Clarity Viewer User Manual.book
Contents
1. CODONICS We bring the future into focus Clarity Viewer User s Manual Codonics Catalog Number CLARITY MNLU March 2 2009 Version 1 1 Codonics Inc 17991 Englewood Drive Middleburg Heights OH 44130 USA 440 243 1198 Phone 440 243 1334 Fax Email info codonics com www codonics com Copyright 2008 2009 by Codonics Inc All rights reserved worldwide Printed in the U S A Part Number 905 052 002 02 No part of this document may be copied or reproduced in any form by any means without prior written consent of Codonics Inc 17991 Englewood Dr Middleburg Heights Ohio 44130 U S A Although every effort has been made to ensure the accuracy of this document Codonics Inc assumes no responsibility for any errors that may appear Codonics Inc makes no commitment to update nor to keep current the information contained in this document A general working knowledge of MIP MPR and Fusion protocols is assumed when using this manual Codonics the Codonics logo and We bring the future into focus are registered trademarks and Clarity Horizon and Virtua are trademarks of Codonics Inc Adobe is a registered trademark of Adobe Systems Incorporated in the United States and other countries Microsoft and Windows are registered trademarks of Microsoft Corporation Intel Pentium is a registered trademark of Intel Corporation or its subsidiaries in the United States and other countries All other regi2. Codonics Clarity Viewer User s Manual Basic Toolbar Commands Table 2 Basic Toolbar Commands Icon Description New Clear Selection Select Browse Print Tile Mode Magnifying Glass Reset Window Level Polarity Synchronize Slices Hide Display Graphics Distance Measurement Angle Measurement Pixel Measurement Close all open series and return to the selection window Go back to the selection window to select an additional series or patient The current series remains open Send the current image window to a Windows printer The Codonics Horizon Imager configured with the PostScript option can be used to create high quality color and grayscale prints Display multiple images from the same series Magnify a portion of the active image Select zoom factor by right clicking in the magnified area from x2 to x8 Resets window levels to the original values Changes the polarity of the active series black becomes white white becomes black In this mode the frames displayed that are in the same orientation will be synchronized Toggle the display of graphics drawing and measurement tools Determine the distance between two points in the active image Determine an angle within the active image Display the pixel value of a point within the active image Codonics Clarity Viewer User s Manual Table 2 Basic Toolbar Commands Continued Icon Description Calibrati
3. Windows Start menu Double click the drive labeled CODONICS to display the contents of the CD DVD Double click RunViewer bat to launch the Viewer Opening a Series of Images When the Viewer launches the Selection window displays EN Selection Patient Mame Pabent ID Bethdate Q 5 15M CA Lt Breast Post Biopsy At ex Sl Bamabas Ace USA 317 150 High Res Knee ex Kumamoto Cyuou Hosp J G 515P C Cadac MAA ex Childiens Hosptal Boston 155 LUMBAR 400066504 e fonn Unrest Horta Shady Date Time Detenphon Accession Ma iah ID B Sy 08 11 2006 1227 16 ch NV col 18476055 eA MR eM MA Codonics Clarity Viewer User s Manual The Selection window is split into two sections e Patient information Displays patient information such as the patient name patient ID birth date and sex e Study information Lists the study folders series folders and patient images Table 1 Selection Window Icons Icon Description Patient Last name first name date of birth patient ID Study Creation date and time study ID procedure description Series Modality series description number of frames creation date creation time Image Image number number of frames DICOM instance UID To list the sub levels on the selection window for example images of a series click the button to show more and the button to show less To access the image contained within that series double click the series 1con
4. a standalone application used for viewing and manipulating digital medical images from various sources CT MR US PET etc The Viewer image manipulation tools include windowing leveling magnification and various measurement tools The Viewer application is included as part of the Codonics Virtua Operating Software System Requirements The Clarity Viewer runs on Windows based PC computers It has been validated under Windows 98 Windows Millennium Windows NT 4 0 Windows 2000 Windows XP and Windows Vista Recommended minimum configuration e Pentium III processor e 512 MB RAM e 40 GB hard drive e 32 bit graphics board e 19 in display e Windows 2000 or XP Required Software The Clarity Viewer does not require any additional software to be installed on the PC However a PDF viewer such as the Adobe Reader is required in order to open the Help documentation The Adobe Reader is available free at http www adobe com Codonics Clarity Viewer User s Manual Quick Start Starting the Viewer If the CD or DVD was burned with the Virtua s Auto Run option turned on the Viewer program will launch when the disc is inserted into a PC s CD DVD drive If this option was not enabled when the disc was burned the Viewer must be started manually If LaunchPad is being used then LaunchPad will be seen before being able to navigate to the Clarity Viewer To start the Viewer manually select My Computer in the
