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eFilm Lite User Guide

1. The explode mode changes the layout of a selected series so that it fills the entire main window while the survey mode reverts to the original series display This function is especially useful for skeletal surveys or any study that has multiple series To explode the series 1 Select the required series 2 Choose one of the following options e On the Tools menu click Toggle Survey Explode Mode e Click 3 The selected series explodes to fill the entire main window Note To return to the survey mode click again The same functionality can be achieved for images within a series Select an image and double click it so that it fills the entire series pane Double click it again to return to the survey mode Toggling the shutter Toggle Shutter allows you to block out extraneous and unwanted data by toggling the shutter for Radiological Fluoroscopy RF images 44 eFilm Lite User Guide Adjusting images using DSA To toggle the shutter i 2 Select any series in a pane Choose one of the following options e On the Tools menu click Toggle Shutter e Click Matching field of view Match Field of View allows you to match series that are all in the same plane to the same scale This is useful for example when comparing images from different studies such as a prior exam with a current one To match the field of view 1 2 Select a series against which to match all
2. MfctModNm gt het 1 2 R I IR ul 20 Acq Tm 00 00 00 xN a Tarr E y d For Help press F1 Note eFilm Lite should launch automatically when you insert a CD with DICOMDIR images burned on it If it does not launch navigate to your CDROM directory and double click eFilmLt exe This window can contain more than one image at a time each in a separate pane arranged in a grid The menu bar appears at the top of the window and the status bar will appear at the bottom if enabled By default the tool bar appears at the top of the window directly beneath the menu bar but you can move it by following the procedure outlined in Moving the toolbar on page 7 6 eFilm Lite User Guide Using the toolbar Using the toolbar Additional tools in the toolbar are displayed based on the customized toolbar settings and activated according to the selected modality type To view the description of a tool hold the cursor over its icon Full descriptions of the tools can be found in Using tools on page 8 In this section you will learn how to e move the toolbar see Moving the toolbar on page 7 e configure the toolbar see Customizing the toolbar on page 7 e access the Mini Bar see Accessing the Mini Bar on page 8 Moving the toolbar The toolbar does not have to remain at the bottom of the window it can be moved to the top to the left or to the right of the wind
3. 2001 by the Therapeutic Products Programme of Health Canada United States of America A 510 k premarket notification for eFilm with Modules was submitted to the United States Food and Drug Administration on March 19 2002 On April 12 2002 eFilm received USFDA clearance as a Class II Medical Device The K number for this product is K020995 Europe According to the guidelines stated in Directive 93 42 EEC of the European Community eFilm is a Class I Medical Device eFilm satisfies the requirements for bearing the CE mark on its labelling Our authorized representative in the European Community is Anton van Kimmenade Merge eMed Spegelt 34 5674 CD Nuenen Netherlands Considerations prior to use The software is not intended to replace the skill and judgement of a qualified medical practitioner and should only be used by people who have been appropriately trained in the software s functions capabilities and limitations The user should be aware of the limitations in the accuracy and correctness of the output data displayed on the screen printed or exported from eFilm The quality of the data is dependent on the correctness of the input data the user s interaction with the data the quality characteristics and settings of the display device or printer and the necessity to interpolate the data for display purposes For example measurement values in eFilm Lite are dependent on the calibration information provided by the modal
4. Image Height 256 Frame Rate Frames Per Second 2 Total Running Time 0 75 in seconds Select the Compression preferences for Type and Quality Specify the Image Width and Image Height dimensions size of the AVI image in screen pixels 10 Select the Frame Rate preferences the number of images frames that display per second Note The Total Running Time value is calculated according to the frame rate 11 Specify the number of repetitions in the cine 12 Once all of your preferences are set click Create The Save As dialog box appears eFilm Lite User Guide 79 Exporting Images 13 Select the directory to which the volume will be saved and enter a filename The new AVI file is saved to this location 14 If you wish to view the AVI volume at this point click View Note When you open the AVI file in Windows the volume will play automatically on your computer s default media player Printing images Images can be printed from a regular printer WARNING Printed images are not to scale i e life size To print images to a paper printer 1 Select the images you want to print by clicking the image marker in the lower right corner of the image The marker fills in orange 2 On the File menu click Print Format and select a page layout Note On the File menu click Print Preview to preview the print job 3 On the File menu click Print to begin printing the images The accuracy and
5. The Window Level pop up menu Note The preset pop up menu differs per modality Select a preset from the menu Alternatively you can use the Function keys as specified in the menu at the top of the keyboard Available presets CT Chest Abdomen Pelvis Lung Brain Bone Head Neck US Low Contrast Medium Contrast and High Contrast MR Abdomen Pelvis T2 Brain Head Neck Spine Abdomen Pelvis T1 Note You can also adjust the window level for a selected series to a custom specification Defining custom window level presets You can define custom window level presets using the following procedure To define custom window level presets 1 2 Select the required series Choose one of the following options e On the Tools menu click Window Level Options e Click the arrow to the immediate right of The Window Level pop up menu appears Select Custom from the preset pop up menu The Custom Window Level control bar appears Adjust the Window and Level values by using the spin arrows or by entering the values manually These specifications will appear in the lower left hand corner of each pane e g W 50 L 100 Click Apply to save the changes or click Cancel to exit without saving any changes eFilm Lite User Guide 37 Manipulating Images Note Custom specifications only apply to the selected series Using non linear window leveling You can use non linear window leveling to compensate for
6. displays all of the toolbar icons available in eFilm Lite To convert the toolbar icons to grayscale e Select Grayscale To automatically hide the toolbar e Select AutoHide Accessing the Mini Bar In addition to the main toolbar you can also use the Mini Bar for quick access to commonly used tools Ti amp x BASRA By default the Mini Bar includes the following six tools Stack Window Level Pan Zoom Probe Tool and Measurement Tool Line This tool set is predefined tools cannot be added to the Mini Bar but if you remove a tool from the toolbar it will also not appear in the Minibar i e a tool will only appear on the Minibar if it is part of the eFilm toolbar If the toolbar is customized not to display any of the tools in this set then those tools will not be displayed in the Mini Bar All of the tools on the Mini Bar can be assigned to either the left or right mouse button To access the Mini Bar e Hold the right mouse button and then click the left mouse button The Mini Bar pops up in the area of the window where you clicked both mouse buttons Using tools eFilm Lite includes a large selection of tools to help you navigate and manipulate study images In this section you will learn about the tools located on the toolbar The tools are erouped as follows e Main access and close studies see Main tools on page 9 e Common apply to all modality types including window level settings la
7. gt Series gt Image s This format also makes it much easier to identify the various levels within the directory structure In addition to the DICOMDIR database file the following files are included with eFilm Lite e Autorun inf e ColorOpacityPresetList xml e ColourMapping txt e eFilmLt chm e eFilmLt exe e efSplash bmp e efTitle txt e GrayscaleOpacityPresetList xml e greyscale xml e License rtf e mrgcom3 msg e VoxLogo bmp The following DLL database library link files are also included with eFilm Lite e DICOMDLL dll e dimpls dll e efCmprss dll e efCommon dll e effCPDirLt dll e eFilmD3DX dll e efLUTMerdll e efVolume dll e efVoxel dll e medadv dll eFilm Lite User Guide 89 File and Directory Structure Overview MFC71 dll MSVCP71 dll MSVCR71 dll msxml4 dll msxmil4a dll msxml4r dll OLEAcc dll picn20 dll picn6920 dll SlsApi dll 90 eFilm Lite User Guide Index A accessing See opening adding annotations 54 filters 46 MPR slabs 74 adjusting See configuring advanced user settings 14 alpha setting 49 angiography 45 angle measurements 57 annotations 54 applying filters 47 arranging studies in panes 23 arrows 57 assigning color mappings 68 grayscale mappings 69 attaching templates 85 automatic series synchronization 33 AVI video files exporting images 77 exporting volumes 78 B background 50 black outside window 67 brightness 35 C calibrating images
8. rotate crop and window the Simgram image eFilm provides a simple way to send the data to Voxel for production of a real holograph Simgram images simulate the transparency of Voxgram images and retain grayscale information Note 3D functionality is only supported for CT and MR studies because only these types of studies contain orientation information on slices eFilm Lite User Guide 61 Creating 3D Images Important Volume rendering is only available on systems meeting the requirements listed in Required hardware for 3D volume rendering on page 6 Furthermore while available the behavior of MIPs is slightly different if your hardware does not meet these requirements WARNING MPRs MIPs Volume rendered Simgram images and corresponding Voxgram images are intended for use as adjuncts to two dimensional medical imaging display techniques The above techniques involve interpolation of data Reference should always be made to the original two dimensional images and the modality parameters when interpreting the data Caution To improve responsiveness the volume first displays at a reduced resolution as indicated by the Reduced Resolution message in the overlay Before interpreting the data please wait for the volume to refine to Full Resolution Caution You should be aware of the limitations inherent in 3D volume rendering techniques To reconstruct a volume interpolation must be performed between points
9. 52 eFilm Lite User Guide Annotating and Measuring Images This section describes the measurement tools which allow you to measure images in a number of ways In this section you will learn how to e overlay text on an image see Overlaying text on page 53 e annotate an image see Annotating images on page 54 e make a linear measurement see Making linear measurements on page 55 e make an elliptical measurement see Making elliptical measurements on page 56 e draw an arrow on an image see Drawing arrows on page 57 e measure the angle between two lines on an image see Displaying angle measurements on page 57 e calibrate the measurement tools see Calibrating images on page 58 e determine the pixel or Hounsfield value of a point on an image see Probing images on page 59 e clear the measurement annotations from an image see Clearing measurements on page 60 Overlaying text Toggling the overlay hides or shows the displayed study information for a series and the scale marker To hide the written study information and scale marker 1 Select a series 2 Choose one of the following options e On the Tools menu click Toggle Overlay e Click eFilm Lite User Guide 53 Annotating and Measuring Images 1ST PH FH h FHH HF E ha lik hit GCP OFCL CeO eR EL HCH o LIF Se Ts batty or i Er I Go Bead rir rir i Hig 1 THL TR d
10. N E E E E ET S 9 C OOR TOOS ee erent ero nr err TT terme me ae ne Terry eer rer nn re er 9 Next Preyio us OOS cerscssccsscsczcaancearnssevccaacsvcsrasprenaesescacnbtoouanttasiancess 10 Men arenen LOONG aa E 10 Mu liplanar fools ssasonononiieni onai ini 11 Image Manipulation tools eseesseeeeeeseeeeeseesessesresrerrerresresrrsresrrsress 11 Image Processing 1001S sisissiavccsacsosseasicosssonsensanenanctiocsanoeiavcanaeancncices 12 TCT AC Ol a a N E A E 12 YOE OO a A E 12 Setting User Preferences Customizing modality settings e eseeeeeeeeeeersersessesresresresresresresresreses 13 Changing modality layouts iatssijesinssinsocsvosesevsatiarcdsucrsetanieasiereennanes 13 Customizing advanced user settings for a modality 0 0 0 14 Customizing Sy Stem preferences tise wiecswsiasousiercovemacassans ions urraeoans 15 Customizing volume settings ole eeeeeeeseeeseeeeeeeseseseeeseeeseseeeeeees 16 B Deve ee 18 ol bo merer rer Terr re etre ore tent metre treet torent errr tre meer 17 Customizing template settings 0 0 eee eseeseceseceeeeseeeeeeeeeseeeeeees 19 Viewing Images sine teer iim LUG viewer sassoni E E 21 Customizing the eFilm Lite Viewer esssseseseereereererrerrerrerreree 22 TS PG UCN SS E N E EE A E E 22 Arranging study series in panes essseeseereereerrerierrerrsrrsrrsersersese 23 VIEWING shidy MI OrmaAtON si csacassesesendecanuinsencostupeaesbanvstnencdpsnanerave 24 Setting the encryption PasSSWOT ee eeeeeee
11. appears Select Image Fusion Pipeline from the preset pop up menu The Image Fusion Pipeline dialog box appears Image Fusion Pipeline Foreground f PT Ea Method l Grayscale t Color Color Mapping HotMetal Specify the foreground as either PT or CT In the Method section choose one of the following options e Grayscale displays the color range of the foreground as white to black e Color displays the color range of the foreground as varying shades of the color specified by clicking Select Color and selecting a color from the Color dialog box e Color Mapping displays the color range of the foreground as varying shades of the color specified by selecting a mapping from the drop down list e g Rainbow Note The colored bar on the right offers a preview of the blend that will be applied to the fused series All settings will be saved in the current user s profile The following table shows the default color mappings and corresponding colored bar that can be applied to the foreground image Color Mapping Color Range Bar HotMetal Rainbow Rainbow16 Rainbow65 Bronson 50 eFilm Lite User Guide Using image fusion 6 Click OK Note Advanced users can add new color mappings or modify existing ones from the ColourMapping txt file in the installation folder We recommend that you save a backup copy before editing this file eFilm Lite User Guide 51 Manipulating Images
12. box appears Select the directory to which images will be saved and enter a filename The new AVI file is saved to this location If you wish to view the AVI image at this point click View Note When you open the AVI file in Windows the movie plays automatically on your computer s default media player Exporting volumes as AVI files You can export 3D volumes as AVI files and view the resulting cine loop using your default media player To export volumes as AVI video files Select the volume you want to export 2 On the Tools menu click Cine or click 5 The Cine control bar appears 78 eFilm Lite User Guide Exporting volumes as AVI files Cine Control Bar i x Slower Faster p i Shuffle Volume Cine Rotation Axis S Axis Y Axis T Z Axis sweep Angle 30 Shep Size E l Tumble Export to Al 3 Adjust the speed of the cine using the slider 4 Click to move forward to move backward or to stop the preview of the cine 5 Specify the Sweep Angle degree of rotation and Step Size degrees per frame values Note Select the Tumble check box if you want the sweep angle to be 360 6 Select one or more of the Rotation Axis check boxes to rotate the volume about the corresponding axes 7 Click Export to AVI The Volume AVI Creation dialog box appears CI xi Compression Microsoft Video 1 E 0 00 Dimensions Image Width 256
13. dimensional display In this section you will learn e about the volume rendering techniques supported by eFilm Lite see 3D modes on page 61 e how to create MIP and Simgram images see Creating 3D images on page 62 e how to create MPR images see Creating MPR images on page 70 Note Some 3D operations require specific hardware which is described in System requirements on page 5 3D modes eFilm Lite includes several 3D imaging techniques e Multi Planar Reformatting MPR reformatting technique that passes a plane through a data set so that you can view the volume along a different direction than that of the original images In effect you can view the image data from different viewpoints without having to rescan the patient e Maximum Intensity Projection MIP interpolation technique that passes rays through a data set that finds and displays the maximum intensity pixel value along each ray This value is used as the final pixel value for the ray You can rotate crop and window an MIP e Volume Rendering this technique projects a volume onto a screen image pane assigning colors based on an opacity map which determines how opaque each intensity value should be rendered and which color the value contributes to the resulting image e Simgram Image mode that uses Voxel s patented Simvision algorithm to simulate the appearance of a holographic 3D Voxgram image on your 2D screen You can
