The Metron `Quick Start` Tutorial
Contents
1. Database Name Location H Old H New STEP 3 Convert Database named to modern format HES HO STEP 4 In Metron 6 0 DRA CR and Metron databases may all be combined into one IF pou wish to do this see Import Database under Database in top bar The panel above is what you would see if you are installing Metron Hoof or Metron Hoof Pro or unbundled Metron DVM In the display above there is just one database and the display shows that it has 50 old items and 17 new items The 17 new items are some sample images that came with version 5 or 6 so they are already in the new format The 50 old items are the number of images that were found in the old pre version 5 database format Before proceeding it is highly recommended that you back up your existing old database just in case anything goes wrong with the conversion process or if for any reason you wish to go back to the previous version of Metron The database conversion that occurs will be a conversion in place and will overwrite and update your database and the database will no longer be readable by a version of Metron prior to 5 If you need to Metron DVM User Manual Version 7 EponaTech LLC 2014 back up your old databases before proceeding then note the location of them from this panel and then click Exit Metron Complete this later to exit Metron After backing them up restart Metron to come back to this panel2. Ww AL e Region W View AddNote Databasg Reject this Image Ls Click on the appropriate anatomical zone one of the green dots to indicate to Metron what anatomy is in the image you are importing into Metron Additionally there is a list in which you select the View that best describes the image e g Lateral DP etc You can adjust the size and location of the annotation on the image as well When complete click the button Accept into Metron to finalize bringing the image into Metron If you had selected several images you would now see the next one repeat the procedure of labeling the anatomy and view of each image Metron DVM User Manual Version 7 EponaTech LLC 2014 WARNING It is up to the operator of Metron to properly choose the anatomy and view corresponding to the image that has been acquired Failure to do this labeling properly will result in an image with an inaccurate annotation label Single Image Tools When an image is in Metron and you view it alone on the screen you can perform various operations on the image You get into Single Image View Edit immediately after importing a new image into Metron or by double clicking any image thumbnail from the Database Browser screen The single image operations are entered by clicking on the large buttons just below the Metron DVM label and above the anatomy chart In the example below there are many operations available Anno
3. y d Collections Compare n n J CT_DB i d Cut yy Databases ub Dic_ DB Import Highlighted Auto Import Images All DICOM Images l Search all sub folders Database Browser Double click a Thumbnail for a Single Radio_F jpq Radio_Ljpg TPLO example jpq TTA examplejpg VHS example jpg You can double click one thumbnail to bring it into Metron or you may highlight a group of images and then click the button Import Highlighted Images This brings to a screen in which you see one image at a time in its full size and with the Anatomy Diagram shown on the right hand portion of the screen Metron DVM User Manual Version 7 EponaTech LLC 2014 METRON Owner SampleOwner M Animal SampleHorse Date 22 Jan 2013 J LF J I Fi a an r y Pa i a oy a r ms i Fi ae rr E f a 1 i 1 a Ea 7h i O 2 _ Poa i Ti e R z nt ae a i a aif y Teee Ria m i LL ie nL 4 Ht a T pe a 3 La ii L T D 7 D Ss E ah vz g AEE k J Fie _ Yl ipi n a a a ee Te er I i Fi ry rs F a a E k a r i p p j ye e e LH g RH Oe DVM Image Import selectthe anatomy of the image then use the Accept into Database button below Skeletal C Dental Radiograph Selectie b Deg DP Nav b Deg OPPS Navicular skyline Med Lat Oblique Annotation oa Forit 10 White
4. ME TRONDVIVI User Manual Version 7 11 EponaTech LLC 2014 Use of the Manual The Metron DVM software is designed to meet international quality and performance standards Personnel operating the software must have a thorough understanding of the proper operation of the system This guide has been prepared to aid medical and technical personnel to understand and operate the system Do not operate the system before reading this manual and gaining a clear understanding of the operation of the system If any part of this manual is not clear please contact EponaTech LLC or your equipment dealer s representative for clarification The information contained herein is based on the experience and knowledge relating to the subject matter gained by EponaTech LLC prior to publication No patent license is granted by this information EponaTech LLC reserves the right to change this information without notice and makes no warranty express or implied with respect to this information EponaTech LLC shall not be liable for any loss or damage including consequential or special damages resulting from any use of this information even if loss or damage is caused by EponaTech LLC s negligence or other fault EponaTech LLC P O Box 361 Creston CA 93432 www Metron Imaging com EponaTech Metron is a registered trademark of EponaTech LLC Metron DVM User Manual Version 7 EponaTech LLC 2014 Metron Desktop PC or Laptop System Requirements
