Home

10 Fusion 3D CAM - Medical Insight

1. 1 10 Product Complaints Any health care professional who has any complaints or has experienced any dis satisfaction in the quality durability reliability safety effectiveness or performance of this product must notify Medical Insight A S If the device malfunctions and may have caused or contributed to a serious injury of a Chapter 1 patient Medical Insight A S must be notified immediately by telephone fax or written cor respondence to Medical Insight Customer Support at support medical insight com Further Medical Insight A S service support addresses all over the world are accessible on the web site at www medical insight com 1 11 Messages Under certain conditions Easy Viz will show a dialog box in the middle of the screen con taining a message This message will tell that either a problem has occurred or that a requested action cannot be performed The user must read these messages carefully It will provide information on what to do from then on Details on the contents of messages can be found in the service documentation which is available to Medical Insight A S service personnel Figure 1 2 Message Start Bu ss so Fs 8B amp PACS WFM General 2D admin 10 18 File Edit View Tools Help Grayscale X 1 Problem Report QEII Victoria General ized NM MILLENNIUM MPR 41 A2392429 Anonyrnized Multiple matching hanging protocols 1 2003 06 11 n x Primary Images Missing
2. EasyViz 4 User man Medical Insight A S Krumtappen 4 3 DK 2500 Valby Denn 45 4655 0444 www medical insigh helpdesk medical ins Manual version 01 03 2012 i este B x dini m 9 Medical Insight _ 0 Table of Contents MICI ED EG II ERE T T NT ET 0 1 Scope of this Manual 0 0 0 0 ccc ccc cece ccc cc ccccccccccecccceeccceeeceseeeeseeeceseees 1 UE M d Sd RERO ERE NU ETC l CODYN CL ei a RERO l E EOM eea E E E E ELLA aT DUE l 1 4 Cautions and Warnings 0 0 20 c cece c cece cece cece cece cece eceeeeeeeeeeeeeeeceeeeseeeeeees 2 KBL sse EE ee eee ee ee 2 1 6 Indications for Use Intended Use s sss ne ne 2 1 7 System Docurmentatlon c suco onte sen E dede Ce d cepi Mecd d ddeeewsSueaales 3 LESEN BAE io ARN OT ERRORI TREE 6 1 5 UNA AMMO ITE sooo Sante nee eg es Mee ap ae lab ie eid tee Lae DE EIS E DLL D I A A AG DLE 6 1 8 1 EC MDD Directive 2 0 0 00 c cece ene ence nes lene ses resins 6 WS oStdnd dide cce ben ci rut DS AQ MD M C D ELLE A eae ed 6 1 8 3 Configuration oi itenduiticietiecdsyeatuadbatidddasedoudadedauadaeishidesdshehideded bbs ialcdadees 7 1 9 Connectivity and Installation 00 0 00 0 e eee e cece eee eeeeeeenseeeues 7 1 10 Product Complaints 20 2 0 0 220 c cece cece cc ccccceececcecccececucececceeeccseeeceees 7 MSM INTC GS A E E tet teat a foal ee E T cee E E cose yak ale A A EES AET 8 1 111 Translations RE EE a a acao r eieiei iea 9 MMi ALG b DI
3. 24 Chapter 3 The Show Prefetched Studies dialog under the File Menu in the WFM Menubar shows which patient data resides on the local workstation as part of prefetched data 3 3 Import of Images It is possible to show the contents of a CD or DVD that contains DICOM data in WFM Besides being able to work with DICOM data on a local workstation it is also possible to import the image data to the PACS archive e Select Open DICOM CD ROM DVD from the File menu which will display the con tents of the CD DVD in the Workflow Manager window e Then select the series that are to be sent and stored in the EasyViz archive and complete by selecting Send Selected Images to the PACS Archive 3 4 Export of Images 3 4 1 To CD ROM DVD The export functions in EasyV iz are used to save selected studies or series from the PACS archive to a CD ROM or DVD By selecting one or more studies and clicking Export Selected Images to DICOM CD ROM DVD mn the File the Export dialog presents the following sub sections Export station Fileset ID Label Export format for images Export format for data 3 4 2 To Other Archive To transfer images to another archive do the following 1 Mark the studies to be exported 2 Choose Transfer Selected Objects in the File menu 3 The dialog shows the destinations to choose from 4 Press Send Figure 3 7 Export Images to Archive Q Anonymized 2392429 41 A2392429 3Study CT ABDOMEN BIL
4. 8 B3 B8f PACS WFM General 2D admin 15 29 Name Xray HeadAngiol ID XAHEADI ime Image 4 133 WW 2400 WL 900 LINEAR iW 293 WL 2006 LINEAR WW 2400 WW 293 CAR Presentation AUTO GENERATED FROM IMAGE Presentation AUTO GENERATED FROM IMAGE To turn off the display of image subtractions for all image data in any series press Toggle Image Subtractions NOTE Itis possible to save all image subtraction steps as Presentation State objects in Compound Presentation States as described in chap ter 7 When a study or series containing image subtractions is loaded as a compound presentation a dialog is displayed requesting con firmation to apply the subtraction steps to the image data 9 8 Shutters in General 2D CAM Display Shutters are overlaid onto images to determine which areas of an image are vis ible Display Shutters are used to focus upon an area of interest in an image and to remove areas of distraction from an image Figure 9 16 The Shutter Toolbar may os Chapter 9 There are three types of Display Shutters rectangular circular and polygon Only rectangular and circular shutters can be added and edited in Easy Viz polygon shutters can be viewed if they come with the image After activating either the Rectangular Shutter KJ or the Circular Shutter amp from the tool bar click in an image and drag the mouse button to size the shutter The first click with the mouse button
5. hg b o ID 1 0 B20f Date 04 17 2003 Date 04 17 2003 a Za S LJ i b Jl H 4 P m ka E 5 Se Se WW 400 Hu WL 30 Hu SUBE V WW 400 Hu WL 30 Hu Name CTH2GHR EN a 4 VAM Name CTFOT F z a a ID RSNAO6 A76270 1 0 B20f l l i a SERB WW 400 Au wr 130 Hu Overview Volume Focus PID RSNA06 A76270 To grab and move a POI place the cursor over the POI Le ft click tdrag To delete a POI click on it and press Deleteon the keyboard Alternatively click on it in the bookmark list in the sidebar and press Delete on the keyboard POIs are saved and loaded from compound presentations as described in chapter 7 To deselect the tool Right click or use the tool in the toolbar 9 16 Vessel Tracking Blood vessels in a MR Brain Angiography MRA series can be extracted and displayed ae along with an MPR via the Vessel Tracking feature in the toolbar which activates the function To toggle it off press the small icon displayed in the image pane The dialog Select New Threshold opens after activation and a threshold for the blood ves sel intensity can be set The threshold can be set on a calibrated scale from 0 100 and the threshold slider controls the amount of voxels that can be included in vessel segments If the slider is positioned at 1006 it corresponds to 4 4 percent of the volume and a slider position of 0 corresponds to 1 1 percent of the volume The scale is
6. 1 NM CCK FLOW diit J 3 2 2011 08 24 SC ny 3 2011 08 24 PR Pr 2002 01 16 RX ABDO 2002 01 15 RF ERCP 2002 01 15 CT ABDO 2002 01 07 MR UPPE 2001 12 31 RX DWZ 2001 12 31 CT UPPEFf Multiple hanging protocols match the primary study equally well Applying the first of 2001 12 29 RX ABDO 00 OC Ut 4 UN NM automatic Automatic with priors x Show details Mac 4 53 Image 1 45 WW 1492 WL 746 LINEAR Series CCK FLOW Presentation FAUTO GENERATED FROM IMAGE Error Primary Images Missing PID 41 A2392429 HP NM automatic Cleaning and Maintenance Since the product does not come in direct contact with the patient or is used in the same environment as the patient cleaning and disinfection of the product 1s not different from that of other IT equipment The system is maintained directly at the server and thus the user does not have to take any special precaution regarding maintenance Environmental Protection EasyV1z is a software program and thus does not impact the environment negatively Med ical Insight A S recommends hardware to be used and treated in an environmentally friendly manner Scope of this Manual For more information please refer to the following websites www medical insight com www dcm4che org 1 11 1 Translations DIRECTIONS FOR USE are available in the other official languages eg FRENCH at the request of the client ATTENTION la demande de l acheteur L
7. 2D CAM Image Subtraction 2D CAM Import Patient Data Inaccuracies Intro Indications for use Intro Insert measurement SUV 3D Intended User Intro Invert ISO Key Objects Loading 2D CAM Key Objects Saving 2D CAM Keyboard Shortcuts kVp Setting Virtual X Ray CAM 14 Index 43 39 39 33 48 48 80 27 49 50 56 25 73 49 56 56 22 75 85 Chapter 14 Liability Intro Limitations for mammographic viewing Intro Link Images 2D CAM Link Mode Mammo toolbar 2D Localizer and scout lines Localizers Hide 2DCAM Localizers Show 2D CAM Localizers Toggle 2D CAM Lock localizers 2D CAM Lock mode 2D Logging in Look up Tables Fusion 3D CAM Lower Window Fusion CAM LUT Viewer Tool 2D CAM 3D CAM Fusion 3D CAM M Magnifying glass Maintenance Intro Mammo 2D Mammography Imaging 2D Mamography Intro Marker Tool 2D CAM mAs Setting Virtual X Ray CAM Measurement Functions Intro Medical Equipment Intro Medical Insight Menubar Report CAM Menus Report CAM Messages Intro 86 53 6l 52 53 53 53 52 53 10 72 72 30 28 59 59 54 75 Ju TI MIP Slab MPR 3D CAM Mirror Image 2D CAM Monitors Image Display Intro More Information Mouse Shortcuts Movie Mode 2DCAM MPR planes N N point measurement Navigation in 2D CAM Network Intro New Report CAM O Omissi
8. Load Compound Presentation To bring up the Load Compound Presentation Dialog Box in 2D click on the Load Com pound Presentation function B8 in the File menu or use the keyboard shortcut Ctr1 L A dialog opens from which any available Compound Presentation for the selected study is displayed and can be loaded When a Compound Presentation is loaded existing Display Sets are replaced with new data and Display Sets To view all 3D Softcopy presentations for the chosen volume the Load Compound Pre sentation function B8 is opened in the File menu or via the keyboard shortcut Ctr1 L For 3D compounds small flags are shown on the list Green flag Y means active and red flag Y means in active Figure 7 1 Load Compound Presentation 3D Select Presentation Description Save Compound Presentation 36 Chapter 7 To bring up the Save Compound Presentation Dialog Box for both 2D CAM and 3D CAM click on the Save Compound Presentation function B in the file menu or use the keyboard shortcut Ctr1 S Figure 7 2 Save Compound Presentation Save Compound Presentation General PACS Destination Name BERERSRISEEN Study HEAD 3 31 10 X Key Objects Key Object Tile For Conference X Mark images with annotations as Key Objects Layout x Presentation State x window Width Level t Region of Interest Zoom Pan x x Annotations and Measurements x Shutters The dialog allows the user to specify the name of the compoun
9. Within the Profile Group 1 it 1s possible to edit the name type and owner of the profile displayed in WFM It also allows for the user to change the visibility and the level of the profile The Search dialog 1s opened by clicking on Search Criteria and the Mode selec tion determines which type of client hardware the Profile will be available on Profile Selector Via the Profile Selector 2 it is possible to adjust the viewing of the profiles by creating rules defining users and determining sequence and visibility of the profiles Columns in WFM Columns in WFM can easily be added 3 removed 4 or modified 5 To add a new column simply click on Add Column 3 in the toolbar at the top of the Profile Editor window To remove a column first click on a column in the bottom part of the Profile Editor win dow and then click on Remove Column 4 To move a column in WFM click on it and drag it to the new position in the table To modify a column click on the column label and edit it through the Column Properties 5 in the Profile Editor window The three scrolling menus 6 at the bottom of the Column Properties allow the selection of information to show the level of patient study and series Columns can be reset to their default configuration by choosing Reset Columns Width and Position from the Edit Menu in the WFM Menubar This modifies the current profile and saves the changes Show Prefetched Studies
10. is available in 2D 3D Fusion CAM and Virtual X Ray and is activated from a menu or toolbar or by using the Shift LeftMouseButtoncom bination Click in a window with the left mouse button and drag the mouse this results in the out lining of a rectangular region which represents the area to be zoomed It is also possible to zoom in 20 percent at a time by clicking with the left mouse button click in the image The function remains active until it is deactivated The Reset Pan Zoom button amp cancels all zoom motions or operations that have been performed for the selected image or series 4 4 Magnifying glass This function is available in 2D 3D and Fusion CAM and is activated from the tool bar or a menu to magnify the area on which it 1s held It is deactivated from the toolbar or menu as well or with a right click on the mouse 4 5 Exit The Exit function XX terminates the current CAM Any modifications to image data and other data are not saved unless an explicit storage step 1s performed prior to terminating the CAM for example saving a Compound Presentation State Administrators however are able to set up 2D CAM to Auto Save 4 6 The Sidebar The sidebar is available in all CAMs and its main feature is the Bookmark widget and the Patient Study Browser The sidebar is automatically displayed when the cursor is moved to the left side of the screen By clicking the pin button in the upper right corner of the sidebar the
11. 2261 images 1 217 foer PACS 4 Study WB MED KONTRAST HV 3518 images 0 2 3 KG 4 9 Study Adult 73 images 270305 L617 s 3Study TRAUME 1906 images j 30 N Advanced 09 4 9Study DTI Perfusion SPECTRO Auto generate MR _ 9Study DTI Perfusion SPECTRO 133 images PR MR SR j 3569 CASE General 2D 5 3 06 General 2D 5 3 06 47000920080723 KO US PR SR General 2D 9 16 08 270305 L617 KO SC PR CT SR General 2D 3 27 05 General 2D General 2D 6 22 06 6 22 06 sr R Search i Update In the WFM it is possible to search for patients via name patient ID or through image data When a series is found it is shown in 2D CAM or 3D CAM Figure 2 5 General 2D CAM File Edit View Tools Help Name OLSEN JAN gt M ID 140339 0905 Aalborg Sygehus Syd Philips Medical Systems MR Gyroscan Intera Study LUMB Date 11 17 2004 Time 10 02 18 CT y Laterality Pos Series COLLUMB SURVEY SSpC Protocol SURVEY SSpC Contrast Mag 2 46 Slice 2 Image 1 8 0 0 mm BodyPart Thickness 10 mm GR OSP TR 23 2779 ms TE 3 933 ms WW 2065 WL 1024 LINEAR Presentation AUTO GENERATED FROM IMAGE PID 140339 0905 HP Default with priors Group 1 Group 2 Figure 2 6 General 3D CAM 3 2 Introduction and Login File Edit View Tools Help lt gt P gt d ev v Name ABILDGAARD LONE F Name
12. 3D CAM 67 Slab MPR AvgIP 3D CAM 67 Slab MPR MinIP 3D CAM 67 Softcopy Presentation States 3D 36 Source Position Virtual X Ray CAM 75 Standardized Uptake Value SUV 3D 72 Standards Intro 6 Start Menu 15 Status of the report Report CAM 80 SUV Measurements 3D 12 Synchronize Images 2D CAM 53 System Documentation Intro 3 T Table Position Virtual X Ray CAM 75 Templates Presets Sidebar 3D 65 Text Annotation 2D CAM 54 Text Overlay Editor 2D CAM 33 the Main toolbar 47 Thumbnail images Sidebar 29 Toggle Scouts 2D CAM 53 Toggle Text Overlays 2D 3D 33 Toggle Zoom Pan Viewer Mammo toolbar 2D 61 Toolbar Report CAM 78 _ 89 Chapter 14 Tools Report CAM 78 Tools 3D 67 Tools and Annotations in 2D 47 Tools Menu Report CAM 78 Training Intro 6 True Size Mammo toolbar 2D 60 U Undo 21 Unzoom 28 Upper Window Fusion CAM 72 User Feedback 2D CAM 39 Using Online Help 2D CAM 39 V Verification Report CAM 79 Verify Report CAM 79 Vessel Tracking 3D CAM 69 View Menu Report CAM 78 Volume pane 63 W Warnings Intro 2 Warranty Intro 2 WFM 18 What s This Help Function 2D CAM 39 Width level 47 Width Level Color Sidebar 65 Wildcards WFM 19 Window Pane 14 Window Terminology 14 Workflow Manager 12 18 00 14 Index Workflow Manager Filtering Functions 19 Zoom 28 _9
13. ABILDGANRD L ONE F ID 0305571776 ID 0305571776 Series CEREBRUM COL CERV Fast Brain T2W TSE Series CEREBRUM COL CE Fasten NEED SE Date 10 31 2004 Date 10 31 2004 4 WW 385 WL 193 Name ABILDGAARD LONE F Name ABILDGAARD LONE F 5 6 1D 0305571776 X Lal hs 7 ID gt 0305571776 Series CEREBRUM4 C L CERV Fast Br ZA rS EC Series CEREBRUM Date 10 31 2004 Date 10 31 200 L SLAB WW 385 WL 193 SLAB WW 385 WL 193 Overview Volume Focus PID 0305571776 2 3 Introduction to CAMs The intention of the CAMs Clinical Application Modules is to present or process med ical images Easy Viz has four basic CAMs the General 2D CAM for most types of image data the General 3D CAM for volume reconstructions and multi planar refor matting MPR the Fusion 3D CAM for viewing of dual modality studies and the Virtual X Ray CAM for simulating 2D X ray images derived from 3D CT data sets An image or visualization CAM is a window in the EasyViz system that is comprised of a menu bar a toolbar and an area for image presentation or visualization All CAMs have the same construction but there are differences in the functions and features that are avail able in the menus and the toolbar There is also a difference in the way image data is dis played and processed among the different CAMs Window Terminology Images and other information are organized and shown within various windows in
