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When to Use IntelliSpace PACS Enterprise

1. ip Exam Lookup Gp Exceptions Lookup Patient Lookup E Installed Programs ff iQuery Local Exam Cache Local Export Ea Locked Exams Machine Filters Y Npsefiltar FN F Te Edit Filter F T Rename Filter amp Mergercmmoaonaersy B My Filters 5 My History 5 Queues Statistics Study Lookup 3 System Filters F Completed Exams F CRAI F CTAI F Last 30 days F Last 7 days F MR All US All 2 When asked Are you sure you want to delete filter lt FilterName gt click Yes The filter is removed from the list 9 11 Sample Machine Filters for Technologists and Radiologists Technologists and radiologists can create and use machine filters to customize IntelliSpace PACS for their needs Technologists can create machine filters based on the following criteria to allow them to link exams create presentation states create exam notes and perform quality assurance CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 167 9 Filtering Worklists e Has Images field set to With Images e Status field set to S Scheduled I In Progress and T Taken e Mark Read field set to Unread exams e Include Exceptions by AE Title Radiologists can create machine filters for reading based on the following criteria e Has Images field set to With Images Status field set to C Completed e Mark Read field set to Unread exams 9 1
2. CREF4 09 291 v4 0 07 2014 6 20 2 Click Merge Patients A confirmation message displays Click OK to merge records and keep the selected patient data The list of patient names is refreshed to display the updated merged patient information The exams from both patients are displayed under the merged patient Using Patient Lookup to Find Patients to Merge In the Patient Lookup enter the desired search criteria to find the patients you want to merge Ctrl click to select the two patients you want to merge When the names are selected right click and from the menu choose Merge Patient The Merge Patients dialog box displays a list of the patient information fields none of which are selected In addition the Merge Patients button is disabled can t be selected or clicked Note the following Ifany of the fields of the first patient record does not have a value but the same field for the second patient has a value then that value is selected automatically When a field does not have a value in either patient record then the first patient s record is selected automatically When both fields are identical the first patient record is selected automatically Each patient column has its own Select All button which will select all of the fields of the given patient Selecting any radio button strikes out the value associated with the same field for the adjacent patient Review the information and select the
3. Enter the Performing Resource for the exam or click the button to search for and select one from the Performing Resource Dictionary Enter the Ordering Location for the exam or click the button to search for and select one from the Ordering Location Dictionary Click Providers to enter provider information See Entering Provider Information When Creating Exams see page 101 Click Exam History to enter exam history information See Entering Exam History Information When Creating Exams see page 102 Click Save Entering Provider Information When Creating Exams Use the Patient Lookup to search for and display a list of patients Right click over a patient or an exam in a list and from the menu choose Create Exam The Create Exam dialog box displays with the Exam Info pane displayed Fill in the fields in the Exam Info pane and click Providers to display the next pane Enter the name of the Referring Physician or click the button to search for and select a referring provider from the Referring Physician Dictionary When you select a provider the providers ID address and phone information displays on the right side of the pane Click Exam History to enter exam history information See Entering Exam History Information When Creating Exams see page 102 Click Save Intellispace PACS Enterprise 4 4 User Guide 101 6 Finding and Managing Patient Information 6 22 2 Entering Exam History Info
4. SUS ec eee E E i gf e EE w ahh are e GR EP w ali g 13 14 15 16 17 18 19 13 14 15 16 18 19 2 21 22 23 24 25 26 20 2i 22 23 24 2 a 27 28 rai ach val eal yl y sa bs 7 893 Notification IV Notify by email in case of error J Print submitted query philips com Cancel Select a priority for the request you are submitting in the Priority field Stat Requests that the archive send the studies immediately and with high priority Intellispace PACS Enterprise 4 4 User Guide 319 15 Retrieving and Exporting Studies 15 4 2 Standard Has the studies available as soon as possible and with normal priority This is the default setting Scheduled Displays the Deadline dialog box and allows you to set the date and time that you need the studies by If you want to be notified if an error occurs while your request is being processed select the Notify by email in case of error check box and enter the email address es to which you want notification sent To print a copy of the request list for your records select the Print submitted query check box When the request is complete a copy of the request is printed to your default printer Click OK when you have finished You return to the main iQuery screen Viewing the iQuery Queue The iQuery Queue provides a number of ways to alter the retrieval process Note that these functions are only available to users with administrative privilege
5. front of it meaning approximate value in e When opening and displaying an image in full resolution the ROI measurement oo values are recalculated The sign is no longer displayed and there might be a small update change from the measurement values displayed initially Right click on the image and from the menu choose one of the following e Measurements and then ROI Ellipse e Measurement Palette then the ROI Ellipse icon in the Measurements toolbar Click on a point from which you want to measure and drag horizontally to include the region you are interested in The region is delineated by an ellipse and ROI values next to the region indicate its mean standard deviation sd and its area in centimeters squared To resize the region click and drag the side handles To rotate the region click and drag the corner handles To move the entire region without altering its size click within the ROI and drag the region to the desired location Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Measuring and Annotating Images 13 CREF4 09 291 v4 0 07 2014 13 11 Using the Point Value Tool The Point Value tool allows you to measure the value of data points at a specific point on the image This feature gives the luminance value for single pixels of the original DICOM image In other words the value given is
6. Editing a Window Width Center Preference Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click Window Width Center The right side of the Preferences dialog box displays the current window width and center setting Select a window width and center preference and either double click it or click Properties The Edit Window Width Center dialog box displays Change the settings as desired Click OK The modified preference is displayed in the Window Width Center list Click Apply to save the settings and continue setting other preferences Click OK to save your changes and close the Preferences dialog box Deleting a Window Width Center Preference Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click Window Width Center The right side of the Preferences dialog box displays the current window width and center setting Select a window width and center preference and click Delete The setting is deleted from the list Click Apply to save the settings and continue setting other preferences If you delete all the User window and center settings IntelliSpace PACS automatically restores the settings from the System window width and center settings Click OK to save your changes and close the Preferences dialog box Intellispace PACS Enterprise 4 4 User Guide 345 17 Setting User Preferences 346 17 4 NOTE 17 5 Setting Keyboard Shortcut Prefe
7. Information on the Signs and Symptoms for the exam Information about the History for the exam Additional Comments about the exam Click Save Viewing Linked Records When Editing Exams Do one of the following Use the Exam Lookup to search for and display a list of exams Use the Patient Lookup to search for and display a list of patients Display the exams for a patient Select a filter that displays exams Right click over an exam in a list and from the menu choose Edit Exam The Edit Exam dialog box displays with the Info pane displayed Click Links and review the information If desired you can remove the link by clicking Remove from Link Click Save Beginning Exams These actions Beginning Completing Canceling and Deleting exams performed in IntelliSpace PACS do not update the HIS RIS so they may cause IntelliSpace PACS to be out of sync with the HIS RIS When you begin an exam the status changes from Scheduled to In Progress and that patient s demographic information is made available for download to the scanner See Understanding Exam Statuses see page 109 for more information on exam statuses Before beginning an exam you should first verify that the Performing Resource in the worklist is correct and that an interpreting provider has entered a protocol for the exam Technologists who share worklists can Intellispace PACS Enterprise 4 4 User Guide 115 Finding and Managing Exam Info
8. Rearrange re size and select certain search criteria columns to hide or display Shift click to select contiguous exceptions or Ctrl click to select multiple non contiguous exceptions 4 If desired open the exam to which the exception was resolved to view the study images and verify resolution Note the following e A message displays if the exam has been deleted e A message displays if the exam does not contain any images if the study is detached or if the user does not have rights to view the images 186 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exceptions 10 10 8 2 10 8 3 10 9 CREF4 09 291 v4 0 07 2014 e Ifyou double click on a resolved exception that points to a deleted exception no exam is opened and no message is displayed Exporting Resolved Exceptions You can export the Resolved Exceptions worklist as a comma separated data file CSV format The worklist is exported as a text list including the data in the columns as they are displayed in IntelliSpace PACS Configure the Resolved Exceptions worklist to view the exceptions you wish to export Click Export From the Save As dialog box navigate to the folder to which you want to export the CSV file Click Save Creating a Filter for Resolved Exceptions You can create User or System filters for Resolved
9. 190 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exceptions 10 NOTE 11 CREF4 09 291 v4 0 07 2014 the patient name was unknown and the exams were done in the Emergency Room Later you could search for the patient in the database If the patient name is in the database you can create an exam for the exception study Refer to your local policy on creating new exam in IntelliSpace PACS before using the Create Exam feature If you have HIS RIS integration exams created in IntelliSpace PACS will not be synchronized in your HIS RIS Use the Exception Lookup to search for exception studies Select an exception and right click From the menu select Resolve Exception The Exceptions Handler displays Review the top part of the Exceptions Handler to see the images of the exception study with the associated data fields Suspect data fields are highlighted Review the bottom part of the Exceptions Handler Click the sign to expand the potential match list This allows you to change search criteria and search again for potential matches Double click on any item in a potential match to view the images associated with it This displays a new tab in the bottom pane that displays the images allowing you to compare the images in the top and bottom part of the Exceptions Handler The Accession MRN Patien
10. 2 7 2011 Normal administr Kpacs Manual Restart 4D508C2 2 7 2011 Normal administr Kpacs Manual 0625355 2 10 2011 Normal administr 22 Server Manual 0132783 2 10 2011 Normal administr 22 Server Manual 1224311 2 10 2011 Normal administr 22 Server Manual 0282710 2 17 2011 Normal administr 22 Server Manual 1478187 2 10 2011 Normal administr 22 Server Manual Cancel Change Priority Active Pending Complete Retrying X Failed 2 Cancel Priority Note the following e Columns are sortable e Action buttons Delete Restart Cancel Change Priority are displayed in the right side of the screen e Status icons with a brief description are displayed at the bottom of the screen System Administrators can add edit and remove existing DICOM destinations for the iExport tool in the System preferences See Setting iExport Preferences see page 380 Do one of the following Intellispace PACS Enterprise 4 4 User Guide 311 15 Retrieving and Exporting Studies Click Queue from the DICOM Export dialog box Click Queue from the Send Export via DICOM dialog box Click the Q icon in the IntelliSpace PACS Control Strip 2 The DICOM queue is displayed in the iExport Queue dialog box Results are filtered by the Status and Export Type criteria The status icons display the current status of the exam s export You can do the followin
11. 14 4 14 4 1 NOTE Philips IntelliSpace CT Colonography Philips IntelliSpace CT Colonography CT Colonography is an application that supports you in the detection of polyps in the colon The application is designed to work on CT scans acquired with CT Colonography scanning protocols The CT scan should contain at least 30 images CT Colonography supports primary 2D or primary 3D hanging protocols for inspection of the colon You can do either of the following e Detect lesions in the original grey scale images with a reference link to a 3D image e Inspect the surface of the colon wall in a primary 3D environment with reference links to grey scale images In both environments it is possible to do a comparison reading of matched series such as supine and prone or previous and current Starting CT Colonography If the selected series are not suitable for CT Colonography Volume Vision opens instead of CT Colonography In the IntelliSpace PACS exam rack select one or two abdomen scans press and hold Shift and then click the thumbnail images Right click one of the thumbnail images select Philips Applications and then select CT Colonography OR In the IntelliSpace PACS exam rack select one or two abdomen scans press and hold Shift and then click the thumbnail images Start Volume Vision See Starting Volume Vision see page 285 In the main menu click Analysis and then click CT Colonography The defa
12. Using the Step Zoom Tool see page 251 Hold down the mouse wheel button while dragging your mouse in the desired direction To pan around an image series such as an MR or CT exam left click the mouse while holding down the Ctrl key and drag the mouse to display the desired area Minimizing Images e Right click in the exam margin and from the menu select Minimize Images Note that if you want to re enlarge images after minimizing them you must do it manually there is no Maximize option Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 12 14 NOTE 12 15 12 16 NOTE Flipping an Image The Flip Image feature allows you to rotate the selected image horizontally around the y axis or vertically around the x axis It can be useful to flip a study acquired as prone to look as supine for ease of interpretation for example kidney stones and other renal protocols e Right click on the image and from the menu select Flip Rotate then Flip Horizontal or Flip Vertical Note that one of the orientation markers at the top or left of the image changes for example from A Anterior to P Posterior Keyboard shortcuts to Flip Horizontal or Flip Vertical can be set in the User preferences Rotating an Image The Rotate Exam feature
13. at the lower left corner of the image When a measurement or annotation is added to an image that image automatically becomes a key image e Press the spacebar while the mouse is over the desired image to make the image a key image When you press the spacebar again the image will no longer be a key image e Press the Tab key to cycle forward through all the visible key images and Shift Tab to cycle backwards e You can also right click on the desired image and select Key Image to make the image a key image When you right click on the image and select Key Image again the image will no longer be a key image Intellispace PACS Enterprise 4 4 User Guide 221 12 Viewing and Manipulating Images 222 12 2 1 12 2 2 Key Image Series The Key Image Series option set in User General preferences lets you place all key images in a series at the beginning of each Exam Row The last key image is displayed on the top Key images are used as a reference cine loop and other features are not available for key images The key image series is located to the left of the exam images when the Exam Rack is viewed in horizontally and directly above the exam images when the rack is viewed vertically You can double click a Key Image Series to open a key images popup window See Using the Key Image Popup Window see page 222 You can set a User preference to display the key image series at the beginning of each exam rack See Set
14. e Some patients for example an ED patient with possible acute appendicitis may require time critical clinical management wet read 128 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing Clinical Information 8 CREF4 09 291 v4 0 07 2014 e Sometimes clinicians look at images before the Radiologist does Patient care is improved if the Radiologist knows that the physician has looked at the images and made conclusions This allows the Radiologist to contact the physician immediately if they disagree with the clinician s impressions or conclusions e Radiologists and clinicians want to respond to each other s findings e Technologists may need to add notes to the exam that are relevant for the exam for example The patient could not hold his breath There are three types of pre defined Exam Notes Preliminary Note Technologist Note and Radiologist Note and up to nine types of generic Exam Notes The PACS administrator can modify the description of the generic note types Intellispace PACS Enterprise 4 4 User Guide 129 8 Viewing Clinical Information Clinical Information Exam Notes 4 4 10 Gilpin Sharon MRN 012 06 000 4CFD7741 Sex F DOB 67 02 02 Ordering MD N A Phone N A Pager N A Accession 4CFD77410001 Exam Code N A Location N A Exam Notes 0 Clinical Info Related Exams All E
15. key Click Search Exceptions for patients in the specified time or date range are displayed The upper right corner of the Exceptions Lookup also displays the total number of exceptions found You can do the following Right click to display a menu with actions Rearrange and select certain search criteria columns to hide or display Shift click to select contiguous exceptions or Ctrl click to select multiple non contiguous exceptions Searching for Exceptions by Exception Date Time You can specify a supplied date time to search for exceptions or specify a custom date range using a calendar control Note that when you enter an Accession the date range you specify is not used in the search If it is not already displayed select Exception Lookup from the Folder List or the Shortcut Bar if you have created a shortcut for this feature In the Date Time column select an Exception Date Time range from the list Note that the time is when IntelliSpace PACS receives the images not the time when the images were acquired Note You can use the Delete key and search for all exceptions regardless of date You cannot type a date in this field or use Ctrl X or Backspace to clear the field Click Search or press Enter Patients with exceptions who match the name search criteria are displayed The upper right corner of the Exceptions Lookup also displays the total number of exceptions found You can do the following Right
16. 18 Setting System Preferences 382 18 9 2 18 10 Click iExport The right side of the Preferences dialog box displays a list of the current remote host descriptions Select the remote host description you want to edit and click Properties or double click the remote host description The Edit iExport Remote SCP Configuration dialog box displays Make the desired changes and click OK You return to the Preferences dialog box Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Deleting an iExport Preference Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click iExport The right side of the Preferences dialog box displays a list of the current remote host descriptions Select the remote host description you want to delete and click Delete Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Setting iQuery Preferences System Administrators can add and edit iQuery preferences that allow users to import archived studies into the IntelliSpace PACS server for viewing with IntelliSpace PACS See iQuery for DICOM Study Retrieval see page 314 Click the P icon in the upper right corner of the IntelliSpace PACS
17. Attribute Tag Description SOP Instance UID 0008 0018 The unique identifier of the SOP instance Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 Attribute Contrast Bolus Agent Scanning Sequence Slice Thickness Echo Time Echo Number s Convolution Kernel Acquisition Number Rows Columns CREF4 09 291 v4 0 07 2014 Tag 0008 0010 0008 0020 0008 0050 0008 0081 0008 0086 0008 1210 0020 0012 0028 0010 0028 0011 Description The Contrast or Bolus agent used Description of the type of data taken Enumerated values SE Spin Echo IR Inversion Recovery GR Gradient Recalled EP Echo planar RM Research Mode Not all search combination are valid Nominal slice thickness in mm Time in ms between the middle of the excitation plus and the peak of the echo produced The echo number used in generating this image In the case of segmented k space it is the effective Echo Number A label describing the convolution kernel or algorithm used to reconstruct the data A number identifying a single contiguous gathering of data over a period of time that resulted in this image Intellispace PACS Enterprise 4 4 User Guide 369 18 Setting System Preferences 370 Click Add Attribute if you want to use a different DICOM tag
18. Exam Priority Select Low Medium High Routine or STAT for the exam priority Note that if the filtering is greater than or equal to three days exams with a priority of STAT are displayed at the top of the worklist Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exam Information 7 CREF4 09 291 v4 0 07 2014 NOTE 7 8 1 Performed Date Time Click the arrow next to the date to select a date from a calendar control Enter the time or click the arrows to set the time You can review the Scheduled Date Time but cannot change it Exam Code Click the button to search for and select an exam code from the Exam Code Dictionary required Entering an Exam Code auto populates the Description Modality and Body Part fields Exam Code Modifier Click the button to search for and select one from the Exam Code Modifier Dictionary Performing Resource Click the button to search for and select one from the Performing Resource Dictionary Ordering Location Click the button to search for and select one from the Ordering Location Dictionary If desired click Providers in the left pane to edit provider information See Changing Provider Information When Editing Exams see page 113 If desired click History in the left pane to edit exam history information See Changing Exam History
19. Gatangs Chuc 010150004 Galange Chuc 01015 0004C Gatangs Chue 010 150004C Gatengs Choe 01015004C 20110615 1036 Noma 20110615 103 20110615 10 36 Normal 100 2011 06 15 10 25 Normal 100 2011 06 15 10 24 Normal 100 wist 2011 06 15 10 24 2011 06 15 10 24 20110615 10 19 Normal 1 e 2011 06 15 1022 2011 06 15 10 23 20110615 10 31 Normal 100 STEV 2011 06 15 10 31 2011 06 15 10 32 t 2011 06 15 10 36 0000 00 00 00 2011 06 15 10 36 0000 00 00 00 2011 06 15 1025 2011 06 15 1025 Gaange Cue 01015004C 1200 20110615 10 24 Normal 100 SOTE 2011 06 15 110615 1024 Gatergs Chae 0101500040 02010007 WPaty MOC 2106 15 ai 100 SEmi 2011 06 15 Gaisg Chuck 0101500040 1940005 Paty MOC 010615101 i 100 ist 2010615 Galang Chuck 010150004C 02010007 Paty MOC 20110615 1025 Normal 1 2 2011 06 15 1025 0110615 1025 Status The Status field is editable in that you can click the dropdown arrow and then select a status to further narrow the query The available options are Submitted the query has been submitted and is waiting to execute the transfer Executing the transfer of the exam is in process Completed the transfer of the exam is complete Cancelled you can select this option to change the status of an exam only if the exam is in the Submitted state Failed the exam failed to transfer Patient Name name of the patient MRN MRN for the patient Accession Accession of the pati
20. In other systems and the film environment this value is displayed in centimeters even though the DICOM value is in millimeters The calculated tag FOV Recon Diameter looks at DICOM 0018 1100 but displays the equivalent values in centimeters IntelliSpace PACS System Administrators can use the separate tag Recon Diameter mm to display the original DICOM value in millimeters e The Custom tag allows IntelliSpace PACS Administrators to customize a specific tag which may not have been already pre defined by IntelliSpace PACS Administrators define a known DICOM tag for configuration e The label of an item in the screen overlay is not shown if the item has no value in the DICOM data However for a label that comprises multiple items the labels of all items are displayed if at least one item has a value 374 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 CREF4 09 291 v4 0 07 2014 Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click Screen Overlays The right side of the Preferences dialog box displays a list of current overlays for modalities and allows to add edit delete export or import overlays Click Add The Overlay dialog box displays the available
21. Intellispace PACS Enterprise 4 4 User Guide 297 15 Retrieving and Exporting Studies You can burn CDs and DVDs directly from IntelliSpace PACS without having to exit the application NOTE CAD markers are not included when you copy images to a CD DVD using the Media Viewer P Enterprise Tools e JOHN G MMS HUS931 HIPS ECHO lt 2YRS 2 17 2011 13 22 07 MR Fa fy Exam Lookup Patient Lookup Gy Exceptions Lookup List of exams Patient Lookup Installed Programs EL iQuery Media Viewer options My History Local Exam Cache Local Export m Eh Locked Exams Machine Filters I Philips Proprietary Format 2 a Candidate s IF DICOM Format My Filters I Remove annotations r My History Queues so F Federation Y iQuery Summary Protection Statistics 1 Exam s Media Viewer s I Enable Password Study Lookup amp System Filters Required Disk Space 132 60 MB Password Personal Folders 5 i Public Folders Available Disk Space 23 99 GB Confirm Password Status 0 0GB 10 0GB 24 0GB Figure 15 1 Media Viewer 15 1 1 Exporting Exams to CD or Other Media When you select Local Export the top part of the window displays the list of exams that have been added to the Local Export folder and the bottom part contains the controls you use to export the exams If you drag exams that have been made anonymous into the Local Export folder the exams copied to the CD or other media wi
22. Philips Healthcare Informatics Inc Accessing IntelliSpace PACS Remotely 4 Icon Compression Level a Grade four h Grade five This is the initial compression level of images viewed when logged in with the Wide Area Network setting Grade six Grade seven no compression full fidelity This is the initial and constant compression level A AN aD O of images viewed when logged in with the Internal Network setting 2 JPEG type compression IntelliSpace PACS lossy compression Intermediate draw symbol 4 4 Image Processing Effects Data in IntelliSpace PACS full resolution is presented without loss that is identical to the original data except in the case where lossy compression is used or image processing is applied These cases are clearly indicated on the display through the following icons in the image pane CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 47 Accessing IntelliSpace PACS Remotely Icon Indicates al Lossy compression has been used on the data hd presented There are six levels of compression each represented by a different version of this icon Some lossy process preceded data presentation for example the lossy flag set in the DICOM J Image source is a lossy JPEG image Image processing has been applied In the case of image processing data is altered to enhance some characteristic This may or may not cause data loss depending on the
23. See Linking Image Series see page 224 Shelf See Exam Rack Shortcut Bar A customizable way to access your most frequently used folders filters and tools See Shortcuts Bar see page 60 Single Read Workflow where a single reader radiologist evaluates and rates the clinical images Split Exam The feature that allows you to split a series according to specific DICOM tags See Splitting Exams see page 256 Step Zoom Zoom function that divides the image into rectangular areas of an equal size Each area is displayed with the pixel to pixel zoom setting All areas can be displayed sequentially in a stepwise manner 430 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Glossary 22 CREF4 09 291 v4 0 07 2014 Study A set of images In IntelliSpace PACS a study is associated with a SUID Study Unique Identifier System Administrator Person with special permissions to define the users of the system and hospital specific settings for example roles and worklists System Filter A filter created by an IntelliSpace PACS user that can be shared with multiple users See Filtering Worklists see page 149 System Preferences Various settings that control the behavior of IntelliSpace PACS that are system wide See Setting System Preferences see page 355 Task Used b
24. The Print to Paper dialog box displays From the Name list select the desired printer From the Print Configuration list select the desired configuration for example 3x4 stack From the Optimize For list select Best Image Quality or Faster Image Printing Enter the Number of copies Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Retrieving and Exporting Studies 15 CREF4 09 291 v4 0 07 2014 15 3 Enter an Image Skip pattern if desired for example to skip every other image enter 2 In the Print Range area select whether you want to print the Entire Exam or Selected Window s In the Print Options area check the options you want For example select the Print single images on separate sheets check box if you want to print different plain film series on separate sheets regardless of how much space is available If you are printing CT MR or other stack series check Print Reference Frame to include the reference frame When this option is checked the Reference Frame Options area becomes active Select the desired Series and Image In the Trim Images area select how or if you want to trim images You can trim from the front back or both After you have selected the desired options the bottom of the Print to Paper dialog box shows the number of pages necessary to print the selected configuration
25. The patient s name sex birth date patient ID and referring physician are displayed below the tab Icon for setting Federation status displayed only when Federation is enabled and system is deployed in Federation mode See Setting Federation Status see page 40 Icon to access the iExport Queue application if you have the proper a privileges See iExport for DICOM Export see page 303 Icon to access the Preferences dialog box always displayed Icon to access the online help always displayed Icon to log off of IntelliSpace PACS always displayed Low memory warning If available memory falls below 50 MB for Intellispace PACS Enterprise or 128 MB for Intellispace PACS Radiology a notification displays in the Control Strip Users should contact their IT department to increase hardware components to meet their viewing needs Displays an About box that displays the Philips end user license agreement and SC omon 50 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Program Layout 5 CREF4 09 291 v4 0 07 2014 5 2 Folder List The Folder List provides access to various IntelliSpace PACS areas and tools Folders are storage places for studies you would like to save User folders are private to the user public folders are shared by everyone who has permission to access public folders You
26. To the maximum extent permitted by law you shall not decompile and or reverse engineer the software or any part thereof Printed in the United States of America CREF4 09 291 Version 4 0 07 2014
27. Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 12 10 Using the Magnifying Glass Tool The Magnifying Glass tool allows you to zoom into a small portion of the image using a pre configured magnification factor When selected the center of the Magnifying Glass window is located at the last location of the cursor You can use the Magnifying Glass tool on an image popup window or a virtual monitor By default the Y key toggles the Magnifying Glass tool on and off The size and magnification factor of the Magnifying Glass window are set in the User Display preferences See Setting Display Preferences see page 350 You can set a keyboard shortcut preference for the Magnifying Glass tool See Setting Keyboard Shortcut Preferences see page 346 The Magnifying Glass tool has two modes e Roaming Any movement of the mouse moves the Magnifying Glass above the underlying image showing the image zoomed in in the set factor so that the underlying portion of the image is centered and zoomed in the Magnifying Glass window just like a physical magnifying glass In Roaming mode the cursor is invisible You can click to switch to Stationary mode e Stationary The Magnifying Glass window stays stationary when the mouse moves and the cursor is visible You can click to switch to Roaming mode Note the following e You can only have one Magnifying Glass window open at a time in each popup window or virtua
28. and so on may be different from that of other users e Please adhere to your site security policy to establish strong passwords and take appropriate measures to secure the network environment to prevent access by unauthorized users and possible modification to patient data e Each user is assigned a unique User ID and password This prevents users from sharing the same personal folders user preferences and shortcuts and prevents one user from deleting or changing the user preferences and personal folders of other users You should never share your User ID and password IntelliSpace PACS requires a monitor color setting of 24 bits or higher A message displays if you are using a lower bit rate See Setting the Monitor Color Resolution see page 35 Intellispace PACS Enterprise 4 4 User Guide 33 3 Getting Started 3 1 Logging on to IntelliSpace PACS 1 In the Log in screen enter the user name and password provided by your System Administrator Welcome to IntelliSpace PACS IntelliSpace PACS Enterprise ISITE Password Main Location 2 In the Log on To field select the appropriate authentication scheme 3 If support for more than one language is installed select the desired language from the Language list 4 Click OK or press Enter Your controls and preferences are loaded and your name is displayed in the upper left corner of the screen NOTE e Users are prevented from logging in after three unsuccess
29. as well as managing queries and retrievals from the Exam Timeline and from within the iQuery window These tasks are available in the PACS Administration page If you have authorization and your institution has one or more digital archives iQuery is available from the Folder List See Folder List see page 51 You can select one remote archive to query or you can select all archives to query When more than one archive is available the default archive selection is All Each archive has a specified Query Model which determines how iQuery filters the tags e Patient Root QR e Patient Study Only QR e Study Root QR Unsupported FIND Order If the configured supported model for the remote archive is not known then the order of negotiation by iQuery is as follows StudyRoot PatientRoot PatientStudyOnly Root The following are the four query levels e Patient level query tags are patient name and MRN Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Retrieving and Exporting Studies 15 CREF4 09 291 v4 0 07 2014 Study level query tags are study date study time Accession Number Study ID Study Instance UID Modalities used in Study referring physician name study description patient birthdate patient sex number of study related series number of study related instances All study level
30. for example in the U S the format is mm dd yyyy 2 Right click on a duplicate patient pair to display a menu with the actions you can take To merge duplicate patient records in the same organization select Merge Records The Merge Patients dialog box displays and allows you to complete the merge To link duplicate patient records in different organizations select Link Records The Link Patients dialog box displays and allows to complete the link To leave the original patient records unchanged select Ignore Patients A confirmation message displays Click Yes to remove the selected merge pair from the Merge Link Candidate s list and leave the original patient records unchanged 90 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6 6 19 CREF4 09 291 v4 0 07 2014 An incomplete merge may produce insufficient data or images that can result in delayed patient treatment or misdiagnosis A warning message at the time of a patient merge error will display indicating that the merge is incomplete and giving the demographics of the two patients being merged The user is given the option to perform the merge again The unsuccessful merge will be indicated as Incomplete in the audit trail Merging Patient Records from the Same Organization With the proper privileges
31. mage Processing Annotations Screen Overlays Paper Printing iExport iQuery Plug Ins DICOM Print Workflow Autoscaling Body Part Dictionary Hanging Protocols HP Sequences l Machine Preferences Network Testing DICOM Sources Name esetption _ Properties _ __ Delete Cancel Help Intellispace PACS Enterprise 4 4 User Guide 365 18 Setting System Preferences 366 4 Click Add The Add DICOM Source dialog box displays Add DICOM Source Presentation State Collection Window Center Series Splitting Source Name Description a Identification MaE Tie f M Modaiy F Manufacturer M Serial Number OA Model Name Exam Code Canco This dialog box has six tabs Main Window Center Series Splitting Sorting Presentation State and Collection You must fill in the information on each tab to adequately identify and properly link DICOM sources You should be as specific as possible to prevent overlapping DICOM sources In the Main tab enter the Source Name and Description for the DICOM source Philips recommends that the Source Name matches the ID field in the DICOM metadata Philips recommends that the Description summarizes the function of the DICOM source such as Slice Thickness Series Splitting In the Identification section select each
32. ve selected for analysis some of the analysis options may be disabled From within Volume Vision select one or more views to be analyzed On the main menu bar click Analysis and then point to the required analysis type See the following table for the available analysis types Application Icon Analysis Types S4 Philips IntelliSpace CT Colonography See Philips IntelliSpace CT Colonography see page 289 ae Philips IntelliSpace CT Pulmonary Embolism Assessment See Philips Intellispace CT Pulmonary Embolism Assessment see page 291 A Philips IntelliSpace CT MR Vessel Explorer See Philips IntelliSpace CT MR Vessel Explorer see page 293 A new screen with the selected application is displayed Click the Exit button in the application to return to the main viewing window OR In the IntelliSpace PACS exam rack right click the image select Philips Applications and then select the required analysis type See the preceding table for the available analysis types A new screen with the selected application is displayed Click the Exit button in the application to return to the IntelliSpace PACS exam rack The images in the exam rack are updated with the results of your work Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Philips IntelliSpace Clinical Applications 14 CREF4 09 291 v4 0 07 2014
33. with a DR Chest AP image from a prior exam Linking series like CT or MR series with the same orientation in one or multiple exams with the same modality type For example linking all axials in CT Chest exam that contains multiple axial series Linking series such as CT or MR series with the same orientation in one or multiple exams with different modality types For example linking a CT Brain axial series of a new exam with a MR Brain axial series of a prior exam Linking mammography MG images using mirrored linking The Link feature lets you synchronize multiple images or series with an image or series that you have designated as the master Synchronize means that IntelliSpace PACS tries to do the following Apply to all linked images the same image navigation options that are applied to the master such as zoom or pan Functions such as flip invert rotate and WW WL remain independent Line up the images from the linked series with the one currently selected as the master This lets you page through multiple series simultaneously The series you page through acts as the master and all the linked slaves display the image in their series that is at the closest location to the master Creating Links Right click the desired image or series and select New Link from the menu This engages linking Intellispace PACS Enterprise 4 4 User Guide 225 12 Viewing and Manipulating Images 2 To a
34. 07 21 1999 10 07 40 Status PRELIM Exam info displayed when you hover mouse over exam in Timeline Figure 11 2 Intellispace PACS Enterprise Patient History Timeline For each exam there is an icon small square box displayed in the timeline that displays from top to bottom e Modality type First four characters of the body part from the dictionary Either a straight line an A or an X A straight line indicates that there are images and the exam status is Scheduled or the conditions for displaying an A have not been not met An A indicates that the exam Intellispace PACS Enterprise 4 4 User Guide 197 11 Using the Canvas Page 198 may exist on a separate archive An X indicates that an exam exists but images are not available Blue text indicates that a report should be available e Date month day If you click on an exam in the Patient History Timeline that displays an X and does not have a Scheduled status the iQuery dialog box displays under the following conditions to initiate a DICOM query from another DICOM device e iQuery is configured e You have the proper privileges to run iQuery e There is at least one DICOM QRP Source configured Otherwise the exam does not load and no action is performed when you click on the exam in the timeline Exams that are present in your institution s archive but are not loaded on the IntelliSpace PACS Server are displayed with
35. 2 Enhancing the Edges of an Image 239 12 6 3 Detecting the Edges of an Image 240 12 6 4 Filtering the Image 241 12 6 5 Using Contrast Limited Adaptive Histogram TUL LNION tossed cesta ig ecto i bs Ltn AA E A a 242 12 6 6 Selecting an Interpolation Scheme n se 243 2 7 Using the Scout Tool seissscccosusieisdessas as woe iuie 244 12 8 Using the Localize Tool uasi tatanane as 245 12 9 Zoom PIESGtG iiss tos eoira sirist i aa AES AiR al ialeias 247 12 10 Using the Magnifying Glass Tool i iacieincosusiasatisduinies cbeatioa cbanaais 249 12 10 1 Closing the Magnifying Tool 250 IZT Zoor SCUMN OS ct ratahacedea hans bs oniestubenstlecsdind teuthocar ao a ENERE 250 EZ True Size LOO vission eiai 250 12 11 2 Using the Step Zoom Tool 251 12 11 3 Digital Mammography Images Display ssssssssssssseenenn 253 12 12 Panning Around an Uae ei 3 dics satylbointeds dada tsastrncdeaaainensbatdeencecns 254 12 13 Minimizing mages anita vice ices eeived a ean Quguguauglan 254 12 14 Flipping an Image cosocasies acivis sasusssiivassnstanadevlerdarelvederabeedles 255 12 15 Rotating n map nona anaie e EKAA R RAR aiaats 255 12 16 Sorting mages ssssssessssseersesseresrseseererrnreesrsrnrenenrnrnrenenrneneenenrre 255 12 17 Splitting Exa MSi naroa a E A E A a 256 12 18 Viewing Shutter Images s ssssssssssssesssisrsrsrsrsrsrestsrstsrsrsrerersrsrerere 256 13 Measuring and Annotating Images s sesssseseseseseeceseseroroeseseeceoeo 259
36. 4 User Guide 31 Safety 32 2 2 Mobile Telephones and IT Equipment This medical device software must be installed on appropriate IT equipment that complies with IEC standard 60950 Other electronic equipment exceeding the limits defined in IEC 60950 such as certain mobile telephones could under unusual circumstances affect the use of the IT equipment and thus the medical device software You should not allow any portable radio transmitting apparatus such as mobile telephones whether switched on or off in the vicinity of the IT equipment Such apparatus could exceed IEC radiation standards and under unusual conditions interfere with the proper functioning of the medical device software This could in extreme cases lead to clinical misdiagnosis and or loss damage of patient data Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc 3 CREF4 09 291 v4 0 07 2014 Getting Started When your System Administrator has assigned your IntelliSpace PACS username and password you can access IntelliSpace PACS Your IntelliSpace PACS System Administrator should ensure you can access the IntelliSpace PACS server and tell you which authentication system to log in to Because IntelliSpace PACS is customized on a user by user basis your interaction with IntelliSpace PACS the patients you have access to the tools available to you
37. 5 12 3 6 Link Symbols The following links are displayed on the images as they are linked Symbol Description Fz Displayed in image thumbnails LINK Displayed in image popup windows LINK Displayed in diagnostic monitors if this has been configured in the System preferences Aligning Linked Series DICOM contains information as to the frame of reference which provides exact information as to the location of the patient at the time of scanning Typically images in the same exam have the same frames of reference and images in different exams have a different frame of reference If the linked series have the same frame of reference IntelliSpace PACS automatically aligns them when the link is created If the linked series do not have the same frame of reference IntelliSpace PACS cannot perform the initial alignment automatically In this case it relies on the user to align the series before linking them and then uses information about the slice spacing to synchronize them as you navigate through the series You can adjust the initial manual or automatic alignment by temporarily disconnecting a series image from a link and manipulating each independently by pressing the Shift key while performing mouse or keyboard actions Creating Mirror Links Mirrored links are primarily used for mammography studies Based on how these images are acquired mammography studies typically capture bilateral breasts and display images which are positio
38. 6 If there is matching data for the selected date the results are displayed in Grid view and the Select Columns button is enabled In addition the Download Report button is enabled 7 If there is no matching data for the selected date an error message displays No data exists for the specified Report Type and Date 8 Click Download Report to open or save the report file 9 In the File Download dialog box click Open to view the file or click Save to save the file as a tab delimited matching text file 16 6 1 Selecting Columns for Statistics Grid View Once you have run a successful query the Select Columns button is enabled in the Study Statistics section of the Usage Statistics tab In this view you can select the output columns that you want visible in grid view The Select Columns options are e Modality e Station e Received Studies e Received Images e Study Size MB e Viewed Studies e Archived Studies e Viewed Studies ISE only e Viewed Studies ISE e Received Exams e Archived Exams e Viewed Exams ISE only e Viewed Exams ISE 334 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Managing Studies and Images 16 CREF4 09 291 v4 0 07 2014 e isPrior e Manufacturer e ipAddress e AETitle e Institution e Department e Model e ProcessorID ProcessorLocation Name e OrganizationID
39. ACC2 93 e The marker T displays when the exam is in the process of being transferred from the federation to the local PACS T Exams with images only I Append results clear all clos a 3 ACPT1 ADAMS JULIE 196666698 3 ACPTI AUSTIN POWERS MONKEY DANCING 3 ACPT1 BADOH ROGER 211360205 3 ACPT1 DODGE RITA 96095155 CT No Descriptions Acc 4236867 CT No Descriptions Acc 4154692 CR No Descriptions Acc 4154568 CR No Descriptions Acc 4093012 CR No Descriptions Acc 4093013 CREF4 09 291 v4 0 07 2014 Date 11 3 1999 10 12 58 Date 8 25 1999 13 57 59 Date 8 24 1999 14 29 14 Date 7 28 1999 20 33 56 Date 7 28 1999 20 33 22 DEFAULT u DEFAULT u DEFAULT u DEFAULT U Org DEFAULT Org DEFAULT Org DEFAULT Org DEFAULT Org Federation Loc ImagingCentre Org Federation Loc ImagingCentre Intellispace PACS Enterprise 4 4 User Guide 69 Finding and Managing Patient Information 70 e The marker C displays when the exam has already transferred and is cached locally You cannot open an exam marked C in the canvas page you must first open a local exam as the main exam and then open the cached exam as a prior I Exams with images only Append results clear a_ close 3 ACPT1 ADAMS JULIE 196666698 7 5 1977 DEFAULT uU 3 ACPT1I AUSTIN POWERS MONKEY DANCING 2 16 2000 DEFAULT U 3 ACPT1 BADOH ROGER 211360205 12 21 1946 DEFAULT U u 3 ACPT1 DODGE RITA 9609
40. CD DVD drive as the export location to save directly to a blank CD DVD A message displays if the selected directory is not empty or if there is no media in the specified drive Select Remove annotations to remove any annotations from the exams Select the desired Language from the list for the IntelliSpace PACS program and documentation Select either the Philips Proprietary Format or DICOM Format check boxes or select both check boxes for the exported exams Philips Proprietary Format The standard wavelet encoded Philips format DICOM Format The raw unadulterated DICOM data from the modality When you set this option the DICOM information is stored in a separate directory on the portable media called DICOM You can copy this directory directly to other DICOM systems and archives This Intellispace PACS Enterprise 4 4 User Guide 299 15 Retrieving and Exporting Studies is the most effective way to transport studies to other facilities that do not have IntelliSpace PACS for consultation education or research Select Include DICOM Viewer to make sure a DICOM Viewer is available Both Selecting both check boxes provides maximum flexibility for working with and transferring the exported data but uses more space on the portable media you select 5 Select the Anonymize check box to export exams with anonymized patient information See Working with Anonymized Exams in the Media Viewer see page 301 6
41. Cc Phone Number Work 123 123 1234 C 4234294234 Phone Number Home 123 123 1234 C 42342714234 Email Address abc efgh ijkl abc abc test Title Cc Suffix C Alias First Name Cc Alias Middle Name C Alias Last Name s Address C 41122 Street one 123 test lane Last floor apt 100 Lost City California 12345 Foster City California 94404 UNITED STATES UNITED STATES gt MRN TEST C test1 C TEST123 gt MRN TEST1 C TESTIABC TESTIMRN Note All other information from the patient record whose patient identifier has been selected will be retained Organization is not configured to accept demographics update Mere Paton The linked patients MRN from the Organization is displayed in the bottom of the Merge Patients dialog box Intellispace PACS Enterprise 4 4 User Guide 93 Finding and Managing Patient Information 6 20 1 NOTE If desired select the MRN of the patient in the Linked Organization section to view the patient s demographic information First Name Middle Name Last Name Sex Date of Birth and Address Click Merge Patients All linked patients with this demographic data are updated if IntelliSpace PACS has been configured to allow this Using the Merge Link Candidate List to Merge Patients Merge candidates appear within the same Organization while Link candidates appear in different Organizations In the Folder List click Merge Link Candidate Enter the
42. Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Deleting an iQuery Preference Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click iQuery The right side of the Preferences dialog box displays a list of the iQuery preferences Intellispace PACS Enterprise 4 4 User Guide 383 18 Setting System Preferences 384 18 11 Select the archive you want to delete and click Delete Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Setting Plug In Preferences System Administrators can add edit or delete plug in preferences Plug ins allow you to create links in the IntelliSpace PACS Folders List and Shortcuts Bar that point to other web interfaces websites For example if your institution s lab results are available from an in house server you can display that server s interface in IntelliSpace PACS by creating a plug in System Administrators can name the plug ins enable them in different IntelliSpace PACS programs and set security for them if necessary Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system pre
43. Click OK iExport for DICOM Export The iExport tool allows users with administrative privileges to monitor the export of DICOM exams and the export queue Your IntelliSpace PACS System Administrator first needs to configure the destination DICOM device s IntelliSpace PACS allows for multiple instances of the iExport Service to support larger distributed configurations and to distribute the processing of requests to export patient studies to external DICOM devices iExport works with the DICOM functions which allow users to export IntelliSpace PACS exams as DICOM to another DICOM device such as a DICOM printer a 3D imaging tool or a DICOM archive Intellispace PACS Enterprise 4 4 User Guide 303 15 Retrieving and Exporting Studies 304 NOTE NOTE All raw DICOM and imaging is exported However native iSyntax presentation states not in GSPS are not exported Certain patients such as politicians entertainers and hospital employees may be designated as VIPs Very Important Persons in IntelliSpace PACS Accessing these patient records and performing all actions such as opening exams viewing images exporting exams and so on are audited If you use iExport for several exams and some of the exams are for sensitive patients the names and MRNs of the sensitive patients are listed before the exams are exported You can choose to either export all these exams or cancel the export operation On any page of the iExpor
44. Clinical Info becomes invisible the Clinical Info dialog is hidden The Clinical Info dialog becomes visible again when you switch back to the same exam display When you close the Exception Handler dialog the Clinical Info dialog is closed as well Intellispace PACS Enterprise 4 4 User Guide 193 10 Finding and Managing Exceptions 194 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc 11 11 1 CREF4 09 291 v4 0 07 2014 Using the Canvas Page Introduction to the Canvas Page The Canvas Page displays patient exams and provides quick access to diagnostic images and series diagnostic reports and exam notes patient information and diagnostic reading workflow You use the Canvas Page to get contextual historical information about the patient You can reposition an image by selecting its information bar dragging and dropping it to the desired location Each exam has its own horizontal scrollbar that you can use to pan through the images and series in that exam You can use the vertical scrollbar at the right side of the screen to view the selected exams if there are more than can fit on the screen e Make sure you label the left and right sides of an image correctly to prevent incorrect patient orientation and the possibility of misdiagnosis Make sure you follow industry best practices for correct patient
45. Control Strip Click the sign next to System Preferences The list of available system preferences displays Click iQuery The right side of the Preferences dialog box displays a list of the iQuery preferences Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 CREF4 09 291 v4 0 07 2014 18 10 1 18 10 2 Click Add The Add iQuery Remote SCP Configuration dialog box displays Enter the AE Title Remote Host Description Host IP and Port Select the Preferred Query Model from the list Select the Close on Cancel or Merge Ark Compatibility check boxes if desired Click OK You return to the Preferences dialog box Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Editing an iQuery Preference Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click iQuery The right side of the Preferences dialog box displays a list of the iQuery preferences Select the archive you want to edit and click Properties or double click the archive The Edit iQuery Remote SCP Configuration dialog box displays Make the desired changes Click OK You return to the Preferences dialog box
46. Date 11 3 1999 13 17 21 a a ms B CT No Descrictions Ace 4736867 Data 11 9 1999 1017 58 5 Double click the exception to open it in the Canvas Page Note the following e Ifyou do a new search the old results are removed unless you select the Append results check box or you expanded a patient s record to display that patient s exam list e By design the top 200 exceptions are displayed e There is no context right click menu for exceptions in the Patient Lookup 6 7 Clearing a List of Patients If you have a list of patients displayed you can clear the patients in the list by starting a new search or by clicking Clear All e With patients displayed in the Patient Lookup click Clear All All names in the list are removed 80 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6 CREF4 09 291 v4 0 07 2014 6 8 6 9 Closing a List of Patients If you have exams displayed in the list of patients you can close the exams individually by clicking the icon to the left of the patient name You can also close the exams for all patients in the list at the same time With patients and exams displayed in the Patient Lookup click Close All The exams for all patients in the list are closed so that only the patient names are listed Showing or Hiding Patient Lookup Columns Y
47. Editing a Window Width Center Preference see page 359 e The Restore Color Image option displays the current color image or stack of color images in its original form without applying any window width or level values Aw ARNING The Restore Color Image feature is configured using DICOM Sources to specify the source and modality type of the study Please exercise caution when using this feature with scanned in images For other modalities such as CR and MR the Window Width Level menus are listed in three separate areas from top to bottom Default WW WL e Modality Default if defined 232 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 12 4 1 12 4 2 12 4 3 NOTE e Histogram Calculation Using the Default WW WL The default WW WL values can be either Modality Default values or Histogram Calculation values The Default WW WL is the same as Modality Default when the WW WL values are provided from the modality If no Modality WW WL values are provided the Default WW WL values will be the same as Histogram Calculation values e Right click on an image and from the menu select Window Width Level and Default WW WL Using the Modality Default WW WL Values Modality Default values are the Window Width and Window Level provided by the modality
48. Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 4 1 Accessing IntelliSpace PACS Remotely Overview IntelliSpace PACS enables you to access patient exams stored at a main location from a remote site such as your home or off site location To compensate for the slower connection speed of a WAN DSL ISDN or 56K modem connection you can select from several levels of compression and image quality adjustments When required you can still download a full fidelity non compressed image which is the highest quality image To use remote access you select your connection method when you log into to IntelliSpace PACS If your institution is a multi site deployment additional locations might be displayed in the Workstation Location list These locations correspond to appropriate site names of your multi site deployment If you are not sure which location to select or if you need clarification on multi site configuration contact your IntelliSpace PACS System Administrator You must be aware of the amount of compression in use when you view images and series in IntelliSpace PACS Note that Hounsfield unit measurements are not correct unless the image you are measuring is at full fidelity You can use the following Workstation Location compression modes when logging in from an off site location depending on whether you
49. Exceptions Lookup Patient Lookup CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 67 Finding and Managing Patient Information 68 If you click several signs in rapid succession the number of requests displays as that same number of signs clicked For example if you click three signs in the patient list quickly the message will read as 3 requests queued for federation As exams are downloaded from the federation a letter marker is added to the left of the modality type and the exam icon is not displayed In addition the organization will display as Federation I Exams with images only 3 J ACPT1 ADAMS JULIE 196666698 7 5 1977 Dt 3 J ACPT1 AUSTIN POWERS MONKEY DANCING 2 16 2000 Dt 3 ACPT1 BADOH ROGER 211360205 12 21 1946 Dt ACPT1 DODGE RITA 96095155 2 5 1918 DI EJ CR No Descriptions 4236873 11 3 1999 13 17 21 DEFAULT E CT No Descriptions Acc 4236867 Date 11 3 1999 10 12 58 Org DEFAULT E CT No Descriptions Acc 4154692 Date 8 25 1999 13 57 59 Org DEFAULT E CR No Descriptions Acc 4154568 Date 8 24 1999 14 29 14 A CR No Descriptions Acc 4093012 Date 7 28 1999 20 33 56 CR No Descriptions Acc 4093013 Date 7 28 1999 20 33 22 CR No Descriptions Acc 4093027 Date 7 28 1999 20 32 18 Org Federation Org Federation Org Federation T T R R CT No Descriptions Acc 4093042 Date 7 28 1999 19 41 46
50. Guide 277 13 Measuring and Annotating Images Setting Annotation Preferences see page 362 Pre defined annotations include Bleed Calcification Cyst Foreign Body Fracture Free Air Mass Node Stone and Tear 22 Jun 1999 15 18 18 Acc 4012956 m Figure 13 7 Annotation Tool example CAUTION IntelliSpace PACS stores data in the fashion that it was received Annotations and other changes are saved in presentation states and are available for subsequent viewers of these images within IntelliSpace PACS but the changes are not preserved when these are exported back to another DICOM device This means that if you want to make permanent changes to any image you need to do this on the modality itself and then send the image back to IntelliSpace PACS Right click the image or series you wish to annotate Note the following e Annotations can be hidden removed or deleted from the screen e Presentation States do not export via DICOM export back to the modality e When printing the Print Measurements and Annotations option must be selected 1 From the menu select Annotations then the tool you want to use for example Triangle 2 Click the part of the image where you want the annotation to start and drag to draw the selected shape 3 Release the mouse button to complete the annotation 278 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healt
51. Information When Editing Exams see page 114 If there are linked records associated with this exam click Links Click Save when you are done You can type data directly in the Exam Code Modifier Performing Resource and Ordering Location fields but if the data is incorrect or non existent the dictionary associated with that field will open and display the message No Matching Records Please refine your Query parameters Either enter the correct parameters for the query and click Search or click Cancel to close the Dictionary Query dialog and then click the button next to the appropriate field to select from the corresponding dictionary Changing Provider Information When Editing Exams Do one of the following Use the Exam Lookup to search for and display a list of exams Use the Patient Lookup to search for and display a list of patients Display the exams for a patient Intellispace PACS Enterprise 4 4 User Guide 113 7 Finding and Managing Exam Information Select a filter that displays exams 2 Right click over an exam in a list and from the menu choose Edit Exam The Edit Exam dialog box displays with the Info pane displayed Fill in the fields in the Info pane and click Providers to display the next pane 3 Enter the name of the Referring Physician or click the button to search for and select a referring provider from the Referring Physician Dictionary If you enter a partial name the Providers D
52. New Link See Linking Image Series see page 224 Link All Axials Sagittals Coronals Obliques for multi sliced series Linking Image Series see page 224 Clone See Using Clone Windows see page 211 Clone Window with Preset Using Clone Windows see page 211 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Using the Canvas Page 11 CREF4 09 291 v4 0 07 2014 11 12 11 12 1 11 13 e Save Saves the image e To Paper Printer See Printing to Paper see page 302 e Flip Rotate Sort Split See Flipping an Image see page 255 e Zoom Presets Allows you to select a preset zoom factor of Fit to Window 100 Original Size 200 300 or 400 e Magnifying Glass See Using the Magnifying Glass Tool see page 249 Using Clone Windows Clones are copies of images or series that provide alternate image processing and enable you to apply different filters and Window Width and Levels When you create a clone it is displayed as a thumbnail image in the Exam Rack on the Canvas Page You can double click a cloned thumbnail to display it in a large image popup window for better resolution You can use clones to clone all single image windows and apply the Invert Image feature to the clone s or to clone all stacked image windows with a Lung or Bone Window Width and Level Preset Clo
53. OK to save your changes and close the Preferences dialog box Setting Image Processing Preferences System Administrators can set the default image processing preferences for edge enhancement edge detection median filters and CLAHE Intellispace PACS Enterprise 4 4 User Guide 359 18 Setting System Preferences e The Edge Enhancement settings allow you to make the edges more prominent while still showing low frequency background information within the image See Enhancing the Edges of an Image see page 239 to see how the Edge Enhancement preference is applied to images e The Edge Detection settings allow you to remove the low frequency background information from within the image leaving only the edges visible See Detecting the Edges of an Image see page 240 for information on how the Edge Detection preference is applied to images e The Median Filter settings allow you to define a low pass filter to remove noise from the image with little or no smoothing of the image You can use the Median Filter preference to place a 3x3 or 5x5 mask over the original image The median medium value becomes the new pixel value See Filtering the Image see page 241 to see how the Median Filter preference is applied to images e The CLAHE Contrast Limited Adaptive Histogram Equalization settings utilize an adaptive form of histogram equalization that enhances the contrast adaptively across the image See
54. Org DEFAULT 8 24 1999 14 29 14 Org DEFAULT 7 28 1999 20 33 56 Org Federation Loc ImagingCentre 7 28 1999 20 33 22 Org Federation Loc ImagingCentre Clicking Missed Locations opens the Missed Locations pop up which displays the name s of each missed location Once you have viewed the information click Close to close the dialog Intellispace PACS Enterprise 4 4 User Guide 71 6 Finding and Managing Patient Information 7 Erama wah magos ely Append su 3 ACPT1 ADAMS JULIE 196666698 74511977 DEFAULT u 3 ACPTI AUSTIN POWERS MONKEY DANCING 2 16 2000 DEFAULT u 3 ACPT1 BADOH ROGER 211360205 12 21 1946 DEFAULT U 4 ACPT1 DODGE RITA 96095155 2 5 1918 DEFAULT uU a CR No Descriptions Acc 4236873 Date 11 3 1999 13 17 21 Org DEFAULT E a CT No Descriptions Acc 4236867 Date 11 3 1999 10 12 58 Org DEFAULT CT No Descriptions Ace 4154692 Date 8 25 1999 13 57 59 Org DEFAULT CR No Descriptions Acc 4154568 Date 8 24 1999 14 29 14 Org DEFAULT M R CR No Descriptions Acc 4093012 Date 7 28 1999 20 33 56 Org Federation Loc ImagingCentre R CR Nof Missed Locations 1 28 1999 20 33 22 Org Federation Loc ImagingCentre R CR N o 1 28 1999 20 32 18 Org Federation Loc ImagingCentre R CT 1 28 1999 19 41 46 Org Federation Loc ImagingCentre R CT 1719 1999 23 27 07 Org Federation Loc ImagingCentre j R CR 1 16 1999 18 29 14 Org Federation Loc ImagingCentre f R CR 1 12 1
55. Org Federation R CT No Descriptions Acc 4066386 Date 7 19 1999 23 27 07 Org Federation R CR No Descriptions Acc 4058452 Date 7 16 1999 18 29 14 Org Federation R CR No Descriptions Acc 4053020 Date 7 12 1999 2 08 04 Org Federation R CR No Descriptions Acc 4033648 Date 7 2 1999 1 54 51 Org Federation R CR No Descriptions Acc 3761586 Date 2 19 1999 2 07 57 Federation e The marker R displays to show that remote exams have been identified in the federation e Right click the Remote Exam and the shortcut menu displays the options Show Report only if a report is present for the remote exam a gray report icon will display to the left of the R marker Fetch Exam select this option to have the exam fetched and then cached locally Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information Personal Folders rats Public Folders Patient 2 Radiology Tools Lookup fg Exam Lookup Gp Exceptions Lookup amp Patient Lookup Installed Programs EL iQuery Local Exam Cache Local Export Ba Locked Exams E Machine Filters mike 3 J Mike Smith CT No Descriptions Acc Mike ACC1 95 CR No Descriptions Acc Mike ACC4 93 tions CT No Descri Show Report Fetch Exam I Exams with images only T Acc Mike ACC1 93 Acc Mike
56. Patient History Timeline with remote exams displayed Remote exams are displayed on the timeline with an initial C R or T below the exam These initials specify the state the exam is in as follows C the remote exam is already cached locally R a remote exam has been identified in the federation T exam is in the process of being transferred from the federation to the local cache In addition when the F icon in the Control Strip is amber one or more remote locations missing an X appears in the far right of the Patient History Timeline to indicate that the timeline may be incomplete because one or more remote locations are missing Intellispace PACS Enterprise 4 4 User Guide 199 11 Using the Canvas Page 200 If an exam is present local either cached locally or in a local PACS the modality and body part displays on the timeline as green while remote exams that are either still remote or are in the process of transferring display as blue on the timeline If you right click a remote exam displaying the R marker on the Patient History Timeline Fetch Exams displays Click Fetch Exams and the transfer process for the remote exam begins displaying the T marker in the timeline as the exam is being transferred Once the exam has transferred and has been cached locally displays the C marker in the timeline you can click the exam and open it in the Canvas Page Intellispace PACS Enterprise 4 4 User Guide CREF4
57. Patient Lookup is the first screen displayed when you log in IntelliSpace PACS allows you to uniquely identify a person and track their care as they enter an organization and become a patient You use the Exam Lookup to find and manage exams see Exam Lookup Overview see page 103 and the Exception Lookup see Exceptions Lookup Overview see page 171 to find and manage exceptions You can view and search for exceptions in the Patient Lookup see Viewing Exceptions in the Patient Lookup see page 79 Clear all or close all for new search Search for exams with images User Default Administrator a I I J ACPTI ADAMS J Wanatara 7451977 3 ACPTI AUSTIN PEs MONKEY DANCING 2 16 2000 Figure 6 1 Patient Lookup Because healthcare organizations can vary significantly from single hospitals to an integrated delivery network consisting of multiple hospitals imaging centers or groups of primary care clinics a person can have multiple patient identifiers When this occurs healthcare organizations may implement a Master Patient Index MPI system to guarantee the uniqueness of a person with multiple patient identifiers in those organizations See Master Patient Index and Patient Demographics see page 75 IntelliSpace PACS Enterprise 4 4 User Guide 63 6 Finding and Managing Patient Information IntelliSpace PACS maintains its own database of Organization IDs Persons and Patients Each Person is
58. Patient Name Exam Date Time Modality Organization Body Part Exam Description and Exam Code are displayed for the images If you cannot find a patient or exam to associate with the study click Create Patient and Exam See Creating a New Patient and Exam from the Exceptions Handler see page 189 If you can find a patient but not an exam click Create Exam See Creating a New Exam from the Exceptions Handler see page 190 When you have found a match click Resolve A message displays asking you to confirm the action Click OK The exception is resolved and any image popup windows you opened are closed Any exception opened from the exception worklist stays highlighted in the list after you have closed the exception if the exception has not been resolved Resolving Accession Not Found Exceptions The mismatch scenario Accession Not Found means that the Accession of a study cannot be found in the IntelliSpace PACS database To resolve this exception you must search the IntelliSpace PACS database with the MRN that was attached to this study The most likely exam is the one without images though this is not always the case Use the Exception Lookup to search for exception studies Select an exception and right click From the menu select Resolve Exception The Exceptions Handler displays Intellispace PACS Enterprise 4 4 User Guide 183 10 Finding and Managing Exceptions 3 Select an item in the
59. Removes only the current image If the exam being viewed has not been read the Reason for Deletion dialog box displays If the exam has been marked as read a confirmation message displays before the image is deleted When you click Yes in the confirmation message the Reason for Deletion dialog box displays Enter the reason for deleting the image or select a reason from the list Click OK The image s are deleted from the selected window and from the corresponding clone window s if any Note that the total number of images is not updated after images are deleted Recovering Deleted Images Deleted images are marked as such in the IntelliSpace PACS database and are no longer accessible to IntelliSpace PACS users IntelliSpace PACS does not remove the actual images from the disk and users with the proper administration privileges can use the Recover Deleted Images feature to undo the accidental deletion of images The Recover Deleted Images feature is available at the exam level not at the individual series image level Right click in the exam margin and from the menu select Recover Deleted Images IntelliSpace PACS displays a message if recovery is successful Close and re open the exam to view the recovered image Questions and Answers on Deleting Images What happens when you delete an image and IntelliSpace PACS receives the same image again The image is rejected ignored by IntelliSpace PACS because of a duplicate Image UI