5. anual 25 suv Calculations With the Clarity Viewer SUV Body Weight is computed using the following values e D injected dose Becquerels e tl time span between injection and acquisition seconds e T half life period of the radio isotope used seconds e W weight of the patient kilograms All these values ought to be imported from the original CTI and the pixel data counts have to be in Bq ml If one is missing the SUV will not be proposed to the user The injected dose is decay corrected to correspond to the existing dose at the time the image is acquired oot D1 e T Then SUV values are obtained using the formula SUV counts e W e ie 26 Codonics Clarity Viewer User s Manual
6. ccedscneceeevescnsedeaanaseerdactesasevestoene EEA EE ARE 10 OVON e E meee tee ere 10 Dockable Toolbar Options ccccccccsecceceeeeceeeeeeeeeseeeeseeeeseeeeseeeesaeeess 11 Reinitializing the Volume ccccccccsscececeeeseeeeeeesseeeseeeeseeeeseeenees 11 Enabling Volume Rotation ccccccececeeeeeseeeeseeeeseeeeseneeseneesaeeeeees 11 Switching VICWS ccccceccccceeeeecneeeeceseeceeseeeseeeeseaeeesaeeeeseseeeneeeeens 11 Displaying Orthogonal ViICWS ccccsececcseeeeeseeeeeeeseeeeeeeeeseneessaees 12 Displaying the Clipping BOX ccccccsesecceeeeeeseeeeeeeeeeeeeeeeseeeesaaees 12 Cine O50 0 10 Renee rais aranana n a na aE O eaS ishrat 13 Codonics Clarity Viewer User s Manual iii SON MOOO essacscs heat ee ce esetic E O EG 14 OIE ssassn EE E EE EE EEE 14 Notes About the Fusion MOUIe cccccceseeeeeeeeeseeeseeeeseeeesaeeeneeeess 15 D PAY NOTE oie E 16 Orhogonal Modo siseses np a EREE 16 Dual Orthogonal Mode ccccsecccceseecceeeeeceeeeeeeueeeseeeesseeessaeees 20 Triple Orthogonal MOdGe cccccsssececseeeeceeeeeeeeeeeeeeessaeeeeseeeeseaes 21 Mosaic Only MOde ccccsescccseecceeeeeceeeeeseeeeeseeeeseuseesseeeenseeeeas 22 Advanced Viewing Considerations cccsccccccsseeeceeeecseeeeesaeeesseeeeeseneeesaaes 23 SUV CalCulatlOnS siseringi E e aE 26 Codonics Clarity Viewer User s Manual Overview The Codonics Clarity Viewer is
7. derations Advanced viewing modules work only on images for which orientation and image position data has been coded by the modality Also all the images of the input series must have the same slice thickness and regular spacing between slices If this is not the case the following error message displays SSS LULU xi X Mot a tomographic image or irregular slice spacing Note that when Orthogonal View or MPR MIP protocols are launched if the application detects that there is not enough memory on the PC to run such protocols with full performance the user is prompted with the following message asking if a resampling is permitted LT Do you want bo resample the input T Not enough memory to run this protocol with Full performance Mote that this will induce a loss in image quality If the user accepts to resample the image quality will be altered by displaying only one pixel out of two on the X Y and Z axis The user may nevertheless decide to continue without resampling the image size but this will affect the performance of the protocol Refer to the following examples to see how rescaling affects the image Codonics Clarity Viewer User s Manual 23 PR rip a 6 4 Fast Preview Fast Rotate Original Image Size 24 Codonics Clarity Viewer User s Manual PR nr D a a alk Fast Preview Fast Rotate Resampled Image Size Codonics Clarity Viewer User s M
8. e dual orthogonal mode it can be selected later when switching to dual ortho mode To clear the selection click the corresponding button Notes About the Fusion Module e The Fusion module works only with images for which the image orientation and image position data has been coded by the modality e All the images of the input series must have the same slice thickness and regular spacing between slices If this is not the case an error message displays and the module aborts Codonics Clarity Viewer User s Manual 15 16 Display Modes Five display modes are available Orthogonal Dual orthogonal Triple orthogonal Horizontal mosaic and Vertical mosaic Switch between those modes using the Display Mode list box Orthogonal Mode Display mode Fusion 8 04 SUV I Ortho view Pe Provection E hinsair 8 04 50v Anatom RABIE pi Funct L m Window levels SUY Scale Mosaic view Vw WK Func Anat Fus CEE Slice thick rm fi 0 2968 4 Td nm HES ae Fusion shows a transparency fusion of both image volumes along the three basic orthogonal directions an MIP of the functional or fusion image and a reconstructed series displayed in mosaic mode Orthogonal Display To toggle the display of the cross target and reference lines click the button HES To toggle the display of the pixel value click the button Codonics Clarity Vie