14. CAM General 2D General 2D General2D General 2D General 2D General 2D General 2D General 2D General 2D Report General 2D General 2D General 2D General 2D General 2D General 2D General 2D General 2D General 2D General 2D General 2D PT KO SC PR CT SR General 2D Date 5 3 07 11 17 04 1 20 10 1 20 10 1 20 10 1 20 10 1 20 10 1 20 10 1 20 10 1 20 10 1 20 10 1 20 10 1 20 10 1 20 10 3 16 10 4 8 10 4 8 10 8 4 11 8 4 11 8 17 11 7 17 06 5 3 06 Tir 01 10 7 gt 8a Search Update An image archive can contain millions of studies The studies come from different types of modalities such as CR CT and MRI and are focused on various anatomical locations or features Furthermore various workflows and tasks are associated with the processing of these studies Profiles give the opportunity to select which studies or sequences are shown and how these are shown A profile is a combination of a specific set of search criteria and a template that defines how the results of the search should be presented to the user The search capabilities of the Workflow Manager can be set by the user or by a system administrator to display patient data in accordance with specialized needs or requirements This is done by creating new Profiles in the system If for example a user needs to see all 18 Chapter 3 X ray studies completed within the last five days a Profile 1s
15. In the 2D CAM Histogram objects can be shown for each image that is viewed To activate the display of a Histogram object for each image or series click on the Toggle Histogram button in the View Menu The diagonal line represents the LUT mapping between pixel values in the image data and the light intensity values of those pixels on a computer display By modifying this LUT mapping the display characteristics of the displayed image are modified CAUTION Histogram objects should only be used on pure grayscale images Edit Window Width Level Presets _ 4g 9 Introduction to General 2D CAM To create or edit a Window Width Level preset select the Edit function 4 to bring up the Preset Editor dialog The editor is composed of a name for the preset zero or more predicates a window width and a window level value a priority an origin and visibility value which determines to which groups of users a particular preset is available this selection can only be made by the system administrator It is possible to show non editable presets by ticking off the box in the left corner Figure 9 9 The Preset Editor for Width Level presets Preset Editor Preset Predicates Width Level Priority Origin Visibility MWN Preset 100 100 User Defined This User New Preset Show non editable presets a Cancel 9 4 2 Invert This function opens up a LUT inversion of a wished image or series The gray scale values are hereby i
16. Intro 7 DICOM HP 2D CAM 42 Directive Council Intro 6 Disclaimer Intro 2 Disinfection Intro 8 Display Set 14 Display Set Show Overview 2D CAM 51 Display Shutters 2D CAM 57 Distance Ratio Measurement 2D CAM 55 Doc CAM 76 Document CAM 76 Document Menu Report CAM 78 E Easy Mammo Survey 2D 6l _ 83 Chapter 14 Edit a report Report CAM Edit Shortcuts 2D Edit Text Overlays 2D CAM Edit the measurement SUV Edit Window Width Level Presets 2D CAM Editing Hanging Protocols 2D CAM Editing Profiles Enlarge Errors Intro Exit Export Patient Data Feedback Help Function 2D CAM Flip Image 2D CAM Floating localizer tool 2D CAM Freehand measurement Full pixel Mammography Further Information Fused images 3D Fusion 3D CAM Fusion toolbar 3D Fusion toolbar Automatic Rotation General 2D CAM General 3D CAM H Hanging Protocols Automatic Layout 2D CAM Hanging Protocols Changing 2D CAM Hanging Protocols Editing 2D CAM 84 79 31 33 74 48 43 23 28 28 25 39 52 22 55 6l 71 71 71 72 41 62 43 43 43 Hanging Protocols Safe tags 2D CAM Hardware specifications Intro Help Online Manual 2D CAM Help Functions 2D CAM Hide Text Overlays 2D 3D Histogram 2D CAM Histogram Toggle 2D CAM History Report CAM Home IEC IHE Image Compression Intro Image filtering Image Filtering Configuration
17. application NOTE V Pixel intensity measurements are only supported on monochrome images a Ye Chapter 9 9 6 Key Objects in General 2D CAM Key Objects are a standard DICOM methodology for identifying objects or changes to images as keys hereby helping other users to view information on objects and changes in patient data Figure 9 13 Key Objects Toolbar LE f m d Jx 1 It is possible to add a Key object by activating the tool Add to Key Objects Selection 1 and mark the image s wished as Key images To remove the mark of an image as a Key image press Remove From Key Objects Selection The Key Objects Selection Documents function 1 brings up a dialog which lists all Key Object Selection Documents for the current study or series It allows for activation or deac tivation of one or all Selection Documents If the Scroll Key Objects Only function is activated scrolling through a series of image data will display only those images marked as Key Objects If the study or series image data 1s viewed in side by side panes all images are shown To solely display images marked as Key Objects in a study or series press Show Only Key Objects Ye and images not marked as Key Objects will not be visible under any dis play mode Images marked as Key Objects contain an icon that indicates its status To un mark all Key object images in a study or series press Clear Key Objects Selection d 9 7 Image Subtractio
18. it is possible to delete items in the report if the report is not in read only mode Right click on the item that is to be deleted and click on Remove To zoom in the report hold down the Ct r1 key on the keyboard while either scrolling up or down on the mouse wheel or click either Ct r1 or Ctrl Menubar There are six default menus in the Menubar of the Report CAM sT a Chapter 13 e File Edit View Document Tools Help the functions below are described in detail as they contain functions not presented earlier The default menus File Edit and Help contain the same functions as in other CAMs A few tools from File are nevertheless mentioned as they are named differently here New B To create a new report click on New Then choose a template from the list that appears and click OK The new report will be created in a tab next to the report that was already open NOTE Creating a new report next to the original one can also be a way of V solving problems with reports containing errors which cannot be cor rected due to for instance lack of free text sections in the template The error can then be amended in the new report Save To save a report click on Save in the File menu or on the tool button BS in the toolbar The Save DICOM Objects dialog appears asking for a PACS destination A report can also be saved by closing the CAM after changes have been made Print Click on
19. 01010 COW System F6 Head System F7 Liver System F8 Lung System F9 MWN Preset Mediastinum System F10 New Preset Spine Bone System F11 TA Spine ST System F12 Abdomen2 System EE COW syste Edit Abdomen Syst Mediastinum Sime byste aiae RON Hea ets y sSyesibjem NED E edet Slice 1 1 54 WW TARP Hu WL 50 Hu LINEAR PID 0001 HP Automatic with priors To activate the Width Level function click on the button 1 and a set of cross hairs appears over the selected image or series corresponding to the window width and window level settings for the image or series Along with the cross hairs presets may be displayed as small markers with identifying text beside them 2 Clicking on the preset marker will move the cross hairs to the preset location and values Window Width and Level is also adjustable by clicking with the middle mouse button in an image and move the mouse around The drop down menu next to the Window Width Level button 1 can also be used to select preset window width and level settings that have been sent from the modality pre viously specified by the user or provided by the system administrator To adjust the values grab the intersection point of the cross hairs and move it about with the mouse or grab an individual cross hair with the mouse and move it Histograms A histogram 3 provides information on the distribution of intensity values in an image
20. 604 Hu WL 61 Hu Overview Volume Focus PID RSNA06 A76270 Freehand Clipping allows the user to clip either inside or outside an area defined by the user The tools are available from the freehand clipping toolbar For both inside and outside freehand clipping the user inserts a number of points defining the clipping shape 1 Select the tool clip inside B or clip outside si 2 Insert points on the volume pane to define the clipping shape 3 Double click or right click to finalize the shape and the clipping is performed either inside figure 1 4 or outside the clipping shape figure 1 5 Toggle clipping will toggle on off the clipping shape and Clear Clipping will delete all freehand clipping from an image Figure 9 24 Freehand Clipping inside 64 9 Introduction to General 3D CAM Stwt L i PACS wee General 3D admin 10 19 SE New ae i Hoepit 3L R ck Damn CT x Stwt AEB BE PACS wee Generd 3D admin 10 23 L Loe i a LILT LP SE Now here hice Bra 3L H8c nsrtnracmwon CT 9 13 2 Color Transfer Functions The Color Transfer Functions Presets tab allows modification of Width Level by the use of color and is available next to the bookmarks tab e Select a color preset from the list and it will be applied to the volume To deselect it press the same preset again or choose another one from the list 5 Chapter 9 To modify preset
21. application also contains a toolbar Figure 6 1 Online Help System Toolbar amp RBnaqas Online Help also includes a menu providing the following functions File Edit View Go Bookmarks Help that all provide sub menus to guide the user through the help func tions Report A Problem Feedback Help For each CAM the Help menu has a selection titled Report A Problem This selection displays a User Feedback dialog which can be used to provide detailed feedback to the support organization and developers of the Easy Viz system This feedback is sent via email to a designated individual that manages and processes the feedbacks The Feedback type can be either a bug or an error within the system a request for a new or modified system feature or any other type of comment The user name and user email address are provided automatically for the user that is logged into the system but users can remain anonymous if so desired The component of the system is chosen automatically in the case of certain errors or fail ures Otherwise this field 1s disabled The subject of the feedback and the actual description of the feedback are provided in the fields in the center of the dialog At the bottom of the dialog any associated log files for the session are shown and can be attached to the feedback email So can a screenshot By clicking on the Acquire Screen shot button a screenshot of the current session is taken and can be attached t
22. current menu or toolbar 4 shows the mode of the entity or the screen 5 shows the tools available for adding removing or relocating elements Figure 4 2 The Tool and Menu Customization Dialog Box Manage Menus Y Available items Items in Main toolbar Annotation Tools Home Main window Auto Rotate Volume undo met ubar ed Ne Hely Redo toolbar NEES cy aN a a LUT Tools Toggle LUT Viewer f Width Level Menus Other Toolbars TO g gle 3D Rotation Box 4 Separator gt Zoom Pan Rotate Width Level Undo Redo lt Separator gt iD Volume Rendering lt Separator gt Toggle MPR Lines Toggle Text Overlay Description lt parator gt 3D Point of Interest Edit Width Level presets 3D Volume of Interest 3D Cri pping This opens a dialog box that enables you to save or delete width level presets Creation of new menus and toolbars 30 4 Common functions for all CAMs in Easy Viz New menus and toolbars can be created by clicking on PF in the upper right corner of the dialog A box opens wherein the name of the new menu or toolbar is written The new ele ment 1s now visible on the list 1 and a group can be added New menus can be added as part of another menu if this is the case the new menu will appear as a sub menu If a new menu or toolbar is not granted a group it will not appear on the list of available items A new menu or toolbar can be placed on the ed
23. d os Shes ie te TREO HERE THERE E TEE E A EE EES 28 Om WC SC CO AM iit ones ce at aay Sas iwe ads cem ELS DL IU E atc nnde lel e D re cep A CDD IE LL LEE 28 4 6 1 Bookmatrks sssssssssssssssssssslslssslnss e s e sem sse esse isse er sense seres 28 4 6 2 Patient Study Brow Set etae ee eee decree ea ode oe ta eoe ab eol Pee ebd ipsas 29 4 7 The LUT Viewer Tool sssssssssssssssssssslleI III RI e Rn ese sn senis 30 4 8 Customize Menus and Toolbars ssussssssssssssssssssssssssssese eee enne 30 4 9 Cursors and Default Tools 0 200 000 0200 es see see eese nne 3l 4 9 1 Keyboard and Mouse Shortcuts 0 000 000 e cece eee e cece eee e cece cece cececeeeeeeeee 22 5 Text overlays ssssusssssssssssssssslssssssssess see sse sse esee esee aaa isse iss r iles rins 33 6 Save Secondary Capture LLduttttuuusssssusssssssssslessss esses e sss esses sse eis 35 7 Compound Presentations 2D and Softcopy Presentations 3D 36 ROU Sane Sete trates teeta dh tle Ed en AS ELM ALIM ek hea LL E S ee 39 9 Introduction to General 2D CAML 200 0002 41 9 1 Navigation in the General 2D CAM 00 0 000020220 cece cece ccc ec ee e e s esee nei 4 9 2 DICOM Hanging Protocols 2 00 2200 e cece sees esse nnne nsns 42 9 2 1 Changing Hanging Protocols losiuuuuuussisussesssseesssssseeee nn nenne 43 9 2 2 Automatic HP Layouts ssss
24. groups in a CAM by using the Selection Han dle and drag either to the top edge of the window or to the bottom edge By pausing the sequence just inside a Display set the series can be dropped moving it from one group to another 9 2 DICOM Hanging Protocols A hanging protocol HP is a template for a set of instructions that the 2D CAM uses when displaying the contents of a study The template specifies which images are to be shown where on the screen they should be placed and how they should be oriented DICOM Hanging Protocols are a standard method for defining the selection grouping and layout of images Because DICOM Hanging Protocols are an accepted standard any defined protocols can be used on workstations from other vendors A DICOM Hanging Protocol is composed of two parts a set of instructions that specify how images should be placed on the screen and a specification of when or for what type of data a hanging pro tocol should be applied As an example a hanging protocol may only be specific to MR images of the knee for workstations that have only one screen When the 2D CAM is launched features and functions of the hanging protocol are acti vated The CAM searches for and rates the applicable hanging protocols by ranking pro tocols so that the most specific protocol receives the highest ranking The highest ranking hanging protocol is then automatically invoked to lay out the images contained in the study _42 9 In
25. on the Volume pane Measurements can be inserted and manipulated in the volume view when MPR mode is enabled but not in direct volume rendering mode When the measurement is manip ulated in the volume view the control points will always stick to the MPR planes Figure 9 27 3 Point Angle Measurement in the Volume view sat Bw p BM PACS WFM General 3D admin 11 13 9 15 3 Point of Interest 3D Point of Interest POI enables you to mark different MPR plane positions that might be relevant to remember Select the POI tool from the toolbar to activate the cursor i When the tool is selected insert one or more POIs by clicking on either the volume or one of the three MPR panes When a POI is inserted it is marked by a POI graphic annotation which is chosen as default or via the drop down menu on the tool Each POI is also displayed as a bookmark on the sidebar which allows the user to easily switch between the POIs To activate or switch to a POI simply click on the POI graphic annotation or the respec tive POI on the sidebar Figure 9 28 3D Point of Interest in 3D CAM 68 9 Introduction to General 3D CAM admin EasyViz SE Start m fal FR E BR pacs WFM General 2D General 3D admin 12 50 File Edit View Tools Help Name CTFO1 F Name CTFOY F ID RSNAO6 A76270 ID RSNAO6 A76270 Series STUDY FOR DEMO OF 3D FUNCMONALITIES PE 1 0 B20f Series STUDY FOR DEMO OF
