User manual Periapical
Contents
1. Beam H Detector H AutoAim T Focal spot J Aiming device Quit Help Start page 2 Select area to be examined Right Left Upper O Molar OPremolar O Canine O incisor O Canine OPremolar O Molar Lower O Molar OPremolar O Canine O Incisor O Canine O Premolar O Molar Qbion AB 2010 05 19 qbion VIRTUAL RADIOLOGY veww gbion com Select area Right 3 Select Detector Upper Molar O Premolar Canine C Incisors O Canine Premolar Molar ower Molar Premolar Canine O Incisors Canine Premolar Molar Detector H E L ocal spo i Aiming device L IL Tod ate how the radiographic depiction is influenced by changes in detector position STARTING POSITION The radiographs reflect the individual ion of the tube head and the ctor Image 1 is static Image 2 is fluoroscopically displayed Change detector position by tilting or horizontal movement Image 2 is continuous ly updated Blue areas represent unexposed parts LOO he m the Ext Back to menu F9 4 Starting position The exercise starts with the tube head aligned for an orthoradial projection of the selected area Two identical radiographs are presented Image 1 gray frame is the resulting orthoradial radiograph and Image 2 white frame is fluoroscopically displayed Use the navigation tools to change the position of the scene to any desired view B2. AutoAim Central ray is automatically directed towards the middle of the detector The central ray keeps hitting the middle of the detector even when x ray tube head focal spot or detector is moved in any direction A correctly projected periapical radiograph is presented as a reference image The radiograph is exposed over a randomly chosen area The task is to expose a new radiograph identical with the reference image The user therefore has to deduce the beam direction based on an analysis of how the anatomical details are depicted in the reference image Detector position for the reference radiograph is displayed in the scene AutoAim is active The proper x ray beam direction is established by turning the scene to a position where you look upon the patient in the same direction as the x ray beam direction used for exposing the reference radiograph Expose the radiograph by pressing the Expose button The exposed radiograph 15 displayed in Image 3 Evaluation Beam direction central ray used for the reference radiograph is visualised as a white line The white ball on the line represents the focal spot The blue line represents the central ray in your radiograph and the blue ball the focal spot position Feedback 15 given as visual comparison and as angulation error If the error is too great the user must correct it before the exercise 15 complete The exercise can be performed in fluoroscopic mode or in ordinary mode I
3. Beam H i i Ejo n L a 5 a 0 Beam and p detector TESE Start page ry to duplicate radiograph in Image 1 Turn the patient to a position where you at the teeth in the correct beam New attempt F7 Back to menu F9 4 Starting position A patient and a detector are presented in the scene The reference radiograph which is an incorrectly projected periapical radiograph is presented in Image 1 gray frame Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window STARTING POSITION The radiograph in Image 1 is a reference image ct beam your duplicate radiograph ady correctly Qbion AB 2010 05 39 5 Task Try to duplicate the reference radiograph in Image 1 Start the exercise by adjusting the x ray beam direction X ray beam direction for a radiograph to be exposed is identical to the direction in which the patient is viewed Turn the scene to a position where you can look at the patient in the same direction the x ray beam direction was pointed when the reference radiograph was exposed The detector is correctly positioned and cannot be moved Hint 1 When exposing the radiograph the x ray beam direction is identical with the viewing direction Hint 2 Use the tools for scene movement to change viewing d
4. STARTING POSITION The radiograph in Image 1 is 8 reference image The detector is located in a random position ul jent to a position wh you look at the teeth in the correct beam direction for your duplicate radiograph 2 Position the detector Proceed 3 Dirt almin New attempt F7 Back to menu F9 Qbion AB 2010 05 46 5 Task Try to duplicate the reference radiograph in Image 1 Both detector position and x ray beam direction must be adjusted for proper imaging Start the exercise by adjusting the x ray beam direction The x ray beam direction for the radiograph to be exposed is identical to the direction in which the patient is viewed Turn the scene to a position where you can look at the patient in the same direction the x ray beam direction was pointed when the reference radiograph was exposed Then move the detector to the position you think it had when the reference radiograph was exposed Adjustment of beam direction and detector position can be made at any time before the radiograph is exposed By pressing the Proceed button the x ray tube head becomes visible The focal spot is positioned along the viewing direction in the previous step Hint 1 When exposing the radiograph the x ray beam direction is identical to the viewing direction Hint 2 Use the tools for scene movement to change the viewing direction Hint 3 The detector is moved horizontally with ri
5. Hint 1 The x ray beam direction is identical with the viewing direction Hint 2 Use the tools for scene movement to change viewing direction The aiming device is directed in a random direction and must now be directed towards the detector for exposure of a radiograph without any cone cut The focal spot remains in its original position when aiming device direction is adjusted Hint 1 Grasp the aiming device and direct it against the detector Hint 2 Tube head housing rotates around the focal spot which has a fixed position Hint 3 Look along the aiming device towards the detector to find the appropriate direction Hint 4 Try viewing the scene from different angles and distances The Back button returns to starting view X ray beam direction can be readjusted Expose your radiograph by pressing the Expose button The exposed radiograph is presented as Image 3 blue frame The central ray and focal spot for the reference radiograph are displayed as a white line and a white ball respectively The central ray and focal spot for the radiograph you exposed blue line and blue ball are visualised inside the tube head housing Qbion AB 2010 05 31 Back F8 Expose F7 Hint EVALUATION Beam direction Angle error 3 93 degrees Adjust iming device Adjust Hint New attempt F7 Back to menu F9 6 Evaluation Observe the differences in r
6. 15 to expose a new radiograph identical with the reference radiograph The user therefore has to deduce the projection parameters for the reference radiograph based on an analysis of how the teeth are depicted in the reference image Detector position for the reference radiograph is displayed in the scene In this exercise the x ray beam direction 15 transferred to the virtual environment in a two step procedure e Positioning the focal spot from which the x ray beam emanates The focal spot is always situated along the central ray of the viewing direction upon the patient Therefore the patient must be turned to a position where you look upon the patient in the same direction as the x ray beam direction used for the reference radiograph Directing the aiming device towards the detector so the collimated x ray beam hits the detector When moving the aiming device focal spot position is fixed Expose your radiograph by pressing the Expose button The exposed radiograph 15 displayed in Image 3 Evaluation Beam direction central ray used for the reference radiograph is visualised as a white line The white ball on the line represents the focal spot The blue line represents the central ray in your radiograph and the blue ball the focal spot position Feedback is given as visual comparison and as angulation error If an error is too great the user must correct it before the exercise 15 complete The exercise can be perform
7. and a detector are presented at the scene The detector is correctly positioned for the reference radiograph The reference radiograph which is an incorrectly projected periapical radiograph is presented in Image 1 gray frame Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window AIM The aim of the exercise is to acquire skill in analysing projection errors in periapical radiographs STARTING POSITION The radiograph in Image 1 is a reference image ition where u look at the teeth in the correct beam direction for your duplicate radiograph already correctly New attempt F7 Back to menu F9 Qbion AB 2010 05 42 5 Task Try to duplicate the reference radiograph in Image 1 Start the exercise by adjusting the x ray beam direction X ray beam direction for a radiograph to be exposed is identical to the direction in which the patient is viewed Turn the scene to a position where you can look at the patient in the same direction the x ray beam direction was pointed when the reference radiograph was exposed By pressing the Proceed button the x ray tube head becomes visible The focal spot is positioned along the viewing direction in the previous step Hint 1 When exposing the radiograph the x ray beam direction is identical with the viewing direction Hint 2 Use the tools for sc
