make sense with the current selection of data the corresponding toolbar icon is dimmed i e grayed out While an icon is displayed pressed the mode it activates e g interactive cine mode remains active To terminate one mode select another Click on a toolbar icon to activate a function If a toolbar icon looks like this the corresponding function is not available for the current selection of data If a toolbar icon is activated it is displayed pressed in and looks like this 35 Selecting functions and switching windows Getting Started with Visage 7 Web Client Locking unlocking In the viewer windows you can hide the toolbar so that you have more space for the viewer toolbar showing the images The toolbar will automatically reappear when you move the mouse pointer over the screen area where the toolbar is usually shown Click Auto Hide Toolbar to hide the toolbar Or Oo Click Lock Toolbar to show the toolbar permanently again Tip Auto Hide Toolbar is particularly useful if you are working with low screen resolu tions and the viewer toolbar is shown in several rows of icons which require a lot of screen space
14. abdomen w contr Modify Modifying a preset In order to modify a preset 1 Select a modality and image type 2 Select the preset you want to change from the Preset Window Values list 3 Click Modify The Modify Window Level Presets dialog box appears xj Modify Window Level Presets Window Center fiso OK Window Width 750 Cancel Filter fo Window Name abdomen wicontr 4 Change the Window Center brightness Window Width contrast or Filter value 5 Change the name as well if necessary 6 Click OK The Modify Window Level Presets dialog box is closed You are now in the Configure Window Level Presets dialog box again 7 Click OK The Configure Window Level Presets dialog box is closed and you return to the Window Level Presets window Also close this dialog box with OK 176 Visage 7 Web Client Reviewing Images Deleting a preset Editing images In order to delete a preset 1 In the Configure Window Level Presets dialog box select a modality and im age type 2 Select the preset you want to delete 3 Click on the Remove button The preset is removed from the list 4 Click OK to close the Configure Window Level Presets dialog box Finally click OK to close the Window Level Presets dialog box Note You can only delete user defined window level presets but not the presets Source 0 and Source 1 Rotating flipping and inve
15. to or every nth image and click OK All selected images are now marked with a solid green box in the lower right hand corner Visage 7 Web Client Printing Exporting and Sending Images Printing images Print preview and starting the printout 1 Drop down the Print icon bar g 2 Select the DICOM Print icon The Dicom Print dialog box pops up The dialog box shows the printer settings as well a preview of the film sheet Tip Note that the image selection from the viewer in which you clicked the DICOM print icon will be printed first top row s or first film sheet s x Device r Layout r Copies Fit Printer Columns Rows Number of DICOMPrinter_Radiology fe xj 2 hd 1 ha a Fit Image s Properties Media Size Type Orientation Color mode El Ea zal eel Cancel 3 Select one of the configured DICOM printers from the list 4 Check and if necessary change the layout The print preview is updated immediately If more segments rows x columns are available than images you have selected for DICOM print part of the film sheet will remain empty Visage 7 Web Client 193 Printing images Printing Exporting and Sending Images 5 Select the number of copies and check the Fit Image s box to make optimum use of your film segments 6 Use the arrow keys to browse through the print preview if you have selected more images than fit on one film sheet lt scrolls to
16. 112 parameters 44 91 108 resetting 110 Fit into Segment Visage 7 Web Client Index Visage 7 Web Client icon 74 103 Fit to segment basic MIP MPR viewer 211 viewer 170 Flipping 178 Forward icon 47 92 Full screen display 39 G Gamma Adjustment icon 78 98 Gamma correction 246 Group assignment 244 H Help icon 42 Hide Show ECG 162 Hide show filter criteria icon 44 91 Hide Show Image Text icon 73 98 Highest Image Number 116 HIS RIS retrieving reports 139 Hounsfield units HU 188 Image icons 146 222 Image Info 126 Image preview 57 63 Image Preview icon 42 Image Preview on off icon 53 Image text 145 222 Images filtering 173 fit to segment 170 flipping 178 inverting 178 loading for comparison 123 loading into viewer 2 122 loading to viewer 1 121 original size 170 panning 169 rotating 177 scrolling 151 windowing 172 zooming 169 Information area 34 Integrated Windows authentication 30 Intended use 11 Interactive cine mode 156 Interactive Cine Mode icon 78 104 Internet Explorer area 34 Invert icon 74 103 Invert selection 120 J JPEG images 197 L Launching Application icon 48 53 61 93 Layout conventions 23 License management 14 Load all series as one icon 52 Load into viewer 1 icon 51 Load into viewer 2 icon 51 Load to Compare Mode icon 51 Loading images 121 Local Cache 124 Local database query 113 Lock Toolbar icon 71 98 Login Favorites 28
17. 2000 01 01 M F o0 MR Ankle 23000 2000 01 01 M 67 04 03 MR Ankle muti 23006 2000 01 01 M 2007 04 03 MR dataset Brain reg2 1911 01 01 2007 04 02 MR Knee 23002 2000 01 01 2007 04 03 lt MR LSpine 23001 A 2007 04 03 MR Shoulder 23005 2007 04 03 MR Spine 23004 F 2007 04 03 O25 Niere Mesenteri 4 M 2007 04 pp X 4 e r E Modalities in Study gt Study Descriptic 2006 07 31 11 55 37 MR MR Ankle Interpretation SCHEDULED MEDIUM 2006 10 27 18 53 33 MR MR Ankle Note You can only load studies of the same patient You cannot combine studies of dif ferent patients in the display protocol viewer 134 Visage 7 Web Client Loading Image Data ue Visage 7 Web Client Loading images from the worklist Loading image data encrypted Visage 7 Web Client always uses secure data transfer protocols for transfer of pa tient data over the intranet or Internet However if you are working outside a firewall you may choose additional encryp tion when loading image data Click Encrypted Data Transfer on the toolbar of the worklist window Or Click Non encrypted Data Transfer on the toolbar of the worklist window For more information about encryption see also Encryption on page 125 Loading thin slice series Just like in the study series window of the client types View Classic and Expert you may choose between preferably loading thick or thin slice series for MT or CT series with very larg
18. 646464 Date of Birth Study Description Study Date 1997 02 20 09 25 48 Slice segments MPR 1 00 MM 340 MPR 1 00 MM Slice cursor 3D overview segment Navigation bar MPR 1 00 MM fi Rotate Done 5 O Trusted sites Information area basic MIP MPR viewer This area of the basic MIP MPR viewer provides information about the loaded pa tient and study Patient Name Name of the loaded patient Patient ID ID of the loaded patient Date of Birth Date of birth of the loaded patient Study descrip Description of the study tion Study Date Time Date and time of the study in the format YYYY MM DD and hh mm ss 24 hour clock 84 Visage 7 Web Client The Visage 7 Web Client Window Basic MIP MPR viewer 3D overview segment Color coding after loading Color coding after moving Image processing Information in the overview segment Visage 7 Web Client When suitable data is loaded into the basic MIP MPR viewer a volume data set is calculated from the acquired slice images The volume is shown as an orientation cube in the overview segment Immediately after you have loaded a 3D data set the anatomical standard views are shown in the slice segments The orientations of these slices are shown as follows on the orientation cube e Surface with yellow border transverse standard view e Surface with red border sagittal standard view e Surface with green border coronal stan
19. Date Here you can select a period After a database query the patient list will only show patients examined over this period Today lists all patients examined today Yesterday lists all patients examined yesterday The last X days lists all patients examined over the last X days Date lists all patients examined on this day From date to date lists all patients examined within the stated period All lists all patients irrespective of examination date Visage 7 Web Client Loading Image Data Finding patients and transferring them to the study series window Modality Physician Location Insertion Date Interpretation Status Here you can filter the patient list according to modality Click the Y icon next to the filter parameter Modality Check one or more modalities After a new database query only patients examined with this modality or these modalities will be shown Here you can filter the patient list according to the name of the referring performing and or reporting physician Click the Y icon next to the filter parameter Physician Check the box Referring physician Performing physician and or Reporting physician and type the name of the physician Or type A for all physicians whose name begin with A for example Or Open a list of all names by clicking on the Y icon behind an entry field A list drops down with all referring performing or reporting physicians of the studies you
20. F11 on your keyboard to toggle between full screen best use of screen and standard view Select View gt Toolbar on the menu bar of the Internet Explorer to show or hide the Internet Explorer s toolbar Tip Since almost all Internet Explorer functions are inactive while Visage 7 Web Client is running we recommend you keep the Internet Explorer toolbar hidden Select View gt Status Bar on the menu bar of the Internet Explorer to show or hide the Internet Explorer s status bar 39 Adjusting a window view Getting Started with Visage 7 Web Client Tip It is advisable to have the status bar displayed while working with Visage 7 Web Client to observe messages progress reports and explanations Adjusting column You can change the width of the columns in the patient study and series lists WiNA 1 Place the mouse pointer precisely on the border between two column headers The mouse pointer now looks like this d 2 Hold the mouse button down and drag the column border right or left to adjust the width of the column Or Double click the border between two column headers to display the column to the left of the border with the width of its longest item 40 Visage 7 Web Client The Visage 7 Web Client Window This section describes the screen layout and the windows you use when working with Visage 7 Web Client You will find a brief functional description of the individual windows the icons and other elements her
21. Move the end of the distance line or leg 4 Release the mouse button on reaching the new end point The new measurement value is displayed 1 Click a measurement Grab handles appear at the ends of the line 2 Left click the line but not a handle and hold the mouse button down 3 Move the whole distance line or the whole leg of an angle The value remains hidden as you move the measurement The new measure ment value is shown as soon as you release the mouse button With Visage 7 Web Client you can statistically evaluate regions of particular interest to you To do this you define the region of interest in an image by drawing a ROI graphic The program will then automatically calculate the following statistical infor mation for this image area and a histogram Visage 7 Web Client Reviewing Images yr mE or Me Visage 7 Web Client Evaluating images e Maximum minimus pixel value Min Max Pixel values are indicated in HU Hounsfield units for CT images e Average pixel intensity value AVG in one of the above listed units e Standard deviation ms e Total area covered by the ROI in square millimeters mm7 estimated square millimeters mm if this information is available in the image or pixels pix Note ROI evaluation is only possible in single frame and grayscale images ROI evaluation also requires that images have been loaded uncompressed or with a lossless compression method Drawing a
22. Report icon in the toolbar If a report already exists for a study it is now shown in the report window in read only mode The report window opens in a floating window You can move it around on the screen so that it is not in your way when reviewing images Creating a report Click the Edit Report icon in the toolbar If no report exists for a study Edit Report will create one for you The report win dow is now shown in editing mode and a report template has been loaded More than one study If you have loaded more than one study into the display protocol viewer leaded e The report that belongs to the study in the currently active viewport viewport with the colored border will open when you click the Edit Report icon e The study whose report is currently shown in the report window is highlighted by a colored header in the thumbnail browser e Only one report window can be open at a time In order to view the report of another loaded study If the report window is shown read only Simply click on a viewport that shows images of the second study The report window will be updated It now displays the report of the second study If the report window is in editing mode Report display will not be updated when you click the viewport of another study You are expected to save or discard your changes and close the report window before you can open another report Saving the report and signing a study Note off Be aware that
23. Users Changing user assignment 1 Switch to the patient window A 2 Select one or more patients 3 Click the Change User Assignment icon The Change User Assignment dialog box opens Change user assignment Access User Login Username Christian Dirk Horst John Mau mk i ok i OK Cancel 4 Click the users who will have access to the selected patients in the future Or Remove the checkmark in front of users to whom you want to deny access to the selected patients in the future 5 Then close the dialog box with OK Changing group assignment 1 Switch to the patient window A 2 Select one or more patients 3 Click the Change Group Assignment icon The Change Group Assignment dialog box opens 244 Visage 7 Web Client Functions and Information for Advanced Users Performing data maintenance Change group assignment M radiology Vv standard standard B surgery OK Cancel 4 Click the user groups who will have access to the selected patients in the future Or Remove the checkmark in front of a group to whom you want to deny access to the selected patients in the future 5 Then close the dialog box with OK Protecting patient data from deletion Old patient data may be automatically deleted from the Visage 7 server after a cer tain time if its capacity is exhausted You can protect patent data from deletion These data can be deleted neither auto m
24. Web Client checks the DICOM head er information in every single image If this DICOM header information does not agree with the patient and study data stored in the Visage 7 database for one or several images this icon is displayed in the upper right hand corner of the affected images The display protocol may define the sort order for the images of a series in the display pro tocol viewer according to certain criteria If images cannot be sorted according to these cri teria the system alerts you to this fact with this icons 222 Visage 7 Web Client Reviewing and Reporting on Images in the Display Protocol Viewer Image text and image icons us A Jv lt i This icon in the upper right hand corner of the image segment indicates that calibration has been applied to distance lines in this image This icon indicates that the displayed images do not originate from an original scan series thin slice series but were generated by a Visage 7 thick slice compilation rule DICOM print selection In the lower right hand corner of each image you will see a small green box which indicates whether the image is currently selected for DICOM print An empty box indicates no selection A solid box indicates selection for DICOM print Marked images These flags are only available in a Siemens diagnostic environment The image is marked with a flag The image is marked with a star Exam status These flags are only availabl
25. Windowing If this icon is pressed you can use the mouse to change the grayscale display brightness contrast in the images While Windowing is active the mouse pointer looks like this Xo Edge Enhancement This filtering enhances the contrast in images While Edge Enhancement is active the mouse pointer looks like this Rn Predefined Level Presets If different window or filter values are predefined for the current image type you can call them up here and apply them to the loaded images Reset Window Level Resets the window and filter values back to default values i e the values with which the im ages were loaded Invert Inverts the grayscale display of an image Bright areas are now shown dark and dark areas are shown light Rotate Rotates the current image 90 clockwise Mirror Mirrors the current image about its vertical axis Fit into Segment Resizes the current image to fit it optimally in the image segment Original size Resets the loaded image to its original size Previous Annotated Image Scrolls up in the stack of loaded images and shows the next image containing annotation graphics or annotation text Next Annotated Image Scrolls down in the stack of loaded images and shows the next image containing annotation graphics or annotation text 74 Visage 7 Web Client The Visage 7 Web Client Window Viewers Measurement Functions Y Opens a selection list with measurement
26. archive options are available e Archiving on RAID hard disks e Archiving on SAN and NAS devices Which archiving method is used will depend on your requirements the hardware used and the configuration of archive option Tip Archiving is always performed in the background As a user you will not actively in tervene in archiving However you can monitor the status of archiving in the study list and exclude studies from archiving 17 Data protection and data security System Overview Data protection and data security Data relating to individuals is subject to data protection In this regard please en sure compliance with all applicable laws and regulations in your country Visage 7 provides extensive security mechanisms that help you assure data protec tion and data security On the administration platform the system administrator can also activate the audit trail option This ensures that the system follows the strict regulations concerning patient data protection and data security according to US law Note For security reasons it is not permitted to make changes to the product Visage 7 and its database Contravention of this will lead to all guarantees being revoked and under some circumstances may even be violating applicable laws Access control and authentication Access to data Access to program functions 18 Visage 7 employs a user management concept that controls both access to study data and the av
27. as miniature images thumbnails Unlike the preview area of the study series window this preview window shows the thumbnails over the full width of the browser window You use the preview area to select images or series You can select an entire study complete series or individual images from one or several series and then load them into a viewer With large series that contain a large number of images and slow data transmission lines selecting and loading only those images that are relevant to your diagnostic problem will save time Moreover the image preview contains information about the study series and the images they contain Visage PACS Microsoft Internet Explorer loj xj Information area preview Ele Edt wew Favorites Tools Help e window Patient Name MR Abdomen Patient ID 23003 Date of Birth 2000 01 01 j Toolbar preview masy an als ne Sk ct window Percy MR Abdomen Date Time 2005 12 20 11 53 48 Referring Physician Dr Smith ID 40227 Ax 2D FIESTA OB Modality MR Images 28 Organ Date Time 2005 12 20 12 01 52 Information about the study Information about a series Thumbnails Navigation bar fe Q M El El El E El ax T1 OB Modality MR Images 28 Organ Date Time 2005 12 20 12 02 48 E Done L T B nene 58 Visage 7 Web Client The Visage 7 Web Client Window Preview window Inf
28. bar to switch to compare mode vertical i e side by side or compare mode horizontal i e top and bottom As far as image display and processing is concerned you can work in both screen halves in just the same way as if a viewer were displayed full screen Tip The toolbars above or to the left of each image view contain the same icons and access the same functions as in one of the full screen viewer windows with one exception Showing scoutlines in suitable CT or MR images is only possible in compare mode but not in any of the full screen image viewers or the report with image view If configured scoutlines are shown by default when you load suitable series into compare mode In dual monitor mode the two viewers are displayed on the two monitors viewer 1 on the left and viewer 2 on the right monitor Visage PACS Microsoft Internet Explorer loj xj Ble Edt wiew Favorites Tools Help atient Name Joe s Shoulder Patient ID 646464 Date of Birth X Patient Name Joe s Shoulder Patient ID 646464 Date of Birth x Study Description Study Date 1997 02 20 09 25 48 A eS6nHeERP2Hoe I ooo 25 gt udy Description Study Date 1997 02 20 09 25 48 esa EReOebPenrs 3 tt ka 1 Query finished A internet Visage 7 Web Client The Visage 7 Web Client Window Basic MIP MPR viewer Basic MIP MPR viewe
29. change its priority or delete the step For procedure steps with status completed this dialog box allows you to reschedule the procedure step or delete it 3 Select an option and click OK 206 Visage 7 Web Client Working in the Basic MIP MPR Viewer Visage 7 Web Client Scanning a body volume with a computer tomograph or magnetic resonance tomo graph produces a sequence of two dimensional slice images If these slice images were acquired with suitable acquisition parameters Visage 7 Web Client can calculate volume data and provide a spatial impression of the exam ined region You can move through this display as you would through a three dimensional mod el That is you can calculate and display new slices irrespective of the original scan direction and orientation of the slices acquired Note 3D reconstruction is only possible for series produced with the modalities CT and MR and only if the series fulfill a number of technical requirements This section provides information about e 3D basics e Anatomical standard views You will also learn how to proceed when e Changing display properties for slice images e Working with the orientation cube e Moving and rotating slices and generating slice images e Changing the slice thickness for slice images 207 3D basics 3D basics Technical requirements Calculation methods 208 Working in the Basic MIP MPR Viewer For Visage 7 Web Client
30. down to reduce the image When you release the mouse button the image will keep its new size If parts of the images are no longer visible in the segment after enlargement 1 Select operating mode Pan from the popup menu The operating mode is now shown bottom left in the segment and the mouse pointer changes shape 2 Left click and drag the image After zooming or panning in one of the slice segments you can apply the new dis play settings to the other slice segments too Simply select Apply to All from the popup menu You cannot apply display settings from the overview segment to slice segments Visage 7 Web Client Working in the Basic MIP MPR Viewer Changing display properties for slice images Resizing an image automatically Fitting to segment Select View gt Fit into Segment from the popup menu The slice image or the orientation cube is zoomed to fit it optimally into the seg ment Or Original size Select View gt Original Size from the popup menu The slice image or orientation cube is shown in its original size as calculated Or Full screen Select View gt Full Size from the popup menu All other 3D view segments are hidden and the current segment is shown in full window size Select View gt Full Size again from the popup menu to exit this view Switching the calculation method When you load a series into the basic MIP MPR viewer the volume data set is first calculated by the multiplanar rec
31. e Images referenced in a presentation state cannot be displayed by Visage 7 Web Client if they were compressed lossily and with matrix reduction Visage 7 Web Client Reviewing Images Slow scrolling Next previous presentation state TR Next previous study or patient Presentation state mode on off Edit and evaluate images Visage 7 Web Client Viewing presentation state images e Only graphical overlays type G 60xx 0040 can be displayed Overlays of type R ROIs cannot be shown Moreover if overlays that are encoded in an image exceed the size of the underlying DICOM image they are clipped to the size of the underlying image e Only curve data of type ECG POLY and ROI 50xx 0020 can be shown More over the Curve Data Value Representation 50xx 0103 must be 0x0000 un signed short and the Axis Units 50xx 0030 must be PIXL PIXL Once you have loaded presentation state images into a viewer you can Scroll through the images of one series in the current presentation state image by image e Image by image slow scrolling Note Cine mode is not possible for presentation state images Scroll through the presentation states of your current study 1 Use these icons in the viewer toolbar to show the images of the next previous presentation state of your study The icons are dimmed if only one presentation state is available for the current study Scroll on to the presentation states of the next stu
32. from another software program 30 integrated Windows authentication 30 multi session 29 standard procedure 29 with shortcut 28 Login screen 27 Logoff 31 Logoff icon 42 Loop All icon 79 159 Lossless JPEG compression 125 Lossy JPEG compression 125 269 270 Magnifying Glass icon 73 100 170 Mark study as read icon 78 98 205 Maximum intensity projection MIP 83 208 Measurement Functions icon 75 100 Measuring angles 183 density 188 distances 180 Mirror icon 74 103 Mirroring 178 Monitor check 249 Monitor selection worklist 94 MPPS Modality Performed Procedure Steps 64 Multiframe images 63 144 Multiplanar reconstruction MPR 83 208 Multiple sessions 29 Multi session operation 19 N Navigation bar 34 41 NetMeeting 235 Network node response list 49 94 Network node query 114 New report 141 Next Annotated Image icon 74 100 Next Frame icon 79 Next Patient icon 51 71 Next Presentation State icon 72 Next Scene icon 98 Next Series icon 72 Next Study icon 72 Next Viewer Layout icon 98 Non encrypted Data Transfer icon 52 93 Number of Images 116 O Online conference 235 Index Orientation cube 212 Original size icon 74 103 basic MIP MPR viewer 211 viewer 170 Overlays 149 P Pan icon 74 100 Panning basic MIP MPR viewer 210 viewer 169 Password 29 change password 31 239 Patient list filtering 108 scrolling 113 searching 111 Patient list
33. functions Distance Measurement Permits measurement of distances in images While this tool is active the mouse pointer looks like this m Measured values are indicated in exact millimeters mm in CT and MR images estimated millimeters mm or in pixels pix if no distance measurement in millimeters is possible The accuracy of distance measurements is 2 pixels Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum accuracy we recommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still i Angle Measurement Permits measurement of angles in images While this tool is active the mouse pointer looks like this TA The accuracy of angle measurements depends on the length of the shorter of the two angle legs The longer the angle legs are the better the accuracy For example Length of shorter angle leg measurement error 10 pixels 12 20 pixels 6 50 pixels 2 5 100 pixels 1 1 Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum ac curacy we recommend zooming into th
34. have access to Se lect a name If you are searching in the network the patient list can only be filtered according to the refer ring physician Here you can filter the patient list according to the patient s ward or the name of the institu tion where the patient was examined Click the Y icon next to the filter parameter Location Select a Ward or Institution Name Here you can sort the patient list according to the date when the patients data were trans ferred to the web server Today lists all patients whose studies were transferred to the web server today Yesterday lists all patients whose studies were transferred to the web server yesterday The last X days lists all patients whose studies were transferred to the web server during the last X days Date lists all patients whose studies were transferred to the web server on that particular day From date to date lists all patients whose studies were transferred to the web server with in the stated period All lists all patients irrespective of when their studies were transferred to the web server Here you can filter the patient list according to the processing status of procedure steps SCHEDULED lists all patients whose studies contain procedure steps that are scheduled for interpretation IN PROGRESS lists all patients whose studies are currently being reviewed in one of the Visage 7 Web Client installations in your network DISCONTINUED l
35. installed If a larger data volume was licensed in a previous version this may lead to the old est data being deleted from the system after the new license has been installed de pending on the auto delete settings defined by the system administrator Visage 7 Web Client provides different client types with different levels of functional ity e Visage 7 Web Client View with essential image viewing functions e Visage 7 Web Client Classic offering more image handling and review func tions e Visage 7 Web Client Expert with full functionality e Visage 7 Web Client Expert Dual Monitor with Expert functionality plus sup port of two monitors e Visage 7 Web Client Expert Reading with all the features required to use Vis age 7 Web Client for primary reading The client type Expert Reading is avail able with the Expert licence For a detailed comparison of the client types refer to the Appendix If your installation does not support one of these license types an error message will be displayed when you try to log in System requirements Server Clients Visage 7 Web Client When describing system requirements we make a distinction between server and clients For a specification of the hardware and software requirements for Visage 7 servers please contact your sales representative These are the minimum hardware and software requirements for Visage 7 Web Cli ent PCs e Operating system and software Microsoft Wi
36. keep the mouse button pressed the new slice image is indistinct It is updated and shown distinctly as soon as you release the mouse You can monitor movement of the slice in the orientation cube 213 Moving and rotating slices and generating slice images Working in the Basic MIP MPR Viewer 00 mm C 1043 W748 Slice Shift Moving one or more slices with the slice cursor 1 Click on the point of intersection of the two slice cursor lines in a slice segment to move the slices in the other two segments x The mouse pointer is now shown like this amp 2 Keep the mouse button pressed and move both slice images simultaneously with the point of intersection As long as you keep the mouse button pressed the new slice images in the oth er two segments are only indistinct They are updated and shown distinctly as soon as you release the mouse You can monitor movement of the slices in the orientation cube Or 214 Visage 7 Web Client Working in the Basic MIP MPR Viewer Moving and rotating slices and generating slice images 1 Click on a cursor line near to the point of intersection in a slice segment to move just this slice in the other two segments The mouse pointer is now shown like this 2 Hold the mouse button down and move the line and also a slice The new slice image is first only displayed indistinctly As soon as you release the mouse button it is shown distinctly You can monitor movement
37. keyboard shortcuts Popup menus are context sensitive This means they offer you only those functions that make sense with the currently selected image s or functions or in the currently selected screen section 1 Right click in the image area The popup menu opens 2 Select an item from the popup menu to run or activate this function 3 Select another item from the popup menu or select a menu item a second time to deactivate the function again Scrolling through images Scroll bars Visage 7 Web Client In order to scroll through loaded images you can use the scroll bar the keyboard or the wheel mouse Scroll bars are displayed along the right and sometimes bottom edge of windows when the content is too large to be displayed all at once Click a right left or up down arrow button to scroll the current display 4 i gt 37 Sorting list views Getting Started with Visage 7 Web Client Keyboard Use the keys on your keyboard for scrolling Wheel mouse If you have a wheel mouse a mouse with a small wheel between the right and left buttons you can use it to scroll Turn the wheel to scroll in the display i N os g Sorting list views The entries in the patient list and in the study and series lists can be sorted by any column Patient Name _ 1 Click a column header to sort by the entries in this column Angiologie Badner Heinz The arrow symbol tells you whether you have sort
38. list 1 0 0 2 cccceeeceseeeedebecneeeeddeeeneeeddeuaneeeedeeeneeeeddeenneeeddeneeneeeede 56 IMAGES POVIOW enina ear shad ence etdapercede eabddacee cians lect at tanagedtedidvteeeaihdeleeatiadaiets 57 Preview WINDOW ceran aE ds ee tceas de tevaubad E Higug send nice tet 58 Information area preview WINKOW ccceceeceeeeseeteeeeeeentaeeeeeeeeneeeeeeetiaeeeeeeenaaes 59 Visage 7 Web Client Table of Contents Visage 7 Web Client 6 0 Toolbar preview WINKOW c cccccceeeeeeeeeeeeenneeeeseeneeeeeeeeaaeeeeeeeeneeeeseeenaeeeeenenaaes 59 Information about the study 0 0 eceeee eee eeee erect eenneeeeeeeeaeeeeeetaaeeeeeeenaeeeeseenaaees 61 Information about a series 0 2 cece eee ceeete tees eeeeaeeeeeeeeaaeeeeeseeaeeeeseeenateeeeeeaaas 61 TUB MAIS as based at aciah piace Aue E E E nated anal cae te aes 63 Image preview POPUP MENU ccccccccecceeceeeceeeeeeeceaeeeeceeeeeeeeeeeeseeecesaaaeeaeeeeeeeees 65 Repo WINDOW a a a osetia a aad aa ane ened at aa ie 66 REPOMTOXU AA EE citi aa eet csalied eee E soda ietest tus cheek at tewatea rad veer hte 67 Report text dis play nisen t a raaa aaea ee aei eean i e taaa adaa dior 68 Report edit rsoc s eae a e ade a dee waa tang eea ages ad doe Dead ete acc AOE N a 68 IMAGE display sienos er EPE E EA EEN ea TUEN aN AEEA aaa 69 VISWETS aeea te eel nee Lue ee el a ee tee a 70 Information area VICWEN ee rinse EEEE AET 71 Toolbar viewer aa a AS A TA O ic ae ee 71 Imag ANCA sii osirig s
39. local 48 Patient list local worklist 94 Patient window 43 107 Patient Window icon 41 Personal Settings dialog box 112 Photofiles 63 161 Pixel lens 188 Plane A B icon 78 Playback cine mode 155 Position indicator bar 81 Predefined Level Presets icon 74 99 Preferably load thin slices icon 93 Preload Study icon 53 Preloading studies 124 Preview area 118 Preview window 58 118 Previous Annotated Image icon 74 100 Previous Frame icon 79 Previous Patient icon 51 71 Previous Presentation State icon 72 Previous Scene icon 98 Previous Series icon 72 Previous Study icon 71 Previous Viewer Layout icon 98 Print icon 72 99 Printing reports 139 Procedure steps 203 completed 205 Visage 7 Web Client Index Visage 7 Web Client scheduled 204 Procedure steps filter 204 Q Query Patient icon 47 92 115 Query Report icon 52 139 Querying local database 113 network nodes 114 Quick Zoom icon 73 100 168 R Range Selection DICOM Print icon 72 99 Ranking display protocols 132 Refresh icon 52 Reinstalling 241 Remove Delete Protection icon 47 Report images 63 161 Report window 66 137 Report Window icon 42 Report with Image icon 42 Reports displaying 137 editing 139 new report 141 printing 139 retrieving 139 Reset Filter Settings icon 46 91 Reset Input Fields icon 46 91 Reset to Default Filter icon 46 91 Reset Window Level icon 74 99 Respons
40. of the ROI graphic an info box border Showing the histogram Click on the little arrow gt in the top right corner of the box that show the statistical values to display pixel values in a historgam A 1448 mm 186 Visage 7 Web Client Reviewing Images Evaluating images Moving or resizing ROI graphics If your ROI graphic does not cover the region that interests you adequately you can move or resize it 1 Click a ROI graphic to select it Grab handles are now shown on the corners and along the lines of a rectangle ROI For circular or elliptical ROIs a bounding box with grab handles is shown Click a grab handle keeping the mouse button pressed and move the mouse to resize the ROI Or Click on a bounding box line but not on a handle keep the mouse button pressed and drag the entire ROI across the image area Release the mouse button The ROI statistics are now recalculated Density measurements Jr Mf Visage 7 Web Client Visage 7 Web Client allows you to calculate pixel densities either along a straight line as a density profile or for individual pixels with the pixel lens Note Density measurement is not possible on images compressed with lossy compres sion Density profile You can calculate a density profile both in single frame and multiframe images Drop down the Measurement Functions icon bar and keep the mouse button pressed Select the Density Profile ic
41. or the images number to select which images are shown next Note In manual mode the physician is responsible for selecting suitable start images be fore linking viewers and starting synchronized scrolling Tip If you selected a synchronization mode that is not supported by the currently dis played image data a message will help you with finding a supported mode Click the first viewport to select it The viewport is highlighted with a colored border Display the image with which you want to start synchronized scrolling in this viewport Select Automatically as a synchronized scrolling mode from the popup menu Hold the Shift key down and click the second viewport This second viewport is now also highlighted with a colored border Start scrolling in both viewports simultaneously Use the wheel mouse cine mode or interactive cine mode to do so Click the first viewport to select it The viewport is highlighted with a colored border Display the image with which you want to start synchronized scrolling in this viewport Select Manually by Position or Manually by Index as a synchronized scroll ing mode from the popup menu Click the second viewport and show the image with which you want to start syn chronized scrolling in this viewport Hold the Shift key down and click the first viewport again Both viewports are now highlighted with a colored border 227 Editing image
42. paten erene E A AREE 132 Selecting e Study erora a E EEA E eva ceee tans 133 Selecting the display protocol sssseeessssssseesrrressssrressennnesrnnnanstnrnanderennneeenennns 133 Loading tWO StUGIOS esasen r ctendhauad inaes tag deeds ea saad te 134 Loading image data encrypted ccc ceeeeceeeeeeeeenneeeeeeeeceeeeeeetaeeeeeeenateeeeeneaas 135 Loading thin Slice serias aeeiiaii eere ETE E ARAE AEEA E OG 135 Selecting a compression level essesssseseersseesrirreesrsrnneernsnnassrennnaderennneeseennee 135 Displaying and Editing Reports 137 Displaying a repart necie ianen EAEN NESTE Eaa AAEE ENAT 137 Retrieving a report from the RIS aaeessseessssssessrrsssssnneesrsnnnessnnnnnsnnnnasddnannndatinnneenna 138 Printing a report t xt esns a a aa a ia ia i E aT 139 Editing a report orninan iui e i a E EEA TEA i ANAA 139 Creating a new re POrt sc cc ccccceeecccceeeeseccceeeeenecceceeenseececenesneceeeeneneaeeeeeneneaceeeeneneees 141 Reviewing Images 143 Single frame and multiframe iMaQeS 0 eeeceeceee scene eeeeeeeceeeeeeenaeeeeeeenaeeeeeeeeaaes 144 Image text ANd image ICONS eect cette eee eeeeeeeeeeeedeeeeeeeteneaeeeeeseeeaeeeeseeenaeees 145 Selecting screen layout and image display ccccceeeeeeeeeeeeeeeeneeeeeeenteeeeeeeaas 147 Changing the layout of the image Area eee eeeeeeeeeeeeeeeeeeeeeneeeeeeeneeeeeeeeaas 147 Showing hiding or Moving the toOlbar ee eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeneee
43. patient s data are currently being updated from the HIS RIS In this case a message is displayed informing you that the patient is temporarily locked Try again later Deleting patient and examination data Deleting patient data 242 n It is possible to delete patient data that has not been delete protected from the pa tient list and therefore from the Visage 7 server Before deleting make sure you and other users no longer need the patient data Once you have deleted a patient from the Visage 7 server you cannot restore the data again unless you have access to the long term archive of the modality Tip Deleting patient data may become necessary for example if patient data are cor rected at a modality after the patient s data have already been sent to the web server Delete the patient on the web server as soon as you learn of this and be fore the corrected patient is sent to the web server again 1 Switch to the patient window 2 Select the patient s you want to delete 3 Click this icon The selected patient s are now irrevocably deleted from the Visage 7 server If you are working with the archive option only the patients study data are delet ed from the database the patient entries remain in the patient list Note If you select patients both with and without delete protection a message will in form you that not all patients will be deleted Visage 7 Web Client Functions and Informat
44. quickly they are subdivided into chapters In the Visage 7 Web Client user manual and online guide each chapter address es a specific task or group of tasks relevant to your daily work with the product For experienced users The Visage 7 Web Client Window section serves as a concise reference guide The Table of Contents and Index sections help you locate a topic quickly To help you find and interpret the appropriate information the following visual orien tation aids are used here e Operating steps Single step actions are presented as plain text 1 Operating steps in sequences of actions are numbered e Bold text Names of windows menus and functions are shown in bold typeface Sections of text given particular emphasis are also highlighted in bold type Tips notes and warnings are highlighted Tip Tips provide additional useful information about a topic Tips for example help you organize your work more efficiently Note Notes mark text that you should pay special attention to A note may for example emphasize a piece of information relating to the safety of functions but where no direct danger is involved Caution is used to indicate the presence of a hazard which can cause personal injury to a patient or damage to the equipment Information on using the online help systems Visage 7 Web Client The Visage 7 Web Client and Visage 7 Client user interfaces and the Visage 7 ad ministration p
45. second time the images will be displayed immediately The Preloaded Images column of the series list tells you that these images have been downloaded to your local cache Alternatively you can actively preload an entire study before displaying its images the first time 1 Be sure Use Local Cache is selected 2 Click Preload Study on the toolbar of the study series list In the Preloaded Images column of the series list you can monitor the progress You can preload as many studies as you like The amount of data you can preload is only restricted by the storage capacity of your hard disk Local cache works on the FIFO First In First Out principle If not enough memory is available to store the images you have requested the first images that you loaded are removed from the memory Visage 7 Web Client Loading Image Data Loading images into a viewer Using data compression and encryption Data compression When loading image data either from the image preview or study series window you can choose between loading the original data which might take longer or loading the data in compressed format Visage 7 Web Client supports the following compression methods e No compression e Lossless JPEG compression e Lossy JPEG compression with specification of the quality factor e Lossy wavelet compression with specification of the quality factor For each image type your system administrator has defined two compression lev e