14. field of view and colorization In this section you will learn how to e adjust window level settings for images see Setting window level values on page 35 e invert image color see Inverting images on page 38 e overlay reference lines on an image see Overlaying reference lines on page 38 e change image orientation see Changing image orientation on page 40 e adjust your view of an image see Adjusting image viewing options on page 41 e reset image settings see Resetting the original image settings on page 43 e adjust your view of a series see Adjusting series viewing options on page 43 e adjust images using Digital Subtraction Angiography DSA see Adjusting images using DSA on page 45 e use filters see Using filters on page 46 e fuse multi modality images see Using image fusion on page 48 setting window level values Window leveling allows you to adjust the brightness and contrast of images This section shows you how to e adjust window level settings manually see Adjusting window level settings manually on page 35 e adjust window level settings using window level presets see Using window level presets on page 37 e use non linear window leveling see Using non linear window leveling on page 38 Adjusting window level settings manually This method allows you to perform manual adjustments to window level settings quickly and
15. intersecting lines on the image 2 Choose one of the following options e On the Tools menu click Measurement Tool Show Angles e Click eFilm Lite User Guide 57 Annotating and Measuring Images The angles between any intersecting lines appear in orange Note To toggle the display of the angle measurements off click E Calibrating images Calibrating allows you to manually specify the image pixel size for images which are not automatically calibrated or for which you wish to recalibrate due to magnification errors Only CT and MR studies are automatically calibrated all other studies must be calibrated manually WARNING Measurements performed on CR DX and MG images may be inaccurate unless you calibarate the measurement tools To calibrate an image 1 Select the image you want to calibrate and follow the procedure outlined in Making linear measurements on page 55 to create a line overlaying a bit of the scale to the right of the image 2 Count how long the line is according to the scale in this example the line is 4 hashmarks long Note Ultrasound image scales correspond to 1 cm between each hashmark 3 Select the line by right clicking anywhere on it The line appears in green 5 104 0 pixels 4 Choose one of the following options e On the Tools menu click Calibrate Measurements 58 eFilm Lite User Guide Probing images e Click The Measurement Calibrat
16. of the original data set and the extent of this interpolation is dependent on the resolution of the original scan Using 3D images This section describes how to create configure and manipulate Maximum Intensity Projection MIP and Simgram images MIP is an interpolation technique that passes rays through a data set to find the maximum intensity pixel value along each ray whereas Simgram simulates the transparency of 3D Voxgram images on your 2D screen In this section you will learn how to e create a MIP or Simgram image see Creating 3D images on page 62 e adjust the loading parameters for MIP or Simgram images see Adjusting loading parameters for 3D volumes on page 63 e crop MIP or Simgram images see Cropping 3D volumes on page 65 e rotate MIP or Simgram images see Rotating 3D volumes on page 66 e view MIP or Simgram images in stereo display mode see Viewing 3D images in stereo display mode on page 67 e set all pixels outside the conventional window to black see Using the black outside WINDOW setting on page 67 e adjust mapping settings for MIP or Simgram images see Adjusting mapping settings for 3D volumes on page 67 Creating 3D images This method allows you to create an MIP or Simgram image as a 3D volume To create a 3D image 1 Select the required series 62 eFilm Lite User Guide Using 3D images 2 Choose one of the following options e On the
17. others Choose one of the following options e On the Tools menu click Match Displayed Field of View e Click Adjusting images using DSA The DSA Digital Subtraction Angiography function allows you to improve the contrast of angiography images for greater definition of vessel structures To adjust the images in a series using DSA 1 zA Select a series Choose one of the following options e On the Tools menu click Digital Subtraction Angiography e Click The Digital Subtraction Angiography control bar appears Digital Subtraction Angiography T 9 1 Ae 100 Contrast E it Positive P l Negative CO2 Using the slider adjust the Mask value to correspond with the image that is to be subtracted from all other images Note The mask is usually the first image in a series however in certain cases it may not be the first one eFilm Lite User Guide 45 Manipulating Images 4 Adjust the Integration value using the slider This adjustment corresponds to how many images you want to integrate Note Integration allows a representation of how the dye flows through the vessel over time You cannot integrate more images than are in the current series 5 Using the slider adjust the Bone value to the required value This value adjusts the intensity of the image 6 Adjust the Alignment values up down left right or center Note Alignment is a manual control used
18. page 84 e resize a template see Resizing templates on page 84 e lock and unlock templates see Locking and unlocking templates on page 85 e attach and detach a template see Attaching and detaching templates on page 85 e hide and show a template see Hiding and showing templates on page 86 e display template labels see Displaying template labels on page 87 e delete a template see Deleting templates on page 87 selecting templates WARNING Ensure that your image is properly calibrated prior to selecting a template by following the procedure outlined in Calibrating images on page 58 A 1 1 scale must be applied to the image using the calibration tool otherwise the template will not be sized properly eFilm Lite User Guide 81 Managing eFilm Ortho Templates To select a template to place on an image 1 Open the appropriate image or series 2 Choose one of the following options e On the Tools menu click Add Template e Click 3 The Template Selection window appears Template Selection E SAMPLES Hip SAMPLE_CUP Anterior Posterior 56 58 60 H SAMPLE_STEM Total templates 6 Update Template Index m Template Information Manufacturer SAMPLES Location Hip Name SAMPLE_CUP View Anterior Posterior Size 60 Date 2002 05 28 Version 1 0 0 Filename C Program Files Merge eFilm eFilmT emplates S amplesS ampleCup3
19. study 1 Select the required study 2 Choose one of the following options e On the Tools menu click Opacity Settings e Click The Color Opacity Settings dialog box appears Color Opacity Settings q x Band 1 Load Presets Opacity Save Presets Add Preset Sharpness 10 Add Preset Delete Preset Left Bound F abdomen Skin x Right Eound 891 Bands 5 B W Setting 3 Click the or buttons to zoom in or out on the graph and the lt or gt buttons to pan left or right Note The Pan options become available once you zoom in 4 Select the number of bands for the series Bands define the range of values in a data set to which specific colors can be assigned This is useful in highlighting different types of tissue for diagnostic purposes The number of bands is limited to 20 5 Select a band range between the blue dashed lines The current range bounds appear in white Double click the selected range The Color dialog box appears Select a basic color or create your own custom color to use as the new color mapping To create a custom color use the color selector on the right or adjust the RGB values directly and then click Add to Custom Colors 9 Click OK to save your changes or Cancel to exit without saving any changes 68 eFilm Lite User Guide 10 11 12 Using 3D images Adjust the Left Bound and Right Bound values by entering them manually or
20. window allows you to customize your orthopaedic template display colors To access the Template Settings tab 1 pe On the Edit menu click Properties The Edit Properties window appears Click the Template Settings tab Edit Properties x Modality Settings System Preferences Volume Settings Image Markers Template Settings Template Colors Template i Diop Shadow Change Change Rotation Asiz Lo Change Selected a Locked p Change Attachment Points 7 Change E Selected amp Locked Change Connected Point P Change MW Show Rotation Axis MW Show Attachment Points W Show Drop Shadow Restore Defaults OF Cancel Help To customize the template display colors 1 3 Click Change beside the template color you want to customize The Color dialog box appears Select a basic color or create your own custom color to use as the new template color Note You can create custom colors either by using the color selector on the right or by adjusting the RGB values directly Once you have created a new color add it to the Custom colors list by clicking Add to Custom Colors Click OK to save your changes eFilm Lite User Guide 19 Setting User Preferences To customize the template display properties 1 Select the Show Rotation Axis check box to display the rotation axis of the template 2 Select the Show Attachment Points check box to
21. 58 canceling See deleting changing See editing cine tool 31 clearing measurements 60 closing studies 28 coherence 38 colors assigning mappings 68 editing mappings 70 inverting 38 loading mappings 70 mapping 50 67 template 19 common tools See tools comparing multiple studies 26 configuring advanced user settings 14 alpha setting 49 color maps 67 custom presets 37 image brightness 35 image contrast 36 image orientation 40 image view 41 images with DSA 45 loading parameters 63 modality layouts 13 modality settings 13 MPR view 73 properties 13 screen layout 25 sensitivity 36 series view 43 system preferences 15 template settings 19 toolbar 7 viewer 22 volume settings 16 considerations ili contrast 36 creating See adding cropping volumes 65 customizing See configuring D defining See configuring deleting annotations 54 MPR view 74 templates 87 detaching templates 85 directory structure 89 displaying See viewing drawing arrows 57 DSA 45 dual monitors 15 eFilm Lite User Guide 91 E editing annotations 54 color mappings 70 filters 47 grayscale mappings 70 passwords 25 preferences 13 eFilm Lite configuring viewer 22 opening viewer 21 overview 5 workspace 6 elliptical measurements 56 encryption password 25 exiting See closing exploding series 44 exporting images as AVI files 77 images as JPEG files 77 volumes as AVI files 78 F field of view 45 file structure 89 filters addi
22. Choose one of the following options e On the Tools menu click Measurement Tool MPR e Click 3 Position the cursor at the starting location and right click and drag the cursor to define the viewing plane 4 Release the mouse button A line appears in green which represents a perpendicular plane passing through the data set to create the MPR viewing plane 72 eFilm Lite User Guide Creating MPR images Creating MPRs from 3D volumes The MPR Volume tool creates an MPR view from a three dimensional volume To create an MPR view from a 3D volume 1 Follow the procedure outlined in Creating 3D images on page 62 2 Choose one of the following options e On the Tools menu click Volume MPR e Click Note With the original series selected click MPR again to remove the MPR plane and the corresponding MPR view If you want to save the MPR view remove the MPR plane Interacting with MPR series The following notes pertain to creating an MPR view from both a 2D image and a 3D volume e The MPR series that you created are added to the right button pop up menu of the selected study To view the MPR series right click in an open pane and select the MPR series e If you right click on the series that contains the MPR line and select a different series to load into that pane you will be prompted to temporarily save or delete the corresponding MPR as a series view e Ifyou close the study prior to tempora
23. Click OK to close the Study Information dialog box Setting the encryption password You can enter an encryption password that will be required to decrypt confidential patient information Using an encryption password prevents unauthorized users from viewing sensitive patient data on your computer Note Currently only the patient name is encrypted To set an encryption password 1 On the Utility menu click Set Password The Encryption Password dialog box appears Encryption Password X The password pou enter acts as the key to encrypting and decrypting confidential patient information Please remember it Password Confirm Doo Password Cancel 2 Enter a password and then confirm the password by entering it again Note The length of this password must be at least five characters 3 Click OK to set the encryption password or Cancel to exit without setting it Adjusting the screen layout Images that appear on the screen are laid out in a side by side 1x2 grid configuration by default This configuration can be adjusted to suit your preferences To adjust the screen layout 1 Choose one of the following options to access the Screen Layout dialog box e On the Tools menu click Screen Layout e Click A The Screen Layout dialog box appears eFilm Lite User Guide 25 Viewing Images Comparing Screen Layout x Series Image DOOO0000 DOOU0000 DOOO0000 Q
24. Lite viewer list and click View When asked to close the current window click No If you click Yes the study currently displayed will be closed 26 eFilm Lite User Guide Selecting images and series 4 When asked to add to the current window click Yes The second study is added to the window If you click No the additional study will display in a separate window 5 Change the screen layout as required by following the procedure outlined in Adjusting the screen layout on page 25 selecting images and series You can select one or more image and series for display in the eFilm Lite window The procedures in this section cover the selection of each of the following e asingle image multiple images and all images in a series see Selecting images on page 27 e asingle series multiple series and all series in a study see Selecting series on page 28 Note Each of these procedures uses image markers which are discussed in Using image markers on page 17 Selecting images These procedures allow you to select a single image multiple images or all images in a series To select a single image 1 View the image that you want to select in any pane 2 Select the selection box in the lower right corner of the image The selection box fills in orange to indicate that it is selected Selection Box To select multiple images 1 View the first image that you want to select in any pan
25. OQU0000 QOO00000 QOO00000 QOO00000 00000000 Custom Rows Columns 1 1 The Series layout determines the format of the panes in the window Each pane can contain one series The Image layout determines the format of the images within the active series Select a layout for the series image or define the values for rows and columns and click Apply Click OK to close the Screen Layout dialog box Note Different series may have different image formats For example a CT exam with two series one scout one axial may be displayed using a 1x2 series layout Furthermore the images in the scout series may be displayed in a 1x1 format and the axials in a 2x2 format multiple studies Multiple studies can be compared either by preselecting all studies or by selecting additional studies while viewing a study To pre select studies for comparison 1 2 3 4 Select the first study from the eFilm Lite viewer list Press Ctrl and select each additional study When finished selecting release Ctrl Click View to load the selected studies Change the screen layout as required by following the procedure outlined in Adjusting the screen layout on page 25 To select an additional study for comparison with the current study being viewed 1 2 3 While viewing the current study open the eFilm Lite viewer by clicking E Select the required study from the eFilm