8. enable dat uesee ti dadadna 33 eee eee 37 Error analysis Beam 38 Error analysis take eee 4 Error analysis Beam and 45 Qbion AB 2010 05 2 Program overview Periapical 15 one of four programs in the Qbion Oral Radiology Package QORP The overall aim of the program 15 to provide an environment for skill training in periapical radiography without the use of ionising radiation Training 1s accomplished by performance and analysis of radiographic examinations of a virtual patient qbion ORAL RADIOLOGY PACKAGE VIRTUAL www qb lon com BITEWING PERIAPICAL PANORAMIC OBJECT LOCALISATION Start the program by clicking on the PERIAPICAL icon The Standard edition of the program contains the two modules Interaction training and Skill training Simulator training philosophy Radiology simulator training is performed in a radiation free environment Radiographic examinations can therefore be repeated without any radiation risks By adding features normally not available in the real world learning can be improved Look in the x ray beam direction Prior to any intraoral radiographic examination the oral cavity must be examined in order to find the prope
9. in any desired direction Image 2 white frame is continuously updated and synchronised with tube head movement Follow the changes in radiographic depiction Hint 1 Grasp the back of the tube head housing and move it in any direction Image 2 is continuously updated Hint 2 The task is easier to complete by zooming out with the navigation tools so the complete tube head is visible LookThrough F7 LOOKTHROUGH 6 LookThrough By pressing the LookThrough button LookThrough mode is entered In this mode the patient is viewed from the focal spot The field of view is restricted by the aiming device The viewing direction is identical with the x ray beam direction used before entering LookThrough mode Use the navigation tools to move tube head Image 2 white frame is continuously updated and synchronised with tube head movement Follow the changes in radiographic depiction Hint Move the tube head with the tools you normally use for scene movement 7 Return to ordinary viewing mode AIM To demonstrate how the radiographic depiction is influenced by tube head movements without any change in beam direction STARTING POSITION The radiographs reflect the individual sition of be he e int Back to menu F9 Push the Exit LookThrough button to return to ordinary viewing mode The exercise continues in the same mode as it started The tube head has the same positio
10. is also directed against the detector TASK Move the tube head so the blue line and focal spot coincides with the white Hint New attempt Fe Back ta menu F9 Interaction training Detector Brief presentation of the exercise The VE presents a scene with a patient with a detector positioned inside the mouth The detector is randomly positioned in the vicinity of the dental arches A white frame slightly larger than the detector is displayed in the vicinity of the detector The distance between the tooth arch and the detector can be changed and the detector can be tilted Clicking right or middle mouse button depending on viewing direction causes a horizontal shift of detector position Tilting 15 performed with the left mouse button as a rotation along a horizontal line in the detector plane TASK The task is to move the detector into the white frame by means of the conventional mouse A sound signal indicates when the task is completed The time for completion of the task is presented in the dialogue window Hint The detector is tilted with left mouse button and moved horizontally by the right or middle mouse buttons Qbion AB 2010 05 The exercise step by step Periapical 1 Select Interaction training in the program bion m e n u YO BARS qb Select Detector Interaction training Skill training Exam Select exercise 3 Use the navigation tools to change the view
11. o ae the scene if needed 4 Use the conventional mouse right middle and Detector left button to position the detector into the white frame Aiming device E 9 When you have succeeded you will hear a 5 beep Startpage Interaction Detector x Short instructions and feedback are presented in AIM the dialogue window The aim of the exercise is to acquire skill in navigation and interaction with the virtual environment STARTING POSITION A white frame is displayed in a random position clase to the detector TASK Move the detector into the white frame Hint Back to menu F9 New attempt Qbion AB 2010 05 8 Interaction training Aiming device Brief presentation of the exercise The VE presents a scene with a patient and tube head A detector is positioned inside the mouth The aiming device is pointed in a random direction When changing the direction the tube head rotates around the focal spot Movement of the aiming device is performed with the left mouse button TASK The task is to move and direct the aiming device toward the detector so an imaginary x ray beam covers the entire detector area A beep sounds signal when the task is completed The time for completion of the task is presented in the dialogue window Hint 1 Grasp the aiming device and direct it toward the detector Hint 2 Tube head housing rotat
12. reference radiograph based on an analysis of how the teeth are depicted in the reference image In this exercise three projection parameters are to be transferred to the virtual environment e Positioning the detector e Positioning the focal spot from which the x ray beam emanates The focal spot is always situated along the central ray of the viewing direction upon the patient Therefore the patient must be turned to a position where you look upon the patient in the same direction as the x ray beam direction used for the reference radiograph Directing the aiming device towards the detector so the collimated x ray beam hits the detector When moving the aiming device focal spot position is fixed Expose your radiograph by pressing the Expose button The exposed radiograph 15 displayed in Image 3 Evaluation The beam direction central ray used for the reference radiograph 15 visualised as a white line The white ball on the line represents the focal spot The blue line represents the central ray in your radiograph and the blue ball the focal spot position Feedback 15 given as visual comparison and as angulation error If the error is too great the user must correct it before the exercise 15 complete The exercise can be performed in fluoroscopic mode or in ordinary mode In fluoroscopic mode a fluoroscopically displayed radiograph 15 presented in Image 2 during the whole exercise The x ray beam direction in fluo
13. this exercise three projection parameters are to be transferred to the virtual environment e Positioning the focal spot from which the x ray beam emanates The focal spot is always situated along the central ray of the viewing direction upon the patient Therefore the patient must be turned to a position where you look upon the patient in the same direction as the x ray beam direction used for the reference radiograph e Positioning the detector Directing the aiming device towards the detector so the collimated x ray beam hits the detector When moving the aiming device focal spot position is fixed Expose your radiograph by pressing the Expose button The exposed radiograph 15 displayed in Image 3 Evaluation The beam direction central ray used for the reference radiograph 15 visualised as a white line The white ball on the line represents the focal spot The blue line represents the central ray in your radiograph and the blue ball the focal spot position Feedback 15 given as visual comparison and as angulation error If the error is too great the user must correct it before the exercise is complete The exercise can be performed in fluoroscopic mode or in ordinary mode In fluoroscopic mode a fluoroscopically displayed radiograph 15 presented in Image 2 during the whole exercise The x ray beam direction in fluoroscopic mode 1s identical to and synchronised with the users viewing direction This function facili
14. QBION ORAL RADIOLOGY PACKAGE Vv a WF ad aen r a A g s j rs ai ki d D A 4 gt User manual PERIAPICAL Contents PHO VICE O W 2 130 1 1 1 5 4 Interaction training Beam 5 Interaction trarne DD CLS 7 Interaction devices a e 9 SKOLTAN e E E 11 12 13 EXPO FOCaLS POl 16 Explore DeleClOn tones che ee 19 Explore Adis GEV 1C Css E 22 EXPOS 25 Expose Bean GAUL 26 29 Expose Beam and detecto nerra tact
