Home

BRIT View User Manual 7 3

Contents

1. View BRIT View User Manual Chapter 10 Annotating the Images Drawing an Arrow To use the Arrows option and the Arrows to All option use the following steps The Arrows option allows the user to draw an arrow that goes only with the image on which the user draws it The Arrows to All option places the arrow s the user draw in exactly the same location on every image in the series T 1 Click the right mouse button to access the pop up menu and select AnnotatesArrows or select Utilities then Annotate gt Arrows from the main menu bar The cursor becomes an 2 Place the point of the arrow cursor at the exact location where the user want the arrow to point on the image click and hold down the left mouse button and move the mouse away from the location 3 Release the mouse and the arrow displays Drawing longer lines before releasing the mouse makes larger arrowheads Users can continue to draw more arrows until the right mouse button is clicked Measurements annotations or other information that is added to an image are not Close automatically saved to that image when the button is selected to exit the exam To save annotations select one of the File gt Save or File gt Print options from the main menu or select one of the Save Print options from the pop up menu Measuring Region of Interest ROI In many cases the physician prefers not only a drawing around an area of interest but als
2. The Status Bar contains the following information Patient ID Patient Name Study Description Series Description Image Window Level Pixel 1115116 V V V WV gt gt Description Value Value Value CIARER CHRIS Stay 1 of 1 CTABDOMENOWCONT Mud of 4 4 total ABDIPEL DELAY Img1of 92 287 total W 400 Li 25 HL Patient ID Number Patient Name Study Description Series Description This value displays the description of the currently selected series in the currently selected study Image Description This value causes the field to be updated with information about the image currently being pointed to is displayed Window Value The current window setting This value changes as the window level setting changes Level Value The current level setting This value changes as the window level setting changes Pixel Value This value changes as the cursor is moved over specific pixels When downloading images from a remote archive the status progress of the download is displayed in the BRIT View s Status Bar The number of images downloaded and the number of images remaining to be downloaded are shown in the Series Description field of the Status Bar The Image Border contains the following information Y V V WV The Image Viewing area displays the images for the study 51 v1 12 29 6 ABD PEL SCOUT Study Number Series Number Date of Exam Body Part Series Description 12 E23 BRIT
3. Technical Publications Department 1909 Hi Line Drive Suite A AVSA BRIT View User Manual Notices Copyrights and Revision Records BRIT Systems BRIT View User Manual Table of Contents Table of Contents CHAPTER 1 INTRODUCTION 2D GN AN GNG NADAAN PA 1 STARTING BRIT VIEW um aaa 1 Starting the BRIT View Application cccccccccssseeesecccccccssssseeseccesensausesseeccessssauensseeeeeessssaaeeeseceessssauaaeseeeesssaaaas 2 USING THE MOUSE ENTRE NRRR ZmmAmmmmmEEBEHA mTTAXVXmXVL 2 COMPONENTS OF THE STUDY wavisasscesnosadvecssareccideundcntutwstsctsesndentiseevaecbaeesdenriavendsahamesdwatbanacdhdancieeteivesdsuharcawavdbames uess 3 COMPONENTS OF BRIT VIEW cccceccececcccecccecccecuccecuccecuececueaecueuusucuuuecsuaecueaesseaesscausecueuecseaecsuaeseeaesueaeaessreeseraees 3 CLOSE AN EXAM AND EXIT seeriana enii a aea aa A aa a e E E a EE 6 CHAPTER 2 SEARCHING FOR PATIENTS cecceccscceccecescesceccscescnscecescesenscncesensenceeeesenseneesensensceenseneesenseness 7 ACCESSING LOCAL PATIENTS k a r E E E EE 7 Filtering the Local Patient LiSt cccccccsseccccseeeeccnscseccnscseccnsaseccsacseeesacuesensausesesauaeessacuesenscuacessaaesssanessssaaass 7 SOn E FAOn S aoai EEA AE 8 Select a Patient to View Images ccccccccccscseesseeceesenssueseececeesssaueseeeecsssssaueuseeecesssssaaeeeeeesssssasaneseeeesssssaaanes 9 Selec ing AVIV
4. Wiew _ BRIT View User Manual Chapter 1 Introduction Turns the image top to bottom 180 gt Turns the image left to right 180 gt f 4 Turns the image 90 counterclockwise or to the left Turns the image 90 clockwise or to the right J Displays all image in the active series in the window Displays a montage of images 1 Toggles between displaying all the series and a single series Click the middle mouse button on the area of interest to optimize window level settings Left click to display the window level presets J Re displays the images repaints the screen and shows the annotation statistics for the ROI gt J Displays all the available reports J Sets the monitors for hanging the images in the exam Ec Allows the user to select a saved hanging protocol for hanging an exam BRIT View User Manual 5 Chapter 1 Introduction The Status Bar contains the following information Patient ID Patient Name Study Description Series Description Image Window Level Pixel Description Value Value Value 115116 CIARER CHRIS Sty 1 of 1 CTABDOMENOWCONT Yu of 4 4 total ABDIPEL DELAY ng of 92 287 total Ww 400 i25 HUE gt Patient ID Number gt Patient Name gt Study Description gt Series Description This value changes as the cursor is moved over the various series gt Image Description This value ch
5. screen to the original settings by pressing the Reset EYEE Cancel button at the far right button If changes are made of any type and the users do not press t image viewing without saving the changes by pressing the ba button View BRIT View User Manual Chapter 7 Window Level and Edge Enhancement While viewing an image or series of images if press the W L button on the Toolbar and a dialog box similar to the following displays Select Window Level CT The system recognizes the type of modality for which images ae are displayed and displays the corresponding settings for that Tee window Level l BONE 1500 IMITIAL 300 LUNG 1100 MINMAX WIDE SOFT TIS 400 Cancel Users can then select a W L Type and the values in that line are applied immediately to the image s Clicking on For Study and activating that radio button first the changes are applied to the whole study being viewed If the user makes changes and then presses Reset tty the W L changes back to the originally stored values If the user selects the option Invert the user must do another Invert to return to your original settings Manual Adjustments for Window Leveling In addition to the preset values for window and leveling the users can manually adjust the setting by using the some other features such as To manually adjust the Window Brightness and Leveling Contrast over the e
6. If the system has monitors with one or more stacked series open and the user selects one of the series to O0000 LILILILI make it active and press the 3330 button every image in that series is opened in that window The entire monitor screen is not filled only the active window Each of the multiple images are reduced in size below a one to one pixel replication show the word Minified at their lower right as shown in the following figure Pressing the Set button on the Toolbar causes an active window to display in a montage of images The format of the montage is calculated by the program and is based on the number and shape of the images in the series If the user has a study displayed in which all series are stacked across multiple monitors and the user selects the maximize button of an active window that series is displayed as a single image on each monitor with 1 1 on the left most monitor 1 2 on the next monitor to the right and so on for each monitor on the system If the user opens only a single series for display across several monitors the images display initially at one BEBE a button each monitor shows an equal number of the available Ha button a calculated montage of images based on the number and per monitor When the user presses the ka images The pa button is inactive in this situation The button applies only to multiple studies and multiple series If users try the shape of the images i
7. clicks on the right most red X in the title bar that 2Views of study otal 2 Desc AXIAL 88 window will close Clicking on the minus sign active mage 3 of view causes the window to minimize while clicking on imasccemmeng oe tatal mages open the middle button causes the window to maximize OTHER inte fill the monitor viewing area Study has O reports currently open O key objects If the user clicks the right mouse button on a title bar of a series an information box Information re This View displays that shows patient study series and image information as shown in the SE E following figure The L button closes the box Thel Ful Dune button provides a complete computer listing of all DICOM parameters in a Notepad dialog box TS BRIT View User Manual Chapter 3 Viewing the Study 16 BRIT View User Manual Chapter 4 Changing the Layout Chapter 4 Changing the Layout The ability to change the layout of the study is accomplished easily in order to view other images in the study or to compare a previous study to a current study This is called changing the layout of the study or the series Initially when the images are loaded into the Viewing area it is shown as one series per window The layout of the study or the series can be changed by Clicking on the desired layout from the Toolbar button Right clicking on the image selecting Format and selecting th
8. For Peer Review For Research Rejected for Quality Reason Y VV ON ON VV ON ON ON WV Quality Issue 4 Move the cursor into the mingow area and type a short note Select L zi place the yellow note in the upper left hand corner of the current image as shown in the following example 5 When closing the image or exam will see the following message appears ES Lggss55 ieeltimeumeE Key Image and or Annotations You have marked one or more images Do you want kc save the marking 6 Select to save this Sticky Note on the server and ucc mu therefore make it available to other DICOM Viewers that support Key Objects 46 SW BRIT View User Manual Chapter 10 Annotating the Images The BRIT View application can be set up to support IHE Presentation States and Key Objects or Sticky Notes This involves adding an application to the workstation to support a DICOM store back to an archive Regardless if any annotations are made a confirmation is requested when closing the exam if the annotations are to be saved If the answer is Yes then the annotations are stored to the archive Sticky Notes are always stored Presentation States Using Presentation States PS is a method of saving the exact look of an image including window and level and all annotations and notes so that another user on a DICOM workstation that also supports Presentation States can view the image with the sa
9. aaaaaawwwwawananaaawaaaaaanananaaaasaaasasanananaaaaanssann 61 CREATING HANGING PROTOCOLO cK 62 View BRIT View User Manual Chapter 1 Introduction Chapter 1 Introduction The BRIT View product is a PACS application that is based on computer and medical imaging standards By using these standards maintaining the maximum flexibility in the equipment is easily done and costs are controlled By using standards newer software upgrades can be more easily accomplished to support the latest and greatest technological advancements Since the users expect to see different ways of performing the same tasks this workstation was developed to complement each clinician s reading style as much as possible The BRIT View connects to the hospital network and receives images from the specified modalities digitizers and servers These images are sent to the workstations automatically or they can be specifically requested from a list of servers The System Administrator can help the hospital staff decide which studies are automatically routed to specific workstations ensuring that prior studies are readily available at the local workstation Once the exams are loaded onto the workstation a list of all patient exams is available After selecting an exam or a set of exams for a specific patient the viewing and image manipulation window opens Work lists can be built by selecting t
10. after the system has been appropriately configured The Patient Select dialog box always has at least one tab at the upper left labeled Local for selecting and viewing images that are stored on the local computer If the BRIT View is configured to access remote archives additional tabs appear on the Patient Select dialog box For each remote archive that is accessible to the BRIT View an additional tab will be present The following figure shows conceptually how the Patient Select dialog box points to the various image locations using tabs Accessing Local Patients When BRIT View is first loaded a window showing all the patient studies that have been downloaded to the local BRIT View workstation opens This local list can be accessed at any time by clicking on the Patient List drop down menu The patient list is displayed in the upper portion of the window To access a patient click on the patient and the studies for that patient are shown in the lower portion of the window Click on the desired study and click on the button to open the selected exam or click on the View All button to view all of the studies for the patient Set Filters Exam Acquisition Date C Disable Today Last3Days Last2 Weeks Filtering the Local Patient List es z Body Part Examined After selecting the Filter the List button the Set Filters dialog is 5 appomen r extpemity M NECK Clear Fitters
11. displayed as shown in the following figure This dialog is used to ANKE TOUT _ PELVIS 5 i 5 i ARM HAND SHOULDER specify the exam information that will be retrieved from the remote r greast HEAD SKULL archive CHEST HEART SPINE C CLAVICLE HIP SPINE L COCCYX KNEE SPINE 5 The Set Filters dialog box is divided into three sections d Cue T SPNET Uread Studies Modality Computed Radiography Nuclear Medicine gt Exam Acquisition Date Computed Tomography lv Ultrasound gt Body Part Examined Magnetic Resonance Other Modality BRIT View User Manual 7 Chapter 2 Searching for Patients If a selection in a given section is not made then that section does not contribute to the filtering process For example if the Last 3 Days radio button is selected and no other selection is made in the remainder of the Set Filters dialog then a exams from the past three days would be listed after the OK button is selected This could still be a very large number of exams The filter would be made more restrictive if a body part also were checked For example if the body part HEAD were selected then only head exams from the last three days would be listed The filter would be still more restrictive if a modality was also checked So for example if Computed Tomography was also selected then only head exams from the last three days that were CT s would be listed Selecting additional
12. 1 Marked 1 by 2 2 Select a format from the list The images will be Waaa Marked 2 by 2 displayed in the chosen format along with the 5 Marked 2 by 3 Mark Images box shown here Mark Marked 3 by 3 hisSenes thishenes Marked 3 by 4 Unmark Mark ALLSeries ALLSeries Marked 4 by 5 Marked all on one bat Select printer View BRIT View User Manual 51 Chapter 11 Printing Saving Sending 3 Mark the images to be printed they will have a iv on the image and TETTE Sain click o The following Ready to Print confirmation message Ready to print 1 Fims displays about how the images were marked consisting of 3 images ing by 2 fornial 4 To continue with the printing select Lx on the Ready to Print Is this OK dialog or select to cancel and return to the image marking screen and the Mark Images box 5 After making the final choices and selecting L i on the Ready to Print dialog the generic Print box displays to allow the printer to be selected and the printing function completed 6 Select the m Frinter click on the ij Mame Status Ready Type HP Color LaserJet 5500 PELE Where hpeolorLaseret5500 Comment Print to file r Copies Humber of copies E ES i Chee EN Saving Images Images can be annotated windowed and leveled or otherwise manipulated and then saved as DICOM presentation states An optional module allows these pre
13. IMAGE PROCESSING 2 200m 34 CHAPTER 8 SCOUT LINES AND MPR 0 cccceccceecsnneseeeeeeeeeccensneeeeeeeeeeconaseeeseeeecconssseneeeeeneoonaaes 35 SCOUT LINES aene E uu 35 zin cR AA AA AA 36 CHAPTER 9 CLONING AND LINKING SERIES ee ecce eei eeeeeeeeere eese eene a nnne nana nhau naar nnns 37 CLONING A SERIES E RT cm 37 HIKING MULTIPLE SERIES ERN 97 CHAPTER 10 ANNOTATING THE IMAGES eel ieeeeeeeeeee ll iiiee nenne eene n anna aan n seas asas ana osea anas nnns 39 nuerwleabni c 39 M asu unng ANAN rr Ep C Ga aNG LU E LAAN Ya 39 VICE SONG IIIS ANCES naa AA AA 40 EDAWN an ATON ama Aa 41 Measuring Region of Interest ROI ccccccsscccccsseeeccsaneeecsaueeesaaeeeessaueeessaaueeessauaeessaaaeessaaueeessauanessagenesssaees 41 Calculating Statistics on Regions of Interest ROI eese eese 42 Ellipse and Rectangle Drawing Options anan aaa aee enne nhanh nnne nns nnna hara nnns snas aaa anna 43 acie sepBic i rie Morc 44 Changing Fonts for Labels and TeXELu uei otro rete RIA o ita NAGDAAN NAPANGANGA NAG A FRA AY Sese s rad ete 45 AA UI cM 46 iz t AN OE AS AA E 47 CHAPTER 11 PRINTING SAVING SENDING 11111 1eeeee eccle rennen
