Home

International

1. 10mm Iu T 7 nnd Figure 3 1 iNtuitionEMV iEMV Viewer R 442 5 se k d Show 1x1 2x1 1x2 2x2 Proto Sync Antr 5 Capture CW CCW id Cine 2D Cine 4D Invert Each button pictured in the previous image is described in this section Use these links to jump to the desired section 3 1 iEMV USR EN INT 4 4B Chapter 3 The Viewer Mouse Modes and Measurements Hover the mouse over the Slice button shown above button to show Ei Slice the complete menu see image at right amp Zoom WindowLevel Mouse Mode Pan The first four items allow you to select the function of the eft mouse en DLA button I Line segment lt Ellipse e Slice page through slices Angle e Zoom move up to make the image larger down to make it smaller nu WindowLevel make the image brighter or darker Text e Pan move image around in the window Arrow Arrow Text The other mouse buttons and button combinations retain their usual I Intensity functions Te TI point Cg TI ellipse Measurements The following is a description of each type of measurement used in the Viewer Distance This feature calculates the distance of a line drawn on the image To draw a line do the following 1 Click on one edge of the area to be measured 2 Drag the mouse across the area 3 Release the mouse to finish drawing Line Segment This allows you to draw a s
2. Window Level e Linear The standard linear curve Sigmoid Sigmoid uses an S shaped curve for the Window Level The contrast then appears more like an X Ray film e Input Value Arbitrary LUT stored in the DICOM files often used with CR DX and MG The curve is calculated and optimized on the scanner to provide the same perceived image on the console monitor and in print You can select Input Value only if the LUT is stored in the DICOM header e Full Range Displays the full acquisition range of HU Chapter 3 Linear Sigmoid Input value Full range Min Max Abdi 350 75 Abd2 250 40 Head 100 45 Lung 1500 700 Bone 2200 200 W 500 L 35 Invert Reset Min Max Selects a Window Level range that displays the image so that the full range of HU values in the data can be seen e W L Preset Values Select from five pre defined W L values depending on the type of tissue being examined e Invert Invert the HU values in the image e Reset Restore the W L to the original values from the DICOM header 2D Image Format Display the image in one of three formats the original format MIP and ThickMPR e Slab When either MIP or ThickMPR is selected the Slab annotation is displayed underneath The default thickness is 5mm but you can click on the annotation to change it Select the desired slab thickness from the pulldown menu MIP Slab 5 00 mm Phases Select a differ
3. 01 1944 Jan 01 1944 Jun 18 1331 Sep 01 1949 May 14 1943 Apr 08 1937 May 01 1954 Oct 15 1958 Series description c123 c1233 TDA 04 12 2006 13 45 TDA 1271922008 17 12 TDA 12 30 2008 15 32 4 5 210 5 210 Gender be CEU T C UE Modalit Study date time Jan 01 2000 Jan 01 2000 Jan 01 2002 10 57 22 AM Feb 12 2003 01 19 09 PM Dec 04 2002 11 58 14 AM Sep 28 2011 01 46 27 PM Feb 12 2005 10 50 57 AM Apr 13 2004 0 Oct 21 2002 0 Oct 21 2002 0 Aug 08 2002 09888 Nov 15 2007 02 28 32 PM Sep 25 2009 03 58 49 PM Nov 10 2011 12 31 06 PM Nov 15 2011 12 59 45 PM Jan 16 2008 1 Series date time Jun 28 2012 12 00 07 PM Jun 28 2012 12 01 47 PM Apr 12 2006 01 45 16 PM Dec 18 2008 05 12 13 PM Dec 30 2008 03 32 19 PM Dec 21 2012 01 57 09 PM Dec 21 2012 01 41 48 PM Figure 2 1 The Patient List Screen The Patient Information Row Number of inst Study description VIRTUAL COLONOSCOPY HEART LUNG MR Angio Pelvis Digital SCREENING with Dual Energy 03 DE Body ngio Bo Abdomen 01 Abdomen100Kx Adult Dual Energy 03 8 DE RSC Adult Dual Energy 08 3 DE Kidney Ston Abdomen 01 BIPHASICLIVER Adult Study ID A 472 473 180 61 1315834 1 3745 3744 4237 000000000137 1 47270 47289 414 4135834 413 4145312 414 Body part examined Manufacturer TOSHIBA TOSHIBA TERARECON TERARECON TERARECON TOSHIBA TOSHI
4. a problem with this website s security certificate The security certificate presented by this website was not issued by a trusted certificate authority The security certificate presented by this website was issued for a different website s address Security certificate problems may indicate an attempt to fool you or intercept any data you send to the server We recommend that you close this webpage and do not continue to this website Click here to close this webpage amp Continue to this website not recommended More information Figure 1 2 SSL Certificate Error Message in Internet Explorer 8 If you encounter this message contact the IT department that manages the AquariusNET server to report the error Viewing confidential patient data over an unsecured Internet connection is a serious problem WARNING Not having a valid SSL certificate results in unencrypted communications over the Internet This is a violation of HIPAA laws and must be remedied 1 1 iEMV USR EN INT 4 4B Chapter 1 System Configuration The iEMV Login Screen Aquarius 3 Nuition EMV Version 4 4 8 36 Revision 94912 TERARECON ING www terarecon com Operating system Windows XP Browser Internet Explorer 7 0 Enter your username and password in the User name and Password boxes Click Login to connect to the server Before iEMV is launched the following dialog is posted to warn you that iEMV is not to be used for diagnostic pu
5. by TeraRecon from time to time Please also be aware that patient information is restricted private and extremely confidential and subject to stringent legal regulations you should control access to the iEMV or patient data contained therein accordingly Devices attached to this product must comply with their own applicable safety standards Precautions Relating to General Use The iEMV software may allow images to be generated in which parts of the original scan data are obscured removed including but not limited to through use of lossy compression hidden or modified Similarly output images and reports can be produced saved and annotated with elements of the original acquisition omitted obscured modified or hidden Hence careful and responsible use of the equipment and its output images requires that the user be aware of and effectively communicate these important facts to untrained or uninformed observers or recipients of the processed information Please ensure that all processing has completed including completion of any final stage subsequent to an intermediate stage of processing before formulating a final interpretative decision In certain situations processing takes a brief time but please ensure that all processing of whatever type has completed including for example completion of any final stage subsequent to an intermediate stage of processing before seeking to validate or validating a final interpretat