5. Minimum Below are the minimum requirements for the Metron software to operate but may not display images at the speed and image quality you might need Operating System Windows XP Pro 32 bit Windows 7 or Windows 8 Make sure the acquisition device supports the specific operating system some of the older devices Older X Ray devices are like printers many older printers will not work on new computers with Windows 7 or Windows 8 Graphics System and Monitor Desktop PC Widescreen 20 monitor with a minimum resolution of 1600 x 1200 or greater 60 Hz image contrast ratio 800 1 the higher the better and response time of 8 ms or better plus an independent graphics card with 512MB is strongly recommended for best image presentation quality Graphics System and Monitor Laptop Laptop should have a 17 inch screen for best display of X Rays Display resolution of 1600x900 or greater with High Definition Anti Glare display strongly recommended RAM Computers running Windows XP Pro will perform best with at least 2GB of RAM Computers running Windows 7 or newer operating system will perform best with at least 4GB of RAM Disk Space To install Metron and have needed space for the images the desktop PC or laptop must have at least 200GB of available disk space Consider 350GB 1ITB disk Also consider the new Solid State Drive SSD for laptops used in mobile laboratory application They are more tolerant of rough use Pro
6. CR plate The best general choice is to locate the plane of interest at a distance above the table corresponding to half of the subject s thickness Metron DVM User Manual Version 7 EponaTech LLC 2014 FFD OFD and Magnification Factor In the Metron software we use the terms Film Focal Distance FFD and Object Film Distance OFD to describe the physical set up and location of the plane of interest The FFD is the distance from the source of X rays to the imaging plate and OFD 1s the distance from the plane of interest to the imaging plate Given these values the magnification factor evident in the radiograph is FFD M FED OFD For example for a subject that is 6 thick so HB in figure 2 is 3 we have the values FFD 37 5 OFD 5 0 Which gives a magnification factor of 1 154 This means everything in the image is 11 54 bigger than true size For all the films you shot on this system if you were to measure with a ruler on the film a 10 distance along the spine would measure 11 54 with your ruler Pragmatism and General Use A great majority of radiographs of interest are not used for measurements in any way so none of these issues of calibration matter at all However in some procedures measurements are important It is also our belief that the small amount of extra effort that must be expended to ensure calibrated images should be expended for all images as a matter of standar
7. Trial Mode until you register your copy of the software In Trial Mode you cannot Import your own images ou can only view some samples that we have provided To register Metron click the Register choice in the top bar If you have already purchased Metron the company you purchased it from can supply you with an Unlock Code which will take you out of Trial Mode and fully enable Metron Metron DVM User Manual Version 7 EponaTech LLC 2014 First Time Install of Version 7 over an Older Version of Metron If you are upgrading from an earlier version of Metron to version 7 you will have to go through a one time database conversion operation This operation will convert your old database s into the modern format for use with Metron version 7 Please see Appendix A for further instructions on this process The Database Browser Metron always starts in the Database Browser This is where you can browse and find all images video clips and reports in your Metron database The basic organization of the database is by Owner then Animal then Date Each Owner may have one or more Animals and each Animal may have been imaged on one or more Dates We sometimes use the term Study for all the images of a given animal on a given date The Database Browser always shows thumbnails small images for all the items in the selected study Metron DVM DATABASE BROWSER Metron DVM 7 11 A Thumbn
8. 6 images side by side as below _ im nn After Trim P3 Descent 0 47 in Coffin Joint Tilt 0 37 deg Palmar Angle 3 01 Weg In multi view below each image you are able to zoom and you can choose to turn off or on any mark up that is drawn over the image Metron DVM User Manual Version 7 EponaTech LLC 2014 Other multi image operations that you can perform are e Delete a group of highlighted images e Export a group of images that is write them out to your disk in whatever image format you choose JPEG Bitmap DICOM etc e Print a group of images you can choose how many per page to print e Stitch 2 or more images into a single image e Send images by posting to www MetronWebViewer com or to 1Pad or iPhone users or send them by DICOM or e mail them see later section in this manual e Burn some images to a DVD or CD e Cut or Copy some images later to be pasted into a different location in the database Just above the buttons that perform operations on multiple images at once are three buttons that can be used to help you highlight or select which images you want to do the operation to You can Select All Select None or Select Next Region The Select Next button will highlight all images from a certain anatomical zone and subsequent clicks to this button will step through the various anatomical zones found in the study Metron DVM User Manual Version 7 EponaT
9. Acquire Acquire Launch eer Linking Images With Applications Return to Database Total 118373216 Skip 1416 Cols 3080 Rows 3080 Rot 0 Swap Bytes Read From C file rawy Metron DVM User Manual Version 7 EponaTech LLC 2014 Importing Images from Files To import images from a digital camera or from any other source you start by clicking on the Image File s or My Computer button in the acquire section of the Database Browser This will bring up a new display of thumbnails but note that these thumbnails to not have the icons in the lower right hand corner beneath them They are not in Metron yet you are simply viewing image files that happen to be on your computer s disk On the right hand side of the screen is a folder Browser which you use to navigate to any folder on your computer indeed to any folder anywhere on your office network as long as remote disks are mounted with drive letters on your PC IM Metron DVM Oo File Preferences Register DataBase Advanced Help Adjust Thumbnail Size 2 Selected gt Root Up Show Image Files Show Video Files p A a i amp Recycle Bin P y Mpa r Asus ibeD ata Boot Dl example jpg Norberg example jpq Photo_F jpq Photo_Ljpq Photo_S jpg X EEEE d DICOM_Originals r Documents and Settings DR_Originals a gt Artwork f ue Asteris