14. Menus M BRIT View s1 v1 1 24 6 3 PLANE LOC File Browser Utilities Patient List Print Ststus Format Views format Images Zoom Close All Help 123156 JOHNSON JOHNNIE Stdy 1 of 1 LUM SP Vu 6 of 8 8 total AX FSE T1F5 C Img 1 of 31 161 total w 1366 L 683 PixYal 5 Saba d BH mahi EH LL UTE E 8 211 dH DI MS TRF_GEMS FILTEREDESGEMSISP SA NPUNVB SEMSIFILTERED GEMS 8 9 1 1 6 1 1 H MSYSEQ GEMSYTRF GEM S FILTERE D_GEMS SP SA WSITRE GEMSIFILTERED GEMSYSPIFS Series Image Border The BRIT View main menu has Drop Down Menus for image related tasks Most of the choices also are available through the pop up menu accessed by clicking the right mouse button on an image The image viewing area is directly below the main menu and Status Bar A Toolbar with large icons buttons is present on the right side of the screen in a single monitor system On a multi monitor system Toolbars can be present on each monitor The Status Bar for the selected exam is at the top of the screen just below the main menu bar If more than one series is in view each series displays in a separate window as shown in the previous figure for eight series on a spine The content of the Status Bar refers to the active highlighted window The left most end of each series title bar has some status information mostly used during DICOM communication VIS BRIT View User Manual Chapter 3 Viewing the Study
15. SEL within the SendCommon Patent 01218215 REG WB Spots Bone Image number O O pixels YOU WILL HAYE OPPORTUNITIES TO TRY AGAIN Images Marked to Send box are YA locations to which the images Ha AN are sent now will move the image out of the way so can proceed unless you say different If the sending of images is completely successful no messages of Error Message a Can t use context 1 2 840 10008 5 1 4 1 1 88 59 It was any type are sent If there are any errors during sending of the notnegotiated images the following error message box appears will choose Try Later in 2 seconds DeleteFile Move file 54 View BRIT View User Manual Chapter 11 Printing Saving Sending 11 Users must now choose from three buttons at the bottom of the message box Press the L button to attempt the transfer again press SON to remove the file from the outbound image queue or press Sa to move the file into a bad directory under the DICOM destination folder BRIT View User Manual 55 Chapter 12 Teaching Files Chapter 12 Teaching Files The ability to create teaching files is a useful function in every hospital environment It helps the new Residents and Interns to learn about standard diagnoses as well as those interesting and unusual cases that do not occur as frequently and provides an easy and accessible method to store and retrieve them Users ca
16. View User Manual Chapter 3 Viewing the Study BRIT Systems Scrolling Features Several methods are available for stepping scrolling through a series of images 1 If one image of a series is currently being displayed placing the mouse cursor on that image and clicking the left mouse button will cause the next image of the series to be displayed Selecting the Next button or the button has the same effect as left clicking with the mouse To back up through the series of images select the Prev button or the lt button If a montage of images is being displayed for example a 3 x 2 array selecting the Next or button will cause the next six images from the series to be displayed Selecting the Prev or lt button will cause the prior six images of the series to be displayed In other words the montage is filled with the next or previous set of images from the series The mouse also can be used in other ways to dynamically step through a series of images It does not matter if the images are displayed in a montage or in stack mode 1 Click the right mouse button to get the pop up menu and select format Images If the Scroll Stack option on the pop up menu does not already have a check mark beside it select Scroll Stack 2 3 Place the cursor about in the middle of the image 4 Hold down the right mouse button and drag the mouse up to move forward through the series and down to move backw
17. assigned click on i The dialog box disappears and the views display across the monitors as they are set up Continue designing the hanging protocol by again selecting format Views Select the option Save Hanging 10 A small dialog box entitled Login for Local Operation displays along with the main dialog box entitled Save Arrangement as Hanging Protocol Enter the User Name in the small dialog box and YY THY M press pus Sen ME pereat EH to proceed 62 BRIT View User Manual 11 12 13 14 Appendix A Burning a CD If a single study is open the Save Arrangement as Hanging Protocol dialog box opens it is specific for only one study being viewed If this box were requested for saving a comparison set of studies there would be additional prompts below the PRIMARY Study in an area labeled COMPARE With The situation of saving hanging protocols for comparison studies is covered in the next subsection Users always see the second dialog box if two monitors on the system The PROTOCOL NAME field displays with the abbreviation of the modality type already present CT in the figure above The remainder of the name must be provided which should be a name that users can recognize for the type of study being displayed and saved Under PRIMARY STUDY are seven items that can be left as they are or set as desired The Study Description Cancel field initially has the radio button beside it selected and contains
18. body parts or modalities would make the filter less restrictive Each item selected causes the filter to include that selected item in the search So using the above example if HEART and ABDOMEN were also selected then the search results would include all exams from the past three days that were CT s of the head heart or abdomen Selecting the Unread Studies button on the Set Filters dialog box will further restrict the filter so that only unread exams are listed The filtering process is applied only to data in the local archive Once the filter has been set selecting the OK button launches a search of the remote archive All searches are performed at the DICOM study level All exams that meet the filter criteria are displayed in the patient list Caution A search should not be launched without any filter restrictions t 02 this could cause a massive amount of data to be returned Once a search is E started it cannot be canceled To exit from the Set Filters dialog box without starting a search select the button To clear the filter and turn off all restrictions select the button The purpose of the button is to quickly reset the filter so that a new filter can be defined Sorting the Patient List Users can sort the Patient Select list by clicking on the various column labels in the window For example to sort by ID click on the Patient ID heading This moves the column on which the sort has been performed to the left most c
19. create annotations work with Key Images and Presentation States gt Patient List Allows the user to access patient studies that are locally downloaded gt Print Allows the user to select a format in which to print images as well as print reports gt Status Allows the user to see the status of the study gt Format Views Allows the user to format the series clone series select hanging protocols perform MPR on the series and close all images in the study gt Format Images Allows the user to select the layout for the images in the series image labels and scout lines gt Zoom Allows the user to magnify the image up to five times the captured size and open a magnifying glass closer viewing gt Close All Closes all images in the study gt Help Provides additional help for different aspects of BRIT View The Toolbar buttons include gt xt Displays the next image in the series re FY Displays the previous image in the series FO mg Displays the next exam All Closes all studies that are open Increases or decreases the size of the image to fit to the current viewing area Displays the image in a one to one pixel ratio of capture pixels to display pixels 4 Displays the image magnified two times the original captured size of the image 200M Provides a round magnifying glass that magnifies the images five times the original size
20. down to the lower end of the measurement and release 1 Place the mouse cursor over the image of interest and press Shift F5 This action immediately activates the length measurement mode and the cursor icon becomes an 2 To measure a distance on an image for example the length or width of an object or body part move the cursor arrow point to where the user want the line to begin on the image and press and hold down the left mouse button 3 While continuing to hold the left mouse button down drag the mouse to the other endpoint of the line segment As the mouse is dragged a line is drawn 4 Release the left mouse button when the line has the desired length and direction A label appears on the line to show the length of the line The label information is taken from the DICOM header data concerning the dimensions used for the image display 5 As long as this measurement mode continues to be active the user can repeat the process in steps 2 through 4 to draw additional measured lines 6 Press the right mouse button once to turn off the Lengths mode The pop up menu WILL NOT appear Measurements annotations or other information that is added to an image are not Close automatically saved to that image when the button is selected to exit the exam To save annotations select one of the File gt Save or File gt Print options from the main menu or select one of the Save Print options from the pop up menu
21. in View box displays Reverse Order select buton range 2 The default value shown in the Image Range is the entire SEES ar Click to set order series However the user can select to reverse images in a Order number range Images in a displayed series are numbered starting in the upper row left to right and then repeated on the next row down and other rows below that Image Rang to Paa View i BRIT View User Manual Chapter 4 Changing the Layout Reverse Order Select the Image Range and then select the Onginal Select the 2 button to place the images back in the order they were in when the series was first opened button to reverse the order of the images Select a when finished ordering images as desired Regardless of the order in which the images are left when the study is closed the images display the next time in their original order To Move an Individual Image An individual image can be moved from its original location to any other location by using the following steps Place the images in a montage mode for example display a single series and select the Bt button or display in a montage of four images wide Determine the image the user wants to move and move the cursor over that image Depress the Shift key hold down the left mouse button and drag the image to its new location The image on which it is dropped moves to the left and all the remaining images move
22. selected image the following symbol appears to indicate movement The entire range of images is inserted between the image where the cursor is released and all images to the right and below it MA BRIT View User Manual 21 Chapter 4 Changing the Layout OOO 0000 gt Clicking on the EE button from the Toolbar gt Right clicking on the image selecting Format Images and selecting the desired layout from the drop down menu Click on the Format Images drop down menu and selecting the desired layout The E button is used to view all images in an active series Click once to view all images click again to go back to the single image view stacked OOO LILILILI Click on the button and the currently active window divides into smaller windows to show all of the images in that series The images do not necessarily fill the entire screen but only the area covered by the single series window If multiple series windows are open showing and the users want to see only the images in one series expand that series to fill the entire screen before selecting BER ogo The Set button acts as a toggle switch It toggles between two different representations of a series exam The representations are the currently selected montage of images and a single image Using the Split Button When a single exam with multiple series is cl on the monitor the user can toggle between displaying all the series and a singl
23. side of the dialog box labeled Window Level is for setting W L values for images Each modality will have two preset levels called INVERT and MINMAX Xue The MINMAX values cannot be CURRENT VALUES WL TYPE DEFAULT WINDOW changed these are for showing the LEVEL biggest W L available The INVERT ETE values are initially set at zero but they 3 may be changed INVERT is for 5 Cancel revealing a reverse contrast One or Add more other values may be present as in the following screen for CT exams If the user selects a modality and tissue type and presses Edit the following dialog box displays Users can erase and type in new WINDOW and LEVEL values and can also change the TYPE if a different name is preferred Window Leyel Entry MAUI all the desired changes are made press the f button to store those changes If the TF BONE user decides to keep the original settings after WINDOW 11500 some changes have been made press the LEVEL 750 Cancel vance button in this case the changes are not kept To add a new TYPE and its settings press the Add button on the right side of the Manage Window Level dialog box The following dialog box displays Type in ne new TYPE name and values and press Window Level Entry If the Remove button is used to remove a modality TYPE p or a W L setting no warning message is displayed Niaga the item is simply removed Users can restore the 2
24. the Save Print options from the pop up menu To use the Rectangle Rect ROI and Rect to All options perform the following steps The Rectangle option simply draws a rectangle but the other two options draw a rectangle and then calculate the following with the Rect to All option applying the rectangle to all images in the series 1 Place the cursor over the image of interest and press the F10 key to activate the Rectangle drawing mode Another option is to click the right mouse button select Annotate and then select Rectangle from the secondary menu This action immediately activates the drawing mode and the cursor becomes an on the screen SS a ienet 2 Press and hold down the left mouse button and move the cursor diagonally across the screen The mouse can be moved in any direction to make a rectangle BRIT View User Manual 43 Chapter 10 Annotating the Images 3 Release the mouse button when the rectangle is properly sized A white rectangle will remain on the Refi New screen When the button is selected the rectangle becomes a dotted outline 4 Ifthe user selects the Rect ROI option or the Rect to All option to draw a rectangle the rectangle will be filled with a solid color Press Re New the rectangle will become a dotted outline and will have the calculations described for Freehand ROI The Rect to All option does the same thing and applies the results to each image in the seri
25. the orientation buttons to implement the desired changes This section covers Rotation and Flipping of the images Rotating the Images The images can be rotated 90 clockwise or counterclockwise by any of the following two methods gt From the Toolbar gt From the pop up window by right clicking in the image window To rotate an image from the Toolbar click on the image and click on the toolbar rotate button The image is rotated 90 in the direction selected There are two rotation directions available through the Toolbar which include gt atate Rotates the image 90 counterclockwise or to the left for each time the button is selected ae Rotates the image 90 clockwise or to the right for each time the button is selected gt Format Images Format Views menu To rotate an image using the pop up right click on the image select Finally these same rotate functions are available through the Flip Rotate pop up Flip Rotate and select the direction The image is rotated to the direction an a Clockwise Rotate CounterCw Rotate selected which include SavejPrint Window Level P Key Mark Report gt Clockwise Rotate mba i Image Labels Ctrl L gt CounterCW Rotate Scout Lines Ctri45 Flipping the Images The images can be flipped top to bottom or left to right by using either of the Flip buttons on the Toolbar or the pop up menu Each time the button is selected the image