6. film screen images is supported only when the software is used without compression and with an FDA approved monitor that offers at least 5M pixel resolution and meets other technical specifications reviewed and accepted by the FDA Under other circumstances such image review is supported but not for the purposes of diagnostic interpretation SAFETY FIRST Position statement on responsible use of COMPUTER ASSISTED AND QUANTITATIVE IMAGING The rapid advance of volumetric imaging technologies such as CT MR and PET has opened up a wide range of new possibilities in medical imaging Such new techniques have been the subject of extensive research and in many cases adoption into routine clinical practice The high speed and high resolution of modern imaging devices has driven a growing demand for tools to help make more efficient the review of such images TeraRecon is a committed pioneer innovating in this field to improve the quality and performance of advanced visualization tools and their accessibility by physicians Such advanced applications include fast 3D visualization to assist with qualitative review of images and also quantitative tools tools for distribution to a range of computing platforms and computer assistance whereby image processing algorithms are applied to derive data of potential interest to the operator iEMV USR EN INT 4 4B iv By their nature advanced visualization systems process input data typically DICOM ima
7. is used by default the next time a study containing Parametric Map APS data is loaded Select Reset to restore the original default color map Delayed Rainbow Viewing Studies Just beneath the Top Tool Bar the studies or series currently loaded are displayed as thumbnail images The name of each study is shown on a tab that contains the Patient ID Patient Name Study Date and Description To view a different study click the corresponding tab 3 11 iEMV USR EN INT 4 4B Chapter 3 The Viewer A 515A AE Ye If there are too many series to be visible all at once use the slider bar to scroll to a series not currently visible When you hover the mouse over a series icon a panel containing detailed information about the series is displayed see the following image Series number Series date Oct 11 2011 series time 11 16 58 AM Modality CT Number of images 24 Image type DERIVEDXSECONDARY SAXIALVAQNET12BITS scan Options Clickable Annotations The annotations on the image are configurable based on the annotation setup in viewer configuration The green annotations are clickable and selectable e Zoom Factor Select the Zoom option e Original Size Display image at 100 the size of the DICOM image e Fit to Screen Display image at a size that fits the screen iEMV USR EN INT 4 4B 3 12 iNtuitionEMV W L Select different options to apply to the Window Width and
8. 3 Vuition INtuition 4 4 International TERARECON INC leraRecon Inc 4000 E 3rd Avenue Suite 200 Foster City CA 94404 USA EMERGO EUROPE Molenstraat 15 E C 2513 BH The Hague nr The Netherlands Phone 31 70 345 8570 Fax 31 70 346 7299 ME20 Australian EMERGO ASIA PACIFIC PTY LTD C Sponsor 201 Sussex Street Darling Park Tower 11 Level 20 Sydney NSW 2000 Australia 0 l 97 Symbols used in the label Consult Instructions for Use The CE 0197 mark applies to AquariusNET Server Aquarius Workstation and AquariusAPS software when such software is installed on the computer to which the CE 0197 mark is affixed Manufacturer The name and address of the manufacturer are listed next to this symbol Date of Manufacture The year of manufacture is listed next to this symbol Authorized Representative in the European Community The name and address of TeraRecon s authorized representative in the European Community are listed next to this symbol GOST R Mark Mark of conformity certifying that Russian Federation safety requirements have been met iEMV USR EN INT 4 4B Notice TeraRecon Inc reserves all rights in this document which is copyrighted Copyright 2012 2013 by TeraRecon Inc TeraRecon Reproduction of this document in any form is strictly prohibited unless specific written consent from TeraRecon has been obtained Contents
9. 44 50 AM 78 SEGMENT 80 0 00s TOSHIBA A Maw O ane 44 50 AM MENT anos n nn OSHIRA Study Management Buttons This group of buttons consists of basic management functions and are displayed by default Below is a discription of each function L Download Anonymize Load Load 3D e Refresh Reloads the Study List This will reflect any changes made to the list such as imports or deletions since the previous time the list was loaded e Search Opens a dialog where search filter rules can be entered iEMV USR EN INT 4 4B 2 4 iNtuitionEMV Chapter 2 Search starts with 1 El El El O Omm CD D E starts with contains 7 O O A Cancel Figure 2 4 Search Filter Dialog The Search filter contains a list of DICOM tags commonly shown in some of the Patient List columns for example the Modality column When a search is being performed using this filter studies in the database are checked against the rules in the filter If all specified fields in the filter match the corresponding tags in a study that study is a match and will be shown in the Patient List Configure the search filter as follows 1 For each DICOM tag that must be matched select a comparator for example equals not equal contains starts with contains Click the down arrow in the contains all input box of the tag and select the comparator see iussum image at right ands w
10. 8 Testing auto cine 201 A CT Oct 11 2011 11 16 59 AM 50 If all the subseries have the same image number only one thumbnail image is displayed The label shows the number of images in series which is calculated from the number of subseries times the number of images for each subseries in the same folder When you hover the mouse over the thumbnail a small window containing images and series information is opened Series number 104 Series date Jan 01 1970 series time 04 04 04 AM Modality cT Number of images 266 Image type ORIGINAL SECONDARY AXIAL Scan Options If a series has preprocessing results from AquariusAPS the letter A is displayed to the Jan 01 1970 04 04 04 AM left of the series item in the list If you hover RPS results available the Mouse over the letter A it displays the APS results that are included in this series Segmentation Body Bone See image at right Label Abdominal Vessels Other Registration Matching 2 7 1EMV USR EN INT 4 4B Chapter 2 The Patient List iEMV USR EN INT 4 4B 2 8 iNtuitionEMV Chapter 3 Chapter 3 The Viewer gt 7 WB scan Compression High Med Low None Check connection speed E E iNuition TERARECON Patient list 024 4D Cardiac Jan 01 1931 M u ENEE E o d t3 lice Ld 1x1 Lim 1X2 2X2 Erta sync EN Anr ns dns CW ECW Flip V FlipH Cine 2D Cine 4D Invert Show EU Ci Se aa s 18 AM 5 105544 6 5 105530 105531 5 105532