46. segment along two standard axes Do not accidentally click on the slice cursor line Visage 7 Web Client 87 Basic MIP MPR viewer The Visage 7 Web Client Window SliceThickness View Fit into Segment Original size Full size Show All slices Slice 2 3 Volume box Slice cursor In the slice segments only Allows you to change the slice thickness of the image shown in this slice segment interac tively Do not accidentally click on the slice cursor line Opens a submenu Enlarges or reduces the image so that it fits optimally into the image segment Shows the image in its original size Displays the current segment in full window size The other three segments are then hid den In the 3D overview segment only Shows or hides all slices in the overview segment In the 3D overview segment only Shows or hides display of individual slices In the 3D overview segment only Shows or hides the volume box in the overview segment In the slice segments only Shows or hides the slice cursor in a slice segment MPR Selects MPR as the volume calculation method default MIP Selects MIP as the volume calculation method Reset Resets all processing steps and again shows the images in all segments as they were when first loaded Unload Removes the data set from the basic MIP MPR viewer All segments are then empty Keyboard In the basic MIP MPR viewer you can activate processing modes in the segment
47. set You can observe the changes in orientation and position of the slices displayed in the 3D overview segment To obtain a better view of details in the displayed slices you can change different display parameters in the slice segments e g window zoom pan Orientation labels Orientation and position of the Slice in the up per right seg ment Orientation and position of the Slice in the low er left segment Current calcu lation method T MPR Ma Current slice thickness Current operat ing mode Example Upper left segment after loading images transverse slice The slice cursor in a slice segment shows you the orientation and position of the slices that are currently shown in the two other slice segments On the slice cursor e a yellow cursor line corresponds to the slice image in the upper left segment e ared cursor line corresponds to the slice image in the upper right segment e a green cursor line corresponds to the slice image in the lower left segment Visage 7 Web Client The Visage 7 Web Client Window Basic MIP MPR viewer Slices in the volume data set You can use the slice cursor of the three slice segments to move through the vol ume data set and display the recalculated slice images If you move the center of the slice cursor you will move the entire slice cursor in the image This moves two view planes simultaneously in the volume data set and shows new slice im ages in both of
48. step to all images of a loaded series When this option is selected all image editing steps are applied to all images of a loaded series immediately and not just to one image alone Visage 7 Web Client 105 Display Protocol Viewer Expert Reading The Visage 7 Web Client Window Undo Show Hide Overlays Hide Show Shutter Delete Measurement Annotation Delete all Measurements Delete all Annotations Delete all Measurements and Annotations Select Image Remove Image Selection SMPTE 1 2 Synchronized Scrolling Show Hide Mea surements and Annotations Undoes the last editing step Shows overlays if any have been created for the loaded images Shows or hides a shutter if a shutter was created for the loaded image Deletes a selected measurement or annotation graphic Deletes all measurement graphics in the currently selected image Deletes all annotation graphics in the currently selected image Deletes all measurement or annotation graphics in the currently selected image Selects the current image i e the image highlighted by a white border for DICOM print DICOM print selection is indicated by a solid green box in the lower right hand corner of the image segment Removes the current image from the DICOM print selection Calls one of two available test images for performing a display quality check of your monitor Allows you to select a mode for synchronized scrolling S
49. study Or Select Deselect all from the popup menu to deselect the images of one series only Click on the title bar of the entire study to invert the selection of images in the entire study Or Click on the title bar of a series to invert the selection of images in this series Or Select Invert selection from the popup menu Previously selected images of the series are deselected All other images of the series are selected Visage 7 Web Client Loading Image Data Loading images into a viewer Displaying the previous or next patient in the study series window If the patient you loaded into the study series window was not the one you were ac tually looking for you can move on to the next or previous patient without having to return to the patient window Next or previous patient refers to the patient below or above the current patient in the patient list 1 Click this icon on the toolbar of the study series window The data of the previous patient i e the patient above the selected patient in the patient list is displayed 2 Click this icon on the toolbar of the study series list The data of the next patient i e the patient below the selected patient in the pa tient list is displayed Loading images into a viewer a2 You have selected the series and images that you want to review in the study series list or in the preview window There are several methods for loading images into a viewer T
50. the Ctrl key down You can undo your filter settings Click the Reset Filter Settings icon on the toolbar Or Click the Reset to Default Filter icon on the toolbar Visage 7 Web Client Loading Image Data Finding patients and transferring them to the study series window Entering search criteria In the upper right and central area of the patient window you will find the entry fields for the search criteria You can restrict the patient list further using the search crite ria 1 Click the Show filter criteria icon in the top left corner of the patient window if search criteria entry boxes are currently not shown 2 Enter search criteria Patient Name Patient ID Patient Comment Date of Birth Study ID Study Description Accession Num ber Searches for a patient by name Enter the patient name in the format last name first name middle name prefix suffix For ex ample Doe John Jack Dr for Dr John J Doe Searches for a patient ID Searches for a patient whose studies contain a specific comment Searches for a patient by date of birth Use the date format indicated next to the search box Your system administrator can con figure this format for you Also remember to enter the complete date of birth here day month year You cannot for example search by year of birth only Searches for a patient with this study ID Searches for a patient with this study description Sear
51. the DICOM Print icon from the viewer 1 toolbar This ensures that the reference image will be printed first 8 Select print settings in the DICOM Print dialog box and start the printout See also Print preview and starting the printout on page 193 Showing scoutlines in slice images 1 Load one series in viewer 1 and the other in viewer 2 rT acs TE 2 Display both viewers side by side compare mode A 3 Select Show Current Scoutline in both screen halves for example When you scroll through one of your two series now the scoutlines will follow your scrolling in the other screen half Visage 7 Web Client 165 Editing images Reviewing Images Hiding scoutlines Click the Show Scoutline icon a second time in one or both screen halves to hide fA scoutlines again Editing images Once you have loaded all images and series you wish to review into one of the Vis age 7 Web Client viewers you can process individual images or apply these chang es to all images at once Note All changes you make only apply temporarily for the current session You cannot save these changes back to the database on the web server These image processing options are available in Visage 7 Web Client e Zooming and panning images e Windowing and filtering images e Rotating flipping and inverting images Immediately after loading one tool for image editing is already selected Your sys tem administrator can assign a default editing t
52. the Visage 7 Client for advanced 3D evaluation Automatic Synchronization with 3D volume Select this option to ensure that both the Visage 7 Web Client and the Visage 7 Client will always show images of the same patient Information about the study The colored header bar of the study shows the following information study description date time referring physician study ID Tip Click on the study information bar to select all images of this study or to invert the current selection of images Double clicking on the study information will load the entire study into viewer 1 Information about a series In the image preview thumbnails are grouped by series Series header bars show the following information about a series series description modality number of images examined organ date time additional series information Visage 7 Web Client 61 Preview window Additional series information 62 The Visage 7 Web Client Window Tip Click on the series information bar to select all images of this series or to invert the current selection of images Double clicking on the series information will load the entire series into viewer 1 CT Series scanned with contrast medium For CT series the abbreviation WC on the right edge of the series information bar indicates that these images were scanned with contrast medium WO indi cates that this series was scanned without contrast medium If a CT series contains b
53. the conference can start Tip Click the Status Information icon on the navigation bar and move on to the Acti ve User List tab card Here you will find a list of all users currently logged on to the Visage 7 server Working with the whiteboard Copying an image to the whiteboard Visage 7 Web Client ao RO ND The whiteboard is a component of NetMeeting It is an electronic chalkboard that all conference participants can access Switch to one of the Visage 7 Web Client viewers Scroll to the image you want to discuss Copy the image to the Windows clipboard Switch to the whiteboard Insert the image Edit gt Paste or shortcut Ctrl V Tip The clipboards of conference participants are open and visible to all other partici pants You can insert the contents of somebody else s clipboard into your own lo cal programs However you can protect your own clipboard from access by other participants Ask your system administrator for details 237 Ending an online conference Setting up an Online Conference Annotating an image Synchronized mouse pointers All conference participants can annotate the image shown on the whiteboard with text or graphics Each conference participant can delete their own annotations The text and graphics annotations are entered just like in any other Microsoft graph ics program Each conference participant can activate a pointer on the whiteboard which is visi b
54. the filter from the list in the Personal Settings dialog box 2 Click the Delete button 3 Click OK to close the dialog box Starting a query in the local database Your system administrator can set your system to start the query automatically ev ery time you enter a filter or search criterion and press RETURN You must start a database query explicitly if you have reset filter or search criteria with the toolbar icons or if the function has not been configured for you Visage PACS Web 1 Select the web server as the data source ce 2 Click the Start Data Query icon on the toolbar rt The patient list is updated For a better overview the patient list does not display all patients found at a time di bb 3 After a rather generic search use these two icons to page through the entire list of patients found Searching and retrieving patients from other network nodes If you cannot find the patient you were looking for on the web server you can search for his or her data on one of the connected network nodes or in an archive To do this perform the following three steps e You search for the patient on one of the connected network nodes e You retrieve patient data from there i e transferring the data to the web server e After a brief time you search for the patient again on the web server Visage 7 Web Client 113 Finding patients and transferring them to the study series window Loading Image Data 114 Archive
55. the first film sheet page lt scrolls to the previous film sheet page gt scrolls to the next film sheet page gt scrolls to the last film sheet page 7 Check and if necessary change other print parameters Your system administrator has configured the options available in the print pa rameter boxes for each connected DICOM printer 8 Click OK to start the printout Tip Use the Status Information dialog box to check whether your print job was sent off successfully See Checking status information Tip For printing reference images and scan series with scoutlines in one DICOM Print job refer to Printing reference image and scan series with scoutlines on page 165 Printing images on a Windows printer 194 When printing images on a local or network Windows printer we recommend that you always use the Visage 7 Web Client function which is available through the print icon in the viewer toolbar That way the images are printed centered on the paper together with a header and footer The system administrator can modify the header and footer in the administra tion tool of the Visage 7 server Note You should not use the standard print function of the Internet Explorer None of the predefined print settings made by the system administrator are available there You yourself are responsible for ensuring adequate print quality A Windows printer will print images exactly as they are currently displayed in the Visage
56. the left monitor for navigating through the loaded images This is synchronized with the right scroll bar Visage PACS Microsoft Internet Explorer la xj Ele Edt View Favorites Tools Help fa a Patient Name CT Abdomen Patient ID 23007 Date of Birth 2000 01 01 ee Study Description CT Abdomen Study Date 2006 10 31 11 35 35 PACS cs Sao O meN oe i a a E E e C H m amp Done A Trusted sites Visage 7 Web Client The Visage 7 Web Client Window Viewers Information area viewer This area of the viewer provides information about the loaded patient and study Patient Name Patient ID Date of Birth Study descrip tion Study Date Time Name of the loaded patient ID of the loaded patient Date of birth of the loaded patient Description of the study Date and time of the study in the format YYYY MM DD and hh mm ss 24 hour clock Toolbar viewer With the icons of the viewer toolbar and the popup menu in the image display area you scroll through the loaded images change the screen layout and optimize the image display The viewer toolbar is shown as one two or three rows of icons depending on your screen resolution and the number of configured icons Note The selection of available icons depends on what images are loaded XA images or others and on how the system administrator has configured the user interface for
57. the other slice segments If you click near to the point of intersection on the cursor line you will only move a single cursor line That will take you through the volume data set along the two other standard axes and up date the view in one of the other slice segments If you click a long way from the point of intersection on the cursor line you can rotate the slice cursor This rotates the cross hair updates the views in the two other slice segments and gener ates slice images with non standard views in them Popup menu en Tip You can monitor all your slice cursor movements in the 3D overview segment This gives you a clear overview of the slices through the volume data set that are cur rently being displayed in the slice segments Right click on a slice segment or on the 3D overview segment A popup menu appears with all the processing options that are possible here Apply to All Windowing Zoom Pan Rotate SliceShift Applies a processing function in the current segment to all other segments too In the overview segment only possible for windowing Activates interactive windowing with the mouse Activates interactive image zooming with the mouse Activates interactive image panning with the mouse In the 3D overview segment only Allows you to rotate the orientation cube in any direction with the mouse In the slice segments only Allows you to move the slice currently shown in the slice
58. the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still 1 Drop down the Measurement Functions icon bar and keep the mouse button pressed 2 Select the Distance Measurement icon The mouse pointer changes shape in the image area 3 Click the starting point of the distance line 4 Hold the mouse button down and drag a line over the image 5 Release the mouse button when you reach the required end point When you release the mouse button a line appears showing the length in exact millimeters mm in CT or MR images estimated millimeters mm or pixels pix if the image data do not allow calculation in millimeters Visage 7 Web Client Reviewing Images Evaluating images Tip Calculation of distances in exact millimeters requires that the image data come with exact distance information in a specific DICOM tag Pixel Spacing Only CT and MR images come with this DICOM tag Therefore indication of distances in exact millimeters is only possible in images of these modalities Images from other modalities such as the XA modality for example usually come with DICOM information that allows a very close estimation of millimeters Dis tance measurements in images from these modalities are therefore usually indi cated in estimated millimeter
59. to add to the Favorites list 2 Click Add In various help topics you will find links that will take you to more detailed informa tion about a subject Text links are shown in blue and underlined Links in overview graphics are shown in italics Use the next and previous icons in the footer of each help topic to scroll through the online help system topic by topic Visage 7 Web Client System Overview Help window toolbar Overview of the Visage 7 product documentation The upper part of the help window shows a number of icon buttons Use these but tons to adapt the help window scroll through topics and print topics Show Hide Back Forward amp Print sig Options Shows the online help tab cards if they are hidden and then changes to the Hide button Hides the online help tab cards if they are shown and then changes to the Show button Returns to the previous topic Returns to the next topic after you have clicked Back Prints the current topic on the set printer Shows a menu with more help functions Visage 7 Web Client 25 Overview of the Visage 7 product documentation System Overview 26 Visage 7 Web Client Starting and Ending the Program This section tells you how to start Visage 7 Web Client log onto the server and close Visage 7 Web Client properly at the end of each session Depending on your system configuration the type of data connection you are using to a
60. version 27 Calling up the login screen Starting and Ending the Program Customer specific translation Shortcuts a Visage PACS Downloading the user manual and online guide Microsoft Windows Vista 28 Servername is a placeholder for the name of the Visage 7 server on the network URLs that follow the convention of previous software versions http serverna me visagepacs en or http servername radin are also still valid If a customer would like to have the user interface translated into any other lan guage than those listed above a separate directory is available for this The customer specific directory cs contains a version of the user interface that can be translated into other languages The address of the login page in this case is http servername cs for customer specific program version To speed up the call up procedure for subsequent logins you can create shortcuts to the login screen 1 Enter the URL of the Visage 7 server in the Internet Explorer address bar 2 Select Favorites gt Add to Favorites in the Internet Explorer menu Or Reduce the Internet Explorer window so that it no longer covers the entire screen and click this icon in front of the URL and drag it onto your Windows desktop 3 Select Visage 7 Web Client in the Favorites menu of the Internet Explorer Or Double click the Visage 7 Web Client icon on your desktop next time you want to call up the Visage 7 Web Client lo
61. when you save your finished report this will only create a report on the Visage 7 server The report will not be communicated to the HIS RIS Visage 7 Web Client 233 Viewing and editing a report Reviewing and Reporting on Images in the Display Protocol Viewer 1 Use this icon to save your new report i e upload it to the web server when you have finished typing it af 2 Do not forget to also mark your study as read This will set the procedure step for this study to completed and your name will be entered as performer in the worklist 234 Visage 7 Web Client Setting up an Online Conference A conference in the Internet or intranet allows you to communicate with colleagues All conference participants can view and annotate an image shown on the white board with text or graphics These annotations are visible to all participants Participants in an online conference may also communicate via video and audio channels if their PCs are equipped for it The conference mode is implemented with the external Microsoft program Net Meeting NetMeeting server The NetMeeting server program is installed on the Visage 7 server This program coordinates the communication between the various participants in an online con ference NetMeeting client Before you can take part in an online conference the NetMeeting client program must be installed on your local PC Note If Microsoft NetMeeting has not yet been installed on your PC p
62. window filter presets After you have windowed or filtered an image you can save these window filter set tings as a preset t 1 Use the mouse to window and filter the currently selected image 2 Select Window Level Presets gt New Window Level Presets from the popup menu The New Window Level Presets dialog box opens The window center and width value of the current image and filter settings are displayed 174 Visage 7 Web Client Reviewing Images Opening the dialog box ta Visage 7 Web Client Editing images Ml y New Window Level Presets Window fe ok Center 50 Window Cancel Width 350 Filter jo Window i ll Name 3 Enter a unique name 4 Click OK Modifying or deleting preset window filter values You can modify or delete user defined window and filter presets at any time Note You cannot modify or delete presets that were defined during the installation of the web server 1 Click the Window Level Presets icon The Window Level Presets dialog box opens The list displays all presets avail able for the current modality and image type 2 Select a preset and click Edit The Configure Window Level Presets dialog box opens This dialog box lists all window and filter presets by modality 175 Editing images Reviewing Images Configure Window Level Presets Image Type CT Image S age Storage hd M Configure Window Level Presets
63. work in one of the viewer windows Here you can export selected images onto your client PC in DICOM bitmap or JPEG format in order to import them into another application from here When images were saved in BMP or JPEG format they may no longer be suitable for diagnosis Visage 7 Web Client 195 Exporting patient data or images Printing Exporting and Sending Images Copy to clipboard You can copy images to the Windows clipboard and subsequently paste them in a presentation or on the whiteboard in an online conference Copy to clipboard offers a quick way of showing images from Visage 7 Web Client in a text file for example When copying images to clipboard you also work from a viewer window Exporting patient data from the patient list AT 1 Select the patient s you want to export in the patient list If the data volume of the selected patient s exceeds the configured maximum data volume the display field for data volume is dimmed E 2 Click Export Patient on the toolbar of the patient window All images of the selected patient s are copied to a separate directory on the server with the best image quality A subdirectory is created there for each patient The ID of the export order is displayed in the message box If your system is equipped with a CD or DVD producer station the data will automat ically be recorded on CD or DVD together with a DICOM viewer Exporting images from the viewer T 1 Load your study o
64. you Change Toolbar Location Moves the toolbar from above to left of the image area i e horizontal to vertical and vice versa Auto Hide Toolbar Lock Toolbar Hides or redisplays the viewer toolbar If the toolbar is hidden move the cursor over the area where it would normally be shown to redisplay it temporarily and to access its icons Previous Patient Shows the first study and series of the patient above the patient currently selected in the pa tient list Next Patient Shows the first study and series of the patient below the patient currently selected in the pa tient list Previous Study Loads the previous study of the current patient and displays its images Visage 7 Web Client 71 Viewers The Visage 7 Web Client Window S BS p Next Study Loads the next study of the current patient and displays its images Previous Series Loads the previous series of the current study and displays its images With multiframe im ages the previous scene is loaded Next Series Loads the next series of the current study and displays its images With multiframe images the next scene is loaded Previous Presentation State Shows the previous presentation state of this patient and study Next Presentation State Shows the next presentation state of this patient and study The Previous Next Presentation State icons are dimmed if only one presentation state ex ists for this study or if no present
65. your own filters filters 1 Click the Set Filter Properties icon on the toolbar B The Personal Settings dialog box opens E xi Personal Settings Filter Name FILTER 1 save as 1DJ01 Z Default Fitter C Filter Description E Reset Query 7 Study Date All Patient Name Study ID Y Modality All Patient ID S Study r CS SY Y Physician All Description Patient Comment i 7 Location All E r Accession No Date of Birth YYYY MM DD v Insertion Date All v Interpretation Status All D Filter Name Interpretation St Physician Patient Comment Study ID c OK Apply New Delete Cancel 7 7 D Trusted sites N Set the filter and search criteria for the new filter o Enter a meaningful name for the filter under Filter Name 4 Enter a description of the filter under Filter Description 112 Visage 7 Web Client Loading Image Data Finding patients and transferring them to the study series window 5 Check Default Filter if you want this filter to be selected by default whenever you start Visage 7 Web Client 6 Click Apply to confirm your new filter definition The new filter is added to the list You can now define more filters change existing filters or delete filters Click on a filter in the list to edit its settings Or Click the New button to start a new filter definition Deleting filters 1 Select
66. 133 Visage 7 Web Client Index Visage 7 Web Client monitor configuration 131 thin slices 135 Worklist Expert Reading 90 Workspace 35 Z Zoom icon 73 100 Zooming basic MIP MPR viewer 210 viewer 169 273 Index 274 Visage 7 Web Client Copyright Visage Imaging GmbH VISAGE IMAGING Visioneering Science for Life For contact information and a list of our world wide office locations visit www visageimaging com Visage Imaging is a wholly owned subsidiary of Pro Medicus Ltd www promedicus com
67. 6 Filtering the study series list euri manri ren aaraa AENEA RE NAE ART E 117 Selecting data from the study or series list ee ceeeeeeeeeeeeeeeeeeeeetteeeeeeenaaes 118 Selecting data in the preview area or preview WINdOW cccceeeeeeeeeteeeeees 118 Showing the preview area or preview WINKOW ccccccceceeeeeeeeetteceeeeeeeeeees 118 Selecting an entire study in the image Preview ccceeceeeeseeeeeeeeetteeeetees 119 Selecting entire series in the image Preview ccceceeceeeeeeeteeeeeeettteeeeeeeees 119 Selecting individual images ccceeeeee terete eet eee eee teeeeeetaeeeeeetnaeeeeree 120 Displaying the previous or next patient in the study series window 0 121 Loading images into a VICWET cceeceeeeeeeeeenteeeeeeeaeeeeeeeeaeeeeseeenaeeeeeeentaneeeeneaas 121 Loading by double click erroa a E E eae ad eee ances ee 121 Loading images into Viewer 1 Of 2 00 eeceeceeeeettee eee eeetteeeeee tants eeetiieeeeeeetnaeeeeen 122 Loading images for COMPALISON ceceeeeeeeeteeee teeter cette eeeeeeetaeeeeeetnaeeeeee 123 Image Comparison in Classic MOE ccecceceeeeeeeeeeeeeeceeeeseenaeeeeeeetaeeeeeeeaaas 123 Image comparison in Expert mode c cccecceeeeeeeeeeeeeeeeeneeaeeeeeeeeeteeeeeees 123 Using the local cachas ensis ina a A AAA ET oe ee 124 Using data compression and encryption c cccceecceeeeeeeeeeeeeeeeeteteeeeeetteeeeeeees 125 Selecting
68. 656565 2007 04 02 MANUS DEXTER 1953 11 04 2007 04 02 MDP_CHILD_01 FLTOPOS 1997 11 03 MDP_TOP FLTOPO3 1920 05 03 MR Abdomen 23003 2000 01 01 MR Ankle 23000 2000 01 01 MR Ankle multi 23006 2000 01 01 MR dataset Brain reg2 1911 01 01 MR Knee 23002 2000 01 01 MR LSpine 23001 2000 01 01 me Shoulder 23005 2000 01 01 Display Protocol Description Monitors Orientation gt l eer View One series per viewp 2 Landscape Blank Vie Use drag and drop to 2 Landscape 2007 04 03 2007 04 02 2007 04 03 2007 04 03 2007 04 5 TA Z ZZTN O MEDIUM ome 07 31 11 55 37 MR MR Ankle MEDIUM 2006 10 27 18 53 33 MR MR Ankle Interpretation SCHEDULED Interpretation SCHEDULED Loading two studies 1 Click a patient to show a list of all his or her studies 2 Click a study to select it 3 Hold the Shift or Ctrl key down while you click the second study The display protocols list is updated It now shows display protocols that have been optimized for comparing studies in top position 4 Double click one of these protocols For example select a protocol labeled Curr Prior to compare the images of a current study with those of a previous examination Sex Insertion Dati a a ee MDP_CHILD_01 FLTOPOS 1997 11 03 F 2007 04 02 AREEN Displ 2 Landscape MDP_TOP FLTOPOS 1920 05 03 F 2007 048 AE Blank Viewports Use 2 Landscape 28 MR Abdomen 23003
69. 7 Web Client viewer which includes zoom pan or window settings as well as measurement and evaluation graphics e g distance lines or ROI graphics Visage 7 Web Client Printing Exporting and Sending Images Exporting patient data or images Windows printout E 1 Load your study or series into one of the viewer windows viewer 1 for exam ple FA EA 2 Select a screen layout to define the number of images to be printed ba In a Windows printout only those images that are currently shown on the screen will be printed for example one image in a 1x1 screen layout four images in a 2x2 layout and so on 3 Drop down the Print icon bar F amp 4 Select the Windows Print icon Images are printed centered on paper with headers and footers Note Because of possible loss of image quality do not use images printed on paper for diagnostic purposes Exporting patient data or images Various alternatives exist for exporting patient and image data for different purpos es Patient data export When exporting all the data of a particular patient stored on the web server you work in the patient window As a rule you export all studies of a patient from here in order to have them written to CD or DVD for example by a CD DVD producer station Patient data export will export the selected data from the web server database onto a predefined file directory on the server Image data export When you export individual images you
70. 7 server from a Visage 7 Web Client or Visage 7 Client in order to review 2D 3D or report data Visage 7 Web Client or to view and process 3D volume data Visage 7 Client The Visage 7 Web Client and Visage 7 Client user documentation addresses this user group System administrator The system administrator of the hospital will perform system maintenance and adapt server configuration and database settings to changes in the system and network environment This user group works on the administration platform The Visage 7 administrator documentation addresses this user group Service personnel This user group will install the system and subsequently perform initial system configuration This group will need the installation manual for system installa tion and the administration documentation for initial system configuration In this section you will find an overview of the available product documentation as well as information on how to work with the Visage 7 user manuals online guide and online help systems User and administrator documentation User documentation Visage 7 Web Client The Visage 7 product documentation addresses the information needs of each of these user groups The Visage 7 Web Client and Visage 7 Client user documentation addresses clinical users It comprises The Visage 7 Web Client user documentation In these documents clinical users will find a complete description of the Visage 7 Web Client us
71. 78 93 104 B Backwards icon 47 92 Basic MIP MPR Viewer technical requirements 208 Basic MIP MPR viewer 83 calculation methods 208 loading data 129 moving slices 213 non standard slices 216 overview segment 85 slice cursor 86 214 slice segments 86 slice thickness 217 SliceShift 213 standard views 209 Basic MIP MPR Viewer icon 42 51 Basic operation scrolling 37 selecting data 39 selecting functions 35 sorting lists 38 switching windows 35 Biplane scenes 64 160 BMP images 197 Bouncing Cine icon 77 104 155 C Calendar 110 Calibrate Distance icon 76 101 Calibration 181 Cancel Data Query icon 46 92 Cancel loading icon 72 98 Change Group Assignment dialog box 244 Change Group Assignment icon 47 92 Change Procedure Step icon 52 93 204 Change Toolbar Location icon 71 Change User Assignment dialog box 244 Change User Assignment icon 47 92 Cine loop 159 267 268 Cine mode 154 angio scenes 158 Cine Mode Backward icon 77 104 Cine Mode Forward icon 77 104 Cine Mode Speed icon 77 104 Cine Mode Stop icon 77 104 Client installation 16 Client software reinstall 241 uninstall 241 Color map icon 78 104 Color palettes 149 Columns adjusting width 40 Compare mode 82 scoutlines 163 Compare Mode horizontal icon 42 Compare Mode vertical icon 42 Compression level A B 125 135 Compression Level A B icon 52 Configurable user interface 33 Constancy chec
72. Client provides a number of tools for the evaluation of image informa tion These tools support you with e Measuring distances and angles e ROI evaluation e Density measurements Measuring distances and angles With Visage 7 Web Client you can measure distances and angles in images For ex ample you can measure the length or width of structures Some modalities and image types allow measurement in millimeters whereas oth ers provide pixel information only For images in this last category Visage 7 Web Client provides a calibration tool This assumes that the images include image markers with known distances Tip If you zoom pan rotate mirror or invert images the measurement graphics are also adjusted Note When you use measurement functions for diagnostic purposes please check the plausibility of your measurement results Visage 7 Web Client 179 Evaluating images 180 Reviewing Images Measuring distances You measure a distance in an image by drawing a line between the two end points As soon as you have finished your line the program displays its distance in millime ters or pixels next to the line You may draw as many lines as you wish in an image The accuracy of distance measurements is 2 pixels Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum accuracy we recommend zooming into
73. Create Annotation dropdown toolbar to open the Spine La bels dialog box Spine Labels Annotate c i oy C om oO Direction si 4 Step Close In order to label vertebrae or intervertebral spaces proceed as follows 1 Select whether you want to label vertebrae or intervertebral space in the Anno tate box 2 Select the Direction in which you want to proceed 3 Select if you want to label vertebrae or intervertebral space consecutively or if you want to label only every second or only every third vertebrae or interverte bral space in the Step box 231 Evaluating and annotating images Reviewing and Reporting on Images in the Display Protocol Viewer 4 Select the vertebra or intervertebral space label with which you will begin 5 Now start clicking vertebrae or intervertebral spaces in your image from top to bottom or bottom to top 6 Use the Properties button in the Spine Label dialog box to change font settings or graphical display settings for the labels and arrows Editing measurements and annotations 1 Click Select Annotation Measurement to change your graphic or text 2 Click a graphic to move it Or Click an end point of a line or a grab handle to resize the graphic Or Right click a graphic or annotation and select Properties from the context menu to change font settings or graphical properties Saving measurements and annotations 232 i AB With appropriate user rights y
74. ROI The relative error of the elliptical or rectangular ROI measurements is 2 pixels shorter radius or shorter side For example Shorter radius or shorter side measurement error 10 pixels 20 20 pixels 10 50 pixels 4 100 pixels 2 Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum ac curacy we recommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still 1 Drop down the Measurement Functions icon bar and keep the mouse button pressed 2 Select the ROI Ellipse or ROI Rectangle icon The mouse pointer changes shape in the image area 3 Click at the starting point of your ROI 4 Hold the mouse button down and drag it across the image area 5 Release the mouse button to finish the ROI graphic 185 Evaluating images Reviewing Images An information box with statistical data pops up next to the ROI graphic A 1446 mm Tip ROI graphics and information boxes are numbered and color coded So if you draw more than one ROI in an image you can tell which information box belongs to which ROI graphic by the number shown in the upper left corner of the information box and by the color
75. Scrolls down in the stack of loaded images and shows the next image containing annotation graphics or annotation text Measurement Functions Opens a selection list with measurement functions Distance Measurement Permits measurement of distances in images While this tool is active the mouse pointer looks like this zs rr Measured values are indicated in exact millimeters mm in CT and MR images estimated millimeters mm or in pixels pix if no distance measurement in millimeters is possible Visage 7 Web Client The Visage 7 Web Client Window Display Protocol Viewer Expert Reading The accuracy of distance measurements is 2 pixels Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum accuracy we recommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still Angle Measurement Permits measurement of angles in images While this tool is active the mouse pointer looks like this TA The accuracy of angle measurements depends on the length of the shorter of the two angle legs The longer the angle legs are the better the accuracy For example Length of shorter angle leg measurement err
76. Visage Web Client Online Guide VISAGE IMAGING Information about manufacturer and distribution contacts as well as regulatory status of the product can be found in the User Manual Some of the specifications described herein may not be currently available in all countries Please contact your local sales representative for the most current information Visioneering Science for Life and Visage Imaging are trademarks and or service marks of Pro Medicus All other products mentioned may be trademarks or registered trademarks of their respective holders Visage Imaging believes this information is accurate as of its publication date and is not responsible for any inadvertent errors The information contained herein is subject to change without notice Copyright Visage Imaging GmbH All rights reserved Document Version 27 00 Table of Contents System Overview Intended USC tnih atari eaa eaa aa ra eae taa niana Eiaeia Constancy heck e a Aa arei Product overio W siise a E A A SyStem architecture oa E aA AA EAER TA License management sessesssrrreessrrrsesrrrresernrnnesnrennnestnnnneseeennne EME S EEE EAE EE ee System requirements aessseeiieeesesrrisesennssetinnneeitannnsnnnnnandnnnnne Hints for Visage 7 Web Client installation cc eeeeeeeeeeeee Archiving with the archive Option cceeeeeeeeeeeeeeeeeeeeeeneeees Data protection and data SECUTitY eteeeeeeeeteeeeeeettteeeeeees Ac
77. Visage 7 Web Client Loading Image Data Viewing a thick slice T Modality g Viewing a thin slice series series Loading images into a viewer With the Show Thin Slice Series icon in the study series window you can toggle between thick slice series only and thin plus thick slice series display in the series list and you can explicitely select a thin slice series for display for example if they are interested in detail You will use this alternative most of the time 1 Deselect Show Thin Slice Series on the study series window toolbar Only thick slice series are now shown in the series list 2 Double click a series in the series list to load its images into viewer 1 for exam ple You may choose this option for individual series in order to see detail 1 Select Show Thin Slice Series on the study series window toolbar The series list now shows both thick and thin slice series next to each other You can tell which one of two series is the thick slice and which one is the thin slice version from its icon and from the number of images it contains 2 Explicitely double click the thin slice version of a series to load it into viewer 1 for example Canceling loading or unloading images Cancel loading Unloading images Visage 7 Web Client With slow data transmission rates and a large number of images the process of loading images in the viewer may be slow You can stop this process for exampl
78. Visage 7 Web Client viewer windows patient study and image information can be shown as image text or icons in the images Visage 7 Web Client 221 Image text and image icons Reviewing and Reporting on Images in the Display Protocol Viewer Image text 1 2 3 Image icons The image text is arranged in text blocks around the edges of an image in this way 1 Patient and examination data 2 Orientation labels 3 4 Window values and filter settings Acquisition parameters 5 Hospital and system information including information on compression level and image quality Image texts that are very long are truncated For example if a study comment text is very long only the first 64 characters are displayed Depending on the modality and image type additional information can be displayed or certain information can be omitted or only displayed in certain modalities In XA scenes for example orientation labels are hidden Your system administrator can configure the image texts for each modality In addition to image text image information may be shown in the form of icons in the images Changed image information Lossy compressed image The quality of the image may have been affected artifacts The quality percentage is indicated next to the icon This warning triangle remains visible even if the image texts are hidden When loading images into one of its viewers Visage 7
79. Without it the software will not run The license code serves as copy protection and controls which product options are enabled This includes e The maximum number of DICOM connections for calling importing data from the network onto the Visage 7 system and for sending data from the Visage 7 sys tem e How many users may access data on the server simultaneously per client type e The maximum data volume on the system e Activation deactivation of the audit trails e The availability of an archive option e The availability of the HL7 Health Level Seven option e The availability of the GSM Global Session Manager option e The availability of the worklist server option e The availability of the failover option e The accessibility of the Visage 7 Client Visage 7 uses the so called floating licenses concept This means that a license is not bound to a particular user name or a dedicated workstation or PC A license for 10 users means that 10 users can work with a Visage 7 Web Client or Visage 7 Cli ent at any one time If an 11th user tries to log on he or she is told to try again later Once one of the original 10 users logs off logon of the 11th user will be permitted Of course licenses can be upgraded Visage 7 Web Client System Overview Product overview Upgrade Client types When upgrading an installation the old license becomes invalid The new Visage 7 license which comes with the upgrade must be
80. a DICOM node into the study series window You must first copy a patient to the local database by double clicking the patient entry or with the Retrieve Study from DICOM Node icon Patient Name Patient ID Study Date Date of Birth Sex Accession Num ber Study De scription Number of Images Referring Physi cian Archive Status Patient Com ment Name of the patient Patient s identification number Date of the study in YYYY MM DD hh mm ss format Date of birth in YYYY MM DD format M male F female O other unknown Job number of the patient in the HIS RIS hospital or radiology information system Description of the study States how many images are stored for this study on the selected network node Name of the referring physician archive option only Here you can monitor the status of archiving of this study The archive status tells you about the availability of the study in the archive w Completely archived Partially archived E Not yet archived Comment text about the patient Visage 7 Web Client 49 Study series window The Visage 7 Web Client Window Study series window a Series and presentation state tab cards Dual monitor Information area stu dy series window Toolbar study series window Study list Image preview Navigation bar Series list Presentation state list 50 The study series window contains all studies series and pres