26. Properties window to display the attachment points for the templates see Customizing template settings on page 19 for instructions eFilm Lite User Guide 85 Managing eFilm Ortho Templates Right click anywhere on one of the templates that you want to attach A pop up menu appears Select Attach from the Template pop up menu The cursor changes to ake l Select the template that you want to attach to the currently selected template The Attach Template dialog box appears Select the point on each of the templates that you want to attach together and click OK Note When two templates are attached moving one template causes both templates to move together Also each template can be rotated about the attachment point and resized on its own This also applies to multi attachments where the template group will rotate or resize about the attachment point unless the templates in that group are locked If one of the templates is locked you will not be able to move either template However you can still rotate and resize the other template if it is unlocked To switch between attachment points on single connections 1 Right click anywhere on the template for which you want to change the attachment point The Template pop up menu appears displaying a selection of attachment points for the template Select an attachment point The template is repositioned to use the new attachment point Note Mouse proximity
27. Tools menu click View 3D Options e Click the arrow to the immediate right of The View 3D pop up menu appears 3 Select either MIP or Simgram Image as the 3D mode The Advanced Volume Loading window appears Adhanced Volume Loading Shee Into rie Pesii Etim atlas if 9 i W ig oom f j 2 Pat Fox f Me Tex fe i toe pE F aus ho Reset Selection interpolation Laval auto I _ 5 Memory Fequarect 73 24 Memory Avadable IEEE Phase prer a tubol ol images r Iinteipolation 1 Gad r Banal St r a Amia Se 2 FRE image ae ces Note This 3D mode becomes the default mode until you close eFilm Lite 4 Adjust the loading parameters see Adjusting loading parameters for 3D volumes on page 63 and click Create Volume The MIP or Simgram Image appears in the eFilm Lite window Adjusting loading parameters for 3D volumes The Advanced Volume Loading window allows you to alter the default volume loading parameters that would normally be hidden or automatically chosen by the software For example you can specify the amount of interpolation to be used or select to load only a subset of images from a series eFilm Lite User Guide 63 Creating 3D Images Advanced Yoleme Loading Yolume Advanced Yoleme Loading Shee indo m E Posio fer a FF incide in Violu r m A PN Series Subset E nan ye i Focus fia a l 4 f Tex se aj i I i Total a3 i ii _ Reset Sele
28. ae Te 121 7 HEED Per TERT Wal Lait E E E a ube To redisplay the written information select the series and click again Note If you applied lossy compression to the image its identifier and compression ratio will not be hidden even when this tool is off Lossy compression information where available is always visible Annotating images The annotation tool allows you to add text to images and then edit or delete the text Annotations can be added to an image to describe certain features in more detail To add an annotation 1 Select an image 2 Choose one of the following options e On the Tools menu click Add User Annotation e Click 3 Click the area in the image where you want to add the annotation A text field appears Type the annotation in the text field When completed press Enter or click again The annotation is set in the image Note Loading a different series into the series window after adding an annotation temporarily hides the annotation which will return if you change the screen layout To edit an annotation e You can edit an annotation by selecting it and then editing the text as necessary You can drag and drop the annotation anywhere on the image 54 eFilm Lite User Guide Making linear measurements Note To restore the original image values click F Annotations can be removed from an image if it is affecting the clarity of the image To delete an annotati
29. an existing data set from either 2D images or 3D volumes From a 2D image the MPR view you generate creates a viewing plane that is perpendicular to the image plane From a 3D volume the MPR view you generate creates a viewing plane that can be rotated to any angle relative to the original image plane You can construct e MPRs of the two orthogonal viewing planes from a 2D image e an MPR ofan arbitrary perpendicular viewing plane from a 2D image e an MPR ofan arbitrary viewing plane through a 3D volume Once created an MPR series behaves the same as a regular eFilm image series You can use most of the eFilm tools such as window level stack zoom pan measurements and reference lines on the MPR series However you cannot apply any 3D image tools to the MPR series until it is saved to the database Note Once an MPR series has been closed you cannot reopen it in eFilm Lite In this section you will learn how to e create MPRs of the two orthogonal viewing planes from a 2D image see Creating Orthogonal MPR viewing planes on page 71 e create MPRs of an arbitrary perpendicular viewing plane from a 2D image see Creating MPRs from 2D images on page 72 e create MPRs of an arbitrary viewing plane through a 3D volume see Creating MPRs from 3D volumes on page 73 e interact with the MPR series you have created see Interacting with MPR series on page 73 e adjust your view of the MPR see Adjus
30. any inherent non linearities in an image Non linear window leveling allows you to apply a wider range of gray tones to a particular section of your windowing range For example the Sigmoidal option applies a wider range to the ends of your windowing range thus giving the image values in the middle range greater contrast and resolution To select non linear window leveling 1 Select the required series 2 Choose one of the following options e On the Tools menu click Window Level Options e Click the arrow to the immediate right of The Window Level pop up menu appears 3 Select Sigmoidal from the preset pop up menu The non linear window leveling function is applied to the image and is automatically activated To adjust the coherence of an image 1 Position the cursor over the image to be adjusted and click and drag the cursor left or right over the image to adjust its coherence Alpha 2 Release the mouse button to apply the new value to all images within the series This value is displayed on the lower left corner of each image e g A 4 00 Inverting images Inverting allows you to invert the sense in which the brightness of displayed pixels is calculated By default low intensity pixels are dark on the screen and high intensity pixels are bright Using the Invert tool will change this so that low intensity pixels are bright and high intensity pixels are dark Applying this tool again restores the previous pixel intensity
31. appearance of printed images depends on the quality and settings of the printer Refer to the original images and modality parameters when interpreting the data 80 eFilm Lite User Guide Managing eFilm Ortho Templates eFilm Ortho is an eFilm add in module designed for orthopaedic surgeons that solves this problem eFilm Ortho gives users such as orthopaedic surgeons the ability to position and size digital prosthetic templates Featured tools include automatic scaling rotation mechanical linking of prosthetic components measurement printing and support for template libraries from most prosthetic manufacturers Note Only sample template files are included with eFilm Lite Support for specific manufacturer templates is license limited and can be purchased as add on modules to eFilm Contact Merge eMed Customer Service for details WARNING Like film digital images are susceptible to magnification errors caused by differing patient sizes and projection distances If not corrected by the modality these errors can affect the accuracy of the calibration information contained in the image s DICOM header This section describes how to select and manipulate orthopaedic templates In this section you will learn how to e select a template see Selecting templates on page 81 e position a template on an image see Moving templates on page 83 e orient a template on an image see Orienting templates on
32. at appears in green indicates that the line is selected and can be manipulated An unselected line appears in orange If the measurement caption has been moved independent of the line moving the line no longer moves the measurement caption as well Making elliptical measurements The Ellipse Measurement tool allows you to measure the area of a region of interest ROI WARNING Measurements performed on CR DX and MG images may be inaccurate unless you calibarate the measurement tools see Calibrating images on page 58 To make an elliptical measurement 1 Choose one of the following options e On the Tools menu click Measurement Tool Ellipse e Click 2 Position the cursor at the starting location and right click and drag the cursor to the ending location 3 Release the mouse button An ellipse with Area Mean and Standard Deviation measurements appears in green Area 24 2 so cm Wean 196 1 HU otd Dev 252 9 HU ee You can stretch or move the ellipse to a new location You can also move the measurement caption to a new location To stretch the ellipse e Right click one of the corner markers and drag and drop it to a new location To move the ellipse e Right click anywhere on the ellipse and drag and drop it to a new location To move the measurement caption e Right click anywhere on the measurement caption and drag and drop it to anew location Note An ellipse that appears
33. changes accordingly You can view the first and last reference lines and current reference line at the same time Changing image orientation For both 2D and 3D images the following four procedures can be used to change image orientation Note For additional 3D specific rotation procedures refer to Creating 3D Images on page 61 To flip an image 180 about the horizontal axis 1 Select the image to flip 2 Choose one of the following options e On the Tools menu click Flip Horizontal e Click To flip an image 180 about the vertical axis 1 Select the image to flip 2 Choose one of the following options e On the Tools menu click Flip Vertical e Click To rotate an image 90 counterclockwise 1 Select the image to rotate 2 Choose one of the following options e On the Tools menu click Rotate Left 90 Degrees e Click To rotate an image 90 clockwise 1 Select the image to rotate 2 Choose one of the following options 40 eFilm Lite User Guide Adjusting image viewing options e On the Tools menu click Rotate Right 90 Degrees e Click Note These functions are applied to all selected series and images in the selected series To restore the original image orientations click f Adjusting Image viewing options Panning Magnifying eFilm Lite includes tools for adjusting the active image view This section shows you how to e pan around an image see Panning o
34. ck a series that contains an MPR line and select a different series to load into that pane you will be prompted as described above to save or delete the corresponding MPR view eFilm Lite User Guide 79 Creating 3D Images 76 eFilm Lite User Guide Exporting Images eFilm Lite can output images in a variety of formats In this section you will learn how to e export images as JPEG files see Exporting images as graphic files on page 77 e export images as AVI files see Exporting images as AVI files on page 77 e export volumes as AVI files see Exporting volumes as AVI files on page 78 e print images see Printing images on page 80 Exporting images as graphic files Images can be exported in any of three formats JPEG jpg bitmap bmp or TIFF tif These files can be viewed using any standard image viewer or web browser To export images as graphic files 1 Select the images that you want to export by clicking the image marker in the lower right corner of each image or by selecting a series and clicking EAI The markers located at the bottom of the selected images fills in orange On the File gt Export menu click as Image s The Save As dialog box appears Select a file format from the Save as type drop down list Select the Windows directory in which to save the images and enter a filename If multiple images are selected the series and image number will be appended to the fil
35. ction Pisara select a subset of images interpolation Infeipolaton Level ute L 5 Memory Fisquredt 58 2ME Maney avala 17153 SB Aan Sef 2 85 imagea Carcel The top left window provides a graphical representation of the slice distribution of the series and indicates which slices are available for inclusion in the volume White slices are included red slices are excluded and the green slice is the currently selected slice in the thumbnail display The top right window displays thumbnails of the slices in the series You can drag the slider to browse through all available slices As you adjust the slider to browse through the slices the thumbnail Slice Info and which slice is highlighted in green are updated to correspond with the selected slice To select only a subset of slices to include in the volume 1 Inthe Series Subset area use the From and To spinners to narrow the range of images that are used to create the volume 2 To exclude only a particular slice instead of a range browse through the available slices until you reach the one you want to exclude Under Slice Info clear the Include in Volume check box 3 Click Reset Selection to return to the default setting of including all the slices in the volume Note The following parameters can optionally be adjusted to improve the result To adjust the loading parameters 1 Ifa series contains multiple orientations or phases s
36. default value places the stereo volume at the center of the screen s surface Note To return the stereo settings to their default values click Restore Defaults 3 Click OK to save your changes Using image markers The Image Markers tab in the Edit Properties window allows you to display image markers and position them as required in the image eFilm Lite User Guide 17 Setting User Preferences To access the Image Markers tab 1 On the Edit menu click Properties The Edit Properties window appears 2 Click the Image Markers tab Edit Properties Modality Settings System Preferences Volume Settings Image Markers Template Settings Preview By pixel offsets By percentage offsets Horizontally 25 pixels Vertically 25 pixels Top Left comer Top Right comer From Bottom Left comer Bottom Right comer IM Show border around marker i Allow marker to calculate dimensions automatically width Jeg E eo i Upper information Lower information MW Use default size Font SIZE Jarial ka la 7 Cancel Help Note Digital mammography scanners attach image markers to their studies so that breast images can be properly identified The default setting for this tab is set to display image markers If you do not want image markers then clear the Show marker on Mammogram MG images check box To position image markers 1 Select either the By pixel offsets or By perc
37. determines the active template point which appears as an orange X Attached points are represented as green Xs These colors are the defaults which can be changed by following the procedure outlined in Customizing template settings on page 19 To detach templates 1 Right click anywhere on the template to be detached The Template pop up menu appears Select Detach from the Template pop up menu to separate the templates You can now move each template separately on the image Note If you detach a template it will be detached entirely from the template group Hiding and showing templates The Hide and Show Templates tools allow you to temporarily hide and display the templates on an image To hide a template Choose one of the following options e On the Tools menu click Hide Templates e Click 86 eFilm Lite User Guide Displaying template labels To show a hidden template e Choose one of the following options e On the Tools menu click Show Templates e Click Displaying template labels The label of a template indicates the manufacturer body part view device and size of the template You can view a template label at any time by hovering the mouse over the template however you can also make the template label remain visible To display a template label so that it persists on the screen 1 Right click anywhere on the template The Template pop up menu appears 2 Select Label from
38. dic templates Allows you to position a template on an image Allows you to rotate or resize a template Temporarily hides a template Displays a hidden template Renders the selected series using the specified 3D mode Crops away unwanted parts of a volume Rotates the volume about the screen s horizontal and vertical axes Toggles the stereoscopic display mode Generates an MPR superimposed on the face of a volume Allows you to assign colors to pixels in a volume 12 eFilm Lite User Guide Setting User Preferences Users can customize your user system and DICOM preferences from the Edit Properties window The following procedures are performed from the various tabs in the Edit Properties window Note You must re select the study in eFilm Lite for the changes to take effect to the image you are currently viewing These changes cannot be preserved In this section you will learn how to e change the default display settings for each modality see Customizing modality settings on page 13 e change your monitor setup see Customizing system preferences on page 15 e specify settings for images displayed as volumes see Customizing volume settings on page 16 e specify where and how to display image markers on images see Using image markers on page 17 e change your template color and display settings see Customizing template settings on page 19 Customizin