15. Repeat the exercises as many times as needed until you can easily control the tools for navigation and interaction The effect of skill training will be jeopardised 1f interaction training is neglected Navigation and interaction User interface components and how to navigate in and interact with the VE are described in a separate manual called Qbion Oral Radiology Package User manual General information Qbion AB 2010 05 Interaction training Beam AutoAim Brief presentation of the exercise AutoAim Central ray is automatically directed towards the middle of the detector The central ray keeps hitting the middle of the detector even when x ray tube head focal spot or detector is moved in any direction The VE presents a scene with a patient model an x ray tube head and a detector in random positions for intraoral imaging The central ray is visualised as a blue line that hits the middle of the detector A white line with a different inclination crosses the blue line on the detector surface The tube head can be moved up down and sideways with the conventional mouse The central ray is fixed to the centre of the detector independent of the tube head movement AutoAim The scene 15 controlled with the interaction tools and the tube head with the conventional mouse right button TASK The task is to move the tube head so the blue and white lines coincide A beep indicates when the task is completed The
16. The simulator exposes two identical radiographs One radiograph is fluoroscopically displayed The fluoroscopically displayed radiograph is synchronised with tube head movements By moving the tube head you can follow how radiographic depiction is influenced by changes in focus position Select Skill training and then Explore in the program menu Interaction training Skill training Exar Explore Expose Error analysis Select area Right Left Upper gt Molar Premolar Canine Incisors gt Canine gt Premolar Molar ower Molar O Premolar Canine Incisors O Canine Premolar Molar Select exercise Beam Detector AutoAim Aiming device Focal spot Quit Help Start page 2 Select area to be examined Right Left Upper O Molar OPremolar O Canine O incisor O Canine O Premolar O Molar Lower O Molar OPremolar O Canine O Incisor O Canine O Premolar O Molar Qbion AB 2010 05 16 3 Select qbion VIRTUAL RADIOLOGY weww gbion com Select area Right e Focal spot Upper gt Molar Premolar Canine Incisors Canine Premolar Molar ower Molar Premolar Canine iIncisors Canine Premolar Molar Select exercise H Detector H E L L ocal spo Aiming device g L L P P STARTING POSITION e radiographs reflect t
17. adiographic depiction between the reference radiograph and the one you exposed Unexposed areas cone cuts are represented as blue fields on the radiograph Any differences in projection parameters between your radiograph and the reference radiograph are presented under the evaluation heading If an error is too great the parameter must be adjusted before the task is completed Hint 1 Adjusting beam direction focal spot position Grasp the back of the tube head housing and move it until the tube head focal spot blue ball coincides with the focal spot position for the reference radiograph white ball Hint 2 Beam direction Angle error is calculated as the angle between the central ray when the reference radiograph was exposed represented by the white line and a line between the blue focal spot and the middle of the detector Hint 3 Adjusting aiming device Grasp the aiming device and redirect it until tube head central ray blue line coincides with the central ray for the reference radiograph projection white line Qbion AB 2010 05 32 Expose Beam and detector Brief presentation of the exercise A correctly projected reference periapical radiograph 15 presented The radiograph 15 exposed over a randomly chosen area The task is to expose a new periapical radiograph identical to the reference radiograph The user therefore has to deduce the projection parameters detector position and x ray beam direction for the
18. al spot Aiming device and Detector In order to refine the exercises each one is designed to deal only with changes in a single projection parameter Before exploring an exercise the area to be examined must be selected All exercises start by displaying the scene with the patient model a tube head and a detector positioned for a periapical radiograph of the selected area In addition two identical radiographs rendered from the individual positions of the detector and tube head relative to the patient are displayed One radiograph is fluoroscopically displayed When projection changes are made the fluoroscopic image is continuously updated One can therefore follow how changes in a projection parameter influences the radiographic depiction in real time Push the LookThrough button to enter LookThrough mode LookThrough In this mode the user looks at the patient from the focal spot through the aiming device The tube head housing is in the same position as it was before entering LookThrough mode This implies that viewing direction is identical with x ray beam direction The teeth are displayed as a transparent mesh giving an illusion of the radiographic depiction which can be compared with the fluoroscopically displayed radiograph Return to ordinary viewing mode by pushing the Exit LookThrough button The x ray beam direction is the same as it was before exiting LookThrough mode Qbion AB 2010 05 12 Exp
19. areas cone cuts are represented as blue fields on the radiograph Any differences in projection parameters between your radiograph and the reference radiograph are presented under the evaluation heading If an error is too great the parameter must be adjusted before the task is completed Hint 1 Adjusting beam direction focal spot position Grasp the back of the tube head housing and move it until the tube head focal spot blue ball coincides with the focal spot position for the reference radiograph white ball Hint 2 Beam direction Angle error is calculated as the angle between the central ray when the reference radiograph was exposed represented by the white line and a line between the blue focal spot and the middle of the detector Hint 3 Adjusting aiming device Grasp the aiming device and redirect it until tube head central ray blue line coincides with the central ray for the reference radiograph projection white line Qbion AB 2010 05 44 Error analysis Beam and detector Brief presentation of the exercise An improperly projected reference radiograph is presented The radiograph is exposed over a randomly chosen area The task is to expose a new radiograph identical to the reference radiograph The user therefore has to deduce the projection parameters detector position and x ray beam direction for the reference radiograph based on an analysis of how the teeth are depicted in the reference image In
20. correctly projected periapical radiograph is presented in Image 1 gray frame Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window New attempt F Back to menu F9 5 Task Qbion AB 2010 05 34 Try to duplicate the reference radiograph in Image 1 Both detector position and x ray beam direction must be adjusted for proper imaging Start the exercise by adjusting the x ray beam direction The x ray beam direction for the radiograph to be exposed is identical to the direction in which the patient is viewed Turn the scene to a position where you can look at the patient in the same direction the x ray beam direction was pointed when the reference radiograph was exposed Then move the detector to the position you think it had when the reference radiograph was exposed Adjustment of beam direction and detector position can be made at any time before the radiograph is exposed By pressing the Proceed button the x ray tube head becomes visible The focal spot is positioned along the viewing direction in the previous step Hint 1 When exposing the radiograph the x ray beam direction is identical to the viewing direction Hint 2 Use the tools for scene movement to change the viewing direction Hint 3 The detector is moved horizontally with right or middle mouse button and tilted with left