81. a a EEE AEEA 37 Scroll DAarS uin i an irn NEEE AAA Ae ee LAANA AA 37 keyboards n aL sais a cae E AA E dee eh AA a a A 38 Wheel MOUSE reca N A aii nea ee eds 38 SOMING ISU VIGWS aina inet ces chtua deeds A desisin Leaked T 38 Selecting data and Objects oere naira eana EEE EIA REAT SARA R 39 Adjusting a window VICW seiegreisar inniinn ianei iii aan i SKER aeiiae ieai raak iR 39 The Visage 7 Web Client Window 41 Navigation Dar eccsiticcs ines edie en nid eee aaa ee 41 Patent WIM OW enaar aaa T AAA E T A 43 Information area patient WINGOW ssssssseessessireeserrressetrrssstntrrsssttrrnsstennnssten 44 Hilter parameters si2 ttetoee tis ook Ment alles ahites ele anaes i es eet ee ee 44 Search CHICKA austere caine nea ata neue auth 45 Toolbar patient window eccceceeeeeeeeeeeeeeteeeeseeenaeeeeeeeeaeeeeseeeaeeeeeeeedieeeeeeeaas 46 SYSTEM MESSAGES aorta En setts ceeciacah sdbesa EAEE EE REEE tees 48 Patient her ocal riera a T ee R 48 Response list network node c cecceceeeeeeeeeeeeee eee eeneeeeeeeteeeeeeeieeeeertiaeeeeeees 49 StuUdy SErieS WINGOW 00 eee eeeeceeee scene e eect eect eee a i aiaa kii a Aa A Aia 50 Information area study SerieS WINGOW 00 0 2 eeeeeeeeeeeeteeeeeeeenteeeeeetttneeeeeetttaeeeeeenee 51 Toolbar Study SerieS WINGOW 0 0 0 ceeeeeeceeeeeeeeeeeeeeeeaaeeeseeeaeeeeseeeaeeeeeeeenaneeeeseeaas 51 E EAE E EE EE E E E etait al Sede coded ate tue aoe 54 Sa E E easel ada evict O E E T 55 Presentation state
82. a priority For studies for which a procedure step exists Allows you to delete the procedure step mark it as completed or reset it to scheduled or change its priority Encrypted Data Transfer The images are transmitted encrypted Non encrypted Data Transfer The images are transmitted without encryption Compression Level A Transfers images with compression level A In compression level A the images are usually only slightly compressed and without loss of quality Your system administrator defines the compression rules Compression Level B Transfers images with compression level B which compresses the images even more Note that compressed images do not contain the full volume of data of the original The di agnostic quality of the images is affected as a result Preferably load thin slices When this option is selected the system will always load the original scans When the option is deselected the system will load a thick slice series instead of the original thin slice series if such a thick slice series is available on the Visage 7 server Display as 3D volume Shows the selected study in the Visage 7 Client for advanced 3D evaluation Automatic Synchronization with 3D volume Select this option to ensure that both the Visage 7 Web Client and the Visage 7 Client will always show images of the same patient Visage 7 Web Client 93 Worklist Expert Reading The Visage 7 Web Client Window Monitor selectio
83. age 7 Web Client In order to be able to use this print option connection to a DICOM printer must have been set up by your system administrator A DICOM printer will print images exactly as they are currently displayed in the viewer window which includes zoom pan or window settings as well as measure ment and evaluation graphics e g distance lines or ROI graphics 191 Printing images Procedure overview 192 Printing Exporting and Sending Images When sending images to a DICOM printer you proceed in this order 1 Load your study or series into the viewer windows viewer 1 viewer 2 or com pare mode 2 Explicitly select the images you intend to send to the DICOM printer in one or both viewer windows 3 Start the printout by from the viewer whose images you want to be printed first Selecting images for DICOM print 1 Click the DICOM print selection box in the lower right hand corner of an image segment A solid box indicates that this image is selected for DICOM print 2 Click more boxes to extend your selection Or Drop down the Select Images icon bar Click this icon to select all loaded images Or Click this icon to deselect all currently selected images Or Click this icon to open the Range Selection dialog box Rl ix Custom Selection Range from to C Interval Every Image OK Cancel Select a range of images from your currently loaded series defined as from
84. age 7 user documentation available for this software Intended use Visage 7 is a system for distributing viewing processing and archiving medical im ages within and outside health care environments TheVisage 7 server receives image data in DICOM format via the hospital network This provides universal connections to archives modalities and workstations The supported modalities are listed in the DICOM Conformance Statement Visage 7 is to be used only by trained and instructed healthcare professionals It can support physicians and or their medical staff in providing their own diagnosis for medical cases The final decision regarding diagnoses however resides with the doctors and or their medical staff in their own area of responsibility Although the web and thin client technologies allow the software to be run on a vari ety of hardware platforms for diagnostic purposes the user must make sure that the display hardware used for reading the images complies with state of the art diag nostic requirements and currently valid laws Only DICOM for presentation images can be used on an FDA approved monitor for mammography for primary image diagnosis Only uncompressed or non lossy compressed images must be used for primary im age diagnosis in mammography Visage 7 Web Client 11 Constancy check System Overview Constancy check Visage 7 is a category A diagnostic imaging device DID for which the equipment used and the ambi
85. age types and monitor configurations In addition to these factory defaults our service person nel can adapt or create display protocols according to your own requirements In the display protocols list protocols are shown sorted according to their suitability for the study currently selected in the study list 131 Loading images from the worklist Loading Image Data Protocol designations A column to the far right in the display protocols list shows the rank of each protocol This column may be hidden in your system as display columns are shown in de scending order of their suitability by default If required you can redisplay the Ranking column Click the column separator line in the column header at the end of the last column and drag it to the right Orientation db n l e i gt n Ranking 7A lt l Landscape cape ipe 2000 Be aware that protocols that are designated blank will not show images immedi ately You are expected to load series into the viewports explicitly from the thumbnail browser of the display protocol viewer window All other display protocols will show images immediately when you load a study into the display protocol viewer Searching for a patient and study When searching for a patient and study in the local Visage 7 database or on con nected network nodes you proceed in just the same way as in the patient window of the client types View Classic and Expert Please refer to s
86. ailability of program functions Each user must log in on to a Visage 7 client with a user name and password The Visage 7 server checks these entries Only if they match is access to the system granted Access rights to study data are defined by the system administrator on the Visage 7 server The basic idea is that only those users who are involved in a particular case should have access to study data Access authorization ensures that users can only view data for which they have ac cess rights In addition to restricting access to data the system administrator can also make cer tain program functions available to some users but not to others This way every user will find only those icons and functions on the user interface that he or she real ly needs Controlling the range of functions available for each user also adds to data security The availability of potentially critical functions such as making specific pa tient data available to other users or deleting data that is no longer needed can be restricted to more experienced users When a function is disabled on a user level the icon or input field for that function is also disabled Visage 7 comes with a number of preset user levels with predefined functionalities The Visage 7 system administrator can adapt these user levels to your require ments Visage 7 Web Client System Overview Login and password User profiles Auto logoff Multi session operation Servi
87. ake from now on apply to all loaded images immediately Tip Apply to All and Auto Apply to All affect only those images that are already loaded You should therefore wait until all images of a series to be processed are loaded before you activate these functions 167 Editing images Reviewing Images Undoing changes You can always undo the last processing step 1 Place the cursor over the image area 2 Click the right mouse button to pop up a context menu 3 Select Undo Zooming and panning images 168 You can zoom in on sections of an image which are of particular interest to you If the enlarged image is too large to be displayed in the segment you can pan it i e move it so that the region of interest is in the center of the image again If overlay graphics or shutters are included in the image that you want to zoom or pan they are adapted accordingly Note If you apply any of the zoom functions to layouts other than 1x1 Zooming is not automatically synchronized l e the images in the separate segments are not shown with the same zoom factor initially Temporarily zooming in on details With Quick Zoom you can temporarily zoom in on an image in order to study de tails When you release the mouse button the image will be displayed in its original size again You can apply the Quick Zoom function to any layout 1 Click this icon Or Select Quick Zoom from the popup menu The mouse pointer chang
88. al standard views are displayed in the slice segments These standard orientations are transverse sagittal coronal Coronal slice Transverse slice Sagittal slice Changing display properties for slice images You can optimize the display of the slice images in the slice segments or the orien tation cube in the overview segment You can perform these processing steps both in the overview segment and in the slice segments Visage 7 Web Client Windowing Zooming and panning images Resizing an image automatically Switching the calculation method 209 Changing display properties for slice images Working in the Basic MIP MPR Viewer Windowing Xo 1 Select operating mode Windowing from the popup menu The operating mode is now shown bottom left in the segment and the mouse pointer changes shape 2 Left click and drag the mouse pointer over the image up down to change the center making the image brighter or darker right left to change the width increasing or decreasing image contrast 3 Select Apply to All from the popup menu if you want to apply these window val ues to all other segments too Zooming and panning images Zoom Ku Pan Ry Apply to All 210 1 Select operating mode Zoom from the popup menu The operating mode is now shown bottom left in the segment and the mouse pointer changes shape 2 Left click and drag the mouse pointer over the image up to enlarge the image
89. alibration Calibrating 1 Drop down the Measurement Functions icon bar keeping the mouse button a k pressed Visage 7 Web Client 181 Evaluating images Calibration examples 182 Reviewing Images 2 Select the Calibrate Distance icon The mouse pointer changes shape in the image area 3 Click on the first point 4 Hold the mouse button down and drag a line to the second point 5 Release the mouse button as soon as you have reached the second point As soon as you release the mouse button the Calibration dialog box opens Calibration 14 pix mm OK Cancel 6 Enter the known distance between the points in millimeters mm and confirm with OK This icon in the upper right hand corner of the image segment indicates that cal ibration has been applied to a distance line in this image Note The measurement and positioning precision is 1 pixel for distance measure ments and another 1 pixel for calibration The higher the relation between calibration or measurement distance and pixel length the more exact the calculation results of distances or angles will be Relative errors in distance measurements depend on calibration and measure ments Calibration or measurement distances of more than 100 pixels therefore have a relative calibration or measurement error smaller than 1 The pixel size is taken from the corresponding DICOM data set and the error percentage can ac cordi
90. all Client Remove Client Debug Mode Change Password Visage 7 Web Client 239 Changing the password 240 Functions and Information for Advanced Users Note that this popup menu might look slightly different in your Visage 7 Web Client installation as your system administrator can configure which menu items are shown here For example Debug Mode may only be available to technicians performing sys tems analysis 3 Select Change Password 4 Enter your user name and your old password in the usual way and press RE TURN You are now prompted to enter a new password on the login screen Visage PACS CS Version Visage PACS 6 0 Please read this note before usin user documentation an on 3 0 8 0 new firm then 5 Enter the new password in the New password box 6 Enter the new password a second time in the Confirm box and press RETURN Use the new password from now on when logging in Tip Be sure to spell the password identically both times If you forget your password ask your system administrator for a new one Visage 7 Web Client Functions and Information for Advanced Users Updating the client software Updating the client software Every time you log onto the Visage 7 server the server automatically checks wheth er a more recent version of the client software is now available When a software update is due either a message will inform you or updating will start automatically If so
91. ange Group Assign ment Ee Change User Assign ment Export Patient ce Launching Application 5 Client type Classic Client type Expert Client type Expert Reading x Visage 7 Web Client 255 Overview of functionality supported by client types Appendix Study series window or worklist Client type View Client type Classic Client type Expert Client type Expert Reading Presentation state tab x x x card Previous Patient x x x hi Next Patient x x x rh Show all Studies x x x Load into viewer 1 x x x rl Load into viewer 2 x x x r Load to Compare Mode x x Mm Load to Compare Mode x x d Load to Basic MIP x MPR Viewer HE Load all series as one x x x iG 256 Visage 7 Web Client Appendix Overview of functionality supported by client types Client type View Client type Classic Client type Expert Client type Expert Reading Refresh x x x Ei Delete object x x Change Procedure x x Step a Archive Protection x x only with archive op tion ca Compression Level A x x x x 3 Compression Level B x x x x e3 Encrypted Data Trans x x x x fer Non encrypted Data x x x x Transfer Query Report x X Ej Use Local Cache x x x T Visage 7 Web Client 257 Overview of functionality supported by client types Appendix Client type View Preload Study Client type Classic x oe Client type Expert x Client type Expert Reading xX Image Preview on
92. anging display properties for slice IMAGES ee ceeceeeeeeceeeeeeeeteeeeeeeettaeeeeeeeaas 209 WindowinNg eresse aranista eiee eI Peat E EAE EIA PE ENTAR 210 ZOOMING ANA PANNING IMAGES seerti errin eeren in EE ARERR NEA A EREE RA E E h 210 Resizing an image automatically 0 0 00 cecceeeeeeeeeeeeeeeceeeeseeeeeeeeeeeneeeeeeeeeeaeees 211 Switching the calculation method cc eeeeeeeeeeeeee eee eeeeeeeeeeeenaeeeeeeennaeeeeeeeaaas 211 Working with the orientation cube 00 eee eeeeee tere entree eee eteeee eee taeeeeeeetnaeeeenes 212 Rotating the orientation CUDC ce cceeeeeeeeeeeeeeeeeeeeteeeeeeeeeeeeeaeeeeetenaeeeeeneeaeets 212 Display of the individual slices in the orientation CUDE ceeeeeeeeeneteeees 213 Moving and rotating slices and generating slice images eect eeeeeeeeeenees 213 Moving a slice in a slice segment 0 2 cece eee eettee eee teee cette tenets ee taeeeeeetntaeeeeee 213 Moving one or more slices with the slice CUFSOTF cceeeeeeeeeeteeeeeettntteeeeeeetee 214 Generating slice images in views other than the standard views 216 Changing the slice thickness for slice IMAGES eeeeeceeeeeteeeeeeeeetteeeeeeettaeteeeeeaaes 217 Changing the slice thickness for the current segment cceeeseeeeeeeeeteeees 217 Changing the slice thickness with the Slice CUISOM ceeeeeeeeeeeeeeeeeteeeneeeees 218 Reviewing and Reporting on Images in the Display Protocol V
93. angles Plane A scene Plane B scene Tip If you want to compare two planes with each other load the scene once in viewer 1 and once in viewer 2 Switch to compare mode and display plane A in one half of the screen and plane B in the other Viewing report photofile images Visage 7 Web Client An angio series may contain one or more scenes dynamic multiframe images as well as a number of report or photofile images So called report images are single images which may contain evaluation informa tion from one of various programs In image preview these report photofile images are displayed next to the corre sponding multiframes as separate series Note Do not confuse report images with study reports Report or photofile images are single XA images created by an evaluation pro gram You can toggle between report image and scene display when XA data are loaded into one of the viewer windows that contain reports photofiles Study reports are text files sent from the HIS RIS which contain study results and findings You use the Visage 7 Web Client report windows to display a study re port 161 Viewing angio scenes Reviewing Images Displaying report images Click the Display Reports icon Instead of the scene the attached report images are displayed Returning to scene display Eh Click the Display Scenes icon to return to the scene display Displaying the ECG Cardiological sce
94. ansfer jobs in the network as well as a list of all logged on users Help Calls a context sensitive online help topic with an explanation of the window that is currently active Logoff Logs you off from the Visage 7 server 42 Visage 7 Web Client The Visage 7 Web Client Window Patient window Patient window Fi Dual monitor Information area patient window Filter parameters Search criteria System messages Toolbar patient window Jata source Patient list local or Response list network node Navigation bar Visage 7 Web Client In the patient window you can search for the patient whose images you wish to re view You can search for the patient in the local database web server or in the database of a configured DICOM partner Entering filter and search criteria will make searching easier Note To ensure the confidentiality of patient data the system administrator will as a rule restrict which examinations you are able to access As a referring physician you may for example only be able to view the data of your own patients When you are working in dual monitor mode the patient list is spread over both monitors The filter elements are shown on the left monitor only PACS Microsoft Internet Explorer laj xj File Edit view Favorites Tools Help ay Patient List dr x Study Date All PatentNam Studyo ss S Modality All Patenti 0 StudyDescipion ent Co
95. ar The Visage 7 Web Client Window E Pes ogee boH E Image Preview not for dual monitor Shows one or all series of an examination as thumbnails You can select individual images or one or more series and load them into the viewers Report Window If a report is stored on the Visage 7 server for a selected study you can view the report text in this window Or Report with Image You can display images of a study together with the report text Viewer 1 Displays the images of a selected study series or individual selected images in viewer 1 Viewer 2 Displays the images of a selected study series or individual selected images in viewer 2 Compare Mode vertical Splits the screen down the center and displays the images loaded in viewer 1 on the left hand side and the images loaded in viewer 2 on the right hand side Compare Mode horizontal Splits the screen across the center and displays the images loaded in viewer 1 in the upper half of the screen and the images loaded in viewer 2 in the lower half Basic MIP MPR Viewer Displays the basic MIP MPR viewer only possible for image data that is suitable for 3D re construction Display Protocol Viewer Shows the loaded images in a screen layout that has been optimized for primary reading This icon and viewer are only available if you have logged on to the client type Expert Read ing Status information Displays information about all data tr
96. aret ine EA EEEO SE EEA EERE ATEL a a TAa AT 79 Position indicator bar viewer ssesessssssseisseserrrsstrrrrsstttrrssstttnrsstttnnrsstetnnssnre n 81 Compare mode srei aaa ashe aian aa Te Ra aaia a ta ia aan rua Pau nabdane tadaa 82 Basic MIP MPR Viewel ccccceeceeeeeeeeececceneaeeeeeeeeeeeeeeseeenaaeaeseeeeeeeeeeeenes 83 Information area basic MIP MPR viewer eeeeeeeceeeeeneeeeeeeeeenaeeeeeeeenateeeeeeeaaes 84 SD overview segont meres niinen EAE AE ERA 85 SIICS SEGMONIS orrara ntina A TESA A AAE E aA ARRA 86 Slice CUISOM esii Ea ar A a a eee ened dv ele etal 86 Popupimenta se ite ties a auntie a tar antag aM cae steamed ert inact 87 Kayon e A a A T E TS ee taeeea ade 88 Mo se clicks oen aieiai iniia aa iaai ESNEA NSA NE AEE AA AAIEN EA AAi 89 Worklist Expert Reading cccccscceesecccceeeeeeeceeeeeedendaeteeeseeeeeeeeedeedaeeeeeseeneeeeneeeaees 90 Information area worklist ec ceeeeeeeeeeeeeeeeeeeeeeeeaaeeeeeeeaaaeeeseeeaeeeeeeeenaeeeeeeeeaas 91 Filter parameters and Search Criteria ccceeeeeeeeeeecnecceeeeeeeeeeeeeesensttneeaeeeeeees 91 Toolbar WOrkliSt 2 223 ccc ss ced ceecetd ede iectidcabcewetivady teeteas lic cement EEEE AEA 91 Monitor selection irira a UAE AET a EATA A tid an ane 94 Patient list loca cria iri e tee dhe dundee a i ea divide Deda 94 Response list network node ssessssseesesrrsessssrreesrtrnnesttennnestennnsstnsnneeetennnnennenne 94 Display protocols
97. arting and Ending the Program Integrated Windows authentication Call up from 30 If your client is connected to the hospital network Windows domain you can work with Visage 7 Web Client without entering a user name and password Your Win dows login will be used instead Note Integrated Windows authentication is only possible for users whose accounts were imported in the Visage 7 system from Windows and for whom the integrated Windows authentication privilege has been set by the system administrator Before calling Visage 7 Web Client via integrated Windows authentication for the first time Start the Internet Explorer and call up the standard Visage 7 Web Client login screen once e g http servername en After that use the following URL for calling Visage 7 Web Client via integrated Win dows authentication https servername en iwa Or https servername en iwa view https servername en iwa classic https servername en iwa expert https servername en iwa 2monitor https servername en iwa expertreading another software program If you are working with other clinical applications on your PC you might be able to call up Visage 7 Web Client directly from such a program e g a hospital or radiolo gy information system HIS RIS or electronic patient browser If Visage 7 has been integrated in the other clinical software application the pro gram will start automatically whenever you select one or more i
98. as they were when first loaded Mouse clicks Visage 7 Web Client In the basic MIP MPR viewer you can also switch operating steps and calculation modes using mouse clicks 1 Left click on the display of the operating mode in a segment to scroll forward through the operating modes Or Right click to scroll backward through the operating modes 2 Left click on the display of the calculation method in the lower right corner of the segments to switch between MPR and MIP 89 Worklist Expert Reading The Visage 7 Web Client Window Worklist Expert Reading Fi Single or dual monitor Information area worklist Filter parameters and search criteria Navigation bar System messages Toolbar worklist Data source Monitor selection Display protocols list Patient list local or Response list network node Study list worklist 90 When you call Visage 7 Web Client with client type Expert Reading the patient win dow is shown in worklist view Tip Filter this list according to interpretation status SCHEDULED for a quick and easy overview of all studies that are scheduled for reporting Your user profile stores your monitor configuration This means the system will re member whether you worked with a single monitor or dual monitors during your last Visage 7 Web Client session Visage PACS Microsoft Internet Explorer E al xj File Edt view aes Tools Help o o o EJ Workl
99. atically nor manually You can remove delete protection again when you are sure you no longer need these patient data The right to set or remove a deletion protection flag allows you to remove the dele tion protection that has been set both by yourself or by another user Set delete protection 1 Switch to the patient window I Select the patient s you want to protect f 3 Click this icon N The selected patient s are now marked with a Yes in the Delete Protect col umn Visage 7 Web Client 245 Performing gamma correction Functions and Information for Advanced Users Remove delete protection 1 Switch to the patient window GF 2 Select the patient s you want to release for deletion 3 3 Click this icon The selected patients are marked with a No in the Delete Protect column Note If all patients are delete protected the next automatic deletion will delete the old est patient data anyway Performing gamma correction Gamma correction is used to compensate for distortions in image brightness caused by the monitor Gamma correction is intended for grayscale images If you have assigned a color palette to your images before calling gamma correction the test image will be dis played in grayscales in the Gamma Adjustment dialog box Gamma correction can nevertheless be applied to color images 1 Open one of the viewer windows e g viewer 1 C 2 Display an image 3 Click this icon on the tool
100. ation State tab card in the study series window Visage 7 Web Client queries its database for presentation states stored for this study If presentation states are found they are listed now and the thumbnails of the first presentation state of this study are shown in the image preview section Note Only one presentation state can be selected at a time and its thumbnails displayed 2 Toggle compression levels if no presentation states are shown even though you are certain they exist for this study 3 Double click a presentation state in the list to load its images and move on to viewer 1 in one go Or Select a presentation state and load it into viewer 1 or 2 Visage 7 Web Client Loading Image Data Loading a series into the basic MIP MPR viewer Subsequently move on to one of the viewer windows m il o Loading a series into the basic MIP MPR viewer In the basic MIP MPR viewer it is only possible to display single series from the CT and MR modalities Moreover CT and MR series must fulfill certain technical re quirements to be suitable for MIP MPR reconstruction When you load a series into the basic MIP MPR viewer the program checks wheth er the images have been scanned with the required acquisition parameters and whether 3D reconstruction is possible If this is not the case an error message ap pears CT MR series can only be loaded into the basic MIP MPR viewer from the study series window not from the previ
101. ation state has been loaded Cancel loading Stops loading images Select Images Offers options for selecting images for printout on a DICOM printer Select all Images Selects all loaded images for DICOM print Range Selection Opens a dialog box for range selection Deselect all Images Undoes the current selection for DICOM print no images are selected after you click this icon Print Allows you to print images on a connected DICOM or Windows printer Windows Print Opens the Windows Print dialog box and prompts you to select a printer and print settings All images currently displayed on the screen will be printed DICOM Print Opens the DICOM Print dialog box and prompts you to select a printer and print settings Only those images that are marked for DICOM print solid green box in the lower right hand corner of the image segment will be printed Copy to Clipboard Copies the currently displayed images to the clipboard From there you can paste the cop ied images into another Windows program e g a presentation or NetMeeting program 72 Visage 7 Web Client The Visage 7 Web Client Window Viewers gl vi DICOM Send Opens a dialog box Select the address es in your DICOM network to which you want to send the selected image or all loaded images DICOM Quick Send Sends the selected image or all loaded images to one or several DICOM nodes immediate ly Your system administrator has de
102. axa Qe als oo er Online Archive Archive Protecti Study Description Study Date Time Study Date Time 1997 02 20 09 25 48 Referring Physician ID 3 a al al 1997 02 20 09 T1 Axial Localizer Modality MR Images 10 Organ Date Time 1997 02 20 09 25 48 A Mei Dy Mi T1 Oblique Coronal Modality MR Images 11 Organ Date Time 1997 02 20 09 29 32 3 l Ea 3 gt N N d B Tye 3D Volume Modality Number of Images Highest imac LL MR 10 10 7 8 MR 11 1 MR 1 amp MR 11 11 gt R F a T2FSE Coronal Modality MR Images 11 Organ Date Time 1997 02 20 09 34 29 MR 19 19 MR 3 3 4 x HB HH O Done L i B 0 trusted sites Visage 7 Web Client The Visage 7 Web Client Window Study series window Information area study series window This area of the study series window provides information about the loaded patient Patient Name Patient ID Date of Birth Name of the loaded patient Identification number of the loaded patient Date of birth of the loaded patient Toolbar study series window In the study series window you will start most of your processing steps with the icons of the toolbar But note that a popup menu is also available for selecting imag es in the image preview area HE Previous Patient Shows the studies and series of the patient above the patient cur
103. bar The Gamma Adjustment dialog box opens You can correct each color compo nent separately or correct all colors together 246 Visage 7 Web Client Functions and Information for Advanced Users r Gamma Adjustment Performing gamma correction ea z Green a Bue al B Reset 4 Check the Link box to move the color component sliders together 5 Correct the colors using the slider If you move the slider the changes are immediately shown in the right image 6 Confirm your changes with OK The Gamma Adjustment dialog box closes Gamma correction will be applied to all images you load from now on Tip The settings for gamma correction are stored for each user on log off and used in the next session In order to reset your gamma correction settings open the Gamma Adjustment dialog box again and click Reset All gamma values will be reset to 1 which is the factory default Visage 7 Web Client 247 Archiving with the archive option Functions and Information for Advanced Users Archiving with the archive option If you have an archive option installed you can choose between various archive methods Which method you use will depend on your requirements your archive hardware and the configuration of the archive The following options are available e Archiving on RAID hard disks e Archiving on SAN and NAS devices The data are sent to the archive according to a configured s
104. can simultaneously show the corre sponding 2D series in one of the Visage 7 Web Client viewers Synchronizing Visage 7 Web Client and Visage 7 Client 130 Activate this icon on the toolbar of the Visage 7 Web Client study series window to synchronize image display in both Visage 7 applications Synchronization ensures that both the Visage 7 Web Client and Visage 7 Client will always show image data of the same patient When you page on to a next patient in one of the Visage 7 Web Client windows this will automatically load a volume data set of that next patient onto the Visage 7 Client view screen If no volume data set exists for this next patient the Visage 7 Client view screen is cleared Note Note that synchronization works on a patient level and will still allow you to view and compare different series or studies of the same patient in 2D and 3D display Visage 7 Web Client Loading Image Data Loading images from the worklist Loading images from the worklist When you have logged on to Visage 7 Web Client with client type Expert Reading the patient window is shown in worklist view Worklist view helps you locate studies scheduled for interpretation quickly It also al lows you to load a study with a display layout that has been optimized for the re spective image types with only a few mouse clicks Selecting your monitor configuration All Protocols All Protocols 1 Monitor Landscape 1 Monitor Portrait
105. ccess the web server and the settings made by your system administrator you will use one of the following methods for calling up Visage 7 Web Client and logging onto the Visage 7 system When you have finished working with Visage 7 Web Client do not forget to log off from the system again Calling up the login screen Standard languages Visage 7 Web Client Before attempting to start Visage 7 Web Client make sure Microsoft Internet Explor er is installed on your PC See also System requirements on page 15 Visage 7 Web Client will not work with older versions of the Microsoft Internet Ex plorer or Web browsers of other manufacturers When you log onto the system Vis age 7 Web Client checks whether the correct browser is installed If it is not a message tells you which browser you need The Visage 7 Web Client user interface is available in six languages You choose a language when you call the Visage 7 Web Client login screen 1 Connect to the Internet or Intranet 2 Start the Internet Explorer 3 Enter the address URL of the Visage 7 server http servername for the default user interface language http servername de for the German program version http servername en for the English program version http servername fr for the French program version http servername es for the Spanish program version http servername it for the Italian program version http servername pt for the Portuguese program
106. ce access permissions Visage 7 Web Client Data protection and data security To ensure that user accounts and their passwords are effectively protected from un authorized access e passwords are encrypted and if this has been configured e passwords will expire e failed login attempts are recorded and multiple failed login attempts will cause a user account to be locked Note Recording logins and other actions only makes sense if all users on the system have their own user names and passwords Tip You should change your password from time to time for data security reasons The working environment of each user user profile is saved on the server when you log out This supports roaming which means that you can log in from any com puter and find exactly the working environment you are accustomed to Visage 7 can be configured so that a logged in user is logged off from the system af ter a configurable period of time with no user interactions This prevents licenses from being unnecessarily blocked and stops any unauthorized persons accessing data if a user has logged on but has forgotten to log off again If configured a user may log on to Visage 7 more than once from different PCs Multi session operation allows users to work from more than one clinical workplace simultaneously and view the same data there Each session makes use of and thereby blocks one license Remote access for service purposes must be gra
107. ceeeeeeeeeeeeeeeeeeeeeeeeseeeeaeeeeseeeaeeeeseeeanes 233 Setting up an Online Conference 235 NetMeeting elements ccccccccceeeceeccceeeecneeeeeesenseseedeneenenedeeneeneecedeneneacedeeteneeaes 236 WING WAILC DOA Yr ses cast ineen a a T vagectenehinadee ac evagens a 236 SOUNG ANG VIREO sai ta ee EA SEARE IE acetate tae 236 Application SNaring abs icctsc t sees cetuntindocevead a a iene ai E de teil 236 Connecting to an interlOCutor sisimpenan a RE aR iie aari 237 Working with the whiteboard eseeeesssseesssrrnesrerssessrrnnsesnnennesnnnnnnesennnnanetenaneeenennne 237 Ending an online Conference ccccceccccceeceeeceeceeeseeeedeennenceeeeeenenseeeeeneneaedennennens 238 Functions and Information for Advanced Users 239 Changing the password ra marar T AA a TAA i 239 Updating the client software eect eee ceentte eee rann EPERE E KARENE EAEE ERARE EREA EEEIEE 241 Performing data maintenance eessseeeeseerrreesrsrnessettnneesrnnnnestnennenennannesttenneeenenaa 241 Deleting patient and examination data eceeceeeceeeceeeeeeeeeeeeeeeeeeneeeeeteeenaees 242 Changing access rights to patient data ceeeeeeeeeeeeeeeeeneeeeeeenaeeeeeeeeaas 243 Changing user assignment ee eeeeee eee eete cece ee eeteeeee ee taeeeeeeetaeeeeeeetiaeeeeenena 244 Changing group assignment eee cece etter eter ettteeee eee taeeeeeeetaeeeeeeetiaeeeeeneaa 244 Protecting patient data from deletion cc ecccecceeeeeeeeeeeeeee
108. cess control and authentication ccceeeeeeeeeeeeeeeeeeeeeneees A dittralS Ea sia ened saad en eve seen aa aana Eea aa seater Ps ENncryptlonyssc2cisat Satie attire tA eter amare taee te eae Overview of the Visage 7 product documentation User and administrator documentation cccceeeeeeseeeeeeeeees Information on using the Visage 7 manuals Information on using the online help systemsS ceeeeeeees Starting and Ending the Program Calling up the login screen cee ceceeeeteeeeeeeeeeeeeeeeettteeeeettnaeeeeees Standard system lOQiN c ccccccceeeeeeeseeeeeeeeeeecteeeeeeseeeeeeeetaeeeeees Integrated Windows authentication 0 cee eeeeeeeeeeeenteeeeeeeenaes Call up from another software program ee eseeeeeeceeeeeeeeeees Changing your PASSWOMG cecceeeeeeeeeeeeeeeeeeeseeeeeeeeeeeeeaeeeeeeenaeees Logging off from the Web SErVer eeeeeceeeeesteeeeeeteteeeeeeettteeeeenens Visage 7 Web Client Table of Contents Getting Started with Visage 7 Web Client 33 The Visage 7 Web Client window layout cccecceeeeeeeeeeteeeeeeettnneeeeeeetieeeeeeetnea 34 Selecting functions and switching WINdOWS c cccceeeeeeeeeeeeeeeeneeeeeeeetaeeeeeeeeaaas 35 Navigation bar ICONS ceses i alee cadena deiner 35 T bar ICONS eeure R san tetentadalecticidal cede ada cdeesstiadiees 35 Popup Moale a DE Aa eet tees ee a idea E AAEE sa aeeaae 37 Scrolling through images siena
109. chedule Tip Archiving is always performed in the background As a user you do not actively in tervene in archiving However you can monitor the status of archiving in the study list and exclude studies from archiving e Setting archive protection e Tracing archiving Setting archive protection apd 248 You can make settings to prevent certain studies from being archived 1 Switch to the study series window 2 Select the study studies 3 Click the Archive Protection icon on the toolbar of the study series window 4 Click this icon to update the study series list Studies with archive protection are marked with a Yes in the Archive Protection column of the study list Visage 7 Web Client Functions and Information for Advanced Users Performing display quality checks Tracing archiving You can check the archiving status of studies in the study list of the study series window When a study is archived its data is transferred from the local database to the ar chive The archiving status of a study describes its availability in the local database and archive Online Status The Online Status column tells you about the availability of the study in the local database Archive Status The Archive Status column tells you about the availability of the study in the ar chive Online Status m3 m w Completely available Partially available Not available Archive Status Not yet a
110. ches for a patient with this accession number Searching with wildcards Visage 7 Web Client If you can only remember part of a name ID or comment text you can use wild cards in your search Or simply type the first few letters of a search string Visage 7 Web Client will automatically search for all those patients whose name begin with the letters you have entered for example 1 Simply type Mil to find the patient names Miller Milford Miltner etc Or Use an asterisk at the beginning This stands for any or no string Type mil for example to find all the above plus Hamilton Or Use a question mark anywhere in your search string A question mark stands for exactly one character Type AB 34 in the patient ID box for example to find the patient IDs AB1234 AB0034 and AB11345678 2 Press the RETURN key to confirm your entries The patient list is updated 111 Finding patients and transferring them to the study series window Loading Image Data Resetting search In order to remove all entries from search fields criteria Click the Reset Input Fields icon on the toolbar Using predefined filters Using predefined filters helps you speed up your workflow A predefined filter allows you to store and reuse a set of filter and search criteria Selecting filters If filters have already been defined No Filter Select a suitable filter from this drop down list on the toolbar Defining your own You can define
111. client types The display protocol viewer is particularly well suited for primary reading When reviewing images of a current and previous study be sure to show image texts in the display protocol viewer This will help you distinguish the two studies in the various viewports Be sure you have correctly identified the current study when reporting on the image data 4 Yisage PACS Microsoft Internet Explorer O x Ele Edt wew Favorites Tools Help a 2 e IE i Ekor 2nHeO hA OOMTADAmMARS AMAA Visag pcs gt oOCDH om j cs 1997 02 20 MR 1997 02 Fo MR 1997 02 MR 1997 02 E L T B internet Thumbnail browser Visage 7 Web Client The thumbnails in this section of the screen represent the series you selected from the worklist The series thumbnails are grouped by study if you have loaded more than one study You can load series into the viewports of the image area from here drag amp drop 97 Display Protocol Viewer Expert Reading The Visage 7 Web Client Window Toolbar display protocol viewer 98 E Gl S amp S g A g A E g Auto Hide Toolbar Lock Toolbar Hides or redisplays the viewer toolbar If the toolbar is hidden move the cursor over the area where it would normally be shown to redisplay it temporarily and to access its icons Display Mode Opens a selection list with different
112. crolls to the previous frame individual image of the multiframe Next Frame Scrolls to the next frame individual image of the multiframe Display Reports Displays the report images originating from the XA environment which are assigned to a scene Display Scenes Switches back from displaying the report images to displaying the multiframe scene Image area Icons The image area shows the loaded images with the selected size and in the selected layout The size of this area depends on the screen resolution and the actual size of the application window Once you have loaded images or started manipulating images icons may appear in the upper right hand corner of the image segments These icons alert you to infor mation you should consider when interpreting the images 5 A R Lossy compressed image The quality of the image may have been affected artifacts The quality percentage is indicated next to the icon This warning triangle remains visible even if the image texts are hidden When loading images into one of its viewers Visage 7 Web Client checks the DICOM head er information in every single image If this DICOM header information does not agree with the patient and study data stored in the Visage 7 database for one or several images this icon is displayed in the upper right hand corner of the affected images If you have manipulated a presentation state image this icon appears in the upper ri