39. display the attachment points of the template 3 Select the Show Drop Shadow check box to display a drop shadow in the template Note To return the template settings to their default values click Restore Defaults 4 Click OK to save your changes 20 eFilm Lite User Guide Viewing Images A study is a set of related images which can be viewed in eFilm Lite You can only view images stored as studies on the CD In this section you will learn how to e use the eFilm Lite viewer see Using the eFilm Lite viewer on page 21 e view and arrange a study see Viewing studies on page 22 e select individual or multiple images and series see Selecting images and series on page 27 e close a study see Closing studies on page 28 Using the eFilm Lite viewer The eFilm Lite viewer allows you to select a study to view in the eFilm Lite window To access the eFilm Lite viewer e On the File menu click Search or click E eFilmLite S x R M Film Th Lite TM software M R G Copyright 71995 2003 Merge eed All rights reserved Healthcare This software is protected by copyright law and is used under the terms of the license agreement provided on this CDROM Ifthere is no license agreement please contact Merge eMed Getting started 1 Click on the exam you wish to view and click on the View button 2 Move the mouse up and down over an image while holding down the left mouse butt
40. e 2 Select the selection box in the lower right corner of the image The selection box fills in orange to indicate that it is selected 3 Continue this procedure to select additional images eFilm Lite User Guide 27 Viewing Images Note Selected images remain selected as you scroll through the series You can select every other image in the series by clicking Select Every 2nd Image In Series on the Edit menu To select all images in a series 1 Click a series in any pane in the window The border around the selected series turns green 2 Choose one of the following options e On the Edit menu click Select Deselect All Images In Series e Click Note To deselect all images in the series click again Selecting series These procedures allow you to select a single series multiple series or all series in a study To select a single series e Click a series in any pane in the window The border around the selected series turns green To select multiple series e Hold Ctrl and click a number of series in any pane in the window The borders around all of the selected series turn green To select all series e On the Edit menu click Select All Visible Series e Click e Press Ctrl A Note This tool only selects all currently displayed series To select all series in a study adjust the screen layout to display the whole study i e all series in the window Closing studies After you a
41. e The default settings of image fusion are that the PET images appear in the foreground and CT images appear in the background Adjusting the Alpha setting The Alpha setting determines the blend value for the foreground and background of the fused image To adjust the Alpha setting 1 Choose one of the following options e On the Tools menu click Image Fusion e Click the arrow to the immediate right of The Image Fusion pop up menu appears Select Alpha Blend from the preset pop up menu The Alpha control bar appears pasenseseese 3 Adjust the Alpha setting by dragging the scroll bar up or down Note Any Alpha setting greater than 50 means more of the foreground image than the background will be contributed to the fused image whereas any Alpha setting less than 50 means more of the background image will be contributed to the fused image than the foreground The blend value will be saved in the current user s profile 4 Click X in the upper right corner to hide the Alpha control bar eFilm Lite User Guide 49 Manipulating Images Configuring the image fusion pipeline You can change the displayed color range of the fused image by configuring the image fusion pipeline To configure the image fusion pipeline 1 2 Select the fused series viewport Choose one of the following options e On the Tools menu click Image Fusion e Click the arrow to the immediate right of The Image Fusion pop up menu
42. e This feature can be useful in soft tissue CT images to remove the skull or ribs from the display To zero all pixel values outside the conventional window 1 Choose one of the following options e On the Tools menu click View 3D Options e Click the arrow to the immediate right of The View 3D pop up menu appears 2 Select Black Outside Window Adjusting mapping settings for 3D volumes You can assign either color and grayscale mappings to 3D volumes as well as load edit and delete mappings of both types This section shows you how to e assign color mappings to a 3D volume see Assigning color mappings to 3D volumes on page 68 eFilm Lite User Guide 67 Creating 3D Images e assign grayscale mappings to a 3D volume see Assigning grayscale mappings to 3D volumes on page 69 e load either color or grayscale mappings see Loading color grayscale mappings on page 70 e edit or delete either color or grayscale mappings see Editing color grayscale mappings on page 70 Important This feature is only available if your system meets the requirements listed in Required hardware for 3D volume rendering on page 6 Assigning color mappings to 3D volumes The Opacity Settings tool allows you to assign color mappings to ranges within a CT or MR study This feature is only available for volume rendering it will not function with Simgram or MIP images To assign color mappings to a range in the
43. e Cine control bar appears Cine Control Bar Slower Faster Shuffle wal a i Volume Eine Rotation Ans AE Aris Z Avis Sweep Angle f z 40 Step Size i 5 j Tumble Export to 41 Adjust the speed of the cine using the slider eFilm Lite User Guide 31 Navigating Images 4 Select the Play Mode Loop repeatedly displays the sequence from the first to the last image in a series Shuffle moves back and forth through the images between the first and last one in a series 5 Click gt to move forward EI to move backward or to stop the cine Moving through series You can move through different series of images using the Next and Previous Series tools Note You can also right click on any image to open a pop up menu from which you can select the required series To go to the next series in an open study e Choose one of the following options e On the Tools menu click Next Series Click To go to the previous series in an open study e Choose one of the following options e On the Tools menu click Previous Series e Click Moving through studies After viewing a study you can go to the next or previous study in your eFilm Lite viewer list To go to the next study e Choose one of the following options e On the Tools menu click Next Study e Click To go to the previous study e Choose one of the following options e On the Too
44. e following options e On the Tools menu click Move Template Label e Click 3 Position the mouse pointer anywhere over the template which changes color and size 4 Click anywhere on the template and drag and drop it to a new location Note These colors are the defaults which can be changed by following the procedure outlined in Customizing template settings on page 19 eFilm Lite User Guide 83 Managing eFilm Ortho Templates Orienting templates Templates can be rotated or flipped relative to the patient s anatomy in the image To rotate a template 1 Load a template by following the procedure outlined in Selecting templates on page 81 Choose one of the following options e On the Tools menu click Rotate Resize Template e Click Position the mouse pointer anywhere over the template which changes color Right click anywhere on the template and move the mouse side to side to rotate the template Moving the mouse to the right rotates the template clockwise about its point of rotation while moving to the left rotates it counter clockwise Release the mouse button when the template is rotated in the required position Select the Show Rotation Axis check box on the Template Settings tab of the Edit Properties window to display the rotation axis of the template This procedure is outlined in Customizing template settings on page 19 Note Moving the mouse up and down with the Rota
45. e information on developing custom image manipulation plug ins or contact a Merge eMed service engineer This section shows you how to e adda filter to eFilm Lite see Adding filters to eFilm Lite on page 46 e apply a filter to an image see Applying filters to images on page 47 e change filter settings see Changing filter settings on page 47 Note Changes to pixel values are temporary and will not be seen if the study is closed and reopened Adding filters to eFilm Lite You can add new filters to eFilm Lite as DLL files 46 eFilm Lite User Guide Using filters To add a filter to eFilm Lite 1 2A Choose one of the following options e On the Tools menu click Add New Filter e Click Browse to the DLL file and click Open Applying filters to images You can apply one of two filters to an image in eFilm Lite To apply a filter to an image 1 Zz Select the image Choose one of the following options e On the Tools menu click Apply Image Filter e Click the arrow to the immediate right of a The Apply Image Filter pop up menu appears Select the filter you want to use from the menu of currently added filters either eFilmClaheFilter or eFilmSharpening Note If you want to restore the original image settings click a Changing filter settings You can change the settings for both types of filters To change filter settings 1 Choose one of the foll
46. eFilm Lite User Guide eFilm Lite 2 1 User Guide Version 1 Part number 009 83091 00 October 6 2005 Copyright notice Copyright 2005 Merge Technologies Inc 6737 W Washington Street Suite 2250 Milwaukee WI 53214 5650 USA Phone 414 977 4000 Fax 414 977 4200 All Rights Reserved This manual shall not wholly or in part in any form or by any means electronic mechanical including photocopying be reproduced or transmitted without the authorized written consent of Merge eMed This guide has been produced to assist in providing instruction for the Merge eMed product suite Every effort has been made to make the information in this guide as accurate as possible The authors of Merge eMed shall have neither liability nor responsibility to any person or entity with respect to any loss or damages in connection with or arising from the information contained in this guide Trademarks Merge eMed eFilm Fusion eFilm eFilm Lite eFilm Scan and eFilm Video are all registered trademarks of Merge Technologies Inc and its subsidiaries Any additional software products named in this document are claimed as trademarks or registered trademarks of their respective companies Regulatory notes Merge eMed provides you with the following information regarding the regulatory status of eFilm in Lite form Canada eFilm is licensed for sale and use in Canada This product possesses a Class 2 Medical Device Licence issued May 30
47. easily Adjusting brightness The level setting controls the brightness of an image To adjust the brightness of an image 1 Choose one of the following options eFilm Lite User Guide 35 Manipulating Images e On the Tools menu click Window Level From here you can adjust the brightness of the selected image 2 Position the cursor over the image to be adjusted and right click and drag the cursor up or down over the image 3 Release the mouse button to apply the new values to all images within the series These values are displayed on the lower left corner of each image e g W 33 L 777 Adjusting contrast The window setting controls the contrast of an image To adjust the contrast of an image 1 Choose one of the following options e On the Tools menu click Window Level From here you can adjust the contrast of the selected image 2 Position the cursor over the image to be adjusted and right click and drag the cursor left or right over the image 3 Release the mouse button to apply the new values to all images within the series These values are displayed on the lower left corner of each image e g W 33 L 777 Note To achieve a finer resolution with window leveling use the arrow cursor keys up and down to adjust brightness and right and left to adjust contrast To compensate for any inherent non linearities in an image use non linear window leveling see Using non linear window levelin
48. eft WARNING Please ensure that your image has been properly calibrated prior to templating Apply Done 4 Click Update Template Index Note You only need to click this button once after installing new templates 5 Locate and select a template by navigating down through the manufacturer body location device view and size branches 6 Select a size The template of the chosen device previews in the pane to the right and the Template Information fields are completed with the corresponding device specifications 7 Click Apply to accept these settings and Done to close the Template Selection window The template appears in the eFilm Lite window 82 eFilm Lite User Guide Moving templates Note Once the template is opened on the patient s image you may find that as you move the mouse pointer over the template the template changes color and size These are the color defaults which can be changed in Customizing template settings on page 19 Note To view a template label at any time position the mouse pointer over the template Its label appears similar to a tool tip and remains on screen until you move the mouse again Moving templates Moving a template allows you to position the template relative to the patient s anatomy in the image To move a template 1 Load a template by following the procedure outlined in Selecting templates on page 81 2 Choose one of th
49. elect a different orientation or phase to use to create the volume 2 Select a different Interpolation Level to use to create the volume By default Auto is selected This option automatically selects the best interpolation pixel spacing that can be handled by your current memory availability Note The Memory Required box displays the memory required to load the volume with the currently selected slices and interpolation settings Compare this value to the Memory Available box which displays the total memory currently available on your system If the Memory Required exceeds the Memory Available you cannot load the volume using the current settings In this case you must reduce the number of slices you are attempting to use 3 Select the sort by Acquisition 64 eFilm Lite User Guide Using 3D images Cropping 3D volumes Cropping allows you to crop a volume in all three dimensions This feature allows the user to identify a volume of interest and remove the other parts of the volume from the display Caution The behavior of this feature will differ for systems that do not meet the video card requirements stated in Required hardware for 3D volume rendering on page 6 To crop a volume 1 Choose one of the following options On the Tools menu click Crop Volume Click Using the sides of the blue volume cube as your cropping planes position the cursor over the edge of the cube you want to crop C
50. ename of each image file 5 Click Save Exporting images as AVI files You can export images as AVI files and view the resulting cine loop using your default media player To export images as AVI video files 1 Select the images to be exported by clicking the image marker in the lower right corner of each image or by selecting a series and clicking The markers located at the bottom of the selected images fills in orange 2 On the File gt Export menu click as AVI Video The Create AVI dialog box appears eFilm Lite User Guide 77 Exporting Images Create AYI X Compression Type Microsoft Video 1 Quality i 100 Dimensions Image Width E 2 Image Height 375 Frame Rate F Use OCON Frame Fate Frames Per Second 25 Total Running Time 0 04 fin seconds Select the Compression preferences for Type and Quality Specify the Image Width and Image Height dimensions the size of the AVI image in screen pixels Select the Frame Rate preferences the number of images or frames that display per second Note The Total Running Time value is calculated according to the frame rate If a DICOM frame rate has been encoded in the DICOM header the Use DICOM Frame Rate check box is activated If you select this option the Frames Per Second value will automatically be set according to the frame rate Once you have set all of your preferences click Create The Save As dialog