10. At any time in the future if this panel is not presented to you automatically when you enter Metron you can always find it under Database in the top bar If you have purchased Metron in a bundle with a digital imaging system then the database conversion panel has a second portion at the bottom as shown below Conversion of Metron Databases to Version 5 0 Format Default C Giganto Local C PX5 68 Debug Databases HMain Giganto C Giganto PX DataBases Common_PX_Database 5 6 CR_Originals PreS 6 C Giganto CR_OriginalsS 6 DR_Originals PreS 6 C Giganto DR_OriginalsS 6 TestDB C Giganto PX DataBases TestDB 5 86 Add CR or DR DB C Giganto CR OriginalsS 6 C Giganto CR_OriginalsS 6 The lower portion of the panel is for converting the CR_Originals and or the DR_Originals databases which were used in Metron version 4 for digital radiography systems The panel shown above also shows that if as an advanced user you had declared multiple Metron databases then they are all shown in the upper portion of this panel Note that in the case of CR or DR originals Metron can t know if you have other archives from version 4 located elsewhere If you do and you wish to convert them to version 5 6 you need to click on the Add CR or DR DB button in order to tell Metron where these archives are Metron DVM User Manual Version 7 EponaTech LLC 2014 When Metron is converting your old database s to modern format it could ha
11. Downloaded Installer 1f applicable If you do not have a CD but have downloaded a Metron installer file simply double click this file to launch the installer If you were given two installer files one for code and one for data run both of them before attempting to enter Metron For a new install of Metron on a computer that it has never been installed on you are required to run the provided Data Installer If it is an upgrade install for a previously installed copy of Metron there is no need to run the Data Installer WARNING WARNING Failure to run the provided Data Installer during a first time install of Metron will result in an incomplete installation of the software If you are not sure if the Data Installer was previously run always run it again it does no harm to run it additional times 3 Starting the Software After the software has installed you will find new icons on your desktop There are shortcuts to the Metron manuals and the shortcut to start the Metron software Metron Double click the Metron software icon and Metron will start in trial mode Metron DVM User Manual Version 7 EponaTech LLC 2014 4 Unlocking the Software 4 1 Startup Metron In the top bar the menus across the very top of the screen click on the Register option and then choose the Pre Paid choice Pre Paid Registration 4 2 Contact your software dealer or Epon
12. compression and or limited screen resolution and or limited contrast ratio of the display More Information Other specialized documents for various portions of Metron are available for example a manual concerning DICOM functions of Metron Also please visit www metron imaging com and www eponatech com for more information Metron DVM User Manual Version 7 EponaTech LLC 2014 Appendix A Updating an Old Database to Version 7 Format Metron versions 5 amp 6 use an updated format for storage of its database In order to use images and video clips and reports etc that you had entered into an earlier version of Metron you will have to convert the old database to version 5 6 format When you first install Metron version 7 if it detects that an older version had previously run on the same PC it will pop up the Convert Old Databases panel as shown below Ik is recommended that you back up all of your Metron databases before proceeding with the conversion process to Metron version 5 0 To do this make a complete copy of all the folders listed under Location in this panel After you have made backups of your data then proceed as indicated below Database Name Location Old New C Epona Databases Hain STEP 1 Convert Database named Default to modern format Wes NO STEP 2 If you have set up additional locations to store DA Originals or CR Originals click here to add to the list below dd CR or DR DB
13. metal markers which can be automatically detected by Metron in order to set a scale factor for the image In this way measurements made in Metron will be accurate and will not include magnification effects normally present in radiographic measures Metron DVM User Manual Version 7 EponaTech LLC 2014 eo om Lateral Radiograph Note the round metal balls which are built into the block and will be used by Metron to calibrate the image Lateral Radiograph As soon as this image is entered in Metron the software automatically locates the metal balls and the image is auto calibrated Metron DVM User Manual Version 7 EponaTech LLC 2014 If Metron fails to automatically find the metal balls they can be picked by the user manually Depending on the exposure and quality of the radiograph the automatic detection algorithm sometimes does not succeed e e Lateral Radiograph Example showing just 2 of the 22 numbers that Metron computes for the analysis of the lateral radiograph These values are accurate because of the automatic scaling performed by the block and the Metron software The Auto Scaler Tool The Auto Scaler is an alternative to using the Metron Block The Auto Scaler can be placed or strapped to locate it as needed It contains the same metal markers which will appear in the radiograph and which Metron can use to automatically set the scale for the image It is important to place the Auto Sc