26. the words that were entered at the time of the order as the study description and saved as part of the DICOM header if any description was entered there Save the hanging protocol by selecting the Study Description which is the most specific parameter to save on and click on the o Sam button However if no study description is present in the header data the study cannot be saved while this parameter is selected Users get the following message which means that the system has no way of matching a study to a protocol in this manner because no description is given If users do Save using the study description only those exams with the exact same Study Description entered in the DICOM header will be hung using this protocol Save Arrangement as Hanging Protocol PROTOCOL NAME CT PRIMARY Study Select by Study Description BRAIN Body Pat Modaltiy C cT Use defaults fo Window _evel WM Flip Rotate V Magnification Also use Series descriptions BRIT View User Manual 63
27. to the right and down To Move a Group of Images A group of images can be moved similar to the way an individual image is moved by following these steps 1 2 3 Changing the Layout of the Study The ability to change the layout of the study is accomplished easily in order to view other images in the study or to compare a previous study to a current study This is called changing the layout of the study or the series Initially when the images are loaded into the Viewing area it is shown as one series in each window with one image displayed The layout of the study or the series can be changed by clicking on the desired image and by Place the cursor over the first image in the range of images users want to move Depress and hold down the Ctrl key and click once with the left mouse button do not hold it down An open parenthesis appears on this first image While users continue to hold down the Ctrl key move the cursor to the last image in the group to be moved Notice that a closed parenthesis bracket moves across the images Depress and hold down the left mouse button on the last image Continue holding down the Ctrl button The following symbol appears While holding down the left mouse button and the Ctrl button drag the group of images over to the image where the image is to be moved and release the mouse button and then press the Ctrl button This drops the images Notice that after the mouse leaves the last
28. warning May be different patients You have images open From a patient with ID 2 For a second patient click on Patient List on the main menu select the second patient s name and again click on View Selected or View All ds For ane with ID The following warning message displays Would you like ko clase Ehe First patient Select No to keep the first patient open along with the second before opening the next 4 Users can open more patients in the same way To see one exam at a time click the Exam button on the Toolbar Repeat clicking on the Exam button to view all open exams in successive order Select Individual Studies or Series Select a patient on the Patient Select list At the bottom of the screen select the Study tab should be selected by default Each study as indicated by a Description and Study ID is listed on a separate line Select only the Study lines to view and press the View Selected button To select more than one line hold down the Ctrl button while clicking on a study line To select an individual series select a patient name and then select the Series tab at the bottom of the Patient Select list The series in all studies are listed Each series has a Series Number along with the Description Modality Number of Images Date and Accession Number if available Users can highlight an individual series and open it by clicking on Yewscbcted If selecting only one series and clicking on the button t
29. AARAA p EY MM MVM ld SU le MA LM KA I P KB KA BABA KAG SS SISSY IT S NS NY WO SANS IN ID II Oo ID II S SS Up 7 S 7 Co Wp A T SY fi fll P bg Ut LIU P MI ME MEY HEY VI M EM MEY HEY ld HEY EY HEY EY ug EY MEY uu u EY EY EY ua ul e ak a4 e ug CV POP PE OUL OUL OUR UU L GUU L DUU L UU CM M MM M M M MM M MM M M TRO M M M M M M M M M E ee MMU UMW SI BN NIN WY WNN NAN SS WWW SNN SN NNS KNN RSX Copyright 2008 RIT Systems Inc rinted in U S A ll rights reserved BRIT Systems Inc Dallas Tx 75207 NI angu RAYON Ly yyy yy Yi Bg ai ty M Ii ul un ub la Me ut ull ua MU ua I a MMMM YO Wp 7 7 WIL c A d Ww uuu ua uw ena ME MM LM CM RRRA 7 I I I TI I PII I III I III SUGO I III I SUGO I III I LUL SYO L IUE I ME ME M MEL MLITNu uU ma xttl Wy I I P I M I M lumi uuu uu ue A I MA Ip M Lr uu um ug uam nen u utt I p MI P ID Midi P III NAO P III P III P OLL ddl II LM M BM I LL ng uua uuu A IN PP PP RE PP PSP PP Og PI RRRA M M M M M M M yyy YUP ME MEd ME IL Lyn naa e n4 eu tk UE I h Ly pitt LE uu un amu acl aua POK MM M M M dll ll ll dil ll seg Notices Copyrights and Revision Records Manual i SS S Release Number ME PP SN LE 7 Yd Jp Ul dll Ml bl ll P I T 7 1 0 0 DY Lg LM ME Mes MEM M MIac u So AL YA YA YA YA YA YA YA YA 7 7 1 0 0 tit Lg MI I LM Al L
30. CR of the same hand with Reverse Contrast turned on in combination with Small Edge Enhancement is shown below as Sample 3 which provides a minor edge enhancement to the current image A CR of the same hand with Reverse Contrast turned on in combination with Big Edge Enhancement is shown below as Sample 4 which provides a heavier edge enhancement of the current image Sample 1 Sample 2 Sample 3 Sample 4 Normal CR View Reverse Contrast On Reverse Contrast On Reverse Contrast On Sharpen Off Sharpen Off Sharpen Light Sharpen Heavy The Edge Enhancement or Process Image feature allows users to enhance the edge definitions within an image by using the mouse and a pop up menu option This feature does not work on a frame grabbed or scanned image 1 Select format Images on the main or pop up menu 2 Move the mouse over the Process Image option and the following Sharpen Heavy F4 sub menu displays 2 Sharpen Medium C rl F4 3 Sharpen Light Shift F4 3 Move the mouse over one of these options to select whichever enhancement level of the to apply and release the mouse button 4 Users can repeat application of this process several times if needed to further the enhancement or contrast 34 BRIT View User Manual Chapter 8 Scout Lines and MPRs Chapter 8 Scout Lines and MPRs Scout lines are used to determine the location of the images in one series compared to another saggital to axia
31. E Images All of these components are matched if the Accession number is the same in all components BRIT View User Manual 56 Chapter 12 Teaching Files The following are some performance suggestions for planning the layout of a teaching file gt It may be desirable to have series studies patients with a large number of images so that the user seldom has to make menu selections However most viewers performance drops when the number of images in a series is too large Also if a patient illustrates only a few didactic points that patient might be more useful in multiple presentations Limit the size of a series to no larger than a fairly large clinical series from the series modality gt If the target viewer does not easily handle series one at a time or a fewat a time limit the number of series in a study gt Try to make each study illustrate only one or two points gt Use a patient to illustrate a set of related points Sample Teaching File Organization This sample is shown as an intended Teaching File containing studies to present something related to lung issues to the new residents The selected studies reflect early middle and late findings The early time period has a couple of natural studies each with two to three series Middle has about four studies each with two to five series and late has about ten studies In the hospital the teaching file patients are identified specifically such as l
32. Fuji Printer Next select the matrix desired to use from Print on the main menu or Plain Paper Printer from Save Print gt Print General on the pop up menu All options begin with the word Marked because the next step is to mark those to print 6 Once the format has been selected a screen is shown with all the images in that series along with a box Image Print used to select images to print as shown in the following figure 7 The options in the Image Print box can be used to select all or no images quickly otherwise just select the individual images by clicking anywhere inside them HB B Pa F Clicking on an image toggles that image between selection and de selection Selected images have a green P in the upper left hand corner BPS ls HBG z Pap ae aA Images not selected have a red B In the example figure the top two rows of images are marked to print and the bottom to rows are not selected 8 Once all images are properly marked select from the Image Print box If any of the images turn black during this process use the button on the Toolbar to repaint the screen The Print General Option To use the Print General option use these steps 1 Select the option Print from the main menu or Print General under File on the main menu or under Save Print on the pop up menu After selecting Print General the following list displays This image only This img true sze Marked 1 by
33. K PI Mg L Aa WHU ME MM 7 1 0 0 yyy MI th tl MES ME MW Lg 4 LM P3 PI till fille fille fill fide tilde fil fill 1 L1 Lll 7 2 0 0 NY pt fs ML ME PI PW 8D MMM MMM 7 2 0 2 ULM MM lg DIN fill PIA IIIA I IIIA Pha 7 2 0 6 MM o Author J SS SSO AOA AAAS N NN NS A MM M M MM M MM MM MMM NI AANA IN SSS W SI M amp W SIN NN N LAAL M M MM MMMM MMA WX SSS ID ID SSS NN III Y Litt Me LM Mol Mt gua BL Wij up I IL I IL I IM P III P III P III P IIIA I Ip SS MATURE p Wel ltl Mle AL AE P a SIS SN SEN NN SN SN KSE SN NN SSS BRA dey Me ey i lg DAL SS W NI T Harris ty tit B C Mel L AMI L L OT SUS Lll AA AA GA BA A LUA GA LLLA LLA LLL A LUL A A T Harris 7 3 0 0 I bt Mg Mg A LI LM PP PIPS p IL I IU MOL I LOL I III P III I IUE I III I UP My Ms YW Ve Vi YW VY YW I Ve hd Yi 1 T Harris 7 3 0 0 ty yy ttt PP he Ae PP PD PB AE MEY PALM LUUL fill P bill P RU I I I I IE IIT IE IIT TUT SA WW WQs SM SSS SS IIII 77 7 YS Mi ANA My lt 7 Me A LS A 7 My WS Ze My I 1 VIP W o SS WO SS SSS ONSSSSCN SS PI SSS SELO NN SS SS ZZ h II NS NI CQ We LOLA AAV III S S IU ME LL ML ME Moor ng lr p LAC UC Mh th bi hh tl ti jo MMMM MMM YM M M MM M M MM MM MM MIT I P NS WNN IN WWWAN WO SS IN SS
34. Teaching files are also supported The BRIT View allows a variety of users to view the patients they have permission to access and perform a variety of tasks on the selected study Measurements and annotations can be made on the images formats can be changed window leveling can be set according to preferences and a variety of other functions can be performed on the BRIT View software In most cases BRIT View is used by the clinical staff including Nurses ER ICU OR and a variety of other functions around the facility BRIT View can also be used by the Radiologist as a diagnostic workstation when used with a higher quality monitor it provides the same viewing quality as the BRIT Vision Diagnostic workstation Starting BRIT View BRIT View runs on Microsoft Windows XP and is downloaded via a web browser An icon can be placed on the desktop the first time the application is downloaded for ease of access BRIT View User Manual 1 amp View Chapter 1 Introduction Starting the BRIT View Application BRIT Viewer To start the BRIT View application click on the BRIT View icon on the desktop lor h ities Patient List tus Help The BRIT View window opens The BRIT View application can be set up to receive images via gt Local only Studies that were downloaded to the computer requesting the study gt Java Interface to Roentgen Files Studies that are stored on the centra
35. To T az I 10 IS APR AR PAA E 9 Select Individual Studies or Series 22 22 2 2 aaa aasa aasa 9 Updating the Patient List when New Studies are Added ccccccccccsseeeeeecccessneseeesseeceessssseauseeeeesssssaaaeess 10 CHAPTER 3 VIEWING THE STUDY 1 eceeuer enne nnne nnnm num n enhn a RR R RR RR RRSR RR RR RERR RR RR RO RR RR Rar NAAN 11 SCROLLING FEATURES ccccceccececcececccceccccucccecuccecucaeceeuecueaeuecuuecuuaecsuausueausecueuecuuaecsuaessuaesecuenecsuaessuaessuauaeceuaeees 13 Moving from Series to Series Exam to Exam 0000 aaa 13 Removing a Series Exam from View uu eesscccccccssseeeececsccssseeeeeeccesecsesauseseeecesesssaeeseeeeessssaseeseecesssssaaaeseecesseaas 14 Comparing between Image Series Other Exam39 22nn naanakan anna naa arant nsn naa 14 TITLE BAR OF THE ACTIVE IMAGE eceeenRI IIR mRI ne aaa 15 CHAPTER 4 CHANGING THE LAYOUT eere rennen nnn nennen nhe nh enne snr snas na na nana ss su she KNA sa uasa ra 17 USING MULTIPLE MONITORS cceccececececcececcceccccececccuuuececaccenececseueuunececsuuaenecscuununecscaueausetscauaunersceuauauaenerstanass 17 Opening a SIN GIS IMAGE naan E pa aLak AALAGA kaa 17 e NING TWO SII ONC RN 17 Working with Multiple Series assinar siaina eii NR a EEE e 18 USING THE FORMAT VIEWS MENU a 18 USING THE FORMAT IMAGES MENU cecececcececececcececcccccececacc
36. User Manual BRIT View December 2008 Release 7 3 BRIT Systems UM BVW 007 3 BRIT View User Manual BRIT Notices Copyrights and Revision Records Systems Notices and Copyrights This document is subject to change without notice and does not represent a commitment by BRIT Systems Inc The information set forth in this document and all rights in and inventions disclosed herein and the patents that might be granted thereon disclosing or employing the materials methods techniques or apparatus described herein are the exclusive property of BRIT Systems Inc Copyright Copyright 2008 BRIT Systems Inc All rights reserved Printed in the United States of America Trademarks BRIT Beyond Roentgen Imaging Technology BRIT Systems Inc BRIT View and the Pincher Man logo icon are trademarks of BRIT Systems Inc Microsoft and MS Windows are registered trademarks of Microsoft Corporation All other product names or trademarks mentioned herein are the property of their respective owners i BRIT View User Manual Revision Records Revision Record for BRIT Vision User i S S 04 LEE Tale Authority P SS Date Gf ll 1M Ml ME d h P fo 2 2004 Vy fi 1 Pg I p i Jl LUL OUL OUL ORUL UE I QUU L MO 3 2004 7 PAG I II I IE I III I II 4 2004 I Bg YY a IL I MT JU VALE a LY PSG VALOLO TOG LOR TOAL OUL ORG MID L LUT OUUU L LUUT LUU 1 Al 6 2004 UI L
37. X aatmth Uj LEA SMES VUE UE I UI I UI I UI I I I EE EEE EE EE EE I L UI L EE EEE L UI P UI L UI P EEE EE EE EE EE I I I L UI L EE SED bl New Version of software Wy SSS iy SGY AA KGG YY MUM MC MCMC AY BGY AY KGG BY AY LG AY KAY YY KB AY SAGO Yt LL Vil OUL ORUL Mle dd bhi fff T lll Mi I Mi MI hl UU si DS TON OUL UU 3 I Mill OUL UU L A M MM M M M M M M EEM Add the BRIT View Burn Module appendix toy P yy MEA MES ME Lf aat ua SY YUP YS BUG E E M0 BUY uk BUG ien HEE SOS BY 0 JEV BY nog lo la ng gud CALM GA KA O KK OO L OUL OQU KA GE GR GT KG GB GA BR GG I GA BE OUI L BR AL P JAL I I I I HII I II I I I HIE II I I IE HI I II T Updated Ws MAA SS NNI aai S N 7 LUL UU N N SS In IN WW AGU gao Updated WWW WAwEe SIDIIY Kw IOS N N W r3 WI UA MME EM Mild Ul GR I I P pP Updated P Qs SAA SIN SIN AN NI SW Ul MOM MMM a 4 WM Updated VW GE lg Ig Pg I a P YY P M MEE LI BY LA LAYAW rw A P P Ml lil Updated A AIG NI WN 7 7 Y 7 IU Wg AMAA SS IN LY HE EY EY POY P p 77 MM ddd Vil WI Vl Ml Wl UME SMe VA UME MEY Mb EEE Le Updated 7 P P P SSS S SS WON WAS WO QA WS 77 Lo 7 I P 12 23008 ty yy yy YM ul un nn NAG pP MAG Ml I Ml I Ml 7 7 UMM MMM a N SONS S SS SN MOQ WOMAN NS SISISIHIN Updated NN N N IS SS WOOK NS VM S SN SENSN SS SESE N GARAR
38. anges as the use scrolls through the images gt Window Value The current window setting This value changes as the window level setting changes Y Level Value The current level setting This value changes as the window level setting changes Pixel Value This value changes as the cursor is moved over specific pixels The Image Border contains the following information 51 v1 12 29 6 ABD PEL SCOUT Study Number Series Number Date of Exam V V V WV Body Part Series Description The Image Viewing area displays the images for the study Close an Exam and Exit To exit the Exam Viewing screen and close the exams being viewed select Close All on the main menu or chive press the button on the Toolbar This automatically returns to the Patient Select window To completely exit the BRIT View application position the mouse cursor over the small x in the uppermost right hand corner of the BRIT View s main window Click the x This closes the BRIT View application The Patient Select window can be closed without closing the BRIT View application View BRIT View User Manual Chapter 2 Searching for Patients Chapter 2 Searching for Patients The BRIT View can be configured to get images from either the local computer the Windows PC on which the BRIT View is running or from remote image archives PACS This section describes how to use the remote patient list user interface