21. d when LookThrough mode was entered Change viewing direction with the navigation tools Image 2 white frame is continuously updated and synchronised with viewing position focal spot Follow the changes in radiographic depiction Hint Change viewing position with the tools you normally use for scene movement 7 Return to ordinary viewing mode STARTING POSITION The radiographs reflect the individual position of the tube head and the detector Image 1 is static Image 2 is fluoroscopically displayed TASK Change beam direction by moving the Exit LoakThrouah fe Back to menu F9 Push the Exit LookThrough button to return to ordinary viewing mode The exercise continues in the same mode as it started X ray beam direction is the same as it was before exiting LookThrough mode Qbion AB 2010 05 15 Explore Focal spot Purpose To demonstrate how the radiographic depiction 15 influenced by changes in focus position tube head position without change in beam direction Brief presentation of the exercise The tube head can be moved up down and sideways Tube head movement and radiographic depiction is synchronised The influence of changes in focus position without simultaneous alignment of the aiming device towards the detector on radiographic depiction can therefore be followed in real time In LookThrough mode using the navigation tools changes the viewing direction The exercise step by step
22. e represents the focal spot The blue line represents the central ray in your radiograph and the blue ball the focal spot position Feedback 15 given as visual comparison and as angulation error If the error is too great the user must correct it before the exercise 15 complete The exercise can be performed in fluoroscopic mode or in ordinary mode In fluoroscopic mode a fluoroscopically displayed radiograph 15 presented in Image 2 during the whole exercise The x ray beam direction in fluoroscopic mode 1s identical to and synchronised with the users viewing direction This function facilitates finding the correct projection In ordinary mode no fluoroscopically displayed radiograph 15 available The exercise step by step Purpose To acquire skill in analysing incorrect projected periapical radiographs The task is to duplicate an improperly projected periapical radiograph The exercise can be performed in either fluoroscopic mode or in ordinary mode as described above The following information describes the exercises in ordinary mode In fluoroscopic mode an additional fluoroscopically displayed radiograph is presented in Image 2 Qbion AB 2010 05 38 1 Select Skill training in the program menu qbion bion com 2 Select Error analysis Il training Exar Error analysis Select exercise Error analysis p Beam 3 Select Beam AutoAim ut L r Beam H u d
23. ed in fluoroscopic mode or in ordinary mode In fluoroscopic mode a fluoroscopically displayed radiograph is presented in Image 2 during the whole exercise The x ray beam direction in fluoroscopic mode 15 identical to and synchronised with the users viewing direction This function facilitates finding the correct projection In ordinary mode no fluoroscopically displayed radiograph 1s available The exercise step by step Purpose To acquire skill in analysing incorrect projected periapical radiographs The task is to duplicate an improperly projected periapical radiograph The exercise can be performed in either fluoroscopic mode or in ordinary mode as described above The following information describes the exercises in ordinary mode In fluoroscopic mode an additional fluoroscopically displayed radiograph is presented in Image 2 Qbion AB 2010 05 41 1 Select Skill training in the program menu FP Bitewing VIRTUAL RADIOLOGY www gbion com 2 Select Error analysis Select exercise Error analysis eam H Beam H 3 Select Beam AutoAim i AutoAim IP eam Go fal Sa eam an detector STARTING POSITION The radiograph in Image 1 is a reference image z po you look at eth in the correct bearn direction for your duplicate radiograph already correctly Hint New attempt F7 Back to menu F9 4 Starting position A patient
24. ene movement to change viewing direction Hint New attempt Backto menu F9 The aiming device is randomly directed The aiming device must now be directed towards the detector for exposure of a radiograph without any cone cut Focal spot remains in its original position when aiming device direction is adjusted Hint 1 Grasp the aiming device and direct it against the detector Hint 2 Tube head housing rotates around the focal spot which has a fixed position Hint 3 Look along the aiming device towards the detector to find the appropriate direction Hint 4 Try viewing the scene from different angles and distances The Back button returns to starting view X ray beam direction can be readjusted Expose your radiograph by pressing the Expose button The exposed radiograph is presented as Image 3 blue frame The central ray and focal spot for the reference radiograph are displayed as a white line and a white ball respectively The central ray and focal spot for the radiograph you exposed blue line and blue ball are visualised inside the tube head housing Qbion AB 2010 05 43 EVALUATION ire Beam direction Angle error 9 10 degrees Adjust Aiming device Adjust Hint New attempt F7 Back to menu F9 6 Evaluation Observe the differences in radiographic depiction between the reference radiograph and the one you exposed Unexposed
25. es around the focal spot which has a fixed position Hint 3 Look along the aiming device towards the detector to find the appropriate direction Hint 4 Try viewing the scene from different directions and distances Qbion AB 2010 05 9 The exercise step by step Periapical 1 Select Interaction training in the program ei qbion 2 Select Aiming device Interaction training Skill training Exam Select exercise 3 Use the navigation tools to change the view of poum the scene if needed 4 Use the conventional mouse right button to Detector direct the aiming device over the detector 5 The aiming device shall be directed so that an Aiming device imaginary x ray beam covers the entire detector area 6 When you have succeeded a beep is heard Help Start page Interaction Aiming device Ioj x Short instructions and feedback are presented in AlN the dialogue window The aim of the exercise is to acquire skill In navigation and interaction with the ittual environment STARTING POSITION The aiming device is randomly directed TASK Direct the aiming device against the detector Hint New attempt F7 Back to menu F8 ii Qbion AB 2010 05 10 Skill training The aim of the skill training module is to MEZA acquire the skills to perform high quality ion periapical radiography examinations and to analyse and interpret p
26. es in projection parameters between your and the reference radiograph are presented under the evaluation heading If an error is too great the parameter must be adjusted before the task is completed Hint 1 Adjusting beam direction focal spot position Grasp the back of the tube head housing and move it until the tube head focal spot blue ball coincides with the focal spot position for the reference radiograph white ball Hint 2 Beam direction Angle error is calculated as the angle between the central ray when the reference radiograph was exposed represented by the white line and a line between the blue focal spot and the middle of the detector Hint 3 Adjusting aiming device Grasp the aiming device and redirect it until tube head central ray blue line coincides with the central ray for the reference radiograph projection white line Hint 4 Adjusting detector position Move the detector to a position inside the white frame Qbion AB 2010 05 36 Error analysis General information The aim is to acquire skill in analysing incorrect projected periapical radiographs The philosophy behind this section 15 that skill in analysing projection errors implies good knowledge in radiographic projection principles Therefore training in error analysis will improve knowledge and skill in radiography The task is to duplicate erroneously projected periapical radiographs For that purpose three exercises with rising difficul
27. ght or middle mouse button and tilted with left mouse button The aiming device is randomly directed and must now be directed towards the detector for exposure of a radiograph without any cone cut Focal spot remains in its original position when aiming device direction is adjusted Hint 1 Grasp the aiming device and direct it against the detector Hint 2 Tube head housing rotates around the focal spot which has a fixed position Hint 3 Look along the aiming device towards the detector to find the appropriate direction Hint 4 Try viewing the scene from different angles and distances The Back button returns to the starting view Detector position and x ray beam direction can be readjusted Qbion AB 2010 05 47 Expose your radiograph by pressing the Expose button The exposed radiograph is presented as Image 3 blue frame The central ray and focal spot for the reference radiograph are displayed as a white line and a white ball respectively The central ray and focal spot for the radiograph you exposed blue line and blue ball are visualised inside the tube head housing Detector position for the reference radiograph is displayed as a white frame 6 Evaluation Observe the differences in radiographic depiction between the reference radiograph and the one you exposed Unexposed areas cone cuts are represented as blue fields on the radiograph Any difference