26. sidebar is locked 4 6 1 Bookmarks The Bookmarks tab is available in all CAMs It displays all measurements anno tations etc which have been placed in the active patient s studies Every time a meas urement or annotation is applied in an image a bookmark is automatically added in the sidebar Bookmarks which have been added to a study remain on the list until the user deletes the bookmark or goes to a new patient When the next patient 1s displayed previous book marks will be deleted if they are not saved as Compound Presentation States A bookmark can be renamed by double clicking on it 28 4 Common functions for all CAMs in Easy V1z 4 6 2 Patient Study Browser Specific for General 2D CAM and Report CAM is the Patient Study Browser 4 It dis plays a 3 level hierarchical structure of patient data which is available from the WFM patient list Just as in the WFM the list can be folded in and out to display studies and sub sequent series The study which is underlined and listed in bold is the study from which the patient data 1s first opened in the WFM Figure 4 1 The Sidebar 1 2003 06 11 HEPATOBILI 2002 01 16 RX ABDOM 2002 01 15 RF ERCP BI 2002 01 15 CT ABDOM 5 2002 01 07 MR UPPER 5 2001 12 31 RX DWZ DI 2001 12 31 CT UPPE 8 2001 12 29 RX ABDOM 1 CR liggend CR AP 2009 10 07 PR Pres 2011 04 05 PR Pres 2011 04 05 PR Pres Lr fs had Bo The
27. that form a subseries are highly similar and related to each other the only variation may be the time at which each individual image 1s obtained or the posi tion within the patient to which each image corresponds The Start Menu Easyviz Enterprise On EasyV iz Enterprise the Start Menu is located at the left edge of the Taskbar From the Start Menu it is possible to view the following functions Online Help Directs the user to the online user manual 15 2 Introduction and Login About Shows information about the EasyV iz system Show license This tab shows information on the license given to the user Re Start PACS WEM Expert This function restarts the Workflow Manager Preferences A number of preferences and properties in EasyV1z are available to be set or modified from the Workflow Manager Preference settings are personal so that each individual user of the system set system properties that apply only to that user Once property modifications are completed click on the OK button to save the changes Disable auto logout This function enables a user to disable an auto log out idle timeout only however if the user is allowed to Disconnect session This function allows an active Easy Viz session to be disconnected and put to sleep on one client device and then reconnected and resumed on another device within 10 minutes Logout Logout terminates the current session with the Easy Viz system The Easy Vi
28. the Easy Viz system Terminology for windows and other container objects used in the Easy Viz system is described hereunder Figure 2 7 Window Terminology _14 Chapter 2 System Window m Canyvie oF G 5 start fei a Be Pacs wrM Genera Edit View T i Display Set Screen Window Image in a Pane The overall Easy Viz system window is called the Screen and within this window one or more Display Set Windows are placed each of which contains a single display set A Dis play Set Window contains one or more Image Panes which contain image data A Display Set Window and an Image Pane can be the same object for example when only a single image is being displayed Note that even if an Image Pane displays only a single image there may be additional stacked images before or after the displayed image these other images are viewed by scrolling through the stack of images In all CAMs the image pane or Display Set with the current focus has a white border and the activated functions will only operate on the image or display set with the current focus A series contains of one or more images which have been retrieved from a scanner under similar conditions settings or imaging protocols A study may contain multiple series if several imaging protocols have been followed during the acquisition process If a series contains more than one image then these images may be grouped into one or more sub series Multiple images
29. upper case or lower case before the search is sent to PACS Mode where one can either choose Optional Cross required Required or Hidden in order to determine the number of fields to be filled out in the remaining properties Matching which denotes how a text 1s used for search Wildcards indicating if a user 1s allowed to make use of and as wildcards Minimal length which denotes the minimum number of characters to be filled in e Regular Expression which is a regular expression used to control how a field ought to look before it is considered to be filled out WARNING When creating a search please ensure that the added fields are sup N ported as matching keys by the PACS systems at your site If a field is not supported the value will not affect the search results but lead to a result set with more results than expected 2 3 Workflow Manager WARNING In order to avoid overloading the system it is important to adjust the properties of the search fields and carefully decide which fields should be included in the search to limit the impact the search will have on the PACS when users activate it A Figure 3 4 Edit Search Edit Search x Title Easy iz Status Normal L visible te Group m 2 Comment Ayalable Fields Search Fields Field Level B 4 Paberi level Patent ID Patent Middle name bsuer Of Patent ID Patent Birth Date Accession Nurnber Patient Birth Time Pat
30. AM the 3D CAM makes it easy to obtain a spatial understanding of the contents of a dataset This 1s possible through various types of rendering methods DVR Direct Volume Rendering which visualizes a solid volume of the 2D slices MIP Maximum Intensity Projection which is similar to DVR except that the data vol ume will display an image which represents the maximum value encountered MinIP Minimum Intensity Projection does the same as MIP but it displays an image which represents the minimum value encountered AvglP Average Intensity Projection displays the average intensity projection 9 11 Select Volume The 3D CAM loads only a single volume at a time which must be a uniformly sampled three dimensional data set The Volume Selection will open if more than one valid series is available in the launched study The Volume Selection dialog can be launched to select another Volume via the Select volume from the File menu To select a volume click it and use the two sliders at the bottom of the dialog to select a slab of the volume for viewing The sliders cannot be moved to specify a slab of fewer than eight slices Figure 9 21 The Volume Selection Dialog 9 12 CAM overview Only four window panes exist in the 3D CAM the Volume rendering pane placed in the upper left corner and three cross sectional visualization panes called the Axial Coronal and Sagittal views Figure 9 22 Overview Mode 62 9 Introduction to G
31. CAM Addendum to report Report CAM Address Adjusting the measurement threshold SUV Advanced Search Advanced Search in the PACS archive Annotations in 2D Automatic Volume Rotation Fusion CAM B Blending Value Fusion CAM 81 6l 54 41 43 43 42 43 55 62 62 19 65 65 33 79 79 74 19 22 53 72 2 Chapter 14 Bookmark info Sidebar 28 Bookmarks 3D POI 68 Boxes Report CAM 80 C CAM FI CAM Intro 14 CAM overview 62 Cautions Intro 2 CE Mark l Cine Viewer 2D CAM 59 Circular Intensity Measurement 2D CAM 55 Cleaning Intro 8 Clear Report CAM 79 Clear verification Report CAM 79 Clinical Application Module 41 62 Clip Planes 63 Close 28 Cobbs measurement 55 Color LUT Fusion CAM TZ Color Transfer Functions Preset Dialog Add or Edit 65 Color Transfer Functions Presets Sidebar 65 Compatibility Intro 6 Complete Report CAM 79 Compound Presentation 3D 36 Compound Presentation Load 36 Compound Presentations 2D CAM 36 Configuration Intro 7 Configuring Image Filters 2D CAM 50 Connectivity Intro J 82 14 Index Contact l Copy Permission i Copyright l Cursors 31 Customer Support l Customizable Search 20 Customize menues toolbars 2D CAM 30 D Default Cursors 31 Default tools 31 Delete a measurement SUV 74 Delete a report Report CAM T Delete Text Overlay 2D CAM 33 Dialog Box Intro 8 DICOM Hanging Protocols 2D CAM 42 DICOM
32. DICOM Conformance Statements can be found on the Medical Insight A S website www medical insight com Furthermore the software can use an enterprise Microsoft Active Directory Server for user management It is the responsibility of the hospital to ensure how the patients legal requirements are to be met how the security of the patient records are maintained and tested audited admin istered locally to cover risks from third party access and how the availability of the serv ices 1s to be maintained in the event of a disaster It is the responsibility of the hospital to ensure how types of access are identified clas sified and how reasons for access are justified Easy Viz installation and configuration is performed by Medical Insight A S or a person trained and approved by Medical Insight A S A limited number of configuration tasks can also be performed by the customer after a Medical Insight A S training course has been provided Contact your local support unit for more information Installation and configuration is described in the Easy Viz Installation Guide which is available to people who have installed the system and the support personnel of Medical Insight A S CAUTION o Administrators of the system must have in place satisfactory archive backup and retrieval systems and these must be periodically checked CAUTION Server users must be certain that the data they have selected and are viewing is for the PACS being used
33. E 319 images s f3Study RX DWZ DISCUS DEGEN DEESSET ABDOMEN BILE Q Anonymized 612081 i fiStudy STUDY FOR DEMO OF NM j CardiacCalcium PostOperative CTM 4 9Study 2 images 3Study 1 image QCTFO1 fHStudy STUDY FOR DEMO OF 3D FUNCTIONALITIES 426 images Enter Destination DICOM Objects ipovccnsccaccccccsccssccsscsscnsscsccusccsscsscscnsscssesccsssesscsssssccsssescnsscsseees seeeeeceseeeeseeeseeeesseeeeeeeseseseeeeeseseseeseeseeceseeseeeeseseeeeseeeeseeseeseesees 295 3 Workflow Manager NOTE V Not all archives are configured to receive images from EasyViz even if they appear on the list of AE titles E m 4 Common functions for all CAMs in Easy Viz 4 Common functions for all CAMs in EasyViz This chapter presents the common functions for all CAMs in EasyViz As part of the edit ing options for CAMs functions and tools can be placed in all menus sub menus and toolbars and all functions and tools can be found in either a toolbar or the main menu Common for all CAMS is the default menu bar at the top of the window It contains drop down menus under File Edit View Tools and Help The content of the menus differ from CAM to CAM and are customizable from the editor dialog found under the Tools menu 4 1 Home Undo and Redo There are three available functions in the Easy Viz CAMs for navigating through steps and actions that have been performed These ar
34. Figure 9 1 2D CAM in Overview Mode admin EasyViz stat Bel wd Fi EL BR PACS WFM General 2D Edit admin 10 38 File View Tools Help ww g Name CTFO1 F ID RSNAO6 A76270 Series STUDY FOR DEM OF 3D FUNCTIGNALITIES PE 1 0 B20f Date 04 17 200 v 17 ae M m Slice 356 J Image 356 408 POs 228 5 mm E A gam W400 Hu WL 30 Hu LINEAR Name CTFOZ F ID RSNAO6 A76270 Series STUDY FOR DEMO OF 3D FUNCTIONALDITIES cille Name CTFO1 F ID RSNAO6 A76270 Series STUDY FOR DEMO OF 3D FUNCTIONALITIES d mo ETIAM Date 04 17 2003 WW 65535 WL 32768 Slice 1 Image 1 1 Pos mm LINEAR Name CTFO1 E ID RSNAO6 A76270 Series STUDY FOR DEMO OF 3D FUNCTIONALITIES Cille Date 04 17 2003 Date 04 17 2003 ne Slice 1 Image 1 1 Pos mm Slice 1 Image 1 4 Pos mm B CHE yg a 4 J m mn c exse ie re Se WW WL WW WL PID RSNA06 A76270 HP Automatic with priors Group 1 Group 2 All image panes and display sets have a small Selection Handle in the upper left corner By using the Selection Handles it is possible to select several images at one time Click on a Selection Handle with the left mouse button while holding down the Ct r1 key on the keyboard or simply focus the pane and press the space key to select it To deselect an already selected image click on the Selection Handle again while holding do
35. TCCHOPDS ee E 9 2 Introduction and Login 00 00 2 occ cece cece cece cece eee ce cece ceeeeeeeeeeeeeeseeeseeees 10 2S Ecos fio cocos cope aa Nene eet 8 ADD IE e ntsc aes teas Le ET LO hoes 10 2 2 The Workflow Managet 000 0 200 c ccc eee cece ccc e cee ce cece ee eceeeeeeeeueeeeeeeeeeeeenaes 12 2 3 Tattoducliomto CAMS uices eodeni bo poste dades da na d ouoo Goes hos cR dau 14 3 Workflow Manager 0 200 c ccc cece cece cece cece cece cece cece ee ceeeeeeeeeeeeeeseeeeeeens 18 S L Searching the PACS Archive acceso p a dec de ec ou ce ede boe M ed dpud 19 3 1 1 Advanced search e eiie eR Rm rb D eben bbludip2 shi iehindeduuu 22 32 PEOBITO Editing oss senti Lit estoit nio biiadaa tbe iue i bM PllensetiblalesneeAELIDid re Lie ieu 23 229 AMADOR OF MINA GCS soca rn sise toate cast a tis Seated LA Ps LO asa LA eS LI DE UL EU Lei 29 3 4 Export of Images 0000000000000000000 0000000000000000 IRI IRI 000a cence ceeeeeeeeeeeeeeeeeeeesees 25 3AL TO CDROWDV Diresse oe eebia a be ind UIROS aerei 25 3 4 2 To Other ATCHIVE 1i eens sense Aidantte RII PDRLIIsEOpereledd un NOD bleed bi does fiii 25 4 Common functions for all CAMs in EasyViz 0 0 0 000 200 c cece cece e eee eee cece ee 27 4 1 Home Undo and Redo 22 00 e Laaa Daa aoaaa 27 dq r du US Zi Le A810 EATER en ee ee E eR EE eT CREME TERT SEES AEA T 28 AA WIA CTI ANNO lasse osse ote tess cosa eke vee cent Lu Pod LAE se LLLA TS 28 zs co
36. age data is displayed at full fidelity and full resolution Aside from the use of lossy compression methods in the streaming of information from servers to workstation during data manipulation actions the Easy Viz system does not use any other lossy compression methods 1 Scope of this Manual Measurement Functions The measurement functions and tools for image data analysis that are part of the Easy Viz system comply with existing IHE descriptions and are tested and validated for accuracy as part of the system development testing and verification procedures However users are encouraged to perform their own accuracy checks of the system by using for example images obtained of phantom devices with known dimensions Printing Functions The quality and fidelity of radiological and other data printed out via the Easy Viz system is dependent upon the quality capabilities and correct adjustment of the printers The Easy Viz system can print from COTS commercial grade printers that are connected to the network from a computer acting as print server and from DICOM printers DICOM printers are medical grade devices designed to produce high quality output with minimal degradation of image data It is important that the guidelines of the printer man ufacturers are followed regarding printer adjustments and calibrations Medical Insight A S always recommends using DICOM printers for printing patient image data If a DICOM printer is not ava
37. b and c disse but not necessarily in sequence 35 Match any item with a second word starting with j r for example Doe John The specialized search features in the Workflow Manager are used in those situations where a Profile does not provide access to the information or patient that is needed By clicking the Search button in the right corner of the Workflow Manager window the simple Search dialog 1s displayed Figure 3 2 Simple Search in the Workflow Manager 1 9 3 Workflow Manager PACS DCM4CHEE DCM4CHEE 7 Edit Patient Name Patient ID Issuer Of Patient ID Accession Number 2 Patient First Name Patient Last Name Study Date Today Include Patient History Search Advanced Reset 4 Cancel The intention of the Simple Search feature is to provide a rapid and simple way to search the entire archive of patient data The results of a simple search are displayed in the WFM using a temporary Profile The dialog allows the user to pick between a set of predefined searches using the list 1 Changing the search will cause the search fields 2 to update accordingly so that only the fields needed for the specific search is shown The user can clear the values by pressing the Reset button 4 and PACS can be changed by using the edit button 3 Note that the default Study Date value is Toda y Customizable Search This feature is only available for administrators and allows for e
38. ble to specify how many panes a Display Set 1s divided into In the Placements section it is possible to specify on which screen the image sets should be displayed along with where on the screen the Display Set should be located It is not allowed to have overlapping display sets In the Presentation Intent section it is possible to specify the orientation of Display Sets Orientations are given with respect to 2 patient coordinates The first coordinate specifies the contents of the right side of the Display Set and the second coordinate specifies the contents of the bottom of the Display Set The special coordinate X indicates that the 46 9 Introduction to General 2D CAM image should be oriented as specified in the DICOM dataset It is also possible to specify whether to invert the grayscale for the Display Set prior to display of the images 9 3 Tools in 2D CAM The 2D General CAM contains a list of tools available to the user This chapter will present the different toolbars and their functions The toolbars available in 2D General CAM are the Main toolbar the Annotations toolbar the Key objects toolbar the Image subtraction toolbar the Shutter toolbar the Cine viewer toolbar the Mammography tool bar and the NM toolbar All toolbars are listed and can be chosen by right clicking with the mouse in the area of the bars or via the View Menu It is possible to edit toolbars and menus as wished by adding or removing tools th