39. ard through the series 5 To turn off scrolling right click the mouse to re display the pop up menu and select Scroll Stack again This will remove the check mark To scroll through images automatically use the Cine function Holding down the button will cine forward through a series Holding down the lt button will cine backward through a series Moving from Series to Series Exam to Exam The Exam button is used to select one exam to view from all the exams open on the monitor and then to switch from exam to exam T 2 3 First select the exam to view first by clicking the left mouse button anywhere in the exam s visible area Select the 2 button The selected exam now occupies the entire monitor Press the eXam button again to view the next exam that is open EI BRIT View User Manual 13 Chapter 3 Viewing the Study Removing a Series Exam from View An exam can be removed from the group of exams currently being viewed To remove an exam from view use these steps 1 2 Select the exam to be removed This action will make that exam s window the active window Closing only the active window then removes the exam To close the window click the left mouse button on the small x in the window s upper right hand corner The window and its associated exam will be removed The icon just to the left of the x maximizes the window size and the one to the left of that the minus sign minimiz
40. ast names beginning with an X and these patient s whose ID begins with XR are certainly their corresponding Patient ID and make the Accession Number Correspond to the Patient ID PATIENT ID XRLUNGS1000 PATIENT NAME XBURNS XGEORGE ACCESSION NUMBER XRLUNGS1000 STUDY DESCRIPTIONS OF Early Middle Late1 or Late2 or Final such as XRLUNGS 1000Early XRLUNGS 1000Middle XRLUNGS1000Late1 XRLUNGS 1000Late2 XRLUNGS1000Final The first study gets a short study description to show in lists such as Early Middle Late1 Late2 or Final 2 CT series each with selected images from a different CT exam of the same patient 1 CR series with images from a different exam for the same patient 2 MRI series selected images from different sequences in one MRI exam The second study gets another Accession number such as XRLUNGS1001 and another short study description such as Early Middle Late1 Late2 or Final 2 CT series exams from different patients 1 CR series exams from different patients 2 MRI series short sequences of exams different patients and so forth mAn BRIT View User Manual 57 Chapter 12 Teaching Files Creating a Teaching File After the naming convention is determined the next step is to select the images from the various studies to place in the teaching files The basic steps are as follows 1 2 10 Select the first patient exam from to be used for the teaching file Once the exa
41. d to the PC as well as DICOM printing DICOM printing requires additional integration The quality of the paper print will depend on your printer To print a single paper image use the following instructions 1 First set up the format and annotate the image s if necessary 2 From Print or File on the main menu select Print WYSIWYG Paper The term WYSIWYG stands for What You See Is What You Get A standard Windows Print dialog box displays as Prnter Mame shown here Status Tupe HP Color LaserJet 5500 PELE 3 Choose the printer paper format and number of Where hpcolorL aserJet5500 copies Comment T Print to file i 5 Print range pop eee 4 Select s to send the image to the oa Of NN printer Pages from URINE In TUE Selection gu Cancel 50 BRIT View User Manual Chapter 11 Printing Saving Sending To print an entire series in a selection of formats use these instructions 1 First display just a single series on the monitor Select Film Printer to Use X Select the Print option on the main menu bar Selected Printer Click on Select Printer from the drop down menu The following Select BRIT Test 1 Film Film Printer to Use dialog box displays This dialog also allows paper printer access All Printers select one From the dialog box select Plain Paper Printer BRIT Test 1 Peper
42. d window and level for that region For example place the cursor over the bone in a CT image and press the middle mouse button the system will use preset values to set the window and level to a bone window The middle mouse button also functions as follows to make fine adjustments in Window and Level when held it down and moved gt gt gt gt Move the cursor up to narrow the density range Move the cursor down to broaden the density range Move the cursor left to view the lighter shades of gray Move the cursor right to view the darker shades of gray The adjustments in these regions are quite fine and the actual values can be seen at the upper right part of the Exam Viewing screen If the user wants to reset the values to their original value select the W L Reset button on the Toolbar Window Level Presets Window and Level values for various tissue types are displayed using preset values from system files when users use the BRIT View The System Administrator can change these initial default values However users can adjust the preset values for different modalities after images are displayed by following these instructions Display the image or image series and make it the active MAMANA Na image Select Utilities from the main menu User Name Select Setup from the drop down menu A secondary menu displays Select Window Level Presets from the secondary menu The following Login for Logical Operat
43. de the user through the use of this feature 1 10 Format on screen the images that to send or if an entire series is to be sent format a montage of part of that series Select FilesImages to Send from the main menu The Mark Images dialog box displays along with the images which now have a P in a small box in the upper right hand corner of each image The means they are still unselected Click the left mouse button once anywhere on an individual image that to mark or select Mark this Series or Mark ALL Series from the Mark Images menu Imapes Marked to Send After the selections are made a P appears on the image There are 1 series with a total of 33 images 2 images are marked For a sending You will send the images using Sendcemman ta the selected destination Click on the ONE e button If Abort is selected the action is stopped without out sending any images Is this OK Another dialog box labeled Images Marked to Send displays as shown in the following figure w Once the marked images are detected in the outbound image directory the system polls the directory every 20 seconds looking for dcm files to send the system automatically sends the images to the currently selected destination s as set up within the BRIT SendCommon application As noted earlier the destination must be specified beforehand by the System Administrator to establish these destinations x The destinations that have GG
44. e desired layout from the drop down menu As additional series are selected the viewing window changes to accommodate the new series Therefore if a second study is selected the window is divided in half so that the images from both studies are shown Using Multiple Monitors An image viewing system for BRIT Vision can be comprised of up to two monitors for viewing because these are systems used typically used by referring or performing physicians whereas systems used by radiologists for diagnoses will commonly have from three to five monitors If users have a system with multiple monitors when the user first starts up and logs in the Patient Select list or Patient Panel when using the Roentgen HIS interface opens on a single monitor Users can drag and drop these windows to another monitor The desktop is spread across all monitors The main menu remains on the left most screen and the Close and Minimize buttons move to the rightmost screen When images are open the Toolbar is present on all screens The single cursor can be controlled by the mouse and moved across all monitors as if they were one large screen When multiple series are opened each series displays in its own active window in stacked mode The following three subsections describe various possible scenarios for displaying images on multiple monitors Opening a Single Image If the user opens an exam with a single image that image opens on the left most monitor In s
45. e Scout Using the Pop up in the Viewer Since the Toolbar only provides the formats of one up two up four up nine up or All formats and occasionally a different format is desired additional layouts are available by right clicking on the viewing window and a pop up window opens as shown here Select Format and a second menu opens to show a list of available formats Scroll down to the desired format click on it and the format changes to the selected layout The layouts available through this method include VVVVVVVVV VV Stack Two page Four page Six page Nine page Twelve page Sixteen page Twenty page One by Two this layout displays one column by two rows of images Two by One this layout displays two columns in one row of images All this layout displays all images in the study or series The format used depends on the number of images Rearranging the Order of the Series When there are multiple images of a series displayed on one or more monitors the user can gt Rearrange images in reverse order gt Move a single image to another location gt Move groups of images to another location in the series The following subsections describe how these features work To Reverse Order a Series 20 Order Images in View l Mote rau can also use mouse Shft or 1 From the main menu bar select format Images and then Ctrl drag drop to change order Reorder Images O The following Order Images
46. e around the original series and left click and hold and the other image depicts the new location The user can scroll through the reconstructed planes Standard measurements and markups can be done as well This MPR operation can take lots of memory If the user gets a message saying that the system does not have enough memory try shutting down all other applications and then try again 36 View BRIT View User Manual Chapter 9 Cloning and Linking Series Chapter 9 Cloning and Linking Series A clone is an exact duplicate of the selected series in stack mode The clone is synchronized with the selected series but the window leveling can be changed separately from the original series This function is helpful when the user wants to look at the series in different window leveling settings Cloning a Series To create a clone follow these steps 1 Select the patient and select the series to be cloned 2 Click on Format Views drop down menu and Select Clone or select Ctrl C on the keyboard For example the original series of the brain may have the window leveling set for brain image on the left while the window leveling setting for the clone image on the right is set to bone It allows side by side comparisons of images in the same series The series are also synchronized so that the same image number is shown as the user scrolls through the series Linking Multiple Series Multiple seri
47. e image around the Viewing Area until the desired portion of the image is shown To enlarge an image from the Toolbar click on the image and click on the toolbar magnification level The image is resized to the magnification level selected There are several magnification levels available through the Toolbar which include Hit gt 00M Enlarges the image to fit the page Ix gt d5 Sets the magnification to the original size of the image gt UU Enlarges the image to twice the original size of the image There are also several magnification levels available through the Zoom drop down menu which include E m gt Fit Window gt X1 x1 1 gt X15 gt X2 g gt X3 gt X5 pa gt X 05 Magnifying Glass X 0 5 0 Mag Glass BRIT View User Manual 25 Chapter 5 Magnifying the Images Finally these same magnification levels are available through the To enlarge an image using the pop up right click on the image select Zoom and select inet vens the magnification level The image is resized to the magnification level selected which sss Adjustable Fit window Us v Y Y Y vha rv v include mae ae Window Level x2 2 gt Fit Window gt X1 Kako e Mag Glass A5 5 gt X 1 5 X2 Image Labels Ctrl L L aba Scout Lines Ctrl4 5 gt X3 gt X5 gt X 05 gt Magnifying Glass Magnifying Glass Q A magnifying glass is available for the images by select
48. e series using the F button on the Toolbar When multiple exams are opened then the I button toggles between the active single series and all the exams To rearrange series within an exam select the top border title bar of the series to move and use the left mouse button to drag its upper left hand corner to the desired position then release it The series from that location and others to the right and below it will slide left to right top to bottom Using Cine Mode The Cine function automatically displays the images of a series in looping succession When the last image of the series is displayed the first one is redisplayed and the loop repeats The series of images must be in Stack mode to use Cine To use the Cine function 1 Select an image from a stacked series of images If the images are not displayed in Stack mode an error message displays 2 With the mouse cursor inside the image window click with the right mouse button A pop up menu appears 3 Select format Images from the pop up menu A secondary menu displays 4 Select Cine from the secondary menu The images in the series start displaying in succession 5 The display rate can be controlled with a slider control that appears as shown here Cine Control The slowest speed is about two images per second 22 ES BRIT View User Manual Chapter 4 Changing the Layout The fastest speed makes the video display look like a rapidly moving picture T
49. eaeuececacueneuecscaeauaesecseauaunecstseauaenerseauaunerscesseanaeners 19 USING THE POP UP IN THE VIEWER ccceccececccecceccecccuccececuccuccucecuecuccecuecuuaucaecuesuuaeceeseueueaeceesausueaecacaeseeseesass 20 Rearranging the Order of the Series eiiis se sseea aane nsns nnn nana n nnns sss sa aaa ains sn sss sas aaa aas n 20 BESSER Nae AA AA AA 22 CHAPTER 5 MAGNIFYING THE IMAGES cccceccecescecceccecescnccecescescnscecescnsencescesensensesensenseneesensenseneesensaas 25 MAGNIFYING THE IMAGES cccccceccececcecceccecccucceccecucceuceccucueceuceceucuecuececucuesucaucsucuusueaesuecsuuueaeceesuuauecesauaeseeseesass 25 WIAGNIP YING GUIASS sic RREEE A A A 26 ADIUSTABLE ZOOM eee ee AE A EEEE NE AE AA AA eee 26 PANNING ston great caditesseanernentnmutascsaunetiucutamacentassodeuesteetaauaebor AA NAO 27 CHAPTER 6 ROTATING FLIPPING IMAGES 0 ccccecescecceccecescncceccscescnccecesensencescesensencesensenseneesensensenensenseas 29 ROTATING THE IMAGES aaa 29 FLIPPING THE IMAGES u s 29 CHAPTER 7 WINDOW LEVEL EDGE ENHANCEMENT cccccsseccesecceeeeceeeeceeeeeseeeaeeeeaeenenseneeeenaeeenass 31 WINDOW LEVEL sicci EE ERR TTE 31 MANUAL ADJUSTMENTS FOR WINDOW LEVELING 2cceccececcecceccecccceccecceccccucceccecuecuccuceecuecausucaeceecuuaueecaceuuaeseenass 33 TS BRIT View User Manual 5 Table of Contents EDGE ENHANCEMENT OR
50. enn nene ahhh nana nennen ananas anne nnns 49 PRINTING A REPORT W m 49 View Create and Select RODOM S sirener E S E E E E EA S 49 PAO OUT a PREDO aa a EA E AE E A AR 50 ECO r O O mM A EA EEE E N EEEN EN EN EEEE A 50 BIET P 50 mii cai 50 THE PRINT GENERAL OPTION 022201000 nn nennnnnai nnns rris ssnsa iain siiis s ssssa isis siis ss ss a ains nisi ssa annes eren ns 51 SAVING IMAGES MERE RR RI 52 Saving IMAGES GS DICOM A 52 Saving Images aS MICE E M 53 SENDINGINACGE aa AA E AA AA AA 53 USING SEND COMMON m naan na 54 CHAPTER 12 TEACHING FILES AA ANNA AA 56 ORGANIZATION OF THE TEACHING FILES u s 56 Sample Teaching File OFQANiZAtiOn ccccccccssseecsecccesecnssesseeeccesssssueussseccesessauuesseecessssasseeseeeecsssssaaaeeseecessesaaas 57 CREATING TEACHING FILE E 58 Protecting Patient Confidentiality cccccccccsccsseeeeeecccescessuessseecessesassessseeccssessausesseeeeessessauaeesececsssssaansseeeees 59 CHAPTER 13 HANGING PROTOCOLS 1c cerLee eec LLLI LLL rre KANAN SSENNNNNN eee annes sas a a err sees s asas aa KAKANAN 60 Screen Settings that can be Set in Hanging Protocols
51. es On CT images the application calculates and displays the Hounsfield Unit value for the pixel below the tip of the cursor The display is in the upper __ PR right corner of the Image Viewing screen as shown in the following figure Ww 400 L 40 HU SI Measurements annotations or other information that is added to an image are not e automatically saved to that image when the button is selected to exit the 272 y Next exam To save annotations select one of the File gt Save or File gt Print options from the main menu or select one of the Save Print options from the pop up menu Freehand Drawing Many times the physicians prefer freehand drawing around an area of interest or having an arrow point to a specific target or drawing a box around the area This section shows how to access various types of freehand drawings To use the Freehand drawing mode 1 Place the cursor over the image of interest and right click and select Annotate and then select Freehand This action immediately activates the drawing mode and the cursor becomes a on the screen 2 To draw a line segment move the pencil cursor to the desired first endpoint to begin and press and hold down the left mouse button 3 While continuing to hold down the left mouse button drag the mouse using curves or straight lines to the point on the image where the second endpoint of the line segment is to be placed As the mouse is dragged a l