11. BA The patient information row contains all the headers for each column in the Patient List such as the Patient ID Patient Name Study Date and so on Read status Read status Note STAT Patient ID Note Patient Name Date c Gen STAT Patient ID Modali Study date time Patient Name Study desc Study ID Accession n Figure 2 2 Patient Information Row partial image 2 iEMV USR EN INT 4 4B Chapter 2 The Patient List Below is a description of each column in the Patient List Read status The Read Status icon indicates the study s current stage of examination To update the status right click the icon A menu of options is opened allowing you to mark the read status Mark as New Select the appropriate status The icon in this column will L change accordingly status Note Mark as Prepared X Mark as Wet read jaf Mark as Read 12 Mark as Reported e Note Note STAT If any notes have been added to a study the Note icon appears in this column circled in the following image You can view the notes by hovering the mouse over the icon Report sent e STAT STAT Patient ID You can change the STAT setting to indicate that the study is urgent and should be given top priority Right click on the STAT Set STAT column in that row to set or remove the STAT icon Remove STAT Figure 2 3 Marked em
12. MR review iEMV can also access non DICOM patient data Modalities iEMV supports the following modalities CT Computed Tomography MR Magnetic Resonance PT Positron emission tomography PET CR Computed Radiography NM Nuclear Medicine US UltraSound XA X Ray Angiography RF Radio Fluoroscopy MG Mammography SR Structured reports IVUS Intravascular Ultrasound Other Features iEMV provides the following features High performance full resolution display 4D display support Display of mammogram CAD markers Automatic Q R of prior studies from the archive Bandwidth analyzer for optimal compression Ability to download and anonymize patient data Healthcare IT standards such as DICOM Traditional standards such as LDAP AD for integration with PACS and EMR Ability to render large amounts of data with a small amount of hardware Access from a PC or Mac Configuration Many of the features in iEMV such as search filters folders for saving data layouts and displays annotations in the image views text appearance keyboard shortcuts synchronization of image manipulation image capture settings and output options can not be configured in iEMV These settings must be configured in iReview When iEMV is launched on an AqNET server it receives the configuration settings that are current in iReview There are local settings that can be changed using the menus and buttons in the Patient List and Viewer These a
13. abled the button has a light color and appears sunken When it is disabled the color is darker and the button appears flat iEMV USR EN INT 4 4B 3 6 iNtuitionEMV Chapter 3 o Capture the selected image in the view window to the Output Panel J e B Orientation Cw CCOw FlipV Orientation There are four orientation functions CW Rotate 90 degrees Clockwise CCW Rotate 90 degrees Counter Clockwise Flip V Vertical Flip Flip H Horizontal Flip Cine 2D Cine 40 There are two functions in the Cine tool Cine 2D plays through the slices of a single series Cine 4D plays a multiphase image as it changes over time while remaining in the same image position Invert Color Invert the color scale for the image This applies to both grayscale and color images 3 7 iEMV USR EN INT 4 4B Chapter 3 The Viewer Figure 3 4 Left Original Grayscale Right Color Inverted PMap PMap displays the parametric map for breast MR data Sub subtracts TO images from the current image Parametric Map Parametric Map is a color coded visualization of the change in intensity over time To analyze the time density curve two thresholds are used in the Parametric Map module One is the uptake value which describes how fast the intensity changes between the pre contrast and peak phases also known as the initial or wash in phase Each pixel in the image has an uptake thr
14. are subject to change without notice This document may only be used if the reader releases TeraRecon from all claims relating to or arising from any errors it may contain Use by the reader herewith constitutes such an understanding This provision may only be modified on an individual basis in a separate written agreement executed between TeraRecon and the owner or licensee of a specific instance of the product to which this documentation relates Apart from any warranty that may be stated in a specific written agreement between a party and TeraRecon TeraRecon makes no warranty of any kind whether expressed or implied relating to the contents of this document or any software provided by TeraRecon including but not limited to iNtuition EMV iEMV iReview Aquarius Workstation Aquarius Workstation iNtuition Edition AquariusGATE AquariusNET AquariusBLUE AquariusAPS AquariusNET Thin Client software and Aquarius iNtuition Client software TeraRecon will not be liable in any event for incidental or consequential damages in connection with or arising out of the provision performance or use of this documentation or any software product to which it may relate or any software or hardware product supplied by TeraRecon for use with any such software product or this documentation itself Microsoft Windows Windows NT Windows 2000 Windows XP Windows 7 Windows Server 2003 and Windows Server 2008 are registered trademarks of Microsoft Corp
15. atent No 4 158 167 Parallel Volume Rendering System with a Resampling Module for Parallel and Perspective Projection Patent No 4 197 203 Method and Apparatus for Illuminating Volume Data in a Rendering Pipeline Patent No 4 420 531 Method and Appartus for Modulating Lighting with Gradient Magnitude of Volume Data in a Rendering Pipelines Patent No 4 435 377 Volume Rendering in XY Image Order Patent No 4 205 327 EU Patents Real Time PC Based Volume Rendering System Patent No 0 903 694 Method and Apparatus for Volume Rendering with Multiple Depth Buffers Patent No 1 014 308 vii iEMV USR EN INT 4 4B Welcome Welcome to the iEMV Manual This guide is intended for users performing and analyzing different studies using the iEMV application Please read the chapters sequentially to gain a complete understanding of the iEMV application You can use the table of contents to navigate to your topics of interest Please do pay attention to all Notices whether onscreen or contained herein including all precautionary statements and advisories as these are essential to the effective and authorized use of the products and applications discussed herein Conventions This guide uses the following conventions e The text that appears on buttons menu items dialog boxes and other elements of the iEMV user interface are printed in a bold font For example Click the Save button e Screen names are capitalized For exa