39. cal Devices Medical Insight A S is certified by notified body DQS 0297 to Annex II Full Quality System Easy Viz 4 0 User Manual Document Number 11134 1 2 Copyright Copyright subsists in this document whether it 1s Medical Insight A S proprietary doc umentation or documentation made available by Medical Insight A S under licence and therefore title to the document remains at all times and for all purposes with Medical Insight A S or with third parties from whom Medical Insight A S has acquired licensed rights No part of this document may be reproduced copied adapted or transmitted in any form or by any means without the written permission of Medical Insight A S Medical Insight A S makes no warranties or representation expressed or implied with respect to the accu racy completeness or usefulness of the information contained in this document and spe cifically disclaims warranties of suitability for any particular purpose Medical Insight A S shall under no circumstances be liable for any damage arising from the use or inability to use any information apparatus method or process disclosed in this document Medical Insight A S reserves the right to make changes to this document without prior notice O Medical Insight A S 2012 1 3 Contact The EasyViz system is manufactured by Medical Insight A S Medical Insight A S Krumtappen 4 3 DK 2500 Valby Denmark Tel 45 4655 0444 Hotline 45 7026 0944 Email helpdesk medical insi
40. cations may overlap 9 Note that the macro text may take up much more space than the actual information displayed in the overlay of an image WARNING Do not save text overlays without patient name and patient ID If the text overlay has misplaced patient orientation labels it will gen erate an error Follow the instructions of the dialog box to correct the error 34 6 Save Secondary Capture 6 Save Secondary Capture The Save Secondary Capture function is available in General 2D 3D and Fusion 3D CAMs The images however are saved differently in the CAMs To open the Save Secondary Capture selection amp click on it in the File menu or use the keyboard shortcut Ct r1 D to bring up the Save Secondary Capture Dialog Box In 2D CAM the dialog shows a sequence description and under the Image selection the currently selected images can be saved as secondary captures A checkbox to save any Image Filtering operations or Image Subtraction operations along with the images 1s also available In 3D CAM and Fusion 3D CAM it is possible to save either all the images or the cur rently selected image as a Secondary Capture It is possible to choose which PACS archive the secondary capture is to be saved in and the default location is the same loca tion that the images in the capture originated from If the secondary capture is to be saved in another PACS archive it can be specified in the Host IP field and the Port field Secondar
41. created to specifically match this need 3 1 Searching the PACS Archive If the list of patients 1s extremely extensive one can either sort the list along the contents of a particular column 5 or enter in search parameters in the filter fields above each column If a CT study for example is being sought after by clicking on the Modality column all CT studies are grouped together for easier perusal This reduces the entries in the list to those that match the filter strings that have been entered Search Expressions Search expressions can be entered to match the beginning of a desired entry The basic wildcard characters for search expressions are underscore question mark n 2 and star The underscore character matches any single word The question mark character matches any single character The star character matches any amount of any characters including empty strings The table below provides some examples of search expressions and the resulting search results Note that a blank search expression or a single underscore character will match every possible result Search Expression Meaning abc Match any item starting with the letters abc abo Match any item ending with the letters abc elie Match any item containing the letters abc in sequence abc def Match any item starting with abc and ending with def 2a Match any item where the second letter 1s a abe Match any item containing the letters a
42. cted via the Document menu History It is possible to view previous versions of the opened report by clicking on the history but ton in the toolbar or on History in the Document menu A History dialog opens listing all previous versions of the report Read only reports Some reports may be in read only mode which means that the current user cannot edit or amend the report A report may be read only due to the user rights the completion flag or one or more verification flags Read only mode will be denoted by a different background color either light pink or green Status of the report In the bottom right of the screen four boxes show the status of the report The first box describes the series which the report belongs to The next two boxes show whether or not the report has been verified or completed by the words Unverified V erified and Not Com pleted Completed respectively The last box states whether the report has been modified or if it is new 80 14 Index 1 1 Pixel Mammo toolbar 2D 2 2 Point Distance Measurement 2D CAM 2D CAM 2D CAM Editing Hanging Protocols 2D CAM Hanging Protocols Editing 2D CAM Presentation Group 2D CAM Safe tags Hanging protocols 3 3 Point and 4 point Angle Measurement 2D CAM 3D CAM 3D CAM Select Volume Add items Report CAM Add New Color Preset Fusion A dd or edit CTF Preset Fusion CAM dialog Add Text Overlay 2D CAM A dd to report Report
43. d achieved The actual FPS speed achieved depends upon the bandwidth and quality of the connection from the client device to the EasyViz server If cine mode runs erratically and not smoothly it 1s advisable to decrease the FPS speed to achieve smoother cine performance The function Use Datasets Recommended Display Frame Rate denotes a default set speed e The functions Previous Next take the user to either the previous or the next image While the cine mode is active other functions can still be performed on the image data such as panning zooming image filtering etc 9 10 Mammography Imaging in General 2D CAM Mammography viewing is accessible from the 2D CAM and provides advanced navi gation tools that improve speed and reliability when reading mammographies The mammo hanging protocol supports fast navigation through full screen viewings of mammo pairs Figure 9 19 The Mammo Toolbar SO Chapter 9 If Computer Aided Detection CAD objects are available with the images the Mam mography Computer Aided Detection Structured Report CAD SR dialog will open auto matically when the images are loaded in the CAM This dialog displays information on CAD findings Algorithm type version Algorithm versio Date Etc Each CAD object comes with a specified Rendering Intent which can be either Required or Optional By default all CAD objects that have Rendering Intent to be Required will be enabled in t
44. d dragging either the line connecting the points or just one of the points To delete a measurement click on it in one of the image panes and it will turn red or mark it in the sidebar and press Delete on the keyboard The Toggle Measurements and Annotations Tool jo toggles between displaying and hid ing all measurements and annotations applied to a selected image or series The Clear Measurements and Annotations Tool removes all measurements and anno tations applied to a selected image or series To undo a clearing step the Redo function can be used After adding annotations and measurements to an image it is possible to save these as a compound presentation in the PACS as described in chapter 7 on Compound Pre sentations and Softcopy Presentations When annotations and measurements have been loaded into an image they are shown in yellow and cannot be changed 9 5 1 Text Annotations The Text Annotation Tool can be used to add text on images Once you activate the tool a dialog opens wherein the text is written It is possible to place the text in an image as an anchor point as a fixed position or in a vertical orientation 9 5 2 Marker Tool 4 The Marker tools are used to draw attention to various structures objects or areas in images Three marker tools are available from the drop down menu of the tool the Arrow Tool the Freehand Tool and the Ellipse Tool To move an annotation made with a marker tool hold down the left
45. d presentation and to choose which information to save along with the presentation by marking Key Objects Layout and Presentation State The PACS Destination Tab allows selection of the destination PACS archive to which the Compound Presentation is to be saved The default location is the same from which the images in the Compound Presentation originated but another PACS archive can be specified via the Host IP field and the Port field Select Presentation State only 2D CAM To bring up the Select Presentation State Dialog Box click on the Select Presentation State function in the View menu In the dialog all of the available Presentation State Objects for the selected series or studies are shown The Group By menu determines how Presentation State Objects are arranged in a hierarchy In the dialog Presentation State Objects are sorted by Description State and Date Figure 7 3 Select Presentation State 27 7 Compound Presentations 2D and Softcopy Presentations 3D Select Presentation State Group by Series Description Date Description State Date Series Description AUTO GENERATED study STUDY FOR DEMO OF 795 of 795 1 4 12 AUTO GENERATED st Presentation AS LAST SEEN T Presentation AS LAS Presentation AS LAST SEEN 0 of 795 6 30 11 Presentation AS LAS The Presentation State Object is made up of four sub objects one for each series that the Presentation State Object is associated wi
46. d the patient the Source Position in mm how close the x ray source 1s to the patient the kVp setting in kV units how much con trast the x ray image contains and the mAs Setting in mAs units how bright the x ray image 1s Figure 11 1 Virtual X Ray CAM as the CT Volume is Rotated a Realistic and Accurate Virtual X Ray is Produced PACS WFM VirtualXRay 3D The Virtual X Ray CAM can produce accurate virtual x rays because CT data represents actual physical density values Thus a CT volume can be used in a model that simulates the passing of x rays through the volume to produce a 2D x ray view As the volume visualization is moved or rotated on the left side of the CAM the cor responding 2D virtual x ray on the right side of the CAM changes in response to the new positioning The image source is modeled as being in center and in front of the CT vol ume while the image plate is modeled as being parallel to the display and behind the CT volume The manipulation of the Volume Visualization is done similarly manipulating and controlling Volume Visualizations in the 3D CAM The volume visualization on the left of the CAM can be manipulated regarding window width and window level or zooming but these settings have no effect on the generated vir tual x ray Moving the cutting planes or faces of the volume will result in the excluded volume data to not be used in generating the virtual x ray Ne 12 Document CAM 12 D
47. defines a corner anchor point for a rectangular shutter or a circular shutter Areas outside of the shutter area are still partly visible to aid in placement of the shutter Once the mouse button is released the shutter 1s defined and areas outside of the shutter are no longer visible Rectangular and circular shutters are combinable in a single image If combined only the area of the image that lies within the intersection of the two 1s visible If the shutters do not intersect no part of the image is visible Figure 9 17 A Rectangular and Circular Display Shutter in the Same Image admin EasyViz stat Be FL BI Q PACS WFM General 2D Name Fusion Demo01 AALBORG SYD ID FUSE D A38093 GE MEDICAL SYSTEMS CT LightSpeed VCT Study CT hals thorax og he r Date 07 31 2008 Time 13 40 20 Series AXIAL 5MM AVG Protocol 5 3 Hals Thorax Abdomen standard Mag 1 16 Contrast PO amp 100ml iomeron400 Slice 93 BodyPart Image 93 151 Laterality Pos 282 0 mm Thickness 5 000000 mm WW 420 Hu WL 60 Hu LINEAR 120 kV mAs 600 msec Presentation AUTO GENERATED FROM IMAGE Automatic with priors Display Shutters have two types of handles a Resize Handle and a Position Handle The cursor changes shape to indicate which type of handle can be selected Once a shutter is applied to an image the Rectangular Shutter icon F or the Circular Shutter icon W is placed on the right side of the image to ind
48. diting and defining of searches The searches are shown in the list 1 For each search it is possible for an administrator to define or edit each title and its separate configuration including which group it is visible to and which profile it is used for The administrator can order the searches to ensure a spe cific order of the searches when shown to the user in the search dialog The order is changed using the up down arrows 3 and can be edited added or removed using the but tons 2 Figure 3 3 Administration of Search 20 Chapter 3 Title Profile type Visible to group 4 New EasyViz WFM DICO Patient Name WFM DICO Edit 2 1 Remove ula 2 OK Cancel When administrators add or edit a search different settings are available It 1s possible to edit the title 1 visibility for groups 2 and comments 3 All available tags fields that the administrator can use in the search are shown in the available tags list 4 Fur thermore the administrator can pick an available tag and move it to the list of search fields 5 and by selecting a search field it 1s possible to change the behavior of the field by tweaking the properties 6 The properties are Label which allows an overwriting of the name of the field e g from Patient ID gt CPR Default value which 1s the value of the field of the first search as well as the value when resetting the search dialog Case which converts the text to either
49. e Home Undo and Redo The Home function returns the CAM to the initial state of the CAM when it was started If the Home function is used that step can still be undone by using the Redo func tion The Undo function becomes active once the user has taken action in using the CAM and each use of the Undo function moves backwards one step in the chain of steps that were performed The Redo function becomes active once the Undo or Home function has been used Each use of the Redo function moves forward one step in the chain of steps that were per formed and then undone NOTE Certain functions or features cannot be accessed or manipulated by V the Undo or Redo functions For example defining a Window Width level Preset cannot be undone although the preset can be deleted the storing of markers or annotations cannot be undone and the modifications made to menus or toolbars cannot be undone 4 2 Pan The Pan function is available in 2D 3D Fusion CAM and Virtual X Ray and is acti vated from a menu or a toolbar or by using the Ctr1 LeftMouseButton com bination To pan an image left click in a window hold down the left mouse button and move the mouse around to pan the image The function remains active until it is deactivated The Reset Pan Zoom button amp cancels all pan motions or operations that have been per formed for the selected image or series 07 Chapter 4 4 3 Zoom The Zoom function
50. e box and drag to the desired size Resizing of the measurement is done in order to make sure that only the important part of the volume is measured To move the measurement box place the cursor over the box click and drag it to a new position The MPR planes move according to the new size Adjusting the measurement threshold Each SUV measurement is based on a specific minimum and maximum threshold In the MPR views the red areas display the pixel which are within the specified thresholds The thresholds are set to default parameters but are adjustable In order to adjust the thresholds the measurement has to be selected It is only possible to adjust one measurement at a time Delete a measurement To delete a measurement select it on either the bookmark list or click on it 1n one of the MPR views and press Delete on the keyboard NOTE The SUV measurements are based on the following DICOM tags 0018 1074 Radionuclide Total Dose e 0010 1030 PatientWeight V e 0054 1102 Decay Correction 0018 1075 Radionuclide Half Life and 0054 1001 Units If any of these tags are incorrectly entered in the dataset the SUV result cannot be trusted _74 11 Virtual X Ray CAM 11 Virtual X Ray CAM The Virtual X Ray CAM is a3D CAM that produces realistic and dynamic 2D x ray images from 3D CT volume data sets The CAM allows the setting of Image Plate Posi tion in mm how close the x ray detector 1s behin