51. entage offsets radio button which will position the image marker either by pixels or by percentage respectively 2 Move the position of the image marker by inserting values in the Horizontally and Vertically fields The preview screen will update according to your selection 3 Select the corner from which the image marker will be oriented by selecting the corresponding corner The preview screen will update according to your selection 4 Click OK to save your changes To format image markers 1 Choose one of the following options e If you want to remove the border clear the Show border around marker check box e Ifyou want to keep the border but change its size select the Show border around marker check box and clear the Allow marker to calculate dimensions automatically check box The Width and Height fields are activated so that you can enter your custom border dimensions 18 eFilm Lite User Guide Customizing template settings Note If you want to change the upper information font select the Upper information option and select a font from the drop down list To change the lower information font repeat this step with the Lower information option To change the font size clear the Use default size check box This activates the Size drop down list so that you can select a different font size Click OK to save your changes Customizing template settings The Template Settings tab in the Edit Properties
52. es 30 searching for studies 21 selecting images 27 series 27 28 templates 381 sensitivity 36 series eFilm Lite User Guide 93 arranging in panes 23 exploding 44 moving through 32 selecting 27 28 synchronizing 32 viewing options 43 setting See configuring settings advanced user 14 alpha 49 black outside window 67 filter 47 modality 13 original image 43 template 19 volumes 16 window level 35 showing templates 86 Sigmoidal images 38 Simgram images 62 single monitor 15 slabs See MPRs slices 38 software requirements 5 stacking images 31 stereo display mode 67 structure 89 studies arranging in panes 23 closing 28 comparing multiple 26 moving through 32 resorting 22 searching for 21 viewing 22 viewing information 24 synchronizing series 32 system preferences 15 requirements 5 T templates attaching 85 colors 19 deleting 87 detaching 85 hiding 86 locking 85 moving 83 moving labels 87 orienting 84 overview 81 resizing 84 selecting 81 settings 19 showing 86 showing labels 87 tools See tools unlocking 85 text 53 3D modes 61 toggling shutter 44 toolbar configuring 7 grayscale 7 hiding 7 minibar 8 moving 7 overview 7 tools 3D cursor 33 angle 57 annotate 54 arrow 57 calibrate 58 cine 31 clear all 60 common 9 ellipse 56 explode 44 image manipulation 11 image processing 12 line 55 magnify 41 main 9 measurement 10 MPR 72 multiplanar 11 next 10 29 overview 8 pan 41 previou
53. ex Creating 3D Images LY TO GCS sts Gere wa csrsesied ea E a E ates Vene o IMACS sian tase lies E diusaua tinea thateeed kauGeveed Creatine SDMA GS arrassar das in a E Adjusting loading parameters for 3D volumes seese Cropping SD VolimneS sapsi E sdaiseiusatndeschastaened Rotatine 3D Voes renia E E N Viewing 3D images in stereo display mode ssec Using the black outside WINDOW setting eeens Adjusting mapping settings for 3D volumes eee Creatine MPR TNI OS hoces a a O Creating Orthogonal MPR viewing planes seses Creatine MERS trom 2D Images sirara n E Creating MPRs from 3D VOIUMES eee eee eseeeeeeseeeseeeseeeseens Interacting with MPR Series sineresia Mee reine uae eee Adjusting tie MPR VIEW ssssiercecssosbsaaxtusvanshaansaussasoatecncieasieuencnseeas Creatine MER SIDS sirieni a ehanteasieas Savine Of deleting MPR VIEWS vaicisieissedcasenevsanedsvadeisavenadosanveraens Exporting Images Exporting images as graphic files essesesessessssersersrsersersererseesresesresees Exp rtine images as AVI GCS rarse E E eau Exporting volumes as AV I IES uars tarreni nia IP BIG 8 magego EE tacatie cl sauna reacts sensaet aletlease Managing eFilm Ortho Templates DELECLING PEM PALO Se eerste pis onennata dee A NE Movino template Serce anthems EA Oriennne LEM DIALES isnan ran na aE ROS FIRES IAIN template Sa a a a r N Locking and unlocking templates 0 cele eeseeseeeseeeeeeseeeseeeaeeees Attaching and detaching tem
54. for greater image clarity This feature aligns the image in relation to the selected mask 7 Select either the Positive Opaque or Negative CO2 contrast option Click X in the top right corner to close the Digital Subtraction Angiography control bar Your changes are applied to the selected series Using filters You can manipulate displayed images in a number of ways using image operations that you can define by programming compatible custom image manipulation plug ins for eFilm Lite The capacity to use an infinite range of custom imaging effects greatly extends eFilm Lite s image manipulation abilities Consult the following notes e Two sample filters are included in eFilm Lite the Contrast Enhancement Filter and Sharpening Filter Both filters operate on any type of modality pixel representation and photometric interpretation supported by eFilm Lite The Contrast Enhancement Filter improves image contrast while the Sharpening Filter enhances edges by subtractive smoothing e Both of the sample filters provided with eFilm Lite are Dynamic Link Library DLL files and may be used as plug ins for eFilm Lite or any other imaging program e A proper interface between eFilm Lite and any custom DLL is needed for successful operation of the plug in e Source code is only available for the Contrast Enhancement Filter This code is intended to assist in custom filter development Please consult our website at www imerge com for mor
55. g on page 38 Adjusting manual window level control sensitivity The sensitivity of the manual adjustment is set by a relative number If the change between window levels is too sensitive and changes too much while you are moving the cursor over the image then lower the sensitivity value If the change between window levels is not sensitive enough then increase the sensitivity value To adjust the sensitivity 1 Choose one of the following options e On the Tools menu click Window Level Options e Click the arrow to the immediate right of The Window Level pop up menu appears 2 Select Sensitivity from the preset pop up menu The Window Level Sensitivity control bar appears 3 Adjust the sensitivity value either by using the up or down arrows or by entering the specification manually The specification is a relative number that you define 4 Click OK 36 eFilm Lite User Guide Setting window level values Note When you change the sensitivity the new value becomes the default and is applied to all images and studies until it is changed again Using window level presets This method allows you to perform adjustments to window level settings using the presets Applying window level presets You can use the preset window level values to change how an image is displayed To apply window level presets 1 2 Select the required series Click the arrow to the immediate right of a appears
56. g modality settings The Modality Settings tab allows you to change the default layout and image display settings for each modality This section shows you how to change e the default layout for a modality see Changing modality layouts on page 13 e advanced image display settings for a modality see Customizing advanced user settings for a modality on page 14 Changing modality layouts The Layout tab in the Modality Settings tab of the Edit Properties window allows you to customize the image layout for each modality Note This feature is useful for CR skeletal surveys where eFilm Lite loads the images in survey mode You can then follow the procedure outlined in Exploding series on page 44 to move between individual images and the survey mode To change screen layout settings for a modality 1 On the Edit menu click Properties The Edit Properties window appears eFilm Lite User Guide 13 Setting User Preferences Click the Modality Settings tab and then click the Layout tab Edit Properties x Modality Settings System Preferences Volume Settings Image Markers Template Settings Modality M A Layout Advanced Seres T AutoFormat Rows Columns Image T AutoFormat Rows Columns Cancel Help Select the required modality from the Modality drop down list Adjust the layout as required Note If you want eFilm to automatically create as many viewports that are nece
57. ick Properties The Edit Properties window appears 2 Click the Volume Settings tab 16 eFilm Lite User Guide Using image markers Edit Properties x Modality Settings System Preferences Volume Settings Image Markers Template Settings MPA Settings Slice separation for MPA series mm E Initial location of range limit of MPRI from 20 to Bo M Suppress creation of oblique MPR view 30 Settings T Hide bounding box when not cropping Stereo Settings Angle g Fo 2 Offset fo Restore Defaults Cancel Help To customize your volume display properties 1 Select the Suppress creation of oblique MPR view to keep eFilm from generating this view when Auto Generate MPR is selected 2 Change the Slice Separation for MPR Series mm value to adjust the slice spacing used to create your MPR views 3 Change the Initial location of range limit settings to adjust the default MPR range limits 4 Select the Hide bounding box when not cropping check box to hide the wire frame surrounding the volume when it is not in crop mode 5 Click OK to save your changes To customize your stereoscopic display settings 1 Change the Angle value to increase or decrease the strength of the stereo effect Note Increasing the angle increases the shift between the red and blue images 2 Change the Z Offset value to make the stereo volume appear to float in front of or behind the display surface The
58. in green indicates that the ellipse is selected and can be manipulated An unselected ellipse appears in orange If the measurement caption has been moved independent of the ellipse moving the ellipse no longer moves the measurement caption as well 56 eFilm Lite User Guide Drawing arrows Drawing arrows You can draw arrows to point to an area of interest on the image To draw an arrow 1 Choose one of the following options e On the Tools menu click Measurement Tool Arrow e Click 2 Position the cursor at the source the arrow tail and right click and drag the cursor to the destination the arrow head 3 Release the mouse button An arrow appears in green with an annotation box in which you can enter notes You can stretch the arrow or move it to a new location To stretch the arrow e Right click either end of the arrow and drag and drop it to a new location To move the arrow e Right click anywhere on the arrow and drag and drop it to a new location Note An arrow that appears in green indicates that the arrow is selected and can be manipulated An unselected arrow will appear in orange When moving the arrow the annotation does not move with it To move the annotation follow the procedure outlined in Annotating images on page 54 Displaying angle measurements Angle measurements allow you to display the angles between intersecting lines To display the angle measurements 1 Draw
59. ion control bar appears 5 Enter the length in centimeters of the line you drew as measured by the scale on the image and click OK All subsequent measurements on the image will be calibrated Note Due to variable scaling per image each image must be calibrated individually Once an image is calibrated you can change its measurement units back to pixels by entering 0 as the length value in the Measurement Calibration control bar Probing images Probing allows you to query the image intensity values To probe the area of an image 1 Choose one of the following options e On the Tools menu click Probe Tool e Click 2 Click anywhere on the image and hold the mouse button down to view the value at that point The Hounsfield value for CT or pixel value for all other modalities is displayed 203 284 72 0 HU eFilm Lite User Guide 59 Annotating and Measuring Images Clearing measurements If you do not want any measurements on the images of a series you can remove them all at once To delete all the measurements from every image in a series 1 Select a series 2 Choose one of the following options e On the Tools menu click Clear Measurement Tools e Click 60 eFilm Lite User Guide Creating 3D Images This section covers the creation of Maximum Intensity Projection MIP Multi Planar Reformatting MPR and Simgram images which allow you to view and manipulate volumes in three
60. ity in the DICOM header While eFilm Lite has been tested extensively it is impossible to completely test any piece of software and errors may remain in the software It is possible that an error could manifest as an incorrect measurement or image Users must be aware of the potential for errors eFilm saves images together with patient information both when saving to the local database and when exporting from eFilm It is important to protect this data from access by unauthorized persons Users should be aware that certain views make use of interpolated data This is data that is created by eFilm based on the original data set Interpolated data may give the appearance of healthy tissue in situations where pathology that is smaller than the scanning resolution may be present On occasion interpolated data may also include image artifacts which should not be interpreted as real pathology Table of Contents Chapter 1 Chapter 2 Chapter 3 eFilm Lite Overview DY SUG A Fe IC A SENS eect spsttn cc scan apie N ed ecues rade nn deeeais 5 erni Lle WNdOW sisirain eiieeii i en 6 ame e Oo E aa E E E ee Te or eer rerer are 7 Moving the toolbar 5 sezaisezaas ssoassdeiuecnswsanneaad saaceastesanieatansauilimiacasseandians 7 Customizing the toolbar srasni err enne Ny mre rT acrrr es Cer re tren rere 7 Accessing tHE MMi DAY scscrcssvcarasavecaswsanscannsasseateesstcatemastaunaianusiansocies 8 DSE ONG ec attiarede pete E E EN 8 DY VIMEO ONS o a
61. izes points between images and planes Creates an MPR from a 2D image Creates two orthogonal and one oblique MPR series from a 2D image Flips the selected image from left to right about the vertical axis Flips the selected image from top to bottom about the horizontal axis Rotates the selected image 90 degrees counter clockwise Rotates the selected image 90 degrees clockwise Inverts the color of the images so that they are displayed either as black on white or white on black Improves the contrast for greater definition of vessel structures only available for 16 bit XA images Applies or removes modality shutter Matches all images on the same plane eFilm Lite User Guide 11 eFilm Lite Overview Image Processing tools Ene Apply Image Filter a 4 Template tools tes L oO th F a Volume tools r ote E E a 4 Reload Original Image Change Filter Settings Add New Filter Add Template Move Template Label Rotate Resize Template Hide Templates Show Templates View 3D Crop Volume Rotate Volume Toggle Stereo Volume MPR Opacity Settings Applies the filter image manipulation effect to the selected image Restores the image s original settings prior to the image filter application Adjusts the filter image manipulation settings Loads a new user defined filter image manipulation effect into eFilm Lite Opens a selection of orthope
62. lick and drag the cursor in the direction you want to crop Release the mouse button to set the new boundary of the cropped volume cube The following notes pertain to both the 3D rotating and cropping tools The left mouse button is used for 3D rotating and cropping Rotating is the default active tool As you move the cursor over the edge a cropping plane the cursor shape changes to the cropping symbol indicating that the cropping tool is now the active tool When in crop mode the highlighted plane indicates the side of the cube that will be resized when you click and drag the mouse The cropped volume cube appears in green You can combine cropping rotating and windowing in any order At first you may find it easier to crop in one of the preset rotations Anterior Posterior Left Right Superior or Inferior which are outlined in Rotating 3D volumes on page 66 While cropping all parts of the volume outside of the cropped volume are displayed at a reduced brightness to help you understand the context of what is in and what is out Once you have finished cropping toggle the crop icon to display only the cropped in volume eFilm Lite User Guide 65 Creating 3D Images 4 Since the cropped volume is smaller it can be rendered faster To improve rendering speed once you have cropped your volume click to display only the cropped volume Note You can reset the crop by clicking Reset on the Crop Volume
63. ls menu click Previous Study e Click synchronizing series The Synchronizing tool allows you to bring all series in the same plane into alignment This tool uses the series slice location to line up image navigation for these series in panes With synchronization you can navigate through the images of one series i e scroll cine and all other series with images in the same plane will navigate accordingly This section shows you how to synchronize series 32 eFilm Lite User Guide Locating points in 3D space e automatically see Synchronizing series automatically on page 33 e manually see Synchronizing series manually on page 33 synchronizing series automatically This method of synchronization is performed automatically it synchronizes images that are related to each other spatially and scanned during the same exam but it will not synchronize images from the same patient from different studies The series must be from the same patient or study otherwise you must perform synchronization of these series manually To synchronize series of the same plane automatically 1 Select the image plane with which you want all others to synchronize 2 Choose one of the following options e On the Tools menu click Auto Series Synchronization e Click If you detect an offset in the images you can manually synchronize the images see Synchronizing series manually on page 33 Synchronizing series manual