113. currently logged in Here you select criteria for filtering the patient list Study Date Modality Physician Here you can select a period After a database query the patient list will only show patients examined over this period Today lists all patients examined today Yesterday lists all patients examined yesterday The last X days lists all patients examined over the last X days Date lists all patients examined on this day From date to date lists all patients examined within the stated period All lists all patients irrespective of examination date Here you can filter the patient list according to modality Click the Y icon next to the filter parameter Modality Check one or more modalities After a new database query only patients examined with this modality or these modalities will be shown Here you can filter the patient list according to the name of the referring performing and or reporting physician Click the Y icon next to the filter parameter Physician Check the box Referring physician Performing physician and or Reporting physician and type the name of the physician Or type A for all physicians whose name begin with A for example Or Open a list of all names by clicking on the Y icon behind an entry field A list drops down with all referring performing or reporting physicians of the studies you have access to Se lect a name If you are searching in the network th
114. dard view Using the Slice cursor you can change the orientation and position of slices in the slice segments The slices always remain mutually orthogonal This calculates and displays new slice images The slices then no longer correspond to the anatomical standard views The following now applies e Surface with yellow border upper left segment e Surface with red border upper right segment e Surface with green border lower left segment To obtain a better view of the orientation and position of the display slices you can rotate the orientation cube in each direction and change display parameters such as window values This is done with the mouse Lossy compression of images Transverse slice Coronal slice Sagittal slice Current calcu Current operat lation method ing mode 85 Basic MIP MPR viewer Slice segments Slice cursor Image processing Information in the slice segments Slice cursor Color coding 86 The Visage 7 Web Client Window After you have loaded the data set the slice segments first show the anatomical standard views e Transverse standard view upper left yellow border e Sagittal standard view upper right red border e Coronal standard view lower left green border You can ascertain the position and orientation of the two other slices by the color of the Slice cursor and from the orientation labels You can use the slice cursor to move through the volume data
115. data compression cceccceeeeeeeeeeeeeeeeeecneeeeeetiaeeeeeeeteeeeeeeeneeeeenes 126 Selecting data Oncryption cccccccceesecceceeeeeccceeeeeseceecenneseececeeenececeaeesececeneneeees 126 Loading thick or thin slice SCPICS 0 0 eee ceeeeee teeter nese eteeeeeeetneeeeeetnaeeeeeee 126 Canceling loading or unloading IMAGES eect eeeeeee eee eeeeeeeeeeteeeeeeeeeeeaeees 127 Loading a presentation State ccc eee ceeeee eee eeeeceeeeeeenaeeeeeeeceeeeeeentaeeeeeseaas 128 Loading a series into the basic MIP MPR viewer ecceeeeeeteeeeeeeenteeeeeeeaaes 129 Loading 3D volume data into Visage 7 Client 0 eee eeeeeeeeeeenteeeeeeeeteeeeeeenaaes 130 Loading 3D Volume datta ccccccccccccccteessecccceeesctececeenededentensseccetenesceecateesecddenteneses 130 Synchronizing Visage 7 Web Client and Visage 7 Client eeeeeeeeeeeees 130 Loading images from the WOrkliSt ccceeeeeeeeeeeeeceeeeeeeeneeeeeeeeaeeeeeeenaeeeeeneaaas 131 Visage 7 Web Client Table of Contents Visage 7 Web Client 6 0 Selecting your Monitor configuration eee eeeete eee teeeeee eee teeeeeeeeeteeaeeeeetenaaeees 131 Interpreting the display protocols list ccececeeeeeccecceeceeeeeeeeseeeeeneecaeeaeeeeees 131 Searching for a patient ANd study o oo eee centre ee eeeeeeeeeeeeeeeeeeeeteeeeaeeeeeeeeaeeees 132 Loading images into the display protocol viewer cceeceeeeeeteeeeeeettteeeeeeees 132 Selecting the
116. ded im ages you can use these icons to advance from one annotated image to the next Click the Previous Annotated Image or Next Annotated Image icon on the toolbar of the viewer 153 Scrolling through the loaded images Reviewing Images Scrolling in compare mode Synchronizing the starting point Scrolling in both window sections If you have loaded two series in compare mode you can scroll through their images simultaneously Select the same layout in both halves of the screen for example layout 1x1 Use the scroll bar or the wheel mouse in both halves to synchronize the starting points of the two series with each other Use the following arrow keys to scroll in both window halves E MEEEELEEL Both series one image back Both series one image forward Both series one line forward Both series one line back Both series one page forward by the number of images displayed Both series one page back by the number of images displayed Both series to the beginning of the series Both series to the end of the series If different layouts are set in the two halves of the screen the images will be scrolled by a different number of images when scrolling page by page Cine mode fast scrolling 154 Cine mode allows you to view selected images or series continuously In this dynamic display mode the images are displayed precisely as edited before the function was started For example if an imag
117. dicates selection for DICOM print Marked images These flags are only available in a Siemens diagnostic environment The image is marked with a flag 146 Visage 7 Web Client Reviewing Images Selecting screen layout and image display i The image is marked with a star Exam status These flags are only available in a Siemens diagnostic environment New no report status has been issued yet Prepared the images are ready for reporting e E Fa Reported the study has been reported J Signed off the study has been signed off by the physician A Unknown no report status available Report status These flags are only available in a Siemens diagnostic environment Fa Dictated the report has been dictated B4 Written the report has been written Validated the report has been validated by the physician Selecting screen layout and image display As soon as you have loaded images they are displayed in the viewer window in a layout determined by the modality One or more images may be seen simultaneous ly The toolbar is usually displayed above the image s Changing the layout of the image area You can choose between different screen layouts depending on whether you are in terested in an overview of a series or in the details in an image Visage 7 Web Client 147 Selecting screen layout and image display Reviewing Images Selecting a layout FA 1 Click the Display mode icon on the toolbar of the viewer and
118. dies over the available viewports yourself in this case 225 Synchronized scrolling Reviewing and Reporting on Images in the Display Protocol Viewer 1 Click a series in the thumbnail browser to select it MR 2006 07 31 2 Drag it into the viewport in which you want to show it 3 Release the mouse button to load the series into this viewport If required you can load more than one series from the same study into one viewport This way you can browse through the series of one study consecutive ly later on Tip If you find it hard to identify the correct series in the thumbnail browser resize the thumbnail browser section J MR 2006 07 31 Or Tip Place the mouse cursor over a series label to show a tool tip with the series name in full length Synchronized scrolling Viewports can be linked for synchronized scrolling Linking of viewports can either have been defined in the display protocol or you can link viewports manually before you start scrolling Visage 7 Web Client offers two modes for synchronized scrolling e Automatic mode In this mode the system will automatically select corresponding images 226 Visage 7 Web Client Reviewing and Reporting on Images in the Display Protocol Viewer Automatic mode Manual mode Visage 7 Web Client Synchronized scrolling Manual mode by position or by index In this mode the system uses geometrical position information stored in the im ages
119. display of the Internet Explorer in this case In this view the logoff icon is always available Tip Your system administrator can configure an HTML link to an Internet page after manual logoff If Visage 7 observes no activity for a certain time default setting 15 minutes a message box appears You are prompted to confirm that you wish to continue work ing If you do not answer you will be logged off automatically after a few seconds The license you were using is now available for another user Only the system administrator can change the automatic logout time 31 Logging off from the web server Starting and Ending the Program 32 Visage 7 Web Client Getting Started with Visage 7 Web Client This section explains the typical structure and operating elements on the Visage 7 Web Client user interface It also explains the general procedures and options for working with the Visage 7 Web Client application program and how to customize the Visage 7 Web Client window Note In these operating instructions we assume that you have worked with Windows application programs before You should have a basic knowledge of how to use Web browsers and be familiar with operating Windows programs with a mouse Configurable user In these instructions we describe the maximum scope of available functions intonace Visage 7 Web Client is however a software product whose user interface can be configured to suit your personal requirem
120. dow one after another Or Click this icon on the toolbar All images in the preview area or preview window are selected You can undo your selection Click on the title bars of the studies in the preview area or preview window again Or Click on the title bars of all series in the preview area preview window again Or Click this icon on the toolbar All images in the preview area or preview window are deselected Selecting entire series in the image preview Click on the title bar s of the series in the preview area or preview window Or 119 Selecting series and images Loading Image Data Deselecting series Series NEURO_BRAIM Selecting images Deselecting images Inverting the selection of images 120 Click on the background in the preview area or preview window Or Select Select all from the popup menu All images in the series are selected You can undo your selection Click on the title bar s of the series in the preview area or preview window again Or Click on the background in the preview area or preview window again Or Click this icon on the toolbar to deselect the entire study Or Select Deselect all from the popup menu to deselect the images of one series only Selecting individual images Select several images using the Ctrl or Shift key Or Left click and drag the mouse pointer over a range of images Click this icon on the toolbar to deselect the entire
121. dy or patient if you have filtered the patient list by modality PR e Switching between patients e Switching between studies Toggle between presentation state display and display of the original images 1 Use the Hide Show Presentation State icon in the viewer toolbar for this Manipulate or evaluate presentation state images in just the same way as you han dle original series images e Editing images e Evaluating images 157 Viewing angio scenes Reviewing Images Note Note that an icon appears in the upper right hand corner of a presentation state image when you manipulate the image display This warns you that the image is no longer displayed as stored in the presentation state Viewing angio scenes Angiographic image data differ in a number of ways from the images of other modal ities Visage 7 Web Client therefore provides a series of special representation methods for such images These options become active whenever you load XA scenes into one of the Visage 7 Web Client image viewers Note Other modalities besides XA also provide multiframe images e g ultrasound US However these angio specific functions are only available if you have load ed XA data Playing back angio scenes 158 Angiographic scenes record dynamic information that is they display a process over time An angio scene is therefore always automatically played back in cine mode layout 1x1 whenever you load an angio sce
122. e You open the Visage 7 Web Client windows via the navigation bar on the left hand side of the screen Tip As an experienced user you can use this section as a quick reference guide Navigation bar Dual monitor Using the icons on the navigation bar you can quickly switch to any of the other Vis age 7 Web Client windows Switching to another window will not load any data into that window Instead the data you last loaded to that window is displayed If you are working with two monitors the navigation bar appears at the left edge of the left monitor and on the right edge of the right monitor It contains the same icons on both monitors A n Audit Warning A message is displayed It informs you that only authorized users are permitted to use Vis age 7 Web Client and that all your actions may be recorded This icon is displayed only if the audit trail license is installed and display of this icon has been configured Patient Window Lists all patients that were found by the last database query You can select a patient here to display his or her study list next When you have logged on to the client type Expert Reading the patient window is shown in worklist view Study Series Window Shows all examinations and series of the selected patient If you activate the preview area you will see preview images of the selected study or series in the right half of the window Visage 7 Web Client 41 Navigation b
123. e if all images of interest to you are already displayed Click this icon on the toolbar of the image window Or Press the Esc key Only the images loaded so far are available in the viewer now If necessary you can remove loaded images from the viewers 127 Loading a presentation state Loading Image Data x Click this icon in the upper right corner of the viewer The viewer is displayed empty Loading a presentation state Presentation State 128 a J r Instead of loading the original series and images of a study into one of the viewers you may choose to work with presentation states A presentation state comprises only those images that the reporting physician con sidered interesting A presentation state contains references to various images from the series of a study and stores these references together with display settings and evaluation results In the patient window you can search for studies containing presentation state ob jects modality PR In the study series window you can toggle between series and presentation state list Presentation states are usually available in both compression levels A and B un less matrix reduction has been configured for any of the images they refer to In that case no presentation states are available for that particular compression level and the study may contain a different number of presentation states for level A and B 1 Click on the Present
124. e accession number or if the patient information in the Visage 7 database was recently updated e Double check if the report is the final report or a draft version If a report is a draft this should always be indicated in the report text 137 Retrieving a report from the RIS Displaying and Editing Reports Automatic report display Manual report display Showing footnote information Visage 7 Web Client can be configured to display the report and images automati cally if a report is present on the Visage 7 server In that case the report with image window is shown instead of the viewer when you load images If automatic report display is not configured proceed as follows 1 Switch to the study series window 2 Double click a study for which a report exists The study is loaded into viewer 1 Viewer 1 is displayed 3 Open the report with image view Or Open the report window view When a report was received from the HIS RIS in the format DICOM Structured Re port it may contain footnote information which is not immediately visible in the HTML report version shown in the report window Move the mouse pointer over these icons which indicate hidden footnote text to show this information in a tooltip Retrieving a report from the RIS 138 a The Report column in the patient and study list shows whether a report exists for a study on the system Just because no report is listed here does not mea
125. e image Adjusting the image size In addition to zooming and panning manually using the mouse you can also use predefined settings to adjust the image size quickly In order to make optimum use of the image segment Click this icon 169 Editing images Return to original size 170 fe Reviewing Images Or Select Fit to segment from the popup menu The image is enlarged or reduced in such a way that it fits exactly into the seg ment Click this icon Or Select Original Size from the popup menu The image will be displayed in its original size acquisition matrix Magnifying portions of an image The magnifying glass function provides you with a fast way of looking at details more closely without zooming the entire image 1 Click this icon Or Select Magnifying Glass from the popup menu The mouse pointer changes shape in the image area 2 Left click on the portion of the image that interests you and hold the mouse but ton down A rectangular area is displayed magnified by a factor of 2 By keeping the left mouse button pressed and moving it over the image you can focus on details as you would if you were holding a magnifying glass in your hand When you release the mouse button again the image will return to its original size Visage 7 Web Client Reviewing Images Editing images Left magnifying glass on right magnifying glass off Windowing and filtering images Visa
126. e image numbers and very thin slice thicknesses Deselect the icon Preferably load thin slices to always load the thick slice series if such a series is available on the server Or Select Preferably load thin slices to explcitly load the original thin slice series whenever both a thin and thick slice series is available on the server For more information about thin and thick slice series see also Loading thick or thin Slice series on page 126 Selecting a compression level When loading image data from the worklist you can choose between loading the original data which might take longer or loading the data in compressed format For each image type your system administrator has defined two compression lev els e Compression level A This level as a rule transfers images in their original data format or compressed with a lossless method e Compression level B This level as a rule transfers images in a data format compressed with a lossless or lossy method 135 Loading images from the worklist Loading Image Data Note Some image types cannot be compressed in lossless mode Lossy compressed images do not contain the full amount of data of the original The quality of the images might be affected as a result Images compressed with a lossy compression method are highlighted by a yellow A warning triangle top right in the Visage 7 Web Client viewers Loading images with compression level A usually takes longer tha
127. e in a Siemens diagnostic environment New no report status has been issued yet Prepared the images are ready for reporting Reported the study has been reported Signed off the study has been signed off by the physician Unknown no report status available Report status These flags are only available in a Siemens diagnostic environment Dictated the report has been dictated Written the report has been written Visage 7 Web Client 223 Changing display settings Reviewing and Reporting on Images in the Display Protocol Viewer Validated the report has been validated by the physician Changing display settings As soon as you have loaded images i e double clicked a patient in the worklist for example the display protocol viewer will open This viewer is shown with the screen layout of the preselected display protocol or the display protocol you selected in the worklist In most cases the images of your study or studies are immediately shown in the various viewports of this layout so that you can start reviewing these images right away In some cases you may however find that this screen layout is after all not the ide al one for the diagnostic problem at hand In this case you can load a different display protocol or change the display mode in one or several viewports Selecting a different display protocol 1 Return to the worklist window ie 2 Double click a different protocol in t
128. e list network node 49 Response list network node worklist 94 Retrieve Study from DICOM Node icon 47 92 115 ROI Ellipse icon 76 101 ROI Rectangle icon 76 102 Rotate icon 74 103 basic MIP MPR viewer 212 viewer 177 S Sagittal 209 Save Annotations icon 103 Saving annotations and measurements 232 Scoutlines 163 Screen layout 147 Scroll bar 152 Scrolling images 151 patient list 113 Scrolling images 37 Search criteria 45 111 resetting 112 Second opinion 13 Select all 120 Select all Images DICOM Print icon 72 98 Select all previews icon 53 Select Annotation Measurement icon 103 Select Images icon 72 98 Selecting functions 35 images 120 multiselection 39 objects 39 series 119 study 119 Series information 61 Series list 55 118 Set Delete Protection icon 47 Set Filter Properties icon 46 91 Shortcut 28 Show 77 103 Show All Scoutlines icon 77 103 Show all Studies icon 51 Show Border and Current Scoutlines icon 77 103 Show Border Scoutlines icon 77 103 Show Current Scoutline icon 77 103 Show Scoutlines icon 164 Show Thin Slice Series icon 53 60 Show hide ECG 162 Explorer toolbar 39 image text 149 overlays 149 shutters 149 271 272 status bar 39 Show Hide Presentation State icon 78 Shutters 149 Single frame images 144 Slice cursor 214 SliceShift 213 SliceThickness 217 Sorting lists 38 Spine labeling 231 Spine Labeling icon 103 Standard languag
129. e mode contain image pairs You can recognize biplane scenes in the image preview by the fact that two multiframe imag es are close together A RAO 33 0 LAO 58 CRA1 For very large series so called truncated thumbnail display mode can be enabled in the image preview see Truncate Thumbnails for Large Series icon in the toolbar One image from the middle of the series followed by three dots is shown in the im age preview for such long series Support of MPPS Modality Performed Procedure Steps can either be activated or deactivated by your system administrator If MPPS support is deactivated the display of the series is staggered according to the SeriesInstancelD and using possible value pairs e g image type If MPPS support is activated however the MPPS ID is used to group series to gether with further value pairs If no MPPS ID is available then the display is stag gered only according to these value pairs e g image type The original image sequence within an MPPS series is retained Visage 7 Web Client The Visage 7 Web Client Window Preview window Study 2 Exam Set Date Time 2001 01 24 16 11 58 Referring Physician Physician Ret MPPS 1 DSA Sub 1 DR program ID X 420010124161427 Modality XA Scenes LAO 38 CRA 4 LAO 38 CRA 4 Image preview popup menu A popup menu is available in the image preview section to help you select images and show image information Select Deselect Se
130. e of its viewers Visage 7 Web Client checks the DICOM head er information in every single image If this DICOM header information does not agree with the patient and study data stored in the Visage 7 database for one or several images this icon is displayed in the upper right hand corner of the affected images The display protocol may define the sort order for the images of a series in the display pro tocol viewer according to certain criteria If images cannot be sorted according to these cri etria the system alerts you to this fact with this icons This icon in the upper right hand corner of the image segment indicates that calibration has been applied to distance lines in this image This icon indicates that the displayed images do not originate from an original scan series thin slice series but were generated by a Visage 7 thick slice compilation rule Popup menu b For your convenience the image area of the Visage 7 Web Client viewers offers a popup menu for quick and easy access to frequent image processing functions Right click in the image display area Note Note that many image display functions are available from both the toolbar and popup menu Others functions are available only from the toolbar or only from the popup menu The following table describes only those functions that have not al ready been explained in the context of the toolbar Apply to All Auto Apply to All Applies the last editing
131. e patient list can only be filtered according to the refer ring physician Visage 7 Web Client The Visage 7 Web Client Window Patient window Location Insertion Date Interpretation Status Here you can filter the patient list according to the patient s ward or the name of the institu tion where the patient was examined Click the Y icon next to the filter parameter Location Select a Ward or Institution Name Here you can sort the patient list according to the date when the patients data were trans ferred to the web server Today lists all patients whose studies were transferred to the web server today Yesterday lists all patients whose studies were transferred to the web server yesterday The last X days lists all patients whose studies were transferred to the web server during the last X days Date lists all patients whose studies were transferred to the web server on that particular day From date to date lists all patients whose studies were transferred to the web server with in the stated period All lists all patients irrespective of when their studies were transferred to the web server Here you can filter the patient list according to the processing status of procedure steps SCHEDULED lists all patients whose studies contain procedure steps that are scheduled for interpretation IN PROGRESS lists all patients whose studies are currently being reviewed in one of the Visage 7 Web C
132. e remaining images need to be retrieved from the archive first See Searching and retrieving patients from other network nodes Filtering the study series list If the imaging systems that send data to the system support marking of images with flags you can filter the study series list so that only studies and series containing marked images are listed All 1 Drop down the marked images filter box 2 Select Flag Star or Flag amp Star Or Select All to reset the filter Visage 7 Web Client 117 Selecting series and images Loading Image Data Selecting data from the study or series list You can select an entire study or an entire series from the study or series lists You cannot select individual images here Selecting a study The first study in the list is selected automatically Only one study can be selected at a time Click the required study in the study list The series list shows all series of this study Depending on how your system is configured either the first series or all series are selected Selecting series Click the required series in the series list Or Select several series using the Ctrl or Shift key Selecting data in the preview area or preview window The preview area of the study series window and the preview window allow you to select the study series or individual images from one or several series Note If you load individual images from more than one series Visage 7 Web Client merge
133. e structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still Visage 7 Web Client 75 Viewers The Visage 7 Web Client Window mJ i Calibrate Distance Permits calibration of distances in images While this tool is active the mouse pointer looks like this o ll a Density Measurement Permits measurement of grayscale values pixel values in images While this tool is active the mouse pointer looks like this ROI Ellipse Permits evaluation of circular or elliptical regions of interest ROIs in grayscale images While this tool is active the mouse pointer looks like this To ROI Rectangle Permits evaluation of rectangular regions of interest ROIs in grayscale images While this tool is active the mouse pointer looks like this T Measured values are indicated in exact square millimeters mm in CT and MR images estimated square millimeters mm or in pixels pix if ROI measurement in millimeters is possible 76 The relative error of the elliptical or rectangular ROI measurements is 2 pixels shorter radius or shorter side For example Shorter radius or shorter side measurement error 10 pixels 20 20 pixels 10 50 pixels 4 100 pixels 2 Larger errors can occur if the image is di
134. e was zoomed beforehand this im age will also be displayed zoomed in dynamic display mode Visage 7 Web Client Reviewing Images oo 12 Visage 7 Web Client Scrolling through the loaded images Cine mode always switches to layout 1x1 to play back the scenes or series Visage 7 Web Client provides two alternatives for dynamic display e Automatic cine mode e Interactive cine mode Note Note that automatic cine mode may result in a loss of image quality Choose interactive cine mode instead if you observe reduced image quality in au tomatic cine mode Automatic cine mode 1 Click the Cine Mode Forward icon to run the movie forward i e from the begin ning of the series to the end Playback may be slower at the beginning while images are still being loaded Or Click Cine Mode Backward to run the movie backward 2 Use the slider to adjust the playback speed and direction The number next to the slider indicates the playback speed in images per sec ond 3 Click Cine Mode Stop to stop the movie 4 Click the Bouncing Cine icon to run the movie back and forth Every time the movie reaches the last image of the series it runs back to the first image then forward to the last image again etc Tip Your system administrator can define whether or not cine mode is started auto matically for images of certain modalities Tip You can window zoom pan or apply other image editing functions while aut
135. eb Client Window Display Protocol Viewer Expert Reading Range Selection Opens a dialog box for range selection Deselect all Images Undoes the current selection for DICOM print no images are selected after you click this icon Print Allows you to print images on a connected DICOM or Windows printer Windows Print Opens the Windows Print dialog box and prompts you to select a printer and print settings All images currently displayed on the screen will be printed DICOM Print Opens the DICOM Print dialog box and prompts you to select a printer and print settings Only those images that are marked for DICOM print solid green box in the lower right hand corner of the image segment will be printed Copy to Clipboard Copies the currently displayed images to the clipboard From there you can paste the cop ied images into another Windows program e g a presentation or NetMeeting program Export Images Exports the currently displayed images to a directory on your local PC You can save the im ages as DICOM images or in BMP or JPEG format DICOM Information Shows the DICOM information of the current image Predefined Level Presets If different window or filter values are predefined for the current image type you can call them up here and apply them to the loaded images Reset Window Level Resets the window and filter values back to default values i e the values with which the im ages were loaded W
136. ecommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still Visage 7 Web Client 229 Evaluating and annotating images Reviewing and Reporting on Images in the Display Protocol Viewer The accuracy of angle measurements depends on the length of the shorter of the two angle legs The longer the angle legs are the better the accuracy For example Length of shorter angle leg measurement error 10 pixels 12 20 pixels 6 50 pixels 2 5 100 pixels 1 1 Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum ac curacy we recommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still e ROI evaluation page 184 The relative error of the elliptical or rectangular ROI measurements is 2 pixels shorter radius or shorter side For example Shorter radius or shorter side measurement error 10 pixels 20 20 pixels 10 50 pixels 4 100 pixels 2 Larger errors can occur if the image is display
137. ections Selecting filter criteria page 108 Entering search criteria page 111 Using predefined filters page 112 Starting a query in the local databa se page 113 Searching and retrieving patients from other network nodes page 113 for details Loading images into the display protocol viewer 132 There are various options for how to proceed when loading study data from the worklist Selecting the patient Double click a patient name to load the first study of this patient with the first display protocol in the display protocol list Visage 7 Web Client Loading Image Data Loading images from the worklist Patient Na Patient ID Lpaeoten sex __ nserton Da Display Protocol Description Monitors Orientation Larry s L Ea 656565 fe 2007 04 0ges View One series per view 2 Landscape MANUS DEXTER 1953 11 04 M peF 14 02 Blank Viewports Use drag and dropt 2 Landscape MDP_CHILD_01 FLTOPOS 1997 11 03 F 2007 04 02 MDP_TOP FLTOPOS 1920 05 0 F 2007 04 02 MR Abdomen 23003 00 01 01 M 2007 04 03 MR Ankle 2000 01 01 M 2007 04 03 MR Ankle muri 3006 2000 01 01 M 2007 04 03 MR dataget Brain reg2 1911 01 01 M 2007 04 02 23002 2000 01 01 F 2007 04 03 23001 2000 01 01 M 2007 04 03 23005 2000 01 01 F 2007 04 ae yo i Procegure ste status Pertormer Priory Study Datetime Modalties in Stuy_ mage Series Study Descrigtic Interpretation SCHEDULED 31 11 55 37 MR MR Ankle Interpretat
138. ed in ascending or descending Biplan Paul ey COTTER alphabetical numeric or chronological order CANOPUS BEN 2 Click again to reverse the sort order Tip The selected sort order will still be selected the next time you start the program Visage 7 Web Client Getting Started with Visage 7 Web Client Selecting data and objects Selecting data and objects Selecting one object Multiple selection You must always select entries in lists images or graphic objects before you can process them Click a list item image or graphic object A selected list item is color highlighted A selected image has a bright border A graphic object has grab handles You can apply some actions to two or more objects at once For example if you have the right to delete patient data on the web server you can select multiple patients and delete them all from the Visage 7 database in one step To select multiple list entries images or objects in one go Click various objects while holding the Ctrl key down to select individual objects Or Click the first object and hold the Shift key down while you click a second object to select all objects between first and the second object Adjusting a window view Full screen or window view F11 Showing and hiding a toolbar Showing and hiding a status bar Visage 7 Web Client While working in Visage 7 Web Client you can resize the Internet Explorer Press function key
139. ed sites Visage 7 Web Client The Visage 7 Web Client Window Worklist Expert Reading Information area worklist This area of the patient window shows the user name you are logged in with Hide show filter criteria Use this icon for collapsing or expanding the filter parameters and search criteria section of the screen Worklist Active window where you are now User name User currently logged in Filter parameters and search criteria In the worklist view of the patient window you can filter the patient list and search for specific patients and studies in just the same way as you can in the patient window of the client types View Classic and Expert Therefore refer to the following sections for details about filter and search criteria e Filter parameters on page 44 e Search criteria on page 45 Toolbar worklist In the worklist you start all processing steps with the icons on the toolbar NoFiter User defined filter You can select a predefined filter here Reset to Default Filter Yi Activates the filter defined as the default filter Set Filter Properties Y The Personal Settings dialog box opens You can define your own filters here Reset Filter Settings All the filter parameters you entered are removed Click Start Data Query to display the un filtered patient list again Reset Input Fields All the search criteria you entered are removed Click Start Data Query to d
140. ed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum ac curacy we recommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still Creating annotations 230 A HORE 1 Drop down the Create Annotation toolbar 2 Select one of these icons Arrow Annotation to draw an arrow Text Annotation to add text Arrow and Text Annotation to combine an arrow and text annotation Circle Annotation to draw a circle around an area of interest eo Click in the image hold the mouse button down and draw your arrow or circle for example Visage 7 Web Client Reviewing and Reporting on Images in the Display Protocol Viewer Spine labeling Visage 7 Web Client Evaluating and annotating images If you have selected Text Annotation the Text Input dialog box opens when you click the spot in the image where you want to add text Enter you annotation text here Use Ctrl Return for line feeds Use the Properties button in the Text Input di alog box to change formatting information for your text e g text color or font set tings Spine labeling offers a quick way to label vertebrae and intervertebral spaces in im ages of the spine 1 Click this icon in the
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142. eeeeaas 148 Showing and hiding image text ee eeeseeceeeeeeeeeeeeeeeeaeeeeeeeeaaeeeeeeetaeeeeeeenaaes 148 Showing and hiding graphic objects and shutters 0 0 0 0 ee eeeeeeeeeeneeeeeeeeeneaes 149 Working with color palettes 2 0 0 eecccceeeeeneneeeeeeeecneeeeeeeaaeeeeeesneeeeeeeeneeeeeeseaaes 149 Toggling single view and Split screen eee eeeceeeeeeeeeeneeeeeeeeeeeeeeeeetaeeeeeeeeaees 150 Scrolling through the loaded iMaQeS ceeccceeeeeeeeeeeeeeeenneeeeeeenaaeeeeeeennaeeeeeeeaas 151 Image by image slow SCTOIiNG ceeeeeeeeceeeeeeneeeeeeeeecaeeeeeeeaaeeeeeeenaaeeeeesenaaes 151 SCPOM DAR EEn E E E veces he feucteet E T E E T E ages 152 KG VDOANG saia a E aa EE R 152 WheelimOUSC aoiu a a a a aa a A ee 153 Icons Onhe too Dba aaea E A TEE 153 5 Table of Contents Scrolling in compare MOE saeia ea AEE EE A EE A R 154 Cine mode fast scrolling 2 2 eceeeeeeeeeeeeeeeeeeeeeeeeeeeeeneeeeeeeseeeaaeeeseeeeeereneeeaaees 154 Automatic cine mMod sseres raer iere aea aS aaRS aLa S LEa Ris 155 Interactive cine Mode cc cc eeccceeeceececeeeeeneeeeedecneesedeeeeneeeeeeeeeneneedeueneeceeeeeenaeae 156 Viewing presentation state iMAQeS eee eceeeeeeeeeeeeeeeeeneeeeeseeeeeeeeeseeeeaeeeeteeeaeees 156 Viewing angio SCONES 6cc ceeceeedeceneeeedeeeeeeeeedde canst eeeddeaeeeeeedeeeneeeedeneeeeeesdnenneeees 158 Playing back angio SCENES 0 00 0 eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeteeeeeeeeeteeeaeeeeeteeeaeeeeeeee
143. elected study already exists on the Visage 7 server the report is down loaded again and the existing report is overwritten 52 Visage 7 Web Client The Visage 7 Web Client Window Study series window S 20g wa Use Local Cache If this icon is activated the images you download from the web server are stored in your lo cal cache memory When you load images into a viewer Visage 7 Web Client searches the local cache first and only retrieves data from the web server if no images are found in the local cache This option speeds up your workflow if you need to load and review one study several times during one Visage 7 Web Client session It is recommended for networks with low data transfer rates Preload Study Loads all images of a selected study into the local cache for the duration of your session When you subsequently load these images into a viewer and move on to this viewer the im ages are displayed immediately This icon is only active if Use Local Cache has also been selected Image Preview on off Switches display of the image area on or off Truncate Thumbnails for Large Series Toggles thumbnail display for large series one or all thumbnails per series are shown in the image preview section Show Thin Slice Series When this option is selected the series list will list both thin slice series original scan series and thick slice series generated image series which permit faster loading and browsi
144. ent Reviewing and Reporting on Images in the Display Protocol Viewer Evaluating and annotating images Evaluating and annotating images Just like in the viewers of the other client types you can measure distances and an gles evaluate ROIs or measure density in images in the display protocol viewer of Expert Reading Unlike in the image viewers of the other client types however you can save these measurements in Expert Reading and you can also add annota tions to highlight or comment on findings Performing measurements 1 Drop down the Measurement Functions toolbar 2 Select one of these icons Distance Measurement to draw a line and measure its length Calibrate Distance to calibrate the distance measurement function Angle Measurement to measure angles Pixel Lens to show the pixel density of a point in an image Density Profile to show the density profile along a line ROI Rectangle ROI Ellipse to evaluate a region of interest Refer to the following sections for details on how to proceed with these measure ment tools Also be sure to observe the following warnings concerning measure ment errors e Density measurements page 187 e Measuring distances and angles page 179 The accuracy of distance measurements is 2 pixels Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum accuracy we r
145. ent proceed in a similar way as you would for a distance measurement Visage 7 Web Client 189 Evaluating images Reviewing Images 190 Visage 7 Web Client Printing Exporting and sending Images Visage 7 Web Client allows you to print copy and export images or to send data over the network for diagnostic documentation or presentation purposes This section will explain how to proceed when e Printing images e Exporting patient data or images e Sending data in the network Printing images DICOM print Windows printout Two alternatives are available for printing images from a Visage 7 Web Client view er window DICOM print and printout on a Windows printer DICOM printers are laser cameras for output of images on film or high resolution laser printers in your hospital s DICOM network with advanced print features In order to send images to a DICOM printer in your network you explicitly select the images you want to print in your viewer windows and start DICOM print from the viewer whose images you want to be printed first If no DICOM printer is available or if no diagnostic output quality is required you can print out images on a local or network Windows printer The output quality will de pend to a great degree on your local client and printer hardware In a Windows printout all those images will be printed that are displayed on screen when you click the Print icon Printing images on a DICOM printer Vis
146. ent conditions at the installation site must meet special require ments R6V German X Ray Ordinance dated January 8 1987 in the version dated June 18 2002 amending the R6V and other atomic energy ordinances Imaging devices of this category are labeled accordingly The user is required to perform a monthly constancy check on these imaging devic es in compliance with R V 16 per DIN 6868 57 DIN V 6868 57 2000 Image quality assurance in diagnostic X ray departments Acceptance testing for image display devices The characteristic and reference values for the constancy check shall be defined during the acceptance test The reference values shall be ascertained using the us er s test instruments luminance meter at least class B DIN 5032 7 with valid cali bration range 0 05 cd m to 10 000 cd m7 Product overview Visage 7 is a client server application It comprises the following components e Central Visage 7 server s in the hospital and e Visage 7 Web Client clients in the wards in special departments or in the physi cians practices e Visage 7 Clients optional In this section you will find information on e System architecture e License management e System requirements e Hints for Visage 7 Web Client installation e Archiving with the archive option System architecture In a hospital all radiological patient data is collected on a central web server for ex ample for the duration of the patient s
147. entation states of the patient currently selected in the patient list You use the study series window to select a study series individual images or a presentation state for display in one of the image viewers To facilitate image selec tion you can display the images of a study as thumbnails in the right screen half of the study series window A presentation state comprises all those images of a study that the reporting physi cian considered particularly important Presentation states are compiled at the diag nostic workstation that sends the study to the web server A presentation state also preserves the image display settings such as window val ues or zoom pan settings that were used at the time when the presentation state was created Presentation states are usually available in both compression levels A and B unless matrix reduction has been configured for any of the images they refer to In that case no presentation states are available for that particular compression level and the study may contain a different number of presentation states for level A and B In dual monitor mode the study series window is shown on the left monitor The right monitor shows the preview area It is not possible to hide the preview area in dual monitor operation Visage PACS Microsoft Internet Explorer laj x Ele Edt View Favorites Tools Help a j nt Name Joe s Shoulder Patient ID 646464 Date of Birth PH 2Deaf