28. he individual position of the tube head and the detector Image 1 is static Image 2 is fluoroscopically displayed Change tube head position in a direction Image 2 is continuously updated Blue areas represent unexposed parts 4 Starting position The exercise starts with the tube head aligned for an orthoradial projection of the selected area Two identical radiographs are presented Image 1 gray frame is the resulting orthoradial radiograph and Image 2 white frame is fluoroscopically displayed Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window Explore Focal spot AIM To demonstrate how the radiographic depiction is influenced by tube head STARTING POSITION The radiographs reflect the individual position of the tube head and the detector Image 1 is static Image 2 is fluoroscopically displayed ASK Change tube head position in any Image 2 is continuous direction ge ly Er LookThrough F7 LOOKTHROUGH The patient is viewer d upon from the focal spot through the aiming device View the patient from any direction by using navigation tools int oer el Back to menu F9 menu F3 Qbion AB 2010 05 17 5 Task Investigate how radiographic depiction is influenced by changes in focus position tube head position Change focus position by moving the tube head
29. he task is to expose a new periapical radiograph identical to the reference radiograph The user therefore has to deduce the projection parameters for the reference radiograph based on an analysis of how the teeth are depicted in the reference image Detector position for the reference radiograph 1s displayed in the scene In this exercise the x ray beam direction 1s transferred to the virtual environment in a two step procedure e Positioning the focal spot from which the x ray beam emanates The focal spot is always situated along the central ray of the viewing direction upon the patient Therefore the patient must be turned to a position where you look upon the patient in the same direction as the x ray beam direction used for the reference radiograph Directing the aiming device towards the detector so the collimated x ray beam hits the detector When moving the aiming device focal spot position is fixed Expose your radiograph by pressing the Expose button The exposed radiograph 15 displayed in Image 3 Evaluation Beam direction central ray used for the reference radiograph is visualised as a white line The white ball on the line represents the focal spot The blue line represents the central ray in your radiograph and the blue ball the focal spot position Feedback is given as visual comparison and as angulation error If an error is too great the user must correct it before the exercise is complete The exerci
30. in radiographic depiction based on adjustments influencing the radiographic image All exercises start by displaying a patient and an intraorally positioned detector In addition a correctly projected periapical radiograph exposed over a randomly chosen area 15 presented as a reference The task for the user 15 to duplicate the reference radiograph by positioning the object or objects for example tube head aiming device and detector influencing the radiographic projection to achieve the same result The position of the focal spot from which the x ray beam emanates for the radiograph which shall be exposed 15 always situated along the central ray of the user s viewing direction upon the patient When preparing an exposure of a radiograph the user therefore has to adjust the viewing direction to find the proper position of the focal spot Changing viewing direction causes a synchronised change in focal spot position In fluoroscopic mode the user gets immediate feedback of projection changes in a separate window In ordinary mode no fluoroscopic guidance is available Exposing radiographs in ordinary mode resembles the clinical conditions at a radiographic exam Task performance is easier in fluoroscopic mode The exercises have defined goals If the image exposed by the user departs too much from the ideal projection parameters it has to be corrected Qbion AB 2010 05 25 Expose Beam AutoAim Brief presentation of the exercise
31. indvidual n of the tube e a e Image 1 is ic Image 2 is fluoroscopically displayed TASK Chal ane je beam aaor anari ne tube head in pan al n Image continuously upi LookThrough F7 Hint LOOKTHROUGH The patientis Viewed upon fri Sa ema Qbion AB 2010 05 14 5 Task Investigate how radiographic depiction is influenced by changes in beam direction Change beam direction by moving the tube head Image 2 white frame is continuously updated and synchronised with tube head movement Follow the changes in radiographic depiction Hint 1 Grasp the back of the tube head housing and move it in any direction Image 2 is continuously updated Hint 2 The task is easier to complete by zooming out with the navigation tools so the complete tube head is visible Explor m AutoAim Seles Image 1 depiction AIM To demonstrate how the radiographic is influenced by changes in bearn direction position e tube a detector Image 1 is static Image 2 is flucroscopically displayed LOOKTHROUGH The patient is viewed upon from the focal spot through the aiming device the patient from any direction by n tools View using navigation okThroug Exit Back to menu F9 6 LookThrough In this mode the patient is viewed from the focal spot The field of view is restricted by the aiming device Viewing direction is identical with the x ray beam direction use
32. io ars ph in Image to ye T delet Aare posi Proceed 7 Hint 2 Dire aimi New attempt F7 Back to menu F9 4 Starting position A patient and a detector are presented in the scene The detector is correctly positioned for the reference radiograph The reference radiograph which is a correctly projected periapical radiograph is presented in Image 1 gray frame Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window ose AIM The aim of the exercise is to acquire skill in exposing correctly projected periapical radiographs POSITION aph in Image 1 is a refer ee Ty oau idiograph a for your di al the tr dpa ee posi Proceed F7 2 DI g device aga the New attempt F7 Back to menu F9 Qbion AB 2010 05 30 5 Task Try to duplicate the reference radiograph in Image 1 Start the exercise by adjusting the x ray beam direction X ray beam direction for a radiograph to be exposed is identical with the direction the patient is viewed Turn the scene so you can look at the patient in the same direction the x ray beam had when the reference radiograph was exposed By pressing the Proceed button the x ray tube head becomes visible The focal spot is positioned along the viewing direction in the previous step
33. irection Expose your radiograph by pressing the Expose button The exposed radiograph is presented as Image 3 blue frame The central ray and focal spot for the reference radiograph are displayed as a white line and a white ball respectively The central ray and focal spot for the radiograph you exposed blue line and blue ball are visualised inside the tube head housing 6 Evaluation Observe the differences in radiographic depiction between the reference radiograph and the one you exposed Any difference in beam direction between your and the reference radiograph is presented under the evaluation heading If the error is too great beam direction has to be adjusted before the task is complete Hint 1 Grasp and move the back of the tube head housing The central ray is always directed towards the middle of the detector when tube head is moved AutoAim Hint 2 The task is easier to complete by zooming out with the navigation tools so the complete tube head is visible Hint 3 Beam direction Angle error is calculated as the angle between the central ray when the reference radiograph was exposed represented by the white line and a line between the blue focal spot and the middle of the detector Qbion AB 2010 05 40 Error analysis Beam Brief presentation of the exercise An improperly projected reference radiograph is presented The radiograph is exposed over a randomly chosen area The task