60. Standard deviation is unitless and is a standard statistical measure of the dispersion of the values in the region of interest The area Intellispace PACS Enterprise 4 4 User Guide 269 13 Measuring and Annotating Images 270 measurement is CM2 if pixel spacing is available otherwise the units are pixels 2 The values for these measurements are computed in floating point and displayed so that the ROI measurement is presented to two decimal places This means that the accuracy is dependent on the magnitude of the values in the region The area is accurate to approximately 1 part in 1045 The standard deviation is displayed to one decimal place which means that the accuracy is dependent on the magnitude of the data For Region of Interest ROI the standard deviation is calculated by using the intensities of all pixels that are inside the ROI If the image has slope intercept that is applied and then the standard deviation is calculated Otherwise the raw pixel data is used to find the standard deviation This means that changing WW WL will not change the measurement and that all pixels within the ROI are considered Note the following e When performing an ROI measurement on an image that is displayed with a resolution smaller than the actual image for example an image in the rack for CT IntelliSpace PACS may calculate the ROI using a sub sample of the original image data The value in this case is an accurate representation o
61. The image zooms in at the location of your cursor To zoom out roll the mouse wheel backward or use the Up or Left arrow keys To zoom into an image series such as an MR or CT exam left click the mouse while holding down the Alt key and drag the mouse forwards to zoom in or backwards to zoom out e Right click on the image and select Zoom Presets then select the desired zoom level When you zoom the scales at the bottom and right of the image adjust to show one of the following e 10 mm per division at smaller zoom factors e 1 mm per division at larger zoom factors To show the current size of the division left click on the scale and hold the mouse button down e Alternatively you can use the Step Zoom tool to step sequentially through portions of the image at full resolution See Using the Step Zoom Tool see page 251 Fit to Window Zoom Preset Fit to Window applies an adjusting zoom factor that always maintains the entire image visible on the screen e Right click on the image and select Zoom Presets then select Fit to window Pixel to Pixel Zoom Preset Original Size Pixel to pixel is a zoom setting where a single pixel in the image corresponds to a single pixel on the screen e Right click on the image and select Zoom Presets then select 100 Original size Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc
62. This is used to allow memory to be utilized by other memory intensive applications 7 In the Override Access Group Autologout section select the Use Machine Auto Logout Time check box to override the system wide auto logout for the machine you are working on You can then set a new auto logout value in seconds Set the seconds settings to 0 if you do not want the machine to ever automatically log out 8 Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box 392 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting Machine Preferences 19 CREF4 09 291 v4 0 07 2014 19 2 Setting Display Monitor Preferences System Administrators can set preferences to configure the dimensions of the diagnostic monitors attached to the machine These dimensions are used in the calibration for the Display Preferences under User preferences including the font size and image overlay size See Setting Display Preferences see page 350 For mammography you need to optimize the display setting if high resolution SMP mammography monitors are connected to the client machine in order to keep the font sizes of screen overlays and menu items readable In addition enable the True Size display option display size on screen the size on the detector Select t
63. You can organize your shortcuts into shortcut groups For example you can create a shortcut group called Filters where you place all your filter shortcuts You can add as many shortcut groups as you want As you add groups they are stacked in the Shortcut Bar You can also drag items from the Folder List into a shortcut group Creating a Shortcut Group Right click on the body of the Shortcuts Bar and from the menu select Add New Group An editable text field called New Group is displayed at the bottom of the Shortcut Bar Intellispace PACS Enterprise 4 4 User Guide 61 Program Layout 62 2 Enter a name for the new shortcut group and press Enter 3 To access the shortcut group click the header 5 6 2 Renaming a Shortcut Group 1 Right click the shortcut group name and from the menu select Rename Group The name field becomes editable 2 Enter the desired name and press Enter 5 6 3 Removing a Shortcut Group 1 Right click the shortcut group name and from the menu select Remove Group A confirmation message displays 2 Click Yes Note that when you remove a group you lose all the shortcuts in that group Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 6 1 Select search criteria and click Search Finding and Managing Patient Information Patient Lookup Overview
64. all actions such as opening exams viewing images exporting exams from the Media Viewer and so on are audited If you move several exams to the Local Exam Cache folder and some of the exams are for sensitive patients the names and MRNs of the sensitive patients are listed before the exams are copied to the Local Exam Cache folder You can choose to either copy all these exams or cancel the operation IntelliSpace PACS System Administrators should note the following Intellispace PACS Enterprise 4 4 User Guide 123 7 Finding and Managing Exam Information e Ifthere is not enough room for a given exam to be downloaded the oldest downloaded exam is deleted If there is still not enough disk space available to download the exam the caching operation is suspended and the user is informed that there is insufficient disk space available e For security reasons all images and metadata are cached in encrypted format e All images are stored on the local hard disk in the user s environment to avoid access privilege problems in Username Local Settings Application Data iSite 4 4 Local Cache Only users who logged into the workstation with the Local Exam Cache privilege can cache and view the cached exams because it is saved under their username If another user logs into the workstation after the previous user had cached exams to the hard disk they will not have access to those previously cached exams e If new images have arrived at t
65. allows you to rotate the selected image or series in 90 degree increments clockwise or counter clockwise e Right click on the image or series and from the menu select Flip Rotate then Rotate 90 CW or Rotate 90 CCW Sorting Images You can sort images by e Table Position Ascending e Table Position Descending e Image Number Ascending e Image Number Descending This option is not available for multi frame images that have the same image number e Select the image and from the menu select Flip Rotate Sort Split then the desired sort option Intellispace PACS Enterprise 4 4 User Guide 255 12 Viewing and Manipulating Images 256 12 17 12 18 Splitting Exams The Split Exam feature allows you to temporarily split a series according to specific DICOM tags This feature is only available for stacked images especially multi frame multi phased stacked windows Note that you cannot split clones If there are no attributes available for splitting or if the split criteria are not met a message displays stating that the exam cannot be split Right click on the image and from the menu select Flip Rotate Sort Split Choose Split Exam from the sub menu The Split Exam dialog box displays Check the DICOM tags that you wish to use for splitting the series The tags depend on the tags associated with the type of series you have selected Click OK The original series is broken into different series according to the selected
66. an A under the following conditions e The exam date and time is older than 48 hours e The system preference Allow DICOM Query to Display in Timeline is enabled e iQuery has been configured with at least one DICOM QRP source e The IntelliSpace PACS user has iQuery access privileges e The exam has no images and the exam status is neither Scheduled nor Non Reportable Left clicking on an exam in the Patient History Timeline displays that exam in the Exam Rack Right clicking on an exam in the Patient History Timeline displays a menu with the following options depending on the exam e Open Close Exam See Opening or Closing an Exam see page 203 Add Exam to Folder See Adding Exams to Folders see page 55 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Using the Canvas Page 11 CREF4 09 291 v4 0 07 2014 11 2 1 Show Report See Displaying and Printing the Current Report see page 145 e View Exam Notes See Viewing Exam Notes see page 133 e Export via DICOM See iExport for DICOM Export see page 303 e Cache Exam See Local Exam Caching see page 123 Federation and the Patient History Timeline When viewing the Patient History Timeline there are some differences when remote Federation exams are displayed ta Li Or aa e FROM PR 2X Figure 11 3 View of the
67. are running IntelliSpace PACS Enterprise or IntelliSpace PACS Radiology e Main no compression e Wide Area Network WAN e DSL cable modem e ISDN cable modem Teleradiology most compression Intellispace PACS Enterprise 4 4 User Guide 43 Accessing IntelliSpace PACS Remotely 4 2 4 2 1 4 2 2 Minimum Network Requirements General Requirements At the minimum a switched 100Mb s local area network LAN shall be provided For Study acquisition scenarios that require STAT interpretation Hardware DICOM processors and storage modules and Client Devices must reside on a contiguous 100Mb s switched LAN DSL cable modem satellite and other non commercial grade technologies should not be used due to high latency e Issues including delays with image retrieval delays in Study migration between servers locations and application responsiveness issues pauses halting may be experienced when the PACS Service is used on a network that does not meet the Minimum Network Requirements e Be aware that remote sites that do not connect directly to the main site and or that connect with a sub optimal bandwidth can cause incomplete transfer of or unavailability of critical data at the time of diagnosis Urgent Cases Emergency Room and Availability Depending on the urgency of a case studies may need to be accessed quickly after acquisition for diagnostic interpretation to provide feedback to a requesting ER physician An E
68. audited Intellispace PACS Enterprise 4 4 User Guide 301 15 Retrieving and Exporting Studies 302 15 1 4 15 2 NOTE If you move several exams to the Media Viewer folder and some of the exams are for sensitive patients the names and MRNs of the sensitive patients are listed before the exams are exported to the Media Viewer folder You can choose to either export all these exams or cancel the export operation Using the CD DVD Insert the portable media device The disk plays automatically when you insert it no internet connection is needed If the portable media device has been password protected a login screen is displayed Enter the password associated with the portable media device Click Log In A list of the exams on the portable media device displays Click the help icon to display the IntelliSpace PACS Media Viewer help Printing to Paper If the image is larger than the paper size for example in true size parts of the image will be automatically cropped out on the print out Images printed to paper from IntelliSpace PACS are not intended for diagnosis and should be used only for communication purposes You can print an entire exam or selected windows to your default printer To print only one or more image s in a series for example two slices of an MR exam make those slices key images and then print only key images Right click on an image and from the menu select Print and then To Paper
69. button s next to the information you want to keep for the merged patient Click Merge Patients A confirmation message displays Click Yes to complete the merge The list of patient names is refreshed in the Patient Lookup Intellispace PACS Enterprise 4 4 User Guide 95 Finding and Managing Patient Information 6 20 3 Merge Patient Examples The following examples illustrate two reasons why you would need to merge patient records Example 1 A single person has been entered into a HIS RIS with two different Medical Record Numbers MRNs as follows e John Smith MRN 123456 M DOB 12 31 00 and e John Smith MRN 111111 M DOB 12 31 00 These records belong to the same individual but because their MRNs are different they are seen by the system as two unique individuals In theory this scenario can pose a risk to patient care In this example the records for two John Smith s both with identical demographic information should be merged into one record Be aware that there are significant implications to merging two patient records If a pair is mistakenly merged patient care could be delayed or impeded Also you cannot undo a patient merge Example 2 An unconscious man is brought into the Emergency Room He is given a fictitious name and MRN and other information when the technologist enters him into the HIS RIS and takes images Later when the patient regains consciousness the technolog
70. by using a wildcard search For example to find patient Doe John you can search for the full name Doe John full last name and partial first name Doe J or partial last name D There is also a wildcard search option that allows you to search on a partial last name and and partial or full first name for example D Joh If it isn t already displayed select Patient Lookup from the Folder List or the Shortcut Bar if you have created a shortcut for this feature Intellispace PACS Enterprise 4 4 User Guide 77 Finding and Managing Patient Information 6 5 2 6 5 3 Enter all or part of the patient s last name followed optionally by a wildcard character a comma and all or part of the first name for example Sm J will match Smith Joyce and Smithy Jim Click Search or press Enter Patients who match the name search criteria are displayed Searching for Patients by Identifier If two or more healthcare organizations want to integrate their systems they can use an MPI patient identifier to enforce the uniqueness between organization identifiers and to link patients across organizations IntelliSpace PACS supports customers who currently use MPIs as well as those who don t use MPI now but plan to The ability to search for patients by MRN or MPI number lets you use IntelliSpace PACS to link patients with different MRNs together under one MPI When running a query using a pat
71. can use folders to save studies for reference later or studies to share with a group of users Folders can help solve workflow process such as quality control or tumor board review sessions Examples of folders include e Tumor Board Physicians can create folders that allow them to save pointers to studies they want to review during a tumor board meeting e Image Quality Radiologists who see an image quality acquisition problem or technique can mark the image with an annotation and save it as a Presentation State They can then move it to a shared system folder marked Image Quality Issues A supervisor or PACS Administrator can review the folder throughout the day and work with the Technologist to resolve the issues e Clinic In an orthopedic group nurses can put studies in Public folders to make it easier for a group of physicians to access them If you have the proper privileges you can create shortcuts for tools and folders You can also create personalized folders that contain links to relevant clinical exams by dragging and dropping Note that dragging and dropping an exam listing to a folder moves links to exams It does not copy the exam or move data from one folder to the next See Adding Exams to Folders see page 55 You can also make patient information associated with exams in Personal Folders anonymous See Making Patient Information Anonymous see page 56 The Folder List contains the following folder
72. ccc 153 9 6 1 Searching for Exams or Exceptions by Patient Name 156 9 6 2 Searching for Exams or Exceptions by Date 156 9 6 3 Searching for Exams or Exceptions Using a Custom Date kange sii oeit i GUTH Winn TALA A EA OAA 157 9 6 4 Stripping Leading Zeros from MRN Searches ccccccee 157 9 7 Sorting Results scckacs shes ds sihasasats ia tensdvted iumne darian K NAA 158 DS Creating Pulte sis wives sheds sti dadia 158 9 8 1 Specifying the Columns for an Exam Worklist cc0c00 163 9 8 2 Specifying the Columns for an Exceptions Worklist 164 9 97 Editing a Filter stissuusaelvsieatesasasnvanssasnde un dtaviecodbovivvalsvisvllptssegeded 166 9 10 Deleting a Filt r ccana naana haaa e E viinnas 166 9 11 Sample Machine Filters for Technologists and Radiologists 167 Intellispace PACS Enterprise 4 4 User Guide 7 911 1 Commas Used as Delimiters in Filters ccccccccccccccsssssssees 168 10 Finding and Managing Exceptions sccccscscsscscsscecscsccoeeees 171 10 1 Exceptions Lookup Overview s2i2i25 226 es2ee5cdectoedntteattvctdatientiventes 171 10 2 Searching for Exceptions sseuiccesssiceivadivosbewssvouibskesceriitsscacaiersdacve 173 10 2 1 Searching for Exceptions by Patient Name 173 10 2 2 Searching for Exceptions by Exception Date Time 174 10 2 3 Searching for Exceptions Using a Custom Date Range 175 10 3 Showing or Hiding Exception Lookup Columns uu eee 175 10 4 Rearranging Exception Lookup
73. check box 3 Click Next Intellispace PACS Enterprise 4 4 User Guide 307 15 Retrieving and Exporting Studies 308 4 Review the anonymous exam information including the First Name Middle Name Last Name MRN DOB and Sex m Export First Name DOB 7 8 1978 v Middle Initial H Sex M Last Name Cressman Randomize Values MPN 1AF51568 z MR HIPS ECHO lt 2YRS W MANIPUL 67AFB21B 02 17 2011 13 22 0 lt Back Cancel Queue 5 If desired click Randomize Values to change the anonymous patient information 6 To change the Description Accession Number or Exam Date select the exam and then click Edit Exam Details or double click the exam in the list The Edit Exam Details dialog box opens allowing you to enter the desired information it ils Enter the desired values for the Exam Accession Number 67AFB21B Exam Date 2 17 2011 gt Time 1 22 07 PM lt a 7 Click OK 8 Click Next Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Retrieving and Exporting Studies 15 CREF4 09 291 v4 0 07 2014 9 Select the DICOM devices to which you wish to export the exam The DICOM devices listed are compiled from an IntelliSpace PACS dictionary set up by your IntelliSpace PACS System Administrator DICOM Exam Export SOOSE JOHN G MRI 50409066936 Please sel
74. check box for which you have information To add a generic DICOM Source only select and complete the Modality field If two or more DICOM sources are configured with an equal Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 CREF4 09 291 v4 0 07 2014 number of matching Identifiers the DICOM source containing an Exam Code takes precedence and is applied over the DICOM source that does not contain an Exam Code In the AE Title field enter the name of the Application Entity DICOM tag 0073 1003 In the Modality field enter the DICOM assigned modality type acronym such as MR for Magnetic Resonance Imaging in DICOM tag 0008 0060 In the Manufacturer field enter the manufacturer s name that appears in the DICOM metadata DICOM tag 0008 0070 In the Serial Number field enter the serial number that appears in the DICOM metadata DICOM tag 0018 1000 If your DICOM metadata does not provide a serial number you should leave the box clear In the Model Name field enter the model that appears in the DICOM metadata DICOM tag 0008 1090 In the Exam Code field enter the desired code from the Exam Dictionary This option lets you specify a specific series display such as series splitting that is only applicable to a specific exam code 8 Click the Window Center tab and enter the va
75. complete revision history for the report Medical treatments are based on diagnostic reports There might be multiple reports for the same exam potentially with updated information Therefore it is important to go back in time to see the full history of reports received for an exam IntelliSpace PACS stores all timestamp information in GMT Microsoft Windows then localizes this information so that all timestamps are presented in local time as configured on the workstation Because Microsoft may make changes in its operating systems to account for Daylight Savings Time in various time zones around the world please ensure that user machines have the most current Microsoft updates installed so that correct times are displayed in IntelliSspace PACS reports The following information is displayed at the top of the Diagnostic Report pane e Patient Information Name MRN Sex Birth Date Intellispace PACS Enterprise 4 4 User Guide 145 8 Viewing Clinical Information e Provider Information Ordering MD Phone Pager Exam Information Accession Number Exam Code Location 1 Display the Diagnostic Report pane of the Clinical Information dialog box in one of the following ways From the Canvas Page click the icon in the Exam Margin Right click on an event in the Patient History Timeline on the Canvas Page and select Show Report From the Patient Lookup Exam Lookup or a worklist that displays exams and has the Report Avail
76. define personal filters that include read and unread exams exams and exceptions or only exceptions User filters are listed under My Filters in the Folder List In addition user filters can be organized into folders within My Filters e System Filters System Administrators can modify the supplied system filters and create and modify the system filters to be used in their organization You can use system filters to search for specific exams and or exceptions System filters are listed under System Filters in the Folder List In addition system filters can be organized into folders within System Filters in the Folder List e Machine Filters System Administrators can create and modify filters for the computer IntelliSpace PACS is running on These filters are used for computers assigned to workstations attached to specific modalities and are available to any user on that computer You can use machine filters to search for specific exams and or exceptions Machine filters are listed under Machine Filters in the Folder List See Sample Machine Filters for Technologists and Radiologists see page 167 Intellispace PACS Enterprise 4 4 User Guide 149 Filtering Worklists Intellispace PACS Enterprise 4 4 User Guide Ber Default Administrator Enterprise Tools Worklists display matching exams if any on top and exceptions if any on the bottom Each area has a separate
77. details for better visibility These options are available when you right click on an image on the Canvas Page e Do one of the following Intellispace PACS Enterprise 4 4 User Guide 231 12 Viewing and Manipulating Images Right click on an image and from the menu select Window Width Level and the option you want Click and hold down the left mouse button while simultaneously dragging your mouse Drag the cursor horizontally across the image to increase or decrease the window width Drag the cursor vertically across the image to increase or decrease the window level NOTE When you adjust the Window Width and Level for a series all slices in that series are affected To adjust the Window Width and Level on one slice in a series hold down the L key while making the adjustment For CTs the Window Width Level menus are listed in three separate areas from top to bottom Default WW WL and Modality Default for all exams e Custom user Window Width Level values Abdominal_NAB Bone_NAB Brain NAB and so on which are defined in the User preferences These settings are mapped to the number keys 1 through 9 in the order listed in the Preferences dialog box allowing you to quickly apply a Window Width Center setting while viewing images See Setting Window Width Center User Preferences see page 344 e System WW WL Presets Abdominal Bone Brain and so on which are defined in the System preferences See
78. edit and from the menu choose Edit Patient The Edit Patient dialog box displays with the Demographics pane displayed Optionally do the following Edit the patient s Medical Record Number MRN The MRN is displayed in the header of the Edit Patient dialog box Edit the patient s first middle and last names The first and last names are mandatory The name is displayed in the header of the Edit Patient dialog box 84 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6 CREF4 09 291 v4 0 07 2014 6 16 From the Sex list edit the patient s gender The sex you enter is displayed in the header of the Edit Patient dialog box Edit the patient s date of birth Either type in or click the up or down arrows to change the date Use Ctrl X or the Backspace key to clear the date field The date of birth displayed in the header of the Edit Patient dialog box Click Contact Info The Contact Info pane displays Optionally edit the patient s address and phone number s Click Linked Records The Link Records pane displays the patients who are linked to the patient you re editing Review the linked record To unlink the patient record select the record and click Remove Link A message displays asking to confirm the action Click Yes to unlink or No to cancel Click Save to s
79. exam Browsing through a series that is part of a link may not display all the images that are available in the other linked series Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 When using the series linking feature it is possible that images may be missing which could cause misdiagnosis Possible causes of missing images are e Linking multiple series with different slice thickness e Linking series that contain different body parts or cover a larger or smaller region e Linking Oblique series Linking a Multi Phase Series with Another Series Multi phase studies contain multiple images with the same location identifier Paging through a multi phase series that has not been split typically results in jumping back to the first slice location each time you reach the end of each phase within the series e Ifa multi phase series is used as the master the other linked series are synchronized on location and display the image with closest location to the one displayed in the master series e Ifthe non multi phase series is used as the master IntelliSpace PACS tries to find the image with the closest location in the multi phase series and because there are potentially multiple matches IntelliSpace PACS displays the best match from the first phase In this example Inte
80. from your HIS RIS Typically the Technologist who creates an exception resolves the problem immediately at their workstation If the exception is not resolved it is not available to be marked read for interpretation Some common causes for exceptions are detailed in the following chart Intellispace PACS Enterprise 4 4 User Guide 177 Finding and Managing Exceptions Common Causes for Exceptions The technologist enters incorrect patient demographics such as the wrong MRN or the Accession is missing A DICOM study is received from a modality that is not receiving patient and order information from the HIS RIS A DICOM study is received from a 3rd party archive and no matching patient record is found A DICOM study is received before the exam information is received from the HIS RIS The original exam is canceled because the ordered exam is not correct If this happens IntelliSpace PACS cannot safely associate the study to the exam because the data was entered incorrectly This problem is due to human error In this case IntelliSpace PACS creates an exception if it cannot safely create a new patient match an existing patient or create a new procedure in the auto create ORG organization of the sending modality The only likely reason a study would come from a 3rd party archive is as a prior for an unread procedure In this case IntelliSpace PACS creates an exception if the patient or order associ
81. group of linked patient records to have varied demographics IntelliSpace PACS provides the option to enable or disable propagation of demographic updates to linked patients when changes to patient demographics name sex DOB etc exclusive of MRN are generated by one of the following e HL7 messaging e the user interface UI Linked patients are defined as patients who are linked because MPI is in use and the patients share an MPI or the patients are auto linked based on defined matching criteria or the patients are manually linked using the UI Merge Link Candidates list A link is a useful way to see patient studies and reports in the same exam timeline and to see all exams for a given person under a patient record in the patient lookup You can link e Patient records in different organizations that represent the same patient Intellispace PACS Enterprise 4 4 User Guide 97 6 Finding and Managing Patient Information Patients who already have existing links to other patients In this case the link connects all linked patients to the same patient record There may be differences between the patients to be linked for example if there has been a name change but much of the demographic information will usually match The following information is displayed side by side for the two selected patients Organization MRN First Name Middle Name Last Name Sex Date of Birth Social Security Number Address
82. has not loaded successfully Indicates that the studies contain a SOP instance that cannot be displayed See H the IntelliSpace PACS DICOM Conformance Statement for information on the SOP classes that are for storage only no display and those that are for storage and display Right clicking in the Exam Margin displays a menu with the following options e Presentation States See Using Presentation States see page 216 e Recover Deleted Image s See Recovering Deleted Images see page 331 e Minimizing Images See Minimizing Images see page 254 Add Exam to Folder See Adding Exams to Folders see page 55 e Exam Information See Displaying Exam Information see page 206 e Export via DICOM See iExport for DICOM Export see page 303 e Horizontal Vertical Rack See Configuring Horizontal or Vertical Racks see page 206 e Exam View See Philips IntelliSpace Clinical Applications see page 283 Intellispace PACS Enterprise 4 4 User Guide 205 11 Using the Canvas Page 206 11 7 11 10 Resizing an Exam Rack Height There are two heights available for Exam Racks small and normal Place the cursor on the bottom border of the Exam Rack you want to resize The normal pointer changes to a resize pointer Click and drag the pointer to change the height of the Exam Rack When you double the height of a normal Exam Rack IntelliSpace PACS automatically changes the size o
83. image in IntelliSpace PACS you can choose which interpolation scheme you want to use e Right click the image and from the menu select Image Processing then Pixel Replication Bilinear Interpolation or Bicubic Interpolation The option you select is checked in the menu Pixel Replication Performed by sampling the nearest neighboring pixel Step like straight boundaries may be evident after the transformation CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 243 12 Viewing and Manipulating Images 244 12 7 Bilinear Interpolation The default presentation of images in IntelliSpace PACS performed by sampling four neighboring pixels Bilinear Interpolation may decrease resolution and blurring by averaging the step like boundaries that may occur with Pixel Replication Bicubic Interpolation Preserves fine details in the image very well It is performed by sampling 16 neighboring pixels and does not have the step like boundary problem of Pixel Replication or the blurring problem of Bilinear Interpolation Using the Scout Tool The Scout tool allows you to see the planar location of an image using another image within the same study as a reference frame Scout lines are displayed on the image or series as you move your mouse over other images of a different orientation Three types of scout lines are available Single Bracket and All The line types are set in the Display section of the User p
84. image to the clipboard and copying it to another application The image may contain confidential patient information e GSPS may contain clinically relevant data such as measurements which may display incorrectly or not at all This could cause a misdiagnosis or a delay in treatment e Ifan error is discovered within the GSPS a warning icon displays that indicates all GSPS content may not be displayed e When multiple third party GSPS are received IntelliSpace PACS displays the most recent one first because no priority information is available This may mean that other Presentation States are not displayed by default so the chronology may be affected possibly leading to misdiagnosis An image artifact may appear when a Modality LUT or a mask is applied to a sub sampled image The sub sampled image means that the image data is not fully retrieved from the server and therefore not displaying at full resolution Diagnosis should only occur on images that are displayed at full 100 resolution If images are displayed at full resolution no artifact should appear If immediate medical treatment is needed or if you disagree with a prior exam note contact the treating physician immediately You should not rely on creating a critical exam note in these situations Measurement values are modality dependent The measurement values that IntelliSpace PACS displays are derived from information sent by the modality responsible for genera
85. is used as the master IntelliSpace PACS tries to find the image with the closest location in the multi phase series and because there are potentially multiple matches IntelliSpace PACS displays the best match from the first phase In this example IntelliSpace PACS would never display image 7 through 12 This means that it is not possible to review all images of a multi phase series by paging through another series while using the Link tool Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Safety 2 MARWN a PARWN Series 1 Series 2 Ifa multi phase series is not split correctly and a user links multiple series where one of the series contains multiple phases the link function will not work correctly because not all images will be displayed while paging through the series IntelliSpace PACS can be configured to automatically split all studies from a particular CT modality in multiple series based on DICOM tag 0021 0012 However because not all modalities can be configured to provide a unique identifier that can be used for splitting IntelliSpace PACS provides the ability to manually split studies A technologist can perform this function and save it as a Presentation State or a Radiologist can manually split a study after first opening the study Awa RNING Linking Multiple Series with Different Slice Thickness A
86. least two organizations e One merge candidate must be linked to a patient in the second organization Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6 CREF4 09 291 v4 0 07 2014 If any linked organization has been configured to accept demographic updates for linked patients in the IntelliSpace PACS AdminTool a warning message is displayed before the Merge Patients dialog box opens Additionally a red exclamation mark is displayed in the Merge Patients dialog box for these organizations and the MRN is displayed in red text indicating that this demographic information will not be transferred after the merge 1 Select the patients to merge and click Merge Patients 2 Select the demographic details of the selected merge candidate from the current Organization Currently selected patient record to merge Linked patient records Merge Patients Se X Carefully review the information for the two patient records you intend to merge and select the fields you wish to keep Selected Patient Information Patient Record 1 Patient Record 2 Select All C Cc MRN DEFAULT 123A C Last Name John1 C Doe First Name C Johnt John Middle Name Cc Sex C F CM Date of Birth 1 1 1945 4 1973 Social Security Number 123 123 1234 C 423142314234 Mother s Maiden Name
87. method chosen For example a median filter is a noise reducer and clearly causes data loss while an edge detector enhances edges thus altering but not necessarily losing data These methods are all documented in Image Processing see page 236 and are industry standard methods When intermediate resolution data is displayed the markers still apply However in the case of uncompressed unprocessed data if the data is not presented pixel for pixel from the source data that is other than 100 then some form of interpolation is used This is a possible combination of subband filtering due to the wavelet representation used in the internal representation and pixel replication bilinear or bicubic interpolation at the display These are also common industry standard methods The display indicates the degree of zooming with 100 indicating pixel for pixel correspondence with the original data Because of the pervasive use of lossy compression and other image processing methods in the medical industry such as edge detection it is at the discretion of the diagnostic viewer to treat these images as diagnostic Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc 5 Program Layout The basic layout elements in IntelliSpace PACS are the Control Strip Folder List and Shortcut Bar When you first log on the Patient Lookup page d
88. monitor Intellispace PACS Enterprise 4 4 User Guide 35 Getting Started 36 5 on black 95 in 100 Do you see a square above Do you see a square inside a square Adjust the brightness and contrast of your monitor until you can see all three squares simultaneously Be sure that the ambient light where you are working isn t too bright 3 4 Configuring Pixel Pitch for the Diagnostic Monitor IntelliSpace PACS features a True Size zoom preset that is available from the hanging protocol or through a shortcut menu setting True Size displays digital mammography images for the same view of the same patient anatomy without consideration for magnification in the same relative size even if these images are produced by different detector technologies with different inherent resolution or matrix size For True Size to be accurate the Diagnostic Monitor pixel pitch must be configured properly in the Machine preferences See Setting Display Monitor Preferences see page 393 for the other settings you make in the Machine preferences Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Getting Started 3 CREF4 09 291 v4 0 07 2014 To calibrate your monitors you should be aware of monitor settings that could affect the native pixel pitch and the appearance of True Size Examples of these settings are horizontal vertical siz
89. names like Smith or Gomez e Ifthe sex of the matching patient is different from the candidate patient 50 points are subtracted A total of 100 points becomes a match candidate merge candidate if in the same organization or a link candidate if in a different organization If there is a total of 125 points the record is auto linked if the organizations Auto Link setting is set to True Intellispace PACS Enterprise 4 4 User Guide 87 Finding and Managing Patient Information Multiple MRN ACC Issuer with MPI IntelliSpace PACS supports the use of a Master Patient Index MPI when it is consistently provided in the HL7 messages from all issuers When MPI is implemented IntelliSpace PACS does not perform any validation on patient demographic information it relies on the authoritative sending systems to send correct demographics IntelliSpace PACS stores a patient s MPI as well as the specific MRNs associated with the appropriate Organizations MPI to MPI merges are supported IntelliSpace PACS can read an MPI value from any field in an HL7 message the field will be determined at the time of implementation and may be a different field for each issuer as necessary Using the Merge Link Candidates List to Merge or Link Patients You can use the Merge Link Candidate s list found in the Folder List to view and manage a list of potential duplicate records Pairs of patient names are grouped together on the list based
90. not want others to have access to the data Note that when deleting an exam with attached DICOM studies the studies become exception studies While deleted exams are not visible in IntelliSpace PACS they are not permanently deleted meaning they are still in the database IntelliSpace PACS audits the following information when an exam is deleted IntelliSpace PACS user ID deletion date deletion time accession MRN and reason for deletion Right click on an exam that does not have a status of Scheduled in a worklist From the menu select Delete Exam The Delete Exam dialog box displays If you select a linked exam a warning message displays indicating that the exam is linked and that images originally received for this exam will no longer be available to the linked exams if the exam is deleted Select the Predefined Reason for deleting the exam or enter a reason Select the Delete Studies check box if you want to delete the images If you do not select this option the exam becomes an exception study Click Delete The exam is deleted and the worklist is refreshed to show the updated patient information Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exam Information 7 CREF4 09 291 v4 0 07 2014 7 13 Linking Exams You can link multiple exams with the same MRN in the same organization to a
91. of the image by clicking on the center box and dragging to the desired location Calculating 6 4962 cm 2f s Using the ROI Ellipse Tool You can use the Region of Interest ROI Ellipse tool to measure the average data value for an elliptical region of an image The units and accuracy are identical to Using the ROI Circle Tool see page 269 Intellispace PACS Enterprise 4 4 User Guide 273 13 Measuring and Annotating Images 274 For Region of Interest ROI the standard deviation is calculated by using the intensities of all pixels that are inside the ROI If the image has slope intercept that is applied and then the standard deviation is calculated Otherwise the raw pixel data is used to find the standard deviation This means that changing WW WL will not change the measurement and that all pixels within the ROI are considered Note the following e When performing an ROI measurement on an image that is displayed with a resolution smaller than the actual image for example an image in the rack for CT IntelliSpace PACS may calculate the ROI using a sub sample of the original image data The value in this case is an accurate representation of the average measured pixel values represented by the interpolated sub sampled image This is a close approximation to the original pixel values e When IntelliSpace PACS calculates a measurement using a sub sample of an image the measurement result is displayed with a
92. on the point you want to use for the angle s endpoint and move the cursor to the second point the angle s apex and click again 3 Move the cursor to the second endpoint and click Notice that when the angle measurement is complete each end of the angle lines is active indicated by the small squares at the ends of the lines 4 Select either part of the line to move and separate the point of the angle Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Measuring and Annotating Images 13 CREF4 09 291 v4 0 07 2014 13 8 Move the upper portion of the angle measurement line to represent a parallel line with the superior aspect of the uppermost vertebrae to be measured Move the lower line to represent a parallel line with the inferior aspect of the lower vertebrae to be measured This angle measurement is the Cobb angle measurement Figure 13 4 COBB Measurement Tool Using the ROI Circle Tool You can use the Region of Interest ROI Circle tool to measure the average data value for a circular region of an image The measurement units of the ROI Circle tool are determined by the modality For example with CT the pixel intensity represents Hounsfield units For other modalities in the IntelliSpace PACS system the pixels represent intensity The units used are explicitly displayed or in the case of pixels left blank
93. on their records containing similar demographic information including the patient address The patient information is analyzed when the patient is created in the system not when information for existing patients is updated The following information is displayed side by side for the two selected patients e Organization e MRN e First Name e Middle Name e Last Name e Sex Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6 CREF4 09 291 v4 0 07 2014 e Date of Birth e Social Security Number e Address e Mothers Maiden Name e Phone Number work e Phone Number home e Email address e Alias Last Name e Alias First Name e Alias Middle Name e Title e Suffix e Optional Prefix The Merge Link Candidate s list is only visible if you have the proper privileges to resolve duplicate patient records PACS Administrators can set the number of days after which Merge link candidates are purged from 1 to 999 days the default is 90 days All merge operations will be audited and logged for e Completion of patient merge The user who performed the merge operation e A time stamp showing when the merge was completed e An identifier such as MRN for the patient e The MRN of the patient who was not kept When IntelliSpace PACS receives a patient merge event through HL
94. only the exception Local Exe Local Exe mq Locked E Machine t amp amp Merge Lin My Filters 5 My Histor Ge PS Queues Gi Resolved Statistics Study Loc System F Patient Info ABC XYZ MAN 01234 ABC XYZ MRN 1234 WARNING Special Attention is required when working with exceptions Please verify that the demographics of the exception study match with the suggested patients in list box x tows Creating a New Patient and Exam from the Exceptions Handler If you cannot find a patient in the database to match the exception to you can create both a patient and an exam to resolve the exception study Refer to your local policy on creating new exams in IntelliSpace PACS before using the Create Patient and Exam feature If you have HIS RIS integration patients and exams created in IntelliSpace PACS will not be synchronized in your HIS RIS Use the Exception Lookup to search for exception studies Select an exception and right click From the menu select Resolve Exception The Exceptions Handler displays Intellispace PACS Enterprise 4 4 User Guide 189 10 Finding and Managing Exceptions 3 Review the top part of the Exceptions Handler to see the images of the exception study with the associated data fields Suspect data fields are highlighted 4 Review the bottom part of the Exceptions Handle
95. or a worklist that displays exams and has the Has Notes column visible right click the exam and select View Exam Notes Click Related Exams in the Clinical Information dialog box and review the information You can click on a related exam to display its report if that exam has a report Select another pane from the Clinical Information dialog box if desired or click Close Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing Clinical Information 8 8 4 Viewing All Exams You can use the All Exams pane of the Clinical Information dialog box to select and view all exam information for the patient This allows you to compare the results of patient exams For each exam IntelliSpace PACS displays the Date Time Accession Status Exam Code Modality and Body Part ACPT1 0h0 Ye MRN Dente Sex U DOB Wryig4t T Ordering MD N A Phone N A Pager N A Accession Exam Code WA Location WA Exam Notes 4 Clinical Info Related Exams 7 19 1999 18 01 42 6 22 1999 16 17 46 All Exams _96 21 1999 17 59 55 Current Providers 1 Display the All Exams pane of the Clinical Information dialog box in one of the following ways From the Canvas Page click the icon in the Exam Rack From the Patient Lookup Exam Lookup or a worklist that displays exams and has the Has Notes column visible right click on the
96. or select the Exams with images only check box Date of Birth Enter the date or click the button in the field to select the date from a calendar control Use Ctrl X or the Backspace key to clear the date field Social Security Number Enter the exact Social Security Number SSN The SSN cannot be more than 50 characters Organization Select the name s of the organization s If you search for patients in a specific organization the patients in that organization are displayed as well as all exams for patient records that are linked to the organization when the patient record is expanded by clicking on the plus icon If you don t specify an organization linked patients are displayed as separate list items in their respective organizations Each list of patients displays all exams from all linked patient records showing under it Exams with images only Select this check box if you only want to find patients with exams that have images Click Search or press Enter Patients who match the search criteria are displayed Viewing Exceptions in the Patient Lookup Verify that the General User Preference Show Exceptions in Patient List has been set If it isn t already displayed select Patient Lookup from the Folder List or the Shortcut Bar if you have created a shortcut for this feature Enter the desired search criteria Press Enter or click Search A list of patients with exams and exceptions who match your sear
97. overlay options and a default screen overlay You can add a total of 50 overlays to images meaning approximately 12 overlay items per corner A line can contain multiple overlays for example name and sex on a single line Blank lines are displayed if the information for that overlay is not available Enter a name for the overlay The name must correspond to a modality type for example CR or US Select the desired overlay text from the tree control on the right side of the Overlay dialog box and drag it to the screen mockup on the left side Remove overlay text by selecting and dragging it off the screen mockup You can only place overlay text on one of the screen s corners not in the center of the image Selected overlays are outlined with a red box Click Font to change the display font for overlays in IntelliSpace PACS The Font dialog box displays Select a font from the list and click OK You return to the Overlay dialog box You can double click overlay text in the screen mockup to view the DICOM tag for that text and to change the font weight and size To add a custom DICOM tag double click an overlay field and enter the new Name and Value in the Tag Edit dialog box The value corresponds to the DICOM metadata field which carries the information in question For instance number always use the DICOM Tag Image Number 0020 0013 As required select the Font Weight and Relative Font Size Click OK when you are done You return
98. page 103 and Filtering Worklists see page 149 PACS Administrators can set a System Preference to specify which columns are displayed in the Patient Lookup See Setting Patient Columns Preferences see page 389 The following columns can be displayed or hidden e Organization e Sex e SSN see Note below If the BSN Burger Service Number feature is enabled on the IntelliSpace PACS server the SSN field is replaced with the BSN field The BSN Burger Service Number feature is only available for IntelliSspace PACS sites in The Netherlands Intellispace PACS Enterprise 4 4 User Guide 65 6 Finding and Managing Patient Information 6 2 Patient Lookup and Federation Federation is the joining of two or more independent PACS to allow clinicians to have a more complete view into a patient s history It links disparate systems or sites with multiple iVaults allowing a user logged into one iVault to see the same patient data in another iVault or another vendor s PACS Federation is available to sites that have the presence of a single patient identifier between the individual PACS this means that the Patient ID MRN is issued consistently in all participating sites and a person has the same MRN in all sites participating in the federation However if the federation does not have a uniform scheme for issuing MRNs there are potential safety issues where an MRN from one organization within the federation matches the MR
99. port number on which you want the request to take place In the Max Concurrent Requests field enter the number of simultaneous associations that you want the receiving device to entertain Select the Send Entire Study on Retry check box if you want all exams in the study to be resent when an export has failed and is being retried Select the Association Across Studies check box if you want an association between the IntelliSpace PACS server and the receiving device to be kept open when multiple studies are being sent instead of opening and closing a separate association for each study If the BSN Burger Service Number feature is enabled on the IntelliSpace PACS server the Export BSN check box is available Select this check box if you want the iExport Remote SCP Configuration to include the BSN when using the iExport feature See iExport for DICOM Export see page 303 The BSN Burger Service Number feature is only available for IntelliSpace PACS sites in The Netherlands Click OK You return to the Preferences dialog box Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Editing an iExport Preference Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Intellispace PACS Enterprise 4 4 User Guide 381
100. server to the designated IntelliSpace PACS System Administrator This email can be sent to multiple email recipients if there is more than one IntelliSpace PACS Administrator The email indicates the following study information if provided e Study Date Time e Accession Number e Study UID e Series UID e Image UID e Missing Invalid DICOM Tag s If any of the UIDs or Tags is invalid per the DICOM standard the email indicates this next to the invalid value This information is useful for IntelliSpace PACS System Administrators to perform baseline troubleshooting by deducing if the study presentation could affect patient care adversely IntelliSpace PACS Administrators equipped with the Study UID can then utilize the Study Lookup to search the IntelliSpace PACS system for the study This feature is designed specifically for IntelliSpace PACS System Administrators who receive email notifications about specific DICOM studies which need to be followed up on such as in DICOM processing errors or DUP UID scenarios The emails do not contain any patient Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Managing Studies and Images 16 CREF4 09 291 v4 0 07 2014 16 5 information With Study Lookup IntelliSpace PACS System Administrators can look up and open a study using just the Study UID provided in the email notification T
101. single image set The related images are available from any of the individual linked exams Linked exams can be for different modality types but must belong to the same patient When you link multiple exams all exams point to the same DICOM study Linking only applies to images it does not influence how reports are stored with exams Canceling one exam does not automatically cancel the other linked exams For example you might have four exams scheduled in the RIS CT HEAD CT CHEST CT ABDOMEN and CT PELVIS all with different Accession numbers The orders are scanned in one sequence and end up in a single DICOM study You can link these exams so they all point to the same study The actions you can take when linking exams for the same patient at the same organization depend on the status of the exams you are linking Note the following when linking exams e You cannot link exams with a status of Canceled or Deleted Studies e You cannot delete linked exams You must first remove the exam link e When exams are linked if only one exam has images associated with it the status of all the exams is the same status as the exam with images attached as long as that exam has status of In Progress I or Taken T e Ifno exams have images attached to them the exam status stays the same after linking e When IntelliSpace PACS receives images for a linked exam and has either the In Progress I or Taken T status the status of the other li
102. the Preferences dialog box 8 To configure another monitor select it from the Display Monitors list 9 Continue to configure monitors as desired 10 Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box 19 3 Setting Plug In Preferences System Administrators can add edit or delete plug in preferences Plug ins allow you to create links in the IntelliSpace PACS Folders List and Shortcuts Bar that point to other web interfaces websites For example if your institution s lab results are available from an in house server you can display that server s interface in IntelliSpace PACS by creating a plug in System Administrators can name the plug ins enable them in different IntelliSpace PACS programs and set security for them if necessary 1 Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip 2 Click the sign next to Machine Preferences The list of available machine preferences displays 3 Click Plug Ins The right side of the Preferences dialog box displays a list of the current plug ins and allows you to add edit or delete plug ins 4 Click Add The Plug In dialog box displays 5 Enter a Name for the plug in 6 Select the Visible in folder tree check box if you want the plug in to be visible in the IntelliSpace PACS Folder List If the plug in is not displayed non administrative users cannot see i
103. the study is not rejected or ignored but instead treated as if it was being received for the first time Soft Merge for Quick Review of Exceptions When a physician opens an exception for a quick review before the exception is resolved to an exam IntelliSpace PACS uses the MRN of the exception to query the database for any possible matches of the exception to existing patient exams If a single matching record is found with a matching patient first and last name IntelliSpace PACS automatically displays the patient s historical images as part of the patient s timeline However the merged exam s study summary dialog has a gray background and displays Warning Some existing studies with same Name Identifier are displayed along with exception study as shown If more than one matching records are found the Select Patient window displays a list of all matching patient records Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exceptions 10 CREF4 09 291 v4 0 07 2014 10 11 NOTE Folder List Personal Fol Public Folder Cee a Radiology To SAN e aa A Sy Except Name XYZ ABC Eo MRN 00001234 amp Installed F DOB 5 6 1994 ff iQuery Select a patient from the list below to display that patient s historical exams with the current exception study or ISR Test cancel to view
104. use the Clinical Information dialog box to display the following types of exam information in a single window e Using Exam Notes see page 128 e Viewing Clinical Info see page 135 e Viewing Related Exams see page 137 e Viewing All Exams see page 139 e Viewing Current Providers see page 140 e Displaying and Printing the Audit Trail see page 142 e Displaying and Printing the Current Report see page 145 NOTE You can add a comment for an anonymous exam similar to an exam note See Adding Comments to an Anonymous Exam see page 58 8 1 Using Exam Notes Exam notes allow IntelliSpace PACS users to communicate setup non diagnostic or diagnostic information about a patient They can range from generic comments about an exam to preliminary findings wet reads that other clinicians can use in their decision making Aw ARNING Exam Notes and Diagnostic Reports are not the same entity Medical treatment plans should never be based on Exam Notes alone as Exam Notes often have preliminary information Diagnostic Reports can be used to help physicians design a medical treatment plan NOTE Only users with access rights associated with specific exam note types can view or create exam notes of that type IntelliSpace PACS includes exam notes to address the following situations e Radiologists may not be in the same locations as clinicians making communication difficult
105. used Displays menu series Also releases any other mouse modes currently in effect CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 401 20 Mouse and Keyboard Reference Sheet Action Double click Click middle button drag up and down Click drag Alt drag Ctrl drag Roll wheel forward or backward 402 Left Button Opens image popup window In a list of patients or exams opens the most recent exam available for that patient Only available when using IntelliSpace PACS on an internal network On a popup window title bar toggles between displaying the entire window and just the title bar On a pane in the diagnostic monitor toggles full screen image mode for that image On the image Changes window level vertically Changes window width horizontally On the image window Moves images or series within the exam rack Zoom Pan in zoomed view Not used Intellispace PACS Enterprise 4 4 User Guide Wheel Right Button Enables Fast Cine mode in Not used the Canvas Page with an initial frame rate that is based on the User Display Preference for the Default Cine Rate See Setting Display Preferences see page 350 Double clicking again turns Fast Cine mode off You can also use the middle wheel click and drag for Fast Cine Enables Coarse Fast Cine mode This mode may skip images depending on how far the mouse is from where the Fast Cine originally be
106. with VIP Patients see page 59 6 In Image Series Linking select the number of degrees up to 40 degrees to allow for linking variance This preference is primarily used to link oblique series that deviate up to 40 degrees from a true plane Axial Coronal or Sagittal with series that are oriented with a true plane 7 In Options you can select the following Select the Allow DICOM Query from Exam check box if you want to enable DICOM queries from the exam using the iQuery tool 356 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 CREF4 09 291 v4 0 07 2014 18 2 8 Select the Automatically apply VOI LUT when available check box to enable auto selection of the first VOI LUT included in the image In Image Orientation select the Enable user preference for automatically flipping of Axial Oblique CT images check box if you want individual users to be able to set their own flipping preferences IntelliSpace PACS automatically flips any axial CTs or oblique views that are up to 22 5 degree variance from the true axial plane where the patient s anatomical right is displayed on the right side of an image as in an acquisition where the patient is in prone position This standard behavior is useful for users viewing CT Sinus studies where IntelliSpace PACS automatically flips to the most pr
107. 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 CREF4 09 291 v4 0 07 2014 18 3 18 3 1 18 4 Editing a Window Width Center Preference Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click Window Width Center The right side of the Preferences dialog box displays the current window width and center setting Select a setting in the list and click Properties or double click the setting in the list The Edit Window Width Center dialog box displays Change the settings as desired Click OK The modified preference is displayed in the Window Width Center list Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Deleting a Window Width Center Preference Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click Window Width Center The right side of the Preferences dialog box displays the current window width and center setting Select a window width and center preference and click Delete The setting is deleted from the list Click Apply to save the settings and continue to set other preferences Click
108. 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Using the Canvas Page 11 CREF4 09 291 v4 0 07 2014 In addition a new icon displays in the exam margin to show that the remote exam is cached and the exam information text and background color is changed dark blue and gray respectively View Exams 1 Exam s Selected ACPT1 Seeine ww Sex U D O B 2 5 1918 PID Mitt Procedure Code N A Referring Physic Last Known Patient Class N A Mark Read Figure 11 4 View of Exam Margin showing remote exam icon circled and the changed exam information text and background Besides the different colors of the text and background there are other changes for cached exams Intellispace PACS Enterprise 4 4 User Guide 201 11 Using the Canvas Page 202 e The exam information summary displays the name of the remote location the size of the exam in KB the timestamp of the cached exam attributes Patient Name DOB and MRN at the remote site and also a warning Limited options are available for remote exams e You have limited access to the HL7 information displayed in the exam information summary e Cached exams can only be opened as a prior and not opened as a main exam which means they cannot be marked read e You cannot view the Clinical Information dialog for cached exams so you cannot view the Exam notes for a cached exam e Diagnostic rep
109. 1 1 Commas Used as Delimiters in Filters For the Ref Phys Name field IntelliSpace PACS interprets search strings according to the following conventions IntelliSpace PACS treats commas as delimiters If the search string does not contain a comma IntelliSpace PACS interprets the character string as the physician s Last Name Ifthe search string contains a comma IntelliSpace PACS interprets any character string before the comma as the physician s Last Name and any character string after the comma as the physician s First Name IntelliSpace PACS ignores characters after any additional commas e IntelliSpace PACS treats percent characters as wildcards If the search string does not contain a wildcard IntelliSpace PACS searches for an exact match If the search string contains one or more wildcards IntelliSpace PACS searches for results that contain the search string in the position indicated by the wildcard s When you design your filters keep in mind that search results also depend on how the Ref Phys Name data is stored in the IntelliSpace PACS database If the referring physician s Last Name or First Name is stored in the database 168 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Filtering Worklists 9 CREF4 09 291 v4 0 07 2014 with extra characters the filter may not return the r
110. 13 1 Changing the Font or Line Style ssssssssssssesisrsisssrsrsrsrsrsrersrererere 260 13 2 Measurement Values for Projection and Non Projection Radiography Modalities lt cccaucicerusiiicesivextciussinscssadeaatarepgctianesietts 260 13 2 1 Accuracy and Precision in Measurements 261 13 2 2 Order of Precedence 262 13 3 Using the Measurement Palette stitisssisisisbisnesdiacatinnpurdensdesbonctend 263 13 4 Clearing Measurements and Annotations s sssssssssesssserererserereeres 264 13 5 Viewing Existing Measurements and Annotations 000 000 265 13 6 Using the Ruler Tool varenie aiiai ai e gai teas 265 13 7 Using the Angle Tool s s ssssssssssssssesesrsrsrsrsrsrsrestsrsrsrsrsrsrersrsrerere 267 3 71 Taking Cobb Measurements ossis 268 13 8 Using the ROI Circle Tool siiccoe sississaisnsisesieateationsevedlivscvedlivadvess 269 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcares Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 14 15 13 9 Using the ROI Freehand Tool nia wiiawaarcaauncatnatea as 271 13 10 Using the ROI Ellipse Tool s ssssssssssssssssessseesssersrssrsrsrsrsesrsrsrss 273 13 11 Using the Point Value Tool iistcsisrstatssstsssencanncaetcanainencantetensacteeas 275 13 12 Calibrating Images sssssesesesseeesesssssserseserererersrsrsrsrsrsrsrsrsrsrsrnres 276 13 13 Taking Ultrasound Meas utements sini doviieientintanrd
111. 263 e Ruler See Using the Ruler Tool see page 265 e Angle See Using the Angle Tool see page 267 e Cobb Measurements See Taking Cobb Measurements see page 268 e ROI Circle See Using the ROI Circle Tool see page 269 e ROI Freehand See Using the ROI Freehand Tool see page 271 e ROI Ellipse See Using the ROI Ellipse Tool see page 273 e Point Value See Using the Point Value Tool see page 275 e Calibrate See Calibrating Images see page 276 e Ultrasound measurements See Taking Ultrasound Measurements see page 277 e Text Annotate See Annotating Images see page 277 Spine Labeling See Spine Labeling see page 280 For information on the format used for measurement value display for Projection Radiography modalities see Measurement Values for Projection and Non Projection Radiography Modalities see page 260 When you add a measurement or annotation to a window IntelliSpace PACS automatically marks that image as a key image You cannot use annotations measurement tools and the Localizer tool at the same time Measurement values are modality dependent The measurement values that IntelliSpace PACS displays are derived from information sent by the modality responsible for generating the image being measured If this modality is incorrectly configured or defective IntelliSpace PACS measurement values may be adversely Intellispace PACS Enterp
112. 4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Retrieving and Exporting Studies 15 CREF4 09 291 v4 0 07 2014 NOTE 15 1 2 15 1 3 Light green arrow In Progress Blue check Completed Red X Failed Dark green dot Inactive After the exams have been exported the specified Export folder contains the MediaViewerLauncher exe file Run the MediaViewerLauncher exe file to open the IntelliSpace PACS Media Viewer If you password protect the CD DVD and subsequently the password is lost there is no way to recover the lost password Working with Anonymized Exams in the Media Viewer Do one of the following In the Folder List copy exams from a Personal or Public Folder that contains anonymized exams to the Local Export folder See Making Patient Information Anonymous see page 56 Copy non anonymized exams to the Local Export folder and make them anonymized from within the Media Viewer Select DICOM Format or both check boxes Philips and DICOM and then select Anonymize for the exported exams Working with VIP Patient Exams in the Media Viewer Certain patients such as politicians entertainers and hospital employees may be designated as VIPs Very Important Persons in IntelliSpace PACS Accessing these patient records and performing all actions such as opening exams viewing images exporting exams from the Media Viewer and so on are
113. 5155 2 5 1918 DEFAULT r 423687 Date 11 3 1999 13 17 21 UL CT No Descriptions Acc 4236867 Date 11 3 1999 10 12 58 Org DEFAUL CR No Descriptions CT No Descriptions Acc 4154692 Date 8 25 1999 13 57 59 Org DEFAULT CR No Descriptions Acc 4154568 Date 8 24 1999 14 29 14 Org DEFAULT B CR No Descriptions Acc 4093012 Date 7 28 1999 13 33 56 Org Federation Loc ImagingCentre CR No Descriptions Acc 4093013 Date 7 28 1999 13 33 22 Org Federation Loc ImagingCentre CR No Descriptions Acc 4093027 Date 7 28 1999 20 32 18 Org Federation Loc ImagingCentre Third party plug ins cannot access remote exams Besides the letter markers R T C the organization displays as Federation the name of the remote location displays as does the size of the exam IntelliSpace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information CREF4 09 291 v4 0 07 2014 When the Federation icon is amber you can right click the icon and get a context menu that tells you how many locations are missing 745 1977 2 16 2000 12 21 1946 2 5 1918 Date Date Date Date I Exams with images only I Append results a i 1 Missed Locations DEFAULT DEFAULT DEFAULT DEFAULT 4 4 Dal 11 3 1999 13 17 21 Org DEFAULT Date 11 3 1999 10 12 58 Org DEFAULT Date 8 25 1999 13 57 59
114. 55 e Rotate See Rotating an Image see page 255 e Sort See Sorting Images see page 255 e Split See Splitting Exams see page 256 Intellispace PACS Enterprise 4 4 User Guide 215 12 Viewing and Manipulating Images Shutter effects See Viewing Shutter Images see page 256 12 1 Using Presentation States A presentation state allows you to save the state of the exam as last viewed This may include annotations and measurements or the way the exam is laid out For example if you open an exam cine to particular slices in a series and adjust the Window Width and Level values then save the presentation state this configuration of the exam is preserved Some features such as the location of Scout Lines and the Localizer Tool are not preserved in presentation states You can create a new presentation state or load a pre configured presentation state created by a user or Technologist When an exam presentation state is displayed the Presentation State icon is displayed in the exam margin The initial presentation state of an exam depends on which presentation states are available The following types of presentation states are available Original DICOM e Technologist e Pre read e User These types are weighted For example if no presentation states have been created the initial presentation state is the Original DICOM state Ifa Technologist has created a presentation state that will be pres
115. 7 it automatically merges the two patients Review the configuration before linking or merging patients to make sure the correct patients are linked or merged Intellispace PACS Enterprise 4 4 User Guide 89 6 Finding and Managing Patient Information 1 From the Folder List click Merge Link Candidate s Pairs of possible duplicate records display sorted by patient name using the first patient name of each set All fields on the Merge Link Candidate s list are searchable allowing you to narrow down the list as desired Note the following The Patient Name and MRN fields support wildcard searches For example to find patient Doe John you can search for the full name Doe John full last name and partial first name Doe J or partial last name D There is also a wildcard search option that allows you to search on a partial last name and and partial or full first name for example D Joh The Organization Type Reason and Sex fields include a list of values you can select but you can also enter the information manually The information you enter manually will match a value in the list Note that these fields do not support wildcard searches The DOB field includes a calendar control but you can also enter the date manually You can enter a date range Start Date and End Date to find all records with a patient Date of birth in that range The date format matches the regional settings on your system
116. 8 In the Equals and Does not Equal fields enter additional parameters Click Update Criteria when done and those parameters display in the Filter Summary General Criteria Exam Worklist Criteria Exception Worklist Criteria Available Filter Criteria Filter On ae Criteria Body Part ity Body Part Organization Performing Resource Contains upper extremity Ea lt Does not Contain lower extremity il lai Remove Criteria T Body Part upper extremity lower extremity Filter Summary 9 You can add more criteria from the Available Filter Criteria list by following Steps 4 through 6 To remove a criteria select it in the Filter Summary and click Remove Criteria 10 Optionally to create an Exam Worklist filter do the following The Exam Worklist check box is selected by default which includes exams with or without images in the new filter However you can also select Exception Worklist or you can select both Select the Exam Date from the dropdown list Click the Exam Worklist Criteria tab and then select values from the Available Filter Criteria list Click the gt arrow to move these values to the Filter On column which then automatically populates the Criteria and Filter Summary fields Intellispace PACS Enterprise 4 4 User Guide 161 9 Filtering Worklists When adding an Ordering Location Exam Code or Referring Physician from the Exam Worklist Criteria you