52. es but keeps the window open Comparing between Image Series Other Exams To compare images between two different exams 1 10 11 12 From the Patient Select screen select the first exam or IBUETmIPAN EE aa series in the exam users wish to compare Users can select individual exams or series under the labeled Study and Warning May be different patients Series tabs at the bottom of the screen You have images open From a patient with ID Select View Selected or to compare all of the study select Haba ON You are requesting images For ane with ID View All The selected exam will open in its own window s CT000000 73 across the Viewer Would you like to clase the First patient Click again on Patient List on the main menu bar to see the before opening the next Patient Select screen Select the second study to use in the comparison and press Lc Ss View Selected or View All A warning message as shown here first displays to let the user know that that another patient is being selected Select No on this warning dialog All exams will then display on the monitor and users can enlarge them individually if necessary The exams open on the screen with each series stacked One exam will be on the left half of the screen or on the left hand monitor and the second exam will be to the right To return to a single exam view highlight one of the series in the exam to be displayed alone on the screen then select
53. es can be linked so they can be scrolled together To link multiple series 1 Select one of the series to link 2 Next select format Views from the main or pop up menu and then select Link Views I from the pull down menu The Link Views dialog box displays as shown in the Link By Relative following figure fe Frame Number ALI Mutti Position 3 The button automatically links all relevant Time Uni This a series Choose how the images are to be matched D INSTRUCTIONS 1 You selected primary View iE controls the rest Frame Number or by Position Select the Now left click on one or more secondary Views button from the Link Views box 3 Right click when done 4 f there is a series that should not be in the group then simply select the series to be unlinked and select Unlink This 5 The linked series can now be scrolled simultaneously by clicking on the original series chosen All of the series in the links are designated by the two chain links on the bottom left hand corner of the series window The chain links on the original series are different from the others View BRIT View User Manual E Chapter 9 Cloning and Linking Series 6 Series also can be selected individually to add to the link Rather than selecting Lo 4 just follow the INSTRUCTIONS in the Link Views box This also works for linking series between exams or in different studies To look at just the l
54. ext as typed use the following steps 1 Select Annotate gt Font Text from Utilities on the main menu or from the pop up menu 2 The Font dialog box displays as shown in the previous figure 3 The Font dialog box shows the default settings for Font Font style and Size The settings can be changed by selecting from the three appropriate list boxes The Sample field shows how the CTTO tre rrr rer rrr x Ok selection appears on the image s After making the changes click on the Lx 4 button the font style and size change accordingly BRIT View User Manual 45 Chapter 10 Annotating the Images Sticky Notes Sticky Notes are a method of typing information on an electronic note that can be saved to the server and made available to other DICOM Workstations These notes are stored in the DICOM Key Object Notes To create a sticky note use the following steps Mark as Key Image 1 Under Utilities on the main menu bar select Key Image Make The Mark as Key Image dialog box displays as shown in the following figure poses code Ofinterest gt T arrow and select the position from the choices of PO gt Radiologist default gt ER Physician Cancel for Entire Series gt Attending physician gt Referring physician gt Technologist 3 Under Reason code the choices are Of Interest default For Referring Provider For Surgery For Teaching For Conference For Therapy For Patient
55. flips accordingly Flips the image top to bottom for each time the button is selected BRIT View User Manual 29 Chapter 6 Rotating Flipping Images gt E Flips the image left to right for each time the button is selected Finally these same rotate functions are available through the To flip an image using the pop up right click on the image select Flip Rotate and select the direction The image is flipped to the direction selected which include gt Top Bottom Flip to flip the image top to bottom for each time the button is format mages b selected aan k Rotate b Left right Flip gt Left Right Flip to flip the image left to right for each time the button is oe qao selected Window Level gt CounterCW Rotate b Key Mark Report Mag Glass b Image Labels Ctrl L Scout Lines Ctrl 5 30 BRIT View User Manual Chapter 7 Window Level and Edge Enhancement Chapter 7 Window Level Edge Enhancement The window and level settings allows the user to change the range of densities being viewed on the screen There are several actions that can be taken to change window and level settings including preset values and manual settings Window and leveling are the adjustments used for brightness and contrast control for the images To adjust the Window and Level control place the pointer over the region of interest or tissue type and click the middle mouse button once This provides an optimize
56. g Sending Adding a Report Adding a report is done in the RIS only Use the Add button on the Manage Report Panel to type a report in the Interpretation Text area Any text already present is saved as a separate report when the selects the Add button to input new text The Cancel button takes the user to the Patient Panel or cancels the current Add or Edit After enters the report press the _ Prelim or Sign button to save the information at the level desired At this time the Edit and Delete buttons become active Editing a Report Editing a report is done in the RIS only Any radiologist may edit a report Use the Edit button to make changes in the Interpretation Text field which is grayed out and inactive when the Manage Report Panel first displays The original text remains until it is changed The Draft Prelim Sign and Cancel buttons do not activate unless changes are made To cancel and not make any changes use the Navigation Compass to return to the Patient Panel Deleting a Report Editing a report is done in the RIS only The Delete button becomes active only when a report is selected Users can delete another radiologist s reports When selecting a report press Delete and the following message displays Question To continue with the deletion select The report is deleted and the Patient Panel appears Otherwise select Printing Images The BRIT View application supports printing to any printer define
57. g ll gg ll i NP P p OUL Md Mle I 9 2004 WS ME MY MEO MEE MEE HUE d SO OL LM Le ee PATA 9 2007 SUS ys yyy th ANT Lg A YL MME Mtl AGUA 2 2008 Z Wd V Rev 27777 WI Sections Pages Affected TSS SWS I ll SS NSSSRNSSSQNESSSQNISSNISSSN A 7 A VLE MEE EE MEE EE TYO SD EE HEV EE HEE EVV LU UL UL OL BA BK M BE M E M BE BE O E AMAG All YY LU BL YY AY P I 727 ME LLL MUUL Mle BL OUL Ml L LUH IS Initial DS SY hy US SE h WES J Vl Mb VAALA CAKA 1 MI A G p G ty BALOU LAA ASINA S S SR RS S WAKA SONS NEN nx 5 bg LL yyy yyy Ui Bg nM LAN AMU Mle NI BAY BY BGY WOME BY AAA ALAM AA MAG MAE All reformatting for functional outline tt LIP LM MI PP M Ill WW Lai HEY HEY EY EY MEY HE nM HEY HEY HEY HEY EY LM PP Bu uu ua unn gx O LGE GG Added Pages for Roentgen RIS Mt ME MR ML du Ile b ME ddiaMW M DY JCC aul nal 00 HEE DO SY IBU MEM 44 YS PS dilute BU M I BS HS ld LL P LL Ip II Mp I OUL a Reformatted and updated MI ML MP Mts bits ME UN P MN B G Cg BT TI OCUB NV GI LN LP BM TIC BI RT LU PT PP PP PP PP P MM 77 MM MM MM MI ddd Ip II M MM P III dcdcdc P II BAK PK M M I Ip P III I I II AMA Ip P pa All LI M MM APP GP PP GP AP AP PP PP PP PAP AP PP AP PAP PAP AP AP AP AP AP AP NAP NAP NARS CLL LU LL LL AG All Reformatting and updating new release Me MEL Md MIEL MN LC LE MFLIWI tkkau uat EVM tc YAY YY wa HE EU SOS IYO HEU BOB MEMINI BMC Ir d
58. ge as a JPEG file for this type of purpose use the following steps 1 Start by setting up the screen as it is to appear 2 Next from the File option on the main menu bar select Save WYSIWGY Jpeg The following Save As dialog box displays 3 The default folder for saving the images is called saen Jpegimages ct EE Jpegimages Select this default folder or select another folder and enter a name for the screen If users do not want to enter a name use the default name that the program enters automatically see name above in the File name field 4 Make sure the Save as type field says Raw Jpeg Files eo Ga jpg Save as type Raw Jpeg Files ip v Cancel 5 Select the Save button to save the JPEG image Sending Images There are several options for sending images to other locations To e mail images to a ages user without a DICOM workstation the user can use the JPEG tool first to create and save ummak Mak the necessary images The user can save the images in the JPEG format to a selected thisSeres thisSeries spot in your directory Then use the attachment feature of your e mail application to Unmak Mark attach the JPEG file and send it pana kaha 1 To send the images back to a DICOM server with presentation states use the fest Save WYSIWYG Dicom option under File on the BRIT View main menu bar This saves the image s as DICOM format Annotate or set up the screen a
59. ges The options on the Annotate menu for Region of Interest include gt Freehand ROI gt Ellipsis ROI gt Rectangle ROI Measurements annotations or other information that is added to an image are not automatically saved to that image when the All button is selected to exit the exam To save annotations select one of the File gt Save or File gt Print options from the main menu or select one of the Save Print options from the pop up menu Calculating Statistics on Regions of Interest ROI To use the Freehand ROI or Freehand ROI to All options use the following steps The aid difference between these two options is that Freehand ROI to All applies the a drawings to all images in a series 1 Place the cursor over the image of interest and press the Ctrl F6 keys to activate the Freehand ROI drawing mode Another option is to click the right mouse button select Annotate and then select Freehand ROI from the secondary menu This action immediately activates the drawing mode and the cursor becomes a on the screen Hold down the left mouse button and draw carefully around the region of interest ROI Release the mouse and a solid color or grid fills the area Users do not have to make a perfectly enclosed drawing because the program connects the distance between the two line endpoints and fills the grid between these points Rell How Click the left mouse button on the button This acti
60. he cursor and perform the annotation or measurement This section covers how to create the markups and annotations Annotating the Image Kr A nguya f Setup b Users can select the Annotate option under Utilities on the main menu ye bar or from the pop up menu The Annotate menu includes options for Annotate making length or angle measurements for inserting arrows for Key Images K i i Key Image Make Ctrl K freehand drawing and for using ellipse Or rectangle shapes kay aaa Seu SHG Annotations also include the capability for typing text on an image and PS markups P for changing the size and format of the text used to label your drawings and measurements PS Select SHFE P Measuring an Angle Angle measurements can be done by selecting Utilities then selecting Annotations and selecting Angles Position the cursor over one area of the part to be measured click the left mouse button drag the mouse down to the lower end of the measurement and release then hold the left mouse button down again and drag the mouse to the third end of the area to be measured for the angle 1 Place the mouse cursor over the image of interest and press F5 This action immediately activates the angle measurement mode and the cursor icon becomes a 2 Press and hold down the left mouse button where the user wants the first line to begin on the image opposite end from where the angle is created 3 While continuing to hold down the
61. he entire study will open BRIT View User Manual 9 Chapter 2 Searching for Patients Updating the Patient List when New Studies are Added l Refresh List The Patient Select list does not refresh automatically The Patient Select window has a Eee l Refresh List l button Selecting the a button causes another query of the remote archive to be made The query uses the current filter settings So if any new patients studies or series have been added since the prior query they will be shown in the new query results Refreshing the list keeps it current As described above when an exam is selected from the remote list for viewing the corresponding images are transferred from the remote archive to the local system The images are then stored on the local system that l l Refresh List is they are now local Selecting the om 1 button under the Local tab of the Patient Select dialog will cause any and all exams that have been transferred and are on the local system to be listed under the Local tab 10 BRIT View User Manual Chapter 3 Viewing the Study In the BRIT View application the reading and diagnostic screen is called the Exam Viewing screen After selecting one or more patients studies series or images for viewing the Patient Select window or Patient Panel on the Roentgen RIS is hidden and the Exam Viewing screen displays as shown in the following figure Drop down Toolbar
62. he types of exams to be read by specifying the type from different regions of interest modalities exam dates or exam status Once the exam is downloaded from the selected server it is available on the local hard drive whenever the user needs to access the exam The viewing and manipulation window supports a variety of functions that are selected from a toolbar mouse functions and even some keystroke shortcuts Users can easily move between images in the same exam or different exams and simultaneously view images from multiple exams by splitting the window Series are easily linked and synchronized for comparison The system comes with a variety of functions such as zooming scanning rotating measuring drawing montage magnification MPR and navigation via scout lines For some modalities cine is also available including synchronized cine motion There are many tools for controlling how these series are displayed on the monitor s and each user can design and customize the workstation to their own viewing preferences such as hanging protocols Key images are also available for the referring physician which allows the user to select important or relevant images that can be viewed separately from the rest of the exam Key images are separately downloadable to the referring physician Adapting this workflow facilitates the best utilization of bandwidth while providing the physician an option to download the entire study if desired
63. ide cErH 8 Single Image shows one image on the window High Cri D Entire View display all images for the series Tee eee gt 1 Wide shows the images in a single image on the window Reorder Images 0 gt 2 Wide shows two images side by side on the window Scroll Stack gt 3 Wide displays three images side by side on the window Cine w Image Labels CErI L gt 4 Wide displays four images side by side on the window SP fctrl4s gt 5 Wide displays five images side by side on the window gt 2 High displays two images on the window one above the other The other selections in the Format Images menu include gt Process Image provides heavy medium and light edge enhancement on the selected image gt Reorder Images allows the user to reverse the order of images or to move around one or more images on a montage gt Scroll Stack must have a V to allow the user to hold the right mouse button down to scroll through the series of images BRIT View User Manual 19 Chapter 4 Changing the Layout gt Cine when in Stack mode allows the user to have the system provide a simulated cine loop of the images in rapid succession gt Image Labels this option turns ON and OFF the DICOM based labels generated by BRIT for the study gt Scout Lines enables the line to appear on the scout image to provide cross sectional reference of the selected location on the image as compared to th