64. ly This method allows you to perform synchronization manually If the new series is from a different patient or study than the original you can still perform manual synchronization if the series are related To manually synchronize series of the same plane 1 Scroll through each series and display the images you want to synchronize 2 Choose one of the following options e On the Tools menu click Manual Series Synchronization e Click Locating points in 3D space 3D Cursor allows you to locate a point in space in all planes To locate a point in space in all planes 1 Choose one of the following options e On the Tools menu click 3D Cursor e Click 2 Right click on any displayed 2D image This same point will be indicated on all other 2D images regardless of the plane by a In order to find the point in another series eFilm may need to display different slices in those series Not all points in the current images necessarily exist on other displayed images In this case the sign will not be displayed eFilm Lite User Guide 33 Navigating Images You can drag the point around the image and the corresponding points in the other images will move accordingly You can navigate through the images i e stack cine and you will still see the point in 3D space 34 eFilm Lite User Guide Manipulating Images This section covers manipulating image display functionality such as orientation magnification
65. mprove the quality of your images e Select Bicubic Interpolation to minimize the effects of aliasing in your images e Select While Stacking to see smooth edges while you stack through your images e Select Histogram Analysis to have the window and level values automatically adjust based on image characteristics This feature only works if the scanner sending the image does not define the window and level settings Note Adjusting these defaults will affect the image processing time 6 Select the Hide stacking scrollbar check box so that the scrollbar will not display see Stacking images on page 31 This is recommended for modalities such as CR DX and MG 7 Click OK to save your changes Customizing system preferences The System Preferences tab in the Edit Properties window allows you to customize your monitor setup To customize your monitor setup 1 On the Edit menu click Properties The Edit Properties window appears 2 Click the System Preferences tab eFilm Lite User Guide 15 Setting User Preferences Edit Properties 3 Select either the Single or Dual option for the setup of your monitors 4 Click OK to save your changes Customizing volume settings The Volume Settings tab in the Edit Properties window allows you to customize your volume and stereo display settings see Viewing 3D images in stereo display mode on page 67 To access the Volume Settings tab 1 On the Edit menu cl
66. n page 41 e magnify an image see Magnifying on page 41 e zoom in and out on an image see Zooming on page 42 Panning allows you to position images within the pane This feature is especially useful when the image is larger than the pane as it usually is after zooming To move an image within the pane 1 Choose one of the following options e On the Tools menu click Pan e Click 2 Position the cursor over the image you want to move and click and drag the cursor around the pane to move the image 3 Release the mouse button to drop the image in its new position Note To restore the original image display value except window level click l Magnifying allows you to magnify an area of interest within a small separate magnification window that moves in conjunction with the cursor eFilm Lite User Guide 41 Manipulating Images To magnify an area of interest 1 Choose one of the following options e On the Tools menu click Magnification Options e Click the arrow to the immediate right of The Magnification pop up menu appears 2 Select one of the following percent magnification values 200 400 600 or 800 Note This specification becomes the default while eFilm Lite remains open 3 Click and drag the mouse over the area of the image you want to magnify The magnifying window appears and follows the cursor as it magnifies the selected area 4 Release the mouse button t
67. ng 46 applying 47 editing 47 overview 46 finding See searching flipping images 40 templates 84 foreground 50 fusing images 48 G grayscale mappings assigning 69 editing 70 loading 70 toolbar 7 H hardware requirements 5 6 hiding templates 86 toolbar 7 histogram analysis 14 I images annotating 54 brightness 35 calibrating 58 coherence 38 color inversion 38 configuring with DSA 45 contrast 36 exporting as AVI files 77 exporting as JPEG files 77 flipping 40 fusing 48 magnifying 41 MIP 62 moving through 29 orienting 40 panning 41 printing 80 probing 59 resetting 43 retrieving 21 rotating 40 scrolling through 30 selecting 27 Sigmoidal 38 Simgram 62 stacking 31 toggling shutter 44 tools See tools viewing in stereo 67 viewing options 41 zooming 42 inserting See adding interacting with MPR series 73 interpolation 14 inverting image color 38 J JPEG image files 77 L labels See templates layouts modality 13 screen 25 linear measurements 55 loading color mappings 70 grayscale mappings 70 locating 3D points 33 locking templates 85 M magnifying images 41 main tools See tools manual series synchronization 33 window levelling 35 92 eFilm Lite User Guide mapping colors 67 markers image 17 matching field of view 45 measurements angle 57 clearing 60 elliptical 56 linear 55 tools See tools minibar 8 MIP images 62 modality CT PET fusion 48 layouts 13 setting
68. nts e Pentium II processor e 256 MB RAM e Minimum display resolution 800 x 600 When choosing computer hardware users should note that the most substantial performance gains result when RAM is increased In order to prevent poor performance of the software Merge eMed does not recommend that eFilm Lite be run on a less powerful system than that listed above Required software and operating systems eFilm Lite requires the following software programs and operating systems in order to operate properly e Windows 2000 or Windows XP Professional eFilm Lite User Guide 5 eFilm Lite Overview Note Windows 95 Windows 98 and Windows NT are no longer supported by Merge eMed To ensure optimal performance it is advisable that you upgrade your operating system to Windows XP before you use eFilm Lite e Microsoft Internet Explorer IE 6 0 or higher Required hardware for 3D volume rendering A video display adapter with at least 128 MB of video RAM that fully supports DirectX 8 1 or later Refer to the product help files and the Merge eMed Web site at www merge com for the most up to date system requirements eFilm Lite window The main eFilm Lite window is a workspace where you can view and manipulate DICOMDIR images stored on a CD il cFilm Lite ANONOOOO 2005 Jul 20 00 00 00 7 WINANS ES E File Edit Utility ToolBars Tools Window Help O i _ x Home QS AH a om E a S B eo Aan ee OO Om Ih
69. o close the magnifying window Zooming There are three methods of performing zooming manual preset and custom zooming Pixel for pixel mode which treats each pixel in the DICOM image as one pixel on your monitor is also available in this section Important Images with a 1 1 pixel aspect ratio look normal when pixel for pixel mode is applied however for images with a different pixel aspect ratio will look compressed in one direction as this feature represents actual pixels but not presentation intent In these cases you must exit pixel for pixel mode by selecting another zoom value To zoom in and out of an image manually 1 Choose one of the following options e On the Tools menu click Zoom e Click 2 Position the cursor over the image and right click and drag Dragging up increases the image magnification and dragging down decreases it 3 Release the mouse button to keep the image at the new magnification To set Zooming specifications 1 Select the required series 42 eFilm Lite User Guide Resetting the original image settings 2 Choose one of the following options e On the Tools menu click Zoom Options e Click the arrow to the immediate right of The Zoom pop up menu appears Note You can select one of the preset magnification values or create a custom value Select Custom from the Zoom pop up menu The Custom Zoom control bar appears 4 Adjust the zoom value either by using the spin arr
70. on 1 Select the annotation 2 Highlight the entire text within the annotation 3 Press Delete 4 Press Enter to confirm deletion or click l Making linear measurements eFilm Lite allows you to make straight line measurements on displayed images On ES OT RF SC US and XA images measurements are displayed in pixels until calibration is performed In all other modalities they are displayed in centimeters WARNING Measurements performed on CR DX and MG images may be inaccurate unless you calibarate the measurement tools see Calibrating images on page 58 To make a linear measurement 1 Choose one of the following options e On the Tools menu click Measurement Tool Line e Click 2 Position the cursor at the starting location and right click and drag the cursor to the ending location 3 Release the mouse button A line with a distance measurement appears in green You can stretch the line or move it to a new location You can also move the measurement caption to a new location To stretch the line e Right click either end of the line and drag and drop it to a new location To move the line e Right click anywhere on the line except at the ends and drag and drop it to a new location To move the measurement caption e Right click anywhere on the measurement caption and drag and drop it to anew location eFilm Lite User Guide 55 Annotating and Measuring Images Note A line th
71. on to scroll through images 3 Move the mouse letto right over an image while holding down the right mouse button to adjust contrast up and down to adjust brightness 4 To view another study click on the search button and repeat step 1 Patient ID Modality Description Date Time Study If The pane lists the studies that are stored in DICOMDIR format on your CD eFilm Lite User Guide 2A Viewing Images Customizing the eFilm Lite viewer You can customize the eFilm Lite viewer to suit your preferences by re sorting the columns and repositioning the fields in the CD exam list To customize the eFilm Lite viewer 1 Click a header to sort the list according to that heading For example click Name to sort the list alphabetically or click Patient ID to sort the list numerically Tip Clicking the header field again will sort the list in the reverse order Click and hold the header you want to move and drag and drop it to a new location Note These changes cannot be preserved Viewing studies Studies are stored in DICOMDIR format on your CD In addition to learning how to view a study this section will show you how to arrange study series in the eFilm Lite window see Arranging study series in panes on page 23 view information for a study see Viewing study information on page 24 set the encryption password see Setting the encryption password on page 25 change the layou
72. ote The Pan options become available once you zoom in Adjust the Sensitivity value by entering it manually or using the spinbox arrows The Sensitivity value specifies the increment by which the Window Level and Opacity spinbox values will change when adjusted You can also set this value by following the procedure outlined in Adjusting manual window level control sensitivity on page 36 Adjust the Window and Level values by entering them manually or using the spinbox arrows Select the Invert check box to switch the Window value from white to black Clear the Invert check box to switch this value from black to white eFilm Lite User Guide 69 Creating 3D Images 7 Adjust the Opacity Slope and Position values by entering them manually or using the spinbox arrows Select the Invert check box to switch the Slope value from white to black Clear the Invert check box to switch this value from black to white 8 Click Auto Opacity Setting to automatically create a straight opacity angle or DICOM Setting to revert to the Window Level settings defined in Defining custom window level presets on page 37 Note To save these settings to the Preset menu follow the procedure described in Editing color grayscale mappings on page 70 9 Click the X in the upper right hand corner to close the Grayscale Opacity Settings dialog box The image is updated according to the new grayscale mapping Loading color grayscale ma
73. ou will need a pair of red blue anaglyphic glasses to view the stereo display Ensure that the red lens goes over your left eye You can view the stereo effect with anaglyphic glasses that have the red lens over the right eye by entering a negative value for the Stereo Angle on the Volume Settings tab of the Edit Properties window see Customizing volume settings on page 16 Important You cannot rely on this mode when making clinical decisions Stereo effect has significant limitations depending on your position relative to the screen As you move left or right up or down the stereo volume will warp As you move closer or further away the stereo volume will shrink or expand respectively If you turn your head so one eye is above the other the stereo effect will vanish To view the volume in stereo mode 1 Choose one of the following options e On the Tools menu click Toggle Stereo e Click 2 To change the strength of the stereo effect adjust the stereo display settings by following the procedure outlined in Customizing volume settings on page 16 3 To toggle the stereo display off click again Note You cannot activate the volume MPR tool while in stereo mode see Creating MPRs from 3D volumes on page 73 Using the black outside WINDOW setting This setting causes all pixel values above and below the conventional window to be set to 0 for the purpose of 3D rendering and appear black in the 3D imag
74. ow in order to accommodate your preferences To move the toolbar e Choose one of the following options e Select the toolbar and drag it to a new location e On the ToolBars menu click one of the default locations e Right click anywhere in the toolbar and select one of the default locations The new location becomes the default for the toolbar Customizing the toolbar There are a number of features available in eFilm Lite that allow you to customize the look and feel of your toolbar All of these features are accessible via either the ToolBars menu or the pop up menu that appears when you right click anywhere in the toolbar region Note All tools are also found in the Tools menu however not all tools listed in this menu are available on the toolbar To customize the number of toolbar icons displayed e Select one of the following options e Minimal displays only the toolbar icons common to all modalities e Standard displays all of the toolbar icons relevant to the modality of the study displayed in the eFilm Lite window e Full displays all of the toolbar icons available in eFilm Lite To customize the size of the displayed toolbar icons e Select one of the following options e Small displays only the toolbar icons common to all modalities e Medium displays all of the toolbar icons relevant to the modality of the study displayed in the eFilm Lite window eFilm Lite User Guide 7 eFilm Lite Overview e Large
75. owing options e On the Tools menu click Change Filter Settings e Click In the case of the CLAHE Contrast Limited Adaptive Histogram Equalization Filter the CLAHE Filter Settings dialog box appears x Clip Limit Value Number of Bing E 256 Number of Contextual Regions Horizontal Vertical f2 2 Adjust the Clip Limit Value 1 10 000 Increased clip limits correspond to increased image contrast The default value is 1 which indicates no filtering 3 Adjust the Number of Contextual Regions 2 16 The Horizontal value determines the width of the image and the Vertical value determines the height of the image The eFilm Lite User Guide 47 Manipulating Images default value of each of these parameters is 2 A higher valued is usually optimal Both sample filters require some user experimentation in order to achieve the optimal values for each parameter Note The only parameter provided in the Sharpening Filter Settings box is Mask Size This parameter is expressed in pixels and is restricted to four options A higher Mask Size requires a longer processing time however the parameter option chosen must be appropriate for the size of the image being manipulated 4 Click OK to save your changes or click Cancel to exit without saving Note If you change the filter settings and want the settings to be applied to the selected image you must either click Apply Image Filter on the Tools menu or click z Image filter settings are not ap