148. ents and preferences to a great degree Therefore some of the functions and features which are described here may be permanently dimmed or not visible at all in your program installation This means that your system administrator has disabled these functions because you do not need them in your daily work or that your installation does not include all the avail able Visage 7 licenses Consult your system administrator if you need any of the functions described here but which are currently not available on your Visage 7 Web Client user interface Visage 7 Web Client 33 The Visage 7 Web Client window layout Getting Started with Visage 7 Web Client The Visage 7 Web Client window layout Internet Explorer area Information area Navigation bar Toolbar 34 Visage 7 Web Client is a web based application program that makes use of the Mi crosoft Internet Explorer A Visage 7 Web Client window comprises the following elements and screen areas Internet Explorer area Workspace Navigation bar Status bar The upper part of the window contains the menu bar and possibly also the toolbar and address bar of the Microsoft Internet Explorer These menus and icons are not active in Visage 7 Web Client Do not click this area while working with Visage 7 Web Client Selecting an Internet Explorer button by mistake will log you off from Visage 7 Web Client and take you back to the login screen Never use the F5 key to upda
149. er the entire study the study reports if available or a presentation state or one or several se lected series only Archive Protection Sets or removes archive protection for the selected study Change Procedure Step Procedure steps are tasks in the diagnostic reading workflow With Visage 7 Web Client you can follow up on the task interpretation from scheduling this task to completion For studies for which no procedure step exists Creates a new procedure step and allows you to assign the new procedure step a priority For studies for which a procedure step exists Allows you to delete the procedure step mark it as completed or reset it to scheduled or change its priority Compression Level A Transfers images with compression level A In compression level A the images are usually only slightly compressed and without loss of quality Your system administrator defines the compression rules for your system Compression Level B Transfers images with compression level B which compresses the images even more Note that compressed images do not contain the full volume of data of the original The di agnostic quality of the images is affected as a result Encrypted Data Transfer The images are transmitted encrypted Non encrypted Data Transfer The images are transmitted without encryption Query Report Requests a report on the currently selected study from the configured report network node If a report on the s
150. er 1 window is displayed Loading images into viewer 1 or 2 1 Select the study series or image s for viewer 1 You can work in the study or series list the preview area or the preview window T 2 Click this icon 3 Select the study series or images for viewer 2 4 Now click this icon r Ci 2 5 Click one of these icons in the navigation bar to move on to viewer 1 or 2 122 Visage 7 Web Client Loading Image Data Loading images into a viewer Loading images for comparison When loading images into compare mode you proceed in a slightly different way in Classic or Expert mode Image comparison in Classic mode When you are working in Classic mode you proceed in two steps First you load the images you wish to compare into viewers 1 and 2 Then you call compare mode Select the study series or images for viewer 1 You can work in the study series list preview area or preview window Click this icon 3 Select the study series or images for viewer 2 4 Click this icon r Now click one of these icons to display the series or images side by side or one above the other in compare mode The compare view is displayed Image comparison in Expert mode In Expert mode you can load two series directly into compare mode 1 T 2 Select two series or images Click one of these icons to display the images side by side or one above the oth er in compare mode T
151. er interface and program functionality In the printed user manual you will find a complete description of all Visage 7 Web Client functions 21 Overview of the Visage 7 product documentation System Overview Administrator documentation Service documentation Release notes 22 The online guide this document offers additional information and task oriented descriptions presented in a step by step style Online guides are available on your installation medium in English and German Visage 7 Web Client also features a context sensitive online help system which you can call up right from the user interface The context sensitive help topics explain all the user interface elements and features of the currently dis played screen in your native language For the English and German user inter face the online help system also contains task oriented step by step instructions e The Visage 7 Client user documentation The user manual pdf file and or printed manual provides a complete descrip tion of all Visage 7 Client functions Visage 7 Client also features an online help system which you can call up from the Help menu The various help topics explain the user interface of the client software Tip You can download the user documentation as pdf files Follow the corresponding link on the login screens The Visage 7 administrator documentation supports system administrators in a hos pital It helps them with user manageme
152. es 27 Standard login 29 Start Data Query icon 46 92 Status bar 35 Status information 200 Status information icon 42 Study information 61 Study list 54 118 Study series window 50 116 Study Series Window icon 42 Switching windows 35 Synchronized scrolling display protocol viewer 226 System architecture 12 System requirements 15 T Teleradiology 12 Text Annotation icon 102 Thumbnail browser 97 load series 225 Thumbnails 63 Toolbar auto hide 148 change location 148 lock toolbar 148 patient window 46 91 preview window 59 study series window 51 viewers 71 Toolbars 34 Tracing archiving 249 Transverse 209 Truncate Thumbnails for Large Series icon 53 Index U Uninstalling 241 Use Local Cache icon 53 User assignment 244 User name 29 User profiles 19 V Viewer 1 70 Viewer 1 icon 42 Viewer 2 70 Viewer 2 icon 42 Viewport 104 Viewports synchronized scrolling 226 W Warning icon calibration 79 105 DICOM header information 79 105 lossy compressed image 79 105 presentation state image manipula tion 79 sort order of images 105 222 thick slices 80 105 Wavelet compression 125 Wheel mouse 153 Whiteboard 236 Window layout 34 Window level presets 173 Windowing 171 icon 74 99 basic MIP MPR viewer 210 resetting levels 173 viewer 172 Windows Print icon 72 99 Worklist compression level 135 load display protocol 133 load more than one study 134 load patient 132 load study
153. es shape in the image area 2 Left click the relevant portion of the image The starting point of the mouse pointer is the center of the enlargement 3 Hold the mouse button down and drag the mouse pointer up to enlarge the image down to reduce the image When you release the mouse button again the image snaps back to its original size Visage 7 Web Client Reviewing Images Fitting an image into a segment EF Visage 7 Web Client Editing images Displaying an image in enlarged reduced size By zooming in on an image you focus on details Zooming back out again will give you a better overview of the situation 1 Click this icon Or Select Zoom from the popup menu The mouse pointer changes shape in the image area The starting point of the mouse pointer is the center of the enlargement 2 Left click and drag the mouse pointer over the image up to enlarge the image down to reduce the image When you release the mouse button the image will keep its new size The Zoom tool remains active until you select another editing tool from the tool bar or popup menu Panning an image After you have zoomed an image parts of it might extend beyond the edge of the image segment You might therefore want to pan the image after zooming so that the region of inter est is in the center of the segment again 1 Click this icon The mouse pointer changes shape in the image area 2 Left click and drag th
154. est Image Number columns in the series list e Number of Images indicates the number of images from this series stored on the web server e The Highest Image Number indicates the total number of images in this series Modality Number of Images Highest image number T 20 21 CT 20 21 Visage 7 Web Client Loading Image Data Selecting series and images In this example one image of each series has not yet been transferred to the web server Return to the patient window after a while query the modality node and transfer the examination to the Visage 7 server again in this case Tip In an emergency situation always contact the physician who is conducting the ex amination by phone to make sure you have received all series and images Note The Number of Images and Highest Image Number columns only provide informa tion about the transfer status of series from modalities that work with single frame images For multiframe images Number of Images and Highest Image number give no indication about the transfer status of a series or study Archived data If you select data in the study series window which has already been archived and is no longer available in the online memory a message is displayed You must first retrieve this data from the archive before you can view these images Images of studies that were only partially archived are displayed But only those im ages that are still on the web server can be shown th
155. esults of their patients Accessibility via the Internet also proves helpful in critical situations where the opinion of an addition al external expert is required The use of a secure data transmission protocol and additional data encryption op tions ensure high data security for this kind of data distribution via the Internet Visage 7 servers are web servers with a database to which the relevant image ma terial is transmitted after examination or reporting An internationally standardized transmission protocol as defined in the DICOM standard is used for this purpose Note Visage 7 will not be able to guarantee the availability of data if studies series that have been transferred by other network partners contain errors As a rule the image data remains on the Visage 7 server only for as long as a pa tient is undergoing treatment or is an actual in patient How long data will be stored on the Visage 7 server depends on the storage capacity of the RAID system and on the license Please be sure to dimension your RAID in accordance with the data volumes in your institution Data storage in Visage 7 is based on the FIFO first in first out principle Changes to patient data result in the data being given a new time stamp Once the storage capacity of the system has been reached the oldest data is automatically deleted in order to create space for new image material The data can be reloaded from the hospital s archive at any time
156. ew window 1 Loading the patient into the study series window CA 2 Select exactly one CT or MR series from the series list Or Select individual images in the preview section in order to use only these images for 3D reconstruction 3 Click Load to Basic MIP MPR Viewer on the toolbar Visage 7 Web Client switches to the basic MIP MPR viewer window and starts load ing the series This may take some time for large series HE Visage 7 Web Client 129 Loading 3D volume data into Visage 7 Client Loading Image Data Loading 3D volume data into Visage 7 Client In addition to the Visage 7 Web Client basic MIP MPR viewer which gives an initial spatial impression of your image data the Visage 7 solution also features a full scale 3D viewer the Visage 7 Client In order to be able to use this viewer for ad vanced 3D viewing and evaluation a 3D volume data set must have been compiled from the original scan series e Loading 3D volume data e Synchronizing Visage 7 Web Client and Visage 7 Client Loading 3D volume data 3D A 1 Select a series for which a 3D volume data set exists in the series list 2 Click Display as 3D volume on the toolbar This starts the Visage 7 Client application and loads the selected volume data set into its View screen Refer to the Visage 7 Client user documentation for information on how to optimize 3D display and evaluate the image data there While you evaluate the 3D data set here you
157. f the patient selected in the patient list Online Status Archive Status Archive Protec tion Study De scription Study Date Time Referring Physi cian Study Comment Accession Num ber Study ID for archive option only The online status tells you about the availability of the study in the local database w Completely available E Partially available E Not available for archive option only The archive status tells you about the availability of the study in the archive m Completely archived l Partially archived El Not yet archived for archive option only Yes study cannot be archived No study can be archived Description of the study Date and time of the study in the format YYYY MM DD and hh mm ss 24 hour clock Name of the referring physician Comment text about the study Accession number of the study Study s identification number 54 Visage 7 Web Client The Visage 7 Web Client Window Study series window Report Procedure Step Status Performer Priority Non viewable Series no report is stored on the Visage 7 server for this study 1 2 3 one or more reports are stored on the Visage 7 server for this study When you display or edit the report the most recent of these report versions will be shown Indicates whether a procedure step exists for this study Visage 7 only supports procedure steps of the type nterpretatio
158. f the selected scan The image number of the selected scan is indicated next to the scoutline Or Select Show All Scoutlines to display the scoutlines of all loaded images as suming that all loaded images fall within the scan range of the reference image Select Show Border Scoutlines to display the scoutlines of the first and last scan in the reference image Select Show Border and Current Scoutlines to display the scoutline of the cur rently selected image as well as the scoutlines of the first and last image Click the Show Scoutline icon a second time to hide scoutlines again Visage 7 Web Client Reviewing Images Displaying scoutlines Printing reference image and scan series with scoutlines You can use compare mode and scoutline display for printing the images of a series or study in a way that gives you a particularly clear overview Note Note that a DICOM printer must be connected to your system and the DICOM print function must have been enabled so that you can print images with scoutlines as described here 1 Load the reference image in viewer 1 2 Load a series of the same study in viewer 2 Y re 3 Display both viewers side by side compare mode 4 Show All Scoutlines in the localizer viewer 1 5 Select the reference image for DICOM print in viewer 1 And E it el a 6 Select all images for DICOM print in viewer 2 See also Selecting images for DICOM print on page 192 g 7 Select
159. fined these addresses for you Export Images Exports the currently displayed images to a directory on your local PC You can save the im ages as DICOM images or in BMP or JPEG format When images were saved in BMP or JPEG format they may no longer be suitable for diagnosis kl DICOM Information Shows the DICOM information of the current image Hide Show Image Text Shows or hides text in the image Edit Report Opens an existing report for editing or creates a new study report on the web server Du C Zoom Allows you to enlarge or reduce the displayed images steplessly using the left mouse but ton While Zoom is active the mouse pointer looks like this he Quick Zoom Permits temporary zooming of a portion of an image As soon as you release the mouse button the image returns to its original size While Quick Zoom is active the mouse pointer looks like this X Magnifying Glass Allows you to enlarge a portion of an image by factor 2 As soon as you release the mouse button the enlargement is no longer displayed While Magnifying Glass is active the mouse pointer looks like this Ro Visage 7 Web Client 73 Viewers The Visage 7 Web Client Window Pan Allows you to move the image in the segment If the portions of the image disappear off the screen after enlargement you can pan them back into view While Pan is active the mouse pointer looks like this Ry
160. ftware updating does not start automatically or if problems occur you can start reinstallation of the client yourself Note Before you remove and reinstall the software make sure you have administrator rights on your client PC 1 Close all Internet Explorer windows first Always start reinstallation directly after you call up the login screen 2 Open the Visage 7 Web Client login screen 3 Open the popup menu of the login screen with the right mouse button 4 Select the Reinstall Client option Or Select the Remove Client option Close the Internet Explorer when the system tells you all client components have been removed Relaunch the Internet Explorer again and pick Visage 7 Web Client from Favori tes again The Visage 7 Web Client software will now be updated automatically Performing data maintenance If you have the appropriate access rights you can perform data maintenance tasks in the patient window e Make patient data available for other users or user groups e Delete patient data or e Protect patient data from being deleted Visage 7 Web Client 241 Performing data maintenance Functions and Information for Advanced Users Note If your Visage 7 Web Client user rights do not permit you to carry out any of these data maintenance tasks the corresponding icons are not shown in the patient win dow toolbar Note On rare occasions data maintenance tasks may not be possible for a brief period because a
161. g them to the study series window Select another network node from the data source list e g an archive node Click the Query Patient icon on the toolbar The name and ID of the selected patient are copied into the filter criteria section You do not have to type this data again A query of the selected network node is started immediately If the patient is found on this network node he or she is now displayed in the pa tient list Importing data 1 Select the patient s whose images you want to retrieve from the response list of the network node Click the Retrieve Study from DICOM Node icon on the toolbar Or Double click on a patient entry to transfer his or her data only The data of the patient s are copied to the local database of the Visage 7 server Tip When you retrieve data from a network node the new patient s may initially be as signed to your user account alone a message is displayed in this case Also assign the new patient s to other users or user groups if you want to make their data available for other users as well Updating the patient list 1 Select the web server as the data source again 2 Start a new query to the local database Start Data Query The patient list of the local Visage 7 database is updated It now includes the pa tients retrieved from the network You can now work with this data in the usual way 115 Selecting series and images Loading Image Data
162. ge 7 Web Client With Visage 7 Web Client you can modify the brightness and contrast of grayscale images You can also filter XA images and improve their focus You can window and filter images either interactively with the mouse or by using predefined window values Note You cannot window 8 bit ultrasound US images and nuclear NM images e g RGB color images The concept of windowing Imaging systems provide diagnostic information in the form of grayscale images with up to several thousand different grayscale values However monitors cannot display such fine grayscale graduations nor can human beings perceive them Windowing means focusing on the range of grayscales of the diagnostically relevant area and tissue type The first step in windowing is therefore to determine the center of the window i e the grayscale value of the type of tissue that is central to your diagnostic problem The smaller the window center the brighter the image With the window width you define how many grayscale values above and below the center value you want to see The smaller the window width the stronger the con trast 171 Editing images Reviewing Images Tip You can see the current window values in the bottom right hand corner of the im ages C center brightness W width contrast Medical images are already stored with window settings on the modality However you can change these window levels when you view image
163. ge is indistinct It is updated and shown distinctly as soon as you release the mouse In the other two slice segments the new slice thickness can be seen by its thick er or thinner slice cursor line 218 Visage 7 Web Client Working in the Basic MIP MPR Viewer Changing the slice thickness for slice images ey MPR 5 65 mm C 11317 W765 C 1137 Y71765 F MPREROO mm C 1131 W 765 Visage 7 Web Client 219 Changing the slice thickness for slice images Working in the Basic MIP MPR Viewer 220 Visage 7 Web Client Reviewing and Reporting on Images in the Display Protocol Viewer Client type Expert Reading features a viewer that is particularly well suited for com H paring image data of several series or more than one study such as a current and earlier examination for example When reviewing images of a current and previous study be sure to show image texts in the display protocol viewer This will help you distinguish the two studies in the various viewports Be sure you have correctly identified the current study when reporting on the image data This section will explain how to work with the display protocol viewer when review ing and reporting on images e Image text and image icons e Changing display settings e Loading images from the thumbnail browser e Synchronized scrolling e Editing images e Evaluating and annotating images e Viewing and editing a report Image text and image icons In the
164. ges 2 Organ Date Time RAO 200 RAO 350 Tip In some modalities multiframe images are also called scenes indicating that they provide dynamic information that is they display a process over time Image text and image icons Image text In the Visage 7 Web Client viewer windows patient study and image information can be shown as image text or icons in the images The image text is arranged in text blocks around the edges of an image in this way 1 Visage 7 Web Client 1 Patient and examination data 2 Orientation labels 3 Acquisition parameters 4 Window values and filter settings 5 Hospital and system information including information on compression level and image quality 145 Image text and image icons Reviewing Images Image icons Image texts that are very long are truncated For example if a study comment text is very long only the first 64 characters are displayed Depending on the modality and image type additional information can be displayed or certain information can be omitted or only displayed in certain modalities In XA scenes for example orientation labels are hidden Your system administrator can configure the image texts for each modality The information contained by multi value tags are shown comma separated Note that your system administrator may have configured some of the information from multi value tags to be hidden In addition to image te
165. ges had be fore you started editing Click this icon on the toolbar to reset your changes to window values and the filter value The window and filter values with which the images were originally loaded are applied again Tip Select Apply to All in the context menu if you wish to reset the window filter val ues of the entire series Using preset window and filter values A series of organ specific and user specific window and filter settings are stored in Visage 7 Web Client Some of these settings were predefined during the installation of the Visage 7 server others have been defined by a user You can apply these presets to images of a particular modality 1 Click this icon on the toolbar Or Select Window Level Presets gt Window Level Presets from the popup menu The Window Level Presets dialog box opens 173 Editing images Reviewing Images Window Level Presets CT Image Storage abdomen w contr bone 1 Cancel bona 2 Edt brain Default 2 Select a user defined preset Or Click Default to return to the settings with which you loaded the images Tip The window and filter settings stored together with the images in the Visage 7 da tabase on the web server are labeled Source 0 For imaging methods e g CT which allow storage of two alternative window settings together with images the two sets are labeled Source 0 and Source 1 Defining new
166. ght hand corner It warns you that the current image no longer corresponds to the image saved in the presentation state at the diagnostic workstation This icon in the upper right hand corner of the image segment indicates that calibration has been applied to distance lines in this image Visage 7 Web Client 79 Viewers The Visage 7 Web Client Window This icon indicates that the displayed images do not originate from an original scan series thin slice series but were generated by a Visage 7 thick slice compilation rule Popup menu D For your convenience the image area of the Visage 7 Web Client viewers offers a popup menu for quick and easy access to frequent image processing functions Right click in the image display area Note Note that many image display functions are available from both the toolbar and popup menu Others functions are available only from the toolbar or only from the popup menu The following table describes only those functions that have not al ready been explained in the context of the toolbar Apply to All Auto Apply to All Undo Show Hide Overlays Hide Show Shutter Delete Measurement Annotation Delete all Measurements Delete all Annotations Delete all Measurements and Annotations Select Image Remove Image Selection Hide Show ECG Applies the last editing step to all images of a loaded series When this option is selected all image edit
167. gin screen 1 Click on the text link Download user documentation on the login screen The link takes you to a web page where you will find the user manual and online guide as pdf files in the language you have selected for the user interface 2 You can download the pdf files from here onto your local PC in order to view it online or print it out When you are calling the login screen from a Windows Vista system for the first time Visage 7 Web Client cannot be installed automatically 1 Follow the link to a download web page that will be displayed instead of the login screen 2 Click the link Visage7_WebClientInstall msi on this page This link will help you with installing Visage 7 Web Client on your computer Visage 7 Web Client Starting and Ending the Program Standard system login Standard system login Dual monitor Multiple sessions Automatic client update Visage 7 Web Client After you have entered the address of the Visage 7 server the Visage 7 Web Client login screen is shown 1 Select one of these client types View Classic Expert Expert Dual Monitor or Expert Reading Or Call up the Visage 7 Web Client login screen in your preferred client type e g http servername en view for client type View http servername en classic for client type Classic http servername en expert for client type Expert http servername en 2monitor for client type Expert Dual Monitor http servername en exper
168. he compare view is displayed Tip If you select the entire study or one series the first two images of this study or se ries are displayed in the compare view Visage 7 Web Client 123 Loading images into a viewer Loading Image Data Using the local cache Local Cache Preload Study 124 FF FF If you are working with slow data transmission rates and your studies comprise a large number of images we recommend you activate the local cache option With this option Visage 7 Web Client will download images into the local cache memory on the hard disk of your computer For reasons of data security the data is however stored on your local hard disk only temporarily for the duration of your current session As soon as you log off from Vis age 7 Web Client all image data are removed from your local hard disk You activate the local cache option in the study series window Visage 7 Web Client offers two alternatives for working with local cache With local cache active all images that you load into a viewer once during your ses sion are automatically downloaded onto your computer for the duration of the cur rent session 1 Click Use Local Cache on the toolbar of the study series window Local cache is active 2 Double click a series for example to load it into viewer 1 Loading the images may be slow the first time But when you return to this series later on in your session and load these images into a viewer a
169. he current scoutline in the reference image Visage 7 Web Client 103 Display Protocol Viewer Expert Reading The Visage 7 Web Client Window fH th oT Cine Mode Backward Plays back the loaded images like a movie The playback direction is backward Cine Mode Stop Stops movie playback Cine Mode Forward Plays back the loaded images like a movie The playback direction is forward Cine Mode Speed If the slider is far left movie playback stops If the slider is far right the movie is played back at maximum speed Bouncing Cine If you click this icon the movie will run without interruption When playback reaches the last image the movie runs backward to the first image then forward again etc Interactive Cine Mode When Interactive Cine Mode is active the images of a series or scene will play back when you move the mouse pointer over the image area This gives the impression of a mov ie being played back Mouse up or right play forward Mouse down or left play backward Mouse stopped still image The direction in which you are supposed to move the mouse can be configured by your sys tem administrator Display as 3D volume Shows the selected study in the Visage 7 Client for advanced 3D evaluation Automatic Synchronization with 3D volume Select this option to ensure that both the Visage 7 Web Client and the Visage 7 Client will always show images of the same patient Color Map All
170. he display protocols list This will change the screen layout in the display viewer It will not affect the load ed data Note Protocols labeled blank do not load image data into the viewports You will have to do this yourself with the help of the thumbnail browser Adding or removing viewports dh o Use Next Previous Viewer Layout to scroll through the viewer layouts of your cur HO HI rently active display protocol Or 224 Visage 7 Web Client Reviewing and Reporting on Images in the Display Protocol Viewer Loading images from the thumbnail brow i L opo Use the or keys on your keyboard to show more viewports if these have been configured in your current display protocol Or Use the number keys to show more or fewer viewports Changing the display mode in a viewport En 7 H m a pe ma Es ma 1 Click a viewport to select it The selected viewport is highlighted by a colored border 2 Drop down the display mode icon bar and select a different mode 1x1 is considered stack mode in the display protocol viewer as the images are arranged in the viewport as an image stack 2x1 2x2 3x2 3x3 and 4x4 are considered tile mode Loading images from the thumbnail browser Visage 7 Web Client If you have selected a blank display protocol before loading data no images are shown in the viewports of the display protocol viewer You are expected to distribute the series of your study or stu
171. he method you use depends on your selection of images and on which image viewer you want to use Loading by double click Loading individual series or images Visage 7 Web Client You use this method when you want to load an entire study series or an individual image into viewer 1 quickly Double click a series or presentation state in the corresponding list Or Double click on the title bar of the series or presentation state in the preview area or preview window Or viewer Double click an image in the preview area The selected series presentation state or image is loaded into viewer 1 Viewer 1 is displayed 121 Loading images into a viewer Loading Image Data Loading a study rR 1 Select Load all series as one 2 Double click the study in the study list or double click the title bar of the study in the preview section All series of this study are loaded into viewer 1 The images are merged into one viewing series This means that you can scroll through an entire study image by image or using cine mode but you cannot scroll series by series in the viewer Note Note that images from different modalities or single frame and multiframe images cannot be merged this way Or 1 Deselect Load all series as one 2 Double click the study in the study list or double click the title bar of the study in the preview section Only the first series of this study is loaded into viewer 1 and the view
172. he same region were scanned with a different orientation e g sagit tal and coronal you can use scoutlines to show the location of the images of the two series with reference to each other Prerequisites In order to be able to show scoutlines your image data must fulfill the following pre conditions The images have been loaded into compare mode 5E Scoutlines cannot be displayed if you are working in the viewer 1 viewer 2 or re port with image window e CT or MR series are displayed e The images loaded in both screen halves originate from the same study e The images loaded in one screen half correlate anatomically to the image s shown in the other screen half Showing scoutlines in a reference image i D 1 Load the reference image in viewer 1 and one or several series in viewer 2 or vice versa TE 2 Display both viewers side by side compare mode Visage 7 Web Client 163 Displaying scoutlines ia i Hiding scoutlines ia 164 Reviewing Images 3 Select an image from your series by clicking it The image is highlighted by a white border Drop down the Show Scoutlines icon bar in the reference image section and select one of these options Select Show Current Scoutline to show where the currently selected image cross sects the reference image When you scroll through your series now the scoutline moves up or down in the reference image It will always show you the exact location o
173. hold the mouse w button down A list of available screen layouts drops down EA 2 Select a layout If more image segments are available than images have been loaded the re maining segments remain empty Tip In compare mode you can choose different layouts in the two screen halves Switching over to Double click an image in the viewer fullscreen display This image is shown in full screen display The 1x1 layout is well suited for im age editing Showing hiding or moving the toolbar If the toolbar obstructs your work when it is displayed above the image section you can move it to the left hand side or you can hide it while you are viewing images pu Click on the Change Toolbar Location icon to toggle the toolbar position Or Click the Auto Hide Toolbar icon to have more space available for image dis Ia play Move the mouse cursor over the area where the toolbar was last shown to redis play it temporarily Or a Click the Lock Toolbar icon to show the viewer toolbar permanently again Showing and hiding image text When you select a different screen layout the font size of the image texts remains the same But as the images are smaller in a 4x4 layout than in a 1x1 layout for ex ample image text might cover part of the diagnostic information You can therefore temporarily hide image texts to create more space for diagnostic information 148 Visage 7 Web Client Reviewing Images Selecting sc
174. hows or hides measurement and annotation graphics stored in an image 106 Tip The SMPTE images you can display here are not suitable for calibration of DICOM printouts Use Testlmage_SMPTE_1k instead You find this test case in the patient list If no patient of this name exists in your patient list ask your system adminis trator to insert this test case into the Visage 7 system from your installation medi um We recommend that you protect the Testlmage_SMPTE_1k test case against deletion so that it will not be deleted automatically when disc space is running low Visage 7 Web Client Loading Image Data In order to view and evaluate images in Visage 7 Web Client first locate the data on the web server Once you have found the patient and examination data you wish to review load these images and display them in one of the available viewers This section helps you with e Finding patients and transferring them to the study series window e Selecting series and images e Loading images into a viewer e Loading a presentation state e Loading a series into the basic MIP MPR viewer e Loading 3D volume data into Visage 7 Client e Loading images from the worklist Finding patients and transferring them to the study se ries window i Visage 7 Web Client You use the patient window to search for and select the patient whose images you wish to display If you have only just called up Visage 7 Web Client the patient w
175. ially clearly If you are working in compare mode scrolling in both screen halves can be synchro nized At the bottom edge of the display window a position indicator bar is visible e Dark green bars represent those images that are in the background and not dis played e Light green bars represent the images currently displayed e A white bar indicates the currently selected image e Dark gray bars represent images that have not yet loaded only appears during loading You can use the position indicator to locate the images that are currently being dis played within the loaded series The position of the slider on the scroll bar also indicates the position of the images displayed but not as precisely Image by image slow scrolling Visage 7 Web Client To scroll through the loaded images you can use e the Scroll bar e the Keyboard e the Wheel mouse e the Icons on the toolbar 151 Scrolling through the loaded images 152 Scroll bar Click into the scroll bar with the mouse Displays the previous image Displays the previous line E Moves the display range hold mouse button down and drag Displays the next line Eal Displays the next image Keyboard Press one of these keys Reviewing Images E GOCO GO EG Jumps to the beginning of the loaded series Jumps to the end of the loaded series Scrolls back one image Scrolls forward one image Scrolls back one
176. ient Description Noof objects size in MB Refresh Priority stop Delete Restart Close Trusted sites Here you will find information about all data transfer jobs that you have initiated DICOM Send Lists transfer jobs that you have passed on to other network nodes with DICOM Send or DICOM Quick Send DICOM Retrieve Lists all transfer jobs with which you called data from other network addresses in the patient window and transferred to your local Visage 7 database DICOM Print Lists all DICOM print jobs Query Report Visage 7 Web Client Printing Exporting and Sending Images Sending data in the network Information about transfer jobs Lists queries for reports that you have requested from the HIS RIS Tip Transfer jobs that involve the retrieval of data are only performed once If for ex ample you attempt to retrieve a study from the archive while a retrieval job for the same study that was initiated by another user is still being performed or pending your retrieval request will be ignored and therefore not listed in the Status infor mation window Check the All users box if you cannot find your job on the corresponding tab card of the Status information window The Status Information window contains two additional tab cards e Active user list A list of all users currently logged onto the Visage 7 server e System Info Indicates which Visage 7 Web Client software version is installed and
177. ient window If you find the patient you are looking for in this list you nevertheless cannot work with this data immediately You must first copy the patient to the local database with this icon This icon is dimmed while the data source web server is selected or while no patient is se lected in a network response list Query Patient This icon is active if a patient was selected in the local patient list and then a DICOM partner was selected in the data source drop down list The patient name and the patient ID of this patient are copied into the search criteria boxes and the search for this patient is started on the DICOM partner DICOM Send Opens a dialog box Select the address es in your DICOM network to which you want to send the selected patient s DICOM Quick Send Sends the selected patient s to one or several DICOM nodes immediately Your system administrator has defined these addresses for you Forward For a better overview the patient list does not display all patients found at a time After a very generic patient search that results in more patients found click this icon to page through the list of all patients found Backward Click this icon to page backward through the list of all patients found Set Delete Protection Delete protected patients cannot be deleted neither automatically by the program nor man ually by the user Remove Delete Protection Cancels delete protection for the selected pa
178. iewer 221 Image text ANd image ICONS eect eeeeeee eee eeeeeeeeeeteeeeeeeeeseeeaaeeeeeeeeaeeeeseeeaaeees 221 Changing display SettingS 0 00 0 ccceeeeneeeeeeeeeneeeeeeeeeeeeeeeeaaeeeeeesaaeeeeeeeiaeeeeeseaes 224 Selecting a different display protocol ee eeeeeeeeeeeeeeeeeeeeeeeeeeeteeneeeeeeeenaees 224 Adding or removing ViCWPOTtS cceceeeceeeeeeneeeeeetetaeeeeeetaaeeeeeesaeeeeeetiaeeeeeres 224 Changing the display mode in a VICWDOTt ce eeeeeeeeeeeeneeeteeeeeneeeeeeetaeeeeeeeaaas 225 Loading images from the thumbnail DrOWSE cccceeeeeeeeeeeeeeteeeeeeentaeeeeeeenaaes 225 SynchroniZed Scrolling c c cssecccecesseecccecesenecceteetseendeceeeeeeeceesensnendererseneceneeeeneecs 226 Editing Images veces cee a EA tae eG Ge Roane eae aa tee 228 Evaluating and annotating images 0 0 0 0 eceeeeeeeeeeeeee eee eeeeneeeeeeeeaaeeeeeeenaeeeeeeenaaes 229 Performing measurements 0 0 0 ce ceeeeececeeeeeeeeeeeeeeeeeeeseeeeeeeeeteeeeeeeeeseeeeaeeeeteeeaneees 229 Creating Annotations aas ansan eee ai edia ea l aaa dioe a iaat aii 230 Visage 7 Web Client Table of Contents Visage 7 Web Client 6 0 SpinelabelinG a ee cher anaes Aiea ates i inecer anced data de aabetiene St 231 Editing measurements and annotations 0 c ce cccecceeeeeeeeeeeeeeeeeteeeeeeeenaeeeeeees 232 Saving measurements and annotations 0 0 0 0 eeeeceeeeeeeeeeeeeeeeeeeeeeeenteeeeeeeenaees 232 Viewing and editing a rePOrt ee ceeeeeceee
179. if needed Visage 7 Web Client allows you to log on to the Visage 7 server and to access the data that is stored on the server using the HTTP HTTPS protocol Data can be accessed in two different ways e From the various wards or departments of a hospital via the intranet or 13 Product overview 3D Thin Client option System Overview e From outside the hospital that is from physicians practices via the Internet fast transmission rates are recommended Visage 7 Web Client use the Microsoft Internet Explorer as a web browser To implement the functions required for editing images special software compo nents are used that are based on ActiveX By using standard Internet technology it is therefore possible to use standard PCs as viewing stations With the additional Visage 7 Client product option the system also supports distribu tion of 3D image data generated from state of the art scanning modalities A 3D render server application server processes the 3D data and makes it avail able over an intranet or Internet connection for 3D image viewing and evaluation The actual DICOM data remains on the 3D application server and is not transferred to the 3D clients Instead of image data a stream of compressed screen content is transmitted during interaction which allows for safe and consistent access even to large volumes of 3D data License management Licenses 14 Every Visage 7 installation comes with a license code