9. e the volume and on each face gives the orientation of the volume e A anterior e P posterior L left e R right e H head e F feet Alternatively you can also press ALT left button while dragging the mouse to rotate the image Switching Views To switch the free angle view from mosaic view four views to full screen view click the button Refer to Cine Control on page 13 for an example of the full screen view Codonics Clarity Viewer User s Manual 11 Displaying Orthogonal Views k i To display on the free angle view click one of the three orthogonal i wi view buttons Displaying the Clipping Box Clipping Box To display the clipping box click the Show button Show Reset The clipping box is displayed only on the orthogonal views Use these three views to isolate the region to view the result is displayed on the free angle view To clear the clipping click the Reset button Below is an example of clipping Clipping Box Show Reset peer 12 Codonics Clarity Viewer User s Manual Cine Control pa m ai To access cine control click the ME button The MIP Cine Control window displays x Start angle Increment O E m gt om views O EE E gt The cine control has to be used like a table For the three axes of rotation specify a start angle The a button applies the angles specified With a Views value and Increment angles entered click the g
10. iews by rotating the blue line The reconstructed series will display the center slice of the new series Layouts To toggle between a 2x2 layout or a 3x1 1 layout click the A or button respectively In the 2x2 layout the orthogonal views are arranged in a 2x2 mosaic and the reconstructed series is displayed in the lower right image box In the 3x1 1 layout the orthogonal views are arranged in a 3x1 column and the reconstructed view is displayed to the right of that column Default Orientation By selecting a default orientation coronal sagittal or transaxial the resliced series is reset to one of the three basic orientations Fast Preview Option When the Fast Preview option is checked the resliced series is displayed without interpolation and only one pixel out of two is computed However the full quality is always applied when saving the new series Uncheck this option for a view of the actual reconstructed series Codonics Clarity Viewer User s Manual Fast Rotate Shee thickness ja POST 25 L Fast Rotate Option When the Fast Rotate option is checked the MPR display is not updated while rotating or dragging the reference cross lines The MPR display is updated upon release of the left mouse button When this option is unchecked the MPR display is updated in real time while rotating or dragging the reference cross However for performance reasons the reconstructed series is alway
11. ion view only the functional image is updated To change the window levels on the anatomical image use the same mouse key combination and hold the ALT key down while moving the mouse Window Levels Options e Use the sliders to set the activity window min and max on the active view e Select the SUV Scale option to display a color bar coded in SUV values on each functional view Codonics Clarity Viewer User s Manual eG Measurements The following measurement buttons are at the bottom of the toolbar e Distance measure the distance on a straight line e Free hand compute statistics on a free form region of interest after drawing the region double click to close the region and display the statistics e Ellipse compute statistics on an elliptical region of interest These features are available only on mosaic views not on orthogonal or MIP views Codonics Clarity Viewer User s Manual 19 Dual Orthogonal Mode Display mode Dual ortho 7 m Fusion 5 704 SUV lt Anatom J 5 704 SUV vd i aj Funct Window levels T SUV Scale m Mosaic view VW PR Func pie Fus fd e Slice thick mr T 3 044 SU is 3 044 SUV Vv y The Dual Orthogonal mode features two orthogonal views for synchronized display of two functional images registered over the same anatomical image or two sets of functional and anatomical images The cross target
12. ng three orthogonal views In addition it also shows the MPR cut plane intersection blue line the current frame displayed on the reconstructed series solid red line and the reconstructed volume limits red dotted lines The reconstructed series view behaves like the regular mosaic views in the general display It shows the reconstructed series along the direction of the blue line Codonics Clarity Viewer User s Manual MPR mip J a0 ol Fast Preview Fast Rotate Slice thickness fo 978 H Dockable Toolbar Options Reslice Mode To toggle the reslice mode click the button e Single oblique button not pressed reslice the volume in a single oblique orientation Click on one of the blue lines and wait until the cursor turns into a rotation arrow Drag the line to the desired angle The intersection of the new slices with the two other views will automatically be updated and reset to an orthogonal angle The reconstructed series will display the center slice of the new series Codonics Clarity Viewer User s Manual Wo ap Fast Preview Double oblique button pressed reslice the volume into any oblique orientation Click on one of the blue lines and wait until the cursor turns into a rotation arrow Drag the line to the desired angle The intersection of the new slices with the two other views will automatically be updated Set the orientation on the other v