76. ows or by entering the value manually 5 Click Apply to save your changes Note To restore the original image display value except window level click l To set pixel for pixel spacing 1 Select the required series 2 Choose one of the following options e On the Tools menu click Zoom Options e Click the arrow to the immediate right of The Zoom pop up menu appears 3 Select Pixel for Pixel from the Zoom pop up menu The image is adjusted to its true pixel for pixel setting Resetting the original image settings The Reset Image Settings tool restores the original values of an image You can reset the image settings after measuring zooming panning changing orientation annotating or matching field of view However the reset will not affect changes due to filters DSA or window level settings To reapply original image settings e Choose one of the following options e On the Tools menu click Reset Image Settings e Click Adjusting series viewing options eFilm Lite includes tools for adjusting the selected series view This section shows you how to e increase or decrease the size of the image panes used to display a series see Exploding series on page 44 e apply or remove the modality shutter see Toggling the shutter on page 44 e match series in the same plane to scale see Matching field of view on page 45 eFilm Lite User Guide 43 Manipulating Images Exploding series
77. plate tool selected rotates the template Refer to Orienting templates on page 84 Locking and unlocking templates Once a template has been repositioned rotated and resized you can lock it to ensure that accidental changes to any of these parameters do not occur To lock a template 1 Right click the template The Template pop up menu appears 2 Select Locked from the Template pop up menu The template turns red and will no longer respond to any move rotate flip or resize commands Note A check mark appears beside Locked when the Template pop up menu appears for a locked template To unlock a template 1 Right click anywhere on a locked template The Template pop up menu appears 2 Select Locked from the Template pop up menu The template reverts to blue and will now respond to any move rotate flip or resize commands Note These colors are the defaults which can be changed by following the procedure outlined in Customizing template settings on page 19 Attaching and detaching templates Composite templates can be attached to each other when placed over a patient s image Attached templates can be separated Note Templates can only be attached in a tree format they cannot be cyclical attachments To attach templates 1 Load the required templates see Selecting templates on page 81 2 Select the Show Attachment Points check box on the Template Settings tab of the Edit
78. plates eee eee eseeseeeseeeseeeseeeaeeees Hiding and showing templates ioniese i ites Ole E dea niatats Displaying template labe esrcerrcneon ra R Deleting templile Saena A AN File and Directory Structure Overview eFilm Lite User Guide eFilm Lite User Guide eFilm Lite Overview eFilm Lite is a more basic version of eFilm which is an application used for viewing and manipulating medical images Digital images and data from various sources including CT MR US RF units computed and direct radiographic devices secondary capture devices scanners imaging gateways or imaging sources can be displayed on workstations and laptops using this software When viewing images users can perform adjustments of window width and level image stacking annotation and measurement of regions of interest and various image alterations In this section you will learn how to e meet minimum system requirements see System requirements on page 5 e understand the layout of the eFilm Lite workspace see eFilm Lite window on page 6 e customize the eFilm Lite toolbar and access the Mini bar see Using the toolbar on page 7 e understand the functions of the tools in the eFilm Lite toolbar see Using tools on page 8 System requirements This section describes the hardware and software required to run eFilm Lite Required hardware eFilm Lite must run on a computer that meets the following hardware requireme
79. plied automatically Using image fusion eFilm Lite assumes image sets are registered in space they will not adjust position to ensure alignment This section shows you how to e fuse two modality image series together see Fusing two modality image series on page 48 e adjust the Alpha setting see Adjusting the Alpha setting on page 49 e configure the image fusion pipeline see Configuring the image fusion pipeline on page 50 Fusing two modality image series You can fuse two series from the same study together to combine CT images with PET images To fuse two modality image series together 1 Opena study taken with CT and PET modalities 2 Choose one of the following options e On the Tools menu click Image Fusion e Click 3 The Fusion Series Generator dialog box appears which indicates the progress of the image fusion stage Fusion Seres Generator Preparing fusion seres Loading image information i 48 eFilm Lite User Guide Using image fusion Once generated the fused series appears in the right hand pane of the main window while the background series appears in the left hand pane and the foreground series appears in the middle pane J a i i a3 i a3 i i a i i i i i a pmm J J J j l 2 a Not
80. pop up menu Rotating 3D volumes There are two ways to rotate a volume manually or preset selection To rotate the volume manually 1 Choose one of the following options e On the Tools menu click Rotate Volume e Click 2 Position the cursor over the volume left click and drag the cursor over the volume The volume rotates in the direction of the mouse movement 3 Release the left mouse button to set the volume at the new rotation To use the preset rotations 1 Select the volume 2 Choose one of the following options e On the Tools menu click Rotate Volume e Click the arrow to the immediate right of The Rotate Volume pop up menu appears 3 Select either Anterior Posterior Left Right Superior or Inferior to rotate the volume to one of the standard anatomical orientations The cube in the bottom right corner of the image pane shows the current rotation of the volume Note You can also use the Flip Horizontal Vertical and Rotate Left Right 90 Degrees tools to change the orientation of the image as outlined in Changing image orientation on page 40 66 eFilm Lite User Guide Using 3D images Viewing 3D images in stereo display mode By default the rendered volume displays as a monoscopic image Displaying the image in stereoscopic mode removes ambiguity between front and rear anatomical structures All 3D operations can be done in stereo mode including rotating cropping and windowing Y
81. ppings A number of predefined color and grayscale mappings grouped by anatomical regions are available which you can load from the Preset menu To load color or grayscale mappings from the Preset menu 1 Choose one of the following options e On the Tools menu click Opacity Settings e Click The Color Opacity Settings dialog box appears 2 Select the color mapping name from the drop down list and click Load Presets Note If you are using B W Setting the presets displayed will correspond to grayscale images see Assigning grayscale mappings to 3D volumes on page 69 Editing color grayscale mappings To edit color or grayscale mappings 1 Load the color or grayscale mapping that you want to edit see Loading color grayscale mappings on page 70 2 Click Add Preset The Edit Dialog dialog box appears 3 Modify the Opacity Name and click OK 4 Click Save Presets The color or grayscale mapping is added to the Preset drop down list Note To remove a color or grayscale mapping select it and click Delete Preset Creating MPR images Multi Planar Reformatting is a technique that passes a plane through a data set so that the user can view the volume from a different direction than that of the original images In effect you can view the image data from different viewpoints without having to rescan the patient 70 eFilm Lite User Guide Creating MPR images You can create MPR views of
82. re finished viewing a study you can close the study without exiting eFilm Lite To close a study e Choose one of the following options e On the File menu click Close e Click x 28 eFilm Lite User Guide Navigating Images This section covers selecting and moving through images and series In this section you will learn how to e navigate through images in a series see Moving through images on page 29 e navigate through series in a study see Moving through series on page 32 e navigate between studies see Moving through studies on page 32 e synchronize series see Synchronizing series on page 32 e locate points on an image in 3D space see Locating points in 3D space on page 33 Moving through images There are four different ways in which you can navigate through the images in a series e Next Previous Image allow you to move through the images of a series one at a time see Using the toolbar to move through images on page 29 e Scrollbar allows you to either move through images one at a time or easily scroll though the images of a series see Using the scrollbar to move through images on page 30 e Stacking allows you to quickly and easily move through the images of a series see Stacking images on page 31 e Cine dynamically displays the stacked images for a video display viewing see Using the Cine tool on page 31 Using the toolbar to move
83. rement tools Probe Tool Gives a pixel or a Hounsfield unit value for a given ta point Measurement Tool Arrow Draws an arrow gt Measurement Tool Line Measures linear distances Measurement Tool Ellipse Measures an elliptical region of interest 3 Measurement Tool Show Angles Measures an angle between two intersecting lines Clear Measurement fouls Erases all measurements from all images in a selected series aoe Calibrate Measurements Manually calibrates images 10 eFilm Lite User Guide Multiplanar tools ee e ie a a H EE Show All Reference Lines Show First and Last Reference Lines Show Current Reference Line Auto Series Synchronization Manual Series Synchronization 3D Cursor Measurement Tool MPR Auto Generate Orthogonal MPR Tools Image Manipulation tools E F cea Flip Horizontal Flip Vertical Rotate Left 90 Degrees Rotate Right 90 Degrees Invert Digital Subtraction Angiography Toggle Shutter Match Displayed Field of View Using tools Shows the location of all the images with reference lines Shows the location of the first and last images Shows the location of the currently active image Synchronizes images that are related to each other spatially and scanned during the same exam For example it will not synchronize images from the same patient from different studies Locks series belonging to the same patient together by image location Synchron
84. rily saving the MPR series the MPR series will be lost and will need to be recreated when you reopen the study e You can adjust your MPR view by manipulating the MPR lines for 2D images or by manually rotating the plane independent of the volume by highlighting the plane to select which item you want to rotate for 3D volumes For details see Adjusting the MPR view on page 73 e You can adjust the slice separation used to create your MPR view on the Volume tab of the Edit Properties window see Customizing volume settings on page 16 Adjusting the MPR view You can adjust the MPR view in two ways either by rotating or by repositioning the MPR line To rotate the MPR line 1 Right click either end of the MPR line The line changes from orange to green eFilm Lite User Guide 73 Creating 3D Images 2 Drag and drop the end to the new location To move the MPR line 1 Right click anywhere on the MPR line The line changes from orange to green 2 Drag and drop the line to the new location Note The corresponding MPR view is dynamically updated as you are rotating or moving the line that defines the MPR plane You can also move the MPR line by stacking through the slices on the MPR view As you stack through the slices the MPR line is dynamically updated to reflect the new viewing plane on the original image Creating MPR slabs MPR slabs add depth to a group of MPR slices To create an MPR
85. rion Adjusts the brightness and or contrast of the image You may specify whether this is done interactively or via LUTs included as part of an image header Adjusts the coherence and or black white bias settings of the image Magnifies the area of interest within the image You may define the percentage of magnification Repositions the images in the window Manually increases or decreases the image s field of view Resets the original image settings after manipulations except the window level settings Hides or displays the written study information and scale bar displayed in the window Allows the user to add and position text in the image Automatically cycles through the images in a series Redisplays series and images in various layouts on the screen Explodes images to fill the screen and returns to the former layout Selects all series currently displayed Selects deselects all images in the selected series Displays more information about the patient and study Fuses CT PT images together eFilm Lite User Guide eFilm Lite Overview Next Previous tools Previous Study Loads the previous study from the CD Next Study Loads the next study from the CD Previous Series Loads the previous series within the selected exam Next Series Loads the next series within the selected exam Previous Image Loads the previous image of the series Next Image Loads the next image of the series Measu
86. row to scroll forward or backward through the stack or click and drag the scrollbar up or down 30 eFilm Lite User Guide Moving through images Stacking images Stacking allows you to move quickly and easily through the images of a stacked series To stack images in a series 1 rA Select the required series Optionally choose one of the following options to define how you want the images to be sorted e On the Tools menu click Stack Options e Click the arrow to the immediate right of The Stack pop up menu appears Optionally select how you want to sort the images in the stack You can sort by Image Number Slice Location Reverse Slice Location Acquisition Time or Image Time Position the mouse pointer over the series and click and drag it up or down within the pane The sort criterion you select becomes the default until it is changed again Therefore if you do not want to change the sort criterion click and follow step 3 Note Stacking becomes faster once you have loaded all images in a series into memory by viewing them To automate this you might consider using the Cine tool see Using the Cine tool on page 31 Using the Cine tool The Cine tool allows you to view stacked images dynamically in a movie like display format To use the Cine tool 1 2A 3 Select the series you want to view Choose one of the following options e On the Tools menu click Cine e Click Th
87. s 10 29 probe 59 reset 43 shutter 44 template 12 volume 12 73 zoom 42 U unlocking templates 85 users advanced settings 14 preferences 13 V viewer configuring 22 opening 21 viewing image options 41 image text 53 images in stereo 67 matching fields 45 94 eFilm Lite User Guide MPRs 70 orthogonal MPR planes 71 reference lines 38 series options 43 stacked images 31 studies 22 study information 24 template labels 87 volumes creating MPRs 73 cropping 65 exporting as AVI files 78 loading parameters 63 rendering 61 rotating 66 settings 16 stereo display mode 67 tools See tools W window levelling custom presets 37 manual 35 non linear 38 presets 37 sensitivity 36 settings 35 workspace 6 Z zooming images 42 eFilm Lite User Guide 95 96 eFilm Lite User Guide
88. s 13 modifying See editing monitors single or dual 15 moving image markers 17 MPR line 73 template labels 87 templates 83 through images 29 through series 32 through studies 32 toolbar 7 MPRs configuring view 73 creating from 2D images 72 creating from 3D volumes 73 creating slabs 74 deleting view 74 interacting with series 73 orthogonal viewing planes 71 saving view 74 viewing 70 multiplanar tools See tools multiple image fusion 48 studies 26 N next tools See tools non linear window levelling 38 notes regulatory ii O opening mini bar 8 viewer 21 operating system 5 orienting images 40 templates 84 orthogonal viewing planes 71 orthopaedic templates See templates overlaying reference lines 38 text 53 overview eFilm Lite 5 filters 46 templates 81 toolbar 7 tools 8 P panes arranging 23 panning images 41 password encryption 25 pipeline image fusion 50 points in 3D space 33 positioning See moving preferences editing 13 system 15 presets configuring custom 37 See also window levelling previous tools See tools printing images 80 prior to use iii probing images 59 Q quitting See closing R reference lines 38 regulatory notes 11 removing See deleting requirements 5 resetting image settings 43 resizing templates 84 resorting studies 22 rotating images 40 MPR line 73 templates 84 volumes 66 S saving MPR view 74 screen layout 13 25 scrolling through imag