14. the Database Browser the current database you are viewing is shown This is usually Default Some Metron users will only ever have this database In fact unless there is a good reason to have multiple databases it is simplest to just have one In the database tools the terms Export and Import are always meant relative to the current Metron database That is you export out of the current database or import into the current database You can export your database or a portion of it onto a thumb drive and then carry it to another computer with Metron then import from the thumb drive into the database of that Metron In the Export Database panel there is also the ability to export the current database to a CD or DVD This is a way to accomplish a back up of your database 4 WARNING It is up to the operator of Metron to perform timely back ups of the Metron database and any other data of importance Metron contains no automated back up facility Back ups are the responsibility of the user or clinic staff Metron DVM User Manual Version 7 EponaTech LLC 2014 The Export Database panel is shown below A subset of the entire database can be specified by giving a range of dates of the studies It is often convenient to export only the studies created in say the prior week and merge them into some other database Metron DVM User Manual Version 7 EponaTech LLC 2014 BE The Databas
15. 4 Concept The Plane of Interest To be precise with radiographic calibration it is not possible to simply program constant offsets into the imaging software This is because it 1s subject dependent and view or procedure dependent exactly where the calibration is needed An important concept is the plane of interest which is a plane parallel to the imaging plate but offset some distance towards the generator Calibration can be used so that accurate measurements can be made in this plane of interest But this requires that A The practitioner decide where the plane of interest should be and B The imaging software must be told where this plane of interest is located For example for a human lying on their side on a table the best general choice for the plane of interest would be at about half the body thickness approximately the plane containing the spine However if you were shooting radiographs intended for pre surgical planning for the knee or some other specific anatomy the ideal choice for the plane of interest is the plane most nearly containing those anatomical features you intend to measure The figure below shows the best general plane for a person lying on the table Of course this is just an example and the same applies for a subject standing in front of a wall mounted detector and so forth Xray Source FFD 37 5 OFD 2 HB Animal Plane of Interest Table Top tt HB
16. aTech LLC to obtain the Unlock Code They will need the Registration Number shown on the panel along with information on who the end user of Metron will be 4 3 Once you get the Unlock Code enter it in the space provided near the bottom of the above panel then click on the OK button 4 4 Use the Check Status choice under the Register pull down to check if your software is now enabled You re done N WARNING WARNING Failure to unlock the Metron software will leave your system in Trial Mode which is not fully functional Metron DVM User Manual Version 7 EponaTech LLC 2014 Starting Metron The installation program has placed an icon on your desktop that looks like this aX Metron Double clicking the icon will start Metron If the icon does not appear on your desktop you can start Metron by going to the Start button extreme lower left on your computer screen then choosing Programs and then choosing EponaTech and then Metron The installation program also places an icon on your desktop called Metron Guide which is a shortcut to this document When Metron Starts Up When you first start up Metron you will see a panel informing you that you are in Trial Mode In Trial Mode you will find many features of Metron are blocked to you But you may be able to explore Metron a little bit and get a feel for it Welcome to Metron in Trial Mode You are in
17. ail Options amp Defaut E Browse amp Acquire Collection 0 items Studies with new images Day Week Month All at Animal Cooper Date 238ep 203 p Add New Image Video Clip Form or Report ih ote p e aa ETE a A TET ts gy ear fi r ry T IFA eeh d 4i Amim ahil a Y D A EN T A AN Report Title Image USB Other 5 oe 3 Apeh wot herreanesta alam H p pt ert File s Video Sources D am enn p D are o S as A A PS Form Report Q R Select items Noa Region Multi i Stitch Burn send A Receive magas cpjpvo images Cu Double click a thumbnail to view D ea y LA Ready a o l SSS la Seal The Database Browser panel and thumbnails representing all the items in a selected study Metron DVM User Manual Version 7 EponaTech LLC 2014 The Database Browser is like the home page of Metron You always start here and you often come back to it The database consists mostly of images but can also contain video clips and reports Additionally there is something called a form which is an image but it is created from several individual images arranged in a certain pattern Beneath each thumbnail is a small icon that indicates what kind of item it is are Metron a Report Mitek t ee Bee eg Owner Smith Ammal iid Elne Date 23 Fal 2 HH Report Title Quiles dewmcnsra lvan ef pluies woe ti habeu
18. aler on the subject to be radiographed such that the axis of the Auto Scaler lies in the plane of interest The plane of interest is the plane perpendicular to the central beam of the x ray generator in which you wish to make accurate measurements Metron DVM User Manual Version 7 EponaTech LLC 2014 The Auto Scaler with optional Velcro strap Auto Scaler strapped to horse s leg Metron DVM User Manual Version 7 EponaTech LLC 2014 Image with Auto Scaler strapped on horse s leg S re F ie The Auto Scalar is particularly useful for Small Animal images Metron DVM User Manual Version 7 EponaTech LLC 2014 The Finger Clips Unlike the other two devices already covered the Finger Clips are not used for radiography They are used for photography of the equine hoof and specifically for the view of the sole We always sell these in sets of two They contain two fiducial points spaced 2 0 or 5 0 cm apart which the user will later be prompted to pick in the image once itis in Metron There is also a space where with a dry erase pen some information which foot date etc can be noted The Finger Scale is clipped to a finger and held so that it lies in the plane of the hoof It should be the same distance from the camera as the hoof plane not closer not further The camera should be pointed perpendicular to the place of the hoof Metron DVM User Manual Vers