13. on ATA Calibrate the active image pixel size Allows for measurement of a known size element within an image and allows for input CAL of the known size Multi Angle Determine the angle between two separate lines within the Measurement Ta active image Cobb Mosaic Mode Split the current display window so that multiple series may be nag displayed Cine Loop emi C m Allows display of multiple images from a series one after the other Clicking on the forward or reverse buttons allows the increase or decrease of the display rate Left Mouse controls or The default action for the left mouse button adjusts the window Window Level Tf level of the active image Left Mouse controls Ste Allows movement of the active image within the display Image Position k a window Left Mouse controls Zoom Level 5 Allows for zooming in and out Left Mouse controls Stack Navigation s Move through the images of the selected series Left Mouse controls Move the series to another display section used in Mosaic s Drag and Drop gt Mode Codonics Clarity Viewer User s Manual EMPR Mode L NOTE This feature is available only on the 3D Fusion Clarity Viewer Overview iD To enable MPR MIP viewing mode click the u button Click on the MPR tab to activate the MPR mode The MPR screen features a dockable toolbar an orthogonal viewer and a reconstructed series display The orthogonal viewer shows the input image alo
14. position is not synchronized on both views they both work independently The two studies can be switched by pressing the Raa button This is especially useful since only the top study can be displayed in other modes such as mosaic or triple orthogonal 20 Codonics Clarity Viewer User s Manual Triple Orthogonal Mode Display mode Triple ortho r Fusion fa Anatom Blend 5 Funct Window levels SUV Scale m Mosaic views VF FP Func Anat Fus F rin ny ET a Ar Slice thick mm V Lin ss The Triple Orthogonal mode features three orthogonal views for synchronized display of the anatomical functional and fusion images The cross target position and the projection cine are synchronized on all views Codonics Clarity Viewer User s Manual 21 Mosaic Only Mode Display mode Horizontal Mose m Fusion iY Ortho IF Pi jection VV Mosai i Anatom Blend Funct Window levels or M SUY Scale m Mosaic view VV T Func Anat Fus U G Slice thick mm fo 978 H iz 5 Z gQ The Mosaic Only mode features three views in a synchronized mosaic display Functional Anatomical and Transparency fusion A synchronized cross target is displayed over the views to help localize the same anatomical point on the three views 22 Codonics Clarity Viewer User s Manual Advanced Viewing Consi
15. rojection the fusion is activated on the MIP display Selecting this option automatically activates the fusion on the ortho view Codonics Clarity Viewer User s Manual 17 Window levels SUW Scale e Mosaic the fusion is activated on the reconstructed images bottom view Select the transparency level using the vertical slider in the dialog bar This slider goes from fully anatomical to fully functional Depending on the Blend check box status the transparency is computed as follows Blend check box not selected the anatomical image is always displayed The functional image is displayed as a transparency overlay intensity varying from 0 to 100 depending on the position of the slider anatomical to functional Blend check box selected the anatomical image is displayed with an intensity varying from 100 to 0 depending on the position of the slider anatomical to functional The functional image is displayed with an intensity varying from 0 to 100 depending on the same slider setting These settings are common to all views displayed in Fusion mode Note that the following actions are not allowed in fusion mode e Inverse video B amp W color palette NOTE When the orthogonal and mosaic views are both in the same mode fusion or not the window levels and color palette are set to be the same on both views The Projection view remains independent NOTE When changing the window levels on a fus