34. is static Image 2 is fluoroscopically displayed But LookThrough on Back to menu F9 Push the Exit LookThrough button to return to ordinary viewing mode The exercise continues in the same mode as it started Detector position is the same as it was before exiting LookThrough mode Qbion AB 2010 05 21 Explore Aiming device Brief presentation of the exercise The aiming device can be pointed in any direction Focal spot position is fixed during aiming device movement Aiming device movement and radiographic depiction 15 synchronised The influence of changes in beam direction on radiographic depiction can therefore be followed in real time Unexposed detector areas are displayed in blue colour in the rendered radiograph In LookThrough mode the viewing direction 15 changed by using the navigation tools The exercise step by step Purpose To demonstrate how the radiographic depiction is influenced by changes in beam direction without any changes in focal spot position The simulator exposes two identical radiographs One radiograph is fluoroscopically displayed The fluoroscopically displayed radiograph is synchronised with tube head movements By moving the tube head you can follow how radiographic depiction is influenced by changes in beam direction l Select Skill training and then 15 x Explore in the program menu qbion Interaction training Skill training Exar Explore Expose Err
35. l spot Aiming device Quit Help Start page 2 Select area to be examined Right Left Upper O Molar OPremolar O Canine O incisor O Canine OPremolar O Molar Lower O Molar O Premolar O Canine O Incisor O Canine O Premolar O Molar Qbion AB 2010 05 13 qbion VIRTUAL Select area Right e Upper Molar Premolar Canine C Incisors Canine Premolar Molar Beam ower gt Molar Premolar Canine OIncisors Canine Premolar Molar 3 Select AutoAim Select exercise Beam AutoAim iJ DQ D O yy Lo es ae res a ae in pl ee monstrate ae radio mei te ea ton ne enced by chang STARTING POSITION chen aroe Ae sue E ig the any direction Image 2 is arate LookThrough F7 Hint OKROG H L i PLOR 040 Back to menu F9 4 Starting position The exercise starts with the tube head aligned for an orthoradial projection of the selected area Two identical radiographs are presented Image 1 gray frame is the resulting orthoradial radiograph and Image 2 white frame is fluoroscopically displayed Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window onstrate how the radiographic influen e in beam direction STARTING POSITION The radiographs reflect the
36. lore Beam AutoAim Purpose To demonstrate how the radiographic depiction is influenced by changes in x ray beam direction Brief presentation of the exercise The tube head can be moved up down and sideways Tube head movement and radiographic depiction is synchronised The influence of changes in beam direction on radiographic depiction can therefore be followed in real time In LookThrough mode using the navigation tools changes the viewing direction AutoAim Central ray is automatically directed towards the middle of the detector The central ray keeps hitting the middle of the detector even when x ray tube head focal spot or detector 1s moved in any direction The exercise step by step The simulator exposes two identical radiographs One radiograph is fluoroscopically displayed and is synchronised with tube head movements By moving the tube head you can follow how radiographic depiction is influenced by changes in beam direction 1 Select Skill training and then Explore in the program menu 2151 x 9 b Ol VIRTUAL RADIOLOGY www gbion com Interaction training Skill training Exarr Pm gr Explore Expose Error analysis Select area _ Right Left Upper gt Molar Premolar gt Canine incisors 8 gt Premolar gt Molar Lower gt Molar Premolar gt Canine gt Incisors Canine _ Premolar Molar Select exercise Beam L Detector AutoAim Foca
37. mouse button New attempt F7 Back to menu F9 The aiming device is randomly directed and must now be directed towards the detector for exposure of a radiograph without any cone cut Focal spot remains in its original position when aiming device direction is adjusted Hint 1 Grasp the aiming device and direct it against the detector Hint 2 Tube head housing rotates around the focal spot which has a fixed position Hint 3 Look along the aiming device towards the detector to find the appropriate direction Hint 4 Try viewing the scene from different angles and distances The Back button returns to the starting view Detector position and x ray beam direction can be readjusted Qbion AB 2010 05 35 Expose your radiograph by pressing the Expose button The exposed radiograph is presented as Image 3 blue frame The central ray and focal spot for the reference radiograph are displayed as a white line and a white ball respectively The central ray and focal spot for the radiograph you exposed blue line and blue ball are visualised inside the tube head housing Detector position for the reference radiograph is displayed as a white frame 6 Evaluation Observe the differences in radiographic depiction between the reference radiograph and the one you exposed Unexposed areas cone cuts are represented as blue fields on the radiograph Any differenc
38. n fluoroscopic mode a fluoroscopically displayed radiograph is presented in Image 2 during the whole exercise The x ray beam direction in fluoroscopic mode 1s identical to and synchronised with the users viewing direction This function facilitates finding the correct projection In ordinary mode no fluoroscopically displayed radiograph 15 available The exercise step by step Purpose To acquire skill in exposing correctly projected periapical radiographs The task is to create a correctly projected radiograph identical to a reference image The exercise can be performed in either fluoroscopic mode or in ordinary mode as described above The following information describes the exercise in ordinary mode In fluoroscopic mode an additional fluoroscopically displayed radiograph is presented in Image 2 Qbion AB 2010 05 26 1 Select Skill training in the program menu qbion 2 Select Expose Select area Right Lett Upper Molar Premolar Canine Canine Premolar Molar ower gt Molar Premolar Canine Incisors Canine Premolar Molar Select Beam AutoAim elect exercise Expose Beam i F Beam l i AutoAim IP 5 AutoAim I P U P ZE r d Beam IF i Beam H al n i pje p Beam and Ik Y Beam and H detector i y detector i P P Start page AIM The aim of the exercise is to acquire skill in exp
39. n as before exiting LookThrough mode Qbion AB 2010 05 18 Explore Detector Purpose To demonstrate how the radiographic depiction is influenced by changes in detector position Brief presentation of the exercise The detector can be moved horizontally and be tilted Tube head position is fixed Horizontal movement of the detector causes changes in focus detector distance Detector is tilted along a horizontal line 1 the detector plane Detector movement and radiographic depiction is synchronised The influence of changes in detector position on radiographic depiction can therefore be followed in real time Unexposed detector areas are displayed in blue colour in rendered radiographs The exercise step by step The simulator exposes two identical radiographs One radiograph is fluoroscopically displayed and is synchronised with tube head movements By moving the detector you can follow how radiographic depiction is influenced by changes in detector position Preis abion VIRTUAL RADIOLOGY www gbion com Select Skill training and then Explore in the program menu Interaction training Skill training Exam Explore Expose Error analysis Select area Right Left Canine Premolar gt Molar Upper Molar Canine Incisors Canine Premolar gt Molar ower Molar _ Premolar Canine Incisors Select exercise
40. or analysis Select area Right Left Upper gt Molar Premolar Canine Incisors Canine gt Premolar Molar Lower Molar _ Premolar Canine Incisors Canine gt Premolar gt Molar Select exercise Beam Detector AutoAim L a F F Focal spot Aiming device i L Quit Help Start page 2 Select area to be examined Right Left Upper O Molar OPremolar O Canine O incisor O Canine OPremolar O Molar Lower O Molar OPremolar O Canine O Incisor O Canine O Premolar O Molar Qbion AB 2010 05 22 SS qbion bee Select area Right Upper gt Molar Premolar Canine C Incisors Canine Premolar Molar Aiming 3 Select device ower gt Molar Premolar Canine Incisors Canine Premolar Molar Select exercise B Detector AutoAim Aiming device i L STARTING POSITION The sition of the tube head and the ae tector Image ote at age 2 is juorosco pically displayed ction by moving th e in any direction Image Bai a Bue e areas d parts Back to menu F9 4 Starting position The exercise starts with the tube head aligned for an orthoradial projection of the selected area Two identical radiographs are presented Image 1 gray frame is the resulting orthoradial radiograph and Image 2 white frame is fluoroscopicall