51. e mode d emploi est disponible en francais 1 12 Safety Directions e e CAUTION Changes additions or maintenance to the Medical Insight products carried out by persons without appropriate qualification and training may lead to serious risk of injury and damage to the equipment as well as making the warranty void CAUTION To avoid images being lost due to a power failure the workstation has to be connected to un interruptible power supply UPS or an institutional standby generator WARNING Portable and mobile RF communications equipment can affect med ical electrical equipment It is therefore recommended that the oper ation of equipment of this type such as mobile telephones cordless microphones and other similar mobile radio equipment be restricted from the vicinity of this device 2 Introduction and Login Easy Viz from Medical Insight A S is an image and data processing system developed for the use of physicians nurses technicians and others employed in the hospital sector The Easy V1z system is a software package used with general purpose client server computing hardware to acquire store distribute analyze process and display images and associated patient data throughout a clinical enterprise The Easy Viz system performs functions of digital image processing measurement communications and storage and provides flex ible and simple access for the processing and visualization of medical images The Eas
52. ece e cece cece ceecceeeeeeeeeeeeeees 65 9 T4 MPR Panes suus eei co iioi ehe dence ELI a e titu tnt thi dabecauaiceteneuaealeaiiedes 66 9 HET Slab WIP R T hick MPR oo iiie ie cereo eit dude eb poo Rto E Oo ote eei Sates 67 9 14 2 Synchronization isusssssssssssssssssslssssssss ees sese esses s memes sess elil 67 9 15 Annotation and Measurements osuuisssssssssssssssssssssse ss e se se seen 67 9 15 1 Measurement on MPR planes 00 2 2000 c cece cece cece cc ece ce cecceeeeceeeees 67 9 15 2 Measurements on the Volume pane 2 200 2220 ccc cece cee e ec cceceeeeeeeeeeees 68 9 15 3 Point of Interest 2 2222 ccc eee eee eee e s ese eee se seen 68 DAG Vessel Ttacketip ee eiie 2t eret Cop Dep EO Seq Setbieo ie eben du teu dad ibas ocanucas 69 10 Fusion 3D CAM sssssslnesImeI eee eee eee eens 71 IT Virtual X Ray CAM unt eet Encre eb niet udrie e god op a Up DU oaran ioa Decks 75 12 Document CAM sssss semen Ime sn sse Is e s ilr se pleri 76 I Rort CAM NR 11 i E o Se EE AEE ATANES AA EET TE A E AEE TNA 81 1 Scope of this Manual This manual contains information on safe and effective operation of Medical Insight A S products 1 1 CE Mark Figure 1 1 CE Mark Class Ila 0297 This product is provided with a CE marking in accordance with the regulations stated in the Council Directive 93 42 EEC of June 14 1993 concerning Medi
53. ed healthcare professionals including but not limited to physicians nursing staff and medical technicians This manual is written for trained users of Medical Insight A S products 1 7 System Documentation The documentation shall be kept with the system for easy reference The most extensive configuration is described within this manual including information on software Not every function option or accessory described may have been purchased or licensed in a particular installation Chapter 1 Technical documentation is available in the product service documentation that is avail able from the product manufacturer Monitors for Image Display The quality and accuracy of radiological and other data displayed on monitors via the EasyV iz system are dependent upon the quality and a correct periodically calibration of the monitors themselves For EasyViz Diagnostic Workstations it is required that image display monitors are cer tified medical grade devices that allow for adjustment and calibration of the monitor bright ness contrast color temperature convergence distortion and other parameters in accordance with DICOM Grayscale Standard Display Function GSDF Such adjust ment and calibration steps must be carried out periodically in accordance with the guide lines of the monitor manufacturer Improperly calibrated image display monitors can result in the degradation of image quality which can adversely impact the diagn
54. eferences _ Preferences Login Server 2inc medical insight corn Choose language Danish Denmark Client window size 1024x768 Preferred screen Max screens En use Single Sign On Clear list of stored usernames It is possible to choose which Login Server to use and the user can choose which lan guage to run the system in Note that a chosen language will only apply AFTER login It is possible to choose the size of the client window size by either choosing Fullscreen which opens EasyViz in full screen without decorations or Maximized which opens EasyViz in full screen with decorations or by choosing either of the screen size formats which can be set by the user When setting preferences for the use of EasyViz it is also possible to choose the number of screens to display Easy Viz on The maximum number of screens is three When the number of screens is chosen the user is able to choose his her preferred screen s between the chosen number screen 1 2 or 3 At the bottom of the dialog the user is able to clear the stored usernames listed in the login dialog Easyviz As part of the EasyViz Work Station it is possible to change the size of the windows after a CAM has been opened Roam Session It is possible to roam a session in Easy Viz which allows for a whole session to be moved from one unit to another To roam a session the user must log in to the system as usual and afterwards log in to another unit
55. eneral 3D CAM admin EasyViz SE Start 15 fal fl E BR PACS wem General 3D admin 10 37 File Edit View Tools Help ew b v Tv Name CardiacCalcium PostOperative CTMULTI M Name CardiatCalcium PostOperative CT MULTI ID 0001 ID 0001 x 2 Series Series Date 12 19 2006 Date 12 19 2006 WW 300 Hu WL 50 Hu SLAB WW 300 Hu WL 50 Hu Name CardiacCalcium PostOperative CTMULTI M Name CardiacCalcium PostOperative CTMULTI M D 0001 4 1D 0001 g PTER E e m 1 I I PT O MEE Series jf ey LU Series T m A bate y 006 i t bate 12 18 2006 it ih Ma r 1 y n f d IN hf UN EN A jj W Mn UN LN M A f id IN d b P i a M UA y uM fa et n p E WI ELO V AT v a X T Ji Aud Vr Ww i uU L an A m m i iT TA l i 1 et i3 A AA d D I le n VA Iran SLAB WW 300 Hu WL 50 Hu SLAB WW 300 Hu WL 50 Hu Overview Volume Focus PID 0001 To enlarge any of these four image panes to full screen size double click in the pane or use the Enter key To return to a previous CAM layout press the Escape key or dou ble click again 9 13 The Volume Pane Navigation in the volume pane is done through a number of functions Zoom per default zoom is activated simply by scrolling The zoom box can be activated by the shortcut Shift left mouse click or from the toolba
56. ent use within the United States of America amp 5 The document user should be aware that within the United States of America Federal law restricts certain referenced products to being used only by or on the order of a qualified and registered physician 1 6 Indications for Use Intended Use The Medical Insight EasyVizTM PACS System is a Diagnostic Softcopy Reading soft ware package to be used for primary diagnosis and clinical review of digital radiology images The product utilizes the conventional TCP IP internetworking infrastructure avail able in most healthcare organizations and it uses commercially available computer plat forms Intel Pentium based and operating systems Microsoft Windows XP Linux The 1 Scope of this Manual product interfaces to existing imaging equipment using the DICOM PS 3 16 2009 Dig ital Imaging And Communications In Medicine standard communication protocol as described and developed by ACR Lossy compressed mammographic images and dig itized film screen images must not be reviewed for primary image interpretations Mam mographic images may only be interpreted using an FDA approved monitor that offers at least 5 M pixel resolution and meets other technical specifications reviewed and accepted by the US FDA The system does not permanently store or produce original medical images WARNING A The user must strictly observe all warnings cautions notes and safety markings within this document and
57. es tend to be listed near the top of the list while more generic overlays with fewer predicates are placed near the bottom It is the responsibility of the system administrator to rank and place the overlays on the list When a text overlay is selected on the list 1 its details are displayed in the remaining sec tions of the dialog These details include Name 3 filter predicates 4 and the textual contents of the text overlay 5 Filter predicates are entered edited or removed via the tool buttons 2 In order to apply text to an empty text location move the mouse cursor to the desired posi tion and a small pencil icon d 6 is displayed Click to open the empty text location for editing or on an already present text to edit it Insert Macro As a help variables can be inserted in the overlay e g DCM PatientID Click on the field in which the variable 1s to be inserted and then on the Insert Macro button 7 A 233 5 Chapter 5 dialog from which the desired variable can be selected is now displayed These variables are predefined and can be used when editing filter predicates and text locations Ignore Patient Name ID Warnings Overlays without patient name and patient ID will generate a warning when the overlays are to be saved By checking the Ignore Patient Name ID Warnings box 8 the Easy Viz system will ignore the warnings for that particular overlay NOTE V sometimes the text of the different text lo
58. et window The LUT Viewer is toggled on off in the View menu standardized Uptake Value Measurement SUV SUV Measurements allow viewing of segmented measurements and is available in both the Image Fusion 3D CAM and General 3D CAM By inserting a measurement based on specified thresholds the SUV measurement area calculates minimum SUV max imum SUV average and VOI volume in cm3 Standardized Uptake Value SUV is a widely used simple PET quantifier It is cal culated as a ratio of tissue radioactivity concentration for example in units kBq ml at time T C p T and injected dose for example in units MBq at the time of injection divided by body weight for example in units kg SUV T Injected dose Patient s weight bw CogT It provides a quantification of size of the lesion and is an important tool when evaluating the progress of a lesion The sidebar bookmarks make it easy to keep track of and switch between the various measurements and results The bookmark tab displays a list of existing SUV meas urements allows the selection of an SUV measurement which makes it active and edi table and allows changing of the min max threshold for segmentation g ml A n 10 Fusion 3D CAM CAUTION SUV Measurements require Attenuation Corrected PET series in order to perform the measurements o Figure 10 3 SUV measurement tool 1 MPR planes 2 SUV measurement box 3 Book marks and measurement in
59. formation and 4 SUV threshold Fusion 3D Insert measurement e Select the SUV Measurement tool from the toolbar or the Tools menu and the active cursor changes to e s when it is possible to insert a SUV measurement Click on one of the three MPR views not the volume view to insert an SUV Measurement box which has its center at the clicked point This particular measurement is now in focus and is red In order to insert one or more measurements in the image the tool has to be toggled again Once a measurement is inserted the respective measurement results are displayed as a tool tip when the mouse is positioned over the desired measurement The results are also dis played in the bookmark Note that the SUV measurement has to be inserted in the fusion images or PET images Select a measurement To select a measurement click on the SUV measurement box or click on the desired measurement on the bookmark list When the measurement has been selected it becomes red and 1s now in focus Once a measurement is inserted or selected the MPR planes move and are positioned in the center of the measurement When a measurement is selected it is automatically selected in the bookmark widget 2135 Chapter 10 Likewise when a measurement is selected via the bookmark widget the measurement box in the MPR view 1s also automatically selected and in focus Edit the measurement To resize the measurement box grab the edge of th
60. ge of the window or as a floating menu above the window Customize Keyboard Shortcuts Easy Viz comes with a set of default shortcuts all of which are fully editable The Cus tomize Keyboard Shortcuts selection makes it possible to create and customize keyboard shortcuts for various features in the CAMs Go to the Tools menu and select Customize Keyboard Shortcuts C to open the Shortcut Editor and allow for the creation of a new shortcut or editing of an already existing short cut To create a new shortcut or edit an already existing shortcut select the desired feature in the Shortcut Editor and click on the Edit button and hereafter the new combination of keys and click OK to save To remove a shortcut select the desired feature in the Shortcut Editor click on the Remove button and then OK To reset all keyboard shortcuts to default shortcuts click on the Restore Defaults button The customized keyboard shortcuts are individual and are saved with the current user s preferences The system administrator can however add and customize shortcuts for all users and groups 4 9 Cursors and Default Tools Active mouse cursors in the EasyViz CAMs provide assistance in the use of the system s features and functions As the mouse 1s moved around within the CAM the cursor changes to indicate what operations are permitted or forbidden and how those operations may be navigated By clicking in a pane the new image now has focus When a funct
61. ght com Chapter 1 Website www medical insight com 1 4 Cautions and Warnings The following samples show how warnings cautions instructions and notes appear in this document WARNING A Warnings are directions which if not followed can cause fatal or serious injuries to a user engineer patient or any other person or can lead to a mistreatment CAUTION Q Cautions are directions which if not followed can cause damage to the system described in this manual e ADVICE Refer to the instruction manual NOTE V Notes provide advice and highlight unusual points A note is not intended as an instruction 1 5 Disclaimer Medical Insight A S assumes no liability for the use of this document where any unauthor ized changes are made to the content or format thereof Every care has been taken by Medical Insight A S to ensure the accuracy of the infor mation presented within this document However Medical Insight A S assumes no respon sibility or liability for errors inaccuracies or omissions that may appear in this document Medical Insight A S reserves the right to change the specifications of any referenced prod uct therein designed to improve reliability function and or design without further notice This document is provided without warranty of any kind implied or expressed including but not limited to the implied warranties of merchantability and fitness for a particular pur pose CAUTION in respect of docum
62. ging Protocol Editor Stress Echo 2 Stages Dual Head General Image Sets Display Javascript Display Set1 Display Set2 Display Set3 Display Set4 Display Set5 Display Set6 Display Set7 Display gt Add General Placement Presentation Intent Copy Presentation Group 1 Screen Patient Orientation Remove Right Bottom z z Stage 1 2 Left Edge XX Image Set 1 Current Right Edge i VOI Type Navigation Group 1 Top Edge Tiling Bottom Edge 0 5 Invert Grayscale R 1 True Size Display OWS Image Justification Hori Columns al zontal Vertical Automatic Tile Reduction Center Center Filter Operations Sorting Operations Include images where Sort images is and is Filter by Image Plane X Track first arriving image Apply Cancel Each display set is accessible by clicking on the tab for that particular Display Set Hanging protocols provide a series of Filter Operations for each Display Set used to remove unwanted or unnecessary images or image sequences from the relevant Display Set Filter Operations are specified via dynamic expressions Sorting Operations are used to order the images in a display set There are three types of dynamic expressions for sorting Field type expressions long axis expressions and expressions regarding the time of study acquisition The General section allows for setting ofthe presentation group and the image set for a par ticular display set In the Tiling section it is possi