16. s displayed in fast preview mode regardless of the status of the Fast Preview check box Slice Thickness Select the number of slices used to construct the 3D model A higher number here can improve response time but may reduce the detail of the reconstruction To view the result in the reconstructed volume frame click the y button NOTE Slice thickness is always an integer multiple of the pixel size Codonics Clarity Viewer User s Manual MIP Mode NOTE This feature is available only on the 3D Fusion Clarity Viewer D Overview 3D To enable MPR MIP viewing mode click the button Click on the MIP tab to activate the MIP mode The MIP is a 3D post process that features three orthogonal views coronal sagittal and transaxial It also features a free angle view and a clipping box to isolate the organs you want to display Every image is visualized with a Maximum Intensity Projection Clipping Box Show Reset paren me 10 Codonics Clarity Viewer User s Manual Dockable Toolbar Options Reinitializing the Volume To reinitialize the volume as it appeared at the first launch click the t button Be aware that the window level is not reinitialized Enabling Volume Rotation a To enable the volume rotation click the S button then press the 2 left mouse button while dragging the mouse The a button is enabled only on the fourth view free angle view The cube moves lik
17. stered and unregistered trademarks are the property of their respective owners European Authorized Representative EC REP CEpartner4U Esdoornlaan 13 3951DB Maarn The Netherlands Tel 31 0 6 516 536 26 Contents RON GW a E E E EEE E S 1 Syslem ReEguUIremeENIS snesena 1 Reguired SOMWONS senccsesdsetcbesenecacnosectdecscetentezenccsdetenssoasesqszdsogsnsdsaesosaenceee2 1 UAC SANA acerca os eee E A ace Aeeas aeoeasendeuccaaceebensece 2 Starting the Viewer coh taste se csisignons aseaswesanseeessesaiaps sists smu saennedasmpeneeseatenesseneen 2 Opening a Series Of IMAGES cccccccseeeeeceeeeeeeeeeeeeeesaeueeeeeseeeeessaaeeeeens 2 Basic Toolbar COMMANACS ccccsscecceeeeeceeeeceeeeeseeeeseaeeeseeeeeseneeesaaes 4 MPA MOGO orini a uncle einen elec En Ee EE ESES 6 COV EIWICW de1 5 csccccarccedceotaptetaseearcecusietaseecidecoaston scene aa a Ea aa aak aAa 6 Dockable Toolbar Options siscrsrrirrserserinenesian daana 7 FS SC MOTO aee EE E EE R 7 BAY QUIS a anccenecdanesedeaeanscunees arses E E saanectence 8 Default Orientation ios ccteeescvestenicuscssiewavcavenstevisadescveedaines peeecusecasdee ince seve 8 Fast Preview Option ccccccccccsecceceeceeeeneeeeeeeceseaeeeseeeeeseaeeeseeeeeeas 8 Fast Rotate ODOM assedsccssiensancanatiines dt cosxoounesaostaxseedeumonevncuduveneaexooeuaness 9 Slice TICKS SS aleseiieneanninthecrescinitetsiaankatiauiasewhddaswevetcciesstdaupednnmenlumaieeads 9 MIP MOOG oc soeecnnsee
18. t button to start a cine with Views frames each one separated by Increment angles foe i The cine can be controlled with the Pause button Stop button or ake Start Increase Cine Speed button There is also a Stop button in the MIP toolbar Codonics Clarity Viewer User s Manual 13 14 Fusion Mode L NOTE This feature is available only on the 3D Fusion Clarity Viewer Overview When selecting the Fusion icon in the main application the Viewer application automatically browses the loaded series If it does not find suitable series the Series Selection dialog box displays Otherwise the Fusion protocol starts with the loaded series Functional image Select gt gt Anatomical image A Select Secondary functional image Optional ZA Select Secondary anatomical image Optional ZA Select OK Cancel In the Series Selection dialog box there are two ways of selecting the input images for Fusion e By activating the requested image in the general display then pressing the corresponding Select button on the selection dialog box e By navigating through the patient study series in the menu tree that pops up by clicking the corresponding button Using one of those methods select a functional image and repeat the operation for the anatomical image if needed Codonics Clarity Viewer User s Manual A second functional image can be selected for use in th
19. wer User s Manual Wo ap To change the color of the cross target and reference lines click the button To use the orthogonal view full screen to hide the reconstructed slices click the button MIP Display An MIP is automatically computed from the transverse slices of the functional image Thirty two projections are computed with an angular shift of 22 5 degrees The MIP is computed in the background A green progress bar shows the computation status upon program startup and after activating the fusion option for the Projection The MIP runs in cine loop mode It can be stopped and restarted using the regular cine loop buttons in the general display of the application A small cross on the MIP display materializes the cross target center on the fusion display Reconstructed Slices Reconstructed slices can be computed from either the functional image or the fusion image These slices are displayed in the lower pane of the Fusion window e Select the orientation of the slices coronal sagittal transverse to recompute the slices in the requested orientation e Change the slice thickness using the corresponding control Slice thickness is always an integer multiple of the original slice thickness Fusion Options Use the dialog bar to choose which views are to be displayed in transparency fusion mode Check the following boxes accordingly e Ortho view the fusion is activated on the three orthogonal planes e P
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