16. d color bar at right are displayed on the image These determine the colors used to show the changes in intensity during the delayed phase Color bar Figure 3 5 Parametric Map The Color Bar The color bar shown in Figure 3 5 controls the color map of the delayed phase There are three color areas one for each type of change Between each pair of adjacent colors is a slider that allows you to change the percentage border for both colors To change the percentage border between two colors click and drag the slider up or down see Figure 3 1 on page 3 9 For example to lower the threshold between the Type I and Type II colors drag the upper slider downward As this threshold is lowered the amount of the Type I color will be increased on the image Figure 3 1 Color Bar 3 9 iEMV USR EN INT 4 4B Chapter 3 The Viewer To change the colors used for the delayed phase do the following Initial Rainbow 1 Click the color bar A menu is opened as shown in the figure at v Rainbow right Red Green Blue Red Blue Green 2 The alternate color maps are shown under the Rainbox color map PEN Red Yellow Blue Click a different color map to select it Dave Reset The following images show from left to right how the Red Green Blue Red Blue Green and Red Yellow Blue color maps highlight the pathology The Uptake Bar The Uptake bar allows you to control how much color overlay to show on the imag
17. display during operation relating to potential problems with the information supplied in those DICOM images Note further that in certain instances even though there may be problems or inconsistencies in the image information iEMV will be unable to detect this and erroneous image display will be unavoidable unless the user properly ensures the correctness of all input data in advance Potential problems relating to errors in the DICOM information include incorrect dimensional readouts incorrect orientation markings and incorrect pixel value calibration Three dimensional imaging inherently offers a wide variety of different imaging views of any given dataset it is an important responsibility of the operator to ensure that a proper visualization is achieved and that a complete review of the data has been performed before reaching any diagnostic or interpretive conclusion relating to the dataset in question Limitations present in the original input data such as those relating to spatial and or temporal resolution pixel size and slice thickness remain valid even when iEMV processes the data and these provisos should be considered when using the equipment for image review The image processing and display techniques offered by iEMV are only intended as an adjunct to and not a substitute for conventional diagnostic review of medical imaging data All results should be validated by qualified physicians trained in the subject matter The iNtu
18. e Drag the threshold slider up and down to increase or decrease the percentage threshold at which color is shown on the image Any pixel whose percentage change is below the threshold will not show any color A lower threshold allows more color to be displayed This makes it less likely that diseased tissue will be missed but there will also be more noise on the image The Uptake bar allows you to try different percentages until the amount of color suits your needs iEMV USR EN INT 4 4B 3 10 iNtuitionEMV Chapter 3 The Initial Phase Bar To access the initial phase bar click the color bar to display the menu Then click Initial Rainbow at the top of the menu see image at right WwW Rainbow The Initial Phase bar is then displayed on the left side of the viewer Red Green Blue The color map for the initial phase is displayed on the image as shown below Red Blue Green You can use the sliders to change the borders between the colors as described in The Color Bar on page 3 9 However no other colors are available for the initial phase Note that the percentage ranges on this bar are different from those on the delayed phase color bar Save and Reset Red Yellow Bll These items appear at the bottom of the menu Select Save to make the current color map the default map for future studies If you change the colors or the borders between colors in the color map and then save it the saved color scheme
19. e 2 5 on page 2 6 T Release version v4 4 8 36 A quarius W iy Welcome by TERARECON INC UserLoginWithToken Previous login info fa OF I onn Dec 09 2005 16 41 50 Corona Coronary CT ry CT AW1672530233 396 1105576307 AW1672530233 396 1105576307 Se 504 oe gt gt St Se 504 2003 12109 w STANDARD cT KEIO UNIV HOSPITAL 2 LightSpeed16 256x256 Tilt 0 00 W 400 L 40 JPEG Low Res Corona ry CT Coronary CT AW1672530233 396 1105576307 AW1672530233 396 1105576307 St Se 504 St Sa 504 256x100 W 400 L 40 Delay 1 2000 ms Figure 2 5 The AquariusWEB Viewer iEMV USR EN INT 4 4B 2 6 iNtuitionEMV Chapter 2 The Series List and Thumbnail List The Series List displays all the series information for one or more selected study The thumbnail list displays all the series in thumnail icons Studies from different dates are displayed in separate rows and scenes are also displayed separately When a series is selected associated thumbnails are highlighted If a series has multiple subseries all the subseries are displayed as separate thumbnails Seria Modality Series date time Num Series description Body part e Manufacturer 104 A CT Jan 01 1970 04 04 04 AM 266 200 A CT Oct 11 2011 11 16 38 AM 24 200 CT Jan 26 2012 03 54 10 PM 1 200 CT Nov 12 2012 04 56 13 PM 2 200 CT Dec 10 2012 06 00 05 PM 6 gt 200 A CE Jul 01 2013 07 57 05 PM 2
20. e Intensity Measurement Results and Graphs If the number of phases plotted in the graph is below 20 the graph is displayed as in Figure 3 3 For time intensity measurements having 20 or more phases only the current phase and value is displayed Report This tool allows you to step from one protocol step to the next or the previous step Click the right arrow to advance to the next step in the protocol or the left arrow to go back to the previous step 3 5 iEMV USR EN INT 4 4B Chapter 3 The Viewer SE 31 rea 49 Be Proto X sync Single Annotations Capture CW Nu Sect protocol step You can also use the Select protocol step panel to select a protocol step out of order Click the down arrow to open this panel Then click the desired protocol The sync button enables the synchronization of images when playing either a 2D or 4D cine in more than one viewport This change remains in effect while the data is loaded Click the button to toggle the synchronization on or off When synchronization is enabled the button has a light color and appears sunken When it is disabled the color is darker and the button appears flat Scroll E The scroll option has two settings single and multi e Single scroll Scroll through one series only e Multi scroll Scroll through all loaded series Annotations Toggle annotations on images on and off When annotations display is en