41. osing correctly projected periapical radiographs STARTING POSITION The radiograph in Image 1 is a reference image 4 Starting position A patient and a detector are presented at the scene The reference radiograph which is a correctly projected periapical radiograph is presented in Image 1 gray frame Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window AIM The aim of the exercise is to acquire skill il i ical in exposing correctly projected periapical radiographs STARTING POSITION The radiograph in Image 1 is a reference image ent to teeth in the correct beam rection for your duplicate radiograph The detector is already correctly positioned New attempt F7 Back to menu F9 5 Task Try to duplicate the reference radiograph in Image 1 Qbion AB 2010 05 27 Start the exercise by adjusting the x ray beam direction X ray beam direction for a radiograph to be exposed is identical with the direction the patient is viewed Turn the scene to look at the patient in the same direction the x ray beam direction pointed when the reference radiograph was exposed The detector is correctly positioned and cannot be moved Hint 1 The x ray beam direction is identical to the viewing direction Hint 2 Use the tools for scene movement to change vie
42. r horizontal and vertical angulation of the tube head and the detector position Viewing the patient in the planned x ray beam direction and then pointing the aiming device in the same direction will align the x ray correctly Skill training exercises where the tube head is to be positioned Expose and Error analysis start with displaying only the patient and the detector Tube head is not visualised Instead the user should turn the patient to a position where he she looks at the patient in the planned x ray beam direction After proceeding the tube head is visualised and the task continues Qbion AB 2010 05 3 Interaction training The aim with the interaction training module is to acquire skills with which to navigate in and interact with the virtual environment VE where the radiology skill training is performed The module is comprised of three separate exercises which are designed for the acquisition of interaction skills necessary for successful performance of the exercises in the skill training module The exercises are Beam AutoAim Detector and Aiming device It is highly recommended that the exercises in the interaction training module are done before entering the skill training module Periapical qbion VIRTUAL RADIOLOGY www gbion com Interaction training Skill training Exam Select exercise Beam H AutoAim Detector Aiming device C Start page
43. rief instructions are presented in the instruction and feedback window ioj xj how the radiographic luenced by changes in POSITION The radiographs reflect the individual position of the tube head and the detector Image 1 is static Image 2 is fiuoroscopically displayed ewed froi ol ing device Change GI The patient is vi rough the aimi etector position in any direction Exit LookThrough eo Qbion AB 2010 05 20 5 Task Investigate how radiographic depiction is influenced by changes in detector position Detector position is changed by interaction with the conventional mouse Image 2 white frame is continuously updated and synchronised with tube head movement Follow the changes in radiographic depiction Hint The detector is moved horizontally with right or middle mouse button and tilted with left mouse button 6 LookThrough In this mode the patient is viewed from the focal spot The field of view is restricted by the aiming device Detector position is the same as it was before entering LookThrough mode Move the detector with the mouse Image 2 white frame is continuously updated and synchronised with detector movement Follow the changes in radiographic depiction Hint The detector is moved horizontally with right or middle mouse button and tilted with left mouse button 7 Return to ordinary viewing mode strate how the radiographic luenced by changes in detector Image 1
44. rojection errors The skill training is organised under the interaction rainina skit training EE following three headings a Right 9 Explore Upper Molar Premolar Canine Incisors Canine Premolar Molar Lower Molar Premolar Canine Incisors Canine Premolar Molar e Expose Select exercise e Error analysis isan masg 99 AutoAim L The Explore exercises demonstrate how radiographic depiction is changed when single projection parameters are altered The exercises under the headings Expose and Error analysis present tasks with clearly defined goals The user s performance is evaluated and the simulator presents immediate feedback Focal spot Aiming device H E L Thorough investigation of the content in each exercise 15 recommended There are no restrictions concerning training order AutoAim This function directs the central ray automatically towards the middle of the detector The central ray keeps hitting the middle of the detector even when x ray tube head focal spot or detector 15 moved in any direction Qbion AB 2010 05 11 Explore General information The exercises under this heading aim to demonstrate how changes in projection parameters such as x ray beam direction and detector positioning influence radiographic depiction There are four exercises called Beam AutoAim Foc
45. roscopic mode 1s identical to and synchronised with the users viewing direction This function facilitates finding the correct projection In ordinary mode no fluoroscopically displayed radiograph 15 available The exercise step by step Purpose To acquire skill in exposing correctly projected periapical radiographs The task is to create a correctly projected periapical radiograph identical to a reference image The exercise can be performed in either fluoroscopic mode or in ordinary mode as described above The following information describes the exercise in ordinary mode In fluoroscopic mode an additional fluoroscopically displayed radiograph is presented in Image 2 Qbion AB 2010 05 33 1 Select Skill training in the program menu qbion VIRTUAL RADIOLOGY veww qgbion com 2 Select Expose Select area Right Upper gt Molar Premolar Canine Incisors Canine Premolar Molar ower gt Molar Premolar Canine Incisors Canine Premolar Molar 3 Select Beam and detector Select exercise Expose eam AutoAim eam AutoAim Beam urm Sr ms eam an detector eam an detector or mI Hint New attempt F7 Back to menu F9 4 Starting position A patient and a detector are presented in the scene The detector is randomly positioned The reference radiograph which is a
46. s in projection parameters between your and the reference radiograph are presented under the evaluation heading If an error is too great the parameter must be adjusted before the task is completed Hint 1 Adjusting beam direction focal spot position Grasp the back of the tube head housing and move it until the tube head focal spot blue ball coincides with the focal spot position for the reference radiograph white ball Hint 2 Beam direction Angle error is calculated as the angle between the central ray when the reference radiograph was exposed represented by the white line and a line between the blue focal spot and the middle of the detector Hint 3 Adjusting aiming device Grasp the aiming device and redirect it until tube head central ray blue line coincides with the central ray for the reference radiograph projection white line Hint 4 Adjusting detector position Move the detector to a position inside the white frame Qbion AB 2010 05 48
47. se can be performed in fluoroscopic mode or in ordinary mode In fluoroscopic mode a fluoroscopically displayed radiograph 15 presented in Image 2 during the whole exercise The x ray beam direction in fluoroscopic mode 1s identical to and synchronised with the users viewing direction This function facilitates finding the correct projection In ordinary mode no fluoroscopically displayed radiograph 1s available The exercise step by step Purpose To acquire skill in exposing correctly projected periapical radiographs The task is to create a correctly projected periapical radiograph identical to a reference image The exercise can be performed in either fluoroscopic mode or in ordinary mode as described above The following information describes the exercise in ordinary mode In fluoroscopic mode an additional fluoroscopically displayed radiograph is presented in Image 2 Qbion AB 2010 05 29 1 Select Skill training in the program menu 2151 x qbion ane On 2 Select Expose Right Upper gt Molar gt Premolar Canine C Incisors Canine Premolar Molar 3 Select Beam ower Molar Premolar Canine Incisors Canine Premolar Molar Select exercise Expose xpose Beam the is to acquire skill correctly projected periapical lographs STARTING POSITION The radiograph in Image 1 is a reference image ay bal plicate the reference rad