180. indow is already open Note The patient list shown here conforms to the filter and search criteria you used the last time you queried the database Visage 7 Web Client records the filter and search settings for the patient list from one session to the next i e if you close the program in between times 107 Finding patients and transferring them to the study series window Loading Image Data You can scroll through the patient list until you have found the patient you are look ing for Or you can specifically search for a patient by entering filter and search crite ria Tip Searching in a database is called querying For that reason the icons in the Vis age 7 Web Client patient window are labeled Start Data Query Stop Data Query and so on Searching for patient data in the patient window involves one or several of these tasks e Selecting filter criteria e Entering search criteria e Using predefined filters e Starting a query in the local database e Searching and retrieving patients from other network nodes e Transferring patient data to the study series window Selecting filter criteria 108 You can limit the patient list displayed and for example list just the patients you ex amined over a certain period 1 Click the Show filter criteria icon in the top left corner of the patient window if filter criteria selection boxes are currently not shown 2 Select from among these filter settings Study
181. indowing If this icon is pressed you can use the mouse to change the grayscale display brightness contrast in the images While Windowing is active the mouse pointer looks like this Xo Edge Enhancement This filtering enhances the contrast in images While Edge Enhancement is active the mouse pointer looks like this Rn Visage 7 Web Client 99 Display Protocol Viewer Expert Reading 100 The Visage 7 Web Client Window Pan Allows you to move the image in the segment If the portions of the image disappear off the screen after enlargement you can pan them back into view While Pan is active the mouse pointer looks like this Re Magnifying Glass Allows you to enlarge a portion of an image by factor 2 As soon as you release the mouse button the enlargement is no longer displayed While Magnifying Glass is active the mouse pointer looks like this Ro Zoom Allows you to enlarge or reduce the displayed images steplessly using the left mouse but ton While Zoom is active the mouse pointer looks like this he Quick Zoom Permits temporary zooming of a portion of an image As soon as you release the mouse button the image returns to its original size While Quick Zoom is active the mouse pointer looks like this RK Previous Annotated Image Scrolls up in the stack of loaded images and shows the next image containing annotation graphics or annotation text Next Annotated Image
182. ing steps are applied to all images of a loaded series immediately and not just to one image alone Undoes the last editing step Shows overlays if any have been created for the loaded images Shows or hides a shutter if a shutter was created for the loaded image Deletes a selected measurement or annotation graphic Deletes all measurement graphics in the currently selected image Deletes all annotation graphics in the currently selected image Deletes all measurement or annotation graphics in the currently selected image Selects the current image i e the image highlighted by a white border for DICOM print DICOM print selection is indicated by a solid green box in the lower right hand corner of the image segment Removes the current image from the DICOM print selection Shows or hides the ECG curve in the image only possible for XA images containing ECG information 80 Visage 7 Web Client The Visage 7 Web Client Window Viewers SMPTE 1 2 Show Hide Mea surements and Annotations Calls one of two available test images for performing a display quality check of your monitor Shows or hides measurement and annotation graphics stored in an image Tip In this client type you can only create measurements and you can delete measure ments or annotation graphics only temporarily and for the duration of the current session You cannot save these changes back to the web server Saving measure ments a
183. ing the printout eeceeeeeeeceeeeeeeeenneeeeeeenaeeeeeeenaas 193 Printing images on a Windows printer ceeeeeeeeeeeeeeeeeeeeeeeeeeeteeeeeeeeteeenaees 194 Exporting patient data Or iM QGES cc cecceceeeeeeeeeeeeceeeeeeenaaeeeeeeenaeeeeeeenaeeeeesenaas 195 Exporting patient data from the patient list cceeeeeeeeeceeceeeeeeeeeeeeeeteees 196 Exporting images from the viewer 0 0 0 ce eeeeeeceeeeceeeeseeeeeeeeeteeeeeeeeeseeaaeeeeeeeeaaees 196 Copying images to the clipboard oe ee eeeee eee eeeeaeeeeeeeeaaeeeeeeetaeeeeeeenaaes 197 Sending data in the NetWork ceeeeceeeeeeeeeeeeeeeeeaeeeeeeeaaeeeeeeeaaeeeseeeneeeeeeneaes 198 Sending data to selected address es DICOM send 198 Sending data to preselected address es DICOM Quick Send 199 Checking status information ceceeeee cece eee eeeeeeeeeeeeaaeeeeeeeaeeeeeeenaeeeeeeeaas 200 Managing the Diagnostic Reading Workflow 203 Creating a procedure Stepenice eniai a aaa a ae 204 Filtering the patient lsiera an a E E OA 204 Marking a study as TEI ciara eiee EA ARAIA AEE 205 Managing procedure steps in the study list ee eeeeseeeeeeeeeeeeeeeeeeneeeeeeeeeaeees 205 Visage 7 Web Client 6 0 7 Table of Contents Working in the Basic MIP MPR Viewer 207 SD DACS ees lea S cites es AAA A ey inate eens pie a hasedegh T eee 208 Anatomical standard ViCWS cccccecceeecceeeeeseeeeeeeeeeeneeeeeeeseneeeeeeseeeaaeeeeseeeaeees 209 Ch
184. ion SCHEDULED EDIM 2006 10 27 18 53 33 MR MR Ankle Selecting the study 1 Click a patient to show a list of all his or her studies 2 Double click one of these studies to load it into the display protocol viewer with the first display protocol in the display protocol list T ot etn Sex___ erent Display Protocol Description Monitors Orientation Larry s L a 656565 o 2007 04 02 View One series per view 2 Landscape MANUS DEXTER 1953 11 04 M 2007 04 9 Blank Viewports Use drag and dropt 2 Landscape MDP_CHILD_01 FLTOPOS 1997 11 03 F 2007 84 02 MDP_TOP FLTOPOS 1920 05 03 F 7 04 02 MR Abdomen 23003 2000 01 01 M 2007 04 03 MR Ankle 23000 2000 01 01 M 2007 04 03 MR Ankle multi 23006 2000 01 01 M 2007 04 03 MR dataset Brain reg2 1911 01 01 b 2007 04 02 MR Knee 23002 2000 01 01 F 2007 04 03 MR LSpine 23001 2000 01 0 M 2007 04 03 el Shoulder 23005 2000 07 01 F 2007 04 ss Procedure Step e N e Modalities in Study _ Study Descriptic Interpretation SCHEDICED MEDIUM 2006 07 31 11 55 37 MR MR Ankle Interpretation SCHEDULED MEDIUM 2006 10 27 MR 4 MR Ankle Selecting the display protocol 1 Click a patient to show a list of all his or her studies 2 Click a study to select it 3 Double click a display protocol in the display protocol list Visage 7 Web Client 133 Loading images from the worklist Loading Image Data pesiectNe _ A relent __ bite tevin Se__ hort Do Larry s L oom
185. ion for Advanced Users Performing data maintenance Deleting You can delete study data only if the patient is not delete protected examination data 1 Switch to the study series window c 2 Select the study you want to delete 3 Click this icon A dialog box pops up requesting confirmation for deleting the entire study a re port associated with this study or one or several selected series or presentation states x If you delete a presentation state only the presentation state object is deleted but not the referenced images in the original series Changing access rights to patient data If you possess appropriate user rights you can share the study data you have ac cess to with other colleagues You can e Grant access rights to individual users or e Grant access rights to whole user groups Note Do not revoke access rights to patient data for your own user account or for a user group that you are a member of Otherwise you will no longer have access to the selected patient s either You cannot restore your own access rights to patient da ta once you have closed the dialog box As soon as the patient list is updated the patient will no longer be displayed You or your user group can only be granted access rights to this patient data again by another user who has the appropriate rights or by the system administrator Visage 7 Web Client 243 Performing data maintenance Functions and Information for Advanced
186. is accession number Toolbar patient window In the patient window you will start all processing steps with the icons of the toolbar No Filter User defined filter You can select a predefined filter here Yi a Reset to Default Filter Activates the filter defined as the default filter Set Filter Properties The Personal Settings dialog box opens You can define your own filters here Reset Filter Settings All the filter parameters you entered are removed Click Start Data Query to display the un filtered patient list again Reset Input Fields All the search criteria you entered are removed Click Start Data Query to display a longer patient list again Visage PACS Web Data source Here you select where to search for data on the local web server database or on a DICOM network node fae hd Start Data Query Starts a data query with the current filter and search criteria in the selected data source As a result the patient list of the web server or a response list from a DICOM node will be dis played Cancel Data Query A query currently in progress is stopped All patients found so far are displayed 46 Visage 7 Web Client The Visage 7 Web Client Window Patient window dd Ez Retrieve Study from DICOM Node If you did not request data in the local database but on a network node you will see the re sponse list of the DICOM node in the pat
187. isplay a longer patient list again Visage 7 Web Client 91 Worklist Expert Reading The Visage 7 Web Client Window Visage PACS Web Data source Here you select where to search for data on the local web server database or on a DICOM network node Start Data Query fe Starts a data query with the current filter and search criteria in the selected data source As a result the patient list of the web server or a response list from a DICOM node will be displayed Cancel Data Query iP A query currently in progress is stopped All patients found so far are displayed Ea Retrieve Study from DICOM Node i If you did not request data in the local database but on a network node you will see the re sponse list of the DICOM node in the patient window If you find the patient you are looking for in this list you nevertheless cannot work with this data immediately You must first copy the patient to the local database with this icon This icon is dimmed while the data source web server is selected or while no patient is se lected in a network response list Query Patient He This icon is active if a patient was selected in the local patient list and then a DICOM partner was selected in the data source drop down list The patient name and the patient ID of this patient are copied into the search criteria boxes and the search for this patient is started on the DICOM partner Forward di For a better overview the patient li
188. ist Dr X oa v Study Date All PaientName Suy tt i S S S C C S POSS v Modality All Patenti StudyDescription Physician All PatientComment ss OSO SAcessionNo f000 lt i SOSSSCCNS Location All Date ofBirth J YrwyMMoD v Insertion Date All v Interpretation Status All 37 Patients found H lal el No Filter gt V1 aK TH Visage PACS Web a mA P pe ER ZaD AS Q ag 1 Monitor Landscape x E amp k ig ILI_INT_TOP 1922 07 24 Series View One series per view 1 stn eine BE arera 7 nimime Stank Viewports Use drag and dropt 1 Amato Terence 000012 1965 03 17 F 2008 01 16 11 ANEVRYSME NEURO o 2008 01 16 11 Angiologie Angi 1999 07 01 o 2008 01 16 11 anonym_pt anonym_pt 1900 01 01 o 2008 01 16 11 AUTOMANTERA 1924 01 26 M 2008 01 16 11 AVE ABDOMEN 0000002019 1978 10 10 M 2008 01 16 11 Biplan Paul 192837465 1967 05 25 M 2008 01 16 11 CANOPUS BEN 29191 1985 09 18 o 2008 01 16 11 Dilow Raleigh A 291101 1911 01 01 M 2008 01 16 11 HAND PATIENT2 9946122 M 2008 01 16 11 HSA Circle of W 421876 M 2008 01 16 11 INSTAN JERRY 8171 F 2008 01 16 11 Interesting Case Testpatient 1940 03 05 F A i a eee w O A Procedure Step Status Performer Priority Study Date Time Modalities in Study Image Series Study Description ry 5 1997 04 28 11 58 32 RF 2 4 E Query finished Trust
189. ists all patients whose studies contain procedure steps with interpreta tion status discontinued COMPLETED lists all patients whose studies contain procedure steps with interpretation status completed Visage 7 Web Client 109 Finding patients and transferring them to the study series window v Modality All Using the calendar function December 2005 he Resetting filter settings w Yi 110 Loading Image Data 1 Click the small triangle to the left of the filter criteria A list with various options opens 2 Select a suitable option The selected option is shown to the right of the filter criterion 3 Click OK or press the RETURN key If you want to filter by examination date or insertion date you can use the calendar to select dates 1 Click the small triangle to the right of the selection list The calendar opens December 2005 Mo Tue We Th Fr 27 28 29 3 4 E 26 10 11 12 13 17 18 19 20 24 25 25 2 4 5 lt gt Today 05 12 2005 2 Click the year on the blue title bar to switch to the next or previous year 3 Click the arrow buttons on the blue title bar to switch to the next or previous month 4 Select the day from the table The calendar window closes and the new date is shown in the selection list Tip You can also set the date directly in the input box Click the day month or year and change the entry by clicking the arrow up and arrow down keys holding
190. ition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still 1 Drop down the Measurement Functions icon bar keeping the mouse button pressed 2 Select the Angle Measurement icon The mouse pointer changes shape in the image area 3 Click the start point of the first leg 4 Hold the mouse button down and drag a line over the image 5 Release the mouse button The first leg is drawn 6 Draw the second leg in the same way The two lines you draw do not have to intersect The program indicates where the two lines would cross with a dot while you do the drawing The point of inter section can lie outside the image The angle in degrees will be displayed as soon as the second leg is completed 183 Evaluating images Deleting a measurement Deleting all measurements Changing a measurement Panning measurement graphics ROI evaluation 184 Reviewing Images Changing moving or deleting measurement graphics You can subsequently change all measurement graphics The Delete Measurement Annotation menu item in the popup menu deletes the last measurement drawn in the active image area The Delete All Measurements and Annotations menu item in the popup menu de letes all measurements drawn in an image 1 Click a measurement Grab handles appear at the ends of the line 2 Left click a handle at the end of a line and hold the mouse button 3
191. k 12 Copy to Clipboard icon 72 99 Coronal 209 Create Annotation icon 102 Customer specific translation 28 D Data compression 125 Data maintenance 241 Data protection 18 Data security 18 Default filter 110 Delete object icon 52 Delete Patients icon 47 Delete Protection 245 Deleting patient data 242 studies series reports 243 Density 188 Density Measurement icon 76 101 Density Profile icon 77 102 Deselect all Images DICOM Print icon 72 99 Deselect all previews icon 53 Diagnostic reading workflow 203 DICOM images 197 DICOM Information icon 53 73 99 Index DICOM Print icon 72 99 DICOM Quick Send 199 DICOM Quick Send icon 47 53 73 92 DICOM Send 198 DICOM Send icon 47 53 73 92 Display as 3D volume icon 53 61 78 93 104 Display Mode icon 77 98 Display protocol viewer 221 synchronized scrolling 226 Display Protocol Viewer icon 42 Display protocols 131 Display protocols list worklist 95 Display Reports icon 79 Display Scenes icon 79 Distance Measurement icon 75 100 Distances 180 Dual monitor 29 E ECG 162 Edge enhancement 172 Edge Enhancement icon 74 99 Edit Report icon 73 98 233 Editing reports 139 Encrypted Data Transfer icon 52 93 Encryption 20 125 Explorer status bar 39 Explorer toolbar 39 Export Images icon 73 99 Export Patient icon 48 Exporting images 196 patient data 196 F Favorites 28 Filter definition
192. latform feature an online help system each 23 Overview of the Visage 7 product documentation System Overview Calling up online help Tab cards Contents Index Search Favorites Links to other topics Scrolling from topic to topic 24 You can call up the online help system from any Visage 7 Web Client window Click the help icon on the Visage 7 Web Client navigation bar along the left edge of the window to open the context sensitive online help system The context sensitive online help displays the help topic relevant to the window that is active when it is called The left half of the Visage 7 Web Client online help window shows tab cards for quick access to the help contents This tab card contains a table of contents similar to that of a printed book 1 Double click the book icon to display a topic and show subheadings 2 Click the page with the question mark icon to display the text of a help page in the right half of the window You can search for index entries here 1 Enter a word you want to search for Or Scroll through the alphabetical index 2 Double click an index entry to display the information about it This tab card permits a full text search 1 Enter a word to search for 2 Press the RETURN key All help topics containing this word will be listed On this tab card you can set bookmarks for help topics that are of particular interest to you 1 Display the topic you want
193. layouts Here you can switch from stack mode to tile mode in the currently selected viewport Select for example the 2x2 view The viewport is divided into 4 segments in this example Depending on the number of images that are loaded up to 4 images will be displayed in the selected viewport at one time Next Viewer Layout Loads the next viewer layout defined in the currently active display protocol Previous Viewer Layout Loads the previous viewer layout from the currently active display protocol Previous Scene Loads the previous scene of a series containing several multiframe images or scenes Next Scene Loads the next scene of a series containing several multiframe images or scenes Hide Show Image Text Shows or hides text in the image Gamma Adjustment Opens a dialog box for the adjustment of the gamma curve of images This adjustment ap plies to all Visage 7 Web Client image viewers Cancel loading Stops loading images Mark study as read Sets the status of the procedure step for this study to completed This icon is only active if a procedure step exists for the study whose images are currently shown in the viewer Edit Report Opens an existing report for editing or creates a new study report on the web server Select Images Offers options for selecting images for printout on a DICOM printer Select all Images Selects all loaded images for DICOM print Visage 7 Web Client The Visage 7 W
194. le to all others Ending an online conference Exiting a conference Finishing a conference 238 As a regular participant you can exit the online conference while the others continue their discussion If you are the host who convened the conference you can terminate it for everyone Click the Hang Up button in your NetMeeting program Or Select Call Stop Call from the menu This interrupts the connection with all the people you called or who called you This will also disconnect people invited to the conference or accepted by other participants It may however not disconnect audio links Click the Finish Conference button in your NetMeeting program Or Close NetMeeting Visage 7 Web Client Functions and Information for Advanced Users This section explains functions that are not required for daily routine tasks with Vis age 7 Web Client e Changing the password e Updating the client software e Performing data maintenance e Performing gamma correction e Archiving with the archive option e Performing display quality checks Changing the password You should change your password from time to time for data security reasons You can also change the password the system administrator gave you along with your user name from the outset and use a password of your choice in its place 1 Open the Visage 7 Web Client login screen 2 Open the popup menu of the login screen with the right mouse button Reinst
195. lease contact your system administrator You should not try to install NetMeeting yourself Further information For more detailed information on net meetings please refer to the Microsoft Net Meeting online help In addition further information about NetMeeting is available at the following ad dress http www microsoft com windows netmeeting This section explains NetMeeting basics and procedures e NetMeeting elements e Connecting to an interlocutor e Working with the whiteboard e Ending an online conference Visage 7 Web Client 235 NetMeeting elements Setting up an Online Conference NetMeeting elements The whiteboard Sound and video These are typical elements that you will use when you have a net meeting e The whiteboard e Sound and video e Application sharing The whiteboard is a kind of electronic drawing board to which all participants in a net conference have access You can copy images from one of the Visage 7 Web Client viewer windows to the Windows clipboard and from there paste them to the whiteboard All parties to the conference can attach graphical or text comments to the image currently being displayed All other participants in the net meeting can then read these comments Whoever entered a comment can delete or change it again at any time Each participant in a conference can also activate a presentation pointer which is then visible in the whiteboard window for all the other parties
196. lect all Deselect all Invert Selection Image Info Selects the thumbnail the cursor is currrently pointing to Deselects the thumbnail the cursor is currrently pointing to Selects all images of a study or series if the cursor points to the study or series title bar or if the cursor points to anywhere between thumbnails Deselects all images of a study or series depending where the cursor is currently pointing Inverts the selection i e selects the currently unselected images of a study or series de pending where the cursor is currently pointing Shows information about the image type and compression level settings for an image Visage 7 Web Client 65 Report window The Visage 7 Web Client Window Report window 66 Visage 7 Web Client can display both images and reports Visage 7 Web Client provides a text only view and a view in which images and re port text are displayed side by side and in which you can also edit a report Tip Your system administrator can define that the report with image view is the pre ferred viewer This means that it will automatically pop up when you double click a study or series in the study series or preview window for which a report exists on the Visage 7 system If no report is available locally and a report interface has been configured with au tomatic report query Visage 7 Web Client will automatically search the HIS RIS for the report every time you load images
197. liSt re a a aa ee aa ea aa ai e a 95 Study list worki St snsnereiuen aa a a i AAA aAa EAN 95 Display Protocol Viewer Expert Reading cccceceeeeeceeeeeeeeeeeeeeeeeeeeeeeeeeeaeeees 97 Thumbnail browser misaia made eis sel cee ec ape tea edad ee atid 97 Toolbar display protocol ViCWEr ccceecceeeeseeeceeeeeeeeeeeeeeeseeeeeeeeseneaaeeeeeeeaaees 98 Image area With VICWPOTFS cee eceeeeee eee eenteeeeeeeeaeeeeeeeaaeeeeeeeaaeeeeeeeaaeeeeseeaaas 104 3 Table of Contents Loading Image Data 107 Finding patients and transferring them to the study series window 00 107 Selecting filter Criteria sni adde ed e i aiak 108 Entering Search Orter rea E E E EE RARS 111 Using predefined TIES oanien A a 112 Starting a query in the local database seeeseeeeeeereeseerrreseeerrsssrrrrsssrrrrsneet 113 Searching and retrieving patients from other network nodes n 113 Querying a network NOE c cece cence eee eeee ee eee tenes e ee eeeeeeeetieeeeeeetieeeeeenaa 114 Shortcut to querying network NOES eee sent ee teeter eee eeeaeeeeeeetaeeeene 114 Importing datas anie ra ii Ei aii e ai ESEE 115 Updating the patient list ccc ccccccccecce cece eeeeececenecaeeeeeeeeeeeeeseceenneecaeeaeeeeeees 115 Transferring patient data to the study series WINGOW eseeeeeeeeteeeeeeenees 116 Selecting series AN IMAGES cccecccceeeeeeecceeeteneececeeteneececeesnseceeenenneeadecenennnnees 11
198. lice thickness for the current segment Visage 7 Web Client This is how you change the slice thickness for the segment in which you are work ing 1 Select SliceThickness operating mode from the popup menu in the slice seg ment whose slice thickness you want to change The operating mode is now shown bottom left in the segment and the mouse pointer changes shape 2 Click on the image and drag the mouse up to increase the slice thickness down to reduce the slice thickness Do not accidentally click on the slice cursor line As soon as you release the mouse the new slice image is shown distinctly In the other two slice segments the new slice thickness can be seen by its thick er or thinner slice cursor line 217 Changing the slice thickness for slice images Working in the Basic MIP MPR Viewer a Vida i Slice A Ny MPR Sho mi C 1043 W 748 Changing the slice thickness with the slice cursor This is how you change the slice thickness in another slice segment 1 Click on the slice cursor line of the segment whose slice thickness you want to Ctrl j change and keep the Ctrl key pressed amp The mouse pointer has the same appearance as the moving cursor 2 Hold the mouse button down and move the mouse pointer up to increase the slice thickness in the other segment down to reduce the slice thickness in the other segment As long as you keep the mouse button pressed the new slice ima
199. lient installations in your network DISCONTINUED lists all patients whose studies contain procedure steps with interpreta tion status discontinued COMPLETED lists all patients whose studies contain procedure steps with interpretation status completed Search criteria Here you can enter search criteria for a database query If you do not remember a name or number you can use wildcards in your search E g Mil to find Miller Milford Miltner or mil to find all the above and also Hamilton or AB 34 to find AB1234 AB0034 and AB11345678 Patient Name Patient ID Patient Comment Searches for a patient by name Enter the patient name in the format last name first name middle name prefix suffix For ex ample Doe John Jack Dr for Dr John J Doe Searches for a patient ID Searches for a patient whose studies contain a specific comment Visage 7 Web Client 45 Patient window The Visage 7 Web Client Window Date of Birth Study ID Study Description Accession Num ber Searches for a patient by date of birth Use the date format indicated next to the search box Your system administrator can con figure this format for you Also remember to enter the complete date of birth here day month year You cannot for example search by year of birth only Searches for a patient with this study ID Searches for a patient with this study description Searches for a patient with th
200. line Scrolls forward one line Scrolls back one page Scrolls forward one page Visage 7 Web Client Reviewing Images Switching between patients Switching between studies Switching between series T Next Previous a Annotated Image Ta Visage 7 Web Client Scrolling through the loaded images Wheel mouse Turn the wheel toward you to scroll forward Or Turn the wheel away from you to scroll backward The faster you turn the wheel the faster you scroll Icons on the toolbar You can also load the previous or next patient study or series right from a viewer window Click the Previous Patient or Next Patient icon on the toolbar of the viewer The images of the previous or next patient are displayed If more than one study is stored on the web server for this patient Click the Previous Study or Next Study icon on the toolbar of the viewer The previous or next study of the same patient is loaded and displayed If the current study contains more than one series Click the Previous Series or Next Series icon on the toolbar of the viewer The previous or next series of the same study is displayed If you have loaded all series of your study as one viewing series i e with the icon Select all series as one in the study series window clicked series by series scroll ing is not possible in the viewer If measurement graphics or annotations had been saved in some of the loa
201. ll images of this series have been trans ferred to the web server Number of images in the local cache Examined organ or body part Description of the series Visage 7 Web Client 55 The Visage 7 Web Client Window Study series window Performing Phy sician Series Date Time Series number Marked images Exam status Report Status Name of the performing physician Date and time of creation of the series in the format YYYY MM DD and hh mm ss 24 hour clock Number of this series within the study In these columns you will find information about whether images in this series have been marked with a star or a flag only relevant if the imaging systems in your hospital support marking images Contains an icon that indicates the current examination status These flags are only available in a Siemens diagnostic environment Prepared 2P v Reported Signed off Unknown If a new exam status has not yet been issued status New this column remains empty Contains an icon that indicates the current report status in the HIS RIS These flags are only available in a Siemens diagnostic environment 2P Dictated Written Validated Presentation state list This tab card lists all presentation states that are stored on the web server for the current study and with the currently selected compression level A or B Label Description Content creator Creation Date Time
202. ls e Compression level A This level as a rule transfers images in their original data format or compressed with a lossless method e Compression level B This level as a rule transfers images in a data format compressed with a lossless or lossy method Note Some image types cannot be compressed in lossless mode Lossy compressed images do not contain the full amount of data of the original The quality of the images might be affected as a result Images compressed with a lossy compression method are highlighted by a yellow warning triangle top right in the Visage 7 Web Client viewers Loading images with compression level A usually takes longer than loading images with compression level B Encryption Visage 7 Web Client always uses secure data transfer protocols for transfer of pa tient data over the intranet or Internet As an additional level of data security you can choose to transfer data in encrypted encoded form Under certain circumstances this option may not be available as your administrator may have specified that data must always be transmitted in encrypted form If available you should always select encrypted data transfer if you are working out side a firewall Encrypted data transmission as a rule takes longer than unencrypted transfer Visage 7 Web Client 125 Loading images into a viewer Loading Image Data Checking compression level settings Selecting a compression level a Fo
203. ly compressed and without loss of quality Your system administrator defines the compression rules Visage 7 Web Client 59 Preview window 60 The Visage 7 Web Client Window Compression Level B Transfers images with compression level B which compresses the images even more Note that compressed images do not contain the full volume of data of the original The di agnostic quality of the images is affected as a result Encrypted Data Transfer The images are transmitted encrypted Non encrypted Data Transfer The images are transmitted without encryption Query Report Requests a report on the currently selected study from the configured report network node If a report on the selected study already exists on the Visage 7 server the report is down loaded again and the existing report is overwritten Use Local Cache If this icon is activated the images you download from the web server are stored in your lo cal cache memory When you load images into a viewer Visage 7 Web Client searches the local cache first and only retrieves data from the web server if no images are found in the local cache This option speeds up your workflow if you need to load and review one study several times during one Visage 7 Web Client session It is recommended for networks with low data transfer rates Preload Study Loads all images of a selected study into the local cache for the duration of your session When you subseq
204. m almost all Visage 7 Web Client windows except for the basic MIP MPR viewer This means that you can send data at all data levels Use the patient window or worklist if you are working in Expert Reading mode to send all studies of one or several patients Or Use the study series window to send a study presentation state or one or several series Or Use one of the viewer windows to send a single image or all loaded images ie O fal El E z To be able to send images you must be connected to a DICOM network and your system administrator must have defined destination addresses for you After sending data you can check whether data transfer has been successful in the status information window Sending data to selected address es DICOM send 1 Select the data that you want to send via the network al 2 Click DICOM Send on the toolbar A dialog box with preconfigured addresses is shown 198 Visage 7 Web Client Printing Exporting and Sending Images Sending data in the network m DICOM Send m Destination Receiving System Send Selected Image Allimages Name r CompressionLevel CA 8B 3 Select one or more network nodes as the send destinations here Depending on which data you want to send you can also specify the following 4 Select the compression method for sending the data 5 Select whether the entire study a selected presentation
205. mage Sesi aan A ad sak earn eases Sante 177 FIIPPINGPIMAGES wes tvcccettuadececes vei ecees A E cia hee sausages S 178 INIVEFLING IMAGES oo 5 i003 a E A E detail AEA 178 Evaluating imagesss sss seccgesecedctnsaset T A dette 179 Visage 7 Web Client Table of Contents Measuring distances and angles ccccecceeeeeeeseeeeeeeeeeeceeeeeeeetieeeeeeetieeeeerenea 179 Measuring distanCes S aaie eiia EEEE EA ENEE EA ERRET 180 Calibrating GiStanCes Ss na a E A TA 181 Measuring angles errorea E R E 183 Changing moving or deleting measurement graphics ccceeeeeeeeeeeeee 184 RO Mevalliationiwi 2 ceil cdeth eet hs ceed teatl ll deeded edith iaia 184 Dawid a Reira isa deeccssdeceads vuage dea AEE R egeehiacdedae tigers OR EARE 185 Showing the histogram eessseeesesrsssessnneeesinsessisinnesnnnnadstnennneatinaanainannnnennnnnne 186 Moving or resizing ROI graphics esseeeeeeeeeerrreserrressttrrsssttrrsstttnrnsstrnnsnnt 187 Density measurements ee ccc eeeeeee eee eeeeee eee eeeeeeeeeteeeeeeeeeeeeeeaeeeeteeeaeeeeeeeeaaeees 187 Densit prolila cennera r A emits thinaee inti 187 Pixel lens ne in E r A N A dace 188 Printing Exporting and Sending Images 191 Printio images oanu R eT A RAE T A RTRS 191 Printing images on a DICOM printer eee ceeeeeeeeeeeeeeeeeeeteeeeeeeeteeeeeeeeeeeenaees 191 Selecting images for DICOM print cceceeeeecteeeeee tennessee titeeeeeetiaeeeeeeeaa 192 Print preview and start
206. mages and call up image display You do not have to enter your login data every time you call up image display in this case The selected images are immediately displayed in the Visage 7 Web Client viewer window If your Visage 7 installation includes the Visage 7 Client license both clients will be called up automatically when you select a patient and study on the HIS RIS for which 3D volume data are available on the Visage 7 system Joint OEM call of Visage 7 Web Client Starting and Ending the Program Logging off from the web server course requires that the HIS RIS has been configured to call Visage 7 with the cor rect parameters and that your Visage 7 user account holds appropriate user rights Logging off from the web server Logging off from the server 2 Automatic logoff Visage 7 Web Client You should always log off from the Visage 7 system If images are currently being loaded please cancel loading with the Esc key before you log out Click this icon in the lower part of the navigation bar This logs you off from the Visage 7 system The Visage 7 Web Client login screen is displayed again Or Click this icon in the top right corner of the program window This logs you off from the Visage 7 system and also closes the Internet Explorer Tip If you are working with a 1024x768 screen resolution the logoff icon in the lower left hand corner of the navigation bar may not be visible Press F11 for a full screen
207. ment in millimeters is possible The relative error of the elliptical or rectangular ROI measurements is 2 pixels shorter radius or shorter side For example Shorter radius or shorter side measurement error 10 pixels 20 20 pixels 10 50 pixels 4 100 pixels 2 Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum ac curacy we recommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still Density Profile Permits evaluation of a density profile along a straight line an arrow indicates the direction While this tool is active the mouse pointer looks like this A Create Annotation Opens a selection list with annotation functions A Arrow Annotation Allows you to annotate images with arrows A Text Annotation Allows you to annotate images with text AB Arrow and Text Annotation K Creates a combined arrow plus text annotation Circle Annotation Allows you to draw a circle around an area of interest Visage 7 Web Client The Visage 7 Web Client Window Display Protocol Viewer Expert Reading i AB Spine Labeling Allows you to label vertebrae or intervertebral spaces in images Clicking
208. mment a Accession No o U Location All Date ofBith J vyv mmoD v Insertion Date All i 37 Patients found B ol E What T a e S Visage PACS Web x ee fae MB z nE e a oT AJLI INT_TOP FLTOPO1 1922 07 24 F AbdomeniKidney DB 1947 12 01 M RF Amato Terence 000012 1965 03 17 F HC ANEVRYSME NEURO o XA Angiologie Angi 1999 07 01 o cT T anonym_pt anonym_pt 1900 01 01 o PT a AUTOMANTERACTIV 1924 01 26 M XA m AVE ABDOMEN 0000002019 1978 10 10 M cT Biren Paul 192837465 1967 05 25 M XA NOPLIS BEN 291391 1985 09 18 o cT Dillow Raleigh Ada 291101 1911 01 01 M cM HAND PATIENT 2 9946122 M CR HSA Circle of Wilis 421876 M cT INSTAN JERRY 8171 F cT Interesting Case Testpatient 1940 03 05 F CR Joe s Shoulder 646464 o MR Johnson Roberta 123 45 6789 1923 10 16 F XA Lancelot Kaycee Ma 234567 1880 05 07 F CR Larry s L Spine 656565 o MR MANUS DEXTER 1952 04 23 M XA MDP_CHILD_01 FLTOPOS 1997 03 11 F RF MOESTOP som FETOPOS 1920 03 05 A T zi i gt i E Query finished CE i B 0 trusted sites 43 Patient window The Visage 7 Web Client Window Information area patient window Filter parameters 44 This area of the patient window shows the user name you are logged in with l Patient List User name Hide show filter criteria Use this icon for collapsing or expanding the filter parameters and search criteria section of the screen Active window where you are now User
209. n Here you select the monitor configuration you are working with that is whether you are working with a single or dual monitors This selection also filters the display protocols list When you select 7 Monitor Landscape for example only those protocols are listed that have been optimized for single monitors with landscape display 1 Monitor Landscape Select your monitor configuration and filter for the display protocols list All protocols shows all display protocols irrespective of their orientation and suitability for a particular monitor configuration Patient list local The local patient list shows all patients found in the web server database who match the search criteria and to whom you have access The patient list contains only one entry for each patient even if several studies exist for this patient Tip You can sort the list by clicking on a column header Patient Name Patient ID Date of Birth Sex Insertion Date Name of the patient Patient s identification number Date of birth in YYYY MM DD format M male F female O other unknown Date and time when the patient data was sent to the Visage 7 server Response list network node 94 If you selected a network node as the data source instead of querying the local Vis age 7 server you will see the response list of the DICOM node instead of the local patient list Here a patient name may be listed more than once a
210. n forgot to mark a study as read in a viewer you can also do this from the study list or worklist The study list or worklist is also from where you would reschedule a procedure step or delete procedure steps for studies that no longer require interpretation 203 Creating a procedure step Managing the Diagnostic Reading Workflow Creating a procedure step 1 Select the study for which you want to create a procedure step in the study se 3 I ries window client type Expert or in the worklist client type Expert Reading 2 Click this icon to open the Change Procedure Step dialog box Rl tik oo Procedure Step G Create New Procedure Priority MEDIUM Step for Interpretation Cancel 3 Select a priority if you want and confirm creation of the new procedure step A new procedure step of type interpretation is created for this study Its status is scheduled Procedure Step Status Performer Priorty Interpretation SCHEDULED MEDIUM Note Visage 7 Web Client only supports procedure steps of type Interpretation in this software version Filtering the patient list 1 Open the patient window client type Expert or worklist client type Expert GF Reading x 2 Click the arrow next to the filter Interpretation Status r All OK 204 Visage 7 Web Client Managing the Diagnostic Reading Workflow Marking a study as read 3 Select SCHEDULED in the filter selection dialog bo
211. n in this software version Indicates the status of the procedure step scheduled in progress discontinued or com pleted Indicates the name of the Visage 7 Web Client user who is currently reviewing the images of this study or who completed this procedure step Low medium or high You can use this column to sort the study list for example Number of series that cannot be displayed Series list This tab card lists all series that are stored on the web server for the current study Type 3D Volume Modality Number of Imag es Highest Image Number Preloaded images Organ Description With Show Thin Slice Series selected both the original scan series thin slice series and thick slice series are listed in the series list When this icon is not selected only thick slice series are displayed Thin slice series original scan series series with a large number of images j Thick slice series generated image series series with a smaller number of images Visage 7 Client option only Indicates if a 3D volume data set is available for this series on the system Only series with a 3D volume data set can be loaded into the Visage 7 Client Modality used to create the series Total number of images of this series on the web server Highest available image number For modalities that work with single frame images comparing the Number of images and the Highest Image Number helps you determine if a
212. n loading images with compression level B 1 Click one of these icons on the worklist toolbar to select the appropriate com J Ba pression level 136 Visage 7 Web Client Displaying and Editing Reports If your Visage 7 Web Client is connected to a HIS RIS that manages study reports these reports can be transferred to the web server In Visage 7 Web Client you can then view the report text only or show the report text together with images of this study With the Visage 7 Web Client report editor you can also edit reports stored on the web server or create new reports Visage 7 can receive and display DICOM Structured Reports The layout in which these structured reports are shown in Visage 7 Web Client can be configured by Customer Service However if Customer Service makes any layout changes at your request you must validate these changes to ensure that all relevant report information is actu ally shown in the HTML report translation of these reports This section explains the procedures for e Displaying a report e Retrieving a report from the RIS e Printing a report text e Editing a report e Creating a new report Displaying a report Visage 7 Web Client When you display reports in Visage 7 Web Client be sure to e Double check that the report and the images it is assigned to refer to the same study Errors in report assignment may occur if the HIS RIS that sends the report man ages several reports under on