117. 999 2 08 04 Org Federation Loc ImagingCentre H R CR 2 1999 1 54 51 Org Federation Loc ImagingCentre R CR 92 19 1999 2 07 57 Org Federation Loc ImagingCentre 3 ACPT1 FRANI DEFAULT u 3 ACPT1 GRI DEFAULT u 3 ACPT1 HAUN DEFAULT u 3 ACPT1 HOFSTA DEFAULT u 3 ACPT1 HORNE DEFAULT U 4 ACPT1ISSACS DEFAULT u 3 ACPTIJACKSO DEFAULT u a ACPT1 KII ARNI rrr NFFAUIT u 6 2 1 Viewing the Federation Queue When exams are in the process of being transferred from the Federation to the local system you can click Queues in the Folder list and then click Federation to view the status of the exams being transferred Note that the Federation queue is only visible when you have the View Queue and Manage Queue permissions NOTE The maximum number of exams that can be displayed in the Federation queue is 100 This number displays in the Max Results field in the upper right corner below the Control Strip The following fields display in the Federation queue 72 IntelliSpace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6 CREF4 09 291 v4 0 07 2014 Lookup A Paent Lookup Bi inctatied Programs Query Local Exam Cache Local Expo E Locked Exams Machine Fiters A Meegeiink Canddatetl My Fiters Study System Fiters 010150040 MNI 01015004 01015004
118. ACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 Edge Enhance Applied to all images in a multi slice series See Enhancing the Edges of an Image see page 239 e Edge Detect Applied to all images in a multi slice series See Detecting the Edges of an Image see page 240 e Median Filter Only applied to one image current image of multi slice series See Filtering the Image see page 241 e CLAHE Contrast Limited Adaptive Histogram Equalization Only applies to single images such as CR DX MG and so on See Using Contrast Limited Adaptive Histogram Equalization see page 242 e Interpolation pixel replication bilinear interpolation bicubic interpolation See Selecting an Interpolation Scheme see page 243 You set options for the processing images features in the Preferences dialog box See Setting Image Processing Preferences see page 346 System Administrators can adjust the supplied settings for the whole institution See Setting Image Processing Preferences see page 359 When you modify or add Image Processing settings IntelliSpace PACS uses these settings over the supplied Image Processing preferences Because the Image Processing filters alter the digital data of the original DICOM images studies with Image Processi
119. AUSTIN POW ACPTI AUSTIN POW ACPTI AUSTIN POW ACPTI AUSTIN POW TB Clemons Robby zAndreou Craig zAndreou Craig MONKEY DA MONKEY DA MONKEY DA MONKEY DA 609 05 000 44 609 05 000 44 609 05 000 44 Exam information icons Figure 7 1 Last 7 days 9 5 2006 10 17 56 9 5 2006 10 18 40 9 5 2006 10 26 10 9 5 2006 10 27 59 9 5 2006 12 54 20 9 5 2006 14 24 18 9 5 2006 14 24 18 Exam Lookup SSS 345345 CR ORBITS x 345345345345 CR HIP UNI M2V RT x 7877676777777 CR ABDOMEN COMP x 45345345345 CR ORBITS x 44FDC5230009 CR ORBITS S 44FDEB020017 CR No Descriptions att 44FDEB02000C SC No Descriptions Li Intellispace PACS Enterprise 4 4 User Guide 103 7 Finding and Managing Exam Information Icons display to the left of exams indicate the following BP Bp I Icon Description STAT exam Locked exam Linked exam H Exam has images You can search for exams using any combination of the following and other criteria The search criteria in bold below must be displayed at all times Stat Exam Loaded Exam Linked Mark Read Report Available Has Notes Has Images Organization Performing Resource Subspecialty Patient Name Patient Sex Date of Birth 104 IntelliSpace PACS Enterprise 4 4 User Guide Exam has been marked read Diagnostic report available Exam has exam notes CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philip
120. Accession and MRN Mismatch Exceptions see page 184 Accession and MRN Not Found Both the Accession and MRN associated with a study are not found in the database See Resolving Accession and MRN Not Found Exceptions see page 185 System Errors Used for additional exception types A single tab of potential matching exams is displayed in the Exceptions Handler for these exceptions You need to know the following information to use the Exceptions Handler safely in a live clinical environment If you do not understand any of these warnings or how they affect you contact your IntelliSpace PACS System Administrator or Philips Customer Care To avoid unauthorized access to imaging exceptions do not leave a computer unattended while the Exceptions Handler is running As a user of the Exceptions Handler you assume responsibility for unauthorized access as long as you are logged in to the program Before leaving a workstation you should close the Exceptions Handler and log out of IntelliSpace PACS When an exception is resolved IntelliSpace PACS discards the original scanner information and replaces it with information from the HIS RIS resulting in a complete loss of scanner information If an exception was resolved in error and the exception is later unresolved by unlinking the exam from the image resulting in a user created or manual exception the window now displays the HIS RIS information that replaced the scanner in
121. Because wildcards are not supported the entire numeric MRN must be entered to get a match Sorting Results By default the selected sort column is set to display all exams on top Clicking the column header in the exam or exception worklist sorts the contents of the worklist using the selected header as the primary sort column Clicking the current sort column toggles the sort order between ascending and descending The secondary sort criteria for Exam and lookup filters is the Exam Date Time descending with newest exams on top Exceptions are sorted by Exception Date Time descending with newest exceptions on top Click the blue column heading that you want to sort by An arrow appears in the column heading to display whether the order is ascending A Z or 1 9 or descending order Z A or 9 1 To reverse the order click the same column heading again Creating Filters You can create filters in one of the following ways e By selecting an existing filter from the Folder List and clicking the Save As button in the right pane above the filter criteria which opens the Add Filter dialog e By right clicking Machine Filters System Filters or My Filters in the Folder List selecting Create Filter in the right click menu defining the filter criteria in the Add Filter dialog box and saving the filter See Sample Machine Filters for Technologists and Radiologists see page 167 See Commas Used as Delimiters in Filte
122. CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Safety 2 CREF4 09 291 v4 0 07 2014 e When an exception is resolved IntelliSpace PACS discards the original scanner information and replaces it with information from the HIS RIS resulting in a complete loss of scanner information If an exception was resolved in error and the exception is later unresolved by unlinking the exam from the image resulting in a user created or manual exception the window now displays the HIS RIS information that replaced the scanner information when the exception was originally resolved This makes resolving the exception difficult because the HIS RIS information is no longer accurate for this exception IntelliSpace PACS retains the HIS RIS data because the original scanner information was discarded upon the initial resolution of the exception and there is no other data in the database to associate with the exception Therefore we strongly recommend that care be taken when resolving exceptions to avoid the loss of original image header information captured at the scanner e Please take care when resolving exceptions to exams that have already been dictated or marked read Philips encourages customers to notify the responsible reading Radiologist of the exception images being added to the exam because these images may not have been viewed at the time of dictation Make sure you associate the excepti
123. CS forces a histogram calculation of the DICOM values if one of the following conditions exists e The window width is greater than the pixel range times 2 e The window level is greater than the pixel maximum times 2 e The window level is less than the pixel minimum times 2 The pixels in an 8 bit grayscale image have a contrast grayscale value between 0 and 255 where 0 is the blackest at the left end and 255 is the whitest at the right end e Right click on an image and from the menu select Window Width Level and Histogram Calculation Value of Interest LUT VOI LUT Value of Interest Look Up Tables VOI LUT are DICOM values that modalities use to define specific processing algorithms for diagnostic presentation of X ray images By default VOI LUT is not applied to images containing VOI LUT However VOI LUT can be applied by default to the images for an entire site when the System Administrator selects the Automatically apply VOI LUT when available in the General System preferences See Setting General Preferences see page 356 The benefits of VOI LUTs include e Post processing corrections for detector defects e Enhancement of the image by reducing noise Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 NOTE NOTE e Altering the dynamic range by
124. Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box The body part you enter in the preference must already exist in the Body Part dictionary Editing Ensure All Viewed Setting Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click Ensure All Viewed The right side of the Preferences dialog box displays a list of modalities and body parts Select the item in the list that you want to edit and click Properties The Edit Ensure All Viewed dialog box opens Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 CREF4 09 291 v4 0 07 2014 NOTE 18 13 3 18 14 NOTE In the Edit Ensure All Viewed dialog box select the Modality and optionally enter the name of the Body Part The system logs image series that have not been displayed on the diagnostic monitors Click OK to close the Edit Ensure All Viewed dialog box Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box The body part you enter in the preference must already exist in the Body Part dictionary Deleting Ensure All Viewed Setting Clic
125. Columns cece 176 10 54 Sorting Res lis oiis itea i GR Tegra nR RA 176 10 6 Exception Resolution Overview s ssssssesesessssisesessrsressrseseresreseses 176 10 7 Using the Exceptions Handler ijciisaviiiiueavecnmiase invents 180 10 7 1 Resolving Accession Not Found Exceptions cc cc0000 183 10 7 2 Resolving MRN Not Found Exceptions 184 10 7 3 Resolving Accession and MRN Mismatch Exceptions 184 10 7 4 Resolving Accession and MRN Not Found Exceptions 185 10 8 Working with Resolved Exceptions 0 cccccceceeneeeeeseeeneeees 185 10 8 1 Viewing Resolved Exceptions 185 10 8 2 Exporting Resolved Exceptions 187 10 8 3 Creating a Filter for Resolved Exceptions assesses 187 10 9 Deleting Exception Studies sie aveaeinvatoustrayanieinione vinden vise 187 10 10 Soft Merge for Quick Review of Exceptions cece 188 10 11 Creating a New Patient and Exam from the Exceptions Handler 189 10 12 Creating a New Exam from the Exceptions Handler 0 190 10 12 1 Entering Provider Information When Creating Exams 192 10 12 2 Entering Exam History Information When Creating EXAMS Eaa Ea tyson a EEEE shea akin Ricca ehapa nanan Gas 192 10 13 Hiding and Closing the Clinical Info Dialog 0 eee 193 11 Using the Canvas Page ccccscsscsccscsccsccccccsccccscscsscscesescoseeees 195 11 1 Introduction to the Canvas Page Wii inane cece 195 11 2 Using the Patient History Latelitie ivi wsecyivvacu
126. D Can you delete an image that is covered by a rectangle or that has a clone that is covered by a rectangle in IntelliSpace PACS Radiology No the Delete option is temporary disabled under these conditions Intellispace PACS Enterprise 4 4 User Guide 331 16 Managing Studies and Images 16 6 What happens to a clone when I delete a series or image The cloned image is also deleted Can you delete an image of an exam after the exam has been marked read Yes but IntelliSpace PACS does display a warning message This exam has been Marked Read Are you sure you want to continue and delete image s of the selected window What happens when a Radiologist loads an exam and after the exam is opened another user deletes a few images of the opened study The Radiologist will not notice any change until they close and reload the exam What about multiple users trying to delete images at the same time When an image is deleted the second delete causes a warning message that this series image has already been deleted by another user What if an exam has only one image left It is not possible to delete an image if it is the last image in an exam In this case the workaround option is to detach the study from the exam and Remove the study from the database What happens when you delete and then recover an image that has measurements or annotations on it In this case you lose the Presentation State information of this ima
127. DICOM sources using DICOM values should be configured for a specific AE Title to ensure that images from other devices are not impacted The DICOM modality values are stored in the Window Center tag 0028 1050 and the Window Width tag 0028 1051 e Right click on an image and from the menu select Window Width Level and Modality Default Using the Histogram WW WL Calculation The histogram is a graph that shows the tone grayscale value distribution total pixel count for each grayscale value in the image It maps luminance which is defined as the way the human eye perceives the brightness of objects By defining the luminance the histogram provides the Window Width and Center for the image instead of the modality Histogram calculation is not available for the CT modality Intellispace PACS Enterprise 4 4 User Guide 233 12 Viewing and Manipulating Images 234 12 5 The histogram distributes the range of tone grayscale value through categories to provide an image that presents the optimal range of grayscale distribution for an image according to the way the human eye perceives the scale of contrast by evenly distributing the grayscale values across the possible range of values Histograms for low resolution images for example thumbnails are significantly different than historgrams for higher resolution images The window width level values for these low resolution images may not be suitable Also IntelliSpace PA
128. Ds In order to manually assign a New Unique Study UID the following conditions must be met e You have been assigned the Images Resolve Duplicate UID Images task e The exam status is anything but Scheduled You can manually assign a new unique Study Instance UID to e One image window that contains single image e One series window that contain series with multiple images e Multiple windows multiple single images series in the rack selected with Shift click Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Managing Studies and Images 16 NOTE CREF4 09 291 v4 0 07 2014 IntelliSpace PACS audits each time a new Study Instance UID is assigned to an image or group of images Users with appropriate permissions should not assign new Study UIDs to studies that have not been confirmed to be complete status is not designated Complete You cannot assign a new Study Instance UID to exams with anonymous patient information See Making Patient Information Anonymous see page 56 In the following example the CT Study of Patient Eric Bowers also contains images of Patient Eric Smith Figure 16 1 DUP UID example Use the Exceptions Lookup to find the images that are flagged as DUP UID images Open the exam that contains the images that are flagged as DUP UID images These images are display
129. English Intellispace PACS Enterprise with iSyntax User Guide R4 4 PHILIPS Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 Contents Introduction ccsccesccnsccnccesccnscceccnscenscceecscensceecensceeeceeeeesceeeees 15 1 1 About IntelliSpace PACS Enterprise sii vccnatecatereaalaceataae ieee 15 1 2 Intended Use a ssasarastsurservedescovheescsri wich Qecuipoedtunsondveseondoaseoosies 16 Ted Irdications for Usesta siirinsesi tetas 16 1 4 When to Use IntelliSpace PACS Enterprise cc eeeeeeeeeeeneeee I7 Gos mame Biss ocean meen iiit ii dianan Ti E per a E e ters ft er 17 1 6 Safe Usage Environment for IntelliSpace PACS Enterprise 17 1 7 Gontratn dications nseni a iaiia 18 Lz When Not to Use IntelliSpace PACS Enterprise soseen 18 1 8 About This Publication sesssesesssesessssesssesseseseerererererersrsrsrsrsrsrersees 18 1 9 Contact and Trademark Information ssssssssesesseseseeseeesrsrsrsrsrsrsrsees 19 1 9 1 Comp ny Contact s en ioe annisa ii iia Oa iE 19 1 9 2 Trademarks and Copyrights 20 ES E E E A E A 21 2I Safe Messages onee o enaA etch tos A a a 21 2 2 Mobile Telephones and IT Equipment s ssssssssessseseseesrseseressrerses 32 Getting Started ccccscsccscsccsccccscsccscscecsscssescscessscessssesecseeees 33 3 1 Logging on to IntelliSpace PACS ieidssticesioedeisiiseitssarsiesdiets 34 3 2 Setting the Monitor Color Resolution sivisiisiseaarssearaesrectsirnaa
130. Exceptions See Creating Filters see page 158 Deleting Exception Studies You may occasionally need to delete exception studies such as those for phantom studies that you can t resolve with confidence You can do this only if you have been assigned the proper permissions Deleting an exception study removes it from the Exceptions Handler and any worklist that shows exceptions Note that images associated with exception studies you delete cannot be linked with data from IntelliSpace PACS e Deleting an exception study is a potentially hazardous operation and cannot be undone and images cannot be recovered You should review the Warnings in this chapter to ensure that you understand the possible ramifications of deleting an exception study Intellispace PACS Enterprise 4 4 User Guide 187 10 Finding and Managing Exceptions 188 10 10 e Make sure that you understand that when you detach DICOM studies from an exam and delete the subsequent exception you are in fact permanently deleting those studies Deleted studies may contain data that would render a different diagnosis Use the Exception Lookup to search for exception studies Select an exception and right click From the menu select Delete Exception A message displays asking you to confirm the action Click OK The study is deleted from the system and removed from the exceptions list If IntelliSpace PACS receives the same images again from the modality
131. For each provider IntelliSpace PACS displays the following information if available e Type of provider for example Admitting Attending Consulting e Name of provider e Phone numbers e Address e Attending Physician 1 Display the Current Providers pane of the Clinical Information dialog box in one of the following ways From the Canvas Page click the icon in the Exam Rack CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 141 Viewing Clinical Information 142 8 6 From the Patient Lookup Exam Lookup or a worklist that displays exams and has the Has Notes column visible right click the exam and select View Exam Notes Click Current Providers and review the information Select another pane from the Clinical Information dialog box if desired or click Close Displaying and Printing the Audit Trail PACS Administrators who are performing HIPAA compliance auditing or troubleshooting are usually accessing exams and viewing images within IntelliSpace PACS Enterprise or IntelliSpace PACS Radiology The admin s workflow is simplified by having the Audit Trail accessible from within the Clinical Information dialog of the following significant HL7 DICOM and user initiated events associated with an exam s Accession Number The following actions are audited and visible in the IntelliSpace PACS AdminTool some actions are visible in the Audit Trail dialog in IntelliSpace PACS Intellis
132. Guide 403 20 Mouse and Keyboard Reference Sheet Cursor Description Window Width Level Pan Zoom Scroll Ds Acceleration Gain Aon You can cycle through the cursor modes by double clicking the middle mouse button or choosing a mode from the Interaction menu in thumbnail or image popup windows When IntelliSpace PACS starts the mouse cursor is set to a regular arrow After you change the cursor mode in the General User preferences it is persistent If the current mouse cursor is set to scroll and the mouse hovers over a non stack image the mouse cursor changes to Window Width Level mode When the cursor is moved over a stack image again it changes back to scroll mode Note the following about enhanced cursors in stack images e You double click the left mouse button to select images and use click drag to perform the mouse mode functions 404 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Mouse and Keyboard Reference Sheet 20 20 1 3 CREF4 09 291 v4 0 07 2014 e When Custom Scrolling is enabled with the Enhanced Mouse Scheme option holding the left mouse button down while scrolling moves through the stack images until the button is released the mouse is halted or the end of the stack has been reached Scrolling Coarse Fast Cine scrolling is the default method but Custom Scrolling is available
133. Healthcare Informatics Inc Setting User Preferences 17 e The Edge Enhancement settings allow you to make the edges more prominent while still showing low frequency background information within the image See Enhancing the Edges of an Image see page 239 to see how the Edge Enhancement preference is applied to images e The Edge Detection settings allow you to remove the low frequency background information from within the image leaving only the edges visible See Detecting the Edges of an Image see page 240 for information on how the Edge Detection preference is applied to images e The Median Filter settings allow you to define a low pass filter to remove noise from the image with little or no smoothing of the image You can use the Median Filter preference to place a 3x3 or 5x5 mask over the original image The median medium value becomes the new pixel value See Filtering the Image see page 241 to see how the Median Filter preference is applied to images e The CLAHE Contrast Limited Adaptive Histogram Equalization settings utilize an adaptive form of histogram equalization that enhances the contrast adaptively across the image See Using Contrast Limited Adaptive Histogram Equalization see page 242 to see how the CLAHE preference is applied to images When you modify or add Image Processing settings IntelliSpace PACS uses these settings over the system default Image Processing prefe
134. IP is commonly used for vascular studies and 3D rotational angiography MPR Multi Planar Reformation A post processing technique which produces new slices from a stack of images The original images are stacked one on top of the other MPR then produces a reconstructed plane of the anatomy in any desired orientation When an MPR slice is widened it becomes a slab The result is then identical to an average intensity projection Volume Rendering Volumes are derived via a post processing technique which uses complex virtual ray methods to produce three dimensional objects from a stack of images The original images are stacked one on top of the other A classification is applied to visualize a selected surface within the volume The MPR MIP toolset includes Real Time Interactive orthogonal oblique and double oblique cuts Curved MPR with intelligent task guidance Interactive slab thickness adjustments Side by side MPR MIP for current and prior exams Triangulation linked cursors Window Level presets Zoom Pan interactive edge enhancement Measurement tools distance open angle points profile free contour vessel diameter 284 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Philips IntelliSpace Clinical Applications 14 CREF4 09 291 v4 0 07 2014 NOTE 14 2 1 NOTE Volume Rendering includes e High resolu
135. IntelliSpace PACS before using the Edit Exam feature If you have HIS RIS integration exams edited in IntelliSspace PACS will not be synchronized in your HIS RIS There are many reasons you might need to edit an exam including e Adding a patient history or reason for exam in one of the Comments fields e Removing older studies received from a 3rd party archive e Updating the Exam Code or Provider fields if they are blank or incorrect 110 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exam Information 7 CREF4 09 291 v4 0 07 2014 NOTE e Assigning a new Accession to an exam if a Technologist accidentally enters an Accession from a different patient at the scanner If the Accession is already in use the study can be detached e Receiving an order with a new exam code for which there is no associated body part When the dictionary is updated so that the exam code has an associated body part the Technologist can edit the exam to update the Body Part field e Adding data not provided by the HIS RIS When you edit an exam the Edit Exam dialog box header displays information about the patient whom the exam is for The patient s identifier last middle and first names sex date of birth and Social Security number are displayed in addition to the exam Accession The following fields in th
136. Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 14 May 1999 10 50 52 Acc 3929650 5 14 1999 10 50 52 AM Acc 3929650 m No Descriptions p No Descriptions general PA Series 1 Figure 12 7 Image with Edge Detect Filter 1 Right click the image and from the menu select Image Processing then Edge Detect 2 Press the comma and period keys to increase or decrease the degree of edge detection 12 6 4 Filtering the Image The Median Filtering tool utilizes a common filtering method to reduce noise in the image For a multi slice series Median Filtering only applies to the current image not the entire series You can change the default setting in the Image Processing section of the Preferences dialog box See Setting Image Processing Preferences see page 346 CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 241 12 Viewing and Manipulating Images 5 14 1999 10 50 52 AM Acc 3929650 14 May 1999 10 50 52 Acc 3929650 No Descriptions wil 1598 2491 No Descriptions wil 1599 2491 general PA e general PA Series 1 Series 1 Figure 12 8 Image with Median Filter e Right click the image and from the menu select Image Processing then Median Filter 12 6 5 Using Contrast Limited Adaptive Histogram Equalization The CLAHE Contrast Limited Ad
137. Mother s Maiden Name Phone Number work Phone Number home Email address Alias Last Name Alias First Name Alias Middle Name Title Suffix Optional Prefix 98 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6 CREF4 09 291 v4 0 07 2014 NOTE 6 22 If you have the proper privileges you can remove patient records from links in the Edit Patient dialog box See Editing Patient Records see page 84 Note the following about removing links e After you remove a link the previously linked patients are not displayed on the Merge Link Candidate list e Ifthe MRN is modified IntelliSpace PACS verifies that the MRN is unique in the organization Use the Patient Lookup to find the patients whose records you want to link You can link two or more patients Ctrl click to select the two patients you want to link When the names are selected right click and from the menu choose Link Patients The Linked Patients dialog box displays a list of all patient records linked to the current patient record including the organization patient MRN and patient name Verify that you are linking the correct patients Review the Organization MRN Last Name First Name Middle Name Sex Date of Birth Social Security Number and Address Click Link Patients The list of patient na
138. N of a different person in a second organization within the same federation Thus images and patient information might be incorrectly assigned to the wrong person Aw ARNING It is the customer s responsibility to make sure patients have unique patient identifiers MRNs within a federation The Federated layer allows the following e iVaults and third party PACS can form a union with shared authorization and viewing privileges e Asingle combined timeline for patients is provided including studies that exist in multiple PACS systems e Enables physicians to access a current study from their local system and then access prior studies from any location in the Federation for comparison e Supports a heterogeneous environment leveraging IHE standards when the appropriate systems are in place and utilizing more traditional methods when they are not e Ifthe user has permission to view patients and exams in the local PACS system then the federation layer assumes that user has the right to view patients and exam in other PACS systems as well 66 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6 If your PACS system is part of a federation you will see some additional icons and messages in the Patient Lookup screen When you click Search in the Patient Lookup pane the color of the F ico
139. OK You return to the Preferences dialog box Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Editing a Paper Printing Preference Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 CREF4 09 291 v4 0 07 2014 18 8 2 18 8 3 Click the sign next to System Preferences The list of available system preferences displays Click Paper Printing The right side of the Preferences dialog box displays a list of the current paper printing preferences Select the paper printing preference you want to edit and click Properties or double click the printing preference The Edit Windows Print Configuration dialog box displays Make the desired changes to name format and overlay settings Click OK You return to the Preferences dialog box Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Exporting a Paper Printing Preference Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click Paper Printing The right side of the Preferences dialog box displays a lis
140. P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click Plug Ins The right side of the Preferences dialog box displays a list of the current plug ins and allows to add edit or delete plug ins Select the plug in you want to edit and click Properties or double click the plug in The Plug In dialog box displays Change the plug in settings as desired Click OK You return to the Preferences dialog box Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Deleting a Plug In Preference Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click Plug Ins The right side of the Preferences dialog box displays a list of the current plug ins and allows to add edit or delete plug ins Select the plug in you want to delete and click Delete Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Intellispace PACS Enterprise 4 4 User Guide 385 18 Setting System Preferences 386 18 12 NOTE Setting Workflow Preferences Workflow refers to the type of screening specified for reading a mammography exam If t
141. Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 12 Viewing and Manipulating Images IntelliSpace PACS includes the following features you can use to view and manipulate images e Presentation States See Using Presentation States see page 216 e Key Images See Using Key Images see page 221 e Linking Image Series See Linking Image Series see page 224 e Window Width Level See Setting the Window Width Level see page 231 e VOI LUT See Value of Interest LUT VOI LUT see page 234 e Edge Enhance See Enhancing the Edges of an Image see page 239 Edge Detect See Detecting the Edges of an Image see page 240 e Median Filter See Filtering the Image see page 241 e Histogram See Using Contrast Limited Adaptive Histogram Equalization see page 242 e Scout Mode See Using the Scout Tool see page 244 e Localizer Tool See Using the Localizer Tool see page 245 e Zooming See Zoom Presets see page 247 e Magnifying Glass See Using the Magnifying Glass Tool see page 249 Step Zoom See Using the Step Zoom Tool see page 251 e Panning See Panning Around an Image see page 254 e Minimizing Images See Minimizing Images see page 254 e Interpolation See Selecting an Interpolation Scheme see page 243 e Flip See Flipping an Image see page 2
142. R case typically needs to be read STAT or immediately If the study is at a remote site any remote workstation pulling a study from that location over the WAN may be limited by the bandwidth and latency given the size of the study In this scenario the user s requirements the radiologist are the ability to view the study in full fidelity in near real time or until the study has been transmitted in full to the workstation using local exam caching Otherwise the radiologist might need to wait until the study is migrated to the main location where a faster connection is available Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Accessing IntelliSpace PACS Remotely 4 CREF4 09 291 v4 0 07 2014 4 3 4 4 Also given the life critical nature of these cases uptime requirements and network quality of the WAN connection service provider should be considered Service Level Agreements SLAs for the service providers need to be considered to ensure that the network remains up and available to meet patient care requirements Teleradiology Mode Teleradiology Mode is the lowest connection speed available and is designed to be used when you connect to IntelliSpace PACS over a telephone line with a 56K modem This mode uses the highest amount of compression to compensate for the extremely poor data transfer rate often experienced over a tele
143. Review the Summary area to see the Required Disk Space and Available Disk Space The initial values reflect the size of the CD DVD version of the IntelliSpace PACS control 7 To remove an exam from the Exam List right click the exam and click Delete Click Yes to remove the selected exam 8 To password protect the CD DVD to protect patient confidentiality select the Enable Password check box enter and confirm the desired password You can only password protect Philips Proprietary Format the DICOM data is not password protected 9 Ifthe BSN Burger Service Number feature is enabled on the IntelliSpace PACS server and the export configuration you have selected has BSN enabled the Export BSN check box is available Select this check box if you want BSN information to be included in the Media Viewer export See Setting iExport Preferences see page 380 NOTE The BSN Burger Service Number feature is only available for IntelliSpace PACS sites in The Netherlands 10 Click Start to begin exporting the exams If you are writing to a CD DVD Windows begins the CD DVD creation process The status bar at the bottom of the screen provides updated information on the progress of the export In addition each exam being written to the media displays a symbol that indicates the progress of that individual exam The following symbols are used Light green dot Ready to be written 300 Intellispace PACS Enterprise 4 4 User Guide CREF
144. Space PACS uses calibrated pixel spacing tag 0028 0030 if present IntelliSpace PACS displays measurements in pixels For US images only 1 2 840 10008 5 1 4 1 1 6 1US Single Frame 1 2 840 10008 5 1 4 1 1 3 1US Multiframe IntelliSpace PACS uses the US region calibration values 0018 602c and 0018 602e for pixel spacing Using the Measurement Palette Measurement values are modality dependent The measurement values that IntelliSpace PACS displays are derived from information sent by the modality responsible for generating the image being measured If this modality is incorrectly configured or defective IntelliSpace PACS measurement values may be adversely affected and may be incorrect Intellispace PACS Enterprise 4 4 User Guide 263 13 Measuring and Annotating Images 264 13 4 IntelliSpace PACS provides a Measurement palette that streamlines your work and allows you to make various measurements and the text annotation on an image You can drag the Measurement palette to any location on your screen You can also toggle the display of the palette by pressing M The Measurement palette displays for the exam until you close the palette Ruler Angle Text annotation ROI ROI ROI Circle Freehand Ellipse Figure 13 1 Measurement Palette You can define keyboard shortcuts for the tools on the Measurement palette that set whether or not the tool remains active persists after you use it on an image See Key
145. System Administrator has disabled this option for the entire site Select the Open user s most recent presentation state check box if you want this presentation state to be opened first Select Automatically connect to federation to activate the Federation layer in the IntelliSpace PACS client only if Federation is configured at the site See section 3 8 Setting Federation Status on page 40 Select Show Exceptions in Patient List to enable searching for and displaying both exams and exceptions that match the search criteria in the Patient Lookup See Viewing Exceptions in the Patient Lookup see page 79 If desired click Change Password The Change Password dialog box displays Enter the desired password changes and click OK Set the Rack Orientation to Vertical or Horizontal and the Initial Size to Small or Normal Click Apply to save the settings and continue setting other preferences Click OK to save your changes and close the Preferences dialog box Intellispace PACS Enterprise 4 4 User Guide 339 17 Setting User Preferences 340 17 2 Setting Mouse Preferences You set the behavior of the mouse in the Mouse Preferences dialog box Two preferences are available e Mouse Scheme Options Allows you to choose whether you want to use the standard mouse actions and cursor Standard or use cursors whose shape indicates their action Enhanced Standard is enabled by default See Standard Mouse Sch
146. To resolve this exception you must find the correct exam to attach the study to You can resolve this exception in one of two ways e Choose from a list of exams with an MRN that is the same as the one attached to the study or search for an exam e Choose the exam with the same Accession that is attached to the study 184 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exceptions 10 CREF4 09 291 v4 0 07 2014 10 7 4 10 8 10 8 1 Resolving Accession and MRN Not Found Exceptions The mismatch scenario Accession and MRN Not Found means that both the Accession and MRN do not exist in the IntelliSpace PACS database You can resolve this exception in one of two ways e Find a different exam for a different existing patient by entering search criteria and searching manually for an existing exam e Create a new patient and exam Working with Resolved Exceptions The Resolved Exceptions worklist is an audit log of exceptions that have been resolved This worklist gives Technologists and PACS Administrators a convenient way to view all resolved exceptions Note the following e Ifan exception was deleted it would appear in the Resolved Exceptions worklist with Resolved to Acc set to Deleted e Ifthe exam that points to Resolved to Acc was later deleted or detached a message will displays sta
147. Using Contrast Limited Adaptive Histogram Equalization see page 242 to see how the CLAHE preference is applied to images Images studies with Image Processing filters cannot be printed to film as diagnostic quality images because these filters alter the digital data of the original DICOM These preferences are applied to the entire series being viewed A read only list of active modalities is also available for each image processing preference You can apply image processing filters using the menu When an image processing filter is applied to an image a P Processed icon is displayed in the metadata area in the Exam Rack and in the image popup window 360 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 CREF4 09 291 v4 0 07 2014 LoL brn tt Image Processing filter applied Figure 18 1 Image with Image Processing icon Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click Image Processing The right side of the Preferences dialog box displays a list of image processing options To set preferences for Edge Enhance do one of the following Click Method and choose 5 pt Laplacian or 9 pt Laplacian Click Degree and choose Light Medium or S
148. XA Multi lmage Mode The feature that allows you to display multiple images in one window in various configurations My Filters A folder in the Folder List that contains your personal filters See Folder List see page 51 426 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Glossary 22 CREF4 09 291 v4 0 07 2014 My History A folder in the Folder List that contains the last 100 exams that you have viewed See Folder List see page 51 Not Read By Me Filter A filter that selects all exams that have not yet been read by the current user This filter creates a personal to do list PACS Picture Archiving and Communication System Patient A person receiving health care services In IntelliSpace PACS the unique identifier for patients is a Medical Record Number MRN also known as a Patient ID Patient Folder A container of studies examinations series images reports requests texts and notes of a patient Patient History A chronological list of all exams available for the selected patient The exams currently selected for display are highlighted with a gray background See Using the Patient History Timeline see page 197 Patient Lookup A search tool that allows you to find patients based on a combination of search criteria Patient Lookup Screen A screen that displays w
149. a number of methods that improve the visibility of specific pathologies Value of Interest Lookup Tables VOI LUT can be used to enhance different features of the image for example bone versus lung versus soft tissue on a chest radiograph Because the acquisition device might have already performed this processing a VOI LUT may be used to provide alternative presentations of the Window Width Level of an image VOI LUTS are used primarily with CR DR images extracted from the DICOM tag 0028 3010 This tag can reference one or more VOI LUTs associated with an image Images can contain single or multiple VOI LUTs If the DICOM header is missing a LUT a default LUT is used This prevents an incorrect LUT from being applied as an image s gray values may not correctly display When VOI LUTs are applied IntelliSpace PACS adds an additional VOI LUT option with VOI LUT name If VOI LUT is applied the user can still adjust the image gray scale with the mouse If modified the VOI LUT name changes and MOD is added where MOD indicates that the original VOI LUT has been modified While you right click the Window Width and Level options in the menu are replaced by VOI LUT Options when VOI LUT is enabled The image can still have Window Width and Level adjusted on top of the VOI LUT presentation The modified VOI LUT is preserved when you save a presentation state of the exam VOI LUT menu options can
150. a r 51 5 2 1 CHCA GAIN EW Foldere oiei RRS 54 5 2 2 Renaming a Folder 54 5 2 3 Showing and Hiding the Folder List aseeseen 55 5 2 4 Adding Exams to Folders assosieer 55 5 2 5 Copying Exams from Folders to Folders nosses 55 5 2 6 Adding Comments to Studies in Personal or Public Folders o antea gi aeonit i a bast she sd E OE E O O 55 5 3 Making Patient Information Anonymous ssssssssssssessersrsrereresreese 56 5 3 1 Displaying or Editing Information about Anonymous Exam ea nan EN E EEN EAEL EEE ene 58 5 3 2 Adding Comments to an Anonymous EXAM vices 58 5 3 3 Viewing Comments for an Anonymous EXAM wees 59 5 3 4 Deleting Comments for an Anonymous EXAM sss 59 5 4 Working with VIP Patients ajith cst ioh alain aseatohn aia taangasarta guaataaainy 59 5 3 Shortcuts Babs iccsrssaess uscuoeds ss tinses eave aiai 60 5 5 1 Adding a Shortcut siistia daiiris 60 5 5 2 Selecting an Item from the Shortcut Bar sosse 61 5 5 3 Removing a Shottiut iiiireirittiri i eaea E 61 5 5 4 Renaming a SDOTECKL i wieschcoesesclesccuossscevvectuadvestonbeocteesses 61 5 5 5 Resizing the Shortcut Are sssr 61 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcares Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 5 6 Ps OPEC Groups erii hs Wn he as eee beac atin 61 5 6 1 Creating a Shortcut Group assesseer 61 5 6 2 Renaming a Shortcut Group sessies 62 5 6 3 Removing a Shortcut Gr
151. able column visible right click and select Show Report Click Diagnostic Report while viewing another pane in the Clinical Information dialog box 2 If desired click the sign to expand and view the Exam Information Patient Information Providers or Preliminary Report sections 3 Click Print for a paper copy of the current report The printed version includes the patient and exam information even if these sections are not expanded on screen 4 Select another pane from the Clinical Information dialog box if desired or click Close 8 8 Displaying Earlier Reports 1 Display the Diagnostic Report pane of the Clinical Information dialog box in one of the following ways From the Canvas Page click the icon in the Exam Rack Right click on an event in the Patient History Timeline on the Canvas Page and select Show Report From the Patient Lookup Exam Lookup or a worklist that displays exams and has the Report Available column visible right click and select Show Report 146 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing Clinical Information 8 CREF4 09 291 v4 0 07 2014 Click the History tab The top part of the window displays information about the previous reports for this exam including the date and time of the report the report status Corrected Final or Preliminary and the name of the provid
152. abled Next hanging protocol Next sequence of hanging protocol Displays the images going forward in order Displays the next opened prior exam if the main exam has more than one prior exam onto the diagnostic monitor s for comparison while keeping the main exam loaded on the diagnostic monitors CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Mouse and Keyboard Reference Sheet 20 CREF4 09 291 v4 0 07 2014 Description Next Series from the Exam Page Navigation Rectangle Backward Page Navigation Rectangle Forward Previous Exam on Worklist Filter Previous Hanging Previous Hanging Sequence Previous Image Previous Prior Previous Series from the Exam Default Hardcoded Keystroke F8 F9 F10 Ctrl F9 Q Shift Q NONE Shift F9 F7 Action When viewing a popup image in a horizontal rack this key hangs the next series from the exam When viewing a popup image in a vertical rack this keys hangs the next exam not the next series within the exam Simultaneously loads the previous current and prior series if available in the exam rack onto the diagnostic monitors Simultaneously loads the next current and prior series if available in the rack onto the diagnostic monitors Displays the previous patient on the worklist Previous hanging protocol Previous sequence of hanging protocol D
153. abled the Export BSN check box is available Select this check box if you want BSN information to be included in the export See Setting iExport Preferences see page 380 The BSN Burger Service Number feature is only available for IntelliSpace PACS sites in The Netherlands Review the exam and destination information and click Back to correct In the Notifications section enter the following additional information if desired Enter an email address for notification of when the export is complete Separate email addresses by commas Select the appropriate Priority Normal Urgent or STAT Add a Description of the exam Click Queue to see how busy the queue is 306 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Retrieving and Exporting Studies 15 CREF4 09 291 v4 0 07 2014 8 Click Finish to begin the export 15 3 1 Exporting Anonymous Exams 1 Right click an exam listing from any worklist the Patient History the Relevant Exams or the exam rack and from the menu select Export via DICOM DICOM Exam Export 8 G MRIN P Senn Ea Please select the exam s you wish to export MR HIPS ECHO lt 2VRS W MANIPULA LT 2 17 2011 13 22 07 02057032470324 m r Cancel Queue 2 Select the exam s that you wish to export To make exported patient information anonymous select the Anonymize Exams
154. age 303 e iQuery See iQuery for DICOM Study Retrieval see page 314 Using the Media Viewer e Do not use CDs and DVDs as a permanent or fail safe archive for patient data When storing data on a CD or DVD IntelliSpace PACS does not verify that the patient data is correctly stored and retrievable In addition CDs and DVDs may deteriorate over time For long term storage all patient data should be stored in an archiving system such as a PACS Do not diagnose from media such as CDs or DVDs The Media Viewer allows you to export an encapsulated version of IntelliSpace PACS and the patient exams you choose to various media including CD DVD USB device and external hard drives You can use the Media Viewer for exams with anonymous patient information See Working with Anonymized Exams in the Media Viewer see page 301 The patient images are all lossless unless the IntelliSpace PACS Server received lossy images from another source Diagnostic reports and presentation states are exported with the patient exams Exam notes allergies other clinical information and some diagnostic report fields are not exported to the CD or other media The Media Viewer provides for easy distribution but most importantly no internet connection is needed to view patient exams Note that if you log out when exam links are still open in the Media Viewer the links are lost and have to be redone when you log back into IntelliSpace PACS
155. althcare Informatics Inc Philips Healthcare Informatics Inc IntelliSpace PACS Quick Reference Table 21 Task Resize an exam row Reorder images in an exam row Print Save image to file or to clipboard Export an exam to DICOM Logout CREF4 09 291 v4 0 07 2014 Action 1 Place your cursor on the margin of the exam row The cursor changes to a resize cursor 2 Click and drag the margin to the desired height or width if you are working in Vertical mode Place your cursor on the image s gray top margin or bottom annotation area left click and drag to a new location Right click on an image and select Print from the menu then choose Paper Printer Right click on the image you wish to save and select Save from the menu Then select Window Image to Clipboard File Right click an exam listing either in the Patient History or in a worklist and select Export via DICOM from the menu Click the X button in the upper right corner of the Control Strip Intellispace PACS Enterprise 4 4 User Guide 419 21 IntelliSpace PACS Quick Reference Table 420 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc 22 CREF4 09 291 v4 0 07 2014 Glossary Accession Number ACC The unique identifier for exams the maximum length of an accession number is 20 characters CAD Marker Computer aided
156. an specify various font and arrow styles for annotations See Annotating Images see page 277 1 Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip 2 Click the sign next to System Preferences The list of available system preferences displays 3 Click Annotations The right side of the Preferences dialog box displays a list of annotation preferences and buttons that allow you to add edit or delete annotations 4 Click Add The Add Annotation dialog box displays 5 Enter a name for the annotation This name is displayed as an annotation option in the menu 6 Click Font if you want to change the font style and size for the annotation 7 Ifyou want the annotation to include an arrow select the Arrow check box and specify the Line Size and Line Style for the arrow 362 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 CREF4 09 291 v4 0 07 2014 18 5 1 18 5 2 Click OK The annotation is added to the list in the Preferences dialog box Click Apply to save the annotation preference and continue to set other pply p preferences Click OK to save your changes and close the Preferences dialog box Editing an Annotation Preference Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to S
157. annotation as desired Click OK Intellispace PACS Enterprise 4 4 User Guide 279 13 Measuring and Annotating Images 13 15 NOTE Spine Labeling You can use the Spine Labeling tool to place markers at each vertebra or vertebral disc You can save labels when you save the configuration as a Presentation State You would typically use this tool for an MR series to label the vertical bodies of a sagittal image and then turn on the Scout tool You could then quickly determine the vertebral body you are looking at when you cine through an axial stack The Spine Labeling tool should only be used on Sagittal or Coronal images KILARNEY CHRISTOP30 Jul 1999 17 36 18 Acc 4089996 fa E 9 Key 9 No Descriptions TE 8 0 TR 617 SE USCTLBOT Sag 2D Spin Echo RC 3 0mm 4 0mm C Series 2 Figure 13 8 Spine Labeling Tool example Right click the series you wish to label From the menu select Annotations then Spine Labeling The Spine Label Panel dialog box displays For an MR stack IntelliSpace PACS automatically sets the stack to the middle slice in the stack 280 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Measuring and Annotating Images 13 CREF4 09 291 v4 0 07 2014 3 Do one of the following Note that spinal labels L6 and T13 are not included in automatic labeling but can be chosen manually from the Spin
158. aptive Histogram Equalization tool utilizes an adaptive form of histogram equalization that enhances the contrast adoptively across the image You can use CLAHE with the following modalities CR DX MG and XA You can change the default setting in the Image Processing section of the Preferences dialog box See Setting Image Processing Preferences see page 346 When CLAHE is applied the Window Width Window Level of the image is automatically adjusted When CLAHE is selected the WW WL is automatically recalculated using the Histogram Calculation because that data range has changed The initial WW WL values are restored when CLAHE is turned off 242 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 14 May 1999 10 50 52 Acc 3929650 6 14 1999 10 50 52 AM Acc 3929650 4 No Descriptions wil 1598 2491 No Descriptions wil 1598 2491 general PA general PA Series 1 Series 1 Figure 12 9 Image with CLAHE Filter To toggle the CLAHE filtering do the following e Right click the image and from the menu select Image Processing then CLAHE 12 6 6 Selecting an Interpolation Scheme Interpolation is the process of adding or subtracting pixels by analyzing the adjacent pixels and estimating intermediate values to increase or decrease the resolution of an image When you resize an
159. ard Reference Sheet 20 CREF4 09 291 v4 0 07 2014 NOTE 20 2 NOTE Note the following about Custom Scrolling sliders e The distance of mouse movement directly correlates to the number of images that increment in the stack after the entire image stack has been read into the IntelliSpace PACS memory e When the slider is set in the middle position and Acceleration Gain is selected the stack scrolls with a standard movement across the height of the display at least 900 images assuming a 2560 x 2048 monitor ina Landscape position e By default the sliders are set to the middle position Slow can go slower and Fast can go faster than the default Mouse Properties settings in Windows The calculations used by the sliders are based on default Mouse Properties settings for Windows on that machine If the user changes these default settings the relative values of Slow and Fast on the sliders are impacted We recommend that users retain the default value for Mouse Properties in Windows when using this feature When either Response Rate or Acceleration Gain is selected when the mouse reaches the top or bottom row of the display the scrolling continues in the same direction as it was previously defined using the speed specified in the slider This means that you do not have to pick the mouse up to begin scrolling again after the mouse has reached the top or bottom of the screen Keyboard Commands This table describes the ke
160. are Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 12 3 8 12 4 IntelliSpace PACS allows you to link oblique series The goal is to provide users with the ability to link oblique series that are more or less in the same orientation However IntelliSpace PACS does not prevent you from linking obliques that have totally different orientation This means that linking obliques that are not of roughly the same orientation leads to unexpected behavior in IntelliSpace PACS Series 1 Series 2 Linked Exams Use Case CT Chest Abdomen Pelvis When exams are linked before being marked as Read when the linked exams are marked Read only one Presentation State is created because the linked exams were not read separately Therefore when a linked exam is opened a Presentation State may not be applied which can display incorrect measurements on screen For example consider a Chest Abdomen Pelvis series where three exams are linked and point to the same DICOM Study Typically all three exams are read in one dictation session loading the CT Chest exam from the worklist Users that subsequently open either the CT Abdomen or CT Pelvis exam will default back to the original DICOM Presentation State and not see the added value stored under the CT Chest DICOM Presentation State Setting the Window Width Level The Window Width and Level settings allow you choose optimal viewing to highlight certain
161. as a Mouse preference See Setting Mouse Preferences see page 340 You engage Coarse Fast Cine mode by left clicking while dragging the mouse down past the point in which you placed your cursor to cine through the images Coarse Fast Cine may skip images depending on how far the mouse is from where the Fast Cine originally began When Custom Scrolling is enabled Coarse Fast Cine is disabled The key difference between Coarse Fast Cine and Custom Scrolling is the following e In Coarse Fast Cine scrolling automatically queues up a number of images and then displays the entire queue based on the initial mouse movement distance e In Custom Scrolling users have precise control of the image set by starting image traversing when the mouse is moved and immediately halting the traversing when the mouse is stopped or the button is released Many users prefer this method of controlling image stack navigation The number of images that scroll when the mouse is moved can be decreased or increased using slider bars Custom Scrolling supports Standard and Enhanced mouse configurations and is disabled by default Intellispace PACS Enterprise 4 4 User Guide 405 20 Mouse and Keyboard Reference Sheet I Custom Scrolling Response Rate Slow H Fast V Acceleration Gai Slow Fast The Response Rate speed and Acceleration Gain options can be used separately or combined as follows e Response Rate allows you to use a
162. associated with one or more Patients and each Patient has an identifier for example an MRN and an Organization ID The way the database of Person and Patient records gets created depends on how the IntelliSpace PACS database is set up and populated Aw ARNING When running a query using a patient s MRN it is possible that the non numeric characters may be stripped from the MRN possibly causing a mismatch of patient data between two or more patients Make sure you validate the MRN against the patient name to ensure the returned patient data matches the patient you are looking for You can quickly find patients with or without associated exams based on a combination of search criteria Patients whose records are based solely on exception studies are not displayed You can search for patients based on any combination of the following The search criteria in bold below must be displayed at all times e Patient Name MRN e Date of Birth e Social Security Number see Note below e Organization e Sex You can set a General User Preference to show and search for exceptions in the Patient List See Setting General Preferences see page 338 and Viewing Exceptions in the Patient Lookup see page 79 If you do not specify search criteria IntelliSpace PACS displays the patient information that you can access that is associated with the most recent 200 exams If additional patients match your criteria the most recent patient
163. ated with the study cannot be identified In this case when the Intellispace PACS receives the HIS RIS feed Intellispace PACS automatically resolves the exceptions to the newly received exam The study becomes an exception and must be manually reconciled to the corrected exam When the images have been deleted the Resolve Exception option is not available when you right click on the exception See section 7 12 Deleting Exams on page 117 for more information about deleting exams Mismatch scenarios are categorized as one of the following e Duplicate UID DUP UID See Resolving Duplicate UIDs see page 323 e ACC Not Entered The exam does not have an Accession e MRN Not Entered The exam does not have an MRN Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exceptions 10 CREF4 09 291 v4 0 07 2014 Accession Not Found The Accession associated with a study is not in the IntelliSpace PACS database See Resolving Accession Not Found Exceptions see page 183 MRN Not Found The MRN associated with a study is not in the IntelliSpace PACS database See Resolving MRN Not Found Exceptions see page 184 Accession and MRN Mismatch Both the Accession and MRN associated with a study are in the database but they belong to different exams See Resolving
164. attributes This is not a permanent change to the exam but rather a type of display To preserve the split for later viewing you must save a Presentation State See Using Presentation States see page 216 Viewing Shutter Images IntelliSpace PACS supports DICOM circular and rectangular shutters If modalities send values in DICOM tags 0018 1610 0018 1612 for circular shutters and DICOM tags 0018 1602 0018 1604 0018 1606 0018 1608 for rectangular shutters IntelliSpace PACS displays a shuttering effect on images that tone down the background of an image so users can focus on a specific region To turn the shuttering effect off hold down the Ctrl Shift F6 keys Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 Figure 12 15 Rectangular shutter effect CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 257 12 Viewing and Manipulating Images 258 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc 13 A warnine CREF4 09 291 v4 0 07 2014 Measuring and Annotating Images IntelliSpace PACS includes the following tools you can use to measure and annotate images e Measurement palette See Using the Measurement Palette see page
165. ave the information and close the dialog box If the MRN is already in use a message displays when you click Save prompting you to change the MRN and try again Deleting Patient Records If you have the proper privileges you can delete patient records You must enter a reason for the deletion which is included in the audit log You can either select a pre defined reason created in the Reason Dictionary or enter a free text reason Note the following about deleted patient records e All studies associated with the deleted patient record become exceptions e The MRN patient identifier of a deleted patient can be reclaimed and assigned to another patient e When you delete a patient who has been linked to another patient the link is removed and the linked patient s record is not changed or deleted e You cannot undo deleting a patient record Intellispace PACS Enterprise 4 4 User Guide 85 Finding and Managing Patient Information A warnine 6 17 The Delete Patient option has been identified as a hazard area in IntelliSspace PACS that could result in no diagnosis or a delayed diagnosis Philips strongly recommends that you take the following precautions when deleting patient records Regularly backup your system only data that has been saved to a backup medium can be restored to your database if you need to restore a patient record that was deleted in error to your database you will need a backup medium from wh
166. ay Cine Loop for multi sliced series Allows you to scroll through the slices in a series either one by one Cine mode or rapidly Fast Cine For a frame by frame review slowly scroll the mouse wheel For rapid review double click the mouse wheel and drag the mouse forward or backward For Coarse Fast Cine mode in Standard mouse mode click the middle mouse button while dragging the mouse up or down past the point in which you placed your cursor In Enhanced mouse mode left click while dragging the mouse down past the point in which you placed your cursor New Link See Linking Image Series see page 224 Link All Axials Sagittals Coronals Obliques for multi sliced series Linking Image Series see page 224 Join Link if link type exists Joins series to the existing link Leave Link if series is linked Removes the series from the link Link Selected Images Links selected windows that are of the same type Unlink All See Unlinking Images see page 226 Activate Deactivate Link See Activating and Deactivating Links see page 226 Save Saves the image Awe RNING Use caution when saving an image to the clipboard and copying it to another application The image may contain confidential patient information Paper See Printing to Paper see page 302 Flip Rotate Sort Split See Flipping an Image see page 255 Delete See Deleting Studies and Images see page 329 Assign New Unique S
167. ayed Searching for Exams or Exceptions by Date You can specify a supplied date time names to search for exams or exceptions or specify a custom date range using a calendar control When you enter an MRN or Accession the date range you specify is not used in the search Display a filter that displays exams exceptions or exams and exceptions In the Date Time column select a time or date range Click Search or press Enter Patients with exceptions who match the name search criteria are displayed The Today item in Exam Date Time Exception Date Time or Filter Date filters on all items that are available for today starting from 00 00 a m until 23 59 p m Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Filtering Worklists 9 CREF4 09 291 v4 0 07 2014 9 6 3 9 6 4 Searching for Exams or Exceptions Using a Custom Date Range Display a filter that displays exams exceptions or exams and exceptions In the Date Time column select Custom A Start Date and End Date window displays a range of Today s date for both start date and end date If a Custom date is set to more than 7 days the filter is not auto refreshed every one minute Also if All is selected as the date for the when the worklist is created the filter is not auto refreshed every one minute Enter the desired start and end dates or click the arrow fo
168. ayed from an Exam Lookup or in a filter You access these features by right clicking over a patient name in the Exam Lookup and selecting an option from the menu A separate set of actions is available when you right click on a patient instead of an exam See Patient Management Overview see page 82 for more information e View Exam Notes See Viewing Exam Notes see page 133 e Export via DICOM See iExport for DICOM Export see page 303 e Cache Exam See Local Exam Caching see page 123 e Create Exam See Creating Exams see page 99 e Edit Exam See Editing Exams see page 110 Begin See Beginning Exams see page 115 e Complete Exam See Completing Exams see page 116 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exam Information 7 CREF4 09 291 v4 0 07 2014 7 7 e Cancel Exam See Canceling Exams see page 116 Delete Exam See Deleting Exams see page 117 e Linking Exams See Linking Exams see page 119 e Unlinking Exams See Unlinking Exams see page 120 e Detach Study See Detaching Studies see page 121 You must use the Exception Handler to resolve exceptions for exams if one of the following occurs See Using the Exceptions Handler see page 180 e An exam has been created automatically by auto cr
169. ays the filter is not auto refreshed Also if AIl is selected as the date for the when the worklist is created the filter is not auto refreshed every one minute In the General Criteria tab select one of the Available Filter Criteria Body Part Modality Organization and Performing Resources and click gt to move it to the Filter On column When adding a Performing Resource in the General Criteria tab you can use a dictionary picker to select or remove criteria To do this press the button to the right of Equals or Does Not Equal This opens the Performing Resources dictionary enabling you to search for the Performing Resources you want to add or remove Enter search values in the Organization Code and Description fields then click Search You can use the Apply button to add or remove multiple Performing Resources When you are done click OK The criteria is added to the Filter Summary When adding a Body Part in the General Criteria tab you can select a pre defined body part from a drop down list in the Equals or Does Not Equal field You can also enter a free text for the body part name The name of the criteria for example Body Part also displays in the Criteria field as well as in the Filter Summary field Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Filtering Worklists 9 CREF4 09 291 v4 0 07 2014
170. ays in the yellow tab above the Shortcuts Folder List columns and the filter criteria display in the right pane Click Search to generate a query based on the filter criteria Click Export to save the query results as a CSV comma separated values file Click Save As to save as a new filter The Add Filter dialog displays where you can rename and change the criteria for the new filter Arranging Exam and Exception Columns in a Worklist Filters have supplied settings When you open a filter any changes you make to the column width sort order or displayed columns are saved If the filter is a User or Machine filter and you have privileges to manage these the worklist header column configuration which includes visible columns column order and column width is saved when you exit IntelliSpace PACS Showing or Hiding an Exam Worklist Column Right click in the exam search criteria area A menu displays showing a check mark to the left of each displayed column Column names that always display are grayed out Select the search criteria you want to show or hide Displayed icons and search criteria are checked hidden criteria are unchecked You cannot hide the fields that are grayed out Intellispace PACS Enterprise 4 4 User Guide 151 Filtering Worklists 9 4 1 2 9 5 9 5 1 1 2 3 4 5 Showing or Hiding an Exception Worklist Column Right click in the column area above the list of exceptions A menu display
171. bleshoot network speeds However if you find that images are displaying slowly or that IntelliSpace PACS is not responding quickly you can test the network on your own Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click Network Testing The right side of the Preferences dialog box displays the current network settings Set the Bandwidth Threshold to the maximum speed of your network You can also set the size of the test pack in this field Set the Latency Threshold to the maximum allowable response time for the server If you are going to run a continuous test set the Delay Between Tests between 0 and 3600 seconds You can set the Bandwidth Test Size between 1 and 20000 KB The Run Continuously check box is only for Philips use and is password protected Select the Log Result to file check box if desired The log is stored in PUBLIC Philips lt majorVersion minorVersion gt iSiteLogs Windows 7 or ALLUSERSPROFILE Application Data Philips lt majorVersion minorVersion gt iSiteLogs Windows XP Select the Log Results to server check box if desired Select the individual server s you want to test or click Select All Intellispace PACS Enterprise 4 4 User Guide 399 19 Setting Machine Preferences 400 8 9 When you have set all options click Start This runs the test you have configured and displays the results below Results displayed in red indicate that the serve
172. board Commands see page 407 Right click on an image and from the menu select Measurements then Measurement Palette The Measurement palette displays Do one of the following To use a tool once click the icon for the tool you want to use To use the tool more than once double click the icon for the tool you want to use The cursor changes to a cross hair when a measurement tool is being used Click the Close icon to close the Measurement Palette Clearing Measurements and Annotations e Right click on an image and from the menu select Delete all Measurements and Annotations Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Measuring and Annotating Images 13 CREF4 09 291 v4 0 07 2014 13 5 13 6 e To clear an individual measurement or annotation select it right click and select Delete Viewing Existing Measurements and Annotations If other users have previously made measurements or annotations on the image these existing measurements and annotations are not shown at initial image display Since measurements and annotations are saved in presentation states you can display the existing measurements or annotations by selecting existing presentation states Right click in the Exam Margin and from the menu select Presentation State and then click on one of the available presentation states Using t
173. can use a dictionary picker to select or remove criteria To do this press the button to the right of Equals or Does Not Equal This opens the specified dictionary enabling you to search for the items you want to add or remove Enter search values in the dictionary window then click Search You can use the Apply button to add or remove multiple items When you are done click OK The criteria is added to the Filter Summary When adding an Ordering Location or Exam Code from the Exam Worklist Criteria you can use a dictionary picker to select or remove criteria To do this press the button to the right of Equals or Does Not Equal When adding a Referring Physician press the button to the right of Contains or Does Not Contain This opens the specified dictionary enabling you to search for the items you want to add or remove Enter search values in the dictionary window then click Search You can use the Apply button to add or remove multiple items When you are done click OK The criteria is added to the Filter Summary You can enter comma separated multiple values for the Exam Code Ordering Location and Subspecialty fields For the Referring Physician field use a comma between the first name and last name and a semi colon between pairs of first and last names Enter additional parameters in the Equals and Does Not Equal text fields and click Update Criteria Click Exam Worklist Columns to define the columns for the worklis
174. candidate list and click Resolve IntelliSpace PACS replaces the study s current Accession with the number you selected If you search for and select a different exam from another patient IntelliSpace PACS replaces both the Accession and the MRN in the study with those from the selected exam 10 7 2 Resolving MRN Not Found Exceptions The mismatch scenario MRN Not Found means that the MRN of a study cannot be found in the IntelliSpace PACS database To resolve this exception you must search the IntelliSpace PACS database for an exam to match this study to Usually the most likely matching exam for this exception is the one with the same Accession but with a different but correct MRN 1 Use the Exception Lookup to search for exception studies 2 Select an exception and right click From the menu select Resolve Exception The Exceptions Handler displays 3 Select an item in the candidate list and click Resolve IntelliSpace PACS replaces the study s current MRN with the number you selected If you search for and select a different exam from another patient IntelliSpace PACS replaces both the Accession and the MRN in the study with those from the selected exam 10 7 3 Resolving Accession and MRN Mismatch Exceptions The mismatch scenario Accession and MRN Mismatch means that both the Accession and MRN exist in the IntelliSpace PACS database but the exam indicated by the Accession has a different MRN attached to it