19. arefully follow calibration procedures may result in the inability to make accurate measurements in the affected image s Calibration Hardware for Metron The Metron Block is a calibration tool that will ensure that equine hoof radiographs and photographs of the hoof can be accurately measured using Metron software Positioning the Hoof on the Block It is important to try to get the horse to stand such that the foot is aligned with the fiducials grooves on the top surface of the block Along the long axis of the block the hoof should be centered on the grooves and we suggest that the widest part of the foot be centered on the other set of grooves The figure below illustrates ideal positioning Note that the block is symmetric side to side but not front to back The front and sides of the block have holes and black screw markers whereas the back of the block has no holes Metron DVM User Manual Version 7 EponaTech LLC 2014 Positioning the Camera when Photographing The most common mistake when trying to document the hoof photographically is that the camera is held too high It is important to hold the camera so the center of the lens is at the same height as the top of the block The camera should be about 2 or 3 feet away from the block although the precise distance is not important as the block can compensate for distance with its built in scales The images below are properly taken photographs of a hoof Lateral pho
20. calibrated Pick 2 Points Next easiest is something metallic of your own that you may have that could be placed In this case Metron won t automatically find it but you can use the calibration option to Pick 2 Points that are a known distance apart and you are calibrated so very easy Known Pixel Pitch Now on to ways that require knowledge of FFD and OFD If there is no scale marker in the plane of interest then the only way to get calibrated is to know the relationship between pixels and physical length on the CR or DR plate and also to know the FFD and OFD so that Metron can do the math to transform all measurement into a plane parallel to the CR or DR plate but offset from it the plane of interest This 1s known as the Known Pixel Pitch method of calibration In the case of CR Metron knows the scan setting used In the case of DR Metron knows the pixel spacing of the detector plate But to transform the measurements that is to take the magnification out we must have the FFD and OFD and this is entered into the calibration panel In case you want an approximate plane of interest always to be a certain height off or your table you can enter these values once and you ll see that Metron will remember values put in for FFD and OFD from session to session Metron DVM User Manual Version 7 EponaTech LLC 2014 WARNING WARNING Metron provides several methods to calibrate images Failure to c
21. cessor Speed Metron will typically perform better on newer faster desktop PC or laptop To maximize the speed efficiency of the Metron program and your overall image processing viewing experience use the fastest desktop PC or laptop possible Internet Connection High speed Internet connection availability is required for any desktop PC or laptop that will be running Metron The internet connection is critical for training amp support New software releases are also provided automatically via internet Also with Metron you can send diagnostic images electronically to a remote radiologist this is not possible without an Internet connection Metron DVM User Manual Version 7 EponaTech LLC 2014 WARNING WARNING Failure to ensure that the host computer satisfies the above stated minimum requirements may cause Metron to be unacceptably slow or cause user interface elements to be off screen and un viewable or other problems with operation Metron DVM User Manual Version 7 EponaTech LLC 2014 Quick Start Guide Thank you for your purchase of Metron Software This guide will walk you through the simple process of installing Metron Software 1 Load the CD if applicable Load the CD into the CD Drive of your computer The CD should auto start and present you with an informative installation screen If it does not start automatically navigate to the CD using Explorer or My Computer and double click on Metron exe 2 Runa
22. d practice Clinics spend a great deal of money for diagnostic imaging and they should be able to have the benefit of accurate measurements in the images obtained The current state of the art is that very few practitioners think about calibration and support for it in the major CR and DR systems on the market is generally lacking The solution adopted by some vendors is simply to add a line to the radiograph s annotation that states Scale is approximate Metron DVM User Manual Version 7 EponaTech LLC 2014 Radiographic Calibration in Metron Metron supports several schemes to achieve calibration due to the number of different systems and situations we work in In some schemes knowledge of the FFD and OFD are not required at all but these schemes require that a special marker was placed in the plane of interest when the image was acquired Metron Scaler The easiest and best ways of calibrating require a marker of known size placed in the plane of interest To this end we sell a little widget called the Metron Scaler which works well It can be Velcro strapped to a leg or placed at mid body or if super accurate calibration not required can simply be placed on the table hence lower than mid body The Metron Scaler will be automatically located by the Metron software most of the time something obstructs it or if the exposure is off it may not find it then you simply pick two points on it and you are