89. seeeseeeseeeeeeaeeeaeeeaes 25 Adjusting the screen layout serris derin n 25 Comparing multiple studies rude caswessccipoaususssenaneuesneaioeanddanosanut ates 26 BElCCUNG imaces ANC SENES sesiis prne EnSan aaa 27 OC NAS eat E NT deta laste ton E E 27 E E E a E T O E 28 Eea E Te e AEE E E E EE trae E E E 28 eFilm Lite User Guide Chapter 4 Chapter 5 Chapter 6 Navigating Images Movine tir OU Fima ES oere n E toaumpsestoass Using the toolbar to move through images esessseserereres Using the scrollbar to move through images sssr DEACKIING Via CCS onia E N Usme Te Cite Tool soseri deschmustavacss Moving hrOUeh series arami Anen a A TNN Movino TOUS HS tUdiES srecno duces sebanctvideastsrdiatvensaneddes SVACATONMI ZUIO SENES e a eetadbtot torres Synchronizing series automatically eeeeeeeeeeeeeeeeereereere Synchronizing series manually iss iennen a LOCATE POMS INO SPACE asisas aa etyncnstaeedonacceednts Manipulating Images Setting window level vales asearsacutentacanassainutoct ae snenia an Adjusting window level settings manually eeens Using window level presets ce ceeeeeseeeseeeseeeseeeseeeseeeseeeseens Using non linear window leveling eee eeeeeeeeeeeeeeseeeeeens Merino LIE RES ia a E E Overlayine reference Ines minnn E EN Changing image orientation ssesseseeseeseeseeresresrrsrrsrrerrsrrerrerrsrrerrerreeses Adjusting image viewing Options s ssssessesreererrsrrsrrsrrsrrsrrerrserees
90. sereeee Fe OUNCE deus caciasdos tasscteavaneboumacedaantevauanseananshestedhdetnnds xtavatgeeneanromeemnoatte IVDO Eo INS les bitches a E etna nicl ZOOME aar A a E Resetting the original image settings essesseseerrerrerrerrerrerrsrrerrerrees Adjusting series viewing Options essssssseseeerereeresrrsrrsresrrerrsereesserseee Exploding serne S ona E E Togene Me SMUE aese e e Matchine field OF Vi W sonara N Adjustine ina ses usine DSA srren a a Usine MCPS as Sata Rsbaceaen 08 Pca atest atte caves dasensemimas re etuasune toutet Prd dine filters t e Ui Lite serranon a Applying Alters tO IMac eg aa beth asted se a Chane Mier seNe S ssprsegira iarr sae Usine mageso aeea a nhs ceicae tease tuiskesaueaaicunc shoes Fusing two modality image series cele eee eeeeseeseeeseeeseeeaeens Adjusting the Alpha setting 4 s cewiect cies e Configuring the image fusion pipeline ssec Annotating and Measuring Images Ovela vine TON seri E eines rare euaeccnns Annot UNE Tia ES ea e E E A ANEN Making linear measurements ccscic stesicventctinstaacedicteacedexterseasetedeeeinevses Making elliptical measurements esi cesses riuiiinaccliatesateaitinntencuniesss Drawn Arrow reeni a O AN Displaying angle measurements seeseseessereerrerrerrsrrsrrerrsrrsersereresereese Calibratne 1 ACES isson OE T PropNE IMAC CS anA R ER A Cl earine mMmegsure meN Ssssrircsa i EEA eFilm Lite User Guide Chapter 7 Chapter 8 Chapter 9 Chapter 10 Ind
91. setting To invert the color of images in selected series 1 Select the image to invert 2 Choose one of the following options e On the Tools menu click Invert e Click Overlaying reference lines Overlaying reference lines allow you to indicate the location of an image slice on another image of an intersecting plane Reference lines are only available for CT and MR studies You can show one of the following with this function e Location of all image slices of the selected series on all intersecting planes or 38 eFilm Lite User Guide Overlaying reference lines e Location of the first and last image slices or e Only the current image slice To display the location of all image slices 1 Select an image 2 Choose one of the following options e On the Tools menu click Show All Reference Lines e Click Note The number at the end of each line is the image number To display the location of the first and last image slices 1 Select an image 2 Choose one of the following options e On the Tools menu click Show First and Last Reference Lines e Click To display the location of the currently active image 1 Select an image 2 Choose one of the following options e On the Tools menu click Show Current Reference Line e Click eFilm Lite User Guide 39 Manipulating Images Note As you scroll through the images of a series the current reference line on other images
92. slab 1 Right click one of the circular nodes on an MPR line The line changes from orange to green 2 Drag and drop the node to the new location This specifies the thickness of the slab Note As you are changing the thickness of the slab that defines the MPR plane the corresponding MPR view is dynamically updated The MPR view is now an MIP of the portion of the stack defined by the slab Saving or deleting MPR views You can choose to delete an MPR view or save it as an additional series in the study Once saved the new MPR series can be sent to another device or reopened for viewing as you would any other eFilm series Note You can also export 3D volumes in AVI format using the Cine tool see Exporting volumes as AVI files on page 78 To save or delete an MPR view 1 Select the MPR line and press Delete A message box appears Note You can delete all MPR lines and views from a series by selecting the series and clicking You will be prompted to delete each MPR view you can click No to all in the message box that appears to avoid multiple prompts 2 Choose one of the following options e Click No to delete the MPR line and the MPR view 74 eFilm Lite User Guide Creating MPR images e Click Yes to save the series The MPR view will be saved temporarily i e the view will be preserved in memory as a temporary series that will be lost once you close the study Note If you right cli
93. ssary to display all the series in an exam select the AutoFormat check boxes Click OK to save your changes Note This feature is useful for CR skeletal surveys where eFilm Lite loads the images in survey mode You can then follow the procedure outlined in Exploding series on page 44 to move between individual images and the survey mode Customizing advanced user settings for a modality The Advanced tab in the Modality Settings tab of the Edit Properties window allows you to customize the settings for image display interpolation and tool behavior for each modality To change advanced user settings for a modality 1 2 3 4 On the Edit menu click Properties The Edit Properties window appears Click the Modality Settings tab and then click the Advanced tab Select the required modality from the Modality drop down list Adjust the settings as required by selecting the options provided in the Advanced User Settings pane 14 eFilm Lite User Guide Customizing system preferences None Fastest lowest quality f Bilinear Bicubie Slowest highest quality Q hile Stacking Separate mult echo sequences CL Allow window leveling of individual images or Auto Window amp Level algorithm Simple Histogram Analysis P71 Hide stacking eecrollbar The defaults for each modality are Bilinear Interpolation and Simple Window amp Level algorithm 5 Select one of the following options to i
94. t of the screen see Adjusting the screen layout on page 25 compare and contrast multiple studies see Comparing multiple studies on page 26 To view a study Select a study from the list and double click it to view it automatically or select a study from the list and click View Hold Ctrl to select multiple studies from the list The study appears in the eFilm Lite window and the toolbar is activated 22 eFilm Lite User Guide Viewing studies il cFilm Lite ANONOOOO 2005 Jul 20 00 00 00 7 WINAMP File Edit Utility ToolBars Tools Window Help MENE oa ENOL AAT n l weR ti AH e W400 L 40 For Help press F1 Note Images appear side by side in a grid default setting 1x2 like the films mounted beside each other on a light box This grid configuration can be adjusted by following the procedure outlined in Adjusting the screen layout on page 25 Arranging study series in panes When viewing a study each series within the study is loaded into a separate pane The active series is outlined in orange and the active image in a series is outlined with a green line il eFilm Lite ANONOOOO 2005 Jul 20 00 00 00 7 WINAMP m File Edit Utility ToolBars Tools Window Help l x mome T TE ENQ S For Help press F1 eFilm Lite User Guide 23 Viewing Images To place a series in a particular pane 1 Right click the pane where
95. te Resize Template tool selected resizes the template Refer to Resizing templates on page 84 To flip a template 1 2 Right click anywhere on the template to display the pop up menu Choose one of the following options e Select to flip the whole image horizontally e Select to flip the whole image vertically Click either or to flip the whole image horizontally or vertically respectively Note A horizontal flip is a reflection of the template on the Y axis A vertical flip is a reflection of the template on the X axis Resizing templates Resizing a template allows you to switch between the available sizes of the currently selected template To resize a template 1 Load a template by following the procedure outlined in Selecting templates on page 81 Choose one of the following options e On the Tools menu click Rotate Resize Template e Click 84 eFilm Lite User Guide Locking and unlocking templates Position the mouse pointer anywhere over the template which changes color Right click and holding the mouse move up to decrease and down to increase the size of the template which will be displayed while you are resizing The template can also be resized by right clicking on it This displays a pop up menu from which a new size can be selected 5 Release the mouse button when the template is resized as required Note Moving the mouse side to side with the Rotate Resize Tem
96. the Template pop up menu to display the template label To move the template label 1 Choose one of the following options e On the Tools menu click Move Template Label e Click 2 Click anywhere on the label and drag and drop it to a new location Deleting templates You can remove a template from an image at any time Note You can hide the template from view instead of permanently removing it by following the procedure outlined in Hiding and showing templates on page 86 To delete a template 1 Right click anywhere on the template The Template pop up menu appears 2 Select Delete from the Template pop up menu The template disappears from the image Note Once a template is removed from an image the removal cannot be undone If you wish to reinsert a template after removal it must be reselected repositioned rotated and resized all over again eFilm Lite User Guide 87 Managing eFilm Ortho Templates 88 eFilm Lite User Guide File and Directory Structure Overview This section offers an overview of the file and directory structure for eFilm Lite In earlier versions of eFilm Lite images were stored by their UIDs However issues in character length arose in some systems that truncated UID strings that exceeded the maximum character length This issue was circumvented in eFilm Lite 1 9 where images are assigned under the following directory structure DICOM gt Patient gt Study
97. through images The Next Previous Image buttons allow you to move through the images in a series one at a time To go to the next image in a series 1 Select the required series 2 Choose one of the following options e Click e Press PgDn To go back to the previous image in a series 1 Select the required series 2 Choose one of the following options e Click eFilm Lite User Guide 29 Navigating Images e Press PgUp To go to the beginning or end of a series 1 2 Select the required series Choose one of the following options e Press Home to go to the beginning of the series e Press End to go to the end of the series To go to a specific image in a series 1 2 Select the required series Choose one of the following options e On the Tools menu click Stack Options e Click the arrow to the immediate right of The Stack pop up menu appears Select Goto Image The Goto Image dialog box appears Goto Image X mz rea Enter the image order number and click Goto to display the required image Using the scrollbar to move through images The scrollbar allows you to both move through images one at a time and scroll easily though the images of a stacked series To scroll through images one at a time Click the Up or Down scrollbar arrow once to move to the next or previous image in the series To scroll through images of a stacked series Click and hold the Up or Down scrollbar ar
98. ting the MPR view on page 73 e create a slab from the MPR view see Creating MPR slabs on page 74 e save or delete the MPR view see Saving or deleting MPR views on page 74 Creating Orthogonal MPR viewing planes The Auto Generate MPR tool allows you to automatically create three MPR views two orthogonal MPR views that are perpendicular to the image plane and one that is at 45 to the other two views To automatically create the two orthogonal plane MPR views 1 Select the appropriate series 2 Choose one of the following options e On the Tools menu click Auto Generate Orthogonal MPR Tools e Click eFilm Lite User Guide 71 Creating 3D Images The MPR views are generated and the screen layout is automatically adjusted to 2 x 2 displaying the original series in the top left corner and the three MPR series in adjacent panes We SAMPR 3 i E t Lin DYN 4 1d DYN W 1500 L 450 Note You can adjust your MPR view by manipulating the MPR lines 3 With the original series selected click again to remove these lines and corresponding views If you close the study prior to saving the views temporarily the MPR views will be lost and need to be recreated when you reopen the study Creating MPRs from 2D images The MPR tool allows you to create an arbitrary MPR view from a two dimensional image To create an arbitrary MPR view from a 2D image 1 Select the appropriate series 2
99. using the spinbox arrows These values define the boundaries for each band range Adjust the Opacity and Sharpness values by entering them manually or using the spinbox arrows Opacity illustrates the intensity of the color value Sharpness illustrates the clarity of the color value Click the X in the upper right hand corner to close the Color Opacity Settings dialog box The image is updated according to the new color mapping Note To save these settings to the Preset menu then follow the procedure described in Editing color grayscale mappings on page 70 Assigning grayscale mappings to 3D volumes The Opacity Settings tool allows you to assign grayscale mappings to ranges within a CT or MR study This feature is only available for volume rendering it will not function with Simgram or MIP images To assign grayscale mappings to a range in the study 1 2A Select the required study Choose one of the following options e On the Tools menu click Opacity Settings e Click Click B W Setting The Grayscale Opacity Settings dialog box appears Grayscale Opacity Settings X Window Level Auto Opacity Setting Window 560 DICOM Setting J23 z Level e Load Opacity Preset Save Opacity Preset Add Preset Delete Preset Position 1204 0 2206 Invert Abdomen_Muscle Click the or buttons to zoom in or out and the lt or gt buttons to pan left or right N
100. you wish to place the series A pop up menu appears The series that is currently occupying the pane is checked in this menu 2 Select a series from the menu using the left mouse button Note The pop up menu displays all the studies belonging to a patient as long as they are available on the CD 3 Ifthe series is currently displayed and you want to move it to another pane hold Shift select the series you wish to move and drag and drop it in a different pane Viewing study information Study information can be requested while viewing the study Note If confidential patient data is encrypted you can decrypt it by entering the encryption password see Setting the encryption password on page 25 To view study information 1 Open and view a study 2 Click E The Study Information dialog box appears BS Study Information DOE JOHN 400 J333 555 jarr Sex h Histoy R20 SUBDURAL CHANGE 2001 May 25 Time 14 32 25 0 Description BRAIN Contrast P Machine ns Admitting Diagnosis M D s Technologist Referring MO NAME Radiologist KE LLY Performing Technologist TIM 24 eFilm Lite User Guide Viewing studies Note If the patient s History field is longer than 64 characters only the first 52 characters will display and lt TRUNCATED gt will appear at the end of the line to indicate that the field has been truncated for display 3
101. yout settings and other image viewing tools see Common tools on page 9 e Next Previous navigate between studies series and images see Next Previous tools on page 10 e Measurements measure regions of an image see Measurement tools on page 10 e Multiplanar work with MultiPlanar Reformatting MPR images see Multiplanar tools on page 11 e Image Manipulation rotate flip and invert images and related functions see Image Manipulation tools on page 11 e Image Processing select and apply image filters see Image Processing tools on page 12 e Templates apply orthopaedic templates to an image see Template tools on page 12 8 eFilm Lite User Guide Using tools e Volume view and manipulate images in three dimensions see Volume tools on page 12 Main tools x Common tools 4 4 Q E J E Search Close Window Stack Window Level Alpha Coherence Beta Black White Bias Magnification Pan Zoom Reset Image Settings Toggle Overlay Add User Annotation Cine Screen Layout Toggle Survey Explode Mode Select All Visible Series Select Deselect All Images In Selected Series Show Study Information Image Fusion Opens a list of patient studies available for viewing on the CD Closes the current study being viewed Manually scrolls through images within a series You may define the sort crite

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