175. cations see page 283 iQuery Allows an authorized user to retrieve DICOM studies from your institution s digital archive and send them to IntelliSpace PACS See iQuery for DICOM Study Retrieval see page 314 Local Exam Cache Allows you to save patient exams on your local machine for later review This speeds up access to image data when running IntelliSpace PACS remotely Local Export Allows you to burn CDs and DVDs of clinical exams with all of their related diagnostic reports and information The resulting CD DVD can include an embedded IntelliSpace PACS Media Viewer allowing the user to examine all the clinical images and information without having to connect to the Internet or download the Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Program Layout 5 CREF4 09 291 v4 0 07 2014 IntelliSpace PACS Viewer See Using the Media Viewer see page 297 and Working with VIP Patient Exams in the Media Viewer see page 301 Locked Exams Lists which exams are opened and locked and by whom Users with the proper privileges can unlock an exam on this worklist See Viewing Locked Exams see page 120 Machine Filters Contains the IntelliSpace PACS supplied machine filters and any system filters set up by your IntelliSpace PACS System Administrator See Creating Filters see page 158 Merg
176. ch criteria is displayed with an exclamation mark icon to the left of the patient name Patients with exams are listed first Exceptions with the same name as patients are listed after the last patient name If no patients match a message displays in the Control Strip Intellispace PACS Enterprise 4 4 User Guide 79 6 Finding and Managing Patient Information Personal Folders An Pubic Folders Patient Lookup 2 Radiology Tools ty Exam Lookup 3 ACPT1 ADAMS JUUE 196666698 71511977 Gp Exceptions Lookup 3 ACPT1 AUSTIN POWERS oe aaa 2 16 2000 A Patient Lookup 3 ACPTI BADOH ROGER 211360205 12 21 194 H Installed Programs LE MR No Descriptions Acc 4198732 Date 9 15 1999 0 00 00 S spri A easing HEI CT No Descriptions Acc 4147128 Date 8 21 1999 0 00 00 Local Export E CT No Descriptions Acc 4135625 Date 8 16 1999 15 36 48 Eh Locked Exams HE MR No Descriptions Ace 4092897 Date 7 29 1999 13 28 43 Machine Fitters E CT No Descriptions Ace 4075517 Date 7 21 1999 10 07 40 SB Merge Link Candidate s HEJ MR No Descriptions Ace 4040345 Date 7 19 1999 0 00 00 S O My Fitters l MR No Descriptions Ace 3812811 Date 3 17 1999 19 22 33 My History ACPT1 BADOH ROGER 211360205 12 21 19 E Queves LB MR Detached from exam Acc 3812811 Date 6 21 2012 8 42 29 Oy Resolved Exceptions 3 RACPTI DOOGE RITA 96095155 251918 Dikin LE CR No Descriptions Acc 4236873
177. ck Method and choose 3x3 Filter or 5x5 Filter 348 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting User Preferences 17 CREF4 09 291 v4 0 07 2014 17 5 1 Click Modalities to view a read only list of modalities To set preferences for CLAHE do one of the following Set the Contextual Region Dimension to 32 64 96 or 128 Set the Number of Bins to 256 or 384 Set the Clip Limit to 1 5 2 0 2 25 2 50 2 75 or 3 0 Set the Map Level to 0 1 or 2 Click Modalities to view a read only list of modalities Click Apply to save the settings and continue setting other preferences Click OK to save your changes and close the Preferences dialog box Restoring the Image Processing Preference Settings to the System Preferences Settings If the System Administrator has changed the System preferences from their original settings the new system preference values are applied Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click Image Processing The right side of the Preferences dialog box displays a list of image processing options Click the method or degree you want to restore Click Restore Defaults A confirmation message displays Click Yes to replace your Image Processing preferences with the system Image Processing preferences or click No to keep your preferences R
178. click to display a menu with actions Rearrange and select certain search criteria columns to hide or display 174 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exceptions 10 CREF4 09 291 v4 0 07 2014 10 2 3 10 3 Shift click to select contiguous exceptions or Ctrl click to select multiple non contiguous exceptions Searching for Exceptions Using a Custom Date Range If it is not already displayed select Exception Lookup from the Folder List or the Shortcut Bar if you have created a shortcut for this feature In the Date Time column select Custom A Start Date and End Date window displays a range of Today s date for both start date and end date If a Custom date is set to more than 7 days the filter is not auto refreshed every one minute Enter the desired start and end dates or click the arrow for either date to enter the date using the calendar control Click OK when you have entered the desired dates Click Search or press Enter Exceptions for patients in the specified date range are displayed The upper right corner of the Exceptions Lookup also displays the total number of exceptions found You can do the following Right click to display a menu with actions Rearrange and select certain search criteria columns to hide or display Shift click to select contiguous exceptio
179. cs Inc Finding and Managing Patient Information 6 CREF4 09 291 v4 0 07 2014 e Manually IntelliSpace PACS provides the option to populate the Merge Link Candidates List upon receipt of an HL7 merge message such as HL7 ADT A40 IntelliSpace PACS does require manual confirmation to merge patients when this option is used Multiple MRN ACC Issuer without MPI When a patient is created without a Master Patient Index MPI IntelliSpace PACS attempts to associate the new patient with existing patients in other Organizations This is most commonly used at sites where multiple MRN issuers are present but MPI is not implemented IntelliSpace PACS uses the following matching criteria also known as a Weighted Match to associate a new patient with an existing one e 50 points are given for an exact match on PatientId This is mainly there to handle auto create organizations with the same issuer as a RIS organization e 25 points are given for the following attributes mrnNumeric patient last name patient first name middle name patient birthdate patient ssn e Ifthe patient birthdate gt 150 years no points are given for the patient birthdate e Ifthe ssn is empty or is equal to 000 00 0000 111 11 1111 or 123 45 6789 no points are given for the ssn Ifthere are more than two matches in any organization no matches are placed on the Merge Link Candidates list for any organization This is to handle very common
180. cscsccccscsccscscssseceees 127 8 1 Using BxcannisIN Ota sia isk cus vk wen ves woes eanan 128 8 1 1 Creating Exam Notes sss ccuscevs sonbetelecclvcdlevidesdlevdberteaydees 132 8 1 2 Viewing Exam INGLES reiii A E E aes 133 8 1 3 Printing Bam TN ONES itis Ssh dati a A sesteeeloets 134 8 1 4 Deleting Exam IN OLE Sie scatinntieatsveRiusanssewuvasastouvaasauesvias 135 8 2 Viewing Clinical Info ssssessssesssssssssessseseererersrsrersrsrsrsrnrsrsrsrnrss 135 8 3 Viewing Related Exams s sssssssssssssesssersrseeerererersrsrersesrsrsrnrsrnres 137 8 4 Viewing All Exams acnnnesonononcniniticiiiiiiiit iiias 139 8 5 Viewing Current Providers s sssssesesssesseseeeeereeersrseserrsrsrsrsrsrsrsres 140 8 6 Displaying and Printing the Audit Trail wnt eee 142 8 7 Displaying and Printing the Current Report wo cece 145 8 8 Displaying Earlier Reports cstv vinivscacsnveesudnn venuveye vente don bens 146 Filtering Work lists ccccccccscsccscscsscccsscsccscsceccscscsssecesesseeeeees 149 Dele Selecting a Filter sornes adel aa cavasvecestvarand vas rence setandbyeitssdieh 151 9 2 Arranging Exam and Exception Columns in a Worklist 151 9 3 Showing or Hiding an Exam Worklist Column oo 151 9 4 Showing or Hiding an Exception Worklist Column 0 0 152 9 5 Rearranging Worklist Columns 4 jiesiusiitenoieesonsavevsonabornauns vevaat ones 152 9 5 1 Rearranging a Filter s Columns 152 9 6 Searching in Exam and Exception Worklists 0
181. d intoa Single Study so cdiasiracnrccvawes ives cess worl aiiai 326 16 4 Searching for Study Instance UIDs isi vsaisescaterareannanatas 328 16 5 Deleting Studies and Images ssssssssssesesisisrsressrsrsrsrsrerersrererere 329 16 5 1 Recovering Deleted Images 331 16 5 2 Questions and Answers on Deleting Images ssns 331 16 6 Using Statistics and Running Reports in IntelliSpace PACS Enterprise 332 16 6 1 Selecting Columns for Statistics Grid View woes 334 Setting User Preferences ccsccscsccscsccscscescecccscsccsssesccseees 337 17 1 Setting General Preferences iiss icciendsnnsioadsesssedcliesdeeseesdecsvuvatves 338 172 Setting Mouse Preferentes oeaiei aiia raticnsnetiey 340 17 3 Setting Window Width Center User Preferences 00 344 17 3 1 Adding a Window Width Center Setting cccccccccccccee 344 17 3 2 Editing a Window Width Center Preference 345 17 3 3 Deleting a Window Width Center Preference 0000004 345 17 4 Setting Keyboard Shortcut Preferences ccicisicssuvpsavvusvsunctvovivens 346 17 5 Setting Image Processing Pretercincescy 5csscecstiussinestestatisndcncdenead 346 CREF4 09 291 v4 0 07 2014 Philips Healthcares Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 18 17 5 1 Restoring the Image Processing Preference Settings to the System Preferences Settings 349 17 6 Setting Display Preferences iui sisssSeiusoselets tats totadarosasanitundeasnen
182. d monthly by your System Administrator for proper operation Intellispace PACS Enterprise 4 4 User Guide 17 Introduction 1 7 1 8 e You should be able to operate the mouse on a smooth surface without any obstructions Contraindications None known When Not to Use IntelliSpace PACS Enterprise IntelliSpace PACS Enterprise should not be used to render a primary diagnosis Do not use this product if e You know that the computer system you are using is clearly malfunctioning e Your System Administrator tells you not to e An error or warning message displays on the computer system e You are aware of any system problems or malfunctions Always notify your System Administrator of any potential system problems or availability issues as soon as possible About This Publication This publication is part of the IntelliSpace PACS Instructions for Use which also includes the following other publications IntelliSpace PACS Radiology User Guide IntelliSpace PACS AdminTool User Guide This Instructions for Use is intended for clinical and administrative users of IntelliSpace PACS Anybody in a health care organization who intends to use this product should read this manual carefully We also recommend that you receive basic product use training from your System Administrator or from a Philips IntelliSpace PACS applications specialist Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philip
183. d or saved An AS LAST SEEN GSPS denotes that it came from a dedicated Volume Vision workstation IntelliSpace PACS Administrators with administrative privileges can delete GSPSs to prevent users from viewing them in IntelliSpace PACS However this is treated like the Delete function in which images can be recovered e GSPS may contain clinically relevant data such as measurements which may display incorrectly or not at all This could cause a misdiagnosis or a delay in treatment e If an error is discovered within the GSPS a warning icon displays that indicates all GSPS content may not be displayed e When multiple third party GSPS are received IntelliSpace PACS displays the most recent one first because no priority information is available This may mean that other Presentation States are not displayed by default so the chronology may be affected possibly leading to misdiagnosis The following table lists the modules supported for display of GSPS objects When IntelliSpace PACS receives GSPS from a non IntelliSpace PACS source these are the supported modules Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 Module Presentation State Identification Presentation State Relationship Presentation State Shutter Presentation State Mask Mask Display Shutt
184. d the desired dates Click Search Exams for patients in the specified date range are displayed Showing or Hiding Exam Lookup Columns You can show or hide any exam search criteria columns except the ones that are grayed out in the list Right click in the column area Select the columns you want to show or hide Shown columns are checked hidden columns are unchecked Repeat steps 1 and 2 as required Intellispace PACS Enterprise 4 4 User Guide 107 Finding and Managing Exam Information 7 4 7 5 7 6 Rearranging Exam Lookup Columns You can click and drag Exam Lookup columns to rearrange their order This allows you to customize the order in which exam information is displayed e Press and drag a column to the position you want and release the mouse button Your changes are saved for your next session after you log out Sorting Results After an exam lookup the list is automatically sorted by exam date time in ascending order e Click the blue column heading that you want to sort by An arrow appears in the column heading to display whether the order is ascending A Z or 1 9 or descending order Z A or 9 1 To reverse the order click the same column heading again Exam Management Overview In IntelliSpace PACS a single requested procedure is an exam Each exam has a unique identifier called an Accession maximum length of 20 characters in an organization You can do the following for exams displ
185. dality and export the overlays as an xml file to be used as a template You can then import and customize the overlays for different modality types Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 CREF4 09 291 v4 0 07 2014 Note the following e Magnetic Resonance Imaging modalities supply a number of overlays which are useful for physicians to have in gaining better tissue characterization IntelliSpace PACS displays these MR overlays in conformance with traditional format that clinicians are used to IntelliSpace PACS enhances support for MR specific tags as follows Scan Options 0018 0022 and Scanning Sequence 0018 0020 IntelliSpace PACS displays multi values separated by a Magnetic Field Strength 0018 0087 IntelliSpace PACS displays MR Magnet value in Tesla Slice Gap as a Calculated Screen Overlay The Slice Gap is calculated by the difference between the slice thickness 0018 0050 and the slice spacing 0018 0088 Note that this also applies to CT e IntelliSpace PACS displays the value for the 0019 1015 tag on the overlays via the CR Dose overlay This means that if you select this overlay for an image IntelliSpace PACS checks to make sure that it is an AGFA CR If it is the value received from the private tag 0019 1015 is displayed The following pre defined scree
186. dd more images select those images right click and choose one of the following e Join Link e Join Mirror Link 3 To select multiple images or series from different exams press the Shift key while selecting images or series Right click and select Link Selected Images from the menu 4 If more than one series in the same exam has the same orientation and the same reference you can link them all simultaneously by selecting the Link All Axial Link All Sagittal Link All Coronal or Link All Oblique depending on the orientation Note that an image can only be joined to a link of its type Single Image Axial Sagittal Coronal or Oblique 12 3 2 Unlinking Images Do one of the following e To unlink a single image right click the linked image and select Leave Link from the menu e To unlink all linked images right click the linked image and select Unlink All from the menu 12 3 3 Activating and Deactivating Links e Do one of the following Right click the image you created the first link for and select Deactivate All Links from the menu This deactivates but does not remove the link Right click the image that has a deactivated link and select Activate All Links from the menu 226 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 12 3 4 12 3
187. detection marker Canvas Page The window in which patient exams are displayed Exams are displayed in Exam Racks that run horizontally or vertically across the Canvas Page See Introduction to the Canvas Page see page 195 cc View position cranial caudal CD Manager See Media Viewer CLAHE Contrast Limited Adaptive Histogram Equalization A digital image process that visually enhances details on the image Control Strip The top portion of the IntelliSpace PACS screen that displays the user name currently active tools and icons for the Preferences dialog box online help and logging off See Control Strip see page 49 Diagnosis The determination of the nature of a disease Or a dedicated viewing workflow for this purpose Intellispace PACS Enterprise 4 4 User Guide 421 22 Glossary 422 DICOM Digital Imaging and Communication in Medicine sometimes referred to as DICOM standard or NEMA PS3 Provides a detailed specification that describes formatting and exchanging images and associated information Dictionary A collection of related items stored in the database that have unique codes for example Body Part Modality Type and so on Dictionaries are configured and maintained in the IntelliSpace PACS AdminTool Discussion Filter A filter that selects all exams where there has been a difference of opinion between the first and second readers This filter creates a to do list for th
188. ding modality applies a pixel padding value to discriminate non anatomic regions of the image e The pixel padding value is far outside the dynamic range of the anatomic data representation e The image data is offset from zero by several thousand gray scale levels e The image is viewed in IntelliSpace PACS at a zoom of 50 or less Intellispace PACS Enterprise 4 4 User Guide 253 12 Viewing and Manipulating Images 254 12 12 12 13 After receipt of such images in IntelliSpace PACS when the iSyntax technology is applied the wavelet representation of the discontinuity created by the applied pixel padding value can result in the presentation of the white outline when the image is viewed at a zoom value of 50 or less This does not occur when the image is viewed at a zoom value of greater than 50 This type of discontinuity can never occur in anatomy The outline is caused by artificial pixel padding values and appears outside of the breast tissue alongside the outer edge of the breast The image quality is not affected by this problem While the outline is displayed at a zoom of 50 or less there is no corruption of the image or image information When the images are viewed diagnostically at a magnification close to one 100 zoom the outline is not present Panning Around an Image You can use the Step Zoom tool to step sequentially through portions of the image at full resolution instead of having to pan manually See
189. dministrator 3 17 PM Note Delete by ISITEWAdministrator E In the Audit Trail dialog the Accession number is displayed in the title bar Below that is the Patient Name MRN DOB Accession Exam Date and Exam Code Open the Clinical Information Exam Notes dialog In the bottom left corner of the dialog click Audit Trail The Audit Trail for the specific Accession displays Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing Clinical Information 8 8 7 CREF4 09 291 v4 0 07 2014 Review the information displayed Click Print to print the list of events In the Print dialog select a Printer and any options you prefer and then click Print When you are done click Close to close the Audit Trail dialog Click Close again to close the Clinical Information Exam Notes dialog Displaying and Printing the Current Report If a report exists the Diagnostic Report pane of the Clinical Information dialog box displays information in two tabs Current and History e The Current tab displays the exam information patient information tae de providers and report of the Radiologist s impressions for the exam You can print this report or view it on screen When you print the report all information is printed even if some of the categories are not expanded on screen e The History tab allows you to see the
190. e IntelliSpace PACS server use the Capture tool in Volume Vision e To save the work you are doing on the image in Volume Vision and return to it later in the IntelliSpace PACS session from within Volume Vision select Session then Hide e To exit Volume Vision and return to IntelliSpace PACS from the Session menu select Exit e In Volume Vision in combination with IntelliSspace PACS Enterprise all modifications are available only during the current session When you exit Volume Vision and return to the IntelliSpace PACS environment all your work is lost e To store the results of your work as photos use the Capture tool in Volume Vision See the Volume Vision online help for more information e You can also use the Capture tool to save the results of MIP MPR and Volume rendering so that your work can be restored and reused during any future session of Volume Vision In addition you can save movies as originals photos or AVI files See the Volume Vision online help for more information e In Volume Vision in combination with Intellispace PACS Radiology all modifications on volume objects are stored and available in the next session of Volume Vision Intellispace PACS Enterprise 4 4 User Guide 287 14 Philips IntelliSpace Clinical Applications 288 NOTE 14 3 NOTE When you exit IntelliSpace PACS you also exit from Volume Vision Analysis Depending on your licenses and the type of images that you
191. e Pincushion Pin Balance and Trapezoid e True Size should not be used as a measurement tool since pixel pitch is often misleading on certain monitors Before making clinical decisions you must ensure that the proportions of the image are close to real size proportions Also you should use the measurement annotation and image scale tools available in IntelliSpace PACS rather than using physical rulers or other tools Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to Machine Preferences The list of available machine preferences displays See Setting Display Monitor Preferences see page 393 Click Display Monitors The right side of the Preferences dialog box displays options for the display monitor s If there is more than one monitor select the first monitor you want to configure from the list The Resolution for the selected monitor displays Each monitor has its own Pixel Pitch setting in the Screen Settings area Select the monitors Pixel Pitch from the list or enter a value in mm manually To determine the monitor pixel pitch refer to the monitor s technical specifications If the monitor s resolution in the Native Resolution is defined by the factory you should be able to use the Pixel Pitch value that is defined in the technical specifications Be aware that any change in the manufacturer defined pixel pitch will affect measurements I
192. e Body Part To select the output criteria select the appropriate check boxes and then click OK Intellispace PACS Enterprise 4 4 User Guide 335 16 Managing Studies and Images 336 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 17 Setting User Preferences You can set preferences to customize your IntelliSpace PACS environment for your individual needs and work habits There are three types of preferences e User preferences for the currently logged in user e Systems preferences that affect every user for IntelliSpace PACS System Administrators only See Setting System Preferences see page 355 e Machine preferences for settings related to the machine on which you are currently working See Setting Machine Preferences see page 391 Users can set the following preferences e General Preferences See Setting General Preferences see page 338 e Mouse Preferences See Setting Mouse Preferences see page 340 e Window Width Center See Setting Window Width Center User Preferences see page 344 e Keyboard Shortcuts See Setting Keyboard Shortcut Preferences see page 346 e Image Processing See Setting Image Processing Preferences see page 346 e Display Preferences See Setting Display Preferences see page 350 e App
193. e Edit Exam dialog are not editable Scheduled Date Time Description Modality and Body Part The Description Modality and Body Part fields auto populate when an Exam Code is selected Do one of the following Use the Exam Lookup to search for and display a list of exams Use the Patient Lookup to search for and display a list of patients Display the exams for a patient Select a filter that displays exams Intellispace PACS Enterprise 4 4 User Guide 111 Finding and Managing Exam Information 112 2 Right click an exam in a worklist and from the menu choose Edit Exam The Edit Exam dialog box displays with the Info pane displayed dit bam Accession 4 1 ACPT2 KDX MR ILE MONO2 4 1 Female 8 12 1958 N A Info Providers Organization History Accession Links Scheduled Date Time Performed Date Time Exam Code Description Exam Code Modifier Performing Resource Ordering Location DEFAULT Exam Priority MINIMEG3 Generate Exam Status 6 41 05 PM 11 18 2000 6 41 05 PM LJ Modality Body Part J m A ROUTINE X Taken m 3 Modify the following fields as desired in the Info pane Cancel Accession Click Generate to generate the Accession The accession number is generated based on the Prefix Current Value settings configured for the noted organization in the IntelliSpace PACS AdminTool The maximum length is 20 characters
194. e Informatics Inc Philips Healthcare Informatics Inc Viewing Clinical Information 8 CREF4 09 291 v4 0 07 2014 8 3 3 Review the information 4 Select another pane from the Clinical Information dialog box if desired or click Close Viewing Related Exams Related exams are filtered based on body part You can use the Related Exams pane of the Clinical Information dialog box to see a list of related exams for the current exam and patient in the context of a report For example if you are doing a tumor response assessment you would want to compare images between two or more exams to determine the progress of a disease or treatment Clinical Info ae001 11 59 12 MLUTO3 i DX ACTP2 Related Evans 2 8 2001 11 59 12 MLUTOI T DX ACTP2 ACPT2 MLUT Test Pattern MRN 1002407 Sex M DOB 2 8 1980 E Ordering MD N A Phone N A Pager N A Accession MLUTO4 Exam Code N A Location N A Exam Notes 0 All Exams Current Providers IntelliSpace PACS Enterprise 4 4 User Guide 137 Viewing Clinical Information 138 Patients sometimes have multiple exams in a 24 hour period while their state is being monitored Therefore it is critical to be able to quickly select navigate and compare relevant reports Display the Related Exams pane of the Clinical Information dialog box in one of the following ways From the Canvas Page click the icon in the Exam Rack From the Patient Lookup Exam Lookup
195. e Label Panel dialog box Click on the desired label in the dialog box then click the location in the image where you wish the label to be placed Highlight the label that you wish to begin with and begin clicking on the image Select the Descending order check box to change the order of automatic labeling When unchecked the labeling is in ascending order Click Show All or Hide All to show or hide all labels 4 To remove an individual label select it and click Delete To remove all labels click Delete All Intellispace PACS Enterprise 4 4 User Guide 281 13 Measuring and Annotating Images 282 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 14 14 1 Philips IntelliSpace Clinical Applications Overview Philips IntelliSpace Clinical Applications is an image processing workstation software package designed to run on standard PC hardware The hardware required is made up of off the shelf standard computer components Philips IntelliSpace Clinical Applications software receives image data from medical scanning devices such as CT and MRI or from image archives Philips IntelliSpace Clinical Applications performs viewing image manipulation communication printing and quantification of images Philips IntelliSpace Clinical Applications include the following applicat
196. e Link Candidates A list of patients that are identified by the IntelliSpace PACS system as candidate pairs for patient linking and merging See Merging Patient Records from the Same Organization see page 91 My Filters While initially empty this folder can contain all of your personalized search filters You create filters in the Preferences dialog box accessed by clicking the P button on the IntelliSpace PACS Control Strip and directly from a worklist Filters can be based on combinations of modality body part exam code date patient age and other criteria See Creating Filters see page 158 My History Contains the last 100 exams you have viewed Additional exam listing information includes Exam Marked Read by Me Queues If you have the proper permissions this folder is available and contains the iQuery and Federation queues if Federation is activated See Viewing the Federation Queue see page 72 and Viewing the iQuery Queue see page 320 Statistics IntelliSpace PACS System Administrators have access to a full range of statistics and billing information from this folder Study Lookup Allows you to search for and open a study using the Study Instance UID SUID number See Searching for Study Instance UIDs see page 328 System Filters Contains the IntelliSpace PACS supplied system filters and any filters set up by your IntelliSpace PACS System Administrator See Creating Filters
197. e PACS Administrator are supplied Exam Note for general information Preliminary Note for preliminary findings Technologist Note for communicating information about the exam for the referring physician or Radiologist If desired select the Critical Note check box to alert providers of its importance Critical exam notes are marked with an icon Type the exam note You can also paste clipboard text from another application into the exam note using Ctrl V Click Save Note The exam note is saved and summary information about the exam note is displayed When a user creates an Exam Note the system audits the event and displays the event in the Exam Audit Trail When user accounts are mapped using Active Directory AD the audit event will indicate the AD username Viewing Exam Notes You select exam notes in the Clinical Information dialog box to view their content The most recent exam notes are listed first Summary information about the exam note is displayed including an icon indicating whether the Intellispace PACS Enterprise 4 4 User Guide 133 8 Viewing Clinical Information note is critical the date and time the note was written the author of the exam note the subject and the note type You can sort the notes by clicking on a column heading In both IntelliSpace PACS Enterprise and IntelliSpace PACS Radiology when the Automatically Display Exam Notes for unread exams user preference is enabled see Sett
198. e PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Measuring and Annotating Images 13 IMPORTANT CREF4 09 291 v4 0 07 2014 13 2 1 lt code gt Pixel Spacing Tag Used Additional Conditions Calibrated Intellispace PACS manual calibration Unknown 0028 0030 When tag 0028 0A02 is absent The following format is used for measurement value display for non Projection Radiography modalities lt value gt lt units gt e lt value gt is the floating point value of the measurement e lt units gt is the units of the measurement e g mm cm Tesla etc For Projection Radiography modalities only if there are measurements that were displayed from a presentation state that was created before IntelliSpace PACS 3 6 48 4 1 48 whose values are different than the current version because of a different pixel spacing value both of the measurements using the original pixel spacing and the currently selected pixel spacing are displayed The current measurement is displayed on top and the original measurement from the presentation state is displayed on the bottom Accuracy and Precision in Measurements IntelliSpace PACS relies directly on the information provided by the manufacturers of the imaging modalities in order to perform any measurements The accuracy of these measurements is determined by the values and interpretations of related fields
199. e been in the queue select AIl in the Status field and then click Search Intellispace PACS Enterprise 4 4 User Guide 321 15 Retrieving and Exporting Studies 322 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 16 16 1 16 2 Managing Studies and Images Overview The following tasks apply to managing studies and images in IntelliSpace PACS e Resolving Duplicate UIDs see page 323 e Resolving Cases Where Multiple Patients Studies are Merged into a Single Study see page 326 e Searching for Study Instance UIDs see page 328 e Deleting Studies and Images see page 329 e Using Statistics and Running Reports in IntelliSpace PACS Enterprise see page 332 Resolving Duplicate UIDs The DICOM standard prohibits assignment of a given Study UID to more than one study however duplicate UIDs can unfortunately still occur The following tools enable you to resolve problems related to duplicate UIDs e Removing the Demographics Mismatch Warning see page 324 e Manually Assigning New Unique Study Instance UIDs see page 324 e Deleting Studies and Images see page 329 Two detection levels for duplicate UIDs are supported e Level 1 Duplicate if the image s Patient ID is different from the reference image s Patient ID and
200. e current image in the collection When the Loop within series check box is selected it causes the auto play to loop back to the beginning of the series after the last image in the series has been displayed rather than moving to the next series in the collection This box is checked by default When you have finished making your selections click OK If the DICOM Source is a duplicate a message displays Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Editing a DICOM Source Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click DICOM Sources The right side of the Preferences dialog box displays a list of DICOM sources and a Properties button that allow you to edit DICOM sources Select the DICOM source you want to edit and click Properties or double click the DICOM source The Edit DICOM Source dialog box displays This dialog box has six tabs Main Window Center Series Splitting and Sorting Presentation State and Collection You must fill in the information on each tab to adequately identify and properly link DICOM sources to IntelliSpace PACS Edit the settings as desired Click OK If the DICOM Source is a duplicate a message displays Click Apply to save the settings and continue to set other preferenc
201. e exception study with the correct patient or exam 1 Use the Exception Lookup to search for exception studies 2 Select an exception that has images associated with it and right click From the menu select Resolve Exception The Exceptions Handler displays Intellispace PACS Enterprise 4 4 User Guide 181 10 Finding and Managing Exceptions 3 Review the top part of the Exceptions Handler to see the images of the exception study with the associated information Suspect fields are highlighted 4 If desired click Generate to generate the Accession The accession number is generated based on the Prefix Current Value settings configured for the noted organization in the IntelliSpace PACS AdminTool The maximum length is 20 characters 5 If desired double click an image to open an image popup window Right clicking in the popup window displays a menu with the following options Window Width Window Level See Setting the Window Width Level see page 231 Image Processing See Image Processing see page 236 Play Cine Loop Activates the cine loop Right click the image again to stop it Save Saves the image to the clipboard or a file Zoom Presets Allows you to select a preset zoom factor of Fit to Window 100 Original Size True Size 200 300 or 400 6 Review the bottom part of the Exceptions Handler to see the potential exam matches that IntelliSpace PACS suggests based on either Acces
202. e filter name is added to the Folder List for future use or modification If you add a new filter while a filter worklist is open that page will be closed and you are returned to the parent folder Specifying the Columns for an Exam Worklist From the Add Filter dialog box check Exam Worklist Intellispace PACS Enterprise 4 4 User Guide 163 Filtering Worklists 164 2 Click Exam Worklist Columns The Exam Worklist Columns dialog box displays Exam Worklist Columns Available fields E Mark Read Images Body Part Date of Birth Exam Code Final Result Laterality Locked By Ordering Location Performing Resource Priority Reader 1 Mendes ri Show these fields in this order Stat Exam Locked Has Notes Has Images Organization Patient Name MRN Exam Date Time Accession Modality Exam Description Exam Status Move Down OK Cancel 3 Optionally do the following In the Available fields column select the desired fields using Ctrl click and then click Add to define the list of columns you want for the exam worklist The names in the right column are the ones used in the worklist Note that you cannot remove the columns for MRN Exam Date Time Accession or Modality as they are required columns Select a field in the right column and click Move Up or Move Down to rearrange the displayed columns Select an optional field in the right column and then clic
203. e lists If there are images associated with the exam you can double click the item to view the images The following fields are shown under the images Images icon if the exam has images associated with it Accession MRN Patient Name Last Name First Name Middle Name Modality Exam Date Time Exam Code Organization Exam Description based on Exam Code 180 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exceptions 10 NOTE CREF4 09 291 v4 0 07 2014 A button or menu item to allow opening the Clinical Information dialog This is not visible if the user does not have the rights to view it Optional fields Body Part Subspecialty Exceptions Handler Exception Study Accession MRN Not Found Reason Unknown Organization Exception study images and data Potential exams and cE J or patients a a Emen Sa that match 4BDA20860001 004 29 000 4BD Wiw 4 23 2010 17 13 42 DEFAULT exception study Tools to create patient and or exam Create Patient And Exam Create Exam Refer to your local policy on creating new exams in IntelliSpace PACS before using the Create Patient and Exam feature If you have HIS RIS integration patients and exams created in IntelliSpace PACS will not be synchronized with your HIS RIS Make sure you associate th
204. e marked the folder as anonymous right click the exam and choose Properties from the menu The Anonymous Exam Details dialog box displays View or edit the First Name Middle Initial Last Name MRN Accession DOB Sex Exam Date Time and Comments for the anonymous exam Click OK when you are done Adding Comments to an Anonymous Exam Comments allow IntelliSpace PACS users to communicate setup non diagnostic or diagnostic information about a patient whose information has been made anonymous They can range from generic comments about an exam to preliminary findings wet reads that other clinicians can use in their decision making If you have the proper privileges you can add view and delete comments in the Comments pane of the Clinical Information dialog box accessed by clicking the icon in the Exam Margin on the Canvas Page Open an anonymous exam From the Canvas Page click the icon in the Exam Margin Click New Comment The Subject area becomes active Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Program Layout 5 CREF4 09 291 v4 0 07 2014 5 3 3 5 3 4 5 4 Wee SS Enter the subject of the comment This appears in the summary when the comment is listed in the Clinical Information dialog box Type the comment You can also paste clipboard text from another application into the exam no
205. e mouse moves and stops incrementing immediately when the mouse stops moving based on the rate sets on the sliders from slow to fast When Custom Scrolling is enabled Coarse Fast Cine is disabled See Scrolling see page 405 Standard Select if you want to use the standard mouse actions and cursor See Standard Mouse Scheme see page 401 Intellispace PACS Enterprise 4 4 User Guide 341 17 Setting User Preferences Enhanced Select if you want to use cursors whose shapes indicate their action as follows You can cycle through the cursor modes by double clicking the middle mouse button or choosing a mode from a menu You still double click the left mouse button to select images and use click drag to perform the mouse mode functions Note that Scroll mode is only available for stack images See Enhanced Mouse Scheme see page 403 Cursor Description Window Width Level Pan Zoom Scroll Acceleration Gain Bon 4 If desired select the Custom Scrolling check box and move the Response Rate slider to the desired speed to set how many images will be displayed based on the distance the mouse travels Note the following e The distance of mouse movement directly correlates to the number of images that increment in the stack after the entire image stack has been read into the IntelliSpace PACS memory e When the slider is set in the middle position the stack scrolls with a standard movement ac
206. e new Name and Value in the Tag Edit dialog box The value corresponds to the DICOM metadata field which carries the information in question For instance number always use the DICOM Tag Image Number 0020 0013 As required select the Font Weight and Relative Font Size Click OK when you are done You return to the Overlay dialog box 6 When you have finished laying out the overlay text click OK You return to the Preferences dialog box 7 Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box 18 7 2 Deleting a Screen Overlay 1 Display the Screen Overlay section of the System preferences 2 Select the overlay you want to delete and click Delete The overlay is removed from the list 376 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 CREF4 09 291 v4 0 07 2014 18 7 3 18 7 4 18 8 Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Exporting a Screen Overlay Display the Screen Overlay section of the System preferences Select the overlay you want to export and click Export The Save As dialog box displays Enter a name for the overlay and click Save The file is saved in xml format in the chosen directory and
207. e patient information associated with exams in Public Folders anonymous See Making Patient Information Anonymous see page 56 Creating a New Folder Right click the folder in which you want to add the new folder From the menu select Add New Folder A folder called New Folder is added The name field is editable Enter the desired folder name Renaming a Folder Right click on a folder and from the menu select Rename The folder s name field becomes editable Enter the desired folder name Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Program Layout 5 CREF4 09 291 v4 0 07 2014 5 2 3 5 2 4 5 2 5 5 2 6 Showing and Hiding the Folder List Do one of the following Click the arrow icon in the Shortcut Bar header or right click in the Shortcut Bar and from the menu choose Show Folder List Or right click in the Shortcut Bar and from the menu select Hide Folder List Click the X on the Folder List header Adding Exams to Folders You can organize and store links to specific exams by adding exams to folders Do one of the following Drag and drop an exam listing to a folder as you would in Windows Explorer Right click in the exam margin or on the exam in the timeline and from the menu select Add Exam to Folder The Folder dialog box displays Navigate to the folder where you wan
208. e rendering Intellispace PACS Enterprise 4 4 User Guide 285 14 Philips IntelliSpace Clinical Applications 3 Volume Vision starts 4 Use the tools available in Volume Vision Refer to the Volume Vision online help for detailed information on the available features Alternatively you can open a complete exam in Volume Vision 1 In the IntelliSpace PACS exam rack right click on the Exam Margin and select Volume Vision 2 Volume Vision starts NOTES e Volume Vision supports only the following image types CR CT CX DR DX MG MR RF US XA and SC Other image types are not supported e Scanned documents are not loaded in Volume Vision e If the system does not have enough memory to load all images Volume Vision displays a warning message that you must set a volume of interest that fits into memory See the Volume Vision online help for more information Awe RNING e If you modified the images in the IntelliSpace PACS environment these modifications will not be available in Volume Vision e In Volume Vision in combination with IntelliSpace PACS Enterprise all modifications are available only during the current session When you exit Volume Vision and return to the Intellispace PACS environment all your work is lost e To store the results of your work as photos use the Capture tool in Volume Vision See the Volume Vision online help for more information e You can also use the Capture tool to save the results
209. e third reader in a double blind read workflow Double Blind Read Workflow where two readers radiologists evaluate and rate the same clinical images The two readers work independently and do not have access to each other s evaluations This method is used to prevent individual bias during rating Duplicate Unique Identifier DUP UID The situation that occurs when the same study identifier UID is given to multiple studies of different patients IntelliSpace PACS includes tools that let you resolve problems related to duplicate UIDs See Resolving Duplicate UIDs see page 323 Edge Enhancement Image setting that improves the perceived sharpness of the image details Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Glossary 22 CREF4 09 291 v4 0 07 2014 Exam An order received from the HIS RIS that resides in the IntelliSpace PACS database Exams do no necessarily have images In IntelliSpace PACS the unique identifier for exams is Accession Exam Lookup A search tool that allows you to find exams based on a combination of search criteria See Exam Lookup Overview see page 103 Exam Rack Patient exams images or image series are displayed in Exam Racks The order of the Exam Rack is chronological and corresponds to the Patient History Exception Handler The feature you use to resolve e
210. ead locked by each other To prevent this from occurring make sure you confirm the patient identity and demographic information before beginning an exam From the Folder List click Locked Exams A list of the currently locked exams displays Enter the desired search criteria Note that you can use the Delete key to clear the date field If you only want to find locked exams that have images select the Exams with images only check box Press Enter or click Refresh A list of exams that match your search criteria is displayed Unlocking Exams Only users with the proper permissions can unlock an exam From the list of locked exams right click on the exam you want to unlock Select Unlock Exam from the menu A confirmation message displays Click OK The exam is unlocked and removed from the list of locked exams Detaching Studies Sometimes it is necessary to detach a study from a patient s exam record For example if images belonging to one patient s exam are accidentally assigned to another patient s exam you must detach those images from that exam and reassign them to the correct patient s exam Intellispace PACS Enterprise 4 4 User Guide 121 Finding and Managing Exam Information NOTE When you detach a study you create an exception that you must resolve in the Exceptions Handler When you attach a study you resolve the exception and reassign the exam to the correct patient You can also detach an individual s
211. eate only occurs in auto create organizations e An exam has been received from a 3rd party archive not by an auto create port e The patient has provided images on a CD and you use a third party tool such as eFilm to import the DICOM images Understanding Exam Statuses It is important to understand the different statuses an exam can have in IntelliSpace PACS to properly use the exam management features The status of an exam changes as it transitions through IntelliSpace PACS and other systems The following table lists the available exam statuses and indicates what the allowable exam statuses are within IntelliSpace PACS Some exam statuses displayed as blank in the table below can only be changed by messages received through the HIS RIS interface Intellispace PACS Enterprise 4 4 User Guide 109 7 Finding and Managing Exam Information Exam Status Allowed From S Scheduled S In Progress S T Taken C Completed S 1 T D Dictated and stored PIRE P Preliminary F Final A Addended R Revised X Cancelled N Non Reportable N X 7 8 Editing Exams You can use the Edit Exam dialog box to make corrections to exam information and to view a list ofall exam records linked to the current exam record See Viewing Linked Records When Editing Exams see page 115 For information on creating exams see Creating Exams see page 99 NOTE Refer to your local policy on creating new exams in
212. ect the destinations for the DICOM export AE Title 01 lt Back Cancel Queue 10 Click Next A summary of the export of the series and images is displayed DICOM port G MRN Priority Normal C Urgent C STAT Description Cancel Queue IntelliSpace PACS Enterprise 4 4 User Guide 309 15 Retrieving and Exporting Studies 310 11 Review the exam and destination information and enter the following additional information in the Notifications section if desired Enter an email address for notification of when the export is complete Separate email addresses by commas Select the appropriate Priority Normal Urgent or STAT Add a Description of the exam Click Queue to see how busy the queue is 12 Click Finish to begin the export 15 3 2 Viewing the iExport Queue If you have the proper permissions you can view the iExport Queue at any time to view the status of all exams being exported in the system Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Retrieving and Exporting Studies 15 CREF4 09 291 v4 0 07 2014 Maximum Results All v ladministr Waray es eee 102 07 0 2 7 2011 Normal ninis 3243 Manual 4D508C2 2 7 2011 Normal administr Kpacs Manual Delete 4D508C2 2 7 2011 Normal administr Kpacs Manual ET 4D50288
213. ed and resolved before its associated images are linked with data from your HIS RIS Ideally the technologist who created an exception resolves the problem immediately at the workstation If the technologist does not resolve the exception the exam is not available for interpretation Select search criteria and click Search Click Export to export a selection from the search results list Sones FokdeeUist NNN searcnly expo Exceptions Enterprise Tools eu z fa ty Exam Lookup Sioi l eer 28 2007 4 28 2011 v amp Patient Lookup fy Installed Programs R iQuery am Lookup Local Exam Cache Local Export Figure 10 1 Exceptions Lookup Intellispace PACS Enterprise 4 4 User Guide 171 10 Finding and Managing Exceptions You can use the Exceptions Lookup to quickly find exceptions based on a combination of search criteria You can search for exceptions using any combination of the following criteria The search criteria in bold below must be displayed at all times Note the following about searching for exceptions e A date range is not required Organization Body Part MRN Patient Name Accession Date of Birth Study Date Time Exception Date Time Number of Images Modality Performing Resource Reason Department Name Station Name AE Title Name Only exact matches for Accession and MRN are supported If you search by Accession or MRN the date range is ignored The
214. ed with a Demographics Mismatch Caution message on top of the image Verify the Study Description and Selected Series Image s information Review the exam to make sure it is a true DUP UID case Ifthe exam is not a true DUP UID and you have administrator privileges right click the image and select Remove Demographic Mismatch from the menu This permanently turns off the warning Intellispace PACS Enterprise 4 4 User Guide 325 16 Managing Studies and Images Ifthe exam is not a true DUP UID and you do not have administrator privileges right click the image and select Hide Demographic Mismatch Warning from the menu This hides the warning but the warning will persist for other users until the PACS Administrator resolves the DUP UID case 5 Ifitisa DUP UID case right click the image and from the menu select Assign New Unique Study UID The Assign New Study UID dialog box displays allowing you to verify the images you have selected and enter a reason for the assignment Note that this option is not available if all image windows in an exam are selected because you cannot delete all image windows in an exam 6 Enter the Reason you want to create a new Study Instance UID for example Images belong to a different patient 7 Click OK The Study Instance UID of the selected images are updated and the exam is rehung A message displays while this occurs Note that the total number of images is not updated afte
215. eferences Click OK to save your changes and close the Preferences dialog box Select the Display Timeline check box to show the Patient History Timeline when an exam is opened Select the Display Key Image Stack check box to display the Key Image Series at the beginning of each exam rack The Key Image Stack enables you to view images in a study that have been flagged as significant Key images are saved in Presentation States and can be flagged for a variety or reasons including improving referring physician access by providing a way to focus on the most pertinent images in a study teaching files consultation and image quality issues Select the Automatically Display Exam Notes for unread main exams check box to have IntelliSpace PACS automatically open the Exam Notes for the unread main exam of each Canvas Page if exam notes are available and the user has proper permissions See Using Exam Notes see page 128 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting User Preferences 17 CREF4 09 291 v4 0 07 2014 Select the Axial Oblique CT check box to automatically display axial and oblique CTs so that the anatomical right is displayed on the left regardless of the initial orientation of the image This setting is mostly applicable to CT s of the sinuses This check box might not be sdisplayed if the
216. eferred viewing orientation In Image Orientation select the Axial Oblique CT Anatomical right on left side of image window check box if you want Axial and Oblique CTs to always be displayed with the anatomical right on the left side of the image In the Clinical Info Source area specify whether information for Patient Comments or Patient History comes from DICOM or Clinical Exam Notes RIS Choose one of the following Main Exam s Comments Select DICOM or Clinical Exam Notes The Patient Comments DICOM tag is 0010 4000 Main Exam s History Select DICOM or Clinical Exam Notes The History DICOM tag is 0010 21B0 Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Setting Window Width Center System Preferences System Administrators can create edit and delete the system supplied Window Width Center preferences Individual users can also create their own Window Width Center preferences which will override the system settings See Setting Window Width Center User Preferences see page 344 Intellispace PACS Enterprise 4 4 User Guide 357 18 Setting System Preferences 358 The Window Width Center preferences allow you to configure an image for optimal viewing or to highlight certain details for better visibility For example changing the brightness or contrast of an image can allow you to more clearly view t
217. either the Patients Name or the Patients Birth Date are different e Level 2 Duplicate if the image s Patient ID is different from the reference image s Patient ID Intellispace PACS Enterprise 4 4 User Guide 323 16 Managing Studies and Images 324 A warnine 16 2 1 16 2 2 Deleting studies is permanent meaning that deleted studies cannot be recovered Deleted images can be recovered However all presentation states measurements and annotations are lost Also if an image has been deleted after receiving a new Study UID the image cannot be recovered Be aware that deleted images may contain data that would render a different diagnosis Removing the Demographics Mismatch Warning Users with administration privileges can permanently resolve the DUP UID warning message users without these privileges can hide the warning message but still view the images Open the study in the Exam Rack Right click on the image and do one of the following To permanently turn the Demographics Mismatch Caution warning off right click and select Remove Demographic Mismatch To temporarily turn the Demographics Mismatch Caution warning off right click and select Hide Demographic Mismatch Warning This only hides the warning message The study is still considered a DUP UID this option is only available if there are multiple demographics associated with the study Manually Assigning New Unique Study Instance UI
218. elliSpace Clinical Applications 14 CREF4 09 291 v4 0 07 2014 14 6 14 6 1 NOTE Philips IntelliSpace CT MR Vessel Explorer Philips IntelliSpace CT MR Vessel Explorer CT MR Vessel Explorer is a post processing application that supports e The visual inspection of vessels by simple navigation along vessel structures in CTA MRA data acquired for the optimization of vessel visualization e Manual and semi automatic measurements e The storage of measurements and visualizations into the form of a secondary capture series Starting CT MR Vessel Explorer CT MR Vessel Explorer can be started from e IntelliSpace PACS canvas e Volume Vision If you start CT MR Vessel Explorer from a volume view in Volume Vision any settings that you have applied to the MIP MPR or volume rendering will be automatically taken over in the inspection view of CT MR Vessel Explorer This allows efficient review and analysis In the IntelliSpace PACS exam rack right click the thumbnail image of the series that you want to inspect select Philips Applications and then select Vessel Explorer If the selected series are not suitable for CT MR Vessel Explorer Volume Vision opens instead of CT MR Vessel Explorer OR In the IntelliSpace PACS exam rack right click the thumbnail image of the series that you want to inspect and select Philips Applications gt Vessel Explorer CT MR Vessel Explorer starts The images are displayed accordin
219. elliSpace PACS Cache To make sure that you have the latest patient and study information delete the study in the Cache using the Server Utility Tool and then use iQuery to search the VNA archive for the latest data Note that when the Cache reaches capacity studies are automatically deleted Therefore verify that the study is present in the Cache because if the Cache is full the study may be deleted automatically Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Retrieving and Exporting Studies 15 CREF4 09 291 v4 0 07 2014 15 4 1 2 During DICOM Query of a VNA from the Timeline a message displays on the Canvas Page if retrieving data from a VNA archive takes too long or if the DICOM file is extremely large The Canvas Page displays the images after they have been retrieved The user can click Retry to load the images Submitting and Confirming the Retrieval List The number of studies your have selected and the archives in which they are stored are displayed in the top dialog box of the iQuery Confirmation dialog Click Retrieve A confirmation page displays iQuery Confirmation Archive Test MRN 103 16 000 4D81470F Images requested 1 Archive Test MRN 103 16 000 4D81470F Series requested 1 Priority Stat Standard C Scheduled Deadline February 2011 March 2011 gt Time 4 00 00 PM
220. eme see page 401 and Enhanced Mouse Scheme see page 403 Scrolling Uses the Coarse Fast Cine feature by default Users who prefer to have images controlled by precise mouse movements can set Custom Scrolling options See Scrolling see page 405 1 Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting User Preferences 17 2 Under User Preferences click Mouse The right side of the Preferences dialog box displays the mouse settings Preferences Dialog CREF4 09 291 v4 0 07 2014 User Preferences General Preferences Mouse Mouse Scheme Options Window Width Center Standard C Enhanced Keyboard Shortcuts Image Processing Display Preferences System Preferences Machine Preferences Network Testing M Custom Scrolling Cancel Apply Help 3 Set one of the following Mouse Scheme Options If you do not want to use the default Coarse Fast Cine scrolling method you can enable Custom Scrolling it is disabled by default With Custom Scrolling you can define how precise image movements are controlled by mouse movements so that images are transitioned based on the distance the mouse travels When you enable Custom Scrolling the image stack begins to move immediately when th
221. ent s exam maximum length is 20 characters Location Federation location where the original exam resides Submission date the query was submitted Priority This field can be set only when the exam is in the Submitted state Options are Normal default value Urgent Stat Intellispace PACS Enterprise 4 4 User Guide 73 Finding and Managing Patient Information NOTE 6 3 NOTE e Complete Displays how far along in the transfer process an exam is e User the person who submitted the query Job Start Time the time the job execution started for the first time Job End Time the time when the job execution completed or Failed e Error Details Gives the details of any errors The exams in the Federation queue stay in the queue until you delete them To delete one or more exams in the queue select them right click and then click Delete Requests that are in the executing state cannot be deleted For more information about Federation and the Canvas Page see Federation and the Patient History Timeline see page 199 Searching for Patients If it isn t already displayed select Patient Lookup from the Folder List or the Shortcut Bar if you have created a shortcut for this feature Enter the desired search criteria If you only want to find patients with exams that have images select the Exams with images only check box Press Enter or click Search A list of patients who match your sea
222. ented first instead of the Original DICOM If a Radiologist has created a presentation state that will be presented first instead of the Technologist s presentation state Note the following e DICOM grayscale presentation state studies are supported See DICOM Grayscale Softcopy Presentation States GSPS see page 218 216 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 12 1 1 12 1 2 e If additional images have been added to the exam since the default presentation was last saved the exam will open using the Original DICOM presentation state and a message will display alerting you that additional images have been added to the exam e Native iSyntax presentation states not in GSPS are not exported Saving a Presentation State Open and make the desired adjustments to the exam Right click the Exam Margin and from the menu select Presentation State then Save Presentation State The Save Presentation State dialog box displays Enter a name for the presentation state Select one of the following types for the presentation state Technologist Select this type if you are a Technologist who is configuring the exam to be reviewed by a Radiologist Pre read Select this type if you are a Radiologist who is performing a preliminary review of an exa
223. epeat steps 3 and 4 for each attribute to be changed for example Edge Detect IntelliSpace PACS restores the User Image Processing preferences to the System Image Processing preference values Click OK to save changes and close the Preferences dialog box Intellispace PACS Enterprise 4 4 User Guide 349 17 Setting User Preferences 17 6 350 Setting Display Preferences You can set the various preferences in the Display section of the Preferences dialog box Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click Display Preferences The right side of the Preferences dialog box displays a list of display options Set the Screen Overlay Font Size for diagnostic images to Large Medium or Small The new font size is not used until you log out of IntelliSpace PACS and log back in The value of each selection is determined by the Machine preferences font size settings See Setting Display Monitor Preferences see page 393 Set the Cine Playback Resolution for a stacked image window displayed in cine to Full Resolution 512x512 256x256 128x128 or select a Default Cine Rate values between 1 and 45 This rate is applied for studies that do not supply a Recommended Display or Cine Rate in their metadata A clip captured at a resolution of 1024 x 1024 can be played back at a resolution of 256 x 256 When you do this series play cine clip is loaded faster because there is
224. eption to paper or film Exporting to CD DVD drive via Media Viewer Attempting to do something that might be destructive to the system for example an SQL injection Changing the UID of a study Intellispace PACS Enterprise 4 4 User Guide 143 Viewing Clinical Information Receiving a query from an Recovering previously deleted Caching an exam locally known or unknown DICOM images device meaning that device is not correctly configured Deleting one or more images Acknowledging a VIP patient Reading VIP patient data from a study warning Caching an exception locally Requesting a VIP patient exam In addition the Audit Trail dialog displays the date and time the event occurred the status of the event if applicable report status if applicable the type of event and who performed the event action You can also print the Audit Trail Audit Trail Accession 4 004 Patient Name ACPT1 9 1 MRN ee DOB Epi Accession 0 Exam Date 7 19 1999 6 56 30 PM Exam Code N A EME Who Notes 1 42 PM Note Create by ISITEAdministrator 1 42 PM Note View by ISITE Administrator 1 43 PM Note Create by ISITE Administrator 1 43 PM Note View by ISITEVAdministrator 1 43 PM Note Create by ISITE Administrator 1 43 PM Note View by ISITE WAdministrator 1 45 PM Note Create by ISITEVAdministrator 1 45 PM Note View by ISITEVAdministrator 2 02 PM Note View by ISITEVAdministrator 3 17 PM Note View by ISITE A
225. er Bitmap Display Shutter Overlay Plane Overlay Activation Displayed Area Graphic Annotation Spatial Transformation Graphic Layer Modality LUT Softcopy VOI LUT Softcopy Presentation LUT SOP Common Supported Note Yes Yes partial No No No Yes partial No Yes partial Yes No Yes partial Yes Yes Yes partial Yes Only direct WW WL is supported Yes For example Invert Yes partial When IntelliSpace PACS exports GSPS to a non IntelliSpace PACS source these are the supported modules Intellispace PACS Enterprise 4 4 User Guide 219 12 Viewing and Manipulating Images Module Supported Presentation State Identification Yes Presentation State Relationship Yes partial Presentation State Shutter Yes Presentation State Mask No Mask No Display Shutter No Bitmap Display Shutter No Overlay Plane Yes partial Overlay Activation Yes Displayed Area Yes partial Graphic Annotation Yes partial Spatial Transformation Yes Graphic Layer Yes Modality LUT Yes partial Softcopy VOI LUT Yes partial Softcopy Presentation LUT Yes partial SOP Common Yes partial When a GSPS is available for a study the GSPS label is added to the Presentation State menu Note the following e The GSPS automatically loads only when there is no Radiologist Dictation or Technologist presentation state These presentation states take precedence over GSPS If IntelliSpace PACS cannot support a
226. er When you select a report the bottom part of the window displays information about the report Select another pane from the Clinical Information dialog box if desired or click Close Intellispace PACS Enterprise 4 4 User Guide 147 Viewing Clinical Information 148 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 NOTE Filtering Worklists A filter is a named set of search criteria The key to driving enterprise productivity is to provide easy and consistent search and filter functionality to all users of IntelliSpace PACS so they do not waste time building or editing worklists IntelliSpace PACS provides extensive search and filter capabilities and includes some filters you can use to quickly find the exam and or exception information you are interested in Three types of filters are available from the Folder List for selecting saving and modifying filters By default up to 200 exams and or exceptions display in the worklist If additional exams or exceptions match your criteria a message displays to alert you to add more search criteria You or your System Administrator can create additional filters based on criteria that you intend to use repeatedly The maximum number of filters is 250 per type of filter which means that a total of 750 filters can be created e User Filters You can
227. er a patient or an exam in a list and from the menu choose Create Exam The Create Exam dialog box displays with the Exam Info pane displayed Fill in the following fields as desired in the Exam Info pane Enter the Organization Enter the Accession required maximum length is 20 characters Click Generate to generate the Accession The accession number is generated based on the Prefix Current Value settings configured for the noted organization in the IntelliSpace PACS AdminTool The maximum length is 20 characters From the Exam Priority list select the priority of the exam From the Exam Status list select the status of the exam Enter the Scheduled Date Time Click the arrow next to the date to select a date from a calendar control Enter the time or click the arrows to set the time You can review the Performed Date Time but cannot change it Enter the Exam Code or click the button to search for and select an exam code from the Exam Code Dictionary required Enter the Modality Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6 CREF4 09 291 v4 0 07 2014 6 22 1 Enter a Description of the exam Enter the Body Part for the exam Enter the Exam Code Modifier or click the button to search for and select one from the Exam Code Modifier Dictionary
228. er to resolve the exception See Using the Exceptions Handler see page 180 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exam Information 7 CREF4 09 291 v4 0 07 2014 7 17 Local Exam Caching The Local Exam Cache feature allows you to download patient exams to your local machines This helps speed up access to patient exams when IntelliSpace PACS is being used remotely The exam is downloaded to the location specified in the Local Exam Caching pane of the Preferences dialog box See Setting Local Exam Caching Preferences see page 396 Cached exams are displayed in the Local Exam Cache folder In addition the individual listings display progress information as the exam is cached The exam listings in the Local Exam Cache provide information about the patient and exam that has been cached The columns include from left to right e Close All exam level listings e Status e Subject Patient name Modality Body Part e Received Date and Time e Sender You can sort the list by clicking these columns The Status icon in the exam listing indicates whether the exam was successfully cached Certain patients such as politicians entertainers and hospital employees may be designated as VIPs Very Important Persons in IntelliSpace PACS Accessing these patient records and performing
229. eral user preferences See Setting General Preferences see page 338 and Enhanced Mouse Scheme see page 403 Window Width Level WW WL See Setting the Window Width Level see page 231 Measurements See Using the Measurement Palette see page 263 Annotations See Annotating Images see page 277 Delete All Measurements and Annotations if there are annotations See Clearing Measurements and Annotations see page 264 Image Processing See Image Processing see page 236 Scout Line Mode for CT MR and PT See Using the Scout Tool see page 244 Localizer Mode for CT MR and PT See Using the Localizer Tool see page 245 Multi Image Mode for stack images Allows you to split a series window so that multiple slices can be displayed in a single image window Key Image See Using Key Images see page 221 Play Cine Loop for multi sliced series Allows you to scroll through the slices in a series either one by one Cine mode or rapidly Fast Cine For a frame by frame review slowly scroll the mouse wheel For rapid review double click the mouse wheel and drag the mouse forward or backward For Coarse Fast Cine mode in Standard mouse mode click the middle mouse button while dragging the mouse up or down past the point in which you placed your cursor In Enhanced mouse mode left click while dragging the mouse down past the point in which you placed your cursor
230. erence group you have selected Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 18 Setting System Preferences System Administrators can set preferences to customize IntelliSpace PACS for individual needs and work habits There are two types of preferences System Administrators can set Systems preferences that affect every user Machine preferences for settings related to the machine on which you are currently working See Setting Machine Preferences see page 391 System Administrators can set the following System preferences General Preferences See Setting General Preferences see page 356 Window Width Center See Setting Window Width Center System Preferences see page 357 Image Processing See Setting Image Processing Preferences see page 359 Annotations See Setting Annotation Preferences see page 362 DICOM Sources See Setting DICOM Sources Preferences see page 364 Screen Overlays See Setting Screen Overlay Preferences see page 372 Paper Printing See Setting Paper Printing Preferences see page 377 iExport See Setting iExport Preferences see page 380 iQuery See Setting iQuery Preferences see page 382 Plug Ins See Setting Plug In Preferences see page 384 Patient Columns Setting Patient Colu
231. erences to configure defaults for Window Center Series Splitting Presentation State Collection and Series and Image Sorting based on a specific modality or modality type You can also stack images coming from RF US or XA DICOM sources must have unique values Ifa DICOM source has the same number of selected identifiers and the same exam values within the identifiers an error is displayed stating that the DICOM source already exists The DICOM Sources feature is only applied for single frame modality images not for multi frame modality images You can set up DICOM sources for a specific DICOM source or a generic DICOM source for each modality s images NOTE IntelliSpace PACS does not process studies larger than 3 4 GB in raw DICOM data DICOM Source sorts series and images within a study rack as follows e First the stacked series are sorted by the image sorting criteria defined in the DICOM Source or by Image Number This defines which image is at the top of each stacked series e To sort the series across the rack IntelliSpace PACS sorts by the series sort criteria defined in the DICOM Source If that is identical such as all series having the same series number then IntelliSpace PACS sorts the series by descending series date time this is a hard coded secondary sort criteria If the series also shares identical series date time as in digitally scanned films or time delay fluoroscopy images which often have the same value