23. e Tools panel gives you a way to count how many images are in your database and to see the total size your images occupy on disk and other tools Sending Images out of Metron Images can be sent via the internet in three ways 1 Send via DICOM send to another DICOM enabled system 2 Send by posting to our web based viewer or so an iPad or iPhone user can access the images or 3 Send by e mail To send images out of Metron via the internet click Send Images Metron DVM User Manual Version 7 EponaTech LLC 2014 In order to send by DICOM first go to Preferences then choose DICOM Preferences and then configure a server to which you will send You will have to ask the recipient for the coordinates of their server In order to send to the Web Viewer or mobile device you use the menu shown below Wserd4 dbe sampleHorse 22 Jan 201 3 You are free to send to any UserID that you wish yours that of your colleague or just create one on the fly Under Preferences and then General you will find a way to set your own UserID to some friendly name that is easy to remember The Metron App is available for purchase from the Apple Store for 29 99 Metron DVM User Manual Version 7 EponaTech LLC 2014 i a 4 WARNING Images posted to www MetronWebViewer com and or to an 1Phone or iPad viewing device are JPEG images and should not be used for a diagnostic reading due to lossy
24. ech LLC 2014 Adding Images into your Metron Database Add New Image video Clip Farm or Report Image Other File s K SOUFCES This section is known as the Acquire Box Any new item that you wish to bring into Metron will be brought in by clicking on one of the choices in this box The exact set of choices in this box may look different in your copy of Metron depending on which hardware devices you have interfaced to Metron Metron is used with CR and DR radiography systems and with USB video cameras e g an inter oral camera and other devices If your Metron came as part of a DR or CR system there will be a large icon on the left hand side of the acquire box which you will click in order to acquire new radiographs The button Add Form lets you add a Form to your study and the button Add Report lets you create a report and add it to your study The button Image File s or in some cases called My Computer is the way to import any image file on your PC into Metron and also any avi video file can be imported this way Finally the Other Sources button brings up a panel with methods to input images from various other sources e g scanners twain devices etc Other Image Sources EJ Digital Camera Media Film Radiographs Twain Image Source eFilm Database Dental Radiographs Thermographs Video 2 2 CFLIR v Browse Browse Browse Browse Browse Launch Launch
25. ered later Metron DVM User Manual Version 7 EponaTech LLC 2014 DATABASE BROWSER Metron DVM 7 11 Browse amp Acquire Collection 0 items Owner Bob Miller Animal Cooper Date 23 Sep 2013 The Database Browser panel lets you find any image in Metron lets you jump into various ways to acquire a new image and lets you operate on sets of images in various ways NOTE Your Database Browser panel may appear with a different icon as that shown above depending which imaging hardware your copy of Metron is configured for Metron DVM User Manual Version 7 EponaTech LLC 2014 Multi Image Operations Multi ae T j send Receive Images Se Images es Oo Double click a thumbnail to view eC An important concept behind the Metron user interface is that you can perform some operations on multiple images at a time whereas other operations only make sense to perform on one image at a time Any time you want to perform an action on several images at once the place you do that is in the Database Browser panel The lower portion of the panel shown above in isolation contains actions that can be performed on multiple images at a time You specify the images by single clicking on the thumbnails which will turn the border of the thumbnail red showing that it is selected For example click on 6 thumbnails to highlight them with a red border then click the button labeled Multi View You will see those
26. ion 7 EponaTech LLC 2014 Free Mark Up The Free Mark Up panel provides a number of different measuring and annotation options NOTE If you elected not to calibrate the current image then many of the measurement tools shown above will be absent from this panel Metron DVM User Manual Version 7 EponaTech LLC 2014 Report Creation An important function of Metron is to generate reports These reports are multi page formatted reports containing images and text Metron users create these reports for their clients and they are a vital communication tool The report generator panel is shown below In this image a report has already been constructed which consists of several pages Create Edit Report Report Name Report Rename Report Generic Report Pages Equine Specialty Pages POF Pages Form based Pages Cover Page Text Page One lmage Page Two lmage Page Four lmage Page Signature Page Contents of this Report Thiz report ig curently empty You create a report by choosing a page type adding it to the report and then using a page editor panel its details depends on the type of page to fill in the images and text on that page Pages come from 3 main categories represented by the 3 tabs in the upper portion of the repot generator panel Generic Pages Specialty Equine Pages and Form Pages Most reports are built from Generic Pages the Specialty Equine Pages format pages i
27. n all image types Metron DVM User Manual Version 7 EponaTech LLC 2014 DE P3 Voice Luminance 3D B amp Skeletal C Dental A l Select View LF i t amp 60 Deg DP Nav be L e 60 Deg DP P3 amp Ea Navicular Skyline eq piap Med Lat Oblique v dir eoa pare a al Annotation Li Font 110 White amp aN x ie NN M RAL IY Region IY View gt Add Note DA aA Blank Anno BlankMarkUp Grid ES Detail Fiters Importedimage A b g BREREAS 3 4 tune T ka a E 8 E LH t 3 RH goH Hefs els fees d gt ee In the single image view edit screen a row of buttons across the bottom of the screen provide image filtering tools and other functions Metron DVM User Manual Version 7 EponaTech LLC 2014 Image Calibration Due to the nature of the geometry of radiographic imaging all radiographs have inherent magnification in them For example if one puts a ruler on a radiographic film the measurements one would get are not true size of the radiographed objects but rather they would measure larger than actual size Example Table Arrangement The figure below shows the physical setup patient on a table The two numbers shown are constant Aray Source Table Top CR plate The two fixed offsets of importance in a table setup Where CR plate is indicated it could instead be a DR flat plate CCD technology or film Metron DVM User Manual Version 7 EponaTech LLC 201