63. gle in a chosen image but differs from 4 point measuring in its presentation of the angle as it connects the lines placed in an mage hereby showing an angle with a connected line 9 5 8 Circular Intensity Measurement The Circular Intensity Measurement tool 1s used to measure the intensity value for the underlying image pixel of an area in the image While the tool 1s active several Circular Intensity Measurements can be made in the same image While the tool is active several regions can be defined The tools are used to measure the intensity value for the under lying image pixel of a point in an image and the tools provide basic statistical information regarding the selected area in an image including size of area covered minimum intensity value maximum intensity value mean intensity value and standard deviation for the inten sity value for the pixels in the selected region The area of the selected region is displayed in the measurement results 9 5 9 Freehand Intensity Measurement tool The Freehand Intensity Measurement tool is likewise used for measuring of intensity values in an image and has the same functions as the Circular Intensity tool apart from the values being measured from an area inserted by a freehand drawing 9 5 10 Pixel Intensity Tool 7 The Pixel Intensity Measurement tool f measures intensity from points in the image Also holding the tool over the image will show the pixel position in the lower part of the
64. he image Click OK to close the dialog and Open the CAD Object Dialog E1 to reopen To toggle all CAD objects on off press Toggle all CAD objects On Off 4 Each of the CAD objects will be marked in the images and detection details will be dis played when the mouse cursor is held over a CAD object Figure 9 20 CAD Objects in a mammography image True size 60 9 Introduction to General 2D CAM The True Size selection displays the images in their true physical size and is toggled on off by pressing the icon again Pixel The 1 1 Pixel feature displays the image in a state where one pixel on the screen con forms to one pixel in the image When 1 1 Pixel is enabled pixel interpolation is switched off which allows viewing of the raw pixels The tool 1s toggled on off by pressing the icon Link Mode The Link tool links the images in the selected image panes together in scrolling zooming and panning If possible scrolling 1s linked spatially if not it is frame based The Link Mode is only available in overview mode Easy Mammo Survey The Easy Mammo Survey is a tool which makes it possible to traverse the mammo image at a 1 1 Pixel zoom level When 1 1 Pixel mode 1s activated the image is often larger than the image pane which makes it difficult to view the whole image An easy way to assess the whole image and compare it with other images is to use the Easy Mammo Survey tool When the Easy Mammo Survey
65. icate that the image data has been modified A shutter is removed by clicking on the respective icon in the image To turn off all display shutters in a CAM press Toggle All Shutters h _ 58 9 Introduction to General 2D CAM Once display shutters have been defined they can be saved in the PACS archive as Pre sentation State objects cf chapter 7 associated with the patient image data for which the shutters were defined 9 9 Cine Viewer in General 2D CAM the Cine Viewer automatically displays images in sequences one after another analogous to the image frames that are displayed when viewing a movie Figure 9 18 Cine Viewer Toolbar To initiate cine mode and display the images in order from first to last click on the Play button To initiate cine mode with the images displayed in reverse order click on the Reverse but ton It is possible to halt the cine viewing mode by pressing Stop or pause it by pressing Pause The Ping Pong button initiates a cine mode in which images are displayed in the order first to last starting with the current image then last to first in a continuous back and forth loop The speed of images shown each second is editable from the toolbar via the small up and down triangles or by entering a number directly into the control box The minimum frames per second FPS is 1 and the maximum is 30 FPS eal The frames per second speed that is set is not necessarily the spee
66. ient First Name 4 _ Other Patent ID j Patient Last Name Other Patent First Name E Study Date dore Patent Middle name Patient Last Name Patient Age Properties Patient Size i Patent Weight Label Patient Patent Ethnec Group Patient Occupation Defauk velum Patient Additional History Case Letter case remains unchanged Patient Comment Patient Nrb of Related Studies Mode Optional Patient Nrb of PFuslabed Senes Patient Nrb of Related instan Matching Starts with had E Patent Sex f Study level Wilde ards Yes user can type ene or mone wildcards z Study Time Primal length ha lima Te C Study ID Study instance UID Modalities In Study E E E Regular Exy z1 OK Cancel 3 1 1 Advanced search To activate the Advanced Search dialog box select Advanced in the Simple Search box The dialog is divided into three groups Patient Study and Series For each group it is possible to put in various search criteria It is possible to search on a known date before or after a set date or within any interval between dates The selections in each of the scrolling menus in the search dialog box are specific to the type of data being searched after Figure 3 5 The Advanced Search Dialog Box 22 Chapter 3 mM ee PACS Advanced Search x PACS B DCMACHEE DCMACHEE Edit Patient Study Series Patient ID starts with Issue
67. ilable the best quality COTS printers should be selected for those situations where a significant amount of patient image data will be printed out via the EasyViz system To print to any other type of printer a screen capture must be done of the 2D CAM and then printing is done via an application external to the Easy Viz sys tem It is only possible to print selected images or display set from the 2D CAM via Print in the File Menu A dialog opens showing the number of images that have been selected for printing and provides options for choosing a print profile including a printer Advanced users can place annotations on the printouts and select other advanced options NOTE V The DICOM Print function is only available to members of the group DICOM Print The system administrator assigns all group mem berships Limitations for Mammoeraphic Viewin Lossy compressed mammographic images and digitized film screen images must not be reviewed for primary image interpretations Mammographic images may only be inter preted using an FDA approved monitor that offers at least a 5 Mpixel resolution and meets other technical specifications reviewed and accepted by the US FDA Product Specifications The Easy Viz system is a software only application designed to operate on a wide range of computers both Easy Viz servers and various Easy V1z clients Enterprise Viewers and Diagnostic Workstations There are however minimum or recommended hardwa
68. ing protolcols is a 2x2 layout 9 2 3 Creating and Editing of Hanging Protocols DICOM hanging protocols can be created edited or removed by selecting Edit Hanging Protocol from the Tool Menu Figure 9 3 Dialog for Editing of DICOM Hanging Protocols Hanging Protocols EasyViz ers Basic HP for 4 Stage Stress Echo st nis HP eates a Presentati _ 43 Chapter 9 When creating a new hanging protocol it is possible to base it on an existing one by mark ing the one wished duplicated and pressing Copy Pressing either New to create a new hanging protocol Edit to edit an existing one or Copy to copy an existing one will open the HP Editor When creating or editing a hanging protocol several criteria are defined in order to use the hanging protocol for a study which complies with the specific definitions To facilitate this process EasyV1z uses safe tags Safe tags are the amount of DICOM tags which in connection with a C FIND is to be expected by the PACS archive to return to the application Safe tags display a list of those tags which can be expected to function as criteria for a hanging protocol and are visible in the overview of hanging protocols by pressing the button in the dialog NOTE The Default Hanging protocol is not available for editing or deletion NOTE V Creation or editing of DICOM Hanging Protocols is advised for advanced or expert users only Figure 9 4 Hanging Protocol Editor Hanging Prot
69. ion is selected in Easy Viz the mouse cursor is always changed to fit the func tion In order to toggle a function off select the function again or choose another function Additionally it is possible to click in any image or series pane with the right mouse button to deactivate the function If the mouse moves over an image that is in a display set which contains multiple images then the cursor automatically changes tosignify that clicking on the image and dragging or scrolling with the mouse wheel will scroll through the stack of images slices Clicking on an image or series with the right mouse button brings up a context menu This menu provides rapid access to a number of functions At the bottom of the context menu the Display Sets that are currently loaded in the 2D CAM are shown along with selected information regarding the series data such as the type of scan imaging parameters the scan date and the number of images The selected 31 Chapter 4 Display Set is flagged via a cross Selecting any Display Set then replaces the selected Dis play Set with the new Display Set 4 9 1 Keyboard and Mouse Shortcuts In addition to the general navigation methods using the mouse and keyboard there are a number of navigation shortcuts for the most common functions that use the mouse and the keyboard The following table provides a list of the most common shortcuts Description Pan Zoom Change focus pane Width Level Scro
70. ll through series e g CT or MR Enlarge pane Image in full screen Undo Redo Deactivate a tool Add remove toolbar Return to multi pane view What s This help func tion Help Close images _32 Shortcut Ctrl left mouse Shifttleft mouse Shift tscroll wheel Arrow keys Middle mouse Scroll wheel arrow keys up down one image at a time Left mouse and drag up down EDLer Double click eZ CUTIIY EIN Clack Right click on menu bar Escape ob grsEL F1 CET E36 5 Text overlays o Text overlays Toggle Text Overlays is used to show or hide all text overlays in images and display sets in 2D 3D Fusion and Virtual X Ray CAMs The Toggle Text Overlay function only controls the text that is automatically displayed with image data in the CAM Text Overlay Editor System Administrator The Text Overlay Editor opens through the tool menu and is a feature which makes it easy to customize text overlays on images Figure 5 1 I List of available text overlays 2 Tool buttons 3 Name of the text overlay 4 Predicate filters 5 Textual content of text overlay 6 Pencil icon 7 Insert Macro 6 Ignore Patient Name ID Warnings 9 Potential overlap in text locations Text Overlay Editor x When an image pane is displayed an overlay is selected Starting from the top of the list 1 the first overlay qualified by its own predicates is selected This means that overlays with very specific predicat
71. logarithmic so that the middle position corresponds to 2 2 percent of the volume When the threshold is set click on OK to run the Vessel Tracking algorithm WARNING A The threshold slider must be used in order to obtain the best vis ualization of blood vessels Figure 9 29 Vessel Tracking 69 Chapter 9 Volume MPR Reconstruction MR Gyroscan Intera Later ality Thickness SP TR 70 10 Fusion 3D CAM 10 Fusion 3D CAM The Fusion 3D CAM allows viewing of dual modality studies The CAM s primary func tion is to fuse two modalities to a single view hereby combining anatomic information with functional information The Fusion 3D CAM also allows the use of different color LUTs for visualizing the PET series or the fused series in order to emphasize and highlight concentrations of the radio nuclide tracer material Modalities for example CT and PET series are fused into a 3D MPR series for easy loca tion of cancer tumors Present example in Figure 10 1 shows three series CT PET and the fused images displayed in the Fusion CAM All three series are displayed in Volume Axial Coronal and Sagittal views The fused MPR view can be manipulated as any other 3D image which includes zoom pan rotation moving the MPR plane location and other specific tools that relate to fused images Figure 10 1 Fusion 3D CAM A PET series is fused with a CT series Fusion 3D Fusion toolbar The Fusio
72. mouse button while dragging it 9 5 3 2 Point Distance Measurement 2 The 2 Point Distance Measurement tool 2 is used to measure a current distance of a defined line segment between two measurement points It is possible to define several 2 Point distances when the tool is active 9 5 4 N Point Distance Measurement tool fu The N Point Distance Measurement tool n is likewise used to measure distances between measurement points but it has the ability to place as many points as wished for As measurement points are placed the current distance of a defined path 1s displayed To stop the line of measurement points double click on the mouse or use the right mouse but ton which will also deselect the tool _54 9 Introduction to General 2D CAM 9 5 5 Distance Ratio Measurement The Distance Ratio Measurement tool is used to rate a distance between two line seg ments While the tool is active several line segments can be defined 9 5 6 3 Point and 4 point Angle Measurement 3 Y4 3 Point and 4 point Angle Measurements V3 Ya are used to measure angles in images by placing connected points to calculate an angle For 4 point measurements 4 points are placed on two separate lines hereby allowing for an angle to be measured without the lines necessarily being connected 9 5 7 Cobbs Angle Measurement Yc The Cobbs Angle Measurement has the same function and purpose as both 3 point and 4 point measurements It calculates an an
73. n The Pan function is activated from a menu or a toolbar or by using the Ctrl LeftMouseButton To pan an image left click in an MPR pane hold down the left mouse button and move the mouse around to pan the image The Reset Pan Zoom button amp cancels all pan motions or operations that have been per formed for the selected image or series 66 9 Introduction to General 3D CAM Rotation Hold the cursor over the MPR lines of the MPR plane and rotate the plane via Ctrl and a left mouse click Scrolling Scrolling is possible with the scroll wheel Left mouse click tdrag the arrows or by selecting either one plane or the intersection of them Placing the mouse in an MPR plane and pressing M on the keyboard is another way to set MPR lines in an MPR plane It is possible to toggle MPR lines on and off via the icon in the toolbar 3 9 14 1 Slab MPR Thick MPR Slab MPR is used to modify the slab by changing the thickness of the slab Slab MPR visualization is activated either from the toolbar or through the shortcut Ctrl Shifttleft mouse click When activated a Slab 3D Mode icon is shown in the right hand side of the image pane When Slab MPR is enabled for the first time the slab thickness 1s set to default thickness Changing the thickness is done by dragging the stippled MPR lines or through the short cul Ct r1q4obhrfisliert mouse ol e The slab thickness is displayed in the text overlay To disable the fu
74. n in General 2D CAM Image subtraction is an image processing operation in which intensity values from a mask image are subtracted from corresponding intensity values in a target image pixel by pixel to highlight the changes between two very similar 2D images The modified target image is rescaled in intensity values to utilize the full dynamic range of the original image Figure 9 14 Image Subtraction Toolbar It is possible to perform an Image Subtraction by toggling on one of the Image Sub traction Tools One To One Subtraction One To Many Subtraction or Display Set Subtraction Activation of one of the tools will allow the user to choose the Mask image and the Target image The subtraction step is then performed as the Mask image is subtracted from each corresponding image in the Target image hereby modifying the Tar get image 56 9 Introduction to General 2D CAM The target image or images are marked with an icon to indicate that the image subtraction operation has modified the image data Display sets and images containing image subtractions will activate the Clear All Sub tractions tool To remove all image subtractions in the series click on this tool To remove subtraction from an image select the Target image and click Remove Sub traction Tool or click the Subtraction flag in the image Figure 9 15 Image Subtraction Completed Display Set Subtraction admin LasyViz 5 fs is v