21. ent phase of a 4D Phase 1 10 image to display The Phase annotation Phase 2 10 circled in the image at right appears in Phase 3 10 the form T a b where a is the currently Phase 4 10 displayed phase out of the total number of Phase 5 10 phases b Phase 6 10 Phase 7 10 Phase 8 10 Select a different phase from the pulldown mi menu Note This annotation applies only to multiphase data 3 13 iEMV USR EN INT 4 4B Original MIP ThickMPR Ss SF 52 S4 Ss S 517 S 15 16 17 18 19 20 22 23 14 11 44 50 AM 11 44 50 AM 11 44 50 AM 11 44 50 AM 11 44 50 AM 11 44 50 AM 11 44 50 AM 11 44 50 AM 11 44 50 AM Phase 10 10 S 21 11 44 50 AM Chapter 3 The Viewer iEMV supports all DICOM format images including Mammographic data 80 RATORI NAME_ 365724 1961 Age 044Y F ACC598314 314 Exam Feb 12 2005 10 53 31 AM i 1 Exam Feb 12 2005 10 54 02 AM Current LL DU Current Inc O 29 kV 64 m s R NAME 365724 F Age 044Y DOB Fel Id AC 314 Ai 314 Exam Feb 12 2005 10 55 43 AM 4 EE Exam Feb 12 2005 10 54 59 AM Current 3 3 Current 65 mm Capture Capture all The contents of the right click menu on images are different Capture all in one depending on the modality of the study Most of the items are the same for all modalities but some modalities have extra funct
22. ergency status Resizing Components of the Patient List Screen The width of individual columns in the Patient List can be changed Hover the mouse over the boundary between two columns The mouse cursor changes to the double arrow icon shown in the following image Clicking and dragging the mouse changes the width of the column on the eft Dragging leftward narrows the target column and dragging rightward widens it In the following image the mouse is hovered over the boundary between the Patient ID and Patient Name columns The cursor has changed to the double arrow icon Clicking and dragging the mouse to the left or right will affect the Patient ID column only Patient ID Patent Name 1178785 0 08 062 To resize any component of the Patient List screen hover the mouse over the double line that separates one component from another The mouse cursor changes to the resize icon You can then move the boundary line up or down for components that are above below each other or left right for components that are beside each other iEMV USR EN INT 4 4B 2 2 iNtuitionEMV Chapter 2 Download Anonymiz Modality Series date time 2 Modality MR L BreastMR Sorting You can sort the Patient List based on the ascending or descending order of any column Click the header of the column you want to use as a basis for sorting and the Patient List will be ordered according to the values in the chosen column Click the same header aga
23. eries of connected line segments by clicking on the image moving the mouse to another point on the image and clicking again at a new point repeating those actions as many times as required The measurement given is the sum of the lengths of all connected segments in this measurement To place a Line Segment measuring tool onto an image do the following Click on one edge of the area to be measured Move the mouse to the endpoint of that segment Click on that point to complete the line segment Repeat steps 1 3 to draw a new line segment as many times as needed Double click to finish drawing UBRWNe iEMV USR EN INT 4 4B 3 2 iNtuitionEMV Chapter 3 Ellipse This feature calculates the average HU value within an area defined by the ellipse drawn on the image see the figure at right To draw an ellipse do the following 1 Click on one edge of the area to be measured 2 Drag the mouse across the area to be measured 3 Release the mouse to finish drawing Note This tool can be used only with MPR images Angle The angle measurement tool displays the degree of the angle between two lines drawn on an image To measure an angle do the following 1 Click on the endpoint of the first line 2 Move the mouse to the vertex point of the angle and click that point to complete the first line 3 Move the mouse to the endpoint of the second line and click to complete the second line Arrows and Text To add an ar
24. eshold that indicates by what percentage that pixel s intensity increased between the two phases In comparing the pixel intensities of the pre and the peak phases it is usually the case depending on the scanning protocol scanner and contrast media used that areas with wash in below 40 60 can be ignored This threshold is set using the Uptake bar The second map shows the speed of the contrast washing out also called the delayed phase Each pixel is compared between the peak and post phases to derive the difference in intensity for that pixel There are three possible results e Type I The pixel intensity has increased gradually e Type II The pixel intensity has not changed e Type III The pixel intensity has decreased gradually Each of these three types is represented by a different color By default Type I is respresented by blue Type III by red and Type II by the rainbow in the middle There is no official standard that defines the percentage borders between each of the 3 types By default the border between Type I and Type II is set to 20 in iEMV This means that an increase in contrast of 20 or more is shown with the blue overlay a decrease of 20 or more is shown iEMV USR EN INT 4 4B 3 8 iNtuitionEMV Chapter 3 with red and values in between use the rainbow overlay These borders can be changed as can the colors themselves To see the parametric map click the Parametric Map button The uptake bar on the left an
25. ge data from a variety of imaging modalities In a typical imaging environment the circumstances under which these images have been acquired are diverse and hence the content of the images themselves are affected by a wide range of parameters that can interact with each other and affect the resulting images in complex and unpredictable ways When regulatory authorities review such systems it is typical to focus on a specific set of reference data and a narrow often generic indication for use It would be impossible in the context of such a regulatory process to cover all possible combinations of the factors that influence the content of the images the system may process or how future improvements to scanning technology may further impact the image content that the system may process in the future Variables that impact the performance of advanced visualization include amongst other things the body habitus of a specific patient the specific type and concentration of contrast medium if any the administration parameters of any such contrast medium the x ray dose parameters selected for a given patient if applicable the possible use of novel reconstruction techniques on the acquisition device to improve image quality with lower dose scans and any complex co morbidities the patient may have which could impact the imaging acquisition These parameters can vary significantly from those that were available and used when a technique was origi