232. erersersrerrnee 217 12 1 2 Selecting a Presentation State 217 12 1 3 DICOM Grayscale Soficopy Presentation States GSPS 218 12 2 Using Key limapi nanenane aiaa ten wal a aia ii 221 I22 4 Keep Image Series iot aiii ravi EAA 222 12 2 2 Using the Key Image Popup Window wceccccccceseiee 222 12 3 Linking Image Series ssctstidustestalenideside Sotacincaspnetcnstitenautateabenitiads 224 T23L Creatine Lank Gnidia a 225 12 3 2 Unlinking Images oossoo 226 12 3 3 Activating and Deactivating LInRS cece 226 12 34 Link Syn Dols sisevess Misesasniusss sige vavivestveoucensverivesusacivevsved 227 12 3 5 Aligning Linked Series iticattcc tine Gaestacaeneteu de vaeteve ted 227 12 3 6 Creating Mirror LIke wiecsecissiseciisiieeitisieceasiion 227 12 3 7 Linking Warnings sssssssesessesssesiesirsrrririeririrrrrererrererenrss 228 12 3 8 Linked Exams Use Case CT Chest Abdomen Pelvis 231 12 4 Setting the Window Width Level ssssssssseesesesssseesssrssssrssrsesrss 231 12 4 1 Using the Default WWIWL onoososeeseeeseeeeeeeeerrenen 233 12 4 2 Using the Modality Default WW WL Values cccccce 233 12 4 3 Using the Histogram WW WL Calculation u cccccecee 233 12 5 Value of Interest LUT VOI LUT wo ce ee ceceeesceeeenees 234 12 6 Image Processing ca saiasenn lanes daniel andgihaatedatadasoen saves i 236 12 6 1 Tnverting an Ta GO roves sas sdeosieaibes Ges isbesienGndiiinescsebiensasts 239 Intellispace PACS Enterprise 4 4 User Guide 9 10 12 6
233. es 84 6 16 Deleting Patient Records cir aicactystinsedent siete tere ne vedaussiosesisrsys 85 6 17 Resolving Merged or Linked Patient Records oo 86 6 18 Using the Merge Link Candidates List to Merge or Link Patients 88 6 19 Merging Patient Records from the Same Organization 0 91 6 20 Merging Linked Patients from Different Organizations 92 6 20 1 Using the Merge Link Candidate List to Merge Patients 94 6 20 2 Using Patient Lookup to Find Patients to Merge 95 6 20 3 Merge Patient Examples asessorin 96 6 21 Linking Patient Records from Different Organizations 0 97 6 22 Creating Exams issis iyini iiaia A AAEE EEEE N 99 6 22 1 Entering Provider Information When Creating Exams 101 Intellispace PACS Enterprise 4 4 User Guide 5 6 22 2 Entering Exam History Information When Creating Exams abausit niyta a anu unn SEA monte tin eiat 102 7 Finding and Managing Exam Information ssssesessssseecesesesesceseeee 103 7 1 Exam Lookup Overview ccieccndivhdiesiadsscceansheiterieiedti citeeincceees 103 Tide SCARCE HOG ES ALIAS oo oira i AAA TE tr aiean ates 105 Azad Searching for Exams by Patient Name 106 fae Searching for Exams by Date sesser 106 7 2 3 Searching for Exams by a Custom Date Range sse 107 7 3 Showing or Hiding Exam Lookup Columns cece 107 7 4 Reattanging Exam Lookup Columns nciadeisieconassisaiies 108 7 50 Sorting Results savin ccscsy stsns vasva
234. es Click OK to save your changes and close the Preferences dialog box Intellispace PACS Enterprise 4 4 User Guide 371 18 Setting System Preferences 372 18 6 2 1 2 3 4 5 18 7 Deleting a DICOM Source Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click DICOM Sources The right side of the Preferences dialog box displays a list of DICOM sources and buttons that allow you to add edit or delete DICOM sources Select the DICOM source you want to delete and click Delete The DICOM source is removed from the list Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Setting Screen Overlay Preferences System Administrators can configure and modify preferences for overlays for various modalities and specify where various patient and exam information will display in the four corners of each image series frame You can add a total of 50 overlays to images meaning approximately 12 overlay items per corner Each overlay must have a unique name You can also do the following when configuring screen overlays e Create custom DICOM tags for screen overlay text or modify existing DICOM tag names and values e Set the screen font for overlay text s e Set up a basic design for screen overlays for a mo
235. es showing the limits of the series being reviewed Select All to show a single scout line as well as a line for every slice in the series being reviewed Set the Localizer Mode to No Scout Lines or Show Scout Lines This setting determines whether or not scout lines are displayed when the Localizer tool is active and you click on an image Set the following options for the Magnifying Glass See Using the Magnifying Glass Tool see page 249 The desired Zoom factor between 150 and 1600 The percentage of the hosting window that you want to magnify 5 to 80 Click Apply to save the settings and continue setting other preferences Click OK when you are done Setting Applications Configuration Rules You can add and delete rules in the Preferences dialog in IntelliSpace PACS only if Volume Vision is installed To open this dialog do the following Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip The Preferences dialog displays Click the sign next to User Preferences in the Preferences dialog Intellispace PACS Enterprise 4 4 User Guide 351 17 Setting User Preferences 3 Select Configuration for Applications The Configuration for Applications panel displays in the right pane of the Preferences dialog Preferences Dialog User Preferences Configuration for applications General Preferences Window Width Center Keyboard Shortcut
236. esesercrceseseeoeeee 297 15 1 Using the Media Viewer ssssssssssssssssssessessrereerersrersrsrsrsrsrnrnrsrss 297 15 1 1 Exporting Exams to CD or Other Media wicecccccccecee 298 15 1 2 Working with Anonymized Exams in the Media Viewer 301 15 1 3 Working with VIP Patient Exams in the Media Viewer 301 Intellispace PACS Enterprise 4 4 User Guide 11 12 16 17 Intellispace PACS Enterprise 4 4 User Guide IRA Usine the OO DVID MM MT eNO EMOTE ae TOTS 302 T32 Printing to Papen sccicugana Weep derna der natin AiE R iiie 302 15 3 abxport for DICOM Export 2 21 520280219005 1 26 45 1 Leacctenceetecn tea tedenact 303 15 3 1 Exporting Anonymous Panis 2 laciducucccssstis eae tcipeipeceiaes 307 15 3 2 Viewing the iExport Quete 310 15 3 3 Viewing iExport Progress Information osses 313 15 3 4 Canceling Active iExport Jobs sss 313 15 4 iQuery for DICOM Study Retrieval ssssssssssesesssesesessrseseressrseses 314 15 4 1 Submitting and Confirming the Retrieval List 004 319 15 42 Viewing the iQuery Queue ossis 320 Managing Studies and Images scsccscsssscscssccccssscsccscscscceees 323 LOL MVS ACWE aitas aa ated edd toda tesa E EEESTIS 323 16 2 Resolving Duplicate UIDs s cississcissssissosssa svindadslensnsnascundenesesudeesy 323 16 2 1 Removing the Demographics Mismatch Warning 324 16 2 2 Manually Assigning New Unique Study Instance UIDs 324 16 3 Resolving Cases Where Multiple Patients Studies are Merge
237. esults you expect from the search string you enter For example if the Last Name stored in the database is Smith M D you cannot find this physician by entering Smith M D as the search string in your filter if you do IntelliSpace PACS searches for a physician whose Last Name is Smith and whose First Name is M D because IntelliSpace PACS interprets the comma in the search string as a delimiter between those two values Intellispace PACS Enterprise 4 4 User Guide 169 Filtering Worklists 170 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 10 10 1 Finding and Managing Exceptions Exceptions Lookup Overview You use the Exceptions Lookup to find and manage exceptions Exceptions occur when there is a mismatch between the gold copy in the IntelliSpace PACS database and the modality metadata information sent by the modality sometimes called a digital flashcard for example when e An MRN medical record number does not exist in IntelliSpace PACS e An ACC accession number does not exist in IntelliSpace PACS The MRN and Accession pair is invalid When these situations occur a provider cannot know with certainty the patient to whom the images belong Because there is no way to automatically determine the correct patient each exception must be review
238. etacinanauannens 197 11 2 1 Federation and the Patient History Timeline 00000 4 199 11 3 Accessing Exams that are not on the IntelliSpace PACS Server 203 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcares Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 12 11 4 Opening or Closing an Exam sii cates il ween Ne banennaarancaans 203 11 5 Ordering of Images in the Exam Rack 2 nacimieimiaatam nies 204 11 6 Using the Exam Margin ssssssssssessssesssesseerererererersrsrsrsrsrserrereses 204 11 7 Resizing an Exam Rack Height sssssssesesesessessseserersserrsrsrseerereens 206 11 8 Configuring Horizontal or Vertical Racks 0 cece 206 11 9 Displaying Exam Information suterssvaviateaaieetiseaas nigrum nateuartaedties 206 11 10 Using Thumbnail images sivies sisiviccoriseietonvsesstorecousivnevenstassueass 206 11 11 Using Image Popup Windows ssssssssssessssesssesseerereerersrsrsrnrsrsrsrss 209 11 12 Using Clone Windows sisiccisiicisisisscisssisansccsvocesvssvadeeseeneiviseeteseees 211 TTA REMOVING Cones oseane eee aaea a RA 211 11 13 Detaching Individual Studies from Exams s sssssssssssesesesssessesese 211 Viewing and Manipulating Images csccscccsscsscscsccscesscceceees 215 12 1 Using Presentation States sssssssssesssesssrsesrerrersesrerrnrsrsrenrsrseeree 216 12 1 1 Saving a Presentation State ssessssssessesesses
239. eted or recovered IntelliSspace PACS provides a tab in the Statistics page in the Folder List where PACS Administrators can review the audit logs e We strongly recommend that you use the Duplicate UID feature to delete an image as images that are accidently deleted using DUPUID can be recovered Users with the administrator privileges can recover deleted images to undo accidental deletion of images However if the selected window has only a single image is a clone or has multi frame image s you cannot delete it You cannot delete images in exams with anonymous patient information See Making Patient Information Anonymous see page 56 Deleting studies is permanent meaning that deleted studies cannot be recovered Deleted images can be recovered However all presentation states measurements and annotations are lost Also if an image has been deleted after receiving a new Study UID the image cannot be recovered Be aware that deleted images may contain data that would render a different diagnosis On the Canvas Page right click on an image and from the menu select one of the following options Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Managing Studies and Images 16 CREF4 09 291 v4 0 07 2014 16 5 1 16 5 2 Delete All Image s Removes every image from a selected series Delete Image
240. exam IntelliSpace PACS shows the wrong modality and body part for the exam To correct this problem manually edit the exam and select an exam code that is associated with the correct modality and body part 1 Right click on the thumbnail image and from the menu select Detach Study from Exam The Detach Study from Exam dialog box displays The Reason field is populated from the Reason dictionary 2 Review the Study Description area to see the original DICOM metadata for the following Patient Name Accession Number Date of Birth Sex MRN Study Date 3 Review the Series Images area tree control to see the following information Study UID of the selected DICOM study Total Number of images associated with the selected DICOM study Series UID s of all the series associated with the selected DICOM study 212 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Using the Canvas Page 11 CREF4 09 291 v4 0 07 2014 Image UID s of all the images associated with the selected DICOM study Enter the reason you want to detach the study or select a Reason from the list Click OK A message displays while the study is being detached from the exam Intellispace PACS Enterprise 4 4 User Guide 213 11 Using the Canvas Page 214 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014
241. exam and select View Exam Notes 2 Click All Exams and review the information CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 139 Viewing Clinical Information 140 To sort click on a column heading You can click an exam to display its report if that exam has a report If the selected exam has no report available a message displayed below the list of exams 3 Select another pane from the Clinical Information dialog box if desired or click Close 8 5 Viewing Current Providers You use the Current Providers pane of the Clinical Information dialog box to view information on all the providers associated with the report and patient including contact information Often referring providers have questions or comments about a report Having easy access to the associated providers with each report gives referring providers the information they need to contact the Radiologist and discuss the report Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing Clinical Information 8 Currel roide ACPT1 00000008 I MRN S Sex U DOB 71941 ie Ordering MD N A Phone N A Pager N A Accession 177 Exam Code WA Location WA Exam Notes 4 Referring Physician MOSESSO VINCENT Clinical Info Requesting Physician Related Exams MOSESSO VINCENT All Exams Current Providers gt
242. exams that match your search criteria displays Intellispace PACS Enterprise 4 4 User Guide 153 9 Filtering Worklists Searching in a Worklist that Only Displays Exceptions 1 Select a filter from the Folder List that displays exceptions 2 Enter the desired search criteria in the search area 3 Click Search or press Enter A list of exceptions that match your search criteria displays NOTE Any exception opened from the exception worklist stays highlighted in the list after you have closed the exception if the exception has not been resolved Searching in a Worklist that Displays Exams and Exceptions 1 Select a filter from the Folder List that displays exams and exceptions 2 Enter the desired search criteria in the search area for exams at the top of the window Note the following about mirrored filter criteria Ifany of the following General criteria from the Add or Edit Filter dialog box are changed in the Exam worklist results at the top that change is mirrored in the Exception worklist results at the bottom See Creating Filters see page 158 These fields are displayed in bold to indicate that their value comes from the Exam worklist results Body Part Organization Modality and Performing Resource Ifthe Mirror field was selected when the filter was created or edited the MRN and or Patient Name fields are mirrored in the worklist This means that whatever you enter in the MRN and or Patient Name
243. f the average measured pixel values represented by the interpolated sub sampled image This is a close approximation to the original pixel values e When IntelliSpace PACS calculates a measurement using a sub sample of an image the measurement result is displayed with a front of it e When opening and displaying an image in full resolution the ROI measurement meaning approximate value in oo values are recalculated The sign is no longer displayed and there might be a small update change from the measurement values displayed initially Right click on the image and from the menu choose one of the following Measurements and then ROI Circle Measurement Palette then the ROI Circle icon Click on a point from which you want to measure and drag the cursor to include the region you are interested in see Figure 1 The region is delineated by a circle and ROI values next to the region indicate its mean Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Measuring and Annotating Images 13 CREF4 09 291 v4 0 07 2014 standard deviation sd and its area in centimeters squared or for a CT image indicate its Hounsfield units standard deviation and area in centimeters squared E 700 57 HU 113 2 sd 15 493 cm 70057 HU 113 2 sd _ ER eae 77 cm a Figure 3 Figure 13 5 ROI Circle Tool exam
244. f the following conditions are not met True Size will not be applied The monitor s pixels must be square so the horizontal pixel pitch is the same as vertical pixel pitch The image pixel spacing values is in mm not pixels The image horizontal and vertical pixel spacing values should be equal so the shape of the image pixel is square Intellispace PACS Enterprise 4 4 User Guide 37 Getting Started 3 4 1 3 5 Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box To configure another monitor select it from the Display Monitors list Continue to configure monitors as desired Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box True Size Verification After configuring the monitor s Pixel Pitch you must verify that the True Size setting behaves as expected One way to verify this is to open an image that complies with the previously described requirements and select the True Size zoom option Once selected the horizontal and vertical scales at the bottom and right side of the image should match a real life ruler unit meaning each division in the scale is 10 mm at lower zoom factors and 1 mm per division at higher zoom factors Many variables can influence the pixel spacing values of the image during acquisition such as distance from the
245. f the images and series in that Exam Rack You can also resize normal sized Exam Racks by right clicking in the Exam Margin and selecting Minimize Images Configuring Horizontal or Vertical Racks You set whether Exam Racks are initially displayed horizontally or vertically in the User preferences See Setting General Preferences see page 338 e Right click in the Exam Margin and from the menu select Horizontal Rack or Vertical Rack Displaying Exam Information Right click in the Exam Margin and from the menu select Exam Information The Exam Information dialog box displays and displays HIS RIS and DICOM metadata about the selected exam Review the information and click OK You return to the Canvas Page Using Thumbnail Images Thumbnail images are the small images displayed in the Exam Rack You can double click a thumbnail image to display it in an image popup window You can also right click a thumbnail image and select Create Popup from the menu See Using Image Popup Windows see page 209 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Using the Canvas Page 11 CREF4 09 291 v4 0 07 2014 Right clicking on a thumbnail image displays a menu with the following options depending on the modality and whether the series is single image or multi sliced Interaction Allows you to select an enhanced cursor f
246. ferences displays Click Plug Ins The right side of the Preferences dialog box displays a list of the current plug ins and allows to add edit or delete plug ins Click Add The Plug In dialog box displays Enter a Name for the plug in Select the Visible in folder tree check box if you want the plug in to be visible in the IntelliSpace PACS Folder List If the plug in is not displayed non administrative users cannot see it in the Folder List Enter the URL for the plug in Select whether you want the plug in enabled in IntelliSpace PACS Enterprise IntelliSpace PACS Radiology or both If desired clear the Disable API check box Only clear this check box if you are sure that the plug in URL supports the IntelliSpace PACS Application Program Interface API Philips recommends leaving this check box selected Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 CREF4 09 291 v4 0 07 2014 18 11 1 18 11 2 Select the Requires Security Code check box and select a code from the list if you only want users with specific security to be able to access the plug in Click OK You return to the Preferences dialog box Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Editing a Plug In Preference Click the
247. fferent organizations or ignore the patient pair See Resolving Merged or Linked Patient Records see page 86 Note that you cannot update certain fields such as nationality race religion and so on when merging You can update these fields manually by editing the patient whose MRN is selected e The Merge option has been identified as a hazard area in IntelliSspace PACS that could result in an incorrect or delayed diagnosis or delayed treatment e Philips strongly recommends that you visually verify the patient records you want to merge before merging e There is no undo function for the patient merge Merging Linked Patients from Different Organizations Two patients within a single organization can be merged in IntelliSpace PACS without having to first manually unlink them The Merge Patients dialog box shows the currently selected merge patients record as well as the organizations to which those patients are linked A patient link indicates that patient records in multiple organizations represent a single individual These patient links may occur automatically as a result of an algorithm be manually created or as the result of there being an MPI When a merge is performed IntelliSpace PACS can be configured to automatically update the demographic information for any patient records linked across organizations The following conditions must be met for this merge linked patients across organization e There must be at
248. for patient data When storing data on a CD or DVD IntelliSpace PACS does not verify that the patient data is correctly stored and retrievable In addition CDs and DVDs may deteriorate over time For long term storage all patient data should be stored in an archiving system such as a PACS Do not diagnose from media such as CDs or DVDs Images printed to paper from IntelliSpace PACS are not intended for diagnosis and should be used only for communication purposes Data that has been retrieved from a VNA archive may be changed in the VNA by a third party user while a copy of the data is stored in the IntelliSpace PACS Cache To make sure that you have the latest patient and study information delete the study in the Cache using the Server Utility Tool and then use iQuery to search the VNA archive for the latest data Note that when the Cache reaches capacity studies are automatically deleted Therefore verify that the study is present in the Cache because if the Cache is full the study may be deleted automatically During DICOM Query of a VNA from the Timeline a message displays on the Canvas Page if retrieving data from a VNA archive takes too long or if the DICOM file is extremely large The Canvas Page displays the images after they have been retrieved The user can click Retry to load the images Intellispace PACS Enterprise 4 4 User Guide 27 Safety Linking Warnings General Warning Message The current implementat
249. formation when the exception was originally resolved This makes resolving the exception difficult because the HIS RIS information is no longer accurate for this exception IntelliSspace PACS retains the HIS RIS data because the original scanner information was discarded upon the Intellispace PACS Enterprise 4 4 User Guide 179 10 Finding and Managing Exceptions initial resolution of the exception and there is no other data in the database to associate with the exception Therefore we strongly recommend that care be taken when resolving exceptions to avoid the loss of original image header information captured at the scanner e Please take care when resolving exceptions to exams that have already been dictated or marked read Philips encourages customers to notify the responsible reading Radiologist of the exception images being added to the exam because these images may not have been viewed at the time of dictation 10 7 Using the Exceptions Handler The Exceptions Handler is divided into two parts e The top part displays the exception reason and the images of the exception study with the associated data fields Accession MRN Patient Name Exam Date Time Modality and Body Part e The bottom part displays a list of potential exams and or patients to match to the exception study One or two tabbed lists display Exams that match Accession and Exams that match MRN IntelliSpace PACS configures the search criteria for thes
250. ften misleading on certain monitors Before making clinical decisions you must ensure that the proportions of the image are close to real size proportions Also you should use the measurement annotation and image scale tools available in IntelliSpace PACS rather than using physical rulers or other tools Incorrect Pixel Spacing and Pixel Pitch values affect the accuracy of the True Size feature Therefore you should always make sure that the size of the image is as expected when reviewing a True Size zoomed image Intellispace PACS Enterprise 4 4 User Guide 21 22 e Issues including delays with image retrieval delays in Study migration between servers locations and application responsiveness issues pauses halting may be experienced when the PACS Service is used on a network that does not meet the Minimum Network Requirements Be aware that remote sites that do not connect directly to the main site and or that connect with a sub optimal bandwidth can cause incomplete transfer of or unavailability of critical data at the time of diagnosis Because of the pervasive use of lossy compression and other image processing methods in the medical industry such as edge detection it is at the discretion of the diagnostic viewer to treat these images as diagnostic It is the customer s responsibility to make sure patients have unique patient identifiers MRNs within a federation After you edit patient related demograp
251. ful login attempts IntelliSpace PACS Enterprise uses integrated login when a user logs into the Windows domain as an administrator and then launches IntelliSpace PACS Enterprise it automatically uses the Windows domain credentials to log the user into the application IntelliSspace PACS However when the user logs out of IntelliSspace PACS Enterprise but does not close the IntelliSpace PACS Enterprise window anyone regardless of their credentials can log into IntelliSpace PACS 34 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Getting Started 3 CREF4 09 291 v4 0 07 2014 3 2 3 3 Enterprise using the cached adminstrator credentials To prevent this from occurring when an authorized user logs out of IntelliSpace PACS Enterprise that user should also close the IntelliSpace PACS Enterprise application Setting the Monitor Color Resolution IntelliSpace PACS requires a monitor color setting of 24 bits or higher If you are using a lower bit rate a message displays Right click on your Windows desktop and select Properties In the Display Properties dialog box click the Settings tab and then set the Colors section pull down menu to 24 bits or higher Click OK A message displays Click OK again to apply the new settings Monitor Calibration Use the following image to calibrate your navigation console not diagnostic
252. g Sort the resulting queued exams by clicking the desired column header Search for iExport requests by clicking Search The following search parameters are supported User Name Priority Status Destination and Export Type Refresh the list by clicking Search Remove an exam from the list by highlighting it and clicking Delete A confirmation message displays You cannot delete export requests with Retrying or Active status Restart an exam export that has failed by clicking Restart You can restart only export requests with Failed status Cancel the request by clicking Cancel You can cancel only export requests with Pending or Retrying status Change the priority of a submitted request by clicking Change Priority You can change the priority only for export requests with Pending status After a request has been picked up by an Export Service changes to priority may not affect the execution of the request Note that the Delete Restart Cancel and Change Priority buttons are all disabled while an export request has Active status 3 Click Close 312 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Retrieving and Exporting Studies 15 CREF4 09 291 v4 0 07 2014 15 3 3 15 3 4 Viewing iExport Progress Information You can double click an iExport job in the iExport Queue dialog box to view its progress i
253. g to the settings in the user profile Intellispace PACS Enterprise 4 4 User Guide 293 14 Philips IntelliSpace Clinical Applications 294 NOTE 14 6 2 14 7 If required prepare and modify a MIP MPR Volume rendered image Select the volume view In the main menu click Analysis and then click Vessel Explorer See Analysis see page 288 e If the system does not have enough memory to load all images CT MR Vessel Explorer shows a warning message that you must set a volume of interest VOI that fits into memory See the Philips IntelliSpace Clinical Applications online help for more information For more information about CT MR Vessel Explorer see the Philips IntelliSpace Clinical Applications online help Closing CT MR Vessel Explorer To close CT MR Vessel Explorer click X on the Vessel Explorer application tab Configuring Automatic Startup You can define rules in Philips IntelliSpace PACS for automatic start up of IntelliSpace PACS Clinical Applications These rules link exams to a clinical application If you double click an exam in an IntelliSpace PACS worklist the linked application starts automatically A rule that links an exam to an application has the following attributes e Modality required Possible modalities are CR CT CX DR DX MG MR RF US Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Ph
254. gan X Rays Pan in zoomed view Not used Stack Series Enables Fast Cine Pan in zoomed view Not used Pan in zoomed view Not used X Rays Zoom into or out of Not used the image at the cursor s location Series Frame by frame review through slices In Cine Mode Exits Cine mode CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Mouse and Keyboard Reference Sheet 20 Action Left Button Hold Shift while Temporarily disengages a stack link cineing a linked stack Move up or down Hold middle mouse button and move mouse vertically or Wheel Right Button Temporarily disengages a stack Temporarily disengages a link stack link In Fast Cine mode changes the frame rate Move the cursor up to cine backward and down to cine forward The farther you move the cursor from the anchor point that is the click point or direction change point the faster the frame rate When Custom Scrolling is selected with the Standard Mouse Scheme option images scroll until either the button is horizontally released the mouse is halted or the end of the stack has been reached 20 1 2 Enhanced Mouse Scheme If you select Enhanced mouse scheme option in the Mouse User preferences the cursors shapes indicate their action See Setting Mouse Preferences see page 340 CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User
255. gate to the previous collection window in the main and prior exam Navigate to the next collection window in the main exam and prior exam Flips an image horizontally Flips an image vertically Jumps to the first and last images in the selected image series respectively Open Intellispace PACS online help Horizontal rack Inverts grayscale Toggles between linking and unlinking images in an exam Toggles the Localizer Tool on and off Intellispace PACS Enterprise 4 4 User Guide 409 20 Mouse and Keyboard Reference Sheet 410 Description Magnifying Glass Mark as Negative Mark as Positive Mark as Read Mark as Undecided Measurement Palette Mirror Link Next Exam on Worklist Filter Next Hanging Next Hanging Sequence Next Image Next Prior Intellispace PACS Enterprise 4 4 User Guide Default Hardcoded Keystroke Y Ctrl Shift N Ctrl Shift P F3 Ctrl Shift U M NONE Ctrl F10 wW Shift W NONE Shift F10 Action Toggles Magnifying Glass on and off Marks a displayed exam with a Negative rating Marks a displayed exam with a Positive rating Marks the current exam as read if it is not marked read already Marks a displayed exam with an Undecided rating Toggles the Measurement Palette on and off Toggles mirror links on and off in an exam Displays the next unread unlocked exam when Mammography features are en
256. ge Typically images are deleted relatively quickly after they are acquired and do not contain critical annotations and measurements Using Statistics and Running Reports in IntelliSpace PACS Enterprise In IntelliSpace PACS Enterprise you can run statistics and publish billing reports 332 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Managing Studies and Images 16 For statistics you can generate the following e Daily Usage Statistics e Monthly Usage Statistics e Monthly Daily Usage Statistics in Grid View You can generate any of the following six Billing Report Types Daily Monthly Archived Exams Archived Studies Received Studies Viewed Studies To view statistics and run a report do the following 1 In IntelliSpace PACS Enterprise click the Statistics folder in the Folder List 2 Select the Usage Statistics tab at the top of the right pane 3 In the Study Statistics section click the Report Type dropdown arrow and select the type of report you want to generate Daily Monthly Archived Exams Archived Studies Received Studies Viewed Studies 4 Click the Date dropdown arrow and select the date that you wish to query 5 When you have made your selections click Query CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 333 16 Managing Studies and Images
257. ge through the images using the very thin 2mm series as the master every image of the 10 mm series will be displayed This means that paging through multiple series simultaneously is possible with the Link tool but images will be skipped unless the series with the thinnest slice thickness is used as the master AARWN e o N Series 1 Series 2 Awa RNING Linking Series that Contain Different Body Parts Series that contain different body parts or cover a larger smaller region of the body can be linked For example a CT series that contain a CHEST ABDOMEN PELVIS might be linked with a CT series that contains only a CHEST By navigating through the CT CHEST series you will never be able to see the ABDOMEN PELVIS of the other series Conversely by using the CHEST ABDOMEN PELVIS as the master series you can look at the CHEST images side by side as well as at the ABDOMEN PELVIS images of the master series This means that using the Link tool you cannot go beyond the scope of the master This might be obvious if the body parts are totally different like in the CHEST ABDOMEN PELVIS example but sometimes they are the same but they do not start at exactly the same location In this case you might miss a few slices AMARwWNh hon Series 1 Series 2 Av ARNING Linking Oblique Series 230 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthc
258. gle use Keeps the ROI ellipse measurement tool active for multiple uses Activates the ROI freehand measurement for a single use Keeps the ROI freehand measurement tool active for multiple uses Rotates the image 90 degrees clockwise Activates the ruler measurement for a single use Keeps the ruler tool active for multiple uses CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Mouse and Keyboard Reference Sheet 20 CREF4 09 291 v4 0 07 2014 Description Scout Line Mode Show Hide All Overlays Show Hide Bit Overlays Show Hide Image Overlays Show Hide Shutter Displays Single Image Window Level Spine Labeling Annotation Step Zoom Step Text Annotation Text Annotation Persistent Toggle All Links Toggle Cine Mode Default Hardcoded Keystroke F11 Yes Ctrl F6 Ctrl Alt F6 F6 Ctrl Shift F6 L left Yes mouse button drag NONE NONE NONE Shift L Action Toggles Scout Mode on and off Toggles image overlays DICOM overlays and any measurements and annotations Toggles bit overlays on and off Toggles screen overlays It does not toggle image overlays shutters and DICOM 6000 Toggles shutter overlays on and off Adjusts the Window Width Level of a single image instead of the entire series when Mammography features are enabled Opens the Spine Labelling panel Activate
259. h A list of exceptions that match your search criteria is displayed The upper right corner of the Exceptions Lookup also displays the total number of exceptions found You can do the following Right click to display a menu with actions Rearrange re size and select certain search criteria columns to hide or display Shift click to select contiguous exceptions or Ctrl click to select multiple non contiguous exceptions Any exception opened from the exception worklist stays highlighted in the list after you have closed the exception if the exception has not been resolved Searching for Exceptions by Patient Name You can use patient names to search for exceptions by entering their last and first name or by using a wildcard search For example to find patient Doe John you can search for the full name Doe John full last name or partial first name Doe J or partial last name D There is also a wildcard search option that allows you to search on a partial last name and or partial or full first name for example D Jo Intellispace PACS Enterprise 4 4 User Guide 173 10 Finding and Managing Exceptions 10 2 2 If it is not already displayed select Exception Lookup from the Folder List or the Shortcut Bar if you have created a shortcut for this feature Enter all or part of the patient s last or first name To search for exceptions from all dates select the Exception Date Time value and press the Delete
260. h exam starting with the most recent e Modality type e Exam description e Accession maximum length is 20 characters e Date and time of order exam if no studies have been received or of studies if they have been received e Organization ORG in which the exam was created Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6 CREF4 09 291 v4 0 07 2014 6 5 1 One of the following icons display next to the exams If there is no icon no images are available for the exam Icon Description ral Image s available ael Exam is scheduled Report is available for exam No icon No images are available Search for and display a patient or list of patients Click the plus sign to the left of a patient s name If the patient has associated exams they display below the name with the most recent exam displayed first Double click on an exam to open it or right click to display a menu with various actions including Create Exam and View Exam Notes To open an exam without locking it press and hold the Alt key while double clicking on the exam Click the minus sign to close the list of exams You can also click Close All to close all displayed exams in a list of patients Searching for Patients by Name You can search for patients by entering their last and first name or
261. hcare Informatics Inc Measuring and Annotating Images 13 13 14 1 CAUTION CREF4 09 291 v4 0 07 2014 13 14 2 13 14 3 To change the line style of the annotation right click the annotation and from the menu select Edit Line Style The Edit Line Style dialog box displays Select the desired line style and click OK Adding a Text Annotation Right click the image or series you wish to annotate Do one of the following from the image menu Select Annotations then Text Select Measurement then Measurement Palette then click the T icon Type your annotation into the textbox To change the font of the text annotation right click the text and from the menu select Edit Font The Edit Font dialog box displays Select the desired font and size and click OK When a text annotation is exported as a GSPS file a 3rd party application might display the text at a different position and size The DICOM standard does not strictly specify how a text annotation should be displayed so each application can have its own interpretation To point to a specific section of the image use the Arrow tool or create the text annotation with an arrow using Preferences System Preferences Annotations Moving an Annotation e Click anywhere on the annotation and drag it to the desired location Editing an Annotation Double click on the annotation The Text Annotation dialog box displays displaying the annotation Edit the
262. he Folder List includes the Study Lookup option that you can use to search for and open a study using the Study UID SUID number IntelliSpace PACS displays the following search result information for the study e Patient name Patient ID e Accession number e Modality e Body Part In the Folder List click Study Lookup Type in or paste the SUID Click Search The study information displays if found Otherwise an error message displays Click Open to view the study on the Canvas Page The Canvas Page displays the study The PACS Administrator can access the integrity of the study to determine if the study needs to be deleted from IntelliSpace PACS and resent from the modality Deleting Studies and Images Depending on your security access rights permissions you can delete an entire study or a single image When an image is deleted IntelliSpace PACS keeps a record of the following information which is available in the Administrator Tool e IntelliSpace PACS User ID e Deletion Date e Deletion Time Intellispace PACS Enterprise 4 4 User Guide 329 16 Managing Studies and Images NOTE 330 e Modality e Accession e MRN Series Image UID e Series Image Description Number e Reason for Deletion Note the following IntelliSpace PACS displays a Warning when you attempt to delete images of an exam that has already been marked read e IntelliSpace PACS audits each time a series or image is del
263. he IntelliSpace PACS Server after they were cached at a client IntelliSpace PACS automatically loads these additional images into the viewer when the user requests them using the standard just in time iSyntax download mechanism These additional images are not cached on the local hard disk The following actions are available when you right click on an exam listing in the Local Exam Cache folder e Show Report Displays the report associated with this exam See Displaying and Printing the Current Report see page 145 e Show Exam Memos Displays the exam notes associated with this exam See Using Exam Notes see page 128 e Export via DICOM Allows you to export the exam via DICOM See iExport for DICOM Export see page 303 e Start Caching Allows you to start the caching of the selected exam s immediately e Cancel Caching Allows you to cancel the caching if the process has already started Delete Cache Item Allows you to delete the selected cached exam s 1 Select the desired exam from a list of exams 124 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exam Information 7 CREF4 09 291 v4 0 07 2014 7 17 1 7 17 2 Drag the exam to the Local Exam Cache folder Click Local Exam Cache in the Folder List to ensure that caching of the exam is complete 100 di
264. he Ruler Tool You can use the Ruler tool to make linear measurements to for example measure the diameter of a tumor as a baseline prior to treatment or measure the diameter of the appendix to diagnose acute appendicitis The measurement units for the Ruler tool are MM units if pixel spacing is specified in the DICOM tags Otherwise it is in pixels The level of accuracy is to tenths of a unit Right click on the image and from the menu choose one of the following Measurements then Ruler Measurement palette then the Ruler icon Click on the point from which you want to measure and either move the cursor to the second point and click or drag the cursor to the second point The value next to the line indicates the length of the span in millimeters or pixels depending on the available DICOM information To edit an endpoint select the line then select the endpoint and drag it to the desired point on the image Intellispace PACS Enterprise 4 4 User Guide 265 13 Measuring and Annotating Images 4 To move the line select the middle of the line and drag it to the desired location 5 To move the label select it and drag it to the desired location The following set of figures shows the various actions you can take using the Ruler tool When you use the ruler tool to measure an image a letter displays next to each measurement This allows you to place the measurement display anywhere in the image This naming conventi
265. he exam description contains a specific descriptive text tag IntelliSpace PACS automatically labels and associates this exam with screening The exact tag is defined during installation and can be modified via the Preferences dialog box in both IntelliSpace PACS Enterprise and IntelliSpace PACS Radiology This preference is only displayed if the Enhanced Mammography Features are enabled on the server Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 CREF4 09 291 v4 0 07 2014 18 13 Click Workflow The right side of the Preferences dialog box displays the Workflow preferences where you can set the Screening criteria for an exam Preferences Dialog User Preferences E System Preferences General Preferences Window Width Center Screening criteria Image Processing Annotations Exam description Type of reading DICOM Sources Screen Overlays sample texi Soia Double Paper Printing Export Query Plug Ins DICOM Print Auto Scaling Body Part Dictionary Hanging Protocols HP Sequences E Machine Preferences Network Testing In the Exam description text box enter a descriptio
266. he following settings for mammo Select 5MP image monitor as the display monitor Set Medium Font size to 29 or whatever is convenient Set image menu font to 29 or whatever is convenient Set Pixel Pitch to 0 165 this depends on the monitor so check the manufacturer s instructions Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to Machine Preferences The list of available machine preferences displays Click Display Monitors The right side of the Preferences dialog box displays options for the display monitor s If there is more than one monitor select the first monitor you want to configure from the Display Monitor list The Resolution for the selected monitor displays If you plan to use the True Size zoom preset select the Pixel Pitch of the Diagnostic Monitor by clicking the dropdown arrow See Configuring Pixel Pitch for the Diagnostic Monitor see page 36 Set the font sizes for Small Font Medium Font Large Font or Image Menu font These font sizes are used for overlays Intellispace PACS Enterprise 4 4 User Guide 393 19 Setting Machine Preferences 6 Set the Measurement Text Size This preference sets the font size for measurement values so that measurements values are can be adjusted for different monitor resolutions 7 Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close
267. he image quality to full fidelity by right clicking and selecting Full Fidelity from the menu The Compression Level icon also includes text that gives further details about the compression levels in use There are three different cases iSyntax compression images display the word Lossy followed by the appropriate compression quality icon based on the quality factor or set to the percentage based on the compression ratio Images using JPEG compression display JPEG Lossy followed by the compression icon that specifies the J type compression level Compacted images display Lossy followed by the compression quality icon that specifies the L type compression level Improving Image Quality To improve image quality to full fidelity in one step right click an image on the Canvas Page and from the menu select Full Fidelity See Introduction to the Canvas Page see page 195 Shown below are the grades of compression Compression Level Grade one highest level of compression This is the initial compression level of images viewed when logged in with the Teleradiology setting Grade two This is the initial compression level of images viewed when logged in with the ISDN setting Grade three This is the initial compression level of images viewed when logged in with the Cable Modem DSL setting 46 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc
268. he part of the image you are most interested in Separate preferences are available for modalities for example CT or MR and for tissue for example bone or lung When an image is first displayed IntelliSpace PACS uses the modality s default WW WL setting if that information is available in the DICOM Window Width Center settings are mapped to the number keys in the order listed in the Preferences dialog box allowing you to quickly apply a Window Width Center setting while viewing images For each setting IntelliSpace PACS displays the name modality width and center for example Brain CT 80 35 You can have up to 100 setting saved Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click Window Width Center The right side of the Preferences dialog box displays the current window width and center settings Click Add The Add Window Width Center dialog box displays Enter the desired Name up to 20 characters for the new window width center setting Select a Modality from the list Enter values for the Width and Center Click OK The new preference is displayed in the Window Width Center list Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4
269. he text Contact and Trademark Information Company Contact Philips Healthcare Informatics Inc 4100 Fast Third Ave Suite 101 Foster City CA 94404 USA IntelliSpace PACS Enterprise 4 4 User Guide 19 1 Introduction 1 9 2 Trademarks and Copyrights Copyright amp Disclaimer Information 2014 N V Koninklijke Philips N V All rights reserved iSyntax is a registered trademark of Koninklijke Philips N V While Philips provides the information in this manual to users of the IntelliSpace PACS product we retain copyright on all text and graphic images This means that you may not distribute the text or graphics to others without the express written permission of Philips mirror or include this information on your own server or documents without our permission modify or re use the text or graphics You MAY print copies of the information for your own personal use store the files on your own computer for your personal use only The information contained herein is designed to be as comprehensive and factual as possible Philips reserves the right however to make changes at any time without notice in products performance specifications and availability Other manufacturers product and service names profiled herein are trademarks and service marks of their respective companies Philips reserves all other rights Please direct all questions about this manual or the trademarks and copyrights contained herei
270. hics the updates are not immediately propagated to other parts of IntelliSpace PACS The Merge option has been identified as a hazard area in IntelliSspace PACS that could result in an incorrect or delayed diagnosis or delayed treatment Philips strongly recommends that you visually verify the patient records you want to merge before merging There is no undo function for the patient merge The Delete Patient option has been identified as a hazard area in IntelliSpace PACS that could result in no diagnosis or a delayed diagnosis If done incorrectly this procedure may affect patient diagnosis and patient care Therefore only qualified and thoroughly trained professionals should be given access to this feature These professionals should be completely aware of the ramifications of deleting a patient record before undertaking this operation Philips strongly recommends that you back up data if possible and visually verify the patient record before deleting The Restore Color Image feature is configured using DICOM Sources to specify the source and modality type of the study Please exercise caution when using this feature with scanned in images Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Safety 2 CREF4 09 291 v4 0 07 2014 Enabling any non zero deviation can cause alteration of true colors You should exercise caution when
271. ich to retrieve the erroneously deleted record e Visually verify the patient record before deleting Use the Patient Lookup to search for and display a list of patient names Right click on the patient name you want to delete and from the menu choose Delete Patient The Delete Patient dialog box displays Do one of the following In the Predefined Reason s list select the reason you want to delete the patient In the Predefined Reason s list select the reason you want to delete the patient and enter additional text to elaborate on the reason Enter a free text reason Click Delete Resolving Merged or Linked Patient Records Patient merging is a critical feature of any healthcare information system Unfortunately it is not uncommon for a single patient to end up with duplicate records in a single system As a result the patient record becomes fragmented meaning clinical decisions can be made with incomplete information which can be a patient care issue There are two options for handling patient merges in IntelliSpace PACS e Automatically IntelliSpace PACS provides the option to automatically merge patients upon receipt of an HL7 merge message such as HL7 ADT A40 IntelliSpace PACS does not require additional confirmation to merge patients when this option is used Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informati
272. ictionary dialog box displays with the matching physicians so that you can select the correct one If searching do the following To search for all referring providers click Search To filter the provider search specify the search criteria and then click Search When the desired referring physician s name is displayed select it and click OK The dictionary closes and the selected Referring Provider name displays in the Edit Exam dialog box 4 If desired click History to edit exam history information See Changing Exam History Information When Editing Exams see page 114 5 Click Save 7 8 2 Changing Exam History Information When Editing Exams 1 Do one of the following Use the Exam Lookup to search for and display a list of exams Use the Patient Lookup to search for and display a list of patients Display the exams for a patient Select a filter that displays exams 2 Right click over an exam in a list and from the menu choose Edit Exam The Edit Exam dialog box displays with the Info pane displayed Fill in the fields in the Info and Providers panes and click History to display the next pane 3 Add or edit the following information as desired 114 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exam Information 7 CREF4 09 291 v4 0 07 2014 7 8 3 7 9 NOTE
273. ient s MRN it is possible that the non numeric characters may be stripped from the MRN possibly causing a mismatch of patient data between two or more patients Make sure you validate the MRN against the patient name to ensure the returned patient data matches the patient you are looking for If it isn t already displayed select Patient Lookup from the Folder List or the Shortcut Bar if you have created a shortcut for this feature Enter all or part of the name or number of the patient identifier usually known as a Medical Record Number MRN but sometimes known as a department ID You do not need to enter leading zeros or the rightmost characters for MRN numbers You can also enter a Person Identifier Master Patient Index or MPI that identifies a person across multiple healthcare organizations each of which may know this person as a patient Click Search or press Enter Patients who match the identifier search criteria are displayed Searching for Patients by Other Criteria If it isn t already displayed select Patient Lookup from the Folder List or the Shortcut Bar if you have created a shortcut for this feature Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6 CREF4 09 291 v4 0 07 2014 6 6 Enter the patient s Date of Birth Social Security Number select an Organization
274. ient name to ensure the returned patient data matches the patient you are looking for CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 155 Filtering Worklists 9 6 1 NOTE 9 6 2 NOTE NOTE Searching for Exams or Exceptions by Patient Name You can use patient names to search for exams or exceptions by entering their last and first name or by using a wildcard search For example to find patient Doe John you can search for the full name Doe John full last name and partial first name Doe J or partial last name D There is also a wildcard search option that allows you to search on a partial last name and and partial or full first name for example D Joh You can also search for exams by multiple referring physician names Separate last names with semi colons and first and last names with commas for example Smith Jones or Smith Robert You can also include the wildcard character to search for partial last or first names for example Smi or Smi Rob Display a filter that displays exams exceptions or exams and exceptions Enter all or part of the patient s last name followed optionally by a wildcard character a comma and all or part of the first name for example D Jo would return Doe John and Doplier Joan Click Search or press Enter Exams or exceptions for patients in the specified time or date range are displ
275. ilips Healthcare Informatics Inc Philips IntelliSpace Clinical Applications 14 CREF4 09 291 v4 0 07 2014 NOTE NOTE 14 7 1 XA e Application required e Body part optional e Exam description optional The body part and the exam description of an exam are used as defined in the IntelliSspace PACS properties You can find them in the Edit Exam dialog box in IntelliSpace PACS To open this dialog right click an exam in a worklist and select Edit Exam The body part of the exam is displayed in the Body Part field The exam description is displayed in the Description field See section 7 8 Editing Exams on page 110 The rule is applied as follows if the modality body part and exam description of an exam match the modality the body part and the exam description of the rule the application defined in the rule starts automatically when you double click the exam in an IntelliSpace PACS worklist If two or more rules match one exam the rule with the strongest match is applied The more attributes of a rule that are defined the stronger the possible match of the rule is If you select two or more exams from an IntelliSpace PACS worklist the automatic start up only applies to the first exam Adding and Deleting Rules You can add and delete rules in the Preferences dialog in IntelliSpace PACS To open this dialog do the following Click the P icon in the upper right corner of the Inte
276. image or series opens an image popup window Right clicking a thumbnail image displays a menu with various options See Using Image Popup Windows see page 209 and Using Thumbnail Images see page 206 3 Patient History Timeline Displays a chronological listing of all of the patient s exams on the IntelliSpace PACS server See Using the Patient History Timeline see page 197 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Using the Canvas Page 11 CREF4 09 291 v4 0 07 2014 11 2 4 Exam Rack A horizontal or vertical display of the thumbnail images for the exam 5 Exam Margin Displays various icons if they are available for the image Right clicking in the Exam Margin displays a menu with various options See Using the Exam Margin see page 204 Using the Patient History Timeline The Patient History Timeline is a fast and intuitive way to view and navigate through a patient s clinical history of diagnostic exams and reports Exams on the IntelliSpace PACS server are listed chronologically with the most recent exam dates displayed on the left and the older exam dates displayed on the right Exams loaded in Exam Rack have gray background Exams with no reports are displayed in green exams with reports are displayed in blue Years are separated with dashed vertical lines ec 4075517 Date Time
277. imaging system See Export for DICOM Export see page 303 System Administrators can add or edit DICOM forwarding addresses that are visible in the iExport dialog box accessed from the menu in the worklists from the exams or by clicking Q in the IntelliSpace PACS Control Strip Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click iExport The right side of the Preferences dialog box displays a list of the current remote host descriptions Click Add The Add iExport Remote SCP Configuration dialog box displays In the Remote Destination AETitle field enter the DICOM remote host to which you want to forward Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 CREF4 09 291 v4 0 07 2014 NOTE 18 9 1 14 15 From the Location Affinity list select the desired location where the iExport Service has been configured These locations can be main and or remote locations and each location can have multiple hosts where the iExport service is configured to run The default Location Affinity is Main Location In the Remote Host Description field enter a brief description of the remote DICOM device Enter the address of the Host IP In the Port field enter the
278. in the Exam part of the worklist is mirrored in the corresponding field in the Exception part of the worklist If mirroring is enabled an icon displays to the left of the MRN and or Patient Name field You can click this icon to disable mirroring and click it again to re enable mirroring for that worklist Clicking this icon does not change the original settings of the filter 3 Click Search or press Enter A list of exams and exceptions that match your search criteria displays 154 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Filtering Worklists 9 The search criteria you enter for exams is translated for exceptions as follows Exam Query Fields Exception Query Fields Organization Organization Modality Modality Performing Resource Performing Resource Subspecialty Patient Name Patient name Date of birth Date of birth MRN MRN Accession Accession Exam Date Time Exception Date Time Procedure Status Procedure Code Body Part Body Part Referring Physician DICOM Tag 0x00080090 Ordering Provider Ordering Location Priority Patient Class Awe RNING When running a worklist query using a patient s MRN it is possible that the non numeric characters may be stripped from the MRN possibly causing a mismatch of patient data between two or more patients Make sure you validate the MRN against the pat
279. include e Disable VOI LUTs If VOI LUT applied e Restore Default Settings If VOI LUT is applied and you modified the WW WL setting e VOI LUT name If enabled in the General System preferences e VOI LUT name MOD If the original VOI LUT was modified After a VOI LUT has been saved in a presentation state the original VOI LUT may not be reproducible If a subsequent Presentation State is created from this second VOI LUT the popup window will designated it as PS MOD PS MOD to indicate that the VOI LUT is removed by two degrees from the original Intellispace PACS Enterprise 4 4 User Guide 235 12 Viewing and Manipulating Images Figure 12 3 VOI LUT example Right click the image and from the menu select VOI LUT Options e To disable the VOI LUT for the image and revert to the Histogram calculation Window Width and Level values select Disable VOI LUTs from the menu 12 6 Image Processing The following image processing options are available The Median Filter option only applies to the current image not an entire multi slice series The appropriate tool depends on the type of image you are viewing You should try various tools to find the best solution for viewing the enhanced image NOTE The image contrast settings affect only the current image display Your changes will not be saved e Invert Image Applied to all images in a multi slice series See Inverting an Image see page 239 236 Intellispace P
280. ing General Preferences see page 338 the first exam opened is the main exam and the Exam Notes for that exam if any automatically open Opening subsequent exams from the Patient History timeline or Relevant Exams ISR only does not display the Exam Notes for the subsequent exam s You must manually click the Exam Notes icon for that exam to open those exam notes In IntelliSpace PACS Enterprise if you open a second exam for the same patient from Patient Lookup the exam notes for the main exam continue to display You then must click the Exam Notes icon for the second exam in order to view those exam notes NOTE You can always click the Exam Notes icon for an exam displayed on the Canvas Page to view any associated exam notes for that exam 1 Display the Exam Notes pane of the Clinical Information dialog box in one of the following ways From the Canvas Page click the icon in the Exam Margin Right click on an event in the Patient History Timeline on the Canvas Page and select View Exam Notes Right click on an exam in the Patient Lookup or Exam Lookup and select View Exam Notes 2 Select the exam note you wish to view The note is displayed at the bottom of the dialog box 8 1 3 Printing Exam Notes IntelliSpace PACS supports the printing of all types of exam notes from the Clinical Information dialog To print an exam note right click an exam note and select Print from the right click menu 134 In
281. ing Preference 379 18 8 3 Importing a Paper Printing Preference asos 379 18 9 Setting iExport Preferences s ssssssssssssssssessrereesrersrersrsrsrsrsrsrersres 380 18 9 1 Editing an iExport Preference soosse 381 18 9 2 Deleting an iExport Preference 382 18 10 Setting iQuery Preferences ssssssssssssesesessrsesrsererererresrsesrsrnrnrnrst 382 18 10 1 Editing an iQuery Preference soosse 383 18 10 2 Deleting an iQuery Preference 383 18 11 Setting Plug In Preferences ss sccsssesdsestseasionsanddtesesvatdevcscsdsevetvets 384 Intellispace PACS Enterprise 4 4 User Guide 13 14 19 20 21 22 23 Intellispace PACS Enterprise 4 4 User Guide 18 11 1 Editing a Plug In Preference 385 18 11 2 Deleting a Plug In Preference nosse 385 18 12 Setting Workflow Prelereneas si isaidstseatuds tatasvendecdcinieadsteneeateanay 386 18 13 Setting Ensure All Viewed Preference occ eteeeneeees 387 813 1 Adding Ensure All Viewed Setting 388 18 13 2 Editing Ensure All Viewed Setting csiitnnuanns indies 388 18 13 3 Deleting Ensure All Viewed Setting ssseeeees 389 18 14 Setting Patient Columns Prereten cess to idaisteeievasrvostovaesessaesaveny 389 Setting Machine Preferences cccccsssccscscsccscccsscecssessccescees 391 19 1 Setting General Preferences tn cphtnpicialestntnieltphagratteaiduad tants aati 392 19 2 Setting Display Monitor Preferences wo cece eens eteeeeneeees 393 19 3 Setting Plis Mic Ppt ete mesa aius oyu
282. ing Preferences see page 399 Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip In the Preferences dialog box click the sign to display the list of Machine Preferences Set the desired machine preferences Click Apply to set a preference and continue setting machine preferences Click OK when you are done Intellispace PACS Enterprise 4 4 User Guide 391 19 Setting Machine Preferences 19 1 Setting General Preferences 1 Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip 2 Click the sign next to Machine Preferences The list of available machine preferences displays 3 Click General Preferences The right side of the Preferences dialog box displays the general preference options 4 In the Overlay Brightness slider adjust the brightness of image overlays displayed over diagnostic images For the most visible overlays set the slider to More 100 5 In the Ram Usage area select the Restrict Cache Size check box to restrict the RAM cache size used by IntelliSpace PACS Note that for Client upgrades where Restrict Cache Size is checked the default cache size will not automatically change to the new default value 6 Enter a Maximum Cache Size This text box is only enabled if Restrict Cache Size is checked The valid range is 256MB to 1 2GB for a 2GB or higher system and half the physical RAM size for systems that have less than 2GB of RAM
283. ing Provider Information When Creating Exams In the Create Exam dialog box click Providers Enter the name of the Referring Physician or click the button to search for and select a referring physician from the Providers Dictionary When you select a provider the available contact and address information is displayed Click Exam History if you want to enter exam history information When you are done click Save You return to the Exceptions Handler Click Resolve A message displays asking you to confirm the action Click OK The exception is resolved Entering Exam History Information When Creating Exams In the Create Exam dialog box click Exam History Enter information on the Signs and Symptoms for the exam Enter information about the History for the exam Enter additional Comments about the exam When you are done click Save You return to the Exceptions Handler Click Resolve A message displays asking you to confirm the action 192 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exceptions 10 CREF4 09 291 v4 0 07 2014 10 13 Click OK The exception is resolved Hiding and Closing the Clinical Info Dialog You can change to a different tab or close the Exception Handler dialog in which case the exam will not be displayed anymore When the exam associated with the currently opened
284. ion each time you reach the end of each phase within the series If you use the Localizer tool to navigate through a multi phase series you will notice that the other linked series are synchronized on location and basically display the image with closest location to the one displayed in the master series If the non multi phase series is used as the master IntelliSpace PACS tries to find the image with the closest location in the multi phase series and because there are potentially multiple matches IntelliSpace PACS displays the best match from the first phase In this example Intellispace PACS would never display image 7 through 12 In other words you cannot review all images of a multi phase series by paging through another series while using the Localizer tool AMAR wh Ei TERE E iw OARWN Series 1 Series 2 Zoom Presets You can zoom in on an image up to 1600 When you zoom the scales at the bottom and right of the image adjust to always show 10 mm per division Scale glyphs are placed every 10 mm 1 cm but the lines are drawn white on black embossing to improve visibility The size of the division is also displayed with embossed text Indicators at the 5th and 10th positions are distinguished by longer lines Do one of the following Intellispace PACS Enterprise 4 4 User Guide 247 12 Viewing and Manipulating Images 248 NOTE Roll the mouse wheel forward or use the Down or Right arrow keys
285. ion of the Link tool allows you to synchronize other windows series with the window series you are currently browsing through In other words there is one master window series typically the one that you have selected with your mouse and IntelliSpace PACS tries to line up the images of the other linked windows Therefore you should always review each and every series by paging through them individually and never rely on linking as a way to review all images within a given exam Browsing through a series that is part of a link may not display all the images that are available in the other linked series When using the series linking feature it is possible that images may be missing which could cause misdiagnosis Possible causes of missing images are e Linking multiple series with different slice thickness e Linking series that contain different body parts or cover a larger or smaller region e Linking Oblique series Linking a Multi Phase Series with Another Series Multi phase studies contain multiple images with the same location identifier Paging through a multi phase series that has not been split typically results in jumping back to the first slice location each time you reach the end of each phase within the series e Ifa multi phase series is used as the master the other linked series are synchronized on location and display the image with closest location to the one displayed in the master series e If the non multi phase series
286. ions e IntelliSpace Volume Vision e IntelliSpace CT Colonography e IntelliSpace CT Pulmonary Embolism Assessment IntelliSpace CT MR Vessel Explorer IntelliSpace Volume Vision is the 2D 3D 4D enhanced viewing application part of the IntelliSpace PACS Clinical Applications R8 2 bundled with the comprehensive IntelliSpace PACS solution IntelliSpace CT Colonography CT Colonography IntelliSpace CT Pulmonary Embolism Assessment CT Pulmonary Embolism Assessment and IntelliSpace CT MR Vessel Explorer CT MR Vessel Explorer are applications for specific types of viewing Note that these three clinical applications are sold separately and require a license If you do not have a license for one or more of these three clinical applications the entries will not appear under Philips Applications when you right click the IntelliSpace PACS canvas Intellispace PACS Enterprise 4 4 User Guide 283 14 Philips IntelliSpace Clinical Applications 14 2 About IntelliSpace Volume Vision IntelliSpace Volume Vision Volume Vision adds real time 3D functionality MIP MPR and Volume Rendering Once Volume Vision is installed you can access these tools by right clicking on a thumbnail image in the IntelliSpace PACS Exam Rack or in an image pop up window and selecting one of the following options MIP Maximum Intensity Projection The maximum voxel value encountered along each ray is displayed on the projection plane plane of the monitor M
287. ionsyjuctauatonstavaceneienanestiouinestuny 394 19 3 1 Editing a Plug In Preference 395 19 3 2 Deleting a Plug In Preference nosses 395 19 4 Setting Local Exam Caching Preferences a visisasnncviinnvssscosvesvoess 396 19 5 Setting IntelliSpace PACS Chat Mail Management Preferences 397 19 6 Setting Network Testing Preferences cece eseeeeeeteeeeneeees 399 Mouse and Keyboard Reference Sheet esessessesossossossossesssssesoe 401 20 1 Mouse Control Reference Sheet s sssssssssesessssersssesissresrresenenrese 401 POLE Standard Mouse SOMME a shsistsssitiasssaidosstiarbisstossiutaseaens 401 20 1 2 Enhanced Mouse Scheme isicceciiudsssisdisssrtiieseicsisiecay 403 2013 OPO G ioiii ONC USIP URE HRC a RNR 405 20 2 Keyboard Commands 0c c anecaenandacininnninin 407 IntelliSpace PACS Quick Reference Table sccssccsscesseeeee 415 Glossar Y ieseseisvndasaeeiade dasa dencsseescienseseeseseeentelsecssnsaseedeasscavecasceadescees 421 Accessing PDF File of Online Help csccscsccscsccscscsccsceees 433 CREF4 09 291 v4 0 07 2014 Philips Healthcares Informatics Inc Philips Healthcare Informatics Inc 1 CAUTION A warnine CREF4 09 291 v4 0 07 2014 Introduction In the United States Federal law restricts this device to sale distribution and use by or on the order of a physician Changes or modifications not expressly approved by the party responsible for compliance could void the user s a
288. iosbaaadonagndes 277 13 14 Annotating Images eonan iii ogiti gearing a os aie IBALL Adding a Text Annotation 279 13 142 Moving an Annotation 279 13 143 Editing an Annotation ossessi 279 13 15 SS US Da el sar avert uaa pa adamaoantan Syeautuh Sta aaas 280 Philips IntelliSpace Clinical Applications cscsecsessceceeees 283 WAM VERVIEW i asst de lunanii aa e e Saudi itvavTussteutiiays 283 14 2 About IntelliSpace Volume Vision wo sesesssseseeeeseeteeneeneeneenees 284 TAQ A Starting Volume Vision ossessi 285 14 2 2 Hold and Resume Volume Vision Sessions cccccccccsecvee 286 14 2 3 Exiting Volume Vision ossos 287 143 Analysis ai ai iii t aai ai 288 14 4 Philips IntelliSpace CT Colonography ssesssesesessssessesesssrsrsesrsesess 289 14 4 1 Starting CT Colonography seeeseeeeseeeeeeee 289 14 4 2 Closing CT CONOR GDI vesccsavsscicsighectiassatencanidecnss leans 290 14 5 Philips IntelliSpace CT Pulmonary Embolism Assessment 291 14 5 1 Starting CT Pulmonary Embolism Assessment w c cc0000 291 14 5 2 Closing CT Pulmonary Embolism Assessment occcccccecee 292 14 6 Philips IntelliSpace CT MR Vessel Explorer cceeeeeeeeseteetee 293 14 6 1 Starting CTIMR Vessel Explorer assos 293 14 6 2 Closing CT MR Vessel Explorer sssssssseeseee 294 14 7 Configuring Automatic Startup sesssssesssseesseeeeseersrsrssrersrsrsrsrerss 294 14 7 1 Adding and Deleting Rules nosece 295 Retrieving and Exporting Studies s sssssseseseserces
289. is when you view the Canvas Page You cannot remove or hide the Shortcuts Bar but you can resize it by clicking on the right border and dragging to the desired size Adding a Shortcut Make sure the Folder List is displayed If it is not click the arrow icon in the Shortcut Bar header to display or right click in the Shortcuts Bar and from the menu choose Show Folder List Do one of the following in the Folder List Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Program Layout 5 5 5 2 5 5 3 5 5 5 5 6 5 6 1 CREF4 09 291 v4 0 07 2014 e Drag an icon from the Folder List to the Shortcut Bar e Right click an item and from the menu select Create Shortcut If you add more shortcuts than can fit in the Shortcuts Bar a button displays Click this button to scroll through your shortcuts Selecting an Item from the Shortcut Bar Click the item The features for that item display in the area to the right Removing a Shortcut Right click the shortcut and from the menu select Remove from Shortcut Bar Renaming a Shortcut Right click the shortcut and from the menu select Rename Shortcut The name field becomes editable Enter the desired name and press Enter Resizing the Shortcut Area Place your cursor on the right divider of the Shortcuts Bar and drag the divider to the desired size Shortcut Groups