75. n toolbar has been configured to include the most used tools when working with fused images The toolbar can be customized and set to fit any user needs Figure 10 2 The Fusion toolbar zy a Chapter 10 ah LW O 5g ml gt UW 17 0g m GEcolor Blend 50 Y Color Look Up Tables LUTs The Fusion 3D CAM allows the use of different color LUTs for visualizing fused and PET series in order to emphasize and highlight concentrations of radionuclide It is pos sible to choose between several different color LUTs Automatic Volume Rotation Images in the volume view can be automatically rotated e Click on Start Volume Auto Rotate to start rotation of the volume Click on Stop Volume Auto Rotate to stop the rotation Rotation is then reset and the volume returns to its original position Next to the Start and Stop icons the rotation speed can be adjusted in relation to degrees per second Click on the up and down arrows or type a number in the box to set the speed Blending Value The blending value of the fused series can be adjusted via the Blend feature on the Fusion toolbar Setting the blending value can also be done via the keyboard shortcut of Ctrl Alt holding down the left mouse button and moving the cursor up or down The mouse cursor will change to Values for the Lower and Upper Window respectively are adjusted in the Fusion toolbar or in the LUT Viewer in the left hand side of the dis play s
76. nction either press the icon T5 or the slab indicator icon displayed in the right hand side of the MPR image pane 9 14 2 Synchronization The pivot position and the MPR intersection is by default synchronized meaning that manipulating one will affect the other It is possible to disable the synchronization from the Tool menu under Preferences so that either changes made to the volume will not affect the MPR planes or vice versa Likewise 1s it possible to toggle off both functions so that neither the volume rendering nor the MPR planes are synchronized when the other is mod ified 9 15 Annotation and Measurements The Annotation toolbar contains a series of measurement tools for measuring distances angles and intensities of image data 9 15 1 Measurement on MPR planes Insert measurement 1 Select a measurement tool 2 Left click to insert control points for the measurement Note that it is possible to use the scroll wheel in between control points 3 Right click to cancel or end the measurement Edit measurement 67 Chapter 9 To edit a measurement drag the control points using the left mouse button This will move the control point in the current MPR plane Right clicking on a measurement will move the current MRP plane to intersect with the control point Delete measurement To delete a measurement click on it in one of the image panes or in the sidebar and press Delete on the keyboard 9 15 2 Measurements
77. nverted to an image or sequence 9 4 3 Toggle Image Filtering The Toggle Image Filtering selection turns image filtering for a selected image on and off Image Filtering is performed as a matrix convolution which requires that the application of the filter at each pixel in the image and a small area around each pixel is math ematically evaluated to determine a new pixel value To select an image Filter click on the drop down menu next to the Toggle Image Fil tering function to display the two default image filters Default Unsharp Mask and Default Gaussian Blur The Unsharp Mask is used for edge enhancement to make edges clearer and more 49 Chapter 9 prominent in an image The Gaussian Blur Filter is used for noise reduction to make structures and objects more blurry in an image which often reduces noise appearing as small specks or dots When a new Filter is chosen via the Toggle Image Filtering selection a dialog box is dis played Figure 9 10 Filter Question Image Filtering Filter Question You have changed the current filter Do you wish to e apply the filter to the selected image It Is also p ossible to replace the filter on the image that already has one Do nothing Replace Apply activates the new filter and Image Filtering is performed with the new filter on the image that has already been processed Do Nothing activates the new filter but no Image Filtering is performed Replace activates
78. o an email What s This The What s This help function activates a query feature so that clicking on any object or area in the CAM displays a text box that describes the selected feature or function All CAMs also provide a tool tip help function which brings up a temporary text box 39 Chapter 8 when the mouse cursor is hovered over an object or function in the CAM The tool tip text box provides a short description of the object and functions for the control or area under the mouse cursor 40 9 Introduction to General 2D CAM 9 Introduction to General 2D CAM The General 2D Clinical Application Module CAM is the main tool for viewing and processing patient image data This chapter explains in detail imaging image processing and navigation in the 2D CAM 9 1 Navigation in the General 2D CAM The General 2D CAM is activated from the Workflow Manager by selecting either a study or a series If only a single study is selected and a hanging protocol is applicable the Easy Viz system automatically obtains and displays prior studies in accordance with the rules in the applied hanging protocol In all other circumstances the selected studies or series are simply opened and displayed in the CAM Note that multiple studies or series that are selected do not need to be from the same patient The General 2D CAM shows images grouped in display sets and the images are shown side by side in the overview mode of the CAM
79. ocalizer lines from a scout image click on the small red triangle that 1s located at the top right side of the set of localizer lines Floating Localizer Tool _52 9 Introduction to General 2D CAM To add floating localizer lines click on the Show Floating Localizer Lines on Scout 7 and once the mouse cursor is hovered over a display set localizer lines automatically appear on the matching scout image and the position of the present slice is displayed on the scout image by a highlighted yellow localizer line The first and last slice of the stack are highlighted by green lines on the scout image and the intermediate lines are indicated by dots along the scout axis Localizers can be locked in place by clicking on the icon and the line can now be grabbed and moved to a new position While the localizers are locked the scout icon changes to a Toggle Localizers and Scouts To toggle the display of localizer lines on a scout image on or off click on the Toggle Localizers selection in the View Menu This also activates deactivates the connection between a scout image and the display set containing slice images All localizers in the 2D CAM are controlled by this toggle function 9 4 9 Link mode The Link tool amp makes it possible to link two or more display sets or series together such that scrolling zooming and panning in one series 1s automatically synchronized with scrolling through another series To activate the t
80. ocol Editor Demo General In the General section of the dialog the Name and Description fields are used to provide a name for the hanging protocol together with a short description of the hanging protocol The Predicates field defines which type of studies can be processed by the hanging pro tocol It is possible to limit the application of the hanging protocol to studies from a par ticular modality to a particular anatomical region or to a particular laterality 44 9 Introduction to General 2D CAM The Environment fields define the conditions under which the hanging protocol is appli cable via screen settings As an example it is possible to specify that the hanging protocol is only applicable for screens with a certain resolution The Owner field is used to specify which users or groups have access to the hanging pro tocol being edited or created Group fields may not be present if the user does not have permission to produce hanging protocols that can be accessed by other users Image Sets An image set relies on the DICOM information that is present in the actual study selected for viewing Hanging protocols are often used to access and display a combination of actual and prior studies Therefore image sets are broken up into two sections one deal ing with non time based requirements and one dealing with time based requirements Time based rules are often used to access and display prior studies that are rela
81. ocument CAM The Document CAM is used to display documents that are associated with a particular patient or study The primary purpose of the CAM is to display documents and to print these documents The Document CAM contains only basic CAM functions such as print ing scrolling and a few others The Document CAM is accessed in one of two ways From the Workflow Manager or from the Taskbar once a CAM has been opened The dialog Choose Document is displayed for loading of chosen documents into the Doc ument CAM Figure 12 1 Document CAM Ex gu Start v Pal T pod PACS WFM General3D MRBrainAngio3D DOC CAM Demo user Easyviz Eile View Help X Choose Document Date User Accession Number Study Epikrise 2007 08 13 20 54 MI NJA j ywZcXxUt I3 76 13 Report CAM 13 Report CAM The purpose of the Report CAM in EasyViz is to connect patient images and their cor responding reports The result of a radiology study is the written report and the image therefore it is useful for clinicians and users if they have instant access to the written report when viewing the images The Report CAM is a structured method of writing reports based on a predefined tem plate EasyViz conforms to the DICOM Structured Report standard A report consists of a hierarchical collection of content items which together form the report Describing images using the SR format means that reports will have a uniform layout which gives the auth
82. on of list of patients Studies and series 5 Column filters 6 Located patients studies and series 7 Show selected study or series 8 Search 9 Update worklist 10 Hierarchical structure of patient data 4 Start General2D PACS WFM File Edit Help 2 PACS Search 5 a Profiles admin medical insight com 13 04 Expand to Study Y a Patient Name j 01524637 maal tjj 3Study i CAT Study 1330 images 9 OLSEN JAN Study LUMB 1170 images 6 12 12 tj amp Study NEURO MONT CRANE 1636 images I Senes localizer 3 images i Series TISE SAG 4mm 30 images Series FLAIR TRA 4mm 30 images i Series DIEFUSION 4mm 90 images i Series DI ION 4mm ADC 30 images Series T2 EG HEMO TRA 24 images iSeries PhoenixZIPReport 7 images Series T1 3D GADO MPRAGE 176 images i Series AX T1 GADO 30 images Series CORO T1 GADO 30 images Series SAG T1 GADO 30 images Series nr 1 1 images i Series test 1 images Series test 1 images i Series sc1 1 images iSeries sc2 1 images Q12756 9 Study Right Ankle Complete Study Min 3 View Q18Y WORAWANNA MISS 9 Study Breast 4 images Q217_efter PACS 9 Study WB MED KONTRAST HV 2261 images s Show7 Patient ID Modality 908 KO SC PR CT SR 140339 0905 KO SC PR MR SR 10 01 20 KO SC PR MR SR 12756 KO PR CR SR 2878415 SC US PR AW1767881647 496 11476 Profiles
83. on the product The Easy Viz system is a software package that is used with general purpose client server computing hardware to acquire store distribute analyze process and display images and associated patient data throughout a clinical enterprise The Easy Viz system performs functions of digital image processing measurement communications and storage The EasyViz system is used with specified computing hardware that supports DICOM based protocols for acquiring transmitting storing viewing processing and printing DICOM images and studies received from a number of modality types including CR DX MG IO XA RF PT CT NM US MR SC ES GM SM XC VL and OP The EasyV iz system is used either for primary reading interpretation or diagnosis of patient data via Easy Viz Diagnostic Workstations or for clinical review of patient data via EasyViz Enterprise Viewer EasyViz Enterprise Viewers are not intended for use in the primary reading interpreting diagnosing of patient image data Because of the technical advantages of the EasyViz system and the ease of use of the sys tem clinical workflows are improved and enterprise wide access 1s provided to all nec essary data and analysis functions to all authorized users at all times and at all locations on a variety of physical devices Intended User The EasyViz system 4 0 is a clinical PACS imaging and data management software sys tem intended to be used by train
84. ons Intro P Pan Patient Study Browser Sidebar Pixel Intensity Tool 2D CAM POI 3D Point of Interest 3D Presets Sidebar 3D Presets for Window Width Level 2D CAM Print Intro Print Report CAM Printing Functions Intro Product specifications Intro Profile Editing Ranking Hanging Protocols 2D CAM 14 Index 67 52 32 59 66 54 41 78 27 29 55 68 68 65 48 78 23 42 87 Chapter 14 Read only reports Report CAM Redo Refresh Report CAM Rename bookmarks Sidebar Report a Problem 2D CAM Report CAM Resolve Problem Intro Responsibility Intro Rotate Image 2D CAM Safe tags Hanging protocols 2D CAM Safety Directions Intro Save a report Report CAM Save bookmarks Sidebar Save Compound Presentation Scope of this manual Intro Screen Layout Screen Layout 2D CAM search Expressions WFM searching for Patient Data secondary Capture 2D CAM secondary Capture 3D CAM secondary Capture Fusion CAM Select a measurement SUV Set preferences Shared Session Shortcut Editor 2D Shortcuts Keyboard Customize 2D Show localizer lines 2D CAM 80 Zi 79 28 39 d 32 43 78 28 36 14 5 19 19 35 35 35 73 11 12 31 31 52 _ 88 14 Index Show Text Overlays 2D 3D 33 Shutdown 28 Shutter Functions 2D CAM 57 Sidebar 28 Sidebar SUV 3D dz Simulating X Ray Images 75 Slab MPR
85. ool click on the Selection Handle in two or more display sets that you wish to link together while holding down the Ct r1 key It is also possible to activate it by using space to select o deselect a display set After selecting the display sets click on the Link tool button 9 and the icon is shown in the right corner of series that are linked together To deactivate the tool click on the button or on either of the indicators Linked image sequences are synchronized in one of two ways If the underlying DICOM information for the linked series specifies spatial positions then the synchronization 1s done only according to spatial position If such information 1s not available the syn chronization is done according to slice position 9 4 10 Toggle Text Overlay The Toggle Text Overlay function is described chapter 5 9 5 The Annotation Toolbar The Annotation toolbar contains a series of annotation tools and measurements tools that are all customizable from the Tool Menu The tools allow the user to measure distances angles and intensities of image data Figure 9 12 The Annotation Toolbar Some general functions apply to all tools _ 53 Chapter 9 A tool is activated through a click on the specific icon in the toolbar To deactivate a tool either click the right mouse button or simply choose a new tool It is possible to move a whole measurement or just one of the measurement points by hold ing down the left mouse button an
86. or an easy fast and similar way of creating reports and which makes it easier to read reports authored by someone else In EasyV iz patient images are persisted into a PACS Navigation in the Report CAM To open the Report CAM from PACS choose the required study in the WFM and click on Report in the drop down menu in the CAM selector column When opening the Report CAM from either the WFM or from one of the other CAMs a new report is auto matically created if the study does not already have an associated report a new dialog opens asking to choose which template to use EasyViz always has a default template installed However if this template does not fit the user s needs a new template can be created from the WFM if the user has administrative rights To edit the default template click on the Edit menu in the WFM and then on Edit SR Templates By use of the Tab key on the keyboard it 1s possible to tab through the various content items of the report The current item in focus will be denoted by a dashed line and the document item will have a yellow background When writing the report text sections can be dragged and dropped inside the text item and between the various text items It is also possible to drag and drop images from the Patient Study Browser in the Sidebar into a thumbnail area of the report Delete and zoom It 1s not possible for EasyV iz users to delete a report Only PACS administrators can do this However