48. tates finding the correct projection In ordinary mode no fluoroscopically displayed radiograph 15 available The exercise step by step Purpose To acquire skill in analysing incorrect projected periapical radiographs The task is to duplicate an improperly projected periapical radiograph The exercise can be performed in either fluoroscopic mode or in ordinary mode as described above The following information describes the exercises in ordinary mode In fluoroscopic mode an additional fluoroscopically displayed radiograph is presented in Image 2 Qbion AB 2010 05 45 1 Select Skill training in the program menu 2 Select Error analysis 3 Select Beam and detector i n a 2 Beam and H Beam and detector detector P ON The radiograph in Image 1 is a image The detector is loc na random position radi e New attempt F7 Back to menu F9 4 Starting position A patient and a detector are presented in the scene The detector is randomly positioned The reference radiograph which is an incorrectly projected periapical radiograph is presented in Image 1 gray frame Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window AIM The aim of the exercise is to acquire skill in analysing projection errors in periapical radiographs
49. time for completion of the task is presented in the dialogue window Hint 1 Grasp the back of the tube head housing and move it The central ray is always directed against the middle of the detector Hint 2 The task is easier to complete by zooming out with the navigation tools so the complete tube head is visible Qbion AB 2010 05 5 The exercise step by step 1 Select Interaction training in the program menu 2 Select Beam AutoAim 3 Use the navigation tools to change the view of the scene so that you can see the relation between the blue central ray from the x ray tube head and the white line from different directions 4 Use the conventional mouse right button to position the x ray tube head so the blue central ray coincide with the corresponding white line 5 A beep indicates a successful attempt Short instructions and feedback are presented in the dialogue window Qbion AB 2010 05 6 Periapical Interaction training Skill training Exam Select exercise Beam AutoAim Detector Aiming device Start page Interaction Beam AutoAini x AIM The aim of the exercise is to acquire skill in navigation and interaction with the Virtual environment STARTING POSITION A white line is randomly directed against the detector A corresponding blue line Inside the tube head housing representing the central ray
50. ty are available The exercises are Beam AutoAim Beam and Beam and detector Each exercise can be performed either in Ordinary mode or in Fluoroscopic mode Ordinary mode resembles the way radiographic exams are performed in real situations In fluoroscopic mode the task 15 made easier as the user can continuously follow changes in radiographic depiction based on adjustments influencing the radiographic image All exercises start by displaying a patient and an intraorally positioned detector In addition a reference image 15 presented which is an erroneously projected periapical radiograph exposed over a randomly chosen area The task for the user 15 to duplicate the reference radiograph by positioning the object or objects tube head aiming device and detector influencing the radiographic projection to achieve the same result The position of the focal spot from which the x ray beam emanates for the radiograph which shall be exposed is always situated along the central ray of the user s viewing direction upon the patient When preparing an exposure of a radiograph the user therefore has to adjust the viewing direction to find the proper position of the focal spot Changing viewing direction causes a synchronised change in focal spot position In fluoroscopic mode the user gets immediate feedback of projection changes in a separate window In ordinary mode no fluoroscopic guidance is available Exposing radiographs in ordinar
51. wing direction Expose your radiograph by pressing the Expose button The exposed radiograph is presented as Image 3 blue frame The central ray and focal spot for the reference radiograph are displayed as a white line and a white ball respectively The central ray and focal spot for the radiograph you exposed blue line and blue ball are visualised inside the tube head housing 6 Evaluation Observe the differences in radiographic depiction between the reference radiograph and the one you exposed Any difference in beam direction between your and the reference radiograph is presented under the evaluation heading If the error is too great beam direction has to be adjusted before the task is complete Hint 1 Grasp and move the back of the tube head housing The central ray is always directed towards the middle of the detector when tube head is moved AutoAim Hint 2 The task is easier to complete by zooming out with the navigation tools so the complete tube head is visible Hint 3 Beam direction Angle error is calculated as the angle between the central ray when the reference radiograph was exposed represented by the white line and a line between the blue focal spot and the middle of the detector Qbion AB 2010 05 28 Expose Beam Brief presentation of the exercise A correctly projected reference periapical radiograph 15 presented The radiograph 1s exposed over a randomly chosen area T
52. with x ray beam direction used when LookThrough mode was entered Change viewing direction by moving the tube head with the navigation tools Image 2 white frame is continuously updated and synchronised with tube head movement Follow the changes in radiographic depiction cone cut as the aiming device moves around Hint Move the aiming device with the tools you normally use for scene movement 7 Return to ordinary viewing mode ite how the radiographic luenced by changes in without any change in m direction by moving the ing device in any direction Image 2 is continuously updated Blue areas represent unexposed parts hrough F7 Hint the focal spot ati LookTI LOOK cal spi Sua Back to menu F9 Push the Exit LookThrough button to return to ordinary viewing mode The x ray beam direction is the same as it was before exiting LookThrough mode Qbion AB 2010 05 24 Expose General information The aim is to acquire skill in exposing correctly projected periapical radiographs For that purpose three exercises with rising difficulty are available The exercises are Beam AutoAim Beam and Beam and detector Each exercise can be performed either in Ordinary mode or in Fluoroscopic mode Ordinary mode resembles the way radiographic exams are performed in real situations In fluoroscopic mode the task 15 made easier as the user can continuously follow changes
53. y displayed Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window positio detector Im tb seic Ta lage 2 215 fluoroscopically displayed ang m direction by moving th aiming device ein ary recton 2 inuol ae eu Back to menu F9 Qbion AB 2010 05 23 5 Task Investigate how radiographic depiction is influenced by changes in beam direction without any changes in focal spot position Change beam direction by moving the aiming device in any desired direction Tube head housing rotates around the focal spot Image 2 white frame is continuously updated and synchronised with tube head movement Follow the changes in radiographic depiction cone cut as the aiming device moves around Hint 1 Grasp the aiming device and move it in any direction Tube head housing rotates around the focal spot Image 2 is continuously updated Hint 2 The task is easier to complete by zooming out with the navigation tools so the complete tube head is visible LOOKTHROUGH The patient is viewed from the focal spot through the aiming device Move the aiming device in any direction Hint rough Back to menu F9 6 LookThrough In this mode the patient is viewed from the focal spot The field of view is restricted by the aiming device Viewing direction is identical
54. y mode resembles the clinical conditions at a radiographic exam Task performance is easier in fluoroscopic mode The exercises have defined goals If the image exposed by the user departs too much from the ideal projection parameters it has to be corrected Qbion AB 2010 05 3 Error analysis Beam AutoAim Brief presentation of the exercise AutoAim Central ray is automatically directed towards the middle of the detector The central ray keeps hitting the middle of the detector even when x ray tube head focal spot or detector is moved in any direction An improperly projected reference radiograph is presented The radiograph is exposed over a randomly chosen area The task is to expose a new radiograph identical to the reference radiograph The user therefore has to deduce the beam direction for the reference radiograph based on an analysis of how the teeth are depicted in the reference image Detector position for the reference radiograph is displayed in the scene AutoAim 15 active The proper x ray beam direction is established by turning the scene to a position where you look upon the patient in the same direction as the x ray beam direction used for exposing the reference radiograph Expose your radiograph by pressing the Expose button The exposed radiograph 1s displayed in Image 3 Evaluation Beam direction central ray used for the reference radiograph is visualised as a white line The white ball on the lin
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