290. isplays allowing you to find patients and their exams You can Shift click to select contiguous patient names or Ctrl click to select multiple non contiguous patient names Control Strip I Append results cle I Exams with images onl Shortcut Bar Enterprise Tools A thy Exam Lookup Gp Exceptions Lookup amp Patient Lookup H Installed Programs ER iQuery W Local Exam Cache Local Export Eh Locked Exams Machine Filters Folder List Figure 5 1 _IntelliSpace PACS program layout 5 1 Control Strip The Control Strip displays at the top of IntelliSpace PACS after you log in User Default Administrator La Figure 5 2 Control Strip CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 49 5 Program Layout It displays the name of the current user and the following Icon Description A tab showing the current action You can click this tab to return to this action from the Canvas page for example Patient Lookup or My Filters You can select multiple non contiguous patients using Ctrl click This tab displays when you double click on an exam in the worklist displaying the Canvas Page If you have viewed more than one patient s exams you can right click on the tab to select the patient whose exams you would like to view or to select the Close All Patient s option Click the icon on the right side of the tab to close the currently displayed exams
291. isplays a check mark to the left of Anonymous Anonymous exams are displayed with a blue dot to the left of the patient name and the folder you right clicked turns blue Patient Lookup My History EB Enterprise Tools fg Exam Lookup Gp Exceptions Lookup Patient Lookup Installed Programs R iQuery Local Exam Cache Local Export Eb Locked Exams Machine Filters 2 amp Merge Link Candidate s My Filters My History B Queues Federation Y iQuery amp Statistics Study Lookup System Filters Personal Folders amp My Anon exam Public Folders aldron WAA HUS931 alton BELS ee BMR861 You can right click the folder and click Anonymous again to deselect it and display the actual patient information for the selected exams Intellispace PACS Enterprise 4 4 User Guide 57 Program Layout 5 3 1 NOTE 5 3 2 Displaying or Editing Information about Anonymous Exam When exams in a folder have been made anonymous you can view and change the properties for the randomly generated patient information This information is available from e The exam in a folder that has been made anonymous e The Media Viewer e The iExport window You can enter comments similar to exam notes for anonymous exams by clicking on the icon in the Exam Margin on the Canvas Page See Adding Comments to an Anonymous Exam see page 58 When you hav
292. isplays the images going backward in order Displays the previously opened prior exam if the main exam has more than one prior exam onto the diagnostic monitor s for comparison while keeping the main exam loaded on the diagnostic monitors When viewing a popup image in a horizontal rack this key hangs the previous series from the exam When viewing a popup image in a vertical rack this key hangs the previous exam not the previous series within the exam Intellispace PACS Enterprise 4 4 User Guide 411 20 Mouse and Keyboard Reference Sheet 412 Description Reset Image Display ROI Circle Measurement ROI Circle Measurement Persistent ROI Ellipse Measurement ROI Ellipse Measurement Persistent ROI Freehand Measurement ROI Freehand Measurement Persistent Rotate 90 CW Ruler Measurement Ruler Measurement Persistent Intellispace PACS Enterprise 4 4 User Guide Default Hardcoded Keystroke Ctrl R NONE NONE NONE NONE NONE NONE NONE NONE NONE Action Resets the image back to its original WWW WL Measurements and annotations can also be reverted This shortcut does not apply to rotating or flipping images when Mammography features are enabled Activates the ROI circle measurement for a single use Keeps the ROI circle measurement tool active for multiple uses Activates the ROI ellipse measurement for a sin
293. ist is informed of his true name date of birth and so on and enters this into the HIS RIS Now two patient records exist for the same patient However IntelliSpace PACS will not recognize these two records as merge candidates In order to merge these patient records you must use the Merge Patient feature and perform a manual merge Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6 CREF4 09 291 v4 0 07 2014 6 21 Linking Patient Records from Different Organizations Many healthcare systems provide MPI or other mechanisms for attempting to maintain a single patient record despite disparate patient management systems Aside from providing a single patient history value is also derived from maintaining a single unified set of patient demographics There are two variations for managing the demographics of linked patients whether linked via MPI PACS driven linking or manual linking e Comprehensive Patient Record Intellispace PACS applies any demographic changes whether received via HL7 or manually performed in the UI to all linked patient records thus maintaining the unified set Single Patient Record IntelliSpace PACS updates the demographics for a single patient record in a linked group of records whether received via HL7 or manually performed in the UI This allows a
294. k Remove to move it out of the right column 4 When you are done click OK You are returned to the Add Filter dialog box 9 8 2 Specifying the Columns for an Exceptions Worklist 1 From the Add Filter dialog box check Exception Worklist Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Filtering Worklists 9 CREF4 09 291 v4 0 07 2014 Click Exception Worklist Columns The Exception Worklist Columns dialog box displays Exception Worklist Columns x Available fields Show these fields in this order E Title Name Organization Body Part a gt MRN Date of Birth Patient Name Department Name Accession Sex Exception Date Time Station Name Images Study Date Time Modality Study Description Performing Resource Reason Optionally do the following In the Available fields column select the desired fields using Ctrl click and then click Add to define the list of columns you want for the exception worklist The names in the right column are the ones used in the worklist Note that you cannot remove the columns for MRN Exception Date Time Accession or Modality as they are required columns Select a field in the right column and click Move Up or Move Down to rearrange the displayed columns Select an optional field in the right column and then click Remove to move it out of the
295. k on an image and select Image Processing from the menu then choose Invert Image CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc IntelliSpace PACS Quick Reference Table 21 Task Flip an image around the x or y axis Rotate an image clockwise or counter clockwise Sort an image series Annotate an image with text or symbols Measure lengths angles or regions of interest Delete measurements Edit measurements format Temporarily disconnect a linked image Unlink images in an exam Auto link expanded images Create a scout view View a series with multi image mode Open a clone image in an image popup window CREF4 09 291 v4 0 07 2014 Action Right click on an image select Flip Rotate Sort from the menu then choose Flip Vertical or Flip Horizontal Right click on an image select Flip Rotate Sort from the menu then choose Rotate 90 CW or Rotate 90 CCW Right click on an image select Flip Rotate Sort from the menu then choose Table Position Ascending Table Position Descending Image Number Ascending or Image Number Descending Right click on an image and select Annotations from the menu Right click on an image and select Measurements from the menu Right click the measurement handle and select Delete All Measurements and Annotations from the menu Right click the measurement handle and select Edit Font or Edit Line St
296. k the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click Ensure All Viewed The right side of the Preferences dialog box displays a list of modalities and body parts Select the item in the list that you want to delete and click Delete The item is removed from the list Click OK to close the Preferences dialog box Setting Patient Columns Preferences This Patient Columns preference allows the PACS administrator to select whether the following columns will be available for display in the Patient Lookup e Organization e Sex e SSN see Note below If the BSN Burger Service Number feature is enabled on the IntelliSpace PACS server the SSN field is replaced with the BSN field The BSN Burger Service Number feature is only available for IntelliSpace PACS sites in The Netherlands Intellispace PACS Enterprise 4 4 User Guide 389 18 Setting System Preferences 390 Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click Patient Columns The right side of the Preferences dialog box displays a list of patient columns By default Sex Organization and SSN are in the Visible list meaning that they are displayed in the Patient Lookup Select the patient column s yo
297. l monitor e You cannot resize the Magnifying Glass window by dragging its border e You cannot move the Magnifying Glass outside the limits of the window in which it appears This means that if a window has multiple images the Magnifying Glass roams above all of them identifying the image being magnified Intellispace PACS Enterprise 4 4 User Guide 249 12 Viewing and Manipulating Images e Ifyou use the Magnifying Glass in an image popup window and resize the window the Magnifying Glass stays at its current location e Overlays or annotations on the original image are not magnified e Cine mode is not available when Magnifying Glass is being used Ifyou change the zoom of the original image to be equal to or bigger than the zoom factor for the Magnifying Glass window the zoom factor of the Magnifying Glass window increases to one increment above the zoom factor of the original image 1 To select the Magnifying Glass do the following e Right click on the image in the popup window or virtual monitor and select Magnifying Glass 2 To adjust the settings for the Magnifying Glass tool right click and select one of the following options Window Width Level options Zoom Presets 200 300 and 400 These presets are only available if the underling image has a smaller zoom factor In a single image you can use the mouse wheel to change the zoom factor of the Magnifying Glass 12 10 1 Closing the Magnifying To
298. lay any sub topics Near the bottom of the Search tab you can select the following options Search previous results limits new search within the previous results Match similar words expands results to include matches of similar words Search titles only limits search to topic titles only CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 39 Getting Started 3 7 3 8 NOTE User Online help Default Administrator Figure 3 2 Accessing online help Setting Preferences Click the P icon on the Control Strip near the upper right corner of the window See Setting User Preferences see page 337 Setting System Preferences see page 355 and Setting Machine Preferences see page 391 Preferences User Default Administrator oS Figure 3 3 Setting preferences Setting Federation Status The F icon is not available in normal PACS deployment This icon is visible only when Federation is deployed and enabled and the user has the rights to use the Federation capability For more information on Federation and its functions see section 6 2 Patient Lookup and Federation on page 66 Click the P icon on the Control Strip In the User Preferences dialog select Automatically connect to federation Click Apply and then click OK Log out of IntelliSpace PACS and then log back in to activate the Federation preference Intellispace PACS Enterprise 4 4 Use
299. lback Number a phone number for the Radiologist to call the ordering or referring physician and Alternate Exam Code field a second Exam Code field that in some organizations is specified as a Universal Service ID are displayed Intellispace PACS Enterprise 4 4 User Guide 135 8 Viewing Clinical Information Clinical Information Clinical Info x a ACPTI SNNME TIM MRN PE Sex U DOB Wy1941 Ordering MD WA Phone N A Pager N A Accession 4 Exam Code WA Location WA Exam Notes 4 Signs and Symptoms History Clinical Info Comments Alternate Exam Code Related Exams Alternate Exam Description Order Callback Numbers All Exams Current Providers The information in this pane helps physicians understand why a patient has been referred to Radiology For example the Radiologist will look for different abnormalities in a cancer case compared to a trauma case 1 Display the Clinical Info pane of the Clinical Information dialog box in one of the following ways From the Canvas Page click the icon in the Exam Rack From the Patient Lookup Exam Lookup or a worklist that displays exams and has the Has Notes column visible right click the exam and select View Exam Notes 2 Click Clinical Info in the Clinical Information dialog box The Signs and Symptoms History and Comments display for the exam 136 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcar
300. less data retrieved from the server but the quality is lower You can improve the image quality by pressing lt F9 gt Note that the Popup Window Size is independent from the image resolution This means that in the previous example the initial Window Size might by 512 x 512 If the stack series is displayed at 256 x 256 it will be stretched to fit the window size When you press lt F9 gt the additional image information is retrieved and the image quality is full fidelity for that window size which is 512 x 512 Set the frames per second playback rate for the Default Cine Rate from 1 to 45 If the Recommended Display Frame tag 0008 2144 is present it is used as the initial frame rate If this DICOM tag is not present IntelliSpace PACS looks for the Cine Rate DICOM tag 0018 0040 If neither of these tags are present the specified Default Cine Rate is used as the initial frame rate Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting User Preferences 17 CREF4 09 291 v4 0 07 2014 17 7 Set the Scout Line Mode to Single Bracket or All This setting determines how scout lines are displayed when the Scout Line tool is active and you click an image Select Single to show the location of the slice that is being reviewed Select Bracket to show the location of the slice being reviewed as well as two lin
301. lications Configuration See Setting Applications Configuration Rules see page 351 Only IntelliSpace PACS System Administrators can set enterprise wide preferences as well as computer specific and account specific settings You may need to be familiar with this area to assist users who are trying to set their own preferences to answer questions about system wide settings and to process requests for changes to those settings System and machine preferences are only available to System Administrators and are not visible to standard users Intellispace PACS Enterprise 4 4 User Guide 337 17 Setting User Preferences 338 Vannie 17 1 If multiple users share the same User Preferences IntelliSpace PACS cannot prevent the users from changing settings in each of the users User Preferences Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Set the desired user preferences Click Apply to save the preference and continue setting user preferences Click OK when you are done Setting General Preferences Any user can set general preferences regardless of their privileges Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip The right side of the Preferences dialog box displays the current general preferences Optionally set the following preferences When you are done with each preference click Apply to save the settings and continue setting other pr
302. lips IntelliSpace Clinical Applications 292 14 5 2 All views are MPRs The application requires complete original CT scans no missing slices with a minimum of 30 slices and a maximum slice thickness of 2 mm to present all views Visualization is possible with slice thickness greater than 2 mm When you start CT Pulmonary Embolism Assessment the hanging protocol used depends on the following criteria e The selected scan dataset or scans e Your user profile permissions e The default hanging protocols The automatically applied default hanging protocol depends on The number of monitors on your reading station A weight factor that prioritizes protocols matching the same criteria See the Philips IntelliSpace Clinical Applications online help for an overview of the standard hanging protocols available for CT Pulmonary Embolism Assessment e Specific actions for CT Pulmonary Embolism Assessment that are automatically applied The application automatically detects the lungs and displays the main axial MPR view Once started the name Philips IntelliSpace CT Pulmonary Embolism Assessment is displayed in the main toolbar Closing CT Pulmonary Embolism Assessment To close CT Pulmonary Embolism Assessment in the main menu click Session and then click Exit Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Philips Int
303. ll remain anonymous You can view and change the properties for the randomly generated patient information when the exam is listed at the top of the Media Viewer window 298 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Retrieving and Exporting Studies 15 CREF4 09 291 v4 0 07 2014 NOTE When burning studies to CD or other media or viewing the images the date time the CD was burned will always display as the local timezone of the machine in which the CD was burned even if the media is opened on a machine in a different time zone To add exams to the Media Viewer do one of the following e Drag exams from a filter or list of exams to the Local Export folder e On the Canvas Page do the following Right click an exam listed in the Patient History Timeline or an exam row margin From the right click menu select Add Exam to Folder In the Folder Dialog Local Export is selected by default Click OK The exam is added to the Exam List in the Media Viewer Once you have all the exams you want to export in the Exam List do the following The default location of the exported files is C Documents and Settings username My Documents My iMediaExport In the Export list click the arrow and choose Browse to navigate to a different destination or create a new folder If you have an internal CD DVD burner you can choose the
304. ll timestamp information in GMT Microsoft Windows then localizes this information so that all timestamps are presented in local time as configured on the workstation Because Microsoft may make changes in its operating systems to account for Daylight Savings Time in various time zones around the world please ensure that user machines have the most current Microsoft updates installed so that correct times are displayed in IntelliSpace PACS reports When running a worklist query using a patient s MRN it is possible that the non numeric characters may be stripped from the MRN possibly causing a mismatch of patient data between two or more patients Make sure you validate the MRN against the patient name to ensure the returned patient data matches the patient you are looking for You need to know the following information to use the Exceptions Handler safely in a live clinical environment If you do not understand any of these warnings or how they affect you contact your IntelliSpace PACS System Administrator or Philips Customer Care e To avoid unauthorized access to imaging exceptions do not leave a computer unattended while the Exceptions Handler is running As a user of the Exceptions Handler you assume responsibility for unauthorized access as long as you are logged in to the program Before leaving a workstation you should close the Exceptions Handler and log out of IntelliSpace PACS Intellispace PACS Enterprise 4 4 User Guide
305. lliSpace PACS Control Strip The Preferences dialog displays Click the sign next to User Preferences in the Preferences dialog Intellispace PACS Enterprise 4 4 User Guide 295 14 Philips IntelliSpace Clinical Applications 3 Select Configuration for Applications The Configuration for Applications panel displays in the right pane of the Preferences dialog Preferences Dialog El User Preferences Configuration for applications General Preferences Window Width Center Keyboard Shortcuts Image Processing odality Body Part n Exam Display Preferences escription i Configuration for applications x z System Preferences Machine Preferences 7 Bacto Network Testing l Modality Body Part Exam Description Application Application Cancel Appl Help For more information on adding and deleting rules see section 17 7 Setting Applications Configuration Rules on page 351 296 IntelliSpace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc 15 CREF4 09 291 v4 0 07 2014 Retrieving and Exporting Studies IntelliSpace PACS includes the following tools you can use to retrieve and export studies e Media Viewer See Using the Media Viewer see page 297 Print to Paper See Printing to Paper see page 302 e Export via DICOM See iExport for DICOM Export see p
306. lliSpace PACS Enterprise IntelliSpace PACS Enterprise is designed to assist you in conjunction with primary diagnostics already provided by a certified Radiologist or while in direct live consultation with a Radiologist Training Users of this software must have received adequate training on its safe and effective use before attempting to operate the product described in this Instructions for Use Training requirements for this type of software will vary from country to country Users must make sure they receive adequate training in accordance with local laws or regulations Safe Usage Environment for IntelliSpace PACS Enterprise Make sure that you have a local printer available in order to print directly from the modality should the system become unavailable Make sure that you are using appropriate monitors and that they are properly configured and calibrated prior to using IntelliSspace PACS Enterprise Before using this product your computer system must be set up in the proper environment for viewing images e Make sure that you are using appropriate monitors and that they are properly configured and calibrated prior to using IntelliSpace PACS Enterprise e Your computer monitor should be placed in a location where there is no direct sun or illumination shining on the monitor e Your computer monitor and chair should be adjusted for a proper viewing height e Your computer system and monitor should get inspecte
307. lliSspace PACS would never display image 7 through 12 This means that it is not possible to review all images of a multi phase series by paging through another series while using the Link tool AMAR WN AARWN Series 1 Series 2 e Ifa multi phase series is not split correctly and a user links multiple series where one of the series contains multiple phases the link function will not work correctly because not all images will be displayed while paging through the series IntelliSpace PACS can be configured to automatically split all studies from a particular CT modality in multiple series based on DICOM tag 0021 0012 However because not all modalities can be configured to provide a unique identifier that can be used for splitting IntelliSpace PACS provides the ability to manually split studies A technologist can perform this function and save it as a Presentation State or a Radiologist can manually split a study after first opening the study Intellispace PACS Enterprise 4 4 User Guide 229 12 Viewing and Manipulating Images Aw ARNING Linking Multiple Series with Different Slice Thickness An exam might contain multiple series acquired at different or even variable slice thickness For example one series might be acquired at 10mm slice thickness and one at 2mm If you link these series and page through them using the very thick 10mm series as the master many images from the 2mm series will be skipped If you pa
308. lue column heading that you want to sort by An arrow appears in the column heading to display whether the order is ascending A Z or 1 9 or descending order Z A or 9 1 To reverse the order click the same column heading again Patient Management Overview IntelliSpace PACS includes the following features you can use to manage patient records You access these features by right clicking over a patient name in the Patient Lookup and selecting an option from the menu A separate set of actions is available when you right click on an exam instead of a patient See Viewing Exam Information see page 76 e Export via DICOM See iExport for DICOM Export see page 303 e Create Patient See Creating Patient Records see page 83 e Edit Patient See Editing Patient Records see page 84 Delete Patient See Deleting Patient Records see page 85 e Link Patients See Linking Patient Records from Different Organizations see page 97 e Merge Patients See Merging Patient Records from the Same Organization see page 91 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6 CREF4 09 291 v4 0 07 2014 6 14 NOTE e Create Exam See Creating Exams see page 99 You can also display a list of potential duplicate patient records to merge or link i
309. lues you wish to use for this source Select Histogram calculation to use a graph showing the total tonal distribution in the image It maps Luminance which is defined from the way the human eye perceives the brightness of certain colors Every pixel in the color or gray image computes to a luminance value between 0 and 255 The histogram uses bins to graph the pixel count of every possible value of luminance or brightness The total tonal range of a pixel s 8 bit tone value is 0 to 255 where the 0 is the blackest at the left end and 255 is the whitest at the right end Select DICOM Values which are the Window Width Center values provided by the modality DICOM sources utilizing DICOM values should be configured for a specific AE Title to ensure that images from other devices are not impacted The DICOM modality values are stored Intellispace PACS Enterprise 4 4 User Guide 367 18 Setting System Preferences 368 in Window Center 0028 1050 and Window Width 0028 0151 DICOM attributes Without these values IntelliSpace PACS applies a histogram calculation that may be less desirable than what the Technologist acquired the image with Select Fixed Values and enter the Width and Center to define values that are applied automatically every time This is most useful when using Exam Code level as a DICOM source For Lossless images you can select whether to enable simulated grayscale WW WL and specify a deviation value from true g
310. ly builds a link between the disparate patient records when the demographics match sufficiently See Linking Patient Records from Different Organizations see page 97 Manual Linking Merging A customer may manually link patient records in the PACS to create a single history See Resolving Merged or Linked Patient Records see page 86 and Using the Merge Link Candidates List to Merge or Link Patients see page 88 IntelliSpace PACS supports organizations that use an MPI as well as those organizations who do not use an MPI The following are features of IntelliSpace PACS support of MPI Receipt of Master Patient Index via the HL7 interface is supported IntelliSpace PACS provides configuration to allow control over whether or not demographics changes to a local patient can be applied to the MPI patient via the HL7 feed IntelliSpace PACS allows MPI to be added to a patient record upon either creation of the patient record in IntelliSpace PACS or at a later date Intellispace PACS Enterprise 4 4 User Guide 75 Finding and Managing Patient Information 76 e IntelliSpace PACS provides the ability to search for patients in the graphical user interface GUI via MPI when the capability to search by Medical Record Number MRN is provided in the MPI organization Enterprise 6 5 Viewing Exam Information You can view a summary of a patient s exams in a list of patients The following information displays for eac
311. m Rack is based on the order defined by the presentation state Using the Exam Margin The Exam Margin displays icons relevant to the exam such as a Report icon if there is a diagnostic report for the exam In addition an icon now displays in the Exam Margin when new images have been added to a study loaded onto that Exam Rack Hovering over the icon displays the tooltip New images or other DICOM was received for this exam and has been loaded Icons in the Exam Margin indicate the following Icon Description A diagnostic report is available An exam note is available m A critical exam note is available a Not all images for this exam may be available Also displayed if new images are received by Intellispace PACS after a Mark Read presentation state has been created New images have arrived This icon is not displayed for exams that have been bay marked Read Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Using the Canvas Page 11 CREF4 09 291 v4 0 07 2014 Icon Description Fy This study has been cached from a remote site w A presentation state has been loaded BS Add a comment for an anonymous exam similar to an exam note This icon displays only if the anonymized exam is opened from an anonymized personal folder Indicates that the GSPS has loaded successfully Indicates that the GSPS
312. m the Folder List or the Shortcut Bar if you have created a shortcut for this feature Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exam Information 7 CREF4 09 291 v4 0 07 2014 7 2 3 NOTE 7 3 In the Exam Date Time column or Scheduled Date Time column select a time or date range from the list Click Search or press Enter Patients with exams who match the date time search criteria are displayed Searching for Exams by a Custom Date Range The maximum date range you can specify in a Custom Date Range search is 100 years If the search range is greater than 100 years for example 6 3 1911 6 3 2011 then an error message displays Custom search date range shall not exceed 100 years Select Exam Lookup from the Folder List or the Shortcut Bar if you have created a shortcut for this feature In the Date Time column select Custom A Start Date and End Date window displays a range of Today s date for both start date and end date If a Custom date is set to more than 7 days the filter is not auto refreshed every one minute Enter the desired start and end dates or click the arrow for either date to enter the date using the calendar control Note that you cannot delete or modify the Date Time field you can only select a date from the calendar control Click OK when you have entere
313. m via IntelliSpace PACS possibly doing measurements remotely from home When you create the final diagnostic report the exam will contain the preliminary measurements User Select this type if you are creating presentation states for your own personal use as these presentation states are only visible by you Click OK The presentation state is saved and listed with the other presentation states The list includes the name of the presentation state the user name and the date and time the presentation state was created Selecting a Presentation State Open an exam Right click the exam margin and from the menu select Presentation State then select the desired presentation state Intellispace PACS Enterprise 4 4 User Guide 217 12 Viewing and Manipulating Images 218 12 1 3 DICOM Grayscale Softcopy Presentation States GSPS DICOM Grayscale Softcopy Presentation State GSPS studies are supported IntelliSpace PACS supports the loading and display of GSPS annotations when associated with an MG image IntelliSpace PACS can display annotations unformatted text value with or without anchor point poly line circle and ellipse from any third party vendor s GSPS It is important to note that flipped images or point and interpolated annotations in GSPS will not display in IntelliSpace PACS Only the aforementioned annotations are supported for display at this time The GSPS annotations are read only and cannot be modifie
314. mage or series which includes the vertebrae and select Spine Labeling from the Annotations menu Click the image where you would like labels inserted in conformance with the Spine Labeling dialog box Hover the mouse over the image that has one of these Image Processing tools applied and click the comma key to decrease the degree parameter and the period to increase the parameter Press the space bar Right click on the left margin of the exam row and select Exam Information from the menu If you are in Vertical mode right click the top margin to access the menu Right click on the left margin of the exam row then select Presentation State from the menu If you are in Vertical mode right click the top margin to access the menu Right click on the left margin of the exam row then select Minimize Images from the menu If you are in Vertical mode right click the top margin to access the menu Right click on the left margin of the exam row then select Close Exam from the menu If you are in Vertical mode right click the top margin to access the menu Click the P Preferences icon in the Control Strip and select or clear the Display check box in the General preferences section Right click on the left margin of the exam row then select Horizontal Rack or Vertical Rack from the menu If you are in Vertical mode right click the top margin to access the menu CREF4 09 291 v4 0 07 2014 Philips He
315. mages attached to the exam You can unlink one or multiple linked exams Unlinking an exam does not change the exam status You should not unlink exams after they are marked as read or if they have a report attached to them From the list of exams right click on the linked exam s you want to unlink Select Unlink Exams from the menu The selected exams are unlinked and the Link icon is removed Viewing Locked Exams When a Radiologist opens an exam to read the exam becomes locked so that no other user can mark the exam as read However sometimes the Radiologist who has the exam open leaves the workstation without closing Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exam Information 7 CREF4 09 291 v4 0 07 2014 7 16 NOTE 7 16 1 the exam or their workstation crashes while the exam is locked If this occurs the System Administrator can unlock the exam so that another Radiologist or the same Radiologist can re open the exam to read IntelliSpace PACS includes a worklist called Locked Exams which shows which exams are opened and locked and by whom Users with the proper privileges can unlock an exam from this worklist Locks are granted on a per user basis This means that if multiple users log into IntelliSpace PACS using the same user ID these users will be able to unlock and mark exams r
316. main users at your facility do not have this type of privilege there is a workaround that keeps the security tight but allows IntelliSpace PACS the ability to use this application section of the registry for our use This is easily changed by adding a policy for domain users to allow full access to the HKEY_LOCAL_MACHINE Software Stentor registry section only plus its inherited keys for authenticated users You only need to add full access to the HKEY_LOCAL_MACHINE Software Stentor not to the full registry Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to Machine Preferences The list of available machine preferences displays Click Local Exam Caching The right side of the Preferences dialog box displays current local exam caching preferences The Local Path field shows where the exams are being stored You cannot edit this path Set the Maximum Cache Size in megabytes This size may be restricted to prevent over utilization of memory resources Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting Machine Preferences 19 CREF4 09 291 v4 0 07 2014 19 5 5 6 Set the following options Select the Delete exams upon logout check box to automatically delete cached exams when you log off of IntelliSpace PACS Select the Automatically delete exams no
317. matically display exam notes for unread exams See Setting General Preferences see page 338 Awa RNING You cannot link exam notes to linked exams For example if you link CHEST ABDOMEN PELVIS exams and an exam note is attached to the CHEST exam this exam note will not be displayed in the worklist and Canvas Page associated with the ABDOMEN and PELVIS exams Also the exam note might contain information on the linked exams that will not be visible to the reading physician or clinician e Display the Exam Notes pane of the Clinical Information dialog box in one of the following ways From the Canvas Page click the icon in the Exam Margin Right click an event in the Patient History Timeline on the Canvas Page and select View Exam Notes Right click an exam in Patient Lookup or Exam Lookup and select View Exam Notes CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 131 8 Viewing Clinical Information inical 5 ACPT1 setttt TIM MRN S Sex U DOB 7941 E Ordering MD N A Phone N A Pager N A Accession Exam Code N A Location WA Exam Notes 4 E 2 1 2011 13 44 59 Default Ad Another missed issue Exam Note Type 6 Clinical Info E 2 1 2011 13 43 51 Default Ad Critical issue Exam Note Type 9 2 1 2011 13 43 12 Default Ad Test Preliminary Note Preliminary Note Related Exams 2 1 2011 13 42 35 Default Ad Test Exam Note Exam Note All Exams Curre
318. measurement using a sub sample of an image the measurement result is displayed with a front of it e When opening and displaying an image in full resolution the ROI measurement meaning approximate value in oo values are recalculated The sign is no longer displayed and there might be a small update change from the measurement values displayed initially Right click on the image and from the menu choose one of the following Measurements and then ROI Freehand Measurement Palette then the ROI Freehand icon Click and drag the cursor to enclose the desired area The shape of your outline can be as complex as necessary but the lines cannot intersect When you release the mouse the start and end points are automatically connected and the ROI values are displayed Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Measuring and Annotating Images 13 13 10 CREF4 09 291 v4 0 07 2014 Release the mouse button when you have finished the outline The ROI Freehand tool automatically connects the first and last points The enclosed area of the outline is displayed in centimeters squared or Hounsfield units for CTs Select any portion of the outline and drag to adjust the outline s contours ACPT1 KILARN10 29 1999 11 52 31 Acc 4309278 E3 M culating 6 4962 cm 20 Drag the outline to any part
319. mes is refreshed and a linked patient icon displays next to the name in the list of patients You can right click on one or more linked patients and select Unlink Patient s to remove patients from a link Creating Exams Some hospitals schedule in real time meaning that orders are created when the patient arrives in Radiology As a result if the HL7 interface goes down IntelliSpace PACS does not have the orders to match the studies against You can use the Create Exam dialog box to manually create exams when the HL7 system is down You can also edit exams See Editing Exams see page 110 Intellispace PACS Enterprise 4 4 User Guide 99 Finding and Managing Patient Information NOTE Refer to your local policy on creating new exams in IntelliSpace PACS before using the Create Exam feature If you have HIS RIS integration exams created in IntelliSpace PACS will not be synchronized in your HIS RIS You might want to use the Create Exam feature when a patient brings in old prior films that do not have matching orders in your HIS RIS You can create an exam so that when those films are digitized and sent to IntelliSpace PACS they can become part of the patient record Do one of the following Use the Exam Lookup to search for and display a list of exams Use the Patient Lookup to search for and display a list of patients Display the exams for a patient Select a filter that displays exams Right click ov
320. mns Preferences see page 389 Workflow See Setting Workflow Preferences see page 386 Ensure All Viewed See Setting Ensure All Viewed Preference see page 387 Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Intellispace PACS Enterprise 4 4 User Guide 355 18 Setting System Preferences 2 In the Preferences dialog box click the sign to display the list of System Preferences 3 Set the desired system preferences 4 Click Apply to set a preference and continue setting other preferences Click OK when you are done 18 1 Setting General Preferences System Administrators can set the General system preferences that control the logon welcome message variance for image series linking and other options 1 Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip 2 Click the sign next to System Preferences The list of available system preferences displays 3 Click General Preferences The right side of the Preferences dialog box displays the current general preferences 4 If desired enter a new Logon welcome message You can use this message to display Help Desk information or to notify users of scheduled maintenance to IntelliSpace PACS 5 Enter the text for the message users see the first time they attempt to perform an action on a patient who has been designated as a VIP patient This message can be up to three lines See Working
321. ms with images only check box Press Enter or click Search A list of exams that match your search criteria is displayed STAT exams are always displayed at the top of the list Searching for Exams by Patient Name You can use patient names to search for exams by entering their last and first name or by using a wildcard search For example to find patient Doe John you can search for the full name Doe John full last name and partial first name Doe J or partial last name D There is also a wildcard search option that allows you to search on a partial last name and and partial or full first name for example D Jo You can also search for exams by multiple referring physician names Separate last names with semi colons and first and last names with commas for example Smith Jones or Smith Robert Jones David You can also include the wildcard character to search for partial last or first names for example Smi or Smi Rob If it is not already displayed select Exam Lookup from the Folder List or the Shortcut Bar if you have created a shortcut for this feature Enter all or part of the patient s last or first name Click Search or press Enter Exams for patients in the specified time or date range are displayed Searching for Exams by Date You can select a supplied date time value to search for exams or specify a custom date range using a calendar control Select Exam Lookup fro
322. n exam might contain multiple series acquired at different or even variable slice thickness For example one series might be acquired at 10mm slice thickness and one at 2mm If you link these series and page through them using the very thick 10mm series as the master many images from the 2mm series will be skipped If you page through the images using the very thin 2mm series as the master every image of the 10 mm series will be displayed This means that paging through multiple series simultaneously is possible with the Link tool but images will be skipped unless the series with the thinnest slice thickness is used as the master AARWN e o nN Series 1 Series 2 Awa RNING Linking Series that Contain Different Body Parts CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 29 Safety AMA RwWNh Series that contain different body parts or cover a larger smaller region of the body can be linked For example a CT series that contain a CHEST ABDOMEN PELVIS might be linked with a CT series that contains only a CHEST By navigating through the CT CHEST series you will never be able to see the ABDOMEN PELVIS of the other series Conversely by using the CHEST ABDOMEN PELVIS as the master series you can look at the CHEST images side by side as well as at the ABDOMEN PELVIS images of the master series This means that using the Link tool you cannot go beyond the scope of the master This might be obviou
323. n in the Control Strip may change color depending on the search results When Federation is activated the default color of the F icon is light beige tan the same color as the other icons in the Control Strip See the following table for an explanation of the different colors for this icon Color of F Icon Description Appears as light tan beige Federation is activated Appears light gray Federation has been de activated by the user for that same client instance Appears green Federation is active and functioning properly Appears amber yellow orange The message Some locations in the federation could not be reached displays in the Control Strip meaning that Federation did not get a response from all sites within the Federation but some sites did respond Appears red The error message An error occurred when 2 accessing the federation displays in the Control Strip meaning that the Federation query did not go through Users will only see exams from their local PACS In Patient Lookup when you click the sign next to a patients name to display the list of available exams for that patient a message appears next to the Search button Shortcuts cw Patient Lookup search _ requests queued for federation 3 ACPT1 ADAMS JULIE 196666698 3 ACPT1 AUSTIN POWERS MONKEY DANCING 3 ACPT1 BADOH ROGER 211360205 Personal Folders Public Folders Radiology Tools itp Exam Lookup Lp
324. n of the exam you are setting the Screening criteria for Select either Single single read or Double double blind read for the Type of reading you want Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Setting Ensure All Viewed Preference The Ensure All Viewed preference is used to identify images in an unread selected exam that have not been displayed After the preference is properly configured an asterisk at the bottom of a thumbnail on the Canvas Page IntelliSpace PACS Enterprise 4 4 User Guide 387 18 Setting System Preferences 388 18 13 1 NOTE 18 13 2 indicates that none of the images represented by the thumbnail have been displayed excluded are thumbnails that represent collections key images captured images or clones Adding Ensure All Viewed Setting Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click Ensure All Viewed The right side of the Preferences dialog box displays a list of modalities and body parts Click Add In the Add Ensure All Viewed dialog box select the Modality and optionally enter the name of the Body Part The system logs image series that have not been displayed on the diagnostic monitors Click OK to close the Add Ensure All Viewed dialog box
325. n overlays are available for MG images Label Name KVP Exposure Exposure Time Filter Material Anode Target Material Compression Force Body Part Thickness Entrance Dose mGy Mean Glandular Dose dGy String Value Comment 00180060 kV 00181152 mAs 00181150 ms 00187050 Filter 00181191 Anode 001811A2 N 001811A0 mm 00408302 mGy 00400316 dGy Up to the 3rd decimal place Intellispace PACS Enterprise 4 4 User Guide 373 18 Setting System Preferences Label Name String Value Comment Orientation This Orientation tag looks for the Image Laterality tag 0020 0062 and the Orientation Tag 0018 5101 If the Orientation tag 0018 5101 is not present Intellispace PACS checks for the presence of DICOM tag 0054 0220 for View Code Sequence and its sub tag 0008 0104 for Mammography orientation display Subsequently Intellispace PACS supports DICOM sub tags Intellispace PACS displays both the Laterality and the Orientation on the same line Screen overlays on MG images are displayed on the outside of the image taking into account the image laterality patient orientation and image horizontal flip This prevents overlays from displaying over the image The Field of View for DICOM tag 0018 1100 is a diameter measurement of a region within the original dataset from which reconstruction of an image was derived The original data and or patient may exist outside of this region
326. n the IntelliSpace PACS Control Strip The maximum results that can be displayed at any time are 50 If more than 50 studies match your search criteria only 50 are displayed and the Control Strip displays a message that you must narrow your search Fora Patient Root Model Query the maximum number of patients displayed is 50 316 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Retrieving and Exporting Studies 15 For a Study Root Query Model the maximum number of studies displayed for a single patient is 50 if all of those studies belong to one patient If any of the studies are expanded and you run another query the results of that subsequent query are also limited to 50 5 View the studies available for a patient by clicking the plus symbol to the left of the patient name E Enterprise Tools API Tester fy Exam Lookup Gp Exceptions Lookup Patient Lookup a Installed Programs Local Exam Cache Local Export Eb Locked Exams Machine Filters amp Merge Link Candidate s My Filters My History Queues Reifel William 103 16 000 4D Test 3 Study Description No Descrip 03 16 2011 16 26 07 Series Number 0 6 Expand the list under the Patient Name by clicking the sign in front of Study Description and then Series Number If there are several series in a study
327. n the Merge Link Candidate s list See Resolving Merged or Linked Patient Records see page 86 Creating Patient Records Most of the time patient records are created through HL7 or through auto create But IntelliSpace PACS also allows users with the proper privileges to create and edit patient records manually You create a patient by entering an MRN demographic information and contact information Refer to your local policy on creating new exam in IntelliSpace PACS before using the Create Patient feature If you have HIS RIS integration patients created in IntelliSpace PACS will not be synchronized in your HIS RIS Use the Patient Lookup to search for and display a list of patient names Right click over a list of patients and from the menu choose Create Patient The Create Patient dialog box displays with the Demographics pane displayed From the Organization list select the organization to which the patient belongs Only organizations to which you can add a patient record are listed Enter the Medical Record Number MRN for the patient mandatory This number must be unique within the organization and cannot be more than 45 alphanumeric characters The MRN you enter is displayed in the header of the Create Patient dialog box Enter the patient s first middle and last names The first and last names are mandatory The name you enter is displayed in the header of the Create Patient dialog box From the Sex list ch
328. n the iExport Job Status Queue window The iExport Job Status Queue window displays the following progress information Creation Date Status Updated Date Retry Count Total Images Images Exported and Error Message Double click an iExport job The iExport Job Status Queue window opens iExport Job Status Queue 2012 15 02 09 Review the information and click Close To view the latest progress of an iExport job click Search in the iExport Queue dialog box to refresh the list then double click the job for which you want to view progress Canceling Active iExport Jobs Long running iExport jobs which are in active state can be canceled from the iExport Queue These jobs are not guaranteed to cancel completely but will stop after the periodic cycle finds a Cancel request for the job Intellispace PACS Enterprise 4 4 User Guide 313 15 Retrieving and Exporting Studies 314 15 4 What is actually canceled depends on what was in the process of being sent when the cancel request occurred iQuery for DICOM Study Retrieval The iQuery tool allows an authorized user to retrieve DICOM studies from your institution s digital archive and send them to IntelliSpace PACS If you have the iQueryExecute permission you can query the archive submit studies to be moved and view the queue In addition with the proper permissions you can perform different tasks related to viewing and managing the queues
329. n to isitecare philips com 20 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 Safety Safety Messages Changes or modifications not expressly approved by the party responsible for compliance could void the user s authority to operate the equipment Do not use portable devices such as smart phones or iPads tablet PCs for diagnostic purposes Make sure that you have a local printer available in order to print directly from the modality should the system become unavailable Make sure that you are using appropriate monitors and that they are properly configured and calibrated prior to using IntelliSpace PACS Enterprise Radiology IntelliSspace PACS Enterprise should not be used to render a primary diagnosis Please adhere to your site security policy to establish strong passwords and take appropriate measures to secure the network environment to prevent access by unauthorized users and possible modification to patient data Each user is assigned a unique User ID and password This prevents users from sharing the same personal folders user preferences and shortcuts and prevents one user from deleting or changing the user preferences and personal folders of other users You should never share your User ID and password True Size should not be used as a measurement tool since pixel pitch is o
330. ncansin 350 17 7 Setting Applications Configuration Rules wc cece 351 IZA DADA EA Rulea iirinn aeaa A E 352 TAL Deleting a Ruletranynienireid aa aaa 353 17 8 Importing All and Exporting All User Preferences cece 353 Setting System Preferences csccscscsscsccscsccccscecsscscscssceceees 355 18 1 Setting General Preterences i 5 cci oisesdianesascdnssensdleveseestessecesteledeeys 356 18 2 Setting Window Width Center System Preferences 0 cee 357 18 3 Editing a Window Width Center Preference cccccceeeeeeeees 359 18 3 1 Deleting a Window Width Center Preference 359 18 4 Setting Image Processing Preferences ssssesesesseesesesreerrrrsrsrsrerss 359 18 5 Setting Annotation Prererences s cisiaicidsignjauianidcaaorseney 362 18 5 1 Editing an Annotation Preference sss 363 18 5 2 Deleting an Annotation Preference nasses 363 18 6 Setting DICOM Sources Preferences sssssesessseeeseererersrsrseeereres 364 18 6 1 Editing a DICOM Source sassone 371 18 6 2 Deleting a DICOM Source 372 18 7 Setting Screen Overlay Preferences osc ss sutst couse teantwaatencantetoncgcsndens 372 18 7 1 Editing a Screen Overlay ossos 376 18 7 2 Deleting a Screen Overlay 376 18 7 3 Exporting a Screen Overlay 377 18 74 Importing a Screen Overlay osooso 377 18 8 Setting Paper Printing Preteretcesx curidevecuonsarisioveansstouvavestonrsvess 377 18 8 1 Editing a Paper Printing Preference aossen 378 18 8 2 Exporting a Paper Print
331. ned images in the Exam Rack are marked with a C and a sequential number C1 C2 and so on e In the Exam Rack right click the image you want to clone From the menu select Clone e Double click the cloned image to open it in an image popup window Removing Clones e Right click a cloned image and select Remove Clone from the menu Detaching Individual Studies from Exams Sometimes a study gets associated with the wrong exam In this case you don t want to detach both studies from an exam just the one that should be associated with another exam If you have the proper privileges you can detach individual DICOM studies from an exam for a thumbnail image on Intellispace PACS Enterprise 4 4 User Guide 211 11 Using the Canvas Page the Canvas Page as long as the selected thumbnail window is not a Clone or Key Image window Detached studies will become exceptions and should be resolved to the correct exam NOTE When a study is detached from an exam IntelliSpace PACS may not be able to determine whether that study was used to set the exam fields Therefore when an exam gets created with no modality type and body part the following might occur e Study arrives and is wrongly attached to the exam The modality and body part of study1 is copied into the exam e When Study 2 arrives for the exam correctly its modality and body part are ignored because the exam already has them set e When you detach Study from the
332. ned sidelong either to the left or right side of image windows Intellispace PACS Enterprise 4 4 User Guide 227 12 Viewing and Manipulating Images 228 Mirror linking allows you to link images at opposite coordinates For example when you zoom into an image that is positioned along the right side of an image window IntelliSpace PACS automatically zooms into the other image positioned along the left side of the linked image window 1 Right click the first image and choose New Link from the menu This engages linking 2 To add more images select those images right click and choose the Join Mirror Link from the menu When mirror linking is activated the following functions affect all linked images Step Zoom See Zoom Settings see page 250 e Pan See Panning Around an Image see page 254 Figure 12 2 Image thumbnails showing Step Zoom with Mirror Link 12 3 7 Linking Warnings Aw ARNING General Warning Message The current implementation of the Link tool allows you to synchronize other windows series with the window series you are currently browsing through In other words there is one master window series typically the one that you have selected with your mouse and IntelliSpace PACS tries to line up the images of the other linked windows Therefore you should always review each and every series by paging through them individually and never rely on linking as a way to review all images within a given
333. nfigured Description Angle Measurement Angle Measurement Persistent Arrow Annotation Arrow Annotation Persistent Circle Intellispace PACS Enterprise 4 4 User Guide Default Keystroke NONE NONE NONE NONE Hardcoded Action Activates the angle measurement for a single use Keeps the angle measurement tool active for multiple uses Activates arrow annotation for a single use Keeps the arrow annotation tool active for multiple uses Activates the Circle Annotation for a single use CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Mouse and Keyboard Reference Sheet 20 CREF4 09 291 v4 0 07 2014 Description CLAHE Collection Navigation Next Prior Exam Collection Navigation Previous Prior Exam Collection Navigation Rectangle Backward Collection Navigation Rectangle Forward Flip Horizontal Flip Vertical Go to Beginning of Stack Go to End of Stack Help Manual Horizontal Rack Invert Grayscale Link Unlink Images Localizer Mode Default Hardcoded Keystroke Shift C NONE NONE NONE NONE Ctrl H Ctrl T Home and End F1 Ctri Alt H l NONE F12 Yes Action Applies the CLAHE filter to the image when Mammography features are enabled Navigate forward to the next prior exam Navigate backward to the previous prior exam Navi
334. ng filters cannot be printed to film as diagnostic quality images See Image Processing Effects see page 47 Except for the Invert Image tool when you apply an image processing filter to an image a P Processed icon is displaced in the lower right corner of the image Note that image processing filters cannot be printed to a DICOM device Images with image processing can be printed to paper copied to the clipboard or saved as a file Intellispace PACS Enterprise 4 4 User Guide 237 12 Viewing and Manipulating Images 238 5 x bnn e Image Processing filter applied Figure 12 4 Image with Image Processing icon Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 12 6 1 Inverting an Image The Invert Image feature reverses the black and white coloration of the selected image Figure 12 5 Inverted image 3 Nov 1999 8 03 59 4319808 m ba 3 SPINE SINGLE VW w l 1402 3033 TRAUMA C sp LT Lat Series 1 12 6 2 To invert an image e Right click the image and from the menu select Image Processing then Invert Image Enhancing the Edges of an Image The Edge Enhance feature uses a Laplacian method to increase the visibility of edges in the image There are three degrees of application Light Medium and Strong Y
335. nge the plug in settings as desired Click OK You return to the Preferences dialog box Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Deleting a Plug In Preference Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to Machine Preferences The list of available machine preferences displays Intellispace PACS Enterprise 4 4 User Guide 395 19 Setting Machine Preferences 396 19 4 Click Plug Ins The right side of the Preferences dialog box displays a list of the current plug ins and allows you to add edit or delete plug ins Select the plug in you want to delete and click Delete Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Setting Local Exam Caching Preferences System Administrators can modify the supplied settings for the local exam cache The Local Exam Cache folder in the Folder List allows you to cache patient exams on your local machine for later review Images are cached in an encrypted format If there is not sufficient memory exams are deleted in a first in first out manner If there is still not sufficient memory a message displays Users who want to change the Local Exam Caching Machine preferences must have write access to the computer s registry settings If do
336. nical decision support by displaying patient demographics exam notes diagnostic reports exam history and provider information Therefore the more clinical information it provides the more clinical users are informed of the patients imaging history and previous diagnoses Make sure that patient demographics are properly completed so that all patient data is available for the Radiologist and Referring Physician and diagnosis is not delayed e Avoid editing patient data at the modality without starting a new exam This could potentially mix patient studies and therefore cause a Duplicate UID IntelliSpace PACS receives clinical data from DICOM via imaging studies and from HL7 via diagnostic reports and patient exam registration events A HIS or RIS integrated with IntelliSpace PACS provides a rich history of the patient s imaging record This information is invaluable for Administrators when resolving exceptions or studies not validated with any patient exam The task of validating an exception with a patient s exam by a PACS Administrator includes accessing the patient s imaging record and deciding which exam the exception should be validated against Therefore to simplify administrative workflow with resolving exceptions the Exception Handler allows direct access to the Clinical Information Dialog to view a patient s entire exam list Intellispace PACS Enterprise 4 4 User Guide 127 8 Viewing Clinical Information You can
337. nked exams is set to the same status when they are still in Scheduled e A warning displays if you try to link two exams where one exam has been marked as read or has a status of Dictated Preliminary or Final Report Status See Understanding Exam Statuses see page 109 for more information on exam statuses e You can unlink exams of any modality type Intellispace PACS Enterprise 4 4 User Guide 119 Finding and Managing Exam Information A warnine 7 14 7 15 You cannot link exam notes to linked exams For example if you link CHEST ABDOMEN PELVIS exams and an exam note is attached to the CHEST exam this exam note will not be displayed in the worklist and Canvas Page associated with the ABDOMEN and PELVIS exams Also the exam note might contain information on the linked exams that will not be visible to the reading physician or clinician From the list of exams Shift click or Ctrl click to select the exams you want to link You can link two or more exams Right click and select Link Exams from the menu The exams are linked and the Link icon is displayed Unlinking Exams The effect of unlinking exams depends on whether or not images have arrived for the exam as follows e When you unlink an exam before images have arrived you undo the Link Exam function e When you unlink an exam from a group of exams after images have arrived the selected exam is removed from the link meaning that there are no longer i
338. nnotations in a GSPS the GSPS will not be loaded and an audit message will be created e You can create new annotations on top of GSPS annotations and save newly created annotation in an IntelliSpace PACS presentation state 220 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 12 2 e You cannot edit or delete annotations loaded from a GSPS because they are read only This also applies if the annotations loaded from a GSPS are saved in an IntelliSpace PACS presentation state An image artifact may appear when a Modality LUT or a mask is applied to a sub sampled image The sub sampled image means that the image data is not fully retrieved from the server and therefore not displaying at full resolution Diagnosis should only occur on images that are displayed at full 100 resolution If images are displayed at full resolution no artifact should appear Using Key Images Key images are images you mark as key They are archived and displayed as a component of presentation states and can be marked as key for a variety of reasons including improving referring physician access by providing a way to focus on the most pertinent images in a study for teaching files consultation and image quality issues Key images are identified by the text message Key
339. not related to what is being displayed on your screen Rather it is the value for a reference point which is mapped to the original DICOM image The x value starts at zero left side of image and increases to the maximum value at the right side The y value starts at zero at the top of the image and increases as you move the cursor toward the bottom of the image The measurement units depend on the modality type and the information provided in the DICOM image header and will be either e Hounsfield units sloped intercept for CT e Mapped pixel intensity for VOI LUT e Pixel intensity as remapped by modality LUT or rescale slope intercept processing as per DICOM standard The level of accuracy is the following e True pixel value no error for untransformed data e Hounsfield units based on 1024 air as per DICOM standard no error e Ifslope intercept is provided then the pixel value is Y mx b with floating point values rounded to the integer pixel value This means that the error is dependent on the magnitude of the value with a maximum deviation of 0 5 Intellispace PACS Enterprise 4 4 User Guide 275 13 Measuring and Annotating Images 276 13 12 Figure 13 6 Point Value Tool example Note the following e When IntelliSpace PACS calculates a measurement using a sub sample of an image the measurement result is displayed with a front of it meaning approximate value in e When opening and displa
340. ns or Ctrl click to select multiple non contiguous exceptions Showing or Hiding Exception Lookup Columns Right click in the column area above the list of exceptions A menu displays showing a check mark to the left of the active criteria type Select the columns you want to show or hide Shown columns are checked hidden columns are unchecked Repeat steps 1 and 2 as required Intellispace PACS Enterprise 4 4 User Guide 175 10 Finding and Managing Exceptions 176 10 4 10 5 NOTE 10 6 Rearranging Exception Lookup Columns You can click and drag Exception Lookup columns to rearrange their order This allows you to customize in what order exception information is displayed e Press and drag a column to the position you want and release the mouse button Sorting Results By default the selected sort column is set to display all exams on top Clicking the column header in the exam or exception worklist sorts the contents of the worklist using the selected header as the primary sort column Clicking the current sort column toggles the sort order between ascending and descending Exceptions are sorted by Exception Date Time descending with newest exceptions on top You cannot sort the Sex Images or Study Description columns Click the blue column heading that you want to sort by An arrow appears in the column heading to display whether the order is ascending A Z or 1 9 or descending order Z A
341. nt Press Ctrl Alt F6 to toggle only DICOM 6000 overlays on off Press Ctrl F6 to toggle all overlays on off IntelliSpace PACS lays IntelliSpace PACS Annotations amp Measurements and Embedded and Declared DICOM Overlays X Ray images With a wheel mouse click and drag the wheel button With a two button mouse left click and drag the mouse while holding down the Ctrl key Series Left click and drag the mouse while holding down the Ctrl key X Ray images With a wheel mouse roll the mouse wheel back and forth With a two button mouse click the left mouse button and drag the mouse while holding down the Alt key Series Click the left mouse button and drag the mouse up down while holding the Alt key With a wheel mouse roll the mouse wheel back and forth With a two button mouse press the up and down arrows keys Double click a multi image stack series The initial frame rate is based on the User Display Preference for the Default Cine Rate See Setting Display Preferences see page 350 Alternatively you can hold down the mouse wheel and drag the mouse up or down Click the small Report icon at the upper left corner of the exam margin This button is white if reports are unavailable or are not supported by your institution You can also right click the exam listing in the Patient History and select Show Reports from the menu Right click on exam listing or the timeline and select View Exam Notes Right clic
342. nt Providers Subject Note Type Exam Note Cenn I Critical Note Audit Trail 8 1 1 Creating Exam Notes You can create up to 25 exam notes up to 5 000 characters for each exam You can also mark exam notes as critical by selecting the Critical Note check box If immediate medical treatment is needed or if you disagree with a prior exam note contact the treating physician immediately You should not rely on creating a critical exam note in these situations 1 Display the Exam Notes pane of the Clinical Information dialog box in one of the following ways From the Canvas Page click the clipboard icon in the Exam Margin 132 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing Clinical Information 8 CREF4 09 291 v4 0 07 2014 NOTE 8 1 2 Right click on an event in the Patient History Timeline on the Canvas Page and select View Exam Notes Right click on an exam in Patient Lookup or Exam Lookup and select View Exam Notes Click New Note The Exam Notes types that you have access rights to display The Subject Note Type and note area become active Enter the subject of the note This appears in the summary when the exam note is listed in the Clinical Information dialog box Select a note type from the list Three types of pre defined exam notes and up to seven generic types modified by th
343. ntableHelpManuals aspx END OF DOCUMENT Intellispace PACS Enterprise 4 4 User Guide 433 23 Accessing PDF File of Online Help 434 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc www philips com healthcare healthcare philips com Manufactured by Philips Healthcare Informatics Inc 4100 E Third Avenue Ste 101 Foster City CA 94404 USA jee rer Authorized European Representative Philips Medical Systems Nederland B V Veenpluis 4 6 5684 PC Best The Netherlands Sponsor for Australia Philips Electronics Australia Ltd 65 Epping Rd North Ryde NSW 2113 Australia PHILIPS Koninklijke Philips N V 2014 All rights are reserved Reproduction or transmission in whole or in part in any form or by any means electronic mechanical or otherwise is prohibited without the prior written consent of the copyright owner 0044 This Medical Device meets the provisions of the transposition of the Medical Device Directive 93 42 EEC within the country of origin of the Notified Body concerned with the device Copyrights and all other proprietary rights in any software and related documentation Software made available to you rest exclusively with Philips or its licensors No title or ownership in the Software is conferred to you Use of the Software is subject to the end user license conditions as are available on request
344. ntelliSpace PACS client honors the overlay activation layer tags when loading GSPS When a GSPS for an image that has DICOM overlays is loaded IntelliSpace PACS only displays those overlay planes for which the overlay activation layer tag in the GSPS instance has some non zero length value IntelliSpace PACS does not display those overlay planes for which the overlay activation layer tag has no value or if the overlay activation tag is missing altogether However all overlay planes will be displayed when the display of overlays is toggled off and on using the shortcut keys for Show Hide All Overlays or Show Hide Bit Overlays See Keyboard Commands see page 407 Click the Collection tab to enable Auto collect series Selecting this option causes all series with less than or equal to the number of specified images in the exam to be added to a single collection by default in the order of Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 CREF4 09 291 v4 0 07 2014 18 6 1 acquisition The Number of images box specifies the maximum number of images that a series can have for it to be auto collected Enter the number between 1 and 200 in the box Select Auto play collection this causes the collection to start auto playing the rest of the images in the collection when the user starts scrolling through th
345. of MIP MPR and Volume rendering so that your work can be restored and reused during any future session of Volume Vision In addition you can save movies as originals photos or AVI files See the Volume Vision online help for more information e In Volume Vision in combination with IntelliSpace PACS Radiology all modifications on volume objects are stored and available in the next session of Volume Vision 14 2 2 Hold and Resume Volume Vision Sessions Patient data displayed in Volume Vision always corresponds to the patient displayed on the IntelliSpace PACS canvas 286 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Philips IntelliSpace Clinical Applications 14 14 2 3 CREF4 09 291 v4 0 07 2014 Therefore if you select another patient in IntelliSpace PACS while the Volume Vision session is still open Volume Vision will become iconized and the session will be temporarily locked You can access that Volume Vision session again only when you select the corresponding patient in IntelliSpace PACS You can also choose to temporarily preserve a specific session of Volume Vision From within Volume Vision from the Session menu select Hold Exiting Volume Vision To exit Volume Vision and return to IntelliSpace PACS do one of the following e To exit Volume Vision and save the reconstructed image back to th
346. ol e Right click on the magnifying glass and select Close 12 11 Zoom Settings NOTE The image zoom settings affect only the current image display Your changes will not be saved 12 11 1 True Size Zoom Av ARNING Do not use True Size as a measurement tool The True Size setting approximately represents the actual size of the anatomical structures on the screen 250 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 12 11 2 Using the Step Zoom Tool The Step Zoom tool allows you to step sequentially through portions of an image in an image popup window or virtual monitor at full resolution instead of having to zoom and pan manually The number of steps is determined by the size of the image and the size of display area The maximum number of steps is 16 For mammography images the first step displays the region of glandular tissue from the anterior side of the breast Thereafter the order in which you step through the image is left to right from top to bottom as shown in the following example Step 1 shows region of glandular tissue Regions of background only are excluded from the step zoom Figure 12 12 Step Zoom sequence example Dashed lines indicate overlap The Step Zoom tool divides the full scale image into smaller overlapping portions at the size of the window that h