26. in to sort the list in reverse order Create Study URL link Create a URL link for a study to be viewed with the AqWeb viewer 1 Right click on the study and select Create Study URL link 64 SLICE CCTA CFA C Create study URL link The URL Link Authentication dialog is displayed URL Link Authentication 2 If authentication is required enter a password here Anyone who tries to access this data will need to enter that password 2 3 iEMV USR EN INT 4 4B Chapter 2 The Patient List A URL is generated for the study URL Link Authentication 172 16 51 82 iemv link aspx l 2 CRQRZYZ99 This link can be entered in a Web browser iEMV is launched allowing access to the selected study R 5 Patient ID Patient Nar 2 Date of b Gend Modali Study date time Study descr Study ID CARDIAC 64 SLICE CFA CA Jul 06 19 CT May 03 2006 11 2 17106 T TTT atient IL Patient Nam 1 factu F il 3 i L rt ie iption Body part e Manufacturer m m iudi m 80 0 005 5 hn CARDIAC 64 SLICE CCTA CFA CA ITE TOSHIBA 0 0 005 TOSHIBA 17 Neer may VV LL Tm nma fu 20 0 005 TOSHIBA 18 A GT May 03 2006 11 44 50 AM 78 SEGMENT 40 0 00s TOSHIBA 19 A CT May 03 2006 11 44 50 AM 78 SEGMENT 5094 0 00s TOSHIBA 20 A Gi May 03 2006 11 44 50 AM 78 SEGMENT 60 0 00s TOSHIBA 22 A CT May 03 2006 11
27. ions or Window level are layed out slightly differently Gamma Zoom k Orientation Overlays Log off iEMV USR EN INT 4 4B 3 14 iNtuitionEMV Function Capture Capture all Capture all in one Window Level Gamma Zoom DICOM data Orientation tion on page 3 7 Overlays Log off Show Hide DICOM Overlays The DICOM header of a study may contain overlay images that give additional information about the images To show an overlay on an image right click on the image and select Overlays then select Show overlays Figure 3 6 on page 3 16 shows an overlay used for dual energy scans It is a circular outline that shows the FOV of the energy source that is not shown in the image 3 15 Capture Capture all Capture all in one Window level Chapter 3 Description Capture the selected image Capture all images currently displayed in the viewer and place each image in a separate cell of the Output Panel Capture all images currently displayed in the viewer and place them all in a single cell of the Output Panel Adjusts the brightness and contrast of the image iEMV has two zoom options e Original Size The image is displayed at 100 of the size of the e Fit to Screen The image is displayed to fit the screen This option is the same as the top bar tool button See Orienta Show hide overlays on the image Log out of iEMV Gamma Zoom Orientation Overlays d Show overla
28. ith Enter the DICOM value or values required for the match Depending on the field data may be entered by typing checking a checkbox or selecting an item from a menu Note To find studies that match any or all of the words in a single tag type each word on the same line separated by a space To find studies that match an exact phrase or sequence of words enclose the entire group of words in single quotes Searches are not case sensitive Click OK when finished configuration 2 5 iEMV USR EN INT 4 4B Chapter 2 The Patient List e Download This option allows you to down the highlighted studies to your local drive When the Download button is clicked a Windows File Download dialog is displayed from which you can save the file open the file or find an application that is able to open it File Download X you want to save this find a program online to open it Name downloadStudy aspx Type Unknown File Type 224 bytes From agnetserver sow toed While files fram the Internet can be useful same files can potentially harm your computer IF do nat trust the source do not find program to open this file or save this file V hat s the risk e Anonymize This option allows you to anonymize the selected study by giving it a new patient name and ID It is then downloaded to your PC e Load Loads a study into the Viewer e Load 3D Opens the AquariusWEB Viewer see Figur
29. ition products provide tools and protocols to quantify metrics and distances relating to structures in the CT MR or other scans or images which are based upon the dimensions of the anatomy scanned or imaged at the time the images were originally acquired from the patient and based on the measurement calibrations provided by the acquiring device The suitability for any particular purpose especially monitoring the progression of disease or the sizing or planning of a device to be implanted in a patient is dependent upon many factors including but not limited to the accuracy of the original acquisition the extent to which the images acquired still represent the patient s anatomy and the way in which the actual device deployment may modify the anatomy into which it is introduced TeraRecon does not represent that the Aquarius products are suitable for such purposes all such activities should always be cross correlated with other techniques to ensure a complete understanding of the patient and contemplated procedure is obtained by the validating physician s in charge Precautions Relating to Magnetic Resonance Imaging Machines Components of iEMV including this document and its packaging or binding may contain metallic or Ferro magnetic components Please ensure that no such component is introduced iii iEMV USR EN INT 4 4B into the influence of magnetic fields from devices such as Magnetic Resonance Imaging Scanners since injury or damage
30. ive decision is not intended for diagnostic use when used via a web browser or mobile device Please also see the Safety First Important Notice on Computer Assisted and Quantitative Imaging position statement following below Precautions Relating to Display Hardware Please be aware that iEMV display is limited in acuity and color or grayscale depth to that of the display device used Display hardware characteristics can vary widely When viewing on a mobile device outdoor lighting conditions can reduce the contrast of images being viewed and may hinder your ability to distinguish subtle changes in the image iEMV USR EN INT 4 4B ii Mobile devices may have auto brightness settings which automatically change screen brightness If it does not properly adjust consider disabling the feature If you do not know how to disable your auto brightness feature consult your mobile device user manual The judgment of the medical imaging professional is essential to reaching the appropriate conclusion from the results presented by iEMV Precautions Relating to Interpretation Please be aware that calculations relating to distances measurements and other physical properties performed by iEMV are dependent in accuracy upon the correct information being supplied in the input DICOM images It is the responsibility of the operator to ensure that inputted DICOM images are correctly formatted and to heed any warnings that the software may