28. n which multiple images which have been measured in Metron are auto scaled and auto cropped and made to line up and also Metron s scoring system results Metron DVM User Manual Version 7 EponaTech LLC 2014 can be reported on the pages The Form Pages allow multiple images to be laid out on a page in various ways Users can create their own forms to get particular layouts of interest Reports in Metron can be re opened and edited at any time From the report generator panel you can choose to export a report as a PDF file the free Adobe Acrobat software is needed to view these If you burn a CD or DVD in Metron and include a report in the study that goes onto the disk it will automatically be converted to a PDF file and put on the disc This way the recipient of your CD will not be able to edit the report Likewise you can e mail a report directly from your Metron database and it will be converted to a PDF file and attached to the e mail There is also a choice in the e mail panel which will let you send a report as well as anything else in your Metron database by e mail to another Metron user who will then be able to bring the items into their own copy of Metron In that case it is not a PDF file that is sent but a fully editable report Metron DVM User Manual Version 7 EponaTech LLC 2014 Burn CD or DVD Another important function is to burn a CD or DVD with images and other items to be given to another person The panel is
29. ppen that it will encounter problems due to a corrupted file or a file that was improperly closed or some other problem The converter is pretty robust and can often continue past such issues If it can t you may also simply restart Metron and try converting again usually on the second try it can get past the problem Appendix B Setting up Automatic Image Rotations For most DR systems and some CR systems that Metron supports there is a way to assign a rotation to the image when it is acquired For small animal systems usually the animal is viewed across the screen but for DV and VD shots it is customary to have the body oriented up and down on the screen For this and other reasons we need a way to rotate images in an automatic fashion depending on the anatomy and the view taken For equine systems the required view rotations can become elaborate The lt Platform gt ViewRotations txt File Here is how to assign automatic image rotations Itis done in a file which sits in C Epona Databases Main and the file is called depending on the system one of these Samsung ViewRotations txt RpanelViewRotations txt or maybe another name Please ask EponaTech if you can t find the file name for your hardware Here is an example of the contents of the lt Platform gt ViewRotations txt file for an equine system VERSION 1 0 Default 90 DP RF 90 DP RR 90 Lateral LF 90 Lateral LR 90 Head 0 The idea is
30. s corpu deleclioviuo opile pro qian Image Form The Database Browser panel is shown below It indicates the currently displayed Owner Animal and Date which tells you which study you are looking at By clicking the down arrow next to the Owner Animal or Date you can switch to another By clicking the New button to the right of each of these you can create a new Owner Animal or Date When you first create a new Animal you can enter its species breed and other data This Animal Data can later be viewed or edited by clicking the Edit button to the right of the animal s name You can delete an owner and all animals and dates and images by using the Del button to the right of the Owner Likewise you can delete an entire animal or you can delete just one study by deleting a certain date Anytime items from the database are deleted they go into Metron s Trash Can which is shown in the lower right corner of the Database Browser panel You can click on the Trash Can icon to un delete items or to finally empty the trash and make the deletions permanent There are filters that let you show only studies which were taken today or during the last week or month Also there is the ability to search by owner name for a particular owner or to search for a particular animal either by its name or by the patient ID The tab labeled Collection 0 Items is for an advanced feature to be cov
31. shown below Generic Report Pages Equine Specialty Pages PDF Pages Form based Pages By default the CD or DVD created by Metron will also contain a mini Metron viewer so that the recipient of the disk can view the images and reports easily This disk will not install any software on the recipient s machine it plays directly off of the CD from the CD drive To write a partial study onto a CD highlight the thumbnails of the images you want to select prior to entering the Burn CD panel From within the panel you can include additional full studies on the disk There is an option at the top of the panel to write a disk without the min Metron viewer but rather with images only If you choose this style of disk you can select the format of the images JPEG TIFF or DICOM Metron DVM User Manual Version 7 EponaTech LLC 2014 Export and Import of Metron Databases There are several reasons why you might want to import or export an entire Metron database or a portion of one For example e To make a back up of your database export a copy of it to another disk e To merge images from a portable Metron based system that went out into the field back into your main database at your office e To give acopy of part or all of your database to a colleague These things are done with items found under the Database entry in the top bar of Metron It is important to note that in the upper right hand corner of