213. n that no report exists for this study in the HIS RIS The report might have been written after the study had been transferred from the modality to the Visage 7 system In such cases you can retrieve the report in the HIS RIS hospital or radiology infor mation system You may also wish to retrieve a report from the HIS RIS if you have found a report on the Visage 7 system that you suspect is not up to date 1 Switch to the study series window 2 Select the study for which you want to request a report from the HIS RIS Visage 7 Web Client Displaying and Editing Reports Printing a report text ae m 3 Click the Query Report icon The HIS RIS is now searched for a report for this study If reports are found they will be transferred to the Visage 7 server Older report versions will be overwrit ten It may take some time to find and transfer a report Then load the study into the viewer 5 Open the report with image view Or Open the report window view Printing a report text You can print out the report text 1 2 3 Place the mouse pointer on the report text Open the popup menu with the right mouse button Select the Print menu item The report text will be output on the connected default Windows printer Editing a report Visage 7 Web Client Visage 7 Web Client offers basic functionality for editing reports on the web server Note Be aware that when you edit a report you will
214. naeees 158 Stopping and restarting a SCONE eee ee eeeeee ee eette eee eetaeeeeeeteeeeeetnaeeeeeees 158 Playing back an entire examination 0 cecceceeeeeseeeeeeeeneeeeeeeeeneeeeeeenaeeeeeeeaas 159 Scrolling Scene by scene cccceeccecccneeeeeeeeeeeeeeeeccaeeeeesecaaneneeeeaaeeeeenseeaaneneeeeas 159 Scrolling frame by frae saeir anana ra sere eee eee tee nese eaaeeeeeeenaeeeene 160 Displaying biplane SCONES oarra teirr neea AARE EEEREN ARAARA E ETKEN KAREPI 160 Viewing report photofile imagesS eessseeessrineeeeernessssrrnesrennnessrnnneesnennneeseenneeene 161 Displaying the ECG sisi iste eal aaah eal aes 162 Displaying SCOULINGS istarsa aE eeeeaeeeeeeeaeeeeeeeeaeeeeeeeeaeeeeeeeeiaeeeeeeenaaes 163 Showing scoutlines in a reference IMAGE ce eeeeeeceeeeeeeeeeeseeetaeeeeeeeneeeeeeeeaaes 163 Printing reference image and scan series with SCOULIINES eeeeeeeeeeeeeeees 165 Showing scoutlines in slice IMAGES 00 0 cece eee eeeeeeeeeeeeeaaeeeeeeetaeeeeeeeaaes 165 EditinGsiMaGes nto atiae A lect estate tities nance tee naar te 166 Selecting and editing images general procedure ccceeeeeteeeeeeeettteeeeeenaes 167 Selecting AN WMAGEK cceceeesssececeeeeeecceeeeseenceceeeeeenececeeeeeaceeeeeeeneateeeneeseeceeeees 167 Applying changes to all iMa QeS ccceeeeeeeeenneeeeeeeeeeeeeeeeeneeeeeeetaeeeeeeeaas 167 Undoing changes anesan ile eR a eae 168 ZOOMING and PANNING IMAGES eee eee
215. nd annotations back to the web server is possible in client type Expert Reading only Tip The SMPTE images you can display here are not suitable for calibration of DICOM printouts Use Testlmage_SMPTE_1k instead You find this test case in the patient list If no patient of this name exists in your patient list ask your system adminis trator to insert this test case into the Visage 7 system from your installation medi um We recommend that you protect the Testlmage_SMPTE_1k test case against deletion so that it will not be deleted automatically when disc space is running low Position indicator bar viewer Light green bar White bar Dark green bar Dark gray bar Visage 7 Web Client You will usually have more images loaded than can be displayed simultaneously in the selected layout The position indicator bar at the bottom edge of the screen tells you which images are visible and which are still in the background These images are visible on the screen This image is selected Loaded images are not visible Image not yet loaded only appears during loading 81 Compare mode The Visage 7 Web Client Window Compare mode Image display and editing Dual monitor Information area viewer Toolbar viewer Viewer 1 Viewer 2 Navigation bar 82 Compare mode shows the two viewers side by side or one above the other You can easily compare two series in this way Use these icons on the navigation
216. nd icons e Single frame and multiframe images e Image text and image icons You will also learn how to proceed when e Selecting screen layout and image display e Scrolling through the loaded images e Viewing angio scenes e Displaying scoutlines e Editing images e Evaluating images 143 Single frame and multiframe images Reviewing Images Single frame and multiframe images Single frame images Multiframe images 144 Different modalities use different data acquisition techniques that basically result in two different image types single frame images and multiframe images e Single frame images CT MR CR SC RTImage MG DX HC IO OT PX RG ES GM XC e Multiframe images XA US NM e RF Radio fluoroscopy or PT Positron emission therapy images may either be single or multiframe images depending on the data acquisition technique used in an examination Single frame and multiframe images are handled differently by the Visage 7 Web Client application program with respect to data management and scrolling This classification scheme is valid for modalities using single frame images e Study An examination performed in order to clarify a diagnostic problem e Series A set of images acquired as part of an examination with a certain modal ity on a certain day and at a certain time During an examination more than one series can be acquired if one series would not be sufficient to answer the diag nostic
217. ndows 7 or Microsoft Windows XP or Microsoft Windows Vista Microsoft Internet Explorer 6 7 or 8 Microsoft NetMeeting optional equipment for teleconferencing 15 Product overview System Overview e Computer processor Intel Pentium III with at least 500 MHz Intel Pentium IV 2 GHz recommended RAM 256 MB more memory may be required depending on the size of your images e Hard disk At least 2 GB free hard disk space e Graphics card Resolution of at least 1024x768 pixels true color e Monitor 17 color monitor 21 recommended or grayscale monitor Note Mammographic images may only be interpreted using an FDA approved monitor that provides at least 5 Mpixel resolution and meets other technical specifications reviewed and accepted by the FDA U S only Tip If you are working with high resolution monitors your system administrator can configure the display of Visage 7 Web Client so that larger font sizes and icons are shown e Other Network link or ISDN analog modem Loudspeakers microphone and web cam optional for use with Microsoft Net Meeting Software Hints for Visage 7 Web Client installation 16 During installation the Visage 7 server is listed as a Trusted Site To ensure that the Visage 7 Web Client ActiveX components can be installed on the client computer you must set the security level for Trusted Sites in the relevant network zone intra net or Internet to Medium or Low The sec
218. ne and switch over to the re spective viewer In cine mode scenes are played back in a loop When they reach the last frame they start again from the beginning until you stop the playback manually Stopping and restarting a scene 1 Click Cine Mode Stop to stop playback The scene stops at the image last displayed which you can then edit 2 Click Cine Mode Forward to restart the scene Visage 7 Web Client Reviewing Images Viewing angio scenes 12 3 Use the slider to adjust the playback speed and direction The number next to the slider indicates the playback speed in frames per sec ond Playing back an entire examination You can play back all the scenes multiframes of an examination one after the oth er beginning with the scene currently displayed and running through to the end of the examination To be able to do so you must have loaded the entire study into the viewer Click Loop All All scenes are played back like a movie Scene 1 Scene 2 Scene n yi yi yi Scrolling scene by scene iii TH Click Next Series or Previous Series to scroll to the next or previous scene agi Previous scene next scene Visage 7 Web Client 159 Viewing angio scenes Reviewing Images Scrolling frame by frame a a Click Next Image or Previous Image to display the next previous image of the Ea Eel scene If dynamic image display wa
219. neeeeseeeeneeeeeteenaeenes 245 Performing gamma correction cceeeeeeeeeeeeeeeeeeeeeecaeeeeeeeaaeeeeeeenaeeeeseeiaeeeeeseaas 246 Archiving with the archive Option ececceceeeeeeeeeeeeeeeeeeeeeseeeeeeeeeseeenaeeeeeeeenanes 248 Setting archive protection eeraa aeee EERE EE EAE AREE 248 iracmg APCMIVING e a E AT E OAT 249 Performing display quality checks ccccccceeeeeeeeeeneeeeeeeeeaeeeeeeeenaeeeeeeeenaeeeeeeeaas 249 9 Table of Contents Appendix 251 List of supported modality types and abbreviations cecceeeeeeeeeeeeteeeees 251 Overview of functionality supported by client tyPeS ei eeeeeeeeeeeeeentteeeeeeenaaes 252 Navigation Darena ede eee ena elated EAE A AA A 252 Patient window or WorkliSt issie i aaa eea aaa aaa a aee aaa aana 253 Study series window or WOFKIISt ccceeeeeeeeeeeeeeeeeeeteeeeeeeeeseeeaeeeeeteeeaeeeeeeeeaeees 256 VIEWSTS eiir age eie e a dea eap a a ideata a oaeee aia adet 259 Index 267 Visage 7 Web Client system Overview Visage 7 is a software product for the distribution of image and report data via intra net or Internet Visage 7 is ideal both for complex requirements of large hospitals and for special ists practices The system can be customized to provide the optimum solution for each customer In this section you will find an overview of the Visage 7 system and the Visage 7 Web Client and its data security concept and an introduction to the Vis
220. nes from the XA modality may contain ECG information If this is the case the ECG can be shown in the lower left hand corner of the screen A pink line in the ECG shows you in which cardiac phase the current frame was acquired Showing the ECG 1 Select Hide Show ECG from the popup menu The menu item is only shown in the popup menu if ECG data are available for this scene b 2 Start cine mode The scene is being played back while the pink line moves along the ECG in the lower left hand corner of the screen E 3 Halt cine mode to focus on a frame 162 Visage 7 Web Client Reviewing Images Displaying scoutlines Scrolling images 1 Click on the pink line in the ECG which indicates the current image 2 Hold the mouse button down and drag the pink line to the right or left to scroll through the frames of the scene Hiding the ECG Select Hide Show ECG from the popup menu a second time to hide the ECG again Displaying scoutlines Visage 7 Web Client supports the display of scoutlines in CT or MR series e that were acquired with a reference image or e in two series of the same region that were scanned with a different orientation A reference image also called topogram scout or localizer depending on the mo dality and acquisition system is a low resolution image that is used for planning the the scan range Showing scoutlines in a reference image helps you identify the ex act location of slice images If two series of t
221. ng When this option is deselected only thick slice series are shown in the series list Select all previews Selects all images in the preview area Deselect all previews Deselects all images currently selected in the preview area DICOM Information Shows the DICOM information of the image selected in the preview area Launching Application Starts another web application if your system administrator has configured this for you The icon is only active if you have selected a study DICOM Send Opens a dialog box Select the address es in your DICOM network to which you want to send the selected study or studies or series DICOM Quick Send Sends the selected study or studies or series to one or several DICOM nodes immediate ly Your system administrator has defined these addresses for you Display as 3D volume Shows the selected data in the Visage 7 Client for advanced 3D evaluation Visage 7 Web Client 53 Study series window The Visage 7 Web Client Window Automatic Synchronization with 3D volume 3D Select this option to ensure that both the Visage 7 Web Client and the Visage 7 Client will always show images of the same patient 7 Marked images filter You can filter the study series lists so that only images marked with a star or flag or both are displayed These flags are however only available in a Siemens diagnostic environment Study list This list shows all studies o
222. ngly be expressed in millimeters Angle measurements based on geometrical views where the legs of the angle are 100 or more pixels long produce a relative error of 1 5 max The measured values are displayed in the viewer windows they cannot be mea sured manually on the monitor The above mentioned relative errors take into consideration measurement and cali bration errors by the user of the software for errors stemming from the imaging mo dalities refer to the respective user information Visage 7 Web Client Reviewing Images os amp Visage 7 Web Client Evaluating images Measuring angles You can define an angle by drawing two lines the legs of an angle in your image The system then calculates the angle between the two lines in the clockwise direc tion and displays the result in the image next to the angle The accuracy of angle measurements depends on the length of the shorter of the two angle legs The longer the angle legs are the better the accuracy For example Length of shorter angle leg measurement error 10 pixels 12 20 pixels 6 50 pixels 2 5 100 pixels 1 1 Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum ac curacy we recommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquis
223. nt Working in the Basic MIP MPR Viewer Moving and rotating slices and generating slice images Display of the individual slices in the orientation cube You can show or hide individual slices in the orientation cube by selecting the View item from the popup menu in the overview segment Hide all slices Show All slices Slice1 2 3 Volume box Hides display of all slices Re displays all slices Shows or hides the slices of segment 1 2 or 3 Shows or hides the volume box Moving and rotating slices and generating slice images In the calculated volume data set you can move the displayed slice images to gen erate new slices This can be done in different ways You can move through the volume data set along the other two main axes in a slice segment You can use the slice cursor in a slice segment to move one or both slices in the other segment or segments You can generate slice images with any orientation or position by rotating and then moving the slice cursor Moving a slice in a slice segment Ny Visage 7 Web Client 1 Select SliceShift operating mode from the popup menu in the slice segment whose slice image you want to move The operating mode is now shown bottom left in the segment and the mouse pointer changes shape Click on the image and drag the mouse up or down to move through the volume data set with this slice Do not accidentally click on the slice cursor line As long as you
224. nt and adapting the system to changes in the overall network environment if this becomes necessary The Visage 7 administrator documentation also helps service personnel with initial system configuration tasks right after system installation or update e The Administration Manual This document is available as a pdf file on your installation medium You can print out this document if you prefer reading on paper e The administration platform Online Help System The Visage 7 administration platform features a context sensitive online help system The context sensitive help topics explain the parameters you will find and the settings you can make on the various configuration screens Whenever relevant background information on selected topics is also given in the online help sys tem Installation instructions for single server systems are available on your installation medium Installation instructions for cluster systems and CS systems are available for Visage Imaging service personnel only Release notes contain additional useful information about the software They focus on technical details You can find the release notes document on your installation medium Visage 7 Web Client System Overview Overview of the Visage 7 product documentation Information on using the Visage 7 manuals Document structure Layout conventions Tips notes warnings In order to help you locate relevant information in the Visage 7 manuals
225. nted explicitly It is therefore up to you if and to what extent you wish to grant access rights to service e Full Access Service has read and write permissions This means that service personnel can analyze problems and can solve these problems or change settings Service ac cess is logged e Limited Access Service has read permission only e No Access Service has no access 19 Data protection and data security System Overview Audit trails Encryption 20 Note Please note that with full access service is granted unlimited access Under cer tain circumstances this may include patient data which has not been anonymized Logging of user actions in Visage 7 occurs in so called audit trails Audit trails are recordings of access controlled actions They are the proof that access to patient data is monitored A message informs users that their actions may be monitored The following activities are recorded if the audit trail option has been activated by the system administrator e Changes to access rights with accessing user date and time e Viewing printing or deleting patient data e Changes to archived images with time date and user e Login and logout and failed attempts to log in e Service sessions local or remote e Software updates as well as backup and restore In addition the highest original number of images is recorded to compare the cur rent number of images Audit trails must be kept for a
226. number of years It is the responsibility of the system administrator to ensure that the relevant log files are archived according to the re quirements that apply to your institution and country The system administrator is the only user who has access to the audit trails via a dedicated viewer For larger systems a separate database server can be made available for audit trails With Visage 7 data is transmitted in accordance with the SSL Secure Socket Lay er standard For this purpose a security certificate which is essential to guarantee the security of data transfer is installed automatically on your computer the first time you start the program Data is then automatically transmitted over a secure connec tion Furthermore it is advisable to additionally encrypt the images using the en cryption function of Visage 7 Web Client for transmission For Visage 7 Web Client users who access the web server over the Internet the system administrator can set data encryption as a default for each data transfer Visage 7 Web Client System Overview Overview of the Visage 7 product documentation The system administrator can also make sure that these Internet users cannot de activate data encryption themselves Overview of the Visage 7 product documentation The Visage 7 product documentation distinguishes between three user groups and the tasks that these groups typically perform Clinical users These users access the Visage
227. of the slice in the orientation cube vA ul h EA ALERA Tip If the slice cursor is currently hidden in a segment make it reappear with View gt SliceCursor from the popup menu Visage 7 Web Client 215 Moving and rotating slices and generating slice images Working in the Basic MIP MPR Viewer Generating slice images in views other than the standard views 1 Click on a slice cursor line a good distance from the point of intersection in a slice segment A The mouse pointer now looks like this 2 Keep the mouse button pressed and move the mouse up down left or right This rotates the cross hair of the slice cursor and rotates the two selected planes You can monitor movement of the slices in the orientation cube Tip By then moving one or both of the new slices you can generate any slice through the volume 216 Visage 7 Web Client Working in the Basic MIP MPR Viewer Changing the slice thickness for slice images Changing the slice thickness for slice images Increasing the slice thickness has the effect of softening the slice image In a thicker slice more volume pixels are used to calculate a pixel in the two dimensional im age The values of the volume pixels are averaged Conversely reducing the slice thickness makes the image grainier The default value for the slice thickness of slice images is 1 mm The value is dis played bottom right in each slice segment Changing the s
228. omat ic cine mode is being played back 155 Viewing presentation state images Reviewing Images Interactive cine mode This mode lets you control the playback rate and direction interactively with the mouse 1 Click the Interactive Cine Mode icon 2 Click the image and hold the mouse button down 3 Drag the mouse fast slowly up the film runs fast slowly forward fast slowly down the film runs fast slowly backward Or depending on the configuration fast slowly right the film runs fast slowly forward fast slowly left the film runs fast slowly backward Or Turn the mouse wheel fast slowly up the film runs fast slowly forward fast slowly down the film runs fast slowly backward Tip Talk to your system administrator if you prefer up down rather than left right mouse movement or vice versa in interactive cine mode Viewing presentation state images 156 If your hospital works with presentation states Visage 7 Web Client can show these images in addition to the original series Presentation state images are shown with all display settings and evaluation results that were active and visible when the presenation state object was created at a di agnostic workstation A few restrictions do however exist for presentation state im ages in the Visage 7 Web Client viewers e Presentation states are only supported for single frame images or multiframes with only one frame
229. on The mouse pointer changes shape in the image area 3 Click the starting point of your line and keep the mouse button pressed Move the mouse to the end point of your line 187 Evaluating images 188 Reviewing Images 5 Release the mouse button An information box pops up at the end point of the density profile line The info box shows the minimum and maximum pixel intensity along the line and a histo gram Max 80 HU Tip In order to move or resize a density profile line proceed in the same way as you would for a distance measurement Pixel lens You can use the pixel lens to measure the brightness of individual pixels of gray scale images which is then displayed as a measure of density To be able to position the pixel lens precisely the image must be displayed in 1x1 layout In CT images the density is stated directly in Hounsfield units HU For images transferred with lossy image compression and color images density cannot be measured 1 Drop down the Measurement Functions icon bar and keep the mouse button pressed 2 Select the Density Measurement icon The mouse pointer changes shape in the image area Visage 7 Web Client Reviewing Images Evaluating images 3 Click on the position in the image whose grayscale value you want to ascertain A small cross and a grayscale value or HU value will be displayed wy Tip In order to move or delete a density measurem
230. only change the latest report version on the Visage 7 server Your changes are not communicated to the HIS RIS where a report was originally created Therefore if your hospital works with a HIS RIS and normally uses this system to create and manage reports always change report text there rather than in Visage 7 Web Client Most likely your system administrator will have configured the system in such a way that the Edit Report icon is not shown at all in this case 139 Editing a report 140 nul Displaying and Editing Reports Switch to the study series window Double click a study for which a report exists The study is loaded into viewer 1 Viewer 1 is displayed Open the report with image view Click the Edit Report icon on the toolbar of the image display section The report section of the screen is now shown in editing mode Click anywhere in the report text white background and add text delete text or change text You cannot change the report header gray background Select text in order to format it Use this icon for example to highlight text The Visage 7 Web Client report editor offers a number of basic text formatting options which allow you to change character and paragraph formats With the Cut Copy Paste icons you can move text around in your report or in sert text from or in other Windows text processing programs Use this icon to save your new report i e upload it
231. onstruction MPR method You can switch over to the maximum intensity projection MIP calculation method if that gives you a clearer view of the phenomena you are interested in Switching to the calculation method applies to the currently selected segment only Select MIP from the popup menu Or ED Click on the calculation method display in the lower right corner of the segment to i switch between MPR and MIP Visage 7 Web Client 211 Working with the orientation cube Working in the Basic MIP MPR Viewer Working with the orientation cube The calculated volume data is shown as an orientation cube in the overview seg ment bottom right of the basic MIP MPR viewer This shows you the orientation and position of the slice images displayed in the three slice segments To obtain a clearer view you can rotate this cube and show or hide single slices and the volume limits e Rotating the orientation cube e Display of the individual slices in the orientation cube Rotating the orientation cube 1 Select operating mode Rotate from the popup menu of the overview segment The operating mode is now shown bottom left in the segment and the mouse 2 pointer changes shape 2 Now click on any point in the overview segment and keep the left mouse button pressed 3 Drag the mouse in the direction in which you want to rotate the cube 4 Release the mouse button again to stop rotating C 1069 W 706 212 Visage 7 Web Clie
232. ool to each modality 166 Visage 7 Web Client Reviewing Images Editing images Selecting and editing images general procedure Visage 7 Web Client As a rule all image processing functions only affect the currently selected image recognizable by the light colored frame However you can easily apply all changes you have made in one image to all other images of the current series as well Tip If you edit a multiframe all changes immediately affect all frames even if cine mode has been stopped Selecting an image One image is always selected This is usually the first image of a loaded series or study unless you have already scrolled through the images or explicitly clicked on another image Click on an image with the left mouse button to select it The selected image is highlighted with a light colored frame You can now window filter Zoom pan magnify rotate flip or invert the gray scales of this image Applying changes to all images As a rule all image editing steps such as windowing filtering zooming apply to the selected image alone However you can easily apply your changes to all other im ages of a loaded series as well Use Apply to All from the popup menu in the image to apply the last editing step to all other images of a loaded series Or Select Auto Apply to All in the popup menu before you start editing an image this menu item is usually selected by default All changes you m
233. or 10 pixels 12 20 pixels 6 50 pixels 2 5 100 pixels 1 1 Larger errors can occur if the image is displayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum ac curacy we recommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still ue Calibrate Distance Permits calibration of distances in images While this tool is active the mouse pointer looks like this 9 Density Measurement Permits measurement of grayscale values pixel values in images While this tool is active the mouse pointer looks like this b ROI Ellipse Permits evaluation of circular or elliptical regions of interest ROIs in grayscale images While this tool is active the mouse pointer looks like this te Z Visage 7 Web Client 101 Display Protocol Viewer Expert Reading 102 The Visage 7 Web Client Window Cl ROI Rectangle E Permits evaluation of rectangular regions of interest ROIs in grayscale images While this tool is active the mouse pointer looks like this To Measured values are indicated in exact square millimeters mm in CT and MR images estimated square millimeters mm or in pixels pix if ROI measure
234. or each patient even if several studies exist for this patient Tip You can sort the list by clicking on a column header Patient Name Patient ID Date of Birth Sex Modalities Patient Comment Report Delete Protect Study Date Insertion Date Name of the patient Patient s identification number Date of birth in YYYY MM DD format M male F female O other unknown Modalities used to examine the patient Comment text about the patient Yes a report exists on the Visage 7 server for one of this patient s studies No no report exists on the Visage 7 server In the study series window you can query for reports on configured report network nodes Yes this patient cannot be deleted No this patient can be deleted Date and time of the study in the format YYYY MM DD and hh mm ss 24 hour clock If more than one study exists the date of the most recent study is displayed Date and time when the patient data was sent to the Visage 7 server 48 Visage 7 Web Client The Visage 7 Web Client Window Patient window Response list network node If you selected a network node as the data source instead of querying the local Vis age 7 server you will see the response list of the DICOM node instead of the local patient list Here a patient name may be listed more than once as each entry repre sents exactly one study Tip You cannot load patient data directly from the response list of
235. original referenced image and vice versa The icon is only active if you have loaded a presentation state Display as 3D volume Shows a loaded series in the Visage 7 Client for advanced 3D evaluation The icon is only active when you are reviewing a series for which a 3D volume data set is available on the server Automatic Synchronization with 3D volume Select this option to ensure that both the Visage 7 Web Client and the Visage 7 Client will always show images of the same patient Mark study as read Sets the status of the procedure step for this study to completed This icon is only active if a procedure step of status scheduled exists for the study whose images are currently shown in the viewer E Color Map Allows you to display the loaded images with another color map that highlights your current diagnostic problem in a better way Angio mode 78 In angio mode with XA images loaded the toolbar contains a number of additional icons They provide special display functions for evaluating XA scenes Plane A Switches to plane A for biplane angio scenes Plane B Switches to plane B for biplane angio scenes Visage 7 Web Client The Visage 7 Web Client Window Viewers Loop All Successively plays back all loaded scenes of a study If you click the Previous Series or Next Series icon during playback the movie will jump back to the last scene or on to the next scene Previous Frame S
236. ormation area preview window This area of the preview window provides information about the loaded patient Patient Name Patient ID Date of Birth Name of the loaded patient ID of the loaded patient Date of birth of the loaded patient Toolbar preview window In the preview window you will start most of your processing steps with the icons of the toolbar But note that a popup menu is also available for selecting images Previous Patient Shows the studies and series of the patient above the patient currently selected in the pa tient list Next Patient Shows the studies and series of the patient below the patient currently selected in the pa tient list Load to Viewer 1 The selected study series or individual images are loaded into viewer 1 Load to Viewer 2 The selected study series or individual images are loaded into viewer 2 Load to Compare Mode Loads the first two series of a selected study or two selected series or two images into compare mode side by side Load to Compare Mode Loads the first two series of a selected study or two selected series or two images into compare mode top and bottom Load all series as one Click this icon before you load an entire study into one of the viewers to merge all images of this study into one viewing series Compression Level A Transfers images with compression level A In compression level A the images are usually only slight
237. oth images that were scanned with and without contrast medium then Visage 7 Web Client splits up this series The images are displayed grouped as two separate series Series CT Series Modality CT Images 1 Organ SPI Mediastin Date Time 19 WC WO MR T1 T2 series For MR series Visage 7 Web Client indicates if the series contains T1 or T2 weighted images If an MR series contains both T1 and T2 weighted images then Visage 7 Web Client splits it up The images are displayed grouped according to their T1 T2 weighting Visage 7 Web Client The Visage 7 Web Client Window Preview window Series MR Series Modality MR Images 1 Organ Date Time 1997 11 04 13 T1 Thumbnails The way the thumbnails themselves are presented also provides information about image types and acquisition data Multiframe images Series of some modalities can contain single images or multiframe images You will recognize multiframe images by the dog ear shown in the top right corner of the thumbnail XA report or XA series may contain report or photofile images with image evaluation information photofile images Report photofile images are displayed next to the corresponding multiframes as separate series LAO 38 CRA 4 Visage 7 Web Client 63 Preview window Biplane scenes Truncated series MPPS Modality Performed Procedure Steps 64 The Visage 7 Web Client Window XA scenes that have been recorded in biplan
238. ou can save measurement graphics or annotations back to the web server In subsequent Visage 7 Web Client sessions you or other users can now browse through any annotated images in this series or study using the Previous Next Annotated Image icons in any of the viewer windows 1 Click Save Annotations to save any annotations and measurement graphics you have added to your images during your current Visage 7 Web Client ses sion The icon appears depressed while Visage 7 Web Client uploads your annota tions and measurement graphics for the currently displayed image A message is shown when uploading is finished Tip If you do not have sufficient user rights to save annotations and measurement graphics the Save Annotations icon is not shown in your display protocol viewer toolbar To preserve an image with annotations anyway use the Copy to Clipboard tool and paste what is currently shown on the screen in another Windows application program for example Visage 7 Web Client Reviewing and Reporting on Images in the Display Protocol Viewer Viewing and editing a report Viewing and editing a report In the display protocol viewer you can create edit or review reports for your stud ies You use the Visage 7 Web Client report editor to do so and proceed in a similar way as when reviewing or editing a report in client type Expert with only a few differ ences See also Editing a report page 139 Displaying a report Click the Edit
239. ow the right monitor shows the report Visage PACS Microsoft Internet Explorer 8 x Ele Edt view Favorites Tools Help El Patient Name CT Abdomen Patient ID 23007 Date of Birth 2000 01 x Study Description CT Abdomen Study Date 2006 10 31 11 35 35 i a ere eh 5 wr bSBPOSSEO RRS O ip toss USPS i adh Ele e gt FO 2D Et PatientID 23007 PP 30 a PatientName CT Abdomen ReadingPhysician InsertionDate April 05 2007 12 53h Radiology Report Diagnosis Abdorninal pain Question Mass Examinations CT abdomen with oral i v contrast Findings The size and shape of the liver are normal Post contrast views f Done By 0 trusted sites When you call one of the report windows with the navigation bar icons the report text is shown view only From the report with image window you can move on to the Visage 7 Web Client re port editor In the text only report window you can only view but not edit a report Note Note that when you edit and save a report in the Visage 7 Web Client report editor this will only change the report stored on Visage 7 but not update the report ver sion stored in the HIS RIS for this study 67 Report window Header information Report text Footnotes 68 The Visage 7 Web Client Window Visage 7 can receive and display DICOM Structured Re
240. ow x x x Report with image x x x Viewer 1 x x x Viewer 2 x x x 252 Visage 7 Web Client Appendix Overview of functionality supported by client types Client type View Compare mode x vertical BE Compare mode x horizontal Basic MIP MPR Viewer iy Display protocol viewer H Status information x Client type Classic Client type Expert Client type Expert Reading Patient window or worklist Client type View Hide show filter criteria l Filter parameters all x Search parameters all x User defined filter No Filter bi Client type Classic Client type Expert Client type Expert Reading x Visage 7 Web Client 253 Overview of functionality supported by client types Appendix Client type View Client type Classic Client type Expert Client type Expert Reading Reset to Default Filter x x x TI Set Filter Properties x x x R Reset Filter Settings x xX x Reset Input Fields x x x Data source local DB only x x x Visage PACS Web z Start Data Query x x x x rie Cancel Data Query x x x x a Retrieve Study from x x x DICOM Node La ti Query Patient x x X E DICOM Send x xX x DICOM Quick Send x x x gt 254 Visage 7 Web Client Appendix Overview of functionality supported by client types Client type View Forward x bb Backward xX dd Set Delete Protection i Remove Delete Protec tion w Delete Patients x Ch
241. ows you to display the loaded images with another color map that highlights your current diagnostic problem in a better way Image area with viewports 104 For most display protocols the image area of this viewer is subdivided into several viewports Viewports are semi independent viewer segments which you use to compare images and series from the same or different studies Viewports can be linked for synchronized scrolling All other image navigation and manipulation functions apply only to the images in the viewport that is currently ac tive highlighted by a colored border Visage 7 Web Client The Visage 7 Web Client Window Display Protocol Viewer Expert Reading Icons Double click a viewport to show it fullscreen Double click a second time to return to the viewport s original size and location Use the or number 1 8 keys on your keyboard to display more viewports or to hide viewports or to switch between predefined layouts Once you have loaded images or started manipulating images icons may appear in the upper right hand corner of the image segments These icons alert you to infor mation you should consider when interpreting the images amp cl i ia Lossy compressed image The quality of the image may have been affected artifacts The quality percentage is indicated next to the icon This warning triangle remains visible even if the image texts are hidden When loading images into on
242. play is divided into 4 segments in this ex ample Depending on the number of images that are loaded up to 4 images will be dis played at one time Cine Mode Backward Plays back the loaded images like a movie The playback direction is backward Cine Mode Stop Stops movie playback Cine Mode Forward Plays back the loaded images like a movie The playback direction is forward Cine Mode Speed If the slider is far left movie playback stops If the slider is far right the movie is played back at maximum speed Bouncing Cine If you click this icon the movie will run without interruption When playback reaches the last image the movie runs backward to the first image then forward again etc Visage 7 Web Client 77 Viewers The Visage 7 Web Client Window Interactive Cine Mode When Interactive Cine Mode is active the images of a series or scene will play back when you move the mouse pointer over the image area This gives the impression of a mov ie being played back Mouse up or right play forward Mouse down or left play backward Mouse stopped still image The direction in which you are supposed to move the mouse can be configured by your sys tem administrator Gamma Adjustment Opens a dialog box for the adjustment of the gamma curve of images This adjustment ap plies to all Visage 7 Web Client image viewers Show Hide Presentation State Toggles image display from presentation state image to
243. ports The layout in which these structured reports are shown in Visage 7 Web Client can be configured by Customer Service However if Customer Service makes any layout changes at your request you must validate these changes to ensure that all relevant report information is actu ally shown in the HTML report translation of these reports Report text display The header of the loaded report shows data about the patient and examination for example accession number study ID patient name and patient ID This data rep resents the information stored for this study and patient in the HIS RIS Compare this data with the patient information in the viewer section if you are work ing in the report with image window or with the patient s information in the study se ries window to ensure the information in the HTML report is up to date If the report is too long for the report window use the scroll bar to scroll through the report text When a report was received from the HIS RIS in the format DICOM Structured Re port it may contain footnote information which is not immediately visible in the HTML report version shown in the report window Move the mouse pointer over these icons which indicate hidden footnote text to show this information in a tooltip Report editor You activate the report editor with this icon in the toolbar of the image display sec tion Once you have switched over from view only to editing mode a toolbar a
244. ppears above the report text with basic text editing and text formatting functions Note You can only edit the report text white background but not the report header gray background Visage 7 Web Client The Visage 7 Web Client Window Report window Report editor toolbar Ek Arial fo gt Save Saves your changes to the report back to the web server Cancel Undoes your editing and displays the report as you last saved it or as it was stored on the web server before you started editing it Font family and size Allows you to change the font family and size for selected report text Cut Copy Paste These icons allow you to cut copy and paste text in your report Icons for editing characters With the icons Bold Italic Underline Strikethrough Superscript and Subscript you can change the format properties of selected characters Icons for paragraph editing With the icons Align left Center Right you can change the alignment of the paragraph in which the text cursor rests at the moment With Numbering you can create numbered lists with Bullets you can create lists with bul lets Use Increase Indent and Decrease Indent to indent paragraphs or to remove inden tion Image display Viewer toolbar Position indicator bar Visage 7 Web Client The image section in the report view contains all those images from the current study that you have loaded into a viewer The image displa
245. problem e Image Individual images belong to a study and series Technically speaking every single frame image is a data file with so called DICOM header informa tion about the series study and patient it belongs to Patient Name HSA Circle of Willis Patient ID 421876Date of Birth ai fe mem 92 sie Cee Study CIRCLE OF WILLIS Date Time 1993 04 21 09 55 15 Referring Physician WEISS ID 1 Series Modality CT Images 20 Organ Date Time 1993 04 21 10 04 02 For modalities using multiframe images a study is an examination performed in order to clarify a diagnostic problem just as it is for modalities using single frame images Series and images however are treated slightly differently A multiframe image comprises a set of frames which are stored sandwich like in a single multiframe file All images belonging to a multiframe have one common DICOM image header One series may contain more than one multiframe image that means more than one stack of images In the Visage 7 Web Client image preview a multiframe image is indicated by a dog ear in the top right hand corner Visage 7 Web Client Reviewing Images Image text and image icons Patient Name Johnson Roberta Patient ID 123 45 6789Date of Birth 1923 10 1 ie fe mae 99 sls ee El E Study Cardiac Catheterization Date Time 1995 02 14 09 40 00 Referring Physician Brown Janet ID 1 Series Modality XA Ima