31. mple Patient List 3D Viewer e The chapters are arranged based on the functions in the iEMV application NOTE contains supplementary information about a topic iEMV USR EN INT 4 4B Contents Introduction i 1 Chapter 1 Starting INtuitionEMV 1 1 Chapter 2 The Patient List 2 1 The SIUS LLS anais ctae i tum tbt e eee i fom PU 2 Study Management Buttons 1 5 m aer be ia 2 4 The Series List and Thumbnail 56 3 3 2 7 Chapter 3 The Viewer 3 1 Top Tool Bar PulletofiS ntt quete dolia 3 VIC WIDE Studies 3 11 Clickable Annotations ia a a a ede 3 12 Viewing Mamtniographic Data ud tie ee ete eed 3 14 Right Click Menus on Study Images 4 44 4 2220 3 14 Chapter 4 Output 4 1 Download And SAV susti sio vu tai d ERE a Ei MAT 4 2 Closing the Output Panel eat a i 4 2 Appendix A Keyboard Shortcuts A 1 Index I 1 iEMV USR EN INT 4 4B iEMV USR EN INT 4 4B iNtuitionEMV Introduction Introduction iNtuitionEMV iEMV is an AquariusNET client designed for the review of 2D modalities mammogram Breast MR and Cardiac MR using a Web browser to access clinical data In particular iEMV has advanced capabilities for Breast MR and Cardiac
32. nally submitted for regulatory review This variability has consequences regarding measurement and other tools provided in advanced visualization systems Such tools can be validated and relied upon for geometric quantities for example length volume change in pixel intensity over time location of image areas with a certain shape profile but should not be relied upon in terms of physiological quantities for example ejection fraction cerebral blood volume location of tumors since these quantities are related to the geometric quantities in complex and unpredictable ways that the advanced visualization software cannot fully determine from the input data It should also be noted that even geometric measurements rely upon the calibration data provided in the DICOM header that is generated by the image acquisition device and hence such tools are more calculating tools than measuring tools since any quantitative data reported is only as accurate as the underlying calibration of the input data Noble efforts are underway to establish standards and to define validated algorithms for quantitative imaging under well defined and controlled circumstances driven by the Radiological Society of North America in the form of the Quantitative Imaging and Biomarkers Alliance or QIBA and by the American College of Radiology in the form of ACR Image Metrix TeraRecon enthusiastically supports such efforts and has actively participated However to da
33. or the iNtuitionEMV iEMV Keyboard shortcuts profile You can reconfigure any of them Shortcut wed window tevs fe Measurement Dane b Sera Mode tose 1 iEMV USR EN INT 4 4B Appendix A Output m Shortcut iEMV USR EN INT 4 4B A 2 Index A Angle measurement 3 3 Anonymize study 2 6 APS 2 7 AquariusAPS 2 7 C Cine 3 7 Color bar parametric map 3 9 D Delayed phase 3 8 Distance measurement 3 2 Download study 2 6 E Ellipse measurement 3 3 I Initial phase 3 8 L Left mouse modes 3 2 Line segment measurement 3 2 M Manage Patient List 2 4 Measurement tools 3 2 Angle 3 3 Distance 3 2 Ellipse 3 3 Line segment 3 2 Time Intensity 3 5 Mouse modes 3 2 N Notes 2 2 O Orientation 3 7 Output 3 7 Output panel 4 1 P Parametric map 3 8 Color bar 3 9 Uptake bar 3 10 Patient List Column headers 2 1 Management 2 4 Refresh 2 4 sorting 2 3 R Read status 2 2 Refresh Patient List 2 4 S Search database 2 4 Show output 4 1 Sort Patient List 2 3 STAT setting 2 2 Study management 2 4 Study URL link 2 3 Synchronization 3 6 T Thumbnail images 2 7 Time Intensity measurement 3 5 U Uptake bar Parametric map 3 10 Uptake in Parametric Maps 3 8 Wash in phase 3 8 Wash out phase 3 8 iEMV USR EN INT 4 4B iEMV USR EN INT 4 4B I 2
34. oration This document contains important helpful use and precautionary information Please review carefully all precautionary statements and advisories whether onscreen or contained herein as these are essential to the effective and authorized use of the products and applications discussed Note Any beta features extended are not to be used clinically and can ONLY be authorized obtained or accessed through an appropriate beta agreement Aquarius iNtuition and the iNtuition logo are trademarks of TeraRecon Inc Copyright 2012 2013 TeraRecon Inc All rights reserved i iEMV USR EN INT 4 4B Indications For Use and Safety Concerns Devices attached to this product must comply with their own applicable safety standards is intended to be used for review and analysis of volumetric medical imaging data acquired by CT or MR scanners iEMV is part of a Class II medical device regulated by the Food and Drug Administration NOTE U S Federal Law restricts use of this device to trained physicians or other suitably qualified and trained personnel on the order of a physician This iEMV is part of a sophisticated medical device and as such MUST ONLY BE USED BY QUALIFIED AND TRAINED PERSONNEL If you require training please contact TeraRecon or a suitably qualified trainer Please keep this documentation readily available near iEMV at all times and please keep it updated with all corrections addenda that may be released
35. re described in detail in this manual However these changes are not 1 1 iEMV USR EN INT 4 4B Introduction iNtuitionEMV preserved between iEMV sessions For detailed information about configuration in iReview please see the Review User Manual iEMV USR EN INT 4 4B i 2 iNtuitionEMV Chapter 1 Chapter 1 Starting iNtuitionEMV Open a Web browser and enter the URL that connects to the iNtuitionEMV iEMV application the AquariusNET server https aqnetserver iemv F Certificate Error Navigation Blocked Windows Internet Explore https agnetserver iemv File Edit Favorites Tools Help Figure 1 1 In the example shown above aqnetserver is the hostname of the AqNET server You will need to enter the actual hostname of the AquariusNET Server node you want to connect to The gray text in the URL in can be entered exactly as it appears here Internet Security When you are first connecting to the AquariusNET server you might encounter an error message indicating a problem with the server s SSL Secure Sockets Layer certificate also referred to as a security certificate There are several possible reasons for this For example The server does not have an SSL certificate The server s certificate was not issued by a trusted certificate authority The certificate has expired The certificate was not installed correctly The certificate was issued to a different web address 5 There is