64. ine will be drawn Note that the program does not force a straight line Wherever the cursor is moved while holding down the left mouse button the line is drawn on the screen 4 Release the left mouse button when the line has the desired length and orientation As long as the drawing mode continues to be active each time the left mouse button is held and moved an additional line is drawn 5 To turn off the drawing mode click the right mouse button once the pop up menu does not appear 44 View BRIT View User Manual Chapter 10 Annotating the Images Measurements annotations or other information that is added to an image are not Close t 02 automatically saved to that image when the button is selected to exit the e exam To save annotations select one of the File gt Save or File gt Print options from the main menu or select one of the Save Print options from the pop up menu Changing Fonts for Labels and Text The options on the Annotate drop down menu that are related to text use or text sizing and formatting include gt Font meas Font Font style Text me Regular Text to All Aral Black Cancel gt Font text o Avia Haide MT Boh Boldltalic To use the Font meas option use these steps SUDAN 1 Place the mouse cursor over the image of interest and 2 select Font meas from the Annotate pop up menu The Sanple Font dialog box displays as shown here AaBbY
65. ing the L 209M button This places a magnifying glass on the selected series and it can be moved to the desired area by left leng on the glass and dragging it to the desired area The size and shape of the magnifying glass can be changed by left clicking on the anchor points one of the four corner points marked with a and dragging it to the desired location and shape and releasing the left mouse button Format Images Format Views Zoom Flip Rotate Annotate Save Print Window Level Key Mark Report The Magnifying glass is also available through the To turn on the magnifying glass using the pop up aie light click on the image select masse cum 7 D Zoom and select the Magnifying v 2X Alt 2 wm C 9 sx was Glass and select the magnification 4X Alt 4 We a ww WES i re SI NN x tes size Of 1X 2X 3X 4X 5X 6X 7X or 8X The image is resized to the 6X Alt 6 na magnification level selected 8x Alt 8 To turn off the Magnifying glass click on the Kag button again Adjustable Zoom The Adjustable Zoom feature is available for single images in a window To access this feature and turn it ON select Zoom from the main or pop up menu then select Adjustable This adds a check mark beside the Adjustable option and the option stays active for the currently active series until the user clicks it again to remove the check mark While holding down the right mouse but
66. inked series remove other series from the screen select format Views from the main or pop up menu and then select Group Views from the drop down menu The Group Views signifies that this is a hotkey for the Group Views function To retrieve all the series select format Views gt All Views v from this menu WUT View Fie Prover Uins Putieet Uist Prii Ratus format Views format inegrs Zoom Clase Al Help Vu 3 of 3 total CT AUDOMEN C O X M12 AZ CT ABDOMEN S a Padre Unkk Mua Aue Link B kapo Urirk This INSTRUCTIONS 5 Liu poppe pleni NG controls the eat On One Gt meee etr s 3 Right etch when done 38 BRIT View User Manual Chapter 10 Annotating the Images EE Chapter 10 Annotating the Images __ There are many different types of annotations that are available for the users to mark and note the relevant areas in the region of interest These could include measurements for distance angles drawing arrows or freehand drawings rectangles circles text notations scoliosis measurements and many others The markups and annotations are saved in the system as Presentation States Annotations and measurements can be completed for a variety of areas such as Angles or Lengths of the image region of interest measurements ROI freehand drawings and different fonts can be selected as desired Annotations can also be turned on and off for the image Select the annotation desired position t
67. ion box displays Enter the special password users have been given and press OK Some systems do not require a password in that case any string of three or more alphanumeric characters will work as a Manage Window Level valid login ll Ni WLTYPE DEFAULT WINDOW LEVEL The following Manage Window Level TOES A ie dialog box displays This box displays with a default setup normally showing the values Carcel for the first modality in the alphabetical list of Add Agd available modalities In the following example the first modality in our list is CR on the left side of the dialog box The BRIT View User Manual 31 Chapter 7 Window Level and Edge Enhancement 10 11 12 19 14 19 16 32 Modalities area on the left also contains three buttons Edit Remove and Add To view the different preset Window and Level values for a modality press the small down arrow on the Modalities field and select the desired modality from the list The values will change to those for the selected modality To add a new modality to the list click the Add button KEME on the left side The following Modality Entry dialog box displays The same box displays for Edit except MCDALITY J that the modality name is present paaa Type the new modality code two letters and press OK if a mistake is made use the Edit button or highlight the entry and press Remove The right hand
68. l for example for MR and CT Scout lines can be used alone to reflect the position on the axial or saggital images in relation to the Scout image or it can be used in conjunction with X Ref to display the corresponding plane of interest in the series as compared to the Scout IN S image The following shows the use of Scout Lines as a stand alone option and with X Ref turned on Scout Lines To use the Scout Lines feature use the following steps Any appropriate image can be selected as the scout 1 With multiple series on the screen select the image that to be the scout by first clicking anywhere in that image s window This becomes the active window as shown by the darker blue color on the window s title bar ISA aL 2 Click the right mouse button di on format Images on the 2 main menu bar or the pop E up menu and then select Scout Lines Ctrl S from the secondary menu Select Scout Lines 3 Select another appropriate window series on the monitor The pop up menu disappears As the user moves through the second series of images the scout lines appear on your selected scout image as shown in the following figure 4 For studies where the scout is not broken out into a separate series users may first want to use the Clone this View feature to create a new series BRIT View User Manual 35 Chapter 8 Scout Lines and MPRs MPRs MPR is typically used with images from CTs
69. l Roentgen Files server gt Web Browser Interface Studies that are stored at a remote site s server Using the Mouse BRIT Systems recommends that a three button mouse be used when working with the BRIT Vision If a two button mouse is the only type available it can be used to duplicate the functions of a three button mouse To do so simultaneously press the right and left buttons on the two button mouse to simulate pressing the middle button of a three button mouse The uses for the three buttons generally are gt Left button Used to select the exam or the image gt Middle button Scroll Wheel Used to control brightness and contrast gt Right button Used for special functions p ed rH ia fat d NI L 1 Ly A QJ Wag bs a ing Sen Vid Ml Ml BBL WUL WH HUUMAA WH WHU HWHH HUU ld ll le LU WHU WMH UHUH WHU 4b b WHU le le lf le WH WHM WUWU WMH Y Select icon move to next image Pans images when image is larger or smaller than the window On Image manual adjust window and level On Icon drag and drop Middle j Calculates window and level from ROI at mouse position Button GE E Re les SIT N Scroll through stack of images moving up down Moves Cine forward back ward moving left right Pops up selection menu a Moves to next W L preset setting Click on toolbar button and hold to access selection for Zoom level j Sutton on W L button For
70. lace the cursor over the image of interest and press the F9 key to activate the Ellipse drawing mode Another option is to click on the right mouse button select Annotate and then select Ellipse from the secondary menu This action immediately activates the drawing mode and the cursor becomes an on the screen 7a T Y 2 Move the cursor to the starting point then press and hold down the left j mouse button Move the cursor diagonally The mouse can be moved Z in any direction to make an ellipse which appears similar to the figure shown here 3 Release the mouse button when the ellipse is properly sized A white ellipse will remain on the screen When the user presses the Re New button the ellipse becomes a dotted outline 4 If the user selects the Ellipse ROI option or the Ellipse to All option to draw an ellipse the ellipse will be filled with a solid color When the user presses Re New the ellipse will become a dotted outline and will have the calculations described above for Freehand ROI The Ellipse to All option does the same thing as Ellipse ROI and calculates results for each image in the series Measurements annotations or other information that is added to an image are not Close automatically saved to that image when the button is selected to exit the exam To save annotations select one of the File gt Save or File gt Print options from the main menu or select one of
71. left mouse button drag the mouse to the other endpoint of the line segment As the mouse is dragged a line is drawn 4 Release the left mouse button when the line has the desired length and direction A label appears on the line to specify the length of the line 5 Move the cursor pointer it is not necessary to hold the left mouse button down to the outer endpoint of the second line that will create the angle Click the left mouse button The angle the user wants to create and the length of the second line appear as labels on the image 6 Each successive measurement place the pointer and click the left mouse button creates another measured line and angle E01 BRIT View User Manual 39 Chapter 10 Annotating the Images To turn off the Angles mode press F5 again or right click the mouse Measurements annotations or other information that is added to an image are not Close automatically saved to that image when the button is selected to exit the exam To save annotations select one of the File gt Save or File gt Print options from the main menu or select one of the Save Print options from the pop up menu Measuring Distance Measuring distance is one of the most commonly used measurement tool Length measurements can be done by selecting Utilities then selecting Annotations and selecting Length Position the cursor over one area of the part to be measured click the left mouse button drag the mouse
72. m is opened click on File gt Make Teaching ian File The Teaching Files Info dialog box displays as shown in the following figure ie Indicates required value rest will be generated j H Patien ael Type in the required Patient Name Patient ID and Your DIA teach ID Patient ID 00000 If desired add the Patient DOB Study Description flYowteachIDf O Accession Number and a Referring Physician Fill in the PatertD0B accession number if to allow access to a report Due to o patient confidentiality a new report needs to be dictated and assigned this Accession number for the teaching files How Accession number 000000000 this teaching report is stored on the RIS needs to be Referring Phys TeachDoc determined with the IS department P cod Hp i or to cancel the creation of a teaching file at this time select When the information is completed on the Teaching Files Info dialog click on Cancel Mark Images When Lixin is selected on the Teaching Files Info dialog the study Teo on Baa images remain and the following small dialog displays khisSeres thisSeries The Mark Images dialog allows the user to mark or unmark all series that are imma Mark open To select an individual image for inclusion in the teaching file move the ALLSeries amp LLSeries cursor over the image and click once on the image with the left mouse button Abort A small box with a appea
73. mat Markups W L Presets tool box and Image Orientation menu GLEE LEELA LLB UG LALLA LEBEL VME MEME MMM There are several terms that are used with the mouse which include gt Click or press or select means to position the mouse pointer also called the cursor over the item of interest then press the mouse button once and immediately release it Shows pop up menu on image I NIRA ISIS SSS gt Left click means to click one time using the left button on the mouse gt Right click means to click one time using the right button on the mouse gt Click and hold or press and hold means to position the mouse pointer over the item of interest then to press and hold down the appropriate mouse button This type of action is used to drag and drop items and in certain types of annotations 2 BRIT View User Manual Chapter 1 Introduction 5 Drag and drop means that the left mouse button is pressed and held down over an item and the mouse is moved in the appropriate direction then the button is released to leave the item where it is currently placed Components of the Study Each patient can have an unlimited number of studies which can consist of multiple series that contain various images Study For example the Study would be compared to a book the Series would be a chapter in the book and the Images would pages in the book be a Series E Images Com
74. me look annotations notes and window and level Key Image and or Annotations Creation of Presentation States Annotations created with the BRIT View will be You have marked one or more images saved as Presentation States on the DICOM Server this requires an additional Do you want te save the marking application and integration When closing an exam a box appears asking if the annotations are to be saved All annotations that are present are saved when eo Pree ee reer rere rer reer rrr clicking on the IBS Ae SR button Displaying Presentation States f an exam is downloaded and has Presentation States this does not require anything additional then the PS button on the Toolbar is activated Selecting this button displays all the images with all Presentation States in a montage E011 BRIT View User Manual 47 Chapter 10 Annotating the Images 48 BRIT View User Manual Chapter 11 Printing Saving Sending Chapter 11 Printing Saving Sending If the hospital has the capability to print users can select the patient reports that need to be printed If a report is available then it is available from both the Roentgen RIS screen and also from within BRIT View Select the Reports button on the right hand Toolbar and the report is displayed in a Notepad window From here the report can be printed edited and saved under another name Printing a Report This option is present under bo
75. n select individual images or series of images that can be used for these Teaching Files There are a variety of theories and studies regarding how these teaching files should be arranged and the most effective means is to create Teaching Folders to help keep these studies efficiently organized These could be designated by body part modality diagnosis or any other description that would help identify the types of studies in the folder The studies are then placed into the appropriate Teaching Folder This application allows the user to set up independent work lists and a monitor can be designated to be used to display the teaching folders only Teaching files can be created from any clinical or research DICOM images that can be read into the BRIT View The image and series specific parameters that are produced by the original modality are retained All of the common patient identification information is replaced by default values Because the files use standard DICOM they can be stored on a central DICOM archive and can be used by anyone with a DICOM viewer and proper authority Depending on the archive they also can be retrieved using web viewers The files do not depend on the existence of any underlying database manager They do contain information to make finding sorting and viewing the appropriate images easier Special patient ID s can be used to designate department section radiologist patient for easy selection from a list
76. ndow This behavior is the same whether users are looking at images from the local system or from a remote archive Hemember however that when viewing images on a remote archive the images first must be transferred from the remote archive to the local system Because some image files or series may be quite large the transfer process introduces a time delay The size of the delay is dependent upon the type of connection that exists between the local system and the remote archive Fortunately this delay only occurs when the images are actually transferred from the remote system to the local system Once they are transferred to the local system they are stored on the local system and do not have to be transferred again until they are erased from the local system While downloading images from a remote archive the status progress of the download is displayed in the BRIT View s Status Bar The number of images downloaded and the number of images remaining to be downloaded are shown in the Series Description field of the Status Bar n addition to showing the download progress the Status Bar also will be filled in with other information about the patient and the exam Selecting Multiple Patients Multiple patients can be selected by performing the following steps 1 Using the local Patient Select list select highlight the first patients MAMANA Aa name and then click on View Selected or View All The appropriate images will open for to view