246. r oy Calculation method 3D operation Dual monitor Visage 7 Web Client The basic MIP MPR Viewer can calculate a volume data set from suitable CT and MR series You can move freely through this volume data set viewing new slice images in any plane or orientation Note The basic MIP MPR viewer is a display mode only It allows you to calculate and display new slice images However it does not provide measurement tools and you cannot save the recalculated images back to the web server If you require advanced 3D evaluation functions contact your Sales Representa tive concerning the Visage 7 Client option The Visage 7 Web Client basic MIP MPR viewer gives you a choice of two 3D cal culation methods e Multiplanar reconstruction MPR This method is the default method used by the program e Maximum intensity projection MIP You can switch each of the four views separately to an MIP based display Unlike other Visage 7 Web Client windows the basic MIP MPR viewer does not pro vide a toolbar for calling operating functions In the basic MIP MPR viewer you work with e Popup menu e Keyboard e Mouse clicks If you are working in dual monitor mode the basic MIP MPR viewer is only shown on the left monitor 83 Basic MIP MPR viewer The Visage 7 Web Client Window Visage PACS Microsoft Internet Explorer Eile Edit view Favorites Tools Help Information area FN Patient Name Joe s Shoulder Patient ID
247. r series into one of the viewer windows e g viewer 1 FA Bx 2 Select a screen layout to define the number of images to be exported All currently displayed images are going to be exported in their current edited state mi 3 Click this icon to open the Export Images dialog box 4 Enter the path for the exported images 196 Visage 7 Web Client Printing Exporting and Sending Images Exporting patient data or images Export Images Folder Browse File Name File Type M DICOM M BMP T JPEG 80 JPEG Quality OK Cancel 5 Assign a meaningful name to the images 6 Select the required image format and image quality for JPEG images only Note Please note that graphic objects or shutters may be lost in bitmap format Images are exported with their current compression level Wavelet compressed images can only be stored in bitmap format 7 Confirm with OK Copying images to the clipboard C 1 Load your study or series into one of the viewer windows viewer 1 for exam ple Ag EA 2 Select the number of images to be copied to the clipboard by choosing a display mode 3 Click the Copy to Clipboard icon The images will be copied to the Windows clipboard You can insert the images into other Windows applications from there Visage 7 Web Client 197 Sending data in the network Printing Exporting and Sending Images Sending data in the network You can send data over the network fro
248. rchived E Partially archived Completely archived Performing display quality checks Visage 7 Web Client supplies test images that allow you to check the display quality of your monitor s from time to time 1 Open one of the viewer windows e g viewer 1 C 2 Select SMPTE 1 or SMPTE 2 from the popup menu An SMPTE test pattern will be displayed Visage 7 Web Client 249 Performing display quality checks Functions and Information for Advanced Users 250 Visage 7 Web Client Appendix List of supported modality types and abbreviations Abbreviation CR CT DR DX ES GM IO MG MR NM OT PR PT PX RF RT SM SR US XA XC Modality Computed Radiography Computed Tomography Digital Radiography Digital Radiography Endoscopy General Microscopy Intra oral Radiography Mammography Magnetic Resonance Nuclear Medicine Other Presentation State Positron emission tomography PET Panoramic X Ray Radio Fluoroscopy Radiotherapy Image Slide Microscopy SR Document Ultrasound X Ray Angiography External camera Photography Visage 7 Web Client 251 Overview of functionality supported by client types Appendix Overview of functionality supported by client types Navigation bar Client type View Client type Classic Client type Expert Client type Expert Reading Patient window x x x Worklist x o Study series window x x x LI Preview window x x x i Report wind
249. reen layout and image display 1 Click this icon to hide obstructing text in images 2 Click the icon again to restore the image texts Showing and hiding graphic objects and shutters The loaded images may contain graphic objects e g evaluation results or shutters generated with another system during evaluation Display of shutters or graphics can be set as default for images types or you can show or hide them while working in the viewer windows Note Display of graphic elements and shutters may affect the performance Graphic objects and shutters are always hidden in cine mode 1 Select Show hide overlays from the popup menu The graphic objects are shown now 2 Select Show hide shutters from the popup menu The shutters are shown now 3 Select the popup menu items again to hide overlays or shutters again Left Shutter on right Shutter off Working with color palettes Visage 7 Web Client can display medical images not only as grayscale images but also in color Using color may help you highlight anomalies making them more noticeable for cer tain diagnostic problems Visage 7 Web Client 149 Selecting screen layout and image display Reviewing Images Visage 7 Web Client provides a number of predefined color palettes that you can apply to loaded images Tip Your system administrator can define that images of certain modalities will be dis played with one of the available color palettes by default
250. rently selected in the pa tient list Next Patient Shows the studies and series of the patient below the patient currently selected in the pa tient list Show all Studies When Visage 7 Web Client is called from another application via the OEM interface this icon shows all studies of the current patient Load into viewer 1 The selected study series presentation state or individual images are loaded into viewer 1 Load into viewer 2 The selected study series presentation state or individual images are loaded into viewer 2 Load to Compare Mode Loads the first two series of a selected study or two selected series or two images into compare mode side by side Load to Compare Mode Loads the first two series of a selected study or two selected series or two images into compare mode top and bottom Load to Basic MIP MPR Viewer Loads the selected series into the basic MIP MPR viewer Only CT or MR series that are suitable for 3D reconstruction can be loaded into the basic MIP MPR viewer Visage 7 Web Client 51 Study series window The Visage 7 Web Client Window iG e D DB p Load all series as one Click this icon before you load an entire study into one of the viewers to merge all images of this study into one viewing series Refresh The study series window is updated Delete object Pops up a dialog box and allows you to select what you want to delete from the web serv
251. report x x Color Map x x x E Display as 3D volume x x x x 3D M Automatic Synchroni x x x x zation with 3D volume 3D Plane A x x x Plane B x x x Loop All x x x fi 264 Visage 7 Web Client Appendix Overview of functionality supported by client types Client type View Client type Classic Client type Expert Client type Expert Reading Previous Frame x x x Ed Next Frame x x x H Ed Display Reports x x x Display Scenes x x x Hide Show ECG x x Mark as read x x E Synchronized scrolling x Create Annotation x A ka Select Annotation Mea x surement i Save Annotation x vf AB Visage 7 Web Client 265 Overview of functionality supported by client types Appendix 266 Visage 7 Web Client Index Visage 7 Web Client 3D Automatic Synchronization with 3D volume 54 61 78 93 104 Display as 3D volume 53 61 78 loading volume data 130 synchronizing 3D image display 130 A Access control 18 Angio mode 158 Angle Measurement icon 75 101 Angles 183 Annotations 230 Archive protection 248 Archive Protection icon 52 Archive query 114 Archiving 17 248 Arrow and Text Annotation icon 102 Arrow Annotation icon 102 Assignment of patients to groups 244 Assignment of patients to users 244 Audit trails 20 Authentication 18 Auto logoff 19 32 Auto Hide Toolbar icon 71 98 Automatic cine mode 155 Automatic Synchronization with 3D vol ume icon 54 61
252. rting images Visage 7 Web Client You can optimize the way you display digital images For example you can rotate the images around an axis You can flip images horizontally or you can invert the grayscale values of images If overlay graphics or shutters are included in the image that you want to rotate or mirror they are adapted accordingly These functions are useful for comparing series acquired with different patient posi tions or scan direction Rotating images You can rotate images clockwise in 90 steps The center of rotation is always the center of the segment You cannot rotate XA scenes 1 Click this icon on the toolbar The image is rotated 90 clockwise 2 Click the icon again to rotate the image another 90 The image orientation labels H F R L and A P change accordingly 177 Editing images Alb 178 Reviewing Images Flipping images With the flip or mirror function you can compare images of series that were ac quired with a different patient position or scan direction more easily You cannot flip XA scenes Click the Mirror icon on the toolbar The image is rotated round its vertical axis The orientation labels are changed accordingly Inverting images When an image has been inverted light areas are displayed dark and dark areas light Click this icon on the toolbar Visage 7 Web Client Reviewing Images Evaluating images Evaluating images Visage 7 Web
253. s The Visage 7 Web Client viewers provide various functions for doing that The edge enhancement filter The edge enhancement filter is used for optimizing image quality and increasing contrast between structures Tip The edge enhancement filter is especially useful for improving the sharpness or definition of XA images Therefore the filter value is displayed in the bottom right hand corner of XA imag es below the window values Windowing with the mouse You can use the mouse to change the way in which the grayscales brightness and contrast of an image are displayed t 1 Click this icon on the toolbar Or Select Windowing from the popup menu h The mouse pointer changes shape in the image area P 2 Left click and drag the mouse pointer over the image up down to change the center making the image brighter or darker right left to change the width increasing or decreasing image contrast Center Nt Width 172 Visage 7 Web Client Reviewing Images if ta Visage 7 Web Client Editing images Filtering images You can use the mouse to emphasize or soften the edges in an image 1 Click this icon on the toolbar The mouse pointer changes shape in the image area 2 Left click and drag the mouse pointer over the image up to sharpen the image down to soften the image Resetting window and filter values You can reset window and filter values at any time to the values the ima
254. s mm Images of all other modalities allow no calculation or estimation of distances in mil limeters Distance measurements in those image types are therefore indicated in pixels pix unless you calibrate the measurement function Calibrating distances The user must decide whether calibration is necessary on the basis of the informa tion provided in the image Several modalities and image types have already been calibrated and allow mea surement of distances directly in millimeters The precision of these measurements depends on the precision of the modality and is documented in the modality s user information For other modalities Visage 7 Web Client allows calculation of distances in the im ages of a series even if the modality or the image provides this information in pixels only In such image types users can perform calibration themselves using image markers with known distances such as a steel ruler or a steel ball in one image of a series It is the responsibility of the user to select suitable means to create such image mark ers Note Calibration is only valid for the images of the current series It is only one option for translating a distance which the user draws in an image and which is indicated in pixels into SI units The relation between pixels and SI units is solely defined by the user It is the us er s responsibility to provide an appropriate reference in the image and to use it for performing c
255. s via the keyboard 1 Click on a segment 2 Then press the corresponding key The display switches or the new operating mode is shown bottom left in the seg ment 3 Now perform the processing step with the mouse w Activates interactive windowing with the mouse z Activates interactive image zooming with the mouse p Activates interactive image panning with the mouse 88 Visage 7 Web Client The Visage 7 Web Client Window Basic MIP MPR viewer 1 2 3 In the 3D overview segment only Allows you to rotate the orientation cube in any direction with the mouse In the slice segments only Allows you to move the slice currently shown in the slice segment along two standard axes Do not accidentally click on the slice cursor line In the slice segments only Allows you to change the slice thickness of the image shown in this slice segment interac tively Do not accidentally click on the slice cursor line Enlarges or reduces the image so that it fits optimally into the image segment Shows the image in its original size In the 3D overview segment only Shows or hides all slices in the overview segment In the 3D overview segment only Shows or hides display of individual slices In the 3D overview segment only Shows or hides the volume box in the overview segment In the slice segments only Shows or hides the slice cursor in a slice segment Resets all processing steps and again shows the images in all segments
256. s Reviewing and Reporting on Images in the Display Protocol Viewer 6 Start scrolling in both viewports simultaneously Use the wheel mouse cine mode or interactive cine mode to do so Editing images In the display protocol viewer you can review edit and evaluate images in just the same way as in the viewer windows in client type Expert for example These are the image editing and evaluation options available in the display protocol viewer Screen layout e Showing hiding or moving the toolbar You cannot move the toolbar in the display protocol viewer However you can only lock and unlock its display e Showing and hiding image text e Showing and hiding graphic objects and shutters e Working with color palettes Scrolling images e Image by image slow scrolling e Cine mode fast scrolling Scoutlines e Displaying scoutlines When reviewing images with scoutlines you use the viewports of the display pro tocol viewer in a similar way to how you use compare mode in the client type Ex pert Editing images e Selecting and editing images general procedure e Zooming and panning images e Windowing and filtering images e Rotating flipping and inverting images Printing and e Printing images on a Windows printer exporting images e Exporting images from the viewer e Copying images to the clipboard Please refer to chapter Printing Exporting and Sending Images page 191 for de tails on these options 228 Visage 7 Web Cli
257. s active it is stopped Or Click Stop Cine Mode to stop playback and then scroll frame by frame with the Moe Xx wheel mouse Ei Or Click Interactive Cine Mode hold the left mouse button down and move the mouse slowly over the image Your progress within a scene is indicated by the position indicator bar at the bot tom edge of the viewer window Scrolling frame by frame Displaying biplane scenes Angio scenes may have been recorded in the so called biplane mode This means that two scenes are recorded simultaneously during a recording sequence showing the same region but with a different orientation The image pairs frame 1 in plane A and frame 1 in plane B for example have the same time stamp You can switch back and forth between these two planes while a biplane scene is being displayed Switching planes means looking at the same area of interest at the same time but from a different direction Information relating to biplane images is displayed in image preview You can recog nize a biplane scene in the image preview of the study series window or in the pre view window by the reduced spacing between the plane A and plane B thumbnails 160 Visage 7 Web Client Reviewing Images Viewing angio scenes Click the Plane A and Plane B icons to toggle between the frames of a biplane scene This allows you to view the same region at the same instant but from different viewing
258. s each entry represents exactly one study Visage 7 Web Client The Visage 7 Web Client Window Worklist Expert Reading Tip You cannot load patient data directly from the response list of a DICOM node into the display protocol viewer You must first copy a patient to the local database by double clicking the patient entry or with the Retrieve Study from DICOM Node icon For an explanation of columns in the response list from a network node refer to sec tion Response list network node on page 49 Display protocols list Here you find a list of all display protocols that are suitable for the selected monitor configuration and study data Display Protocol Description Monitors Orientation Ranking Name of the display protocol which usually includes a description of how many viewports will be available in the viewer as well as an indication of the display layout used in these viewports More detailed description for a display protocol Indicates whether this display protocol supports single or dual monitor configuration Indicates whether this display protocol supports landscape or portrait displays Suitability ranking of a display protocol for the study data selected in the patient or study list section of this window This column may be hidden Study list worklist Lists all studies that are available on the Visage 7 server for the selected patient Procedure Step Status Performer Priority
259. s these images into one series in the viewer But note the following restrictions for image selection Images from different mo dalities or single frame and multiframe images cannot be loaded together Showing the preview area or preview window Click this icon on the study series window toolbar to show or hide the preview area next to the study and series list Click this icon on the navigation bar to show the preview window If your series contain a large number of images clicking the Truncate Thumbnails BEBE for Large Series icon in the toolbar helps you with a quick overview of your study 118 Visage 7 Web Client Loading Image Data Selecting a study Study BRAIN Date Deselecting all Study BRAIN Date Selecting series Series NEURO_BRAIM Visage 7 Web Client Selecting series and images Note If Truncate Thumbnails for Large Series is selected one image followed by three dots is shown in the preview section or window for each large series Your system administrator can configure the threshold for what the system considers large series Double clicking such an image in the preview section or window or double clicking the series header will load the entire series and not only this one image Selecting an entire study in the image preview Click on the title bar of the study in the preview area or preview window Or Click on the title bars of all series in the preview area or preview win
260. splayed with reduced matrix size that is if not every original pixel is shown on the screen due to zoom out For optimum ac curacy we recommend zooming into the structure of interest as much as possible The accuracy is further limited by the physical resolution of the acquisition itself If the monitor used for display does not permit exact pixel selection the inaccuracy can be greater still Visage 7 Web Client The Visage 7 Web Client Window Viewers y Density Profile Permits evaluation of a density profile along a straight line an arrow indicates the direction While this tool is active the mouse pointer looks like this RU ap Ge H ip Show Scoutlines compare mode only Shows the position of selected images on the corresponding reference images Note that this icon is only shown in the viewer toolbars in compare mode It will only become active ifa CT or MR study has been loaded that contains suitable image data Show All Scoutlines Shows all scoutlines in the reference image Show Border Scoutlines Shows only the first and last scoutline in the reference image Show Border and Current Scoutlines Shows the scoutline of the current image and the first and last scoutline in the reference im age Show Current Scoutline Shows only the current scoutline in the reference image RI Display Mode Opens a selection list with different layouts Select for example the 2x2 view The image dis
261. st does not display all patients found at a time After a very generic patient search that results in more patients found click this icon to page through the list of all patients found Backward dd Click this icon to page backward through the list of all patients found DICOM Send Opens a dialog box Select the address es in your DICOM network to which you want to send the selected patient s p DICOM Quick Send Sends the selected patient s to one or several DICOM nodes immediately Your system administrator has defined these addresses for you ie Change Group Assignment The Change Group Assignment dialog box opens Here you can define which user groups have access to the selected patients Change User Assignment a B The Change User Assignment dialog box opens Here you can define which users have access to the selected patients 92 Visage 7 Web Client The Visage 7 Web Client Window Worklist Expert Reading We Launching Application Starts another web application if your system administrator has configured this for you The icon is only active if you have selected a patient Change Procedure Step Procedure steps are tasks in the diagnostic reading workflow With Visage 7 Web Client you can follow up on the task interpretation from scheduling this task to completion For studies for which no procedure step exists Creates a new procedure step and allows you to assign the new procedure step
262. state or one or several selected series are to be sent when sending data from the study series win dow 6 Select whether a single image or all loaded images are to be sent when sending data from a viewer window 7 Click OK to send the data Sending data to preselected address es DICOM Quick Send DICOM Quick Send is a fast way of sending data to recurring destinations Tip Talk to your system administrator and ask him or her to set up standard network addresses to which you are repeatedly required to send data as a DICOM quick send node Depending on the configuration DICOM Quick Send sends the data to one or more network addresses simultaneously 1 Select the data that you want to send via the network Visage 7 Web Client 199 Sending data in the network He 2 Printing Exporting and Sending Images Click DICOM Quick Send on the toolbar The data are immediately sent via the network all data transmission parameters such as network address es compression level etc have been predefined by your system administrator Checking status information Tab cards 200 The Status information window provides an overview of your data transfer jobs in the network and allows you to check whether these have been executed without er ror H Call Status information via the navigation bar Dicom Retrieve Dicom Print Report Query Active User List System Info Destination Object Pat
263. stay Each modality used to examine the pa tient sends the study data not only to a long term archive but also to the web server If physicians require information on patients and their examinations they can call up an Visage 7 client from anywhere within the hospital intranet and will find the re 12 Visage 7 Web Client System Overview Web server Web clients Visage 7 Web Client Product overview quired study information there In order to make sure the patient information on the web server is complete and up to date physicians can query other nodes in the net work for recent examination data Whereas a HIS RIS only makes administrative data generally available throughout the hospital the Visage 7 solution takes the idea of central data collection and uni versal availability of data one step further Visage 7 Web Client makes radiological study data which includes DICOM image data and reports available at the clinical workplace In this context the central web server functions as temporary storage medium of im age data usually for the duration of a patient s stay at the hospital e g 2 4 weeks and as an image distribution center Moreover Visage 7 also extends beyond the hospital and its internal data network With appropriate authorization the web server can be accessed from the outside as well making use of the Internet This way referring physicians can quickly and easi ly call up information on the examination r
264. te the Internet Explorer while working with Visage 7 Web Client as this will log you off too In the patient window this area shows the user name with which you are currently logged in All other Visage 7 Web Client windows show data about the selected pa tient and study here With the icons of the navigation bar you can switch back and forth between the var ious Visage 7 Web Client windows call up status information or online help or log off from the web server You use the icon buttons of the toolbar of each window to perform the various oper ating steps that can be carried out in this particular window Visage 7 Web Client Getting Started with Visage 7 Web Client Selecting functions and switching windows Workspace Status bar In the viewer windows the toolbar will either be shown as a single row of icons or ar ranged in several rows of icons depending on your screen resolution and the num ber of configured icons The workspace is where the selected patients studies or images are displayed in the various Visage 7 Web Client windows The status bar at the bottom of the screen displays information about the status of the program for example about the progress made when searching It also indi cates if an action failed Selecting functions and switching windows In Visage 7 Web Client all actions are started with icon buttons or popup menus Navigation bar icons ao Toolbar icons E Visage 7 Web Client
265. this icon opens the Spine Labels dialog box In this dialog box you can select what you want to label whether you want to proceed from top to bottom or from bottom to top and if you want to label vertebrae consecutively or only every second or third Select Annotation Measurement Allows you to select an annotation graphic in order to move or to delete it or to change its display properties Save Annotations Saves any annotations you have created in the currently loaded data back to the web serv er ae Ge H ib Original size Resets the loaded image to its original size Fit into Segment Resizes the current image to fit it optimally in the image segment Mirror Mirrors the current image about its vertical axis Rotate Rotates the current image 90 clockwise Invert Inverts the grayscale display of an image Bright areas are now shown dark and dark areas are shown light Show Scoutlines Shows the position of selected images on the corresponding reference images Note that this icon will only become active if a CT or MR study has been loaded that con tains suitable image data Show All Scoutlines Shows all scoutlines in the reference image Show Border Scoutlines Shows only the first and last scoutline in the reference image Show Border and Current Scoutlines Shows the scoutline of the current image and the first and last scoutline in the reference im age Show Current Scoutline Shows only t
266. tient s Delete Patients The selected patient s is are deleted from the local database if delete protection is not ac tive The status bar shows the progress of deletion You cannot continue your work until deletion has been completed Change Group Assignment The Change Group Assignment dialog box opens Here you can define which user groups have access to the selected patients Change User Assignment The Change User Assignment dialog box opens Here you can define which users have access to the selected patients Visage 7 Web Client 47 Patient window The Visage 7 Web Client Window Export Patient The data of the selected patient s is exported The data is first written to a directory on the server and then written to CD or DVD depending on the configuration If you use a CD or DVD producer station disks can be recorded automatically Next to the icon the volume of data that is stored for the selected patient s in the Visage 7 database is displayed Launching Application Starts another web application if your system administrator has configured this for you The icon is only active if you have selected a patient System messages This part of the patient window shows important messages from the system Patient list local The local patient list shows all patients found in the web server database who match the search criteria and to whom you have access The patient list contains only one entry f
267. to be able to calculate a volume data set from a series the images must fulfill the following preconditions The modality must be CT or MR One series must be selected The photometric interpretation must be MONOCHROME2 The value for Bits Allocated must be 16 The value for Samples per Pixel must be 1 All images must be of the same size All images must have the same orientation The upper left point of all images must be on one straight line The distances between consecutive images must be identical Visage 7 Web Client gives you a choice of two 3D calculation methods Multiplanar reconstruction MPR This method is especially suitable for producing secondary slice images that is slices with a new orientation through the region being examined The result is al ways a new two dimensional image Maximum intensity projection MIP Maximum intensity projection looks through the volume in one direction and projects the volume pixels with the greatest intensity onto a surface Tip Maximum intensity projection MIP is especially suitable for contrast agent exam inations in angiography Vessels filled with contrast agent then appear in the vol ume as structures with the most intensive grayscale values Visage 7 Web Client Working in the Basic MIP MPR Viewer Anatomical standard views Anatomical standard views Immediately after you have loaded a series into the basic MIP MPR viewer the slice images of the anatomic
268. to the web server Or Use this icon to undo your editing and show the report in the version that is stored on the web server again Or Click this icon in the upper right corner of the viewer section to close the study images and report without saving changes Visage 7 Web Client Displaying and Editing Reports Creating a new report Creating a new report If no report exists for a study on the web server so far you can use Visage 7 Web Client to create a new report Note Note that your new report will be stored on the web server only It will not be sent to the HIS RIS 1 Load the study for which you want to create a new report into one of the viewer windows for example viewer 1 2 Click the Edit report icon on the toolbar of the image display section Visage 7 Web Client switches over to the report with image window creates a BE new empty report and displays it in the report editor section of the screen 3 Add text here and remember that you cannot change the report header gray background 4 Select your text in order to format it 5 Use this icon for example to highlight text The Visage 7 Web Client report editor offers a number of basic text formatting options which allow you to change character and paragraph properties With the Cut Copy Paste icons you can move text around in your report or in sert text from or in other Windows text processing programs 6 Use this icon to save yo
269. treading for client type Expert Reading 2 Enter your user name and password Visage 7 Web Client makes a distinction between upper and lower case letters 3 Press the RETURN key or click the Login button The Visage 7 Web Client patient window opens If you are unable to log in either the maximum permissible number of users may be logged in at the moment or your license does not support the selected client type In this case try logging on again a few minutes later or select another client type If Visage 7 Web Client still does not start check the network connection or con tact your system administrator In dual monitor mode you work with two monitors simultaneously The operating ele ments and screen areas of Visage 7 Web Client are distributed over two monitors This makes working with Visage 7 Web Client easier Dual monitor mode is only available if you have an Expert license and the required user privileges If your administrator has activated this function for you you can log on to several workstations with the same user data and continue on one workstation with the work you started on another one Every time you log onto the Visage 7 server the server automatically checks wheth er a more recent version of the client software is now available Client update starts automatically unless your system administrator has disabled this option A mes sage is displayed in this case 29 Integrated Windows authentication St
270. trieved either Consult you system administrator for information on how your sys tem has been configured For DICOM Print jobs successful execution of the job can mean that the print job was suc essfully sent to the DICOM printer It gives no indication of whether the images were actual ly printed If the DICOM printer is out of paper for example a print job may have been sucessfully executed from a network point of view but in actual fact the images have not yet been printed Canceled The job has been canceled Visage 7 Web Client user who initiated data transfer Priority of the job Date and time when data transfer was initiated in the format YYYY MM DD and hh mm ss 24 hour clock Processing options 202 In the status information window you can Refresh Priority Stop Delete Restart Close Refresh the display to make sure recently initiated transfer jobs are also shown Change the priority of selected jobs if they have not already been successfully completed Stop jobs that currently have Pending or Processing status The jobs are then no longer processed but remain in the job list Delete jobs from the job list only possible for jobs that have been successfully completed or that have been canceled or have failed Restart jobs that have been stopped Canceled or have failed Failed Close the status information dialog box The jobs it contains are still processed in the back ground
271. uently load these images into a viewer and move on to this viewer the im ages are displayed immediately This option is only active if Use Local Cache has also been selected Truncate Thumbnails for Large Series Toggles thumbnail display for large series one or all thumbnails per series are shown in the image preview section Show Thin Slice Series When this option is selected the series list will list both thin slice series original scan series and thick slice series generated image series which permit faster loading and browsing When this option is deselected only thick slice series are shown in the series list Select all previews Selects all images in the preview window Deselect all previews Deselects all images currently selected in the preview window DICOM Information Shows the DICOM information of the selected image Visage 7 Web Client The Visage 7 Web Client Window Preview window E Launching Application Starts another web application if your system administrator has configured this for you The icon is only active if you have selected a study DICOM Send Opens a dialog box Select the address es in your DICOM network to which you want to send the selected series or image s DICOM Quick Send Sends the selected series or image s to one or several DICOM nodes immediately Your system administrator has defined these addresses for you Display as 3D volume Shows the selected data in
272. ur new report i e upload it to the web server Or x Click this icon in the upper right corner of the viewer section to discard your re port Visage 7 Web Client 141 Creating a new report Displaying and Editing Reports 142 Visage 7 Web Client Reviewing Images Gl iol Visage 7 Web Client Visage 7 Web Client provides numerous options for adjusting image display in the viewer windows to suit your needs e A toolbar contains icons for accessing image display and editing functions quick ly This selection of icons is slightly different for different image types and modal ities e By selecting a suitable screen layout you can display one or several images at a time e Series and scenes can be played back automatically or mouse controlled cine or movie mode They can also be played back in loops e Display of scoutlines in reference images provides an excellent overview when reviewing CT or MR studies All image display and editing functions described here are available in all Visage 7 Web Client image viewers unless otherwise specified viewer 1 viewer 2 compare mode and report with image window Tip When working in the Visage 7 Web Client image viewers remember that all chang es you make to the display of images are temporary you cannot save edited imag es back to the database of the web server In this section you will find basic information about different image types and how to interpret image text a
273. urity level High would prevent Activex components from running In order to change the security level for Trusted Sites 1 Open the Internet Options menu Tools gt Internet Options dialog box in the Internet Explorer 2 Click the Security tab card Visage 7 Web Client System Overview Product overview 3 Click Trusted Sites and Custom Level 4 Check the settings for Trusted Sites and change them if necessary 5 Also be sure to disable Use PopUp Blocker if you are working with Windows XP Service Pack 2 or higher In order to add a Trusted Site manually 1 Enter the Visage 7 Web Client URL e g http servername en in the Internet Explorer address bar 2 Select and copy the URL Ctrl C 3 Open the Internet Options menu Tools gt Internet Options dialog box in the Internet Explorer 4 Click Trusted Sites and Sites 5 Paste the URL in the Add this Web site to the zone box Ctrl V 6 Click Add and then close the dialog box with OK Note For installation administrator privileges are required on the client computer Tip At some sites Visage 7 Web Client is distributed in the Windows Domain with a so called MSI Package If this is the case Visage 7 Web Client will be installed auto matically no user interaction is required here Archiving with the archive option Visage 7 Web Client With the archive option data is sent to the archive according to a configurable schedule These
274. which software patches are installed On the tab cards you will find the following information about data transfer jobs All users Destination Re trieve from Object Description Report received Number of ob jects size in MB Status Tt i Check this box to show all transfer jobs initiated by all Visage 7 Web Client users Or Uncheck this box to show your own transfer jobs only Name of the destination node or sender of the data Which data have been sent or fetched e g a study series or a single image Text describing the object sent States whether a report has been successfully fetched from the HIS RIS Indicates the number of objects already transmitted the total number of objects to be trans mitted and the volume of data to be transmitted in megabytes Indicates the processing status of the job Pending The job has been addressed and is waiting for processing Processing The job is being processed Failed The job has failed Visage 7 Web Client 201 Sending data in the network Printing Exporting and Sending Images User Priority Insertion Successful The job has been successfully completed Note that depending on your system configuration successful execution of a Report Query may only confirm that the report node was successfully queried It may not necessarily mean that a report was actually retrieved If no report exists on the report node no report can be re
275. x and click OK Marking a study as read Load a study into one of the Visage 7 Web Client viewer windows 1 E 2 Review the images here and dictate or write your report 3 Click Mark study as read before you move on to your next task 2 B Em e The procedure step for this study has now been set to completed and your name has been entered as performer in the study list or worklist Note The Mark study as read icon is dimmed when you are reviewing a study for which no procedure step exists or whose procedure step has the status completed Managing procedure steps in the study list You can manage procedure steps from the study list or worklist You can set the sta tus of scheduled steps to completed reschedule or delete procedure steps 1 Select a study with a procedure step in the study series window client type Ex 3 A pert or in the worklist client type Expert Reading Py 2 Click this icon to open the Change Procedure Step dialog box Change Procedure Step Delete Procedure Step Change Procedure Step Delete Procedure Step C Set Procedure Step to COMPLETED Change Priority MEDIUM gt Cancel C Re schedule Procedure Step i Cancel Visage 7 Web Client 205 Managing procedure steps in the study list Managing the Diagnostic Reading Workflow For procedure steps with status scheduled this dialog box allows you to set the pro cedure step status to completed or
276. xpert Reading Select Images x Y Windows Print x x x DICOM Print x x Copy to Clipboard x x x x DICOM Send x x x DICOM Quick Send x x x Ea Export Images x x DICOM Information x x x x Hide Show Image Text x x x x Zoom x x x x aC Oo Quick Zoom x x x rl iO Visage 7 Web Client 261 Overview of functionality supported by client types Appendix Client type View Client type Classic Client type Expert Client type Expert Reading Magnifying Glass x x x Pan x x x x Windowing x x xX x Edge Enhancement x x x x Predefined Level Pre x x x x sets t Reset Window Level x x x x ey Invert x x x x Rotate x xX x x r h Mirror x x x x All Fit into Segment x x x x EJ 262 Visage 7 Web Client Appendix Overview of functionality supported by client types Client type View Client type Classic Client type Expert Client type Expert Reading Original size x x x x Measurement Func x x x tions m kaal Show Scoutlines com x x x pare mode only Display Mode x x x x ka Previous Viewer Layout x m HT Next Viewer Layout x fr HT Cine Mode Backward x x x x 4 Cine Mode Stop x x x x a Cine Mode Speed x x x x Bouncing Cine x x x x 5 Visage 7 Web Client 263 Overview of functionality supported by client types Appendix Client type View Client type Classic Client type Expert Client type Expert Reading Interactive Cine Mode x x x x Gamma Adjustment x x Show Hide Presenta x x x tion State Edit
277. xt image information may be shown in the form of icons in the images gt A R A tt Changed image information Lossy compressed image The quality of the image may have been affected artifacts The quality percentage is indicated next to the icon This warning triangle remains visible even if the image texts are hidden When loading images into one of its viewers Visage 7 Web Client checks the DICOM head er information in every single image If this DICOM header information does not agree with the patient and study data stored in the Visage 7 database for one or several images this icon is displayed in the upper right hand corner of the affected images If you have manipulated a presentation state image this icon appears in the upper right hand corner It warns you that the current image no longer corresponds to the image saved in the presentation state at the diagnostic workstation This icon in the upper right hand corner of the image segment indicates that calibration has been applied to distance lines in this image This icon indicates that the displayed images do not originate from an original scan series thin slice series but were generated by a Visage 7 thick slice compilation rule DICOM print selection In the lower right hand corner of each image you will see a small green box which indicates whether the image is currently selected for DICOM print An empty box indicates no selection A solid box in
278. y in the report window provides you with the same image display and editing functions as any of the viewer windows Use the icons on the toolbar above the image display to change the display of the loaded image to evaluate image information and to print images See also Toolbar viewer The position indicator bar below the image display shows you which image of a loaded series is currently visible See also Position indicator bar viewer 69 Viewers Viewers Viewers 1 and 2 Modality specific options Dual monitor Information area Toolbar viewers Image area Navigation bar Position indicator bar viewer 70 The Visage 7 Web Client Window The viewer windows integrate all functions required for reviewing images In the viewer windows you can scroll through the loaded images select a screen layout best suited to your problem optimize image display of individual or all loaded images for the duration of the current Visage 7 Web Client session and evaluate image information Visage 7 Web Client offers you two viewer windows The layout of the windows and the function of the toolbar icons are identical in both viewers Depending on the modality of the loaded images the toolbar of the viewer may con tain a number of extra icons e Standard mode all modalities except for XA e Angio mode XA In dual monitor operation the viewer is spread across both monitors It contains an additional scroll bar on

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