347. om another system See iQuery for DICOM Study Retrieval see page 314 iQuery Queue The feature that enables you to monitor the progress of an exam being retrieved remove requested studies from the queue and perform other administrative functions See Viewing the iQuery Queue see page 320 Intellispace PACS Administration Tool The application used by IntelliSpace PACS System Administrators and Technical Support to view and modify site configuration settings such as security and dictionaries 424 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Glossary 22 CREF4 09 291 v4 0 07 2014 IntelliSpace PACS Enterprise An enterprise wide Web based image distribution solution that delivers the power of radiology to the point of patient care IntelliSpace PACS Radiology IntelliSpace PACS diagnostic viewer designed for Radiologists Keypad A small hardware device placed next to the keyboard that offers a quick method for launching frequently used functions LCC View position and breast examined left cranial caudal LMLO View position and breast examined left medial lateral oblique Local Exam The tool that enables you to download patient exams to your local machine This speeds up access to image data when running IntelliSpace PACS remotely Localizer Tool The tool that helps you visuali
348. om the list To configure the overlay for paper printing click Overlay The Overlay dialog box displays the available overlay options and a default screen overlay You can add a total of 50 overlays to images meaning approximately 12 overlay items per corner A line can contain multiple overlays for example name and sex on a single line Select the desired overlay text from the tree control on the right side of the Overlay dialog box and drag it to the screen mockup on the left side Remove overlay text by selecting and dragging it off the screen mockup You can only place overlay text on one of the screen s corners not in the center of the image Selected overlays are outlined with a red box Click Font if you want to change the display font for overlays printed on paper The Font dialog box displays Select a font from the list and click OK You return to the Overlay dialog box You can double click overlay text in the screen mockup to view the DICOM tag for that text To add a custom DICOM tag double click an overlay field and enter the new Name and Value in the Tag Edit dialog box The value corresponds to the DICOM metadata field which carries the information in question For instance number always use the DICOM Tag Image Number 0020 0013 Click OK when you are done You return to the Overlay dialog box Click OK to return to the Add Windows Print Configuration dialog box When you have finished configuring the overlay click
349. omplete and a box in the angle indicates the measurement of the angle in degrees The following set of figures shows the various actions you can take using the Angle tool e Figure 1 Create the angle by clicking on the point you want to serve as the angle s endpoint moving the cursor to the second point the angle s apex clicking again and moving the cursor to the other endpoint and clicking again e Figure 2 Move the entire angle without repositioning either endpoint by clicking on the apex and dragging it to the new location e Figure 3 Reposition either end of the angle tool by clicking on that end and dragging it to the new location This enables you to measure wide angles where the apex is not on the image e Figure 4 Articulate the arms of the angle by clicking anywhere on them and dragging them to a new location Intellispace PACS Enterprise 4 4 User Guide 267 13 Measuring and Annotating Images 268 18 Feb 1999 18 07 57 3761586 fmyMMMl18Feb 1999 18 07 57 3761586 my Figure 1 Figure 2 18 Feb 1999 18 07 57 3761586 mj M 18 Feb 1999 Figure 3 Figure 4 Figure 13 3 Angle Tool example 13 7 1 Taking Cobb Measurements Cobb measurements are in degrees and the limits of accuracy are the same as the canonical angular measurements 1 Right click on the image and from the menu choose one of the following Measurements and then Angle Measurement Palette then the Angle icon 2 Click
350. on is image specific meaning that you can have an A B or C in different images The letters are preserved in a presentation state Figure 1 Measure a region with the ruler Figure 2 Select and drag the entire ruler without repositioning either end Figure 3 Reposition either end of the ruler by clicking and dragging on an endpoint e Figure 4 Reposition the measurement value by clicking it and dragging to the desired position Figure 1 Figure 3 Figure 4 Figure 13 2 Ruler Tool example 266 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Measuring and Annotating Images 13 CREF4 09 291 v4 0 07 2014 13 7 Using the Angle Tool You can use the Angle tool to measure the angular alignment of two objects The measurement units for the Angle tool are degrees The level of accuracy is based on the angle being computed as a floating point value and truncated to an integer This implies a maximum angular error of approximately 0 5 degrees Right click on the image and from the menu choose one of the following Measurements and then Angle Measurement Palette then the Angle icon Click on the point you want to use for the angle s endpoint and move the cursor to the second point the angle s apex and click again Move the cursor to the second endpoint and click The angle is c
351. on study with the correct patient or exam e Deleting an exception study is a potentially hazardous operation and cannot be undone and images cannot be recovered You should review the Warnings in this chapter to ensure that you understand the possible ramifications of deleting an exception study e Make sure that you understand that when you detach DICOM studies from an exam and delete the subsequent exception you are in fact permanently deleting those studies Deleted studies may contain data that would render a different diagnosis e Make sure you label the left and right sides of an image correctly to prevent incorrect patient orientation and the possibility of misdiagnosis e Make sure you follow industry best practices for correct patient orientation e Make sure the images were acquired correctly at the modality before using them for diagnosis e Make sure you validate third party software to ensure that it is using the correct information from the outside source In addition proper validation of third party software must be done to ensure that it is using standard DICOM tags Images that Intellispace PACS Enterprise 4 4 User Guide 25 Safety are submitted with a different pixel spacing tag than what IntelliSpace PACS uses 0018 1164 to perform measurements on projection radiography images could lead to incorrect measurement readings thus leading to misdiagnosis and treatment planning Use caution when saving an
352. one or lung These settings are mapped to the number keys 1 through 9 in the order listed in the Preferences dialog box allowing you to quickly apply a Window Width Center setting while viewing images When an image is first displayed IntelliSpace PACS uses the modality s default WW WL setting if that information is available in the DICOM When you modify or add Window Width Center settings IntelliSpace PACS uses these settings over the system default Window Width Center preferences Adding a Window Width Center Setting Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Under User Preferences click Window Width Center The right side of the Preferences dialog box displays the current window width and center settings Click Add The Add Window Width Center dialog box displays Enter the desired Name for the new window width center setting You can put a number or letter in front of the name for easier sorting Select a Modality from the list Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting User Preferences 17 CREF4 09 291 v4 0 07 2014 17 3 2 17 3 3 Enter values for the Width and Center Click OK The preference is added to the list Click Apply to save the settings and continue setting other preferences Click OK to save your changes and close the Preferences dialog box
353. onsidered for querying All other tags are ignored If a single archive is selected whose Query Model is set to either Unknown Patient Study Only or Patient Root only the Patient level tags are considered for querying All other tags are ignored Intellispace PACS Enterprise 4 4 User Guide 315 15 Retrieving and Exporting Studies e Ifa single archive is selected whose Query Model is set to Study Root only the Patient and Study tags are considered for querying All other tags are ignored To perform a query using iQuery 1 Click iQuery in the Folder List The iQuery main page displays and contains the search fields you use to enter the patient data that you wish to retrieve search amp Personal Folders Public Folders 3 6 Radiology Tools fy Exam Lookup Gp Exceptions Lookup Patient Lookup Installed Programs gt a r a 2 Enter the query criteria into the appropriate search fields and click Search iQuery searches all available archives 3 To restrict your search to a particular archive such as VNA select it from the Archive list by clicking the dropdown arrow in the Archive field and then clicking Search 4 During the search the Search button changes to a Stop button which is enabled To stop the query click Stop The patients that match your query are displayed below the query fields If no studies match your query you will be notified by a message i
354. oose the patient s gender The sex you select is displayed in the header of the Create Patient dialog box Intellispace PACS Enterprise 4 4 User Guide 83 6 Finding and Managing Patient Information 6 15 NOTE Enter the patient s date of birth Either type in or click the up or down arrows to change the date Use Ctrl X or the Backspace key to clear the date field The date of birth you enter is displayed in the header of the Create Patient dialog box Click Contact Info The Contact Info pane displays Optionally enter the patient s address and phone number s Click Save to save the information and close the dialog box If the MRN is already in use a message displays when you click Save prompting you to change the MRN and try again Editing Patient Records You can use the Edit Patient dialog box to modify demographic or contact information for an existing patient or to view or remove links from patient records However you cannot update the patient s organization After you edit patient related demographics the updates are not immediately propagated to other parts of IntelliSpace PACS Refer to your local policy on creating new exam in IntelliSpace PACS before using the Edit Patient feature If you have HIS RIS integration patients edited in IntelliSpace PACS will not be synchronized in your HIS RIS Use the Patient Lookup to search for and display a list of patient names Right click on the patient you want to
355. or 9 1 To reverse the order click the same column heading again Exception Resolution Overview Exceptions occur when there is a mismatch between the gold copy in the IntelliSpace PACS database and the modality metadata information sent by the modality sometimes called a digital flashcard This can happen for a number of reasons depending on configuration and external system behavior It is critical that DICOM studies are associated with the proper patient and procedure to avoid the presentation of images with the wrong patient You use the Exceptions Lookup to find exception studies See Exceptions Lookup Overview see page 171 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exceptions 10 CREF4 09 291 v4 0 07 2014 If you have the correct access privileges you can use the Exceptions Handler to resolve exceptions by associating received DICOM studies with patients and procedures in the system database You can also delete exception studies if they cannot be resolved See Deleting Exception Studies see page 187 When an exception occurs the provider cannot know with certainty the patient to whom the images belong Because there is no way to automatically determine the correct patient each exception must be reviewed and resolved before the associated images are linked with data
356. or exams and exceptions in a worklist and either view this information as you are working or save it as a new filter Depending on how they are defined worklists can display one of the following e Exams only e Exceptions only Resolved or Unresolved e Exams and exceptions Note the following about searching for exams and exceptions e For filters displaying exams exceptions or both exams and exceptions you can specify the desired start and end dates by selecting Custom from the Exam Date Time list or Exception Date Time list If a Custom date is set to more than 7 days the filter is not auto refreshed every one minute Also if All is selected as the date for the when the worklist is created the filter is not auto refreshed every one minute See Creating Filters see page 158 e Only exact matches for Accession and MRN are supported The maximum number of exams matching your search criteria is configurable You will be notified if a search returns more exams than the maximum allowed The message will display the total number of exams returned by the search e The total number of exception studies matching your search criteria is displayed The message will display the total number of exceptions returned by the search Searching in a Worklist That Only Displays Exams Select a filter from the Folder List that displays exams Enter the desired search criteria in the search area Click Search or press Enter A list of
357. or several instances in a series the series and instances are numbered based on the Series Number and Instance Number DICOM tags respectively 7 To configure the query retrieval columns display right click a Series Number or Instance Number including any DICOM state such as a Presentation State to select deselect the columns you want to display By CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 317 15 Retrieving and Exporting Studies 318 default all query retrieval columns are selected Note that Patient Name MRN Archive Study UID and Series Instance UID are automatically selected and grayed out so they cannot be deselected Patient Name MRN Reifel William Study Description N Series Number 0 Instance Numb Archive Study Date Time Patient Birthdate Patient Sex Study ID Accession Number Modalities in Study Study UID Referring Physician Study Series Count Study Instance Count Modality Series Number Series Instance UID Requested Proc ID Scheduled Proc ID PPS Start Date Time Series Instance Count Series Description Instance Number SOP Instance UID SOP Class UID Series Number 1 Y v 7 v v M v v v vY M v v v v v vY v M v M v v v 8 Right click any displayed row and click Retrieve Awe RNING Data that has been retrieved from a VNA archive may be changed in the VNA by a third party user while a copy of the data is stored in the Int
358. or zoom pan scroll or brightness if you have enabled this in the General user preferences See Setting General Preferences see page 338 and Enhanced Mouse Scheme see page 403 Window Width and Level WW WL See Setting the Window Width Level see page 231 Image Processing See Image Processing see page 236 Scout Line Mode for CT MR PT See Using the Scout Tool see page 244 Localizer Mode for CT MR PT See Using the Localizer Tool see page 245 Create Popup Displays the image in a separate window Key Image See Using Key Images see page 221 Measurements See Using the Measurement Palette see page 263 Annotations Annotating Images see page 277 Delete All Measurements and Annotations Using the Measurement Palette see page 263 VOI LUT for CR DX and MG See Value of Interest LUT VOI LUT see page 234 Clone See Using Clone Windows see page 211 Remove Clone See Removing Clones see page 211 Zoom Presets Allows you to select a preset zoom factor of Fit to Window 100 Original Size 200 300 or 400 Export Allows you to select Export via DICOM Export Image via DICOM or Anonymous Export via DICOM See iExport for DICOM Export see page 303 Clone Window with Preset See Using Clone Windows see page 211 Intellispace PACS Enterprise 4 4 User Guide 207 11 Using the Canvas Page Pl
359. orientation e Make sure the images were acquired correctly at the modality before using them for diagnosis e Make sure you validate third party software to ensure that it is using the correct information from the outside source In addition proper validation of third party software must be done to ensure that it is using standard DICOM tags Images that are submitted with a different pixel spacing tag than what IntelliSpace PACS uses 0018 1164 to perform measurements on projection radiography images could lead to incorrect measurement readings thus leading to misdiagnosis and treatment planning The IntelliSpace Enterprise Canvas Page displays the following Intellispace PACS Enterprise 4 4 User Guide 195 11 Using the Canvas Page 196 3 Timeline 4 Exam Rack 5 Exam Margin 1 Patient Information Area 2 Image Thumbnail Figure 11 1 Intellispace PACS Enterprise Canvas Page 1 Patient Information Area Displays general information about the patient whose exams you are viewing including the patient s name sex date of birth MRN and referring physician It also displays a Patient Class entry which designates the type of patient typically Inpatient I Outpatient O Emergency E and so forth This information comes from the HIS RIS 2 Image Thumbnail Displays thumbnail images and or image series of an exam Each image or series has an information bar below it Double clicking a thumbnail
360. orklists as well as tools for creating dynamic and static worklists that is filters and folders Intellispace PACS Enterprise 4 4 User Guide 427 22 Glossary 428 Permissions The functions the user is permitted to perform on the system Permissions are linked to the role that the user is given by the system administrator Personal Folders A folder in the Folder List that contains exam links you want to save for future reference See Folder List see page 51 Pixel to Pixel Zoom Zoom setting where a single pixel in the image corresponds to a single pixel on the screen Presentation State The presentation state of images or series refers to the attributes which determine how the images or series are displayed e g zoom window width level settings whether or not annotations and measurements are shown Prior Clinical images from previous exams of a patient that can be relevant for diagnosing or rating the current medical condition of that patient Public Folders A folder in the Folder List that can be shared with multiple users See Folder List see page 51 Rack See Exam Rack RCC View position and breast examined right cranial caudal Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Glossary 22 CREF4 09 291 v4 0 07 2014 Recent Images Clinical images from previous exam
361. orts for remote cached exams show only the text of the report and not the other tabs normally displayed in the Clinical Information dialog e You cannot create a conference presentation state for the main exam while the cached exam is open e Right click options for a cached exam are limited You can load an existing presentation state but you cannot create edit save a new presentation state assign a new SUID export DICOM If the local Patient demographics are different from the cached exam demographics the text is displayed in red Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Using the Canvas Page 11 CREF4 09 291 v4 0 07 2014 11 3 11 4 NOTE e You can delete cached remote exams by right clicking on the patient exam from the Worklist and selecting Delete Exam from the context menu Accessing Exams that are not on the Intellispace PACS Server e Double click an exam with an A in the timeline IntelliSpace PACS queries the available archives to retrieve the exam in question An empty exam rack loads in the Canvas Page while the exam is being retrieved The Modality Accession Number Referring Physician and Status are displayed as well as an estimate of how much time remains before the exam is retrieved and a display of the images being requested Click Cancel to stop the archive retrieval O
362. osts the image The order in which you step through the image is top to bottom then left to right as shown in the following example CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 251 12 Viewing and Manipulating Images 252 Figure 12 13 Step Zoom example By default the S key initiates the Step Zoom tool and is used to sequentially step through the image If desired you can set a User preference to define a different keyboard shortcut See Setting Keyboard Shortcut Preferences see page 346 Note the following The number of steps for an image is based on the size of the full scale image and the size of the window For example if the size of the full size image is 1000X2000 pixels and the size of the window is 400X600 the number of steps is 12 3X4 e The Step Zoom tool has no effect on a full scale image that is not bigger than the size of the window or if the number of steps required to step through all the parts of the image is greater than 16 e There is a minimal overlap of 10 of the size of the window between each horizontal and vertical step area Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 12 11 3 e When you use the Step Zoom tool in a fixed window such as a virtual monitor the correlating th
363. ou can change the default setting in the Image Processing section of the Preferences dialog box See Setting Image Processing Preferences see page 346 When you select the Edge Enhance feature it is applied to all images in a series This may cause a slight display delay when IntelliSpace PACS actively processes these images in multi image or Fast Cine mode Intellispace PACS Enterprise 4 4 User Guide 239 12 Viewing and Manipulating Images 14 May 1999 10 50 52 Acc 3929650 5 14 1999 10 e R a No Descriptions wil 1598 2491 No Descriptions wil 1598 2491 general PA C general PA Series 1 Series 1 Figure 12 6 Image with Edge Enhance Filter 1 Right click the image and from the menu select Image Processing then Edge Enhance 2 Press the comma and period keys to increase or decrease the degree of edge enhancement 12 6 3 Detecting the Edges of an Image The Edge Detect tool is an alternative to the Edge Enhance tool and uses a Sobel operator to increase the visibility of edges There are three degrees of application Light Medium and Strong You can change the default setting in the Image Processing section of the Preferences dialog box See Setting Image Processing Preferences see page 346 When you select the Edge Detect feature it is applied to all images in a series This may cause a slight display delay when IntelliSpace PACS actively processes these images in multi image or Fast Cine mode 240
364. ou can show or hide any Patient Lookup columns except Patient Name MRN and Date of Birth Right click in the column area above the list of patient names Select the columns you want to show or hide Shown columns are checked hidden columns are unchecked Repeat steps 1 and 2 as required Rearranging Patient Lookup Columns You can click and drag Patient Lookup columns to rearrange their order except for Patient Name and MRN This allows you to customize the order in which patient information is displayed Click and drag a column to the position you want and release the mouse button Appending Patients to an Existing List You can use Append results to build a list of patients by specifying different search criteria For example you can search for two different MRNs or to find two patients you wish to link or merge Intellispace PACS Enterprise 4 4 User Guide 81 Finding and Managing Patient Information If it isn t already displayed select Patient Lookup from the Folder List or the Shortcut Bar if you have created a shortcut for this feature Search for the first set of patients using one set of search criteria When the list of patients is displayed select the Append results check box and enter the next set of search criteria Click Search or press Enter The new search results are added to the original list Sorting Results The list is automatically sorted by patient name in alphabetical order Click the b
365. oup 62 Finding and Managing Patient Information csccccscsssssseeees 63 6 1 Patient Lookup Overview s s ssssssssssesssisesesssrsesesresrsesesreseserrsrsesese 63 6 2 Patient Lookup and Federation sssssssssssssessssrsesessesrsesesresrsesesresrese 66 6 2 1 Viewing the Federation Quete 72 6 3 Searching for Patients isc svsisascsonssixsnscasatensesssbendsdisevederdiersdeedeletenss 74 6 4 Master Patient Index and Patient Demographics 00 0 eee 75 6 5 Viewing Exam Information asisecdasiseaivsssvancscososnesivivenivivuenntvisieeeles 76 6 5 1 Searching for Patients by Name osooso 77 6 5 2 Searching for Patients by Identifier 78 6 5 3 Searching for Patients by Other Criteria sses 78 6 6 Viewing Exceptions in the Patient Lookup o ccc eee 79 6 7 Clearing a List of Patients s s cacr0siensiesdysdintpnaien tenedesnmeaibesasnddenwaanens 80 6 8 Closing a List of Patients s s sssssssisisesisrsresestsesrsrsrsrsrsrsrersrersrererese 8l 6 9 Showing or Hiding Patient Lookup Columns cee 81 6 10 Rearranging Patient Lookup Columns wo c ccc eeeeeeeeees 81 6 11 Appending Patients to an Existing List s i icccsissccscssacccecnatenssecnses 81 6 12 Sorting Results uzata i ina hA ou ind tus sind tivasibasaatbeceons 82 6 13 Patient Management Overview esssssessessessersrsreresrseseerenrserrsrseseee 82 6 14 Creatine Patient RECORS eiie iiaiai a 83 6 15 Editing Patient Records ccisvisisiiiie avisivanivcotnetecsivanivnvanenies ay
366. ow Width Center Nearest Phone Image Processing Annotations DICOM Sources For additional support please contact your system administrator IntelliSpace PACS Chat Mail Management Screen Overlays Paper Printing iExport iQuery Plug Ins DICOM Print Workflow Autoscaling Body Part Dictionary Hanging Protocols HP Sequences Machine Preferences General Preferences Display Monitors Plug Ins Local Exam Caching Scanner Preference Remote Reading Network Testing LS 7 lll r Cancel Apply Help Under Location Settings enter the Machine Location and the Nearest Phone Click Apply to save the settings and continue setting other preferences Click OK when you are done Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting Machine Preferences 19 CREF4 09 291 v4 0 07 2014 19 6 NOTE Setting Network Testing Preferences Network Testing is not a Machine Preference It is however present and configurable in the Preferences dialog below Machine Preferences System Administrators with the proper privileges can configure numerous aspects of network testing and view the results of those tests on a server by server basis In most cases the network testing options will be used by an IntelliSpace PACS user in conjunction with a Philips Customer Care representative to trou
367. pace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing Clinical Information CREF4 09 291 v4 0 07 2014 Creating a patient Deleting a patient Creating or deleting an exam Viewing an exam Scheduling an exam Beginning an exam Completing an exam Creating an exam note Finalizing a report Opening a report Detaching a study from an exam Marking an exam read Viewing an exception study Exporting an image to the clipboard or disk Logging into or out of the system Viewing a patient record Linking or unlinking a patient Updating an exam record Printing an exam to paper or film Dictating an exam Canceling an exam Force unlocking an exam Deleting an exam note Changing an Exam Code Modifier Transcribing a report Marking an exam unread Deleting an exception study Exporting an exam study to a network device Updating a password Adding updating or deleting a presentation state for a study Updating a patient record Merging a patient Linking or unlinking exams Creating an exception Editing the scheduled date time of an exam Changing the exam status to Taken Viewing an exam note Viewing an exam report Resolving an exception and attaching a study to an exam Acknowledging a duplicate UID warning Exporting an exam image to clipboard or disk Printing an exc
368. pening or Closing an Exam You can have up to 30 exams open at a time If IntelliSpace PACS cannot open an exam because of low memory usage a message is displayed indicating that the exam cannot be opened Also if an exam in a prior Exam Rack cannot open because of low memory a memory error is displayed on the Exam Rack with a Retry Close button This allows you to either close the Exam Rack or try opening the prior again after closing some other exams to free some memory Either left click on an exam in the timeline or right click on an exam in the timeline and select Open Exam from the menu If an exam is already loaded into the Exam Rack and you want to unload it right click on the exam in the timeline and from the menu select Close Exam If an exam cannot open because of low memory and no other exams are open an unexpected low memory error is displayed It is highly recommended that after you click OK to close the message you should restart the IntelliSpace PACS client The results of future actions will be unpredictable and crashes may occur if the client is not restarted Intellispace PACS Enterprise 4 4 User Guide 203 11 Using the Canvas Page 204 11 5 11 6 Ordering of Images in the Exam Rack Note how the following conditions affect how images are ordered in the Exam Rack e When an exam is opened from the worklist and there is a presentation state that will be loaded the order of the images on the Exa
369. phone line In the Login screen enter your username and password From the Workstation Location list select Teleradiology The supplied setting is Main Location You may use this setting if you do not wish to use compression but you should note that transmission times are increased and image quality transfer may fail if the available bandwidth is insufficient In Teleradiology Mode IntelliSpace PACS displays a notification message warning that images are compressed and explaining the compression indicator When you load an exam in this mode IntelliSpace PACS displays the progress of the exam loading The number listed is the percentage of the number of total images loaded To cancel this process at any time click Cancel Image Quality Indicator When images in other than full fidelity are displayed in IntelliSpace PACS the quality of the image is marked with an icon in the lower right corner that represents the degree of compression for that image There are two possible icons Intellispace PACS Enterprise 4 4 User Guide 45 4 Accessing IntelliSpace PACS Remotely 4 4 1 Icon G hd rw 9 The JPEG Lossy icon is displayed when images are received by IntelliSpace PACS from a modality that are already compressed using the JPEG lossy compression The Compression Level icon is displayed when IntelliSpace PACS has applied a higher compression to improve upload time to the client In this case you can improve t
370. plate different depth of field and so on Incorrect Pixel Spacing and Pixel Pitch values affect the accuracy of the True Size feature Therefore you should always make sure that the size of the image is as expected when reviewing a True Size zoomed image Accessing Patients and Exams Patient Lookup is the first screen displayed when you log in to IntelliSpace PACS It allows you to quickly find patients with or without associated exams based on a combination of search criteria See Finding and Managing Patient Information see page 63 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Getting Started 3 Enterprise Tools ty Exam Lookup Patient Lookup O Exceptions Lookup amp Patient Lookup Installed Programs a iQuery E Local Exam Cache Local Export Eh Locked Exams Machine Filters amp MergelLink Candidate s My Filters My History Queues amp Statistics amp Study Lookup S O System Filters Personal Folders Public Folders Figure 3 1 Patient Lookup 3 6 Accessing Online Help 1 Click the question mark icon on the Control Strip near the upper right corner of the window 2 Either type the word or phrase that you need information about and click List Topics and then click Display or click the Contents tab and click on the desired topic double clicking the topic to disp
371. ple 3 To move the entire region without altering its size click on the ROI center and drag the region to the desired location see Figure 2 4 To resize the region click and drag the circle s perimeter see Figure 3 13 9 Using the ROI Freehand Tool You can use the Region of Interest ROI Freehand tool to measure the average data value for a non circular region of an image The units and accuracy are identical to the ROI Circle tool Intellispace PACS Enterprise 4 4 User Guide 271 13 Measuring and Annotating Images 272 For Region of Interest ROI the standard deviation is calculated by using the intensities of all pixels that are inside the ROI If the image has slope intercept that is applied and then the standard deviation is calculated Otherwise the raw pixel data is used to find the standard deviation This means that changing WW WL will not change the measurement and that all pixels within the ROI are considered Note the following e When performing an ROI measurement on an image that is displayed with a resolution smaller than the actual image for example an image in the rack for CT IntelliSpace PACS may calculate the ROI using a sub sample of the original image data The value in this case is an accurate representation of the average measured pixel values represented by the interpolated sub sampled image This is a close approximation to the original pixel values e When IntelliSpace PACS calculates a
372. quare pixels for Projection Radiography modalities SOP Classes Modality 1 2 840 10008 5 1 4 1 1 1 CR 1 2 840 10008 5 1 4 1 1 1 1 DX 1 2 840 10008 5 1 4 1 1 1 2 MG 1 2 840 10008 5 1 4 1 1 1 2 1 MG Unprocessed 1 2 840 10008 5 1 4 1 1 1 3 IO 1 2 840 10008 5 1 4 1 1 12 1 XA 1 2 840 10008 5 1 4 1 1 12 1 1 Enhance XA 1 2 840 10008 5 1 4 1 1 12 2 XRF 1 2 840 10008 5 1 4 1 1 12 2 1 Enhance XRF 262 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Measuring and Annotating Images 13 CREF4 09 291 v4 0 07 2014 Note the following IntelliSpace PACS uses the calculated pixel spacing values if the image was manually calibrated using the IntelliSpace PACS Image Calibration tool IntelliSpace PACS uses calibrated pixel spacing tag 0028 0030 if present and different than tag 0018 1164 or if 0018 1164 is not present IntelliSpace PACS uses the imager pixel spacing 0018 1164 divided by the estimated radiographic magnification factor 0018 1114 if both are present and the value of 18 1114 is not 1 0 IntelliSpace PACS uses the imager pixel spacing 0018 1164 if present IntelliSpace PACS displays measurements in pixels For all other modalities the following applies IntelliSpace PACS uses the calculated pixel spacing values if the image was manually calibrated using the IntelliSpace PACS Image Calibration tool Intelli
373. queries can be done only for a given patient Series level query tags are modality Series Number Series Instance UID requested procedure ID scheduled procedure Step ID performed procedure step start date performed procedure step start time number of series related instances series description All series level queries can be done only for a given patient and Study UID Image level query tags are Instance number SOP Instance UID SOP Class UID iQuery filters the query tags based on whether the Patient Name and MRN are specified as wild cards When the Patient Name and MRN are not specified as wild cards iQuery filters the query tags based on the selection of the Archives chosen as follows If the All archives option is selected only the Patient Name and MRN tags are considered for querying All other tags are ignored If a single archive is selected whose Query Model is set to either Unknown or Patient Study Only only the Patient and Study level tags are considered for querying All other tags are ignored If a single archive is selected whose Query Model is set to either Patient Root or Study Root tags at all levels are considered for querying When the Patient Name and MRN are specified as wild cards iQuery filters the query tags based on the selection of the Archives chosen for querying as follows If the All archives option is selected only the Patient Name and MRN tags are c
374. r Click the sign to expand the potential match list This allows you to change column headers and or change search criteria and search again for potential matches Double click on any item in a potential match to view the images associated with it This displays a new tab in the bottom pane that displays the images allowing you to compare the images in the top and bottom part of the Exceptions Handler The Accession MRN Patient Name Modality Exam Date Time Exam Code and Organization are displayed for the images 5 Ifyou cannot find a patient or exam to associate with the study click Create Patient and Exam The Create Patient and Exam dialog box displays with the Patient Info pane displayed The patient must have exams to use this feature 6 Select the Organization from the list 7 Enter the MRN number and information on the patient 8 Click Exam Info The Organization you selected in the Patient Info pane is displayed and cannot be changed 9 Enter the exam information 10 When you are done click Save You return to the Exceptions Handler 11 Click Resolve A message displays asking you to confirm the action 12 Click OK The exception is resolved 10 12 Creating a New Exam from the Exceptions Handler If you can find a patient but cannot find an exam to resolve the exception you can create an exam for the exception study from the Exceptions Handler For example in a trauma case the images would be exceptions if
375. r Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Getting Started 3 CREF4 09 291 v4 0 07 2014 5 The F icon on the Control Strip near the upper right corner of the window should appear as a light colored beige background Federation Jser Default Administrator Figure 3 4 Viewing Federation status 6 To disable Federation click the F icon The icon color will turn gray 7 To enable Federation again click the F icon The icon color changes back to beige See section 6 2 Patient Lookup and Federation on page 66 for more information about the Federation icon and the significance of its color changes 3 9 Viewing IntelliSpace PACS Version Information Click the Philips logo on the Control Strip near the upper right corner of the window to display an About screen that displays the IntelliSpace PACS version information IntelliSpace PACS version User Default Administrator yp N Figure 3 5 Viewing IntelliSpace PACS version IntelliSpace PACS Enterprise 4 4 User Guide 41 Getting Started 42 3 10 Logging Off e Click the X icon on the Control Strip near the upper right corner of the window If you are viewing an exam a message displays asking if you are sure you want to close all exam s Log off icon User Default Administrator yp N Figure 3 6 Log off icon Intellispace PACS
376. r a new Study UID is assigned 8 Verify that the images have not become an exception study NOTE The images that have been assigned a new Study Instance UID are re registered Therefore the DICOM metadata key fields are used to validate the images against an existing patient and exam If the images cannot be validated the new study becomes an exception 16 3 Resolving Cases Where Multiple Patients Studies are Merged into a Single Study In cases where multiple patient s images have been merged into a single study the Demographics Mismatch Caution message does not display because all the images in the exam have the same patient demographics You can use the Split Exam feature to temporarily split a series according to specific DICOM tags to assign a new Study Instance UID In the following example a CR CHEST image accidentally ended up in a CR ANKLE study 326 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Managing Studies and Images 16 CREF4 09 291 v4 0 07 2014 Figure 16 2 DUP UID merge example Use the Patient Lookup or Exam Lookup to find the exam that requires study management Open the exam and identify the series images that belong to a different patient study Note that the DUP UID Mismatch Caution message does not display on the image because all the patient demographics of all images in this exam a
377. r either date to enter the date using the calendar control Click OK when you have entered the desired dates Click Search or press Enter IntelliSpace PACS displays matching exams and exceptions for patients in the specified date range Stripping Leading Zeros from MRN Searches You can choose whether or not to have the client application strip leading zeros from MRN searches The option is off disabled by default but you can ask CARE to enable it if you want this option With this option disabled off the default state e You can enter any text value in the MRN search field Explicit wildcards e g are allowed and the client appends implicit wildcards e Ina search the client application does not strip leading zeros only patients with MRNs starting with or equal to the exact MRN search value are returned With this option enabled on e You can enter only a numerical value in the MRN search field Explicit wildcards e g are not allowed and the client application does not add implicit wildcards If you enter any character other than 0 through 9 an error message is displayed Intellispace PACS Enterprise 4 4 User Guide 157 Filtering Worklists 9 7 9 8 e Ina search the client application removes leading zeros from the search value you entered and the resulting value is matched against the numeric version of each MRN in the database i e the MRN with all non numbers and leading zeros removed
378. r should be investigated by a System Administrator or Philips Customer Care representative Click OK to save your changes and close the Preferences dialog box Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc 20 Mouse and Keyboard Reference Sheet 20 1 Mouse Control Reference Sheet IntelliSpace PACS includes User preferences for the following mouse options e Mouse Scheme Options You can choose whether you want to use the standard mouse actions and cursor Standard or use cursors whose shape indicates their action Enhanced Standard is enabled by default See Standard Mouse Scheme see page 401 Enhanced Mouse Scheme see page 403 and Setting Mouse Preferences see page 340 e Scrolling You can choose one of two options Coarse Fast Cine scrolling or Custom Scrolling See Scrolling see page 405 and Setting Mouse Preferences see page 340 Scrolling will either be Fast Cine or Custom Scrolling depending on which method you choose Custom Scrolling works the same in the Standard and Enhanced modes as Coarse Fast Cine 20 1 1 Standard Mouse Scheme If you select Standard mouse scheme options in the Mouse User preferences the following actions are available See Setting Mouse Preferences see page 340 Action Left Button Wheel Right Button Click Selects and deselects images and or Not
379. rag to the end of the known distance Release the mouse button The Image Calibration dialog box displays Enter the length of the known distance in millimeters and click OK From now on all measurements of distance and area are based on the newly defined scale Also the interactive scaled rulers are resized Taking Ultrasound Measurements You can use IntelliSpace PACS to take length measurements on Ultrasound B Mode images Measurements on Spectral M Mode or Dual B Mode images are not supported For these images you can use the Calibrate Image tool to manually calibrate the images See Calibrating Images see page 276 There are a few instances when measurements on ultrasound images might not be possible For example the scanner might not send IntelliSpace PACS the calibration information needed for the measurements Annotating Images The Text Annotation tool is a quick and useful way to annotate images with shapes or text For example you can use annotations to document marker lesions for cancer trials Annotations can make it easier for a clinician to interpret the image You can apply several annotation styles including line circle arrow triangle text and freehand as well as custom annotation styles Note that you cannot use the annotations measurement tools and the Localizer tools at the same time System Administrators can create and personalize annotation styles See Intellispace PACS Enterprise 4 4 User
380. ray from 0 to 3 For Lossy images you can select whether to enable simulated grayscale WW WL and specify a deviation value from true gray from 0 to 32 If you select one of these check boxes the Restore Color Image option is added to the WW WL menu to enable you to restore the original RGB presentation of the image Note that selecting a non zero threshold is audited and you must acknowledge a warning message stating that this feature can alter true color values Grayscale is represented in an RGB image by having the R G and B values identical and in the range of 0 to 255 inclusive The simulated grayscale WW WL filters values that have identical RGB and treats them as a grayscale value and replaces the RGB values with the newly computed WW WL value Due to noise from the scanner or degradation from lossy compression values you may wish to interpret as grayscale deviate from an exact RGB representation This deviation is treated as a parameterized deviation in the DICOM source so you can adjust the sensitivity to true gray to meet your needs Click the Series Splitting tab and specify how you would like to split series in the exam rack For example you might want to create separate image windows for monochrome versus color images You can also right click the exam menu on the rack to split the series on a per study basis You cannot remove the following default attributes and tags which are preconfigured and available for series splitting
381. rch criteria is displayed If no patients match IntelliSpace PACS displays a message in the Control Strip If you do a new search the old results are removed unless you select the Append results check box or you expanded a patient s record to display that patient s exam list See Appending Patients to an Existing List see page 81 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6 CREF4 09 291 v4 0 07 2014 6 4 Master Patient Index and Patient Demographics In a PACS system there are typically three methods for combining data driven from disparate patient management systems into a single comprehensive patient record Master Patient Index MPI MPI functionality is typically used by larger healthcare organizations Using an MPI allows organizations to bring disparate patient management systems together under a single umbrella The primary benefit to an MPI is the ability to maintain a comprehensive patient record even across disparate patient management systems where patients may have demographics that are dissimilar enough to each other that they would not be combined by a PACS driven linking algorithm PACS driven Linking Upon receipt of an HL7 message which creates a patient PACS uses an algorithm that compares demographics to extant patients in the PACS and automatical
382. re the same You can only determine that images belong to a different patient study by being familiar with the patient study and by reviewing the images themselves Select the series that belong to a different patient study by highlighting the image series or selecting multiple image series using the Shift key Right click and select Assign New Unique Study UID from the menu Enter the Reason you want to assign the new Study Instance UID Click OK One of the following occurs Study stays in the same exam rack This may occur if the MRN and Accession Number match the current exam Study moves to a different exam rack This may occur if the MRN and Accession Number match a different exam Study becomes an Exception This may occur if the MRN and or Accession Number do not match an existing exam Intellispace PACS Enterprise 4 4 User Guide 327 16 Managing Studies and Images 328 16 4 The image is still displayed in the same Exam Rack because besides the new unique Study Instance UID the image still has the same patient and exam demographics Right click the image and select Detach Study from Exam from the menu The study will become an exception in the Exceptions Lookup Use the Exceptions Handler to resolve the exception See Using the Exceptions Handler see page 180 Searching for Study Instance UIDs When IntelliSpace PACS encounters DICOM processing errors an email is sent from the IntelliSpace PACS
383. re the same User Preferences IntelliSpace PACS cannot prevent the users from changing settings in each of the users User Preferences In the Add DICOM Source dialog box for Color WWIWL Settings enabling any non zero deviation value can cause alteration of true colors Attempting to select a non zero deviation value will cause the message Setting a deviation value other than 0 can alter true color values to display You should also exercise caution when using this feature with scanned in images Coarse Fast Cine may skip images depending on how far the mouse is from where the Fast Cine originally began When the Acceleration Gain option is selected the cursor changes shape when a set of images is passed over and not shown to indicate that some image skipping is occurring This is analogous to a flipping through the pages of a book to quickly get to the area of the book you want to begin to read When you select this option you must acknowledge the following message which informs you that images may be skipped when navigating a large number of images You control when skipping occurs by the rapidity with which you move the mouse The cursor changes shape to indicate that images are being skipped during a non diagnostic transversal of images i Note The Acceleration Gain feature permits images to be skipped while navigating a large number of images rapidly in a non diagnostic mode IntelliSpace PACS Enterprise 4
384. references See Setting Display Preferences see page 350 The Scout tool is available for CT MR and PT modalities and works with the Localizer tool See Using the Localizer Tool see page 245 To leave the image selected for displaying scout lines unobstructed the reference lines only appear when the cursor is passed over another image or series As the other series is reviewed the corresponding scout line is highlighted to indicate the planar location of the image as seen below Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 12 8 Figure 12 10 Scout lines example Do one of the following Right click the image or series and select Scout Line Mode from the menu Press F11 The Scout Mode item is displayed with a check mark in the Image menu Select Scout Mode or press F11 again to remove the scout lines Using the Localizer Tool Like Scout lines the Localizer tool helps you visualize and navigate to a location in multiple series with different orientations You can use the Localizer tool to navigate through multiple series with different orientations Axial Sagittal and Coronal simultaneously A crosshair is displayed in every series of an exam at the x y coordinates that correspond to the location of your cursor The cros
385. rences The Edge Enhance and Edge Detect preferences are applied to the entire series being viewed A read only list of active modalities is also available for each image processing preference You can apply image processing filters using the menu When an image processing filter is applied to an image a P Processed icon is displayed in the metadata area of the image in the Exam Rack and in the image popup window CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 347 17 Setting User Preferences Joo eh Image Processing filter applied Figure 17 1 Image with processing filter applied 1 Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip 2 Click Image Processing The right side of the Preferences dialog box displays a list of image processing options 3 To set preferences for Edge Enhance do one of the following Click Method and choose 5 pt Laplacian or 9 pt Laplacian Click Degree and choose Light Medium or Strong Click Modalities to view a read only list of modalities 4 To set preferences for Edge Detect do one of the following Click Method Sobel is the only choice The Sobel operator scales the result and adds it back into the original image data Click Degree and choose Light Medium or Strong Click Modalities to view a read only list of modalities 5 To set preferences for Median Filter do one of the following Cli
386. rences You can set keyboard shortcuts to map keys and key combinations to IntelliSpace PACS actions See Keyboard Commands see page 407 for a list of default keyboard shortcuts The following keyboard shortcuts are not editable e Localizer Mode F12 e Scout Line Mode F11 e Single Image Window Level L e Toggle Key Image Space e Worklist Canvas Page Refresh F4 Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click Keyboard Shortcuts The right side of the Preferences dialog box displays the keyboard shortcuts that have been configured To change a keyboard shortcut select it and click Edit In the Edit Keyboard Shortcut dialog click in the Shortcut field and press the keys or combinations of keys you want to assign to the selected action If you want to set the shortcut back to its original setting click Reset Click Restore Default Settings to reset all shortcuts back to their original settings Click OK A message displays if the keyboard shortcut is already being used for another action If this happens choose another keyboard shortcut that is not already in use Click Apply to save changes Setting Image Processing Preferences You can set image processing preferences for edge enhancement edge detection median filters and CLAHE Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips
387. rens 35 3 3 Monitor Calibration uns mdncdnianatiiniaus mg iin mievoniinernievelss 35 3 4 Configuring Pixel Pitch for the Diagnostic Monitor ce 36 3 4 1 True Size Verification fines is icidecbeivede ecu haathoneucscusagescien 38 3 5 Accessing Patients atid Exams cissiisssssisdsssosnindeedierieeedieriendserstesss 38 3 6 2 Accessing Online FIC Oc chshnsstnsonhtonitpshnahcue Anes WRAITH 39 3 7 Setting Preferences senceda 40 3 8 Setting Federation Statts oiiaii i a 40 3 9 Viewing IntelliSpace PACS Version Information 00 cece 4 Intellispace PACS Enterprise 4 4 User Guide 3 10n Logins Ofat n res rerer eer nes veer oer ren ore reo 42 4 Accessing IntelliSpace PACS Remotely scssssssscsscsssscscees 43 EA NOVEGRIEW ipenn asan a EAAS EA E E EE ier tenin 43 4 2 Minimum Network Requirements sssssssssssssisesrsisesrereseseserrsesesese 44 4 2 1 General Requirements sossssssssssssssessisrisrririsrrirrererirreree 44 4 2 2 Urgent Cases Emergency Room and Availability 0 4 44 4 3 Teleradiology Mode siete soceuubuts ton tadstulsdutietrcnaacdmnades tessa stv ube 45 4 4 Image Quality Indicators cidhiswubiawinwaimicamuguanaucuiaiinrs 45 4 4 1 Improving Image Quality assessoires 46 4 4 2 Image Processing Effects ROT ER OMT oe eT 47 5 Program LayoOut cccccccccccsscscsccscccsscscscesccccessccccsssssssscessssoeeeee 49 Sele Control Stp oerna aY ilu data aa Ra RA a e 49 5 2 Polder Lst ios ci ton ak oes catena andi
388. right column When you are done click OK You are returned to the Add Filter dialog box IntelliSpace PACS Enterprise 4 4 User Guide 165 9 Filtering Worklists 9 9 Editing a Filter 1 In the Folder List right click the filter you want to edit and then click Edit Filter Enterprise Tools rats fg Exam Lookup Patient Cp Exceptions Lookup Lookup Patient Lookup Installed Programs Ea A iQuery Local Exam Cache My History Local Export Ga Locked Exams B Machine Filters F New Filter 2 F Test F Test Delete Filter amp Merger My Filte Rename Filter My Hist Queues Export Filter J 2 The Add Filter dialog box displays 3 Make the desired edits to the fields in the Add Filter dialog box including defining or rearranging exam or exception worklist columns by clicking Exam Worklist Columns or Exception Worklist Columns respectively 4 When you are finished editing the filter click Save 9 10 Deleting a Filter If you have the proper privileges you can delete filters from the Folder List 166 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Filtering Worklists 9 1 To delete a filter from the Folder List select the filter right click and select Delete Filter 6 Personal Folders 65 Public Folders 3 6 Radiology Tools
389. rise 4 4 User Guide 259 13 Measuring and Annotating Images 260 13 1 13 2 affected and may be incorrect Philips strongly recommends the use of an appropriately placed object of known size for determining what magnification factor has been applied to the image Changing the Font or Line Style When you right click on a measurement or annotation you can select Edit Font Edit Line Style or both depending on the measurement or annotation For Font you can select from a list of fonts available on your workstation To resize the font of a text annotation drag a corner of the text box e For Line Style if the line is solid you can select a line width from 1 thinnest to 4 thickest The line style can be solid dashed or dotted Measurement Values for Projection and Non Projection Radiography Modalities The following format is used for measurement value display for Projection Radiography modalities lt value gt lt units gt lt code gt e lt value gt is the floating point value of the measurement e lt units gt is the units of the measurement e g mm cm Tesla etc e lt code gt is one of the following lt code gt Pixel Spacing Tag Used Additional Conditions Geometric 0028 30 Tag 0028 0A02 has the value GEOMETRY Imager 0018 1164 Geometric 0018 1164 amp 0018 1114 0018 1114 is not equal to 0or 1 Fiducial 0028 0030 Tag 0028 0A02 has the value FIDUCIAL Intellispac
390. rmation 7 10 NOTE 7 11 NOTE differentiate between exams with a status of Scheduled and a status of In Progress This allows Technologists to update Radiologists on an exam status before the images are sent to the PACS e Right click on a scheduled exam in a worklist and select Begin Exam from the menu Completing Exams These actions Beginning Completing Canceling and Deleting exams performed in IntelliSpace PACS do not update the HIS RIS so they may cause IntelliSpace PACS to be out of sync with the HIS RIS IntelliSpace PACS is usually configured so that the exam status is set to Completed when the exam is created using the auto create port See Understanding Exam Statuses see page 109 for more information on exam statuses After a Technologist performs a procedure they often want to inform other IntelliSpace PACS users that the exam has been performed and is ready for review They do this by setting the exam status to Completed Many Radiologists create a worklist filter so that only Completed orders are displayed Right click on an exam with a status of In Progress in a worklist From the menu select Complete Exam The status of the exam changes from In Progress to Complete and the worklist is refreshed to show the updated exam status Canceling Exams These actions Beginning Completing Canceling and Deleting exams performed in IntelliSpace PACS do not update the HIS RIS so they may cause In
391. rmation When Creating Exams 1 Do one of the following Use the Exam Lookup to search for and display a list of exams Use the Patient Lookup to search for and display a list of patients Display the exams for a patient Select a filter that displays exams 2 Right click over a patient or an exam in a list and from the menu choose Create Exam The Create Exam dialog box displays with the Exam Info pane displayed 3 Fill in the fields in the Exam Info and Providers panes and click Exam History to display the next pane Enter information on the Signs and Symptoms for the exam Enter information about the History for the exam Enter additional Comments about the exam Click Save yane 102 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 7 1 Finding and Managing Exam Information Exam Lookup Overview You can use the Exam Lookup to quickly find exams based on a combination of search criteria You can also use the Patient Lookup to display a list of exams by expanding the list of exams under a patient name but the Exam Lookup is a more efficient way to find exams See Patient Lookup Overview see page 63 Note that the list of exams is not automatically updated when new exams come in Select search criteria and click Search Search for exams with images ACPTI
392. ross the height of the display is approximately 900 images assuming a 2560 x 2048 monitor in a Landscape position 342 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting User Preferences 17 CREF4 09 291 v4 0 07 2014 NOTE e By default the slider is set to the middle position Slow can go 30 lower and Fast can go 30 higher than the default Mouse Properties settings in Windows V Custom Scrolling Response Rate Slow Fast V Acceleration Gais Slow Fast If desired select the Acceleration Gain check box and move the slider to the desired acceleration sensitivity When the Acceleration Gain option is selected the cursor changes shape when a set of images is passed over and not shown to indicate that some image skipping is occurring This is analogous to a flipping through the pages of a book to quickly get to the area of the book you want to begin to read If you select the Acceleration Gain option you must acknowledge the following message which informs you that images may be skipped when navigating a large number of images You control when skipping occurs by the rapidity with which you move the mouse The cursor changes shape to indicate that images are being skipped during a non diagnostic transversal of images Click OK in this message to proceed i Note The Acceleration Gain feature permi
393. rs see page 168 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Filtering Worklists 9 CREF4 09 291 v4 0 07 2014 1 Select a filter from the Folder List 2 Click Save As The Add Filter dialog box displays Add Filter Name iption Mirror Auto Refresh z S E Exam Worklist Columns a e i Exception Worklist Columns Resolved Unresolved Exam Date Exception Date fast 24 hours z Last 24 hours x Exception Worklist Criteria Filter On Criteria gt Ea Fitter Summary ee 3 Enter the Name and Description for the new filter The Name is required 4 Select whether you want the MRN and or the Patient Name to be mirrored from the Exam worklist to the Exception worklist The Mirror field is only enabled when you add or edit a filter that contains both exams and exceptions When you are using the filter you can change the mirroring properties for these fields after the filters have been defined Intellispace PACS Enterprise 4 4 User Guide 159 Filtering Worklists 160 Select whether you want the filter to be refreshed with updated information every 1 minute by selecting the Auto refresh check box This setting is applied to all filters for all ranges except Custom date ranges you set in the Exam or Exception worklist Ifa Custom date is set to more than 7 d
394. rst displayed Turns the True Size zoom on and off when Mammography features are enabled Vertical rack Refresh Worklist Canvas Page CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc 21 IntelliSpace PACS Quick Reference Table This table describes IntelliSpace PACS features from basic image selection and viewing features to the more complex image manipulation features You can set preferences for keyboard shortcut to map keys and key combinations to actions in IntelliSpace PACS See Setting Keyboard Shortcut Preferences see page 346 You can also specify enhanced cursors by setting a User General preference See Setting General Preferences see page 338 Task Quickly load or unload an exam Expand an image or image series Adjust brightness and contrast Window Width Window Level Compare link images in an exam Compare two or more exams CREF4 09 291 v4 0 07 2014 Action Right click the exam listing in the Patient History and select Open Close exam Double click the left mouse button on the desired image or image series Left click the image and drag the left mouse button horizontally or vertically respectively Default WW WL Histogram Calculation and Modality Default values are available for all modalities in the menu CT exams also display preset Window Width Level values in the menu These values include the Defaul
395. s To view the studies awaiting retrieval in the Folder List click Queues and then click iQuery The studies display in the right pane of IntelliSpace PACS Enterprise Tools P API Tester ty Exam Lookup Z Search ID Exceptions Lookup Completed Rede Witham 103 16 000 4081470F 2011 03 17 1216 Stat 100 P Parent Lookup H installed Programs amp Query Local Exam Cache D Local Export Locked Exams I Machine Fitters R Merge Link Candidate s D My Fiters gt or raton Ga P Statistics 2 3 The Status of each retrieved study retrieval is listed in the first column and the Complete of each study retrieval is displayed as well Do one of the following 320 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Retrieving and Exporting Studies 15 CREF4 09 291 v4 0 07 2014 To remove a study from the queue highlight that study and click Delete A confirmation message displays Note that only completed and failed jobs can be deleted Only Submitted jobs can be canceled In addition you can change the priority of a Submitted job You cannot retry the studies which iQuery failed to retrieve however the Retrieve operation is programmed for automatic retry To search for retrieve jobs that meet the criteria specified in the query fields click Search To show all retrieve jobs that hav
396. s showing a check mark to the left of the active criteria type Select the columns you want to show or hide Shown columns are checked hidden columns are unchecked You cannot hide the fields that are grayed out Rearranging Worklist Columns You can click and drag columns in an exam or exception worklist to rearrange their order This allows you to customize in what order exam information is displayed Click and drag a column to the position you want and release the mouse button Rearranging a Filter s Columns Right click the filter in the Folder List and then click Edit Filter The Add Filter dialog box displays Click Exam Worklist Columns or Exception Worklist Columns depending on the columns you want to rearrange The Worklist Columns dialog box displays In the right pane of the dialog select the column header you want to rearrange and click Move Up or Move Down until the header is in the desired position Note that you cannot move required columns and there are limits on how far you can move certain columns Click OK when you are done to save your changes and close the Worklist Column dialog box Click Save to close the Add Filter dialog Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Filtering Worklists 9 CREF4 09 291 v4 0 07 2014 9 6 Searching in Exam and Exception Worklists You can search f
397. s Exam Image Processing odality Body Part apes Application Display Preferences Description Configuration for applications System Preferences Machine Preferences Restore Network Testing M Modality Body Part Exam Description Application Cancel 17 7 1 Adding a Rule 1 Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip 2 In the User Preferences list click Configuration for Applications The Configuration for Applications panel displays in the right pane of the Preferences dialog 3 Select a modality from the Modality dropdown list Required 4 Optionally enter a body part in the Body Part text field or leave the field empty 352 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting User Preferences 17 CREF4 09 291 v4 0 07 2014 17 7 2 NOTE 17 8 BO Oe ae Se Optionally enter an exam description in the Exam Description field or leave this field empty Select an application from the Application dropdown list Required Click Add To add another rule perform Steps 3 through 6 of this procedure Click OK when you are done adding rules Deleting a Rule Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip In the User Preferences list click Configuration for Applications The Config
398. s Healthcare Informatics Inc Finding and Managing Exam Information 7 e MRN e Exam Date Time e Scheduled Date Time e Accession e Modality e Exam Description e Exam Code e Exam Status e Body Part e Referring Physician e Referring Physician ID e laterality e Ordering Location e Images e Locked By e Time Locked e Priority e Patient Class When a list of exams is displayed you can do the following e Double click an exam to open it To open an exam without locking it press and hold the Alt key while double clicking on the exam e Right click to display a menu with actions e Rearrange and select certain search criteria columns to hide or display e Shift click to select contiguous exams or Ctrl click to select multiple non contiguous exams e Resize columns by clicking the right edge of the column and dragging it to the left or right e Sort the list by clicking on each column header 7 2 Searching for Exams 1 Select Exam Lookup from the Folder List or the Shortcut Bar if you have created a shortcut for this feature CREF4 09 291 v4 0 07 2014 Intellispace PACS Enterprise 4 4 User Guide 105 Finding and Managing Exam Information 7 2 1 NOTE 7 2 2 Enter the desired search criteria If you search by Accession or MRN the Exam Date Time field is ignored Note that you can t use Patient Sex as a search criteria If you only want to find exams that have images select the Exa
399. s Healthcare Informatics Inc Philips Healthcare Informatics Inc Introduction 1 warnine IMPORTANT 1 9 1 9 1 CREF4 09 291 v4 0 07 2014 Before attempting to use this software you must read this Instructions for Use thoroughly paying particular attention to all Warnings Cautions and Notes it contains You must pay special attention to all the information given and procedures described in the Safety section In addition you must pay special attention to on screen messages that may relate to the function being executed Warnings are directives which if not followed could cause fatal or serious injury to a user patient or other person or could lead to clinical misdiagnosis and or loss damage of patient related data Cautions are directions which if not followed could cause damage to equipment on which the software is installed Notes are intended to highlight points of attention as an aid to users This Instructions for Use describes the most extensive configuration of the software with the maximum number of options Not every function described may be available The Safety chapter describes safety aspects and should be read first before using this software The screen captures in the Instructions for Use show the user interface in English and have been included as samples of the user interface Callouts or red circles on screen captures identify the part of the user interface that is described in t
400. s are displayed with a message indicating that additional patients match your criteria To find these additional patients narrow your search by adding additional criteria The System Administrator can set the maximum number of displayed exams up to 1 000 but the supplied value is 200 exams When a list of patient names is displayed you can do the following 64 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6 CREF4 09 291 v4 0 07 2014 NOTE NOTE e View and open exams See Viewing Exam Information see page 76 e Select patients to link or merge See Linking Patient Records from Different Organizations see page 97 and Merging Patient Records from the Same Organization see page 91 e Right click to display a menu with actions e Rearrange and select certain search criteria columns to hide or display See Rearranging Patient Lookup Columns see page 81 e Shift click to select contiguous patient names or Ctrl click to select multiple non contiguous patient names e Shift click to select contiguous exams or Ctrl click to select multiple non contiguous exams You cannot view canceled exams in the Patient Lookup but you can view these exams in the Exam Lookup My Filters System Filters and Machine Filters See Finding and Managing Exam Information see
401. s if the body parts are totally different like in the CHEST ABDOMEN PELVIS example but sometimes they are the same but they do not start at exactly the same location In this case you might miss a few slices hon Series 1 Series 2 Linking Oblique Series IntelliSpace PACS allows you to link oblique series The goal is to provide users with the ability to link oblique series that are more or less in the same orientation However IntelliSpace PACS does not prevent you from linking obliques that have totally different orientation This means that linking obliques that are not of roughly the same orientation leads to unexpected behavior in IntelliSpace PACS Series 1 Series 2 Deleting studies is permanent meaning that deleted studies cannot be recovered Deleted images can be recovered However all presentation states measurements and annotations are lost Also if an image has been deleted after receiving a new Study UID the image cannot be recovered Be aware that deleted images may contain data that would render a different diagnosis Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Safety 2 CREF4 09 291 v4 0 07 2014 Users with appropriate permissions should not assign new Study UIDs to studies that have not been confirmed to be complete status is not designated Complete If multiple users sha
402. s in the series level metadata you can use an option to bypass the series sort criteria and use the image sorting criteria directly for sorting series display within a study rack 364 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting System Preferences 18 A WARNING CREF4 09 291 v4 0 07 2014 In the Add DICOM Source dialog box for Color WWIWL Settings enabling any non zero deviation value can cause alteration of true colors Attempting to select a non zero deviation value will cause the message Setting a deviation value other than 0 can alter true color values to display You should also exercise caution when using this feature with scanned in images Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays sorted alphabetically by name Click DICOM Sources The right side of the Preferences dialog box displays a list of DICOM sources and buttons that allow you to add edit or delete DICOM sources Preferences Dialog User Preferences General Preferences Window Width Center Keyboard Shortcuts Mammography Keypad setting Image Processing Display Preferences Hanging Protocols HP Sequences Canvas Page System Preferences General Preferences Window Width Center
403. s of a patient that can be relevant for diagnosing or rating the current medical condition of that patient Recent images date back to a limited time in the past typically several weeks Relevant Prior An exam with same body part or modality plus body part that is considered to be relevant to the current exam Report A written language representation or a voice recording of a diagnosis or a description of a procedure on paper audiotape and or in electronic form RIS Radiology Information System RMLO View position and breast examined right medial lateral oblique ROI Region of interest Role Defines the type of user for instance a radiologist a radiographer or a system administrator A set of permissions and access to system functions are associated with a role Screening Examination or testing of a group of individuals to separate those who are well from those who have an undiagnosed disease or defect or who are at high risk Intellispace PACS Enterprise 4 4 User Guide 429 22 Glossary Breast Screening A federal program to gather information about breast cancer in a defined group of the population Sequence Ordered list of hanging protocols Series Set of medical images that are acquired with one piece of equipment and are spatially related to each other i e same frame of reference Series and Image Linking The ability to combine two images to view pan or view slices simultaneously