77. ntire range of values for the image hold the middle mouse button down and move the mouse To automatically get optimum Window and Leveling settings on the image relative to where the cursor is placed either on bone or tissue click with the middle mouse button Ae oa the Window Level setting for the image left click on the S button and the Select Window Level dialog box opens 80Ne Click on the desired setting and the window leveling settings INITIAL change on the selected series RT MIN Mass SOFT_TIS 400 E1311 BRIT View User Manual 33 amp Chapter 7 Window Level and Edge Enhancement Edge Enhancement or Image Processing Edge enhancement uses digital image processing to increase the contrast or pronounce the edges on an image to enhance the details of the image resulting in a more detailed image that makes it easier to spot minute tissue textures bone fragmentation or subtle color variations on the mucous membrane Edge enhancements are predominantly used with CR and film digitized images One of the features that helps greatly with Edge Enhancement particularly with bone is Reverse Contrast When used in combination these two features can help the radiologist easily identify fractures or breaks in bone For example a CR of a hand in a normal window level view is shown below as Sample 1 A CR of the same hand with Reverse contrast turned on is shown below as Sample 2 A
78. o wants measurements for that area these are called Region of Interest and includes the drawings and various measurements This section shows how to access various types of Region of interest drawings The Hounsfield Units average for a region is calculated using the ROI tool and indicates the density of the region of interest indicating air fat water tissue or bone Generally 1000 HU indicates air 120 HU indicates fat Zero 0 HU indicates water and ranges beginning with 40 HU indicating muscle on up to 3071 HU indicating various densities of other tissue and bone 1 Click the right mouse button to access the pop up menu and select Annotate gt Ell meas only or Rect meas only Users also can select these options from Utilities Annotate on the main menu bar The cursor becomes an l 2 Place the point of the arrow cursor at the location where one corner of the ellipse frame or of the rectangle is to be set and hold down the left mouse button 3 Move the mouse in the direction toward the opposite corner and an ellipse or rectangle shows outlined on the screen At the desired size and shape release the mouse button the ellipse or rectangle remains on the screen 4 The ellipse or rectangle can now be used for measurement purposes Select the option Annotate gt Lengths and the lines that are drawn within the ellipse or rectangle appear with measurements E01 BRIT View User Manual 41 Chapter 10 Annotating the Ima
79. o end the Cine display select the Stop button on the slider control The Re New Button Hel The button is on the Toolbar and has several functions related to formatting the view during the routine use of the BRIT View as follows Repaints the screen if other Windows boxes get displayed in this application Closes the right mouse click pop up menu without changing the image being viewed Displays statistics after drawing with the Annotate options Freehand ROI Ellipse ROI and Rectangle ROI gt Forces are display of all of the images currently visible Repaints the screen if the screen displays some black images BRIT View User Manual 23 Chapter 4 Changing the Layout 24 BRIT View User Manual Chapter 5 Magnifying the Images Chapter 5 Magnifying the Images To manipulate the images in the study the magnification size and orientation of the images can be easily changed by selecting one of the magnification or orientation buttons to implement the desired changes This section covers Zoom Magnification the Magnifying Glass and Adjustable Zoom settings Magnifying the Images There are three ways to magnify the image gt From the Toolbar gt From the Zoom drop down menu gt From the pop up window by right clicking in the image window If the image is magnified and is larger than the viewing area click on the image with the left mouse button hold the button down and drag th
80. ocols can be defined and users can select any of those as the default or dynamically as desired Hanging protocols are supported for exams by exam type body region and modality for each user These hanging protocol tools can be used to rearrange an exam s images and then save the settings under a specific name just for that modality or exam type The saved view can be quickly applied by clicking on the name in the list that displays Users can establish name and save the preferred settings and hanging arrangements based on study descriptions body parts and modalities Default settings can be accepted or changed for window and level flip rotate and magnification In subsequent image viewing sessions the exams that match one of the predefined protocols is displayed in the preferred manner Users can also create alternative protocols and change to one or more of these different protocols during viewing The hanging protocols feature also allows users to open two studies to perform a comparison and create a hanging protocol for the two studies together the PRIMARY Study and the COMPARE With study As with a single study users can choose to save the hanging protocol by study description body part or modality and accept default settings or change settings for window and level flip rotate and magnify for each of the two studies This section identifies the components that can be defined the steps to set up hanging protocols and how
81. of patients BRIT Systems retain all of the original raw image data and the associated information needed to show the images properly as teaching files The images and studies series generally is displayed exactly as if the oatient study series was obtained directly from the image modality A few relationships may be lost because only some of the images from the original studies series are retained and a few others because the created teaching studies series are derived from multiple clinical studies series With very little effort users are able to select partial series studies that play as naturally as the original full series studies on a DICOM viewer and combine images series studies from different real world patients into a new teaching patient Organization of the Teaching Files A teaching file can be a single patients exam image multiple exams images for the same patient or a mixture of exams and images from multiple patients The user A determines how the files are organized TAN Each patient can have an unlimited number of studies which can p Study TEN consist of multiple series that contain various images For example the Study would be compared to a book the Series would be a chapter in the book and the Images would be a page the book Generally each Study has a corresponding Report that the Radiologist has dictated and approved that relate the findings from the images in the exam
82. olumn and it pushes all other columns to the right The sort can be reversed of any left most column by clicking in its title bar Click in the title bar again to return to the original sort format Notice that the Latest Study column sorts from the oldest exam to the newest the newest exams will be on the bottom of the list The Birth Date column sorts from unknown dates at the top to the oldest age and then down to the youngest The Patient ID sort places the numerical IDs on top from smallest number to largest followed by the alphabetical IDs below The system does not remember the sort order that was set on the Patient t 02 Select window after logging out from a session and logging back in A new gt T session always begins with the Names in the left most column with Patient IDs just to the right followed by Birth Date Sex and Latest Study View BRIT View User Manual Chapter 2 Searching for Patients Select a Patient to View Images After defining a filter and completing a query the Patient Select dialog fills with a list of patients and exams that match the search criteria To view all of the studies for a given patient select the patient and then the button Alternatively to view a specific study select highlight the desired study at the bottom under the Study tab and then select the a button This causes the Patient Select window to be hidden and the requested images to display in the Image Viewing wi
83. ome cases if the user is retrieving images through the Roentgen HIS interface a single image opens on the monitor just to the right of the Patient Panel Opening Two Studies If the system has two monitors when the user opens a patient with two studies the first study opens on the left hand monitor and the second study opens on the right hand monitor even if study one has only a single image and study two has multiple series and dozens of images If there are several series stacked on each monitor and the user drags one of the open series from one monitor to another the entire study switches Close All monitors When Jis selected on any of the monitors it closes all studies on all monitors BRIT View User Manual 17 Chapter 4 Changing the Layout If the system has two active monitors and the user opens studies or series that are spread across the two monitors the user can minimize or close the study or series on one monitor and press the Split button on the other monitor s Toolbar to spread the visible study or series to both monitors with a single image on each monitor If the user then presses Next or 5 both images change to the next two in the series Pressing Split again will equally divide all images or series across both monitors If the user then clicks on a different series title bar to make it active and press Split that series spreads across the two monitors as individual images Working with Multiple Series
84. on causes the grid to disappear The drawing becomes a dotted outline and the program computes the following values for the area gt nimgPix the number of image pixels within the ROI gt Mean mean pixel gray scale value gray scale runs from O through 4091 or mean Hounsfield Unit values on CTs HU values range from 1000 to 1000 gt S D standard deviation standard deviation of the gray scale or HU values as appropriate gt Area enclosed area in square centimeters or other appropriate dimension gt Perim perimeter distance around the enclosed area in dimension 4 Perform the same steps to measure another ROI 42 centimeters or other appropriate BRIT View User Manual Chapter 10 Annotating the Images Measurements annotations or other information that is added to an image are not Clave S automatically saved to that image when the All button is selected to exit the YANG exam To save annotations select one of the File gt Save or File gt Print options from the main menu or select one of the Save Print options from the pop up menu Ellipse and Rectangle Drawing Options To use the Ellipse Ellipse ROI and Ellipse to All options use the following steps The Ellipse option simply draws an ellipse but the other two options draw an ellipse and then calculate the five measurements described above with the Ellipse to All option applying the same ellipse to all images in the series 1 P
85. or MRs to build a reconstruction of a specified plane MPR takes the data from multiple CT or MR images and builds the images into other planes and provides another perspective for viewing the region of interest To launch a simple MPR follow these steps 1 Select and open in Stack view the series of images users wish to reconstruct The scout image also may prove useful to have open 2 Select format Views and then MPR this View M from the main menu bar or from the pop up menu or select m from the keyboard A red hourglass shows on the screen while the images are loaded into memory The screen then divides into two additional windows and the two views to be constructed appear in their own windows An example of an MPR screen is shown in the following figure with the reconstructions and their labels in the bottom two windows 3 Move the cursor into the series being reconstructed do not press any of the mouse buttons As the cursor moves over the image the other two planes corresponding to and intersecting at the cursor location are dynamically built in their windows 4 To adjust the window and level magnification and so on in the reconstructed images press and hold down the Shift key while moving the cursor to those other windows Then adjust the window and level and other settings as users normally do The orthogonal projection is built in tts own window Navigation around this image is performed by moving the mous
86. ponents of BRIT View Once the user has logged in the BRIT View window displays This window is has a variety of features and toolbar buttons that allow the user to view annotate reformat flip rotate magnify and otherwise view the images in each series of the study Once the patient is selected either view the Local Patient List or the Browser for the list of patients on the server the general components of this window are shown Drop down Menus BRIT View s1 v3 4 20 99 Cor T1 SE Tool bar Buttons File Browser Utilities Patient List Print Sta format Views format Images Zoom Close All Help 1212 GE MR KNEE Stdy 1 of 1 RIGHTKNEE Vu 2 of 4 4 total Img 1 of 28 74 total W s1 v1 4 20 99 3 Plane Loc V2 4 20 99 Ax T1 SE 2 27 08 1 1 17 2 1 28 a b T 04 20 1999 12 2 H Ip gt 1 28 NP PFF E AP GEMS JEDR GEMS1SP Status Bar E TH Borders E N Qo e Nal o Su 3 Image Viewing Area mAn BRIT View User Manual 3 Chapter 1 Introduction The Drop down menus include gt File Contains a variety of menu selections to allow users to save images create and view reports print reports and images make teaching files send images and exit the application gt Browser Allows the user to access patient studies that are located on the Roentgen Files server or another remote server gt Utilities Provides a variety of efficient methods to set window leveling values
87. rch is a completely different sort of application The user operates under protocols through a database manager which has access to all of the original patient information But the user usually sees only summary information about statistical relationships and there are Strict security and user audit procedures F View BRIT View User Manual 59 Appendix A Burning a CD Chapter E SEM Hanging Protocols There are many different ways that the studies can be set up for viewing the series and images These include the format that is used window and leveling preferences rotation preferences and several other variables These settings are called Hanging Protocols and can be defined based on the modality on which the study is performed as well as the body part Different modalities and body parts can be set up with specific hanging protocols This ability for users to create and use hanging protocols is one of the most important and time saving features in BRIT Vision Since users can establish preferred settings and hanging arrangements for all the different modalities and body parts that are automatically applied when an exam is opened the Radiologist doesn t waste time selecting the format window leveling settings and other variables that they want set to their personal preferences In all subsequent sessions any exams that match the pre defined protocol descriptions are displayed in the manner preferred Multiple prot
88. rs are in use This option often is used after using the All Views Imgs option described below If multiple studies are open all studies and series will be stacked MPR this View provides a Multi Planar Reconstruction view of the selected series in the study Clone this View provides a duplicate copy of the selected series in the study Link Views synchronizes the selected series so that when the user scrolls through the master series the clone scrolls through at the same time Group Views only the series data associated with each study Hang Monitors allows the user to define different Hanging Protocols or layouts and desired settings for the studies when they are first opened Select Hanging allows the user to select the desired Hanging Protocol for the open study Save Hanging allows the user to save the current settings and define it as a Hanging Protocol Delete Hanging allows the user to remove the selected Hanging Protocol Close All closes all open exams for the patient Using the Format Images Menu Control over the formatting of images allows the user to decide how many Single Image A images are simultaneously viewed on the screen A multiple image screen is Ea Aj referred to as a montage of images To change the format of images select bles Cere format Images from the main menu or pop up menu and the following menu 2 Wide cbr 2 displays 3 Wide Ctrl 3 The formatting choices are NG duas 5 w