32. stance from the camera Metron can automatically compensate for the focal distance of your camera No matter how close you were to the block and no matter how your camera was zoomed measurements are accurately resolved to the centerline of the block centerline of the hoof for a lateral radiograph and at the widest part of the foot for a frontal photograph It 1s only important that you hold the camera so that the center of the lens is at the height of the block and point the camera perpendicular to the long axis of the block Best is to have the camera about 3 feet away from the block being too close and using wide angle zoom can introduce some perspective effects that can reduce accuracy Positioning the X Ray Generator for Radiography The height of the Metron block is such that it is appropriate for use with a typical x ray generator such as a MinXray HF80 We position the generator about 30 away from the block but the distance is not crucial as the block contains internal metal scaling markers which will provide accurate measurements regardless of the film focal distance used The film cassette or DR detector plate is placed on the ground just to the side of the block Note that the positioning of the foot on the block is just as we have shown above for photography do NOT move the foot to the side of the block to get it close to the film or DR detector Calibration in Metron for Radiographs The Metron block contains special
33. tation All images have this feature which lets you pick the anatomy and view Calibration Prior to making measurements in images you need to calibrate Free Mark Up A set of tools that let you make measurements and add notes to an image Guided Mark Up A protocol for making measurements for certain image types In Metron we have patent hoof analysis measurements that you are guided to make For small animals we support the Vertebral Heart Score VHS and the TPLO procedure for dogs and other such tools will be added in the future Measures this panel presents the measurements which resulted from a Guided mark Up session Scores this panel presents a scoring system associated with guided mark up 3 D Bones this is a specialty function just for later radiographs of the equine foot Metron creates approximate 3 D models of the 4 bones of the distal limb P3 Analysis this is patent pending method we propose for measuring the health of the equine pedal bone available for lateral radiographs Luminance this is a beta feature related to measuring bone density but not fully developed yet We are engaged in university research in this area Metron DVM User Manual Version 7 EponaTech LLC 2014 P3 LF 60 Deg DP Nav 60 Deg DPP3 Navicular Skyline Med Lat Oblique LH The number of buttons displayed at the top of the graphic will depend on the kind of image that you are viewing Not all operations are available o
34. the default values in Samsung ViewRotations txt which is for equine you will see a rather complete example of good settings for an equine system DENTAL Similar files exist for DR Dental systems e g DRDental ViewRotations Accent txt They are essentially only used for flipping the image by 180 depending if in the Right side or the Left side of the mouth Metron DVM User Manual Version 7 EponaTech LLC 2014
35. this in the second line I give the Default Rotation which is applied to all images unless the default is overridden in a following line in the file So the current default is 90 To understand it you have to know where zero is Metron DVM User Manual Version 7 EponaTech LLC 2014 Each line of the file can specify the rotation to use instead of the default for a given Region View and Limb For example if you put in the line Foot Lateral RF 90 it would use a 90 degree rotation for the Right Front lateral of the Foot Then Metron is set it up so that asterisk is the wild card So in the current file the line DP RF 90 Means that the DP view of ANY region for the RF will be 90 So this works for Foot Pastern Fetlock Cannon in fact every shot that has a view called DP You see later in the file I have Head 0 Meaning that any view of the head I think we want an image wider than tall so we use rotation 0 which happens to be the correct number for one certain panel it may not be for yours The only values of rotation you can give are 0 90 90 180 You have to use RR and LR for hind limbs not RH and LH Finally you want to keep this list the number of lines in the file as short as possible simplicity is good the system searches down this list after each shot to check if the shot should be rotated or not so its best if the list is not hundreds of lines long Note if you look at
36. tograph Note that a dry erase pen is used to write the horse s name and the date of the image on the side of the block Note that the top surface of the block is seen edge on if you can see the top surface of the block then you held the camera too high Also note that you must be aligned with the block such that you can see the black markers at the bottom of the circular holes in the side of the block this ensures you were lined up approximately perpendicular to the block Practice taking some images and then compare your results to this image Metron DVM User Manual Version 7 EponaTech LLC 2014 Frontal photo Make sure the block is positioned so there are the holes in the side of the block facing the camera A dry erase pen is used to write the name of the horse which foot and the date of the image Note that you can see the black markers at the bottom of the circular holes if you have positioned the camera properly Calibration in Metron for Photographs Metron will prompt you to pick the four black marker points on the block two are on the surface of the block and two are in the circular holes as shown in the image below Lateral Photo Metron prompts you to pick the four black markers on the block Here they are highlighted in green after they are picked Metron DVM User Manual Version 7 EponaTech LLC 2014 Why Four Calibration Points By picking four points two of which are at a different di
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