36. row to an image 1 Select Arrow from the menu 2 Click on the spot that you want the arrow to point to The arrow is always drawn from the pointing end 3 Drag the mouse away from the initial spot 4 Release the mouse when the arrow has the desired length 3 3 iEMV USR EN INT 4 4B Chapter 3 The Viewer To add text 1 Select Text from the menu 2 Click on the spot where you want to place the text The following dialog is opened Figure 3 2 Add Text Dialog 3 Type in the desired text and click OK The text is shown inside a box whose upper left corner touches the spot you clicked on see the following image To add an arrow and text in one step 1 Select Arrow Text from the menu 2 Click on the spot that you want the arrow to point to The arrow is drawn from the pointing end 3 Drag the mouse away from the initial spot 4 Release the mouse when the arrow has the desired length The Add Text Dialog see Figure 3 2 is opened 5 Type in the desired text and click OK The text is shown inside a box whose lower left corner touches the endpoint of the arrow iEMV USR EN INT 4 4B 3 4 iNtuitionEMV Chapter 3 Time Intensity Measurement There are two kinds of time intensity measurements point and ellipse These objects are drawn in the same way as described above The following two images show the time intensity point left and time intensity ellipse right Figure 3 3 Tim
37. rposes Click OK to launch iEMV iEMV USR EN INT 4 4B 1 2 iNtuitionEMV Chapter 2 The Patient List Chapter 2 When you have successfully logged into the local server the iNtuitionEMV iEMV Client opens the Patient List as shown in the following image P scan Jun 26 2013 05 26 P Clear task log Y Filter Completed Completed The Study list Refresh X AguariusNET Viewer E O Viewer SSS emm Patient ID _ 1 3 6 1 4 1 9328 50 3 0647 _ 1 3 6 1 4 1 9328 50 3 0648 5 Med2 _ _ 2457533010 3 ID 861412 _ 678 300092 300092 012300 0005251664 _ 3D Pacs Reserch Groupe4 Siemens Dual Energy 02 Siemens Dual Energy 03 10102457 18203533 2067392 7 _ 1178785 0 _ 2065491 9 ot 2 Push Download Anonymize Load Study history for Patient ID TD Patient Name Lung LIDC 0647 Lung LIDC 0648 MDCT 5 Medicsight Lung 2 MedicsightLung2007 MRI Merge Data NAME 365724 OB Perdunc Perdunc PULMONARY EMB S DE 08 001 S64 CT Abdomen liver Siemens Dual Energy 02 Siemens Dual Energy 03 Stf08 011 Stf08 013 508 027 508 062 508 088 y B 2002 1 study Series Modality Q Date of birth Jan 01 1936 Feb 02 1961 Jan
38. te such standards have not yet been fully defined by these standards organizations and consequently software companies have not adopted a unified standard Accordingly until industry wide reference standards are defined and adopted for such ad vanced visualization techniques TeraRecon advises that advanced visualization techniques should be used with care and that beyond the core indication for use of multi dimensional geometric measurement shape detection and advanced 3D visualization using an off the shelf computer no assumption is made regarding the validation of the system or its suitability for use in any specific medical undertaking Independent confirmation via an al ternative validated technique is always advisable and only the professional judgment of a qualified and authorized physician can determine patient care decisions Using such tools in V iEMV USR EN INT 4 4B this way and in this context ensures the appropriate and safe use of the technology for the optimum benefit iEMV USR EN INT 4 4B vi Patent Information The product described in this document is protected by the following patents US Patents http www terarecon com wordpress patents Japanese Patents Real Time PC Based Volume Rendering System Patent No 3 129 701 Volume Rendering Pipelines Patent No 4 158 006 A Method for Rendering Sections of a Volume Data Set Patent No 4 158 007 A Method for Rendering Miniblocks of a Volume Data Set P
39. to equipment or property could occur Precautions Relating to Risk of Loss of Data iEMV and or iNtuition is not intended to be used as a primary archive for medical imaging data This means that a secure copy of any data should be maintained in a location separate from the software for example in the scanner in a PACS archive or on archive media Please do not rely on iEMV and or iNtuition as your primary archive In addition do not rely on iEMV and or iNtuition to convey data from its acquisition point to your primary archive because in this configuration a failure in iEMV and or iNtuition could compromise your primary archive Your primary archive should be maintained in a manner independent of and not relying on iEMV and or iNtuition Precautions Relating to Computer Software and Hardware NOTE THAT THE INSTALLATION AND USE OF ANY ADDITIONAL SOFTWARE OR HARDWARE COMPONENT WITHOUT THE SPECIFIC DIRECTION AND APPROVAL OF TERARECON MAY IMPAIR THE SAFETY AND EFFECTIVENESS OF THE PRODUCT HENCE NO ADDITIONAL SOFTWARE OR HARDWARE COMPONENT SHOULD BE ADDED TO iEMV and or AquariusNET NOR SHOULD THE CONFIGURATION BE CHANGED IN ANY WAY EXCEPT UNDER THE EXPRESS DIRECTION OF TERARECON PERSONNEL DO NOT USE THE SOFTWARE IF IT IS DAMAGED COMPROMISED OR IF YOU IN ANY WAY SUSPECT THAT ITS SAFETY MAY HAVE BEEN COMPROMISED IN THIS EVENT CONTACT YOUR CUSTOMER SERVICE REPRESENTATIVE IMMEDIATELY Interpretation of mammographic images or digitized
40. ys Log off Hide overlays iEMV USR EN INT 4 4B Chapter 3 The Viewer DS 0705 I 10mm div Figure 3 6 Dual Energy Overlay 1EMV USR EN INT 4 4B 3 16 iNtuitionEMV Chapter 4 Output Chapter 4 When images are captured they are stored temporarily in the Output Panel To view the Output Panel click the Show Output button in the upper right corner of the iNtuitionEMV 1 Viewer gt B TERARECON Patient ist 4 4 ardiac 87 01 1931 M AM 0 i i I EAEE o gt a 3 Layout Protocoi 1I B Anne n 21 EXE EEE Shov at The Output Panel is opened Figure 4 1 The Output Panel 4 1 Cancel iEMV USR EN INT 4 4B Chapter 4 Output Download and Save Save a series or image on your local hard disk To save an image click the image and then click Save A Windows navigation dialog is opened so you can specify where to save the file A zipped folder is created in that location and is given a filename consisting of the date and time The file itself is saved in JPEG format and is numbered sequentially Closing the Output Panel To close the Output Panel window click the X box in the upper right corner or click the Cancel button Note Be aware that images are deleted from the Output Panel when a different study is loaded iEMV USR EN INT 4 4B 4 2 INtuitionEMV Appendix A Appendix A Keyboard Shortcuts These are the default values f

International

Contents

Download Pdf Manuals

Related Search

Related Contents