89. rs on the image To de select an image click on it again with the left mouse button A x indicates the image is deselected Abort Users can select the Aton button on the Mark Images box at any time and none of the images are saved but the images will remain in BRIT View When al desired images are marked from this patient Eizsu Bussi There are 1 series with a total cF 4 images click on the Mark Images dialog The 4 images are marked for a teaching File following dd displays to verify the actions These will be converted to Teaching File images You will send the images using Sendcommoaon to the selected destination is selected the images are pala under the created patient name If Lx mos is selected at this point none of the images are saved but the images remain in BRIT View Is this OK mm Close this exam and then select the next patient who has images to add into this teaching file 58 View BRIT View User Manual Chapter 12 Teaching Files Protecting Patient Confidentiality One of the goals of the teaching file creation method is to require as little labor as possible and still retain a reasonably high level of patient confidentiality In order to guard patient confidentiality it is necessary to remove most of the patient related DICOM attributes and replace most of the remainder It is also necessary to break DICOM cross references to other studies
90. s Select Hanging Save Hanging Dslete Hanging Cose All v v dori 8 T CErH A M C L a Hj Ctrl HJ SHFE H Esc Screen Settings that can be Set in Hanging Protocols Hanging protocols are intended to save time by letting pre setting many variables of the BRIT View application The images that are viewed can be arranged in almost an endless number of ways using the various tools and settings The variables that are pre set and saved in the hanging protocols include the following Number of monitors Format of multiple images or series on the screen Zoom magnification or Fit Window and level Rotation and Flipping Reverse Contrast Y VV ON ON WV Positioning of series VIS BRIT View User Manual Appendix A Burning a CD Creating Hanging Protocols Use the following steps to create and save a hanging protocol that applies to a single study 1 Open the study for which to create a hanging protocol 2 Select format Views and then select the option Hang Monitors H 3 The Select studies or views to hang dialog box EEDIT EO Oa displays as shown in the following figures This dialog allows the user to assign the various views Display Monitor ES or series to one monitor as shown to the right or across two monitors as shown below Clear Monitors Stdy 1 CT 19990503 BRAIN S L View 1 SCOUT S 1 View 2 PRE CONTRAST S 1 View 3 POST5 CONTRAST Lef
91. s desired 3 Two other methods involve using the options Images to Send and Images to CD which can be accessed from File on the main menu or from Save Print on the pop up menu 4 Images to Send allows selection of images to transfer to a DICOM server via SendCommon if configured at the installation When selecting the Images to Send option a small Mark Images dialog box displays as follows 5 Click on L and an Images Marked to Send dialog displays to verify that what is marked is really the images to send mAn BRIT View User Manual 53 Chapter 11 Printing Saving Sending 6 Click Ls application i and the images are sent to one or both locations enabled in the SendCommon Systems documentation regarding how to use the Rimage CD burner If a Rimage high volume CD burning is available on the system attached to the t 02 Radiology Workbench for Windows please refer to the separate Rimage and BRIT Using Send Common The ability to send images to another location using BRIT s SendCommon application requires system set up by a System Administrator prior to your use The user can designate two active destinations Many destinations can be established and available but only two can be active at any one time The user can send DICOM images to both active destinations or the user can select only a single destination Assuming that the SendCommon destinations have been set up and tested the following steps gui
92. s provided Using the Format Views Menu awe D The format Views option from the main or pop up menu provides the ability to Next View down perform various types of screen formatting as shown here Next Examfstudy X Tile Stack All T The options include AlViews Imgs Cera One View Only places one image on each monitor from the active series MPR this view M If images from one series are open in a three by two montage nothing will C oneiupUns QE change by pressing One View Only Eins views iL Group Views i gt All Views places all series on a screen or on multiple monitors This is Hang Monitors H applicable when multiple series already are open Select Hanging Ctrl H Save Hanging SHFE H gt 1 View per Screen places one image or series per monitor depending on pa e elete Hanging whether multiple images or multiple series are open Close All Esc niic BESO e gt o ra 18 View BRIT View User Manual Chapter 4 Changing the Layout gt v V NV V WV Next View activates the title bar of the next successive series when multiple series are stacked on one or multiple monitors If only one series is visible One View Only but multiple series are open it displays the next series in the study Next Exam Study opens the next exam if multiple exams are open Tile Stack All causes images to be formatted as stacked series across all monitors if multiple monito
93. sentation states to be stored back on the server so they can be downloaded by other users Saving Images as DICOM Images can be annotated windowed and leveled or otherwise manipulated and then saved as DICOM presentation states An optional module allows these presentation states to be stored back on the server so they can be downloaded by other users To save an ES image or screen of images as a DICOM image Se cin INE TE 1 Start by setting up the screen just as it is to Gass7 s926 appear Pi 2 Next from the File option on the main menu bar select Save WYSIWGY Dicom The following 476 36 1450 Save As dialog box displays m Filename GRABOOXROO1O_001 3 The default folder for saving the images is called Save as type Erann esa s e Cancel DICOMImages This default folder can be 52 View BRIT View User Manual Chapter 11 Printing Saving Sending selected another folder and the user must enter a name for the screen that is being saved If users do not want to enter a name the default name that the program enters automatically see name above in the File name field is entered 4 Make sure the Save as type field says Dicom Files dcm 5 Select the Save button to save the DICOM image Saving Images as JPG Images can be annotated windowed and leveled formatted and saved to the operating system for incorporation into PowerPoint presentations or other documents To save an ima
94. series and to disguise exam times and dates Most of the valuable information can be automatically altered and still retain its teaching value without requiring a lot of user entered information Additional steps need to be taken in some cases For instance some native DICOM images have patient information burned in to the image itself as in the case of some CR and many ultrasound images All digitized film and most frame grab secondary capture images contain patient information These images may need to have regions blacked out before including them in teaching files In other unusual instances patient information may be buried within DICOM comment fields or within attributes intended for other things BRIT s approach is to retain as much of the valuable information as possible without requiring the user to scrubb each bit of information within each DICOM attribute This is adequate for the great majority of situations except for burned in images BRIT has examined a fair number of DICOM images from different institutions and manufacturers and believe that the following measures provide adequate confidentiality for the great majority of medical teaching applications Additional security would require great effort on the part of the person preparing the teaching file Nevertheless we recommend that distribution of and access to the teaching files is limited Note that data mining for the purpose of resea
95. t Monitor Right Monitor Cancal Push Me To use both Monitors for a single Study or View Clear Monitors Select the studies or views to hang select monitor s first E3 Stdy 1 S 1 View 1 S 1 View 2 S 1 View 3 S 1 View 4 S 1 View 5 S 1 View 6 S 1 View 7 S 1 View 8 S 1 View 9 S 1 View 10 S 1 View 11 S 1 View 12 EMT TET 4 f only a single monitor is available the Display Monitor box appears to be selected Move the cursor over the desired view for this monitor and click the left mouse button once The view name moves from the list to inside the Display Monitor box When selecting views to be placed on the monitor the system displays them in the order selected left to right across the top and then down the screen So if a specific type of view is desired in the upper left hand corner of the monitor select that view first in order for the view to be placed there in the hanging protocol This also applies to a two monitor system as views are selected for each monitor 5 lfatwo monitor system is available after all the desired views have been moved to the Left Monitor box click the mouse on the Right Monitor box and then move any additional views to that monitor 6 Cancel can be selected at any time to close the dialog box or click on Clear Monitors to reset the names on the list and on the buttons as they were before assigning them to monitors After the desired views are
96. th the File and Print bi main menu options and from the pop up menu under Save Print The term WYSIWYG stands for What You See Is What You Get To print reports with Printer Name im ages Status Ready 1 First set up the images in the viewing area as ie AE Peel bases aU eg they are to be printed Where hpeolorLaseret5500 2 Select File from the main menu bar p NNNM lE 3 On the drop down menu select Print Report Pitine Copies WYSIWYG The generic Windows Print su RD NE dialog box displays as shown in the following Pon DES AERIS figure ag 2 Prony O KO 4 Select the printer to the destination to send Selection 4c dE the report and on screen image s select the 2 number of copies and then press OK The Cancel report and images are then printed View Create and Select Reports Reports also are available under the File option on the main menu as follows or from Key Mark Report item on the pop up menu gt FilesReports View displays report information the same as the Reports button on the Toolbar in a Notepad dialog box gt File gt Reports Create if activated on the menu this feature initializes report creation for example starting dictation equipment gt File Reports Select if structured reports exist for the study this feature displays the structured report BRIT View User Manual 49 Chapter 11 Printing Savin
97. the Exam button from the Toolbar Selecting the Exam button again displays the other exam To view the exams on the same screen again from format Views on the main Toolbar select All Views V The v hotkey also acts as a toggle between one exam and all exams To compare an exam with one that had not been selected originally if it is another patient s exam then without using the Close All button select Patient List from the main menu bar This will again display the Patient Select window Select the third exam to compare and select View All or View Selected A warning message as shown above first displays to let user know that another patient has been selected for viewing Select No again Sa Chi Select to close all of the exams simultaneously E 14 View BRIT View User Manual Chapter 3 Viewing the Study Title Bar of the Active Image Each series is displayed on the Image Viewing Screen in a separate window with a title bar description and the set of three buttons that users see at the left Information re This Yiew Clicking the left mouse button on a title bar it becomes darker and is designated as the active e 2248 Sex F DOB 09 09 1999 Name GE CT BRAIN window Users can move series of images around ts stupy on the screen by using the mouse and dragging id 1of1 open Dese CT HEAD W 0 CONTRAST and dropping a window by its title bar If the user
98. to create sequential hanging protocols In order for hanging protocols to work properly it is extremely important that information about study descriptions modality names types and body parts be entered into the computer system completely correctly and consistently This information comes from the DICOM header as studies are matched to the saved hanging protocols therefore the information entered for those fields must be consistent at all times BRIT View User Manual s0 To access the options for hanging protocols select format Views from either the main menu bar or the pop up menu The following menu displays The four options related to hanging protocols is shown below Hang Monitors Allows users to select the studies or views to hang On your monitor s Select Hanging Allows users to select a protocol for hanging the currently displayed study or studies Save Hanging Allows users to name describe and save a hanging protocol to the local PC and to the server Delete Hanging Allows users to delete a protocol from a specific list of protocols Vv WV vv Users also can use the two bottom buttons on the Toolbar to access the A Hang Monitors 3 dialog or _3 to select a protocol during the viewing of images Appendix A Burning a CD One View Only Al views Next View Mask Examj study Tie Stack All Al ViewslImqs MPP this View Cone this View Link Views aoup Views Hang Monitor
99. ton move to the right to enlarge the image or move to the left to make the image smaller This is also known as l The magnification setting under Zoom on the main or pop up menus can have a value of 0 5X 1X 1 5X 2X 3X or 5X This setting refers to the original image data whereas the magnification under the Mag Glass option available range is 1X through 8X refers only to the magnifying glass With this in mind if users have an image with the magnification set at 3X and users set the magnifying glass at 1X the image under the magnifying glass will be minified to 1X 26 BRIT View User Manual Chapter 5 Magnifying the Images Panning If an image is displayed at a size so that not all of it fits on the screen drag the image around the screen to bring off screen portions of the image into the viewing area This is called panning To pan an image press on the left mouse button and hold it down then drag the image around the screen Once the image has been panned if the user chooses another image from the exam it will be positioned likewise This function does not work if the entire image is visible in the display BRIT View User Manual 07 Chapter 5 Magnifying the Images 28 BRIT View User Manual Chapter 6 Rotating Flipping Images Chapter 6 Rotating Flipping Images The manipulation of images in the study by rotating or flipping the images can be easily changed by selecting one of
100. yZz 2 he Font dialog box shows the default settings for Font Al Font style and Size The user can change these settings Script by selecting from the three appropriate list boxes The RM ET Sample field shows the user the selection that appear on the image s After the changes are made press 2 i 4 the font style and size that the measurements exhibit change accordingly The only difference between these two options is that the Text option is applied only to the image whereas the Text to All option is applied to all images in the series To use the Text option or the Text to All option use the following steps 1 Select AnnotatesText or AnnotatesText to All from Utilities on the main menu or from the pop up menu The cursor becomes a vertical bar 2 Move the cursor to where the beginning area to type the text and press the left mouse button once 3 Begin typing To type more text in another location on the image Just place the cursor at the desired location press the left mouse button again and start typing Measurements annotations or other information that is added to an image are not Close automatically saved to that image when the button is selected to exit the exam To save annotations select one of the File gt Save or File gt Print options from the main menu or select one of the Save Print options from the pop up menu To use the Font text option for changing the font style or size for the t

Download Pdf Manuals

Related Search

Related Contents

Spring `09 - LPT Home Page - HP LaserJet and Lexmark Parts  TECHNICAL MANUAL MANUAL TÉCNICO  Eclipse 100er Serie  CONTAIMPULSI/TEMPORIZZATORE  Pontiac G5 User's Manual  LG Incite Windows Mobile Pocket PC User's Manual  ISTRUZIONI - Olympus  Samsung SP-50L6HX Manual de Usuario  Colunas Bluetooth Interior/Exterior  Sony VAIO VPCSA31GX/BI notebook  

Copyright © All rights reserved. Failed to retrieve file