404. s that you cannot rename or delete Intellispace PACS Enterprise 4 4 User Guide 51 Program Layout 52 e Enterprise Radiology Tools The Tools folder contains the basic IntelliSpace PACS Enterprise or Radiology tools depending on which application you are using The list of tools is based on your preferences and user privileges The complete list of IntelliSpace PACS Tools is displayed below You cannot add folders to the Tools folder Exam Lookup Allows you to find exams based on a combination of search criteria See Exam Lookup Overview see page 103 Exceptions Lookup Allows you to find exceptions defined as exams whose DICOM information conflicts with information from the HIS RIS or the IntelliSpace PACS database See Exceptions Lookup Overview see page 171 Patient Lookup Allows you to find patients based on a combination of search criteria See Patient Lookup Overview see page 63 Resolved Exceptions Displays the Resolved Exceptions worklist allowing you to view a list of all resolved exceptions See Working with Resolved Exceptions see page 185 Installed Programs Displays the currently installed programs such as the IntelliSpace PACS Volume Vision product If the current version of Volume Vision is already installed the Install button is inactive if the current version is not installed you can click Install to get the latest version See Philips IntelliSpace Clinical Appli
405. s the Step Zoom tool in an image You can change this to another keyboard shortcut in the User preferences Enables the text annotation for a single use Keeps the text annotation tool active for multiple uses Toggles links on and off When the links are off the link symbols disappear from the windows description and the word Link does not appear in the overlay portion Toggles cine mode Intellispace PACS Enterprise 4 4 User Guide 413 20 Mouse and Keyboard Reference Sheet 414 Description Toggle Hanging Protocol Monitor Icons Toggle Key Image Toggle Pixel to Pixel Zoom Toggle SR CAD Results Toggle True Size Zoom Vertical Rack Worklist Canvas Page Refresh Intellispace PACS Enterprise 4 4 User Guide Default Hardcoded Keystroke F2 Space Yes Shift S Ctrl Altt V F4 Yes Action On a one monitor system toggles between displaying the first and second series of the main exam On a two monitor system toggles between what is displayed on Monitor 1 and Monitor 2 Toggles key images Toggles pixel to pixel zoom Toggle SR CAD results The label CAD Markers On is displayed at the bottom of the image when the keyboard shortcut to display CAD markers has been used The label CAD Markers Off is displayed at the bottom of the image when the keyboard shortcut has been used to turn the marker off CAD Markers Off is also displayed when an image is fi
406. search criteria for Organization and Type Merge or Link If you do not select an Organization or Type all merge link candidates for all organizations are retrieved Press Enter or click Search A list of pairs of potential patients to merge or link displays If no patients match IntelliSpace PACS displays a message in the Control Strip Right click on a set of patients names and from the menu select Merge Patients for merge candidates or Link Patients for link candidates Review the Type column to determine whether you can merge or link See Linking Patient Records from Different Organizations see page 97 The Merge Patients dialog box displays displaying information from both patient records side by side The information for the first patient you selected is displayed in the left column and all fields are selected for this patient Select the fields you wish to keep for the new record Fields you do not select are not kept in the merged record The fields you can select are Last Name Middle Name First Name Sex Date of Birth Social Security Number and Address When you select a field the corresponding field in the other record is displayed with a red line through it indicating that you do not want to keep this information Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Patient Information 6
407. see page 158 Intellispace PACS Enterprise 4 4 User Guide 53 Program Layout 5 2 1 5 2 2 awp e Personal Folders You can create private folders to create special collections of exam links for future reference For example you might want to save interesting cases for presentation or publication You can add up to 25 sub folders to each Personal Folder A folder cannot contain more than 500 exam links and cannot be more than four levels deep The contents of the Personal Folder are only visible to the user who created it If you log out of IntelliSpace PACS on a certain computer and log back in on a different one you will be the only one who can see your Personal Folders Initially the Personal folder is empty You can add a comment to studies in Personal Folders See Adding Comments to Studies in Personal or Public Folders see page 55 You can also make patient information associated with exams in Personal Folders anonymous See Making Patient Information Anonymous see page 56 Public Folders Like Personal Folders Public Folders can be other folders you create or links to clinical exams for other clinicians if you have permission to access public folders The only difference between Personal and Public Folders is that the Public Folders can be viewed by all users You can add a comment to studies in Personal Folders See Adding Comments to Studies in Personal or Public Folders see page 55 You can also mak
408. sessment comprised of linked MPR views are intended to support Radiologists and referring Physicians in localizing and reporting on lung emboli CT Pulmonary Embolism Assessment can be used for rapid risk assessment in patients with suspected acute pulmonary embolism The assessment includes the possibility of measuring the ratio of the ventricular dimensions Evidence from scientific studies suggests that there is a relationship between right ventricular enlargement and prognosis of the patient Starting CT Pulmonary Embolism Assessment In the IntelliSpace PACS exam rack select one or more series press and hold Shift and then click the thumbnail images Right click the image select Philips Applications and then select Pulmonary Embolism Assessment If the selected series are not suitable for CT Pulmonary Embolism Assessment Volume Vision opens instead of CT Pulmonary Embolism Assessment OR In the IntelliSpace PACS exam rack select one or more series press and hold Shift and then click the thumbnail images Start Volume Vision See Starting Volume Vision see page 285 On the main menu click Analysis and then click Pulmonary Embolism Assessment See Analysis see page 288 The default hanging protocol of CT Pulmonary Embolism Assessment for your hardware setup is applied to the scan The Main axial and orthogonal MPR zoomed views are created Intellispace PACS Enterprise 4 4 User Guide 291 14 Phi
409. set of mandatory and optional columns You can display exams exams and exceptions or only exceptions for new and modified filters There are permissions that determine whether you can access the following e Manage user filters e View and manage machine filters e View and manage system filters The filters you can add edit or delete are based on your privileges The procedures for creating editing deleting and selecting filters are the same for User System and Machine filters When you select a filter a list of exams and or exceptions matching the filter s criteria displays Save as fig Exam Lookup Gi Exceptions Lookup Patient Lookup E Installed Programs ff iQuery E Local Exam Cache Local Export Ea Locked Exams 5 Machine Filters WY New Filter 2 YF Test01 Y 2 Merge Link Candid My Filters My History 5 Queues Statistics Study Lookup System Filters YF Completed Exar F CRAI F CTAI C Completed v Last 14 days Figure 9 1 Worklist Filters CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Filtering Worklists 9 CREF4 09 291 v4 0 07 2014 9 1 9 2 9 3 Selecting a Filter From the Folder List click the sign next to the desired filter type Machine Filters My Filters System Filters Click the filter you want to use to display exams and or exceptions The name of the filter displ
410. shairs move in sync as you move the cursor over the specified series The Localizer tool is useful for PET CT studies allowing you to create a ghost cursor on the other Axial Slices This only works if the CT and PET images have the same DICOM frame of reference Intellispace PACS Enterprise 4 4 User Guide 245 12 Viewing and Manipulating Images 246 NOTE You set whether or not the Localizer tool shows scout lines in the Display section of the User preferences See Setting Display Preferences see page 350 The state of the Localizer tool for an image or series is not saved as part of Presentation States Also clicking and dragging does not adjust the Window Width and Level of Localizer enabled images Figure 12 11 Localizer tool example Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 12 9 Do one of the following Right click the image or series and select Localizer Tool from the menu Press F12 The Localizer Tool item is displayed with a check mark in the menu Select Localizer Tool again to remove the localizer lines Multi phase studies contain multiple images with the same location identifier Paging through a multi phase series that has not has been split typically results in jumping back to the first slice locat
411. sion or MRN Use the open search fields to manually search for matching exams If you enter an MRN or Accession IntelliSpace PACS disables the Exam Date Time field and therefore the exam date time criteria is excluded from your query If you only search by MRN or Patient Name patients without exams are displayed An Image icon displays to the left of the exam if there are images A Patient icon displays to the left of the name if the patient does not have any exams You can create exams for patients without exams by selecting the name and clicking Create Exam A visual indicator is displayed for patients with exams This indicator can be expanded or collapsed Exams are grouped and displayed in descending order of the exam date and time 182 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exceptions 10 CREF4 09 291 v4 0 07 2014 NOTE 10 7 1 10 If there is no value in the Exam Date Time column all other columns except MRN Accession Patient Name and Organization are disabled and are not considered when performing the search Double click on any item in a potential match to view the images associated with it This displays a new tab in the bottom pane that displays the images allowing you to compare the images in the top and bottom part of the Exceptions Handler The Accession MRN
412. slider to set how fast you want to want to move through a stack of images If the Response Rate slider is set without an Acceleration Gain enabled no images are skipped regardless of the speed at which the mouse moves The slower the mouse moves the more accurate correlation there is between the number of viewed images and the distance the mouse is moved due to processor and cache limitations e Acceleration Gain allows you to use a slider to set the acceleration sensitivity Aw ARNING When the Acceleration Gain option is selected the cursor changes shape when a set of images is passed over and not shown to indicate that some image skipping is occurring This is analogous to a flipping through the pages of a book to quickly get to the area of the book you want to begin to read When you select this option you must acknowledge the following message which informs you that images may be skipped when navigating a large number of images You control when skipping occurs by the rapidity with which you move the mouse The cursor changes shape to indicate that images are being skipped during a non diagnostic transversal of images i Note TheAcceleration Gain feature permits images to be skipped while navigating a large number of images rapidly in a non diagnostic mode 406 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Mouse and Keybo
413. splays in the Status column of the cached exam Opening a Cached Exam You cannot open an exam until it has been downloaded completely To open a cached exam click the Local Exam Cache folder in the Folder List Double click the exam Viewing Preferences of Local Exam Caching Click P in the Control Strip to open the Preferences dialog Click the sign in front of Machine Preferences to expand the list Click Local Exam Caching The Local Exam Caching preferences are displayed in the right pane When you are done viewing the preferences click OK to close the Preferences dialog Intellispace PACS Enterprise 4 4 User Guide 125 Finding and Managing Exam Information 126 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 Viewing Clinical Information Physicians base their treatment plan and diagnosis not only on their own findings but also on the diagnosis and recommendations of other specialists This is especially true for Radiology where typically every radiology exam that is ordered by a Referring Physician is reported on by a Radiologist and the results called the Diagnostic Report are provided back to the Referring Physician The Clinical Information dialog allows users to draw relevant clinical information when rendering diagnoses or determining treatment plans It provides cli
414. t display See Specifying the Columns for an Exam Worklist see page 163 11 Optionally to create an Exception Worklist filter do the following Select the Exception Worklist check box and choose Resolved or Unresolved if you want exceptions to be included in the new filter Select the Exception Date from the dropdown list 162 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Filtering Worklists 9 CREF4 09 291 v4 0 07 2014 NOTE 9 8 1 12 Click the Exception Worklist Criteria tab and then select values from the Available Filter Criteria list Click the gt arrow to move these values to the Filter On column which then automatically populates the Criteria and Filter Summary fields You can create the following filters for exams unresolved exceptions and resolved exceptions Exam Unresolved Exceptions Exams Only Unresolved Exceptions Only Exam Resolved Exceptions Resolved Exceptions Only Enter additional parameters in the Equals and Does Not Equal text fields and click Update Criteria Click Exception Worklist Columns to define the columns for the worklist See Specifying the Columns for an Exceptions Worklist see page 164 When you are done selecting the criteria for the new filter click Save The list of exams and or exceptions is sorted based on the filter you created and th
415. t Name Modality Exam Date Time Exam Code and Organization are displayed for the images If you can find a patient but not an exam click Create Exam The Create Exam dialog box displays with the Exam Info pane displayed From the Exam Priority list select the priority of the exam Enter the Accession for the exam This field is mandatory Enter the Scheduled Date Click the arrow to display a calendar control Enter the Exam Code or click the button to search for and select an exam code from the Exam Code Dictionary Enter the Exam Code Modifier or click the button to search for and select one from the Exam Code Modifier Dictionary Intellispace PACS Enterprise 4 4 User Guide 191 10 Finding and Managing Exceptions 15 16 17 10 12 1 Duna p 10 12 2 Soun ayp Enter the Performing Resource or click the button to search for and select one from the Performing Resource Dictionary Enter the Ordering Location for the exam or click the button to search for and select one from the Ordering Location Dictionary If desired enter information in the Providers and Exam History panes See Entering Provider Information When Creating Exams see page 192 or Entering Exam History Information When Creating Exams see page 192 When you are done click Save You return to the Exceptions Handler Click Resolve A message displays asking you to confirm the action Click OK The exception is resolved Enter
416. t WWW WL Abdomen Brain Bone Liver Lung Mediastinum and any custom Window Width Levels created by the Intellispace PACS System Administrator on a site by site basis Right click on an image and select the New Link from the menu Right click on the image you would like to link and then select Join Link You can also quickly link all images with the same point of reference by choosing Link All 1 Open the exams you wish to compare 2 Double click on the desired images to get expanded view 3 Resize or relocate images so they are side by side X Ray Images Manually link Series Auto linked when images margins are edge to edge Intellispace PACS Enterprise 4 4 User Guide 415 21 IntelliSpace PACS Quick Reference Table 416 Task Resize image windows or exam rows Select and deselect images or image series Release any current mouse mode Access image menu Show hide image overlays Pan Zoom Review series frame by frame Fast Cine review for series Access diagnostic reports for an exam or patient Access exam notes Invert brightness and contrast Intellispace PACS Enterprise 4 4 User Guide Action Place your cursor on the window s borders or on the exam row s bottom margin left click and drag Left click on the desired image or image series Left click Right click on the desired image or image series Press F6 to toggle lays on and off for all exams in the active patie
417. t Wizard you can click Queue to open the iExport Queue dialog to see how busy the queue is See Viewing the iExport Queue see page 310 You can use iExport for exams with anonymous patient information See Exporting Anonymous Exams see page 307 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Retrieving and Exporting Studies 15 CREF4 09 291 v4 0 07 2014 Right click an exam listing from any worklist the Patient History the Relevant Exams or the exam rack and from the menu select Export via DICOM Please select the exam s you wish to export I Anonymize Exams MR HIPS ECHO lt 2YRS W MANIPULA LT 2 17 2011 13 22 07 02057032470324 Select the exam s that you wish to export To make exported patient information anonymous select the Anonymize Exams check box See Exporting Anonymous Exams see page 307 Intellispace PACS Enterprise 4 4 User Guide 305 15 Retrieving and Exporting Studies 3 NOTE Click Next DICOM Exam Export SOOSE JOHN G MRN 0945750409066936 x Please select the destinations for the DICOM export AE Title 01 lt Back Cancel Queue Select the destinations for the DICOM export and click Next If the BSN Burger Service Number feature is enabled on the IntelliSpace PACS server and the export configuration you have selected has BSN en
418. t accessed for more than check box to permit the system to automatically delete exams in your cache after the amount of time you specify Click Restore Defaults to return the local exam caching settings to their default values Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Setting IntelliSpace PACS Chat Mail Management Preferences The Chat Mail Management preferences are used to identify the machine location and the number of the closest telephone to that machine when a Workflow Layer user is chatting or emailing using the IntelliSpace PACS Chat Mail feature This information is seen next to the user s name in the contact list of users when you click the arrow to the left of the contact s name See the ntelliSpace PACS Workflow Layer 2 0 User Guide for more information on viewing this contact data Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to Machine Preferences The list of available machine preferences displays Intellispace PACS Enterprise 4 4 User Guide 397 19 Setting Machine Preferences 398 3 Click IntelliSpace PACS Chat Mail Management The right side of the Preferences dialog box displays the Chat Mail Management preferences you can set Hanging Protocols HP Sequences Canvas Page System Preferences General Preferences Machine Location Wind
419. t in the Folder List 7 Enter the URL for the plug in 394 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Setting Machine Preferences 19 CREF4 09 291 v4 0 07 2014 19 3 1 19 3 2 Select whether you want the plug in enabled in IntelliSpace PACS Enterprise IntelliSpace PACS Radiology or both If desired clear the Disable API check box Only clear this check box if you are sure that the plug in URL supports the IntelliSpace PACS Application Program Interface API Philips recommends leaving this check box selected Select the Requires Security Code check box and select a code from the list if you only want users with specific security to be able to access the plug in Click OK You return to the Preferences dialog box Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Editing a Plug In Preference Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to Machine Preferences The list of available machine preferences displays Click Plug Ins The right side of the Preferences dialog box displays a list of the current plug ins and allows you to add edit or delete plug ins Select the plug in you want to edit and click Properties The Edit Plug In dialog box displays Cha
420. t of the current paper printing preferences Select the printing preference you want to export and click Export The Save As dialog box displays Choose the desired Save In directory enter a name for the printing preference and click Save The file is saved in xml format in the chosen directory and you return to the Preferences dialog box Importing a Paper Printing Preference You can import a file that contains one or more print configurations Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Intellispace PACS Enterprise 4 4 User Guide 379 18 Setting System Preferences 380 18 9 Click Paper Printing The right side of the Preferences dialog box displays a list of the current paper printing preferences Click Import The Open dialog box displays Select the xml file for the preference you want to import and click Open You return to the Preferences dialog box The imported file is displayed in the list If the imported setting has the same name as an existing one Import_ is prepended to the name Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box Setting iExport Preferences The iExport tool enables you to export exams in DICOM format to another DICOM device such as a DICOM printer or 3D
421. t to place the new exam and click OK Copying Exams from Folders to Folders Select the exam that you want to copy to another folder Hold the Ctrl key while dragging the exam to the desired folder The exam is copied rather than moved Adding Comments to Studies in Personal or Public Folders Open the Personal or Public folder that contains the study for which you want to add a comment Right click on the study and choose Properties from the menu The Edit Exam Details dialog box displays Enter the desired Comment Click OK Intellispace PACS Enterprise 4 4 User Guide 55 Program Layout 5 3 NOTE Making Patient Information Anonymous When using IntelliSpace PACS for teaching presentations or demonstrations you can make personal patient information associated with exams in Personal and Public folders anonymous When you do this IntelliSpace PACS substitutes actual patient information with randomly generated information for the patient name MRN and Accession number Sex and birth date are not anonymized You can view the properties of an anonymous exam after the random information has been generated if you want to change any of this information See Displaying or Editing Information about Anonymous Exam see page 58 When anonymous exams are opened in the Canvas Page the substituted patient information is displayed instead of the actual patient information in the Patient History timeline and Relevant E
422. tations excluding Spine Labeling See Annotating Images see page 277 Image Processing See Image Processing see page 236 Save Saves the image in full resolution or window what is currently visible to the clipboard or a file Supported image formats are BMP TIFF JPEG PNG or GIE Print gt To Paper Printer See Printing to Paper see page 302 Flip Rotate See Flipping an Image see page 255 and Rotating an Image see page 255 Intellispace PACS Enterprise 4 4 User Guide 223 12 Viewing and Manipulating Images 224 12 3 e Zoom Presets Allows you to select a preset zoom factor of Fit to Window 100 Original Size 200 300 400 or 1600 e Magnifying Glass See Using the Magnifying Glass Tool see page 249 e Multi Image Mode Lets you choose how you want to display stack images in Multi Image mode in the Key Image Series popup window e Delete All Measurements and Annotations when measurements and annotations are present See Annotating Images see page 277 Linking Image Series The Link feature allows you to synchronize multiple images or series with an image or series that you have designated as the master You can link two or more images and zoom pan or view slices simultaneously You can also link cloned or expanded windows of stacked series of the same imaging plane by dragging their respective popup windows together on the same monitor to snap
423. te using Ctrl V Click Save Comment The comment is saved and summary information about the comment is displayed Viewing Comments for an Anonymous Exam You select comments in the Comments window to view their content The most recent comments are listed first Summary information about the comments is displayed including the date and time the comment was written the author of the comment and the subject You can sort the notes by clicking on a column heading Open an anonymous exam From the Canvas Page click the icon in the Exam Margin Select the comment you wish to view The comment is displayed at the bottom of the dialog box Deleting Comments for an Anonymous Exam Open an anonymous exam From the Canvas Page click the icon in the Exam Margin Select the comment you wish to delete Click Delete Comment A confirmation message displays Click Yes to delete the comment or No to cancel Working with VIP Patients Certain patients such as politicians entertainers and hospital employees may be designated as VIPs Very Important Persons in IntelliSpace PACS Accessing these patient records and performing all actions such as opening exams viewing images copying exams to the Media Viewer and so on are audited Ifa patient has a VIP status a system definable warning message is Intellispace PACS Enterprise 4 4 User Guide 59 Program Layout 5 5 5 5 1 displayed notifying the user that this is a sensiti
424. telliSpace PACS to be out of sync with the HIS RIS Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exam Information 7 CREF4 09 291 v4 0 07 2014 NOTE gt YY SN You can manually cancel exams that have a status of Scheduled The Accession numbers of canceled exams are not re released and you cannot undo canceling an exam Canceled exams are still visible in the worklist Images received for canceled exams become an exception study See Understanding Exam Statuses see page 109 for more information on exam statuses Right click on an exam with a status of Scheduled in a worklist From the menu select Cancel Exam The Cancel Exam dialog box displays Select the Predefined Reason you want to cancel the exam or enter a reason Click OK Deleting Exams The incorrect use of the Delete Exam feature poses serious threats to patient diagnosis and patient care Therefore only qualified and thoroughly trained professionals should be given access to this feature You should take the following precautions when deleting patient exams e Regularly backup your system only data that has been saved to a backup medium can be restored to your database if you need to restore a patient record that was deleted in error you will need a backup medium from which to retrieve the erroneously deleted record e Vis
425. tellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing Clinical Information 8 CREF4 09 291 v4 0 07 2014 NOTE 8 1 4 NOTE 8 2 When a user prints an Exam Note the system audits the event and displays the event in the Exam Audit Trail When user accounts are mapped using Active Directory AD the audit event will indicate the AD username Deleting Exam Notes Display the Exam Notes pane of the Clinical Information dialog box in one of the following ways From the Canvas Page click the icon in the Exam Margin Right click on an event in the Patient History Timeline on the Canvas Page and select View Exam Notes Right click on an exam in the Patient Lookup or Exam Lookup and select View Exam Notes Select the exam note you wish to delete Click Delete Note A confirmation message displays Click Yes to delete the exam note or No to cancel When a user deletes an Exam Note the system audits the event and displays the event in the Exam Audit Trail When user accounts are mapped using Active Directory AD the audit event will indicate the AD username Viewing Clinical Info The Clinical Info pane of the Clinical Information dialog box allows you to view signs and symptoms patient history and allergies that are relevant to the exam and give background information on the patient If available an Order Cal
426. terswsysv vevnrevcowpavunerivasivesnevetaviven 108 7 6 Exam Management Overview a aidaliuitiatentaniannannnamniastes 108 7 7 Understanding Exar Statuses s siciissascinisassnssiaiesvisnsivsvsenstessivess 109 78o Edine EXAMS innrita e 110 7 8 1 Changing Provider Information When Editing Exams 113 7 8 2 Changing Exam History Information When Editing EQNS Secs tele eldec i by weeded feed Aa GT 114 7 8 3 Viewing Linked Records When Editing Exams 0004 115 FD ECTS ExamMsonnennins nenn a o EEEE Eei 115 7 10 Completing EXAMS iraniani hinhin iieri initin iiini 116 TII aCe A SFE AIS inal edit A AAAA masrndon vs vvaen vibigonivs 116 TAZ Deleting Exams saccciaticitisnes sie iusivatibosjeatasasguadadslionsdinleosdialivatunse 117 Flo SEM EECA enina dii i RRR R 119 7 14 Unlinking Exams ssssscsoeesiiiai naeia 120 7 15 Viewing LOCKED EXAMS mninntir 120 7 16 Unlocking Exams s ssssesssssesisrsrsrsrsrsrsreserererersrsrsrsrsrernrneeereeeses 121 7 16 1 Detaching Studies nsssessssesssssssessisssssrenrirrernsirrererenrereses 121 7 17 Local Ezani Caching ciisiwiudi icici dcammencemssuecivespuecs 123 7 17 1 Opening a Cached Exam 125 7 17 2 Viewing Preferences of Local Exam Caching osses 125 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcares Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 Viewing Clinical Information cccccccccsccc
427. than the defaults for series splitting The Enter Tag dialog box displays Enter the desired tag ID after the 0x and click OK The DICOM tag is displayed in the list alphabetically Series are split by rows and columns so that the system will not create a stack with differently sized images Click the Sorting tab to set how the studies and series coming from this DICOM source are sorted Set the desired sorting options for Series Sorting and Image Sorting To sort only by image criteria not series criteria select Image Sorting Criteria Only Click the Presentation State tab The settings in this tab determine whether to display or hide some or all of the DICOM overlay planes when loading a GSPS It specifies how IntelliSpace PACS interprets the overlay activation module in GSPS Overlay Activation defines a way to control whether or not bit mapped overlay information is displayed The settings in this tab are only used when loading GSPS If desired under Overlay Activation select the check box for Initially display incorrectly specified overlays This setting is useful for sites that have applications that do not generate GSPS with correct overlay activation layer tags 60xx 1001 When selected IntelliSpace PACS ignores the overlay activation tags that are present or missing in the GSPS created by an application that matches the DICOM Source and displays all overlay planes If Initially display incorrectly specified overlays is not selected I
428. them together When linking is activated the following functions affect all linked images e Window Width Level See section 12 4 Setting the Window Width Level on page 231 e Zoom See section 12 9 Zoom Presets on page 247 and Using the Step Zoom Tool see page 251 e Pan See Panning Around an Image see page 254 You can create the following types of links e Axial e Sagittal e Coronal e Oblique e Mirrored Note the following e A series is considered to be Axial Sagittal or Coronal if it is oriented within 5 degrees of the true plane corresponding axis Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 12 3 1 A series is considered to be oblique if 1 It is not within 5 degrees of one of the major axes Axial Sagittal Coronal or 2 It contains images of different orientations such that they are not all aligned with the same axis The following link options are available Linking single images such as CR or DR images in one or multiple exams with the same modality type For example linking a CR Chest AP image of a new exam with a CR Chest AP image from a prior exam Linking single images such as CR or DR images in one or multiple exams with different modality type For example linking a CR Chest AP image
429. this exam note will not be displayed in the worklist and Canvas Page associated with the ABDOMEN and PELVIS exams Also the exam note might contain information on the linked exams that will not be visible to the reading physician or clinician Locks are granted on a per user basis This means that if multiple users log into IntelliSpace PACS using the same user ID these users will be able to unlock and mark read exams that are locked by each other To prevent this from occurring make sure you confirm the patient identity and demographic information before beginning an exam Intellispace PACS Enterprise 4 4 User Guide 23 24 Make sure that patient demographics are properly completed so that all patient data is available for the Radiologist and Referring Physician and diagnosis is not delayed e Avoid editing patient data at the modality without starting a new exam This could potentially mix patient studies and therefore cause a Duplicate UID Exam Notes and Diagnostic Reports are not the same entity Medical treatment plans should never be based on Exam Notes alone as Exam Notes often have preliminary information Diagnostic Reports can be used to help physicians design a medical treatment plan If immediate medical treatment is needed or if you disagree with a prior exam note contact the treating physician immediately You should not rely on creating a critical exam note in these situations IntelliSpace PACS stores a
430. ting General Preferences see page 338 The image manipulations options are displayed in the same way in the Key Image Series as on the exam image except for Scout lines You navigate through a Key Image Series as follows e Use the mouse wheel or the arrow keys to cine through slices e Press the Tab and Shift Tab keys to cycle through the series The Key Image Series updates in real time As you mark images in the exam as Key Images by pressing the spacebar the Key Image Series is populated simultaneously Using the Key Image Popup Window The Key images popup window provides access to all key images of an exam and includes more image manipulation features than are available for key images in the Exam Rack For IntelliSpace PACS Enterprise Multi Image Mode and the Magnifying Glass are available as options in the key image popup window while they are not available from the key image series in the exam rack Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing and Manipulating Images 12 CREF4 09 291 v4 0 07 2014 Figure 12 1 Key Image popup window example Right clicking in a Key Image Series popup window displays a menu with the following options Window Widthi Level See Setting the Window Width Level see page 231 Measurements See Using the Measurement Palette see page 263 Anno
431. ting that the exam could not be opened Viewing Resolved Exceptions You can use the Resolved Exceptions worklist to quickly find resolved exceptions based on a combination of search criteria You can search for exceptions using any combination of the following criteria The search criteria in bold below must be displayed at all times e Organization e Body Part e MRN e Name e Accession Number e Sex e DOB e Study Date Time e Exception Date Time e Images Intellispace PACS Enterprise 4 4 User Guide 185 10 Finding and Managing Exceptions e Modality e Performing Resource e Reason e Department Name e AE Title Name e Study Description e Station Name e Resolved By e Resolved To ACC e Resolved Date Time e Resolved Organization 1 Select Resolved Exceptions from the Folder List or the Shortcut Bar list if you have created a shortcut for this feature 2 Enter the desired search criteria You can use wildcard searches using patient name MRN or Accession in the Resolved Exceptions worklist for example an MRN of 1234 returns matching MRNs 123456 and 123498 To search for resolved exceptions from all dates select the Exception Date Time value and press the Delete key 3 Click Search A list of resolved exceptions that match your search criteria is displayed The upper right corner of the Resolved Exceptions worklist also displays the total number of resolved exceptions found You can do the following
432. ting the image being measured If this modality is incorrectly configured or defective IntelliSpace PACS measurement values may be adversely affected and may be incorrect Philips strongly recommends the use of an appropriately placed object of known size for determining what magnification factor has been applied to the image Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Safety 2 CREF4 09 291 v4 0 07 2014 Note the following When performing an ROI measurement on an image that is displayed with a resolution smaller than the actual image for example an image in the rack for CT IntelliSpace PACS may calculate the ROI using a sub sample of the original image data The value in this case is an accurate representation of the average measured pixel values represented by the interpolated sub sampled image This is a close approximation to the original pixel values When IntelliSpace PACS calculates a measurement using a sub sample of an image the measurement result is displayed with a front of it When opening and displaying an image in full resolution the ROI measurement meaning approximate value in co values are recalculated The sign is no longer displayed and there might be a small updatelchange from the measurement values displayed initially Do not use CDs and DVDs as a permanent or fail safe archive
433. tion shaded volume rendering technique e Standard views and interactive rotations Predefined 3D classification gallery e Interactive classification opacity threshold and color adjustment e Interactive slab thickness adjustment quick segmentation e MPR or MIP reference images with linked cursors e 3D Measurement tools same as above plus multi slice contours Patient data that has been anonymized in IntelliSpace PACS is not anonymized in Volume Vision or third party applications Also printing is not supported in Volume Vision As a workaround you may have to do a secondary capture of the MPR send data back to IntelliSpace PACS then print Starting Volume Vision When you view images in IntelliSpace PACS with Volume Vision image and metadata are transferred from IntelliSpace PACS to Volume Vision and Volume Vision is displayed on top of IntelliSpace PACS A progress bar displays as the image is being transferred Volume Vision does not support any printing As a workaround you can do a secondary capture of the MPR send data back to IntelliSpace PACS and then print from IntelliSpace PACS To open one or more series do the following In the IntelliSpace PACS Exam Rack select one or more series press and hold Shift and click on the thumbnails Right click on one of the selected thumbnail images and select one of the following options e MPR Multi Planar Reformat MIP Maximum Intensity Projection e Volum
434. to acquire store distribute process and display images and associated data throughout a clinical environment The software performs digital image processing measurement communication and storage IntelliSpace PACS 4 4 supports receiving sending printing storing and displaying studies received from the following modality types via DICOM CT MR NM US XA PET DX DR RE RT MG SC VL as well as hospital radiology information systems Indications for Use IntelliSpace PACS 4 4 is an image management system intended to be used by trained professionals including but not limited to physicians nurses and medical technicians The system is a software package used with general purpose computing hardware to acquire store distribute process and display images and associated data throughout a clinical environment The software performs digital image processing measurement communication and storage Lossy compressed mammographic images and digitized screen images must not be reviewed for primary image interpretations Mammographic images may only be interpreted using an FDA approved monitor that offers at least 5 Mpixel resolution and meets other technical specifications reviewed and accepted by FDA Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Introduction 1 1 4 1 5 CREF4 09 291 v4 0 07 2014 When to Use Inte
435. to the Overlay dialog box When you have finished laying out the overlay text click OK You return to the Preferences dialog box To show the Bit Overlays by default set the Show by default check box Intellispace PACS Enterprise 4 4 User Guide 375 18 Setting System Preferences 11 Click Apply to save the settings and continue to set other preferences Click OK to save your changes and close the Preferences dialog box 18 7 1 Editing a Screen Overlay 1 Display the Screen Overlay section of the System preferences 2 Select the overlay you want to edit and click Properties or double click the overlay The Overlay dialog box displays the properties of the selected overlay 3 Select the desired overlay text from the tree control on the right side of the Overlay dialog box and drag it to the screen mockup on the left side Remove overlay text by selecting and dragging it off the screen mockup You can only place overlay text on one of the screen s corners not in the center of the image Selected overlays are outlined with a red box 4 Click Font if you want to change the display font for overlays in IntelliSpace PACS The Font dialog box displays Select a font from the list and click OK You return to the Overlay dialog box 5 You can double click overlay text in the screen mockup to view the DICOM tag for that text and to change the font weight and size To add a custom DICOM tag double click an overlay field and enter th
436. total number of exception studies matching your search criteria is displayed If more exception studies match your criteria than can be displayed a message displays in the Control Strip NOTE The algorithm used to resolve exceptions uses the MRN and ACC Before resolving the exception you should open the images in question in IntelliSspace PACS Radiology to verify matching of the patient demographics 172 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Finding and Managing Exceptions 10 CREF4 09 291 v4 0 07 2014 10 2 NOTE 10 2 1 You use the Exceptions Handler to resolve exceptions See Using the Exceptions Handler see page 180 You use the Resolved Exceptions worklist to view a list of all resolved exceptions See Working with Resolved Exceptions see page 185 Searching for Exceptions Select Exceptions Lookup from the Folder List or the Shortcut Bar list if you have created a shortcut for this feature Enter the desired search criteria Note that you cannot use Patient Sex or Images as a search criteria You can use wildcard searches using patient name MRN or Accession in the Exceptions Lookup for example an MRN of 1234 returns matching MRNs 123456 and 123498 To search for exceptions from all dates select the Exception Date Time value and press the Delete key Click Searc
437. trong Click Modalities to view a read only list of modalities To set preferences for Edge Detect do one of the following Click Method Sobol is the only choice The Sobol operator scales the result and adds it back into the original image data Click Degree and choose Light Medium or Strong Click Modalities to view a read only list of modalities To set preferences for Median Filter do one of the following Click Method and choose 3x3 Filter or 5x5 Filter Intellispace PACS Enterprise 4 4 User Guide 361 18 Setting System Preferences Click Modalities to view a read only list of modalities 7 To set preferences for CLAHE do one of the following Set the Contextual Region Dimension to 32 64 96 or 128 Set the Number of Bins to 256 or 384 Set the Clip Limit to 1 5 2 0 2 25 2 50 2 75 or 3 0 Set the Map Level to 0 1 or 2 8 Click Modalities to view a read only list of modalities 9 Click Apply to save the settings and continue setting other preferences Click OK to save your changes and close the Preferences dialog box 18 5 Setting Annotation Preferences System Administrators can set preferences for images to be annotated by physicians or Radiologists IntelliSpace PACS has 10 pre defined annotations which is also the limit on the number of custom annotations Therefore before you can add a custom annotation to your preferences you need to delete one of the 10 existing annotations You c
438. ts images to be skipped while navigating a large number of images rapidly in a non diagnostic mode Click Apply to save the settings and continue setting other preferences Click OK to save your changes and close the Preferences dialog box The calculations used by the sliders are based on default Mouse Properties settings for Windows on that machine If the user changes these default settings the relative values of Slow and Fast on the sliders are impacted We recommend that users retain the default value for Mouse Properties in Windows when using this feature IntelliSpace PACS Enterprise 4 4 User Guide 343 17 Setting User Preferences 344 17 3 17 3 1 Setting Window Width Center User Preferences You can create edit and delete Window Width Center preferences for your own use System Administrators can set Window Width Center preferences for all IntelliSpace PACS users See Setting Window Width Center System Preferences see page 357 You can specify any modality but you must give a unique name to a new custom setting The Window Width Center preferences allow you to configure an image for optimal viewing or to highlight certain details for better visibility For example changing the brightness or contrast of an image can allow you to more clearly view the part of the image you are most interested in Separate preferences are available for modalities for example CT or MR and for tissue for example b
439. tudy UID See Manually Assigning New Unique Study Instance UIDs see page 324 Detach Study from Exam for exams having two or more studies See Detaching Individual Studies from Exams see page 211 208 Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Using the Canvas Page 11 11 11 Using Image Popup Windows Image popup windows provide additional image manipulation functionality not available for thumbnail images You can arrange these windows by dragging them to the desired location on the Canvas Page and resizing them You can display an image popup window by doing one of the following e Double clicking a thumbnail image e Right clicking an image and selecting Create Popup from the menu You can minimize popup windows by double clicking on the window s top margin To re enlarge the window double click the image margin ADAMS JULIE 24 May 1999 8 34 19 Acc 3949044 m E3 CRSTOGE Figure 11 5 Window Shades Right clicking in an image popup window displays a menu with the following options depending on the modality and whether the series is single image or multi sliced CREF4 09 291 v4 0 07 2014 IntelliSpace PACS Enterprise 4 4 User Guide 209 11 Using the Canvas Page 210 Interaction Allows you to select an enhanced cursor for zoom pan scroll or brightness if you have enabled this in the Gen
440. tudy from an exam in the Canvas Page See Detaching Individual Studies from Exams see page 211 Note that you cannot detach linked exams When a study is detached from an exam IntelliSpace PACS may not be able to determine whether that study was used to set the exam fields Therefore when an exam gets created with no modality type and body part the following might occur e Study arrives and is wrongly attached to the exam The modality and body part of study1 is copied into the exam e When study2 arrives for the exam correctly its modality and body part are ignored because the exam already has them set e When you detach study from the exam IntelliSspace PACS shows the wrong modality and body part for the exam To correct this problem manually edit the exam and select an exam code that is associated with the correct modality and body part In the Patient Lookup Exam Lookup or a worklist that shows exams find the exam from which you want to detach a study Right click on the exam and from the menu select Detach Study A confirmation message displays Click OK The study is detached and becomes an exception You now need to resolve the exception and reassign the exam to the correct patient In the Exception Lookup or a worklist that shows exceptions find the exam you detached Right click on the exam and from the menu select Resolve Exception The Exceptions Handler displays Use the Exceptions Handl
441. u do not want to display and click the left arrow to move those columns into the Available list These columns will not be displayed in the Patient Lookup Click Apply to save the settings and continue setting other preferences Click OK to save your changes and close the Preferences dialog box Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 19 Setting Machine Preferences System Administrators can set preferences to customize the IntelliSpace PACS environment for individual needs and work habits There are two types of preferences System Administrators can set e Systems preferences that affect every user See Setting System Preferences see page 355 e Machine preferences for settings related to the machine on which you are currently working System Administrators can set the following Machine preferences e General Preferences See Setting General Preferences see page 392 e Display Monitors See Setting Display Monitor Preferences see page 393 e Plug Ins See Setting Plug In Preferences see page 394 e Local Exam Caching See Setting Local Exam Caching Preferences see page 396 e IntelliSpace PACS Chat Mail Management See Setting IntelliSpace PACS Chat Mail Management Preferences see page 397 e Network Testing See Setting Network Test
442. ually verify the patient exam before deleting These actions Beginning Completing Canceling and Deleting exams performed in IntelliSpace PACS do not update the HIS RIS so they may cause IntelliSpace PACS to be out of sync with the HIS RIS A deleted exam is an exam that was scheduled and possibly performed but whose folder was deleted Deleting an exam removes all associated information including exam notes Deleted exams are not displayed in the Exam timeline Accession numbers you delete are released and available for re use for other patient exams You cannot undo a delete Intellispace PACS Enterprise 4 4 User Guide 117 Finding and Managing Exam Information You should delete an exam only in the rare instance that the exam never should have been scheduled For example if two separate patients have the same name and an exam is performed on the correct patient but recorded under the wrong name you would need to delete the exam from IntelliSpace PACS and re enter the information under the correct name Other reasons you might want to delete an exam include e Test studies created at modalities need to be deleted e There are orders for procedures that IntelliSpace PACS does not receive images for such as Radiology Non Image Chargeables lab orders and so on Deleting these reduces clutter in the timeline and the rest of IntelliSpace PACS The Technologist or someone else has made an error they want to undo and do
443. ult CT colon hanging protocol is applied to the selected data See Analysis see page 288 Intellispace PACS Enterprise 4 4 User Guide 289 14 Philips IntelliSpace Clinical Applications 290 4 Alternatively Apply a CT colon hanging protocol Do one of the following In the main menu click Protocols and then click Hanging protocols Click the Hanging protocols button on the main toolbar For more information about CT Colonography see the Philips IntelliSpace Clinical Applications online help When CT Colonography is started e the CT colon hanging protocol is applied to the selected data e dedicated classifications are applied to the views e the colon is automatically segmented e a path through the colon is automatically generated 14 4 2 Closing CT Colonography To close CT Colonography from the main menu click Session and then click Exit Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Philips IntelliSpace Clinical Applications 14 CREF4 09 291 v4 0 07 2014 14 5 14 5 1 NOTE Philips IntelliSpace CT Pulmonary Embolism Assessment Philips IntelliSpace CT Pulmonary Embolism Assessment CT Pulmonary Embolism Assessment is a postprocessing application for use in viewing assessing and reporting computed tomography CT thorax studies The optimized visualizations of CT Pulmonary Embolism As
444. umbnail shows a red navigation rectangle representing the portion of the image that is currently being viewed e Ifyou resize flip rotate re hang split the monitor or change the layout of the window the Step Zoom tool cycle is reset e You can use the Step Zoom tool in unlinked linked and mirror linked MG images If the linked images are not the same size and or their windows are not the same size the number of steps may differ between the images This could cause a synchronization loss as you step through the images Display an image in an image popup window or virtual monitor The size of the image in 100 zoom must be larger than the size of the window in which is it displayed for the Step Zoom tool to work Press S to initiate the Step Zoom tool You can set a User preference to change this default key if desired See Setting Keyboard Shortcut Preferences see page 346 Continue to press S or the other assigned key to step through different portions of the image from top to bottom and left to right When all the portions of the image are shown the next time you click S or the other assigned key the image is shown in Fit to Window mode Digital Mammography Images Display Digital Mammography images viewed in IntelliSpace PACS may display a thin white outline a few pixels wide along the outer edge of the breast tissue For this issue to present in IntelliSpace PACS the following things must occur e The sen
445. uration for Applications panel displays in the right pane of the Preferences dialog Select the check box of the rule s that you want to delete To select all rules select the check box to the left of the word Modality in the middle of the Configuration for Applications panel Click Delete To restore a deleted rule click Restore Click OK when you are done deleting rules Study Comments Reason for Study Importing All and Exporting All User Preferences You can import all and export all the following preferences e Window Width Center e Image Processing Intellispace PACS Enterprise 4 4 User Guide 353 17 Setting User Preferences 354 Importing preferences overrides any preferences in the system A warning message displays when you import preferences 1 Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip 2 Select one of the previously specified User Preferences in the preference tree 3 Right click the preference From the menu choose either the Import All or Export All option When you select Import All the following message displays Importing preferences will override the existing preferences Do you want to continue Click Yes and the Open dialog displays prompting you to select the specific xml file to import When you select Export All The Save As dialog displays and you are prompted to save the specific xml file that corresponds to the pref
446. using the Restore Color Image feature and verify the accuracy or display with a phantom You should also exercise caution with using this feature with scanned in images Review the configuration before linking or merging patients to make sure the correct patients are linked or merged An incomplete merge may result in insufficient data or images that can result in delayed patient treatment or misdiagnosis A warning message at the time of a patient merge error will display indicating that the merge is incomplete and giving the demographics of the two patients being merged The user is given the option to perform the merge again The unsuccessful merge will be indicated as Incomplete in the audit trail The incorrect use of the Delete Exam feature poses serious threats to patient diagnosis and patient care Therefore only qualified and thoroughly trained professionals should be given access to this feature You should take the following precautions when deleting patient exams e Regularly backup your system only data that has been saved to a backup medium can be restored to your database if you need to restore a patient record that was deleted in error you will need a backup medium from which to retrieve the erroneously deleted record e Visually verify the patient exam before deleting You cannot link exam notes to linked exams For example if you link CHESTABDOMEN PELVIS exams and an exam note is attached to the CHEST exam
447. uthority to operate the equipment About IntelliSpace PACS Enterprise Do not use portable devices such as smart phones or iPads tablet PCs for diagnostic purposes IntelliSpace PACS Enterprise is an enterprise wide Web based image distribution solution that delivers the power of radiology to the point of patient care IntelliSpace PACS Enterprise is based on iSyntax technology which provides clinicians access to diagnostic quality images anytime anyplace throughout the healthcare environment Physicians can access all images including radiology cardiology dermatology mammography and pathology Clinicians can access a patient history timeline to view a patient s entire clinical history Additional features include Presentation States scout tools for advanced navigation and interrogation cross modality linking and color support for all modalities These advanced clinical tools enable clinicians to provide faster and more accurate care to their patients IntelliSpace PACS Enterprise runs on standard PCs and networks and does not require expensive dedicated workstations and networks Intellispace PACS Enterprise 4 4 User Guide 15 Introduction 1 2 1 3 Intended Use IntelliSpace PACS 4 4 is an image management system intended to be used by trained professionals including but not limited to physicians nurses and medical technicians The system is a software package used with general purpose computing hardware
448. ve patient record and displaying the patient name and MRN For information on specifying the text for this message see Setting General Preferences see page 356 After you click Yes in the VIP Warning message it does not display again during the same IntelliSpace PACS session for that patient The message will display for other VIP patients in that session When you start a new session and access the same sensitive patient record the message displays again and the new activities you perform on this record are audited If you select more than one VIP patient for an action the message lists all the patient names and MRNs of the selected VIP patients If you click Yes in this message every action for all the listed patients will be audited You cannot select a subset of patients in this message If the Automatically open next unread exam from active filter after marking read check box is selected in the General User Preferences and you attempt to open an exam for a VIP patient after marking an exam as having been read a warning is displayed asking you to acknowledge the VIP status of the patient whose exam is about to be opened You can click Yes to proceed and read this exam or click Skip to move to the next unread exam See Setting General Preferences see page 338 Shortcuts Bar The Shortcuts Bar allows you to quickly access your most frequently used folders filters and tools The only time the Shortcuts Bar is not visible
449. within the DICOM imaging standard For example for tomographic modalities pixel size is determined based on the value of the Pixel Spacing DICOM tag 0028 0030 and is being used to determine the physical distance in the object space Pixel spacing of 1 mm implies measurement accuracy of 0 5 mm Similarly for projective modalities if DICOM Presentation Size Mode is set to TRUE SIZE Imager Pixel Spacing 0070 0100 can be used to estimate the size of the object The actual estimate of accuracy will vary depending on the modality type and the specifics of the imaging protocol Intellispace PACS Enterprise 4 4 User Guide 261 13 Measuring and Annotating Images Measurement Length Ruler Unit of Measure millimeters mm Precision 1 10 of a unit i e 0 1 mm if in millimeters Angle Angle tool and Degrees Whole numbers as in 1 unit i e 45 Cobb measurements degrees Area ROI Circle ROI cm 2 lt 10 1 1234 Freehand ROI Ellipse lt 100 11 123 lt 1000 111 12 lt 10000 1111 1 gt 10000 will be whole numbers Brightness ROI Circle ROI Freehand units for others ROI Ellipse Point unit Value Tool Hounsfield units for CT grayscale Density 1 100 of a unit i e 1 00 Standard Deviation whole numbers as in 1 13 2 2 Order of Precedence IntelliSpace PACS uses the following order of precedence for the pixel spacing for measurements and image display in the case of non s
450. xams Current Providers Note Type Exam Note Type 10 I Critical Note Audit Trail Figure 8 1 Exam Notes pane in the Clinical Information dialog Each Exam Note type has three tasks roles based on access privileges e Full access to the Exam Note type e Read only access to the Exam Note type e Ability to Read Delete and Create your own Exam Notes but with read only access to Exam Notes created by others If you have the proper privileges you can 130 IntelliSspace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Viewing Clinical Information 8 e Add view and delete exam notes in the Exam Notes pane of the Clinical Information dialog box which is accessed by doing one of the following In the Canvas Page clicking the clipboard icon in the Exam Margin Right clicking on an exam in Patient Lookup or Exam Lookup and selecting View Exam Notes e Mark an exam note as critical to alert providers of its importance When critical exam notes are available for an exam an icon displays in the Clinical Information dialog as well as on the clipboard icon in the Exam Margin However in the Worklist the icon does not display to indicate the presence of a Critical Note You cannot edit an exam note that you have saved To correct a note you need to delete the note and create a new one You can set a User preference to auto
451. xams area Note the following for anonymous exams e Certain features and menu items are disabled including assigning a new study instance UID and deleting images e Screen overlays display the anonymous patient information e You can export exams with anonymous patient information to the Media Viewer and use the iExport tool for these exams See Working with Anonymized Exams in the Media Viewer see page 301 and iExport for DICOM Export see page 303 e You can enter comments similar to exam notes for anonymous exams by clicking on the icon in the Exam Margin on the Canvas Page See Adding Comments to an Anonymous Exam see page 58 e Patient information you make anonymous in IntelliSpace PACS is not anonymous in program extensions such as IntelliSpace PACS Volume Vision or other third party applications If you have an exam opened as anonymous and then try to open the exam with the actual patient information a message displays stating that the exam is already opened Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Program Layout CREF4 09 291 v4 0 07 2014 4 Drag the exams you want to make anonymous into the desired Personal or Public folder Right click the folder that contains the exams you wish to make anonymous Select Anonymous from the menu When selected this menu item d
452. xams whose DICOM information conflict with information from the RIS See Using the Exceptions Handler see page 180 Filter Tool for dynamic search and selection based on user defined criteria and resulting in a dynamic worklist Filter Criteria The information you specify for a filter such as Organization and Modality Folder Container for storing patient exams of specific relevance or interest resulting in a static worklist for example teaching files Folder List Provides access to a variety of IntelliSpace PACS tools filters and folders See Folder List see page 51 Intellispace PACS Enterprise 4 4 User Guide 423 22 Glossary History Folder The folder in the Folder List that contains the last 100 exams you have viewed See Folder List see page 51 iExport The feature used to export exams via DICOM to another system or workstation such as a 3D workstation See iExport for DICOM Export see page 303 iExport Queue A real time display of the status of exams that have been exported using the iExport feature You can also delete and restart exported exams from the iExport Queue See Viewing the iExport Queue see page 310 Image quality icon An icon in the lower right corner of the image that indicates the relative quality of the image See Image Quality Indicator see page 45 iQuery The feature used to retrieve studies through DICOM Query Retrieve fr
453. y System Administrators to assign organization specific privileges to users Tele Radiology The feature that allows users to retrieve images that are lossy compressed non diagnostic quality See Teleradiology Mode see page 45 True Size Zoom Zoom setting that approximately represents the actual size of the anatomical structures on the screen User Filter A filter created by an IntelliSpace PACS user that is only available to that user See Filtering Worklists see page 149 Intellispace PACS Enterprise 4 4 User Guide 431 22 Glossary 432 User Preferences Various settings that control the behavior of IntelliSpace PACS for the user See Setting User Preferences see page 337 Window Width Window Level Window Width is the total range of pixel values displayed on the screen Increasing the window width will decrease the contrast Window Level is the value of the pixels at the center of the range defined by window width Increasing the window level will decrease the brightness Worklist A list of cases to be worked on The user may specify the contents of the worklist Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc CREF4 09 291 v4 0 07 2014 23 Accessing PDF File of Online Help To view this book in PDF format go to http lt server IP gt PACSAdministration Help Pri
454. yboard commands when using IntelliSpace PACS with a two button mouse These commands replace the wheel function of the three button mouse but can also be used by three button mouse users You can program other input devices such as the ShuttlePro to use the IntelliSpace PACS keyboard shortcuts See the applicable device user manual for general configuration instructions You can set a User preference to change and create keyboard shortcuts See Setting Keyboard Shortcut Preferences see page 346 The table below indicates which keyboard shortcuts are hardcoded and cannot be changed Intellispace PACS Enterprise 4 4 User Guide 407 20 Mouse and Keyboard Reference Sheet 408 The following keyboard shortcuts cannot be configured Description Numbers 1 9 Delete Home and End Mouse over Period and Comma Action Allows you to cycle through the various preset window width level settings for a CT image or series Removes the currently selected measurement or annotation from the image The user must first select that annotation and then click Delete Jumps to the first and last images in the selected image series respectively Brings a popup window to the foreground Increases or decreases the angle for the Edge Enhancement and Edge Detection Image Processing tools For CLAHE Image Processing alternately increases or decreases the clip parameter The following keyboard shortcuts can be co
455. ying an image in full resolution the Point value eI measurement values are recalculated The sign is no longer displayed and there might be a small update change from the measurement values displayed initially Right click on the image and from the menu choose Measurements and then Point Value Screen overlay text labeled Point Value is displayed at the bottom of the image followed by the x and y coordinates and a number that changes as you move the cursor over the image Click the image to disable the Point Value display Calibrating Images The Calibrate Image tool allows you to calibrate the image on your screen for certain known measurements You cannot use this tool with images that have valid DICOM defined pixel spacing Also note that using the Calibrate Image tool on an image that has already been calibrated changes Intellispace PACS Enterprise 4 4 User Guide CREF4 09 291 v4 0 07 2014 Philips Healthcare Informatics Inc Philips Healthcare Informatics Inc Measuring and Annotating Images 13 CREF4 09 291 v4 0 07 2014 13 13 13 14 the measurement values for that image and displays a warning message If the calibrate selection is gray the system has received correct DICOM header information to automatically calibrate the measure distance tool Right click the image and from the menu select Measurements and then Calibrate Image Place your cursor at the end point of a known distance and d
456. yle from the menu Hold down the Shift key while performing image manipulation with the mouse or the keyboard Right click on the image you wish to unlink and select Leave Link from the menu Expanded CT or MR images auto link when their margins are placed side by side Left click on the image s top margin or bottom annotation area and drag images margins edge to edge Right click on an image and select Scout Line Mode from the menu To view a series with several slices displayed simultaneously in one window right click the series and select the desired configuration from the Multi image mode menu Right click an image and select Clone Window from the menu then double click the cloned image Intellispace PACS Enterprise 4 4 User Guide 417 21 IntelliSpace PACS Quick Reference Table 418 Task Copy to the Windows clipboard Apply spine labeling to an image of the spine Increase or decrease the angle for the Edge Enhancement CLAHE and Edge Detection Image Processing tools Mark an image as a key image View exam information View the available presentation state for an exam Minimize all images in an exam row Close an exam Hide or display the Patient History Change between horizontal and vertical rack modes Intellispace PACS Enterprise 4 4 User Guide Action Right click on an image and select Save and Window Image To Clipboard from the menu Right click on any i
457. you can merge two patient records with different identifiers from the same organization into one surviving patient identifier The surviving identifier is associated with all records originally belonging to the two patient identifiers There are two methods for generating merge candidates e Weighted Match default option e Exact Match In a Weighted Match configuration a merge candidate pair will appear on the Candidates list based on a Point system see Resolving Merged or Linked Patient Records see page 86 In the Exact Match configuration a merge candidate pair will appear based on very specific matching criteria This is to support the 3 X legacy merge candidate functionality e If Auto Link is enabled all the fields Last Name First Name Middle Name Sex and Date of Birth match exactly to confirm identity e If Auto link is disabled and Merge Link Candidates is enabled the candidate is considered a match and added to the list if Last Name First Name and Date of Birth match exactly Middle Name matches exactly or is blank for any of the compared patients Sex matches exactly or is Unknown for any of the compared patients Intellispace PACS Enterprise 4 4 User Guide 91 Finding and Managing Patient Information 6 20 If the patients match they are put on the Merge Link Candidates list The System Administrator can then merge if they are in the same organization link if they are in di
458. you return to the Preferences dialog box Importing a Screen Overlay Display the Screen Overlay section of the System preferences Click Import The Open dialog box displays allowing you to find the xml overlay file you want to import Find and select the xml file and click Open A message displays asking you to confirm importing the file Click OK to import or No to cancel The imported overlay is added to the list in the Preferences dialog box Setting Paper Printing Preferences System Administrators can create unique print configurations that users can select to specify exactly how image metadata is printed as an overlay You can save up to 10 print configurations The overlays you configure here only apply to paper output not to the overlays displayed on the screen or used in DICOM printing See Printing to Paper see page 302 Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click Paper Printing The right side of the Preferences dialog box displays a list of the current paper printing preferences Intellispace PACS Enterprise 4 4 User Guide 377 18 Setting System Preferences 378 18 8 1 MS Wop Intellispace PACS Enterprise 4 4 User Guide Click Add The Add Windows Print Configuration dialog box displays Enter the Name of the print configuration Select a Format fr
459. ystem Preferences The list of available system preferences displays Click Annotations The right side of the Preferences dialog box displays a list of annotation preferences and a Properties button that allow you to edit annotations Select the annotation you want to edit and click Properties or double click the annotation The Edit Annotation dialog box displays Change the properties of the annotation as desired Click OK The modified annotation is added to the list in the Preferences dialog box Click Apply to save the annotation preference and continue to set other pply p preferences Click OK to save your changes and close the Preferences dialog box Deleting an Annotation Preference Click the P icon in the upper right corner of the IntelliSpace PACS Control Strip Click the sign next to System Preferences The list of available system preferences displays Click Annotations The right side of the Preferences dialog box displays a list of annotation preferences and a Delete button that enables you to delete annotations Select the annotation you want to delete and click Delete The annotation is removed from the list IntelliSpace PACS Enterprise 4 4 User Guide 363 18 Setting System Preferences 5 Click Apply to save the deletion and continue to set other preferences Click OK to save your changes and close the Preferences dialog box 18 6 Setting DICOM Sources Preferences You can set DICOM Sources pref
460. ze and navigate to a location in multiple series with different orientations See Using the Localizer Tool see page 245 Machine Auto Logout Time The amount of time after which a machine automatically logs you off from IntelliSpace PACS The System Administrator can set a machine preference to override the system wide auto logout time See Setting General Preferences see page 392 Intellispace PACS Enterprise 4 4 User Guide 425 22 Glossary Machine Filter A filter that is associated with a specified machine workstation Users can only use a machine filter associated with the machine they are working on See Filtering Worklists see page 149 Machine Preference Various settings that control the behavior of IntelliSpace PACS on a specific machine See Setting Machine Preferences see page 391 Media Viewer The feature that allows you to create personalized CDs and DVDs that include an encapsulated version of IntelliSpace PACS and the patient exams you choose See Using the Media Viewer see page 297 Merge Link Candidate List A list of patients that are identified by the IntelliSpace PACS system as candidate pairs for patient linking and merging See Merging Patient Records from the Same Organization see page 91 MLO View position medial lateral oblique Modality Type of acquisition device used to generate the images of an examination Examples are CR MG RE US MR

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