87. osis of patient image data For EasyViz Enterprise viewer it is recommended that the highest quality monitors are selected for the intended use of the system A wide variety of hardware devices and mon itors can be used as EasyViz Enterprise viewers and there are guidelines for the mini mum type of hardware computer and screen that can be used for each type of Easy V1z Enterprise viewer Where applicable it is recommended that monitors for EasyViz Enter prise viewers be adjusted and calibrated with applicable tools supplied by the monitor manufacturer or from third party vendors WARNING EasyViz renders images in accordance with DICOM Grayscale Stand ard Display Function GSDF Hence all monitors must be calibrated correspondingly before any diagnosis of patient image data is carried out A WARNING A EasyViz Enterprise Viewer may not be used for primary reading of patient image data Image Compression Easy Viz Enterprise Viewer uses lossy compression methods when displaying patient image data that are being manipulated by the user This is due to the streaming methods that are used for communication between clients and servers Depending upon the avail able bandwidth in the connection between the Easy Viz server and the Easy VizEnterprise Viewers and other parameters the displayed images will be degraded to some extent and caution should be used when viewing such images When manipulation tasks are com pleted the im
88. overview amp i or the currently selected Display Set is the only display shown in the Presentation Group or the currently selected image is the only image shown within the Presentation Group 9 4 5 Screen Layout Display Set layout These functions are used to modify screen layouts Screen Layout controls the splitting up of the screen for the presentation of display sets and Display Set Layout defines the configuration of image panes in a display set By pressing either a dialog opens that allows the user to determine rows and columns for the layout Each of the layout buttons have an associated drop down menu that likewise enables the user to decide rows and columns for the display sets 5 Chapter 9 By modifying the layout of the screen via the button Presentation Groups in 2D CAM are automatically added or removed so that the desired screen layouts can be accom modated 9 4 6 Horizontal Vertical Flip gt Flipping is done either along the vertical or horizontal axis The Vertical Flip Tool flips the selected image or series along the vertical axis The Horizontal Flip Tool flips the selected image or series along the horizontal axis When an image or series is in a flipped state a Flip Flag is added to the right side of the image pane 9 4 7 Rotate Clockwise Counter Clockwise 9 To rotate a selected image or series by 90 degrees clockwise click on the Rotate Clock wise Tool To rota
89. r H Pan Ctrl left mouse click or from the toolbar Rotation per default rotation is activated via a left mouse click or when other tools are active Alt left mouse click or from the toolbar e Set Pivot The Set Pivot function allows the user to change the center of the image pane by moving the volume relatively to the center Select the tool and left click on the position wished as the center As a shortcut the pivot point can be set by right clicking in the volume pane NOTE V Itis possible to toggle on and off the marker showing the center of the image pane via the Toggle 3D Pivot in the View menu 9 13 1 Clipping Clip Planes are toggled on from the toolbar and will activate a clip box The box con sists of 6 clip planes each of which can be individually controlled D Chapter 9 To move a Clip Plane click with the left mouse button on a Clip Plane and move it in the direction suggested by the mouse cursor Figure 9 23 3D CAM Clip Planes admin EasyViz Start m ER BU pacs WFM General 2D General 3D admin 11 34 File Edit View Tools Help A X em lt 4 gt Name CTFO1 F BrighamandWomensHospital ID RSNAO6 A76270 3D Reconstruction CT Study STUDY FOR DEMO OF 3D FUNCTIONALITIES Date 04 17 2003 Time 11 00 22 i Series PE 1 0 B20f Protocol 07 PE Pelvis Contrast APPLIED BodyPart CHEST Laterality Thickness 1 mm 120 kV 211 mAs 500 msec WW
90. r of ID starts with First Name starts with Middle Names startswith O Last Name starts with yf rear ofbith j aaf Sex O male O female other any Patient History Search Description tA eee study date is within last 1 days Search Reset I Cancel 3 2 Profile Editing It is possible to edit a profile after it is opened in the WFM The Profile Editor is used to define a template that determines the manner in which information is presented in the Workflow Manager table regarding patients studies and series To activate the Profile Editor select Edit Profile in the Edit Menu from the Menubar of WFM Figure 3 6 Profile Editor 1 Profile Group 2 Profile Selector 3 Add Column 4 Remove Column 5 Column Properties 6 Values QE 3 Workflow Manager x gt Start PACS WFM admin medical insight com 13 10 Profile Editor Profile Selecto2 amp E Ji E 4v x Profile 1 Column Properties 5 Name CR Undersegelser 1 dag Title Type WFM DICOM QR Sort Type Owner EV Administrator amp Justification Visible by Group EasyViz Internal Users 8 Maximum Width Uniimit Search Criteria s within last 1 days Modalities in study contains CR A Current Width Expand Level Study Minimum Width Unlimit Mode PDA Hightes 5n 6 idy Patientnav Patient CPR Modalitet CAM Dato Tid Accession nummer Undersagelses kommentarer Henvisende laege
91. re con figurations for each of the EasyViz components Chapter 1 1 7 1 Training The user must have received adequate Medical Insight A S training on the safe and effec tive use of the product before attempting to work with it Training requirements may vary from country to country Users must make sure that training 1s received in accordance with local laws or regulations that have the force of law Y our local Medical Insight A S representative can provide further information on training See website for details www medical insight com WARNING A Safety is only guaranteed when personnel trained by Medical Insight A S have installed EasyViz 1 8 Compatibility Easy Viz workstations are only to be used in combination with other equipment or com ponents if these are expressly recognized by Medical Insight A S as compatible A list of such equipment and components is available from Medical Insight A S service on request Changes or additions to the equipment must only be carried out by persons authorized to do so by Medical Insight A S Such changes must comply with best engineering practice and all applicable laws and regulations that have the force of law within the jurisdiction of the hospital Easy Viz Enterprise can be used with all equipment complying with the minimum require ments specified by Medical Insight A S 1 8 1 EC MDD Directive This product is compliant with COUNCIL DIRECTIVE 93 42 EEC of 14 June 1993 con ce
92. rning medical devices including revisions up to and including M5 Directive 2007 47 EC of the European Parliament and of the Council of 5 September 2007 Details of the certification can be found on the Medical Insight Web Site www medical insight com 1 8 2 Standards e SO 14971 Medical Devices Application of Risk Management to Medical Devices 2009 IEC 60601 1 2005 Medical electrical equipment Part 1 General requirements for basic safety and essential performance EC 62304 Ed 1 Medical device software Software life cycle processes computer software e EC 62366 Medical devices Application of usability engineering to medical devices 2007 US FDA compliance is as required by Part 820 of Title 21 of the Code of Federal Reg ulations CFR e SO 13485 2003 Quality management systems Requirements for regulatory purposes 1 Scope of this Manual Canada Health Canadian Medical Devices Regulations MDR compliance is reviewed annually 1 8 3 Configuration It is not possible for end users to configure the Easy Viz system only system admin istrators can do this Information on how to configure the system can be found in the sys tem administration guide 1 9 Connectivity and Installation Easy Viz communicates with other devices in the hospital network by using the standards DICOM amp HL7 For detailed information please see the DICOM conformance statement and IHE integration statement
93. rough the Tools menu 9 4 The Main Toolbar The Main toolbar contains seven tools already described in the chapter on Common Func tions for all CAMS ch 4 these are Home Undo Redo Pan Zoom Reset Pan Zoom and Magnifying Glass The remaining tools will be described hereunder unless otherwise stated Figure 9 7 The Main Toolbar 9 4 1 Width Level Width and level is part of the LUT tools which are functions that control and modify the Look Up Tables LUT for image data A LUT defines how intensity values in an image are displayed on a viewing monitor as images are composed of pixels and each pixel has an intensity value A LUT determines how those pixel values are mapped to actual light intensity values on a display device By modifying the LUT the mapping is changed between pixel values and light intensities thus modifying the appearance or characteristics of an image contrast and brightness Image contrast is known as the Window Width for an image and image brightness is known as the Window Level for an image Together Width Level defines image bright ness and contrast in a displayed image or series Figure 9 8 Width Level overview 47 Chapter 9 admin EasyViz l stat f Bel fal al PH Pacs WFM General 2D admin 14 36 File Edit View Tools Help Q lt gt OvM AYE A WB SOFT_TISSUE F2 acc o Abdomenl System F4 CardiacCalcium PostOperative Abdomen2 System F5
94. rt is in the process Verify Once a report is completed it has to be verified by a radiologist and using this function can be seen as a personal signature e To verify the report simply click on the Verify tool button in the toolbar The Verify function can also used before the Complete option In this case the report will still have to be completed afterwards Clear verification Sometimes it can be necessary to change a report even though it has been verified This can be done by using the Clear Verification function and clicking on the tool button b in the toolbar Edit An existing report can normally be edited however this depends on which type of doc ument template the report is based on A report consists of content items which can be filled out and the number of these content items depend on the template To edit each content item click in the text field under the two headlines in each content item The Tab key on the keyboard can also be used to navigate between content items Remember to save the report after it has been edited Addendum to report Even though a document template has been chosen before creating the report certain con tent items in the report can still be added to fit the user s needs unless the report is read only _79 Chapter 13 Click on the arrow next to the Addendum to report and add any of the content items to the report The Addendum to report option can also be sele
95. s right click on the desired preset and select Edit To create a new Color Transfer Functions Preset either right click anywhere in the side bar and select Add new or click on the More Options drop down menu in the Sidebar and then the Add new color preset A preset editor dialog opens and the new preset set tings can be entered and saved Figure 9 26 A Color Transfer admin EasyViz Start E pe vx Fel Exi 6m PACS WFM General 3D admin 10 34 File Edit View Tools Help Name CardiacCalcium PostOperative CTMULTI M St Nowhere Hospital ID 0001 3D Reconstruction CT Study Date 12 19 2006 Time 10 13 44 j Skin and Bone All default CT Series All Protocol Contrast BodyPart Laterality Thickness mm More Options Y kV mAs msec WW 1566 Hu WL 372 Hu Overview Volume Focus PID 0001 9 14 MPR Panes Navigation in the MPR panes is done through a number of functions Zoom The Zoom function 2 is activated from a menu or toolbar or by using the onrrts Left Mousebutton Click in the MPR panewith the left mouse button and drag the mouse to outline a rec tangular region which represents the area to be zoomed It is also possible to zoom in 20 percent at a time by clicking with the left mouse button click in the image The Reset Pan Zoom button amp cancels all zoom motions or operations that have been performed for the selected image or series Pa
96. series level displays a thumbnail image from the series which can either be a single image or a stack of images A stack of images will be denoted by having two underlying images behind the front thumbnail image It is possible to shift between the various images of the current patient image data by click ing on a thumbnail image and drag it to the image pane for display The size of thumbnail 29 Chapter 4 images is also changeable by clicking on the Thumbnail button F in the lower right corner of the sidebar 4 7 The LUT Viewer Tool The LUT Viewer tool is available in the General 2D 3D Fusion 3D and Virtual X Ray CAMS It contains two control objects an upper cutoff bar and a lower cutoff bar These bars determine which image values are mapped to white above the upper cutoff and which image values are mapped to black below the lower cutoff The image values between these limits are mapped to shades of gray The LUT Viewer is used pre dominantly with nuclear medicine data and using this tool 1s equivalent to using the Width Level tool To activate the LUT Viewer click on the LUT Viewer button l in a toolbar or menu 4 8 Customize Menus and Toolbars The function Customize is used for editing of menus and toolbars in all CAMs It is pos sible to add remove or relocate functions and options 1 shows available elements to be added or removed 2 shows the menu or toolbar to be edited 3 shows elements in the
97. sessssssssese enne 54 9 5 5 Distance Ratio Measurement 0 020 0022 cece cece eee ec ee eee eee se see nene 55 9 5 6 3 Point and 4 point Angle Measurement 00 2 00 220 cc cece cece e eee ceeeeeeeee 55 9 5 7 Cobbs Angle Measurement 0 000 20 ccc cece cece cece cece cece ceeeceeceeeeceeeees 55 9 5 8 Circular Intensity Measurement 0 200 02200 c cece cece e cece cece cece ceeeceeeeceeees 55 9 5 9 Freehand Intensity Measurement tool 0 000 0 2000 c cece cece cece c eee eeeeceeceeeees 55 9 5 10 Pixel Intensity DOOL eai onic ss iacaebien wenwad iei reei ae 55 9 6 Key Objects in General 2D CAM sssesssssssssellsle els eee ne eee eeeeseeeesees 56 9 7 Image Subtraction in General 2D CAM 20 00 0200 2 ccc cece ee ee eee eee 56 9 8 Shutters in General 2D CAM sesssssnhemmmRImmRIImmIIImIIIlmImIIllllllllllllllllll 3J 9 9 Cine Viewer in General 2D CAM oa nnn L LLL nee ceee sees 59 9 10 Mammography Imaging in General 2D CAM 0 00 00220022 ccc e eee e cece ee eee eee 59 9 Introduction to General 3D CAM 200 002 62 o Al AS i E DUMP TTE INTER 62 9 12 CAM overview ARREEEEEENNNNNNNMNNWMWWWV 62 9 13 The Volume PANG c snucotnsecet aide dele etes a dee bes Duca uad da veau rae Bebes Aas 63 JUNO uL M 63 9 13 2 Color Transfer Functions 0 0002200 cc cece cece c
98. ssssssssssssssssssssssssss esses sse emen esses sse lil 43 9 2 3 Creating and Editing of Hanging Protocols 0 0200 2 20 c ccc eee eee cece cece ee 43 VS MEO MD UCET 47 9 4 The Main Toolbar ssssssssssssssssssssssssssssIIsI IIR IR Rm ense sese sls r essersi 47 22 I Wy GUNA VC ei cee tetas Sy ce EROS 47 92 MAY CU 23 2 eerie earnest baat eae LLLI Die ced A a ALL L LL Pe DLL ALI D C 49 9 4 3 Toggle Image Filtering siuuisssiussesssssssssssssnsnnImI Rm mm mme 49 9 4 4 Show Overview Function Single Display Set Function Single Image Function 51 9 4 5 Screen Layout Display Set layout 0 002002 c ccc eee eee cece cece ceeeceeeeeees 51 9 4 6 Horizontal Vertical Flip sess 00000000110101 22 9 4 7 Rotate Clockwise Counter Clockwise loue 22 9 4 8 Localizer and Scout Lines iiussssssssssssssssssssssssssssn esse s sensn ei 52 SASER Od E esr e e a ai 53 9 4 10 Toggle Text Overlay 00 0200 c ccc ccc ccc cece cece cece III RI cece ceeeeeeeeeeeeeees 53 9 5 The Annotation Toolbar 2 2 2 0 eee ccc cece cece ene eee ene en hee ene nene 53 9 5 1 Text Annotations iissssssssssssusssssssssssesssn ss e s Rss ss esr se sr sees n oi 54 2A Mak r TOOL ceases toh asceyiteoen a LIN c E ba EEEE 54 9 5 3 2 Point Distance Measurement sissuuuusssssssssssssssssssssssss s e se seen ei 54 9 5 4 N Point Distance Measurement tool oseuiussssess
99. te a selected image or series by 90 degrees counter clockwise click on the Rotate Counter Clockwise Tool 9 When an image or series is in a rotated state a Rotation Flag is added to the right side of the image pane 9 4 8 Localizer and Scout Lines T Localizer and scout lines make it possible to see where a given slice image 1s located within another image Many CT and MRI modalities specify via DICOM codes which images can be used as scout images for which stacks of sliced images Not all modalities however provide this information automatically therefore the EasyViz system provides functions that allow the selection of a scout image along with a stack of sliced images which are then displayed together with localizer lines on the scout image showing the posi tion of a particular slice image NOTE V Optimally the scout image and the sliced images should be orthog onal to each other however under Preferences the angle can be adjusted Add localizer lines It is possible to manually add and remove localizer lines in an image by adding the func tion to a menu or a toolbar By selecting the slice image set and the position you wish displayed via scout lines a scout image can be chosen Once a scout image and a display set containing slices have been selected the scout image displays the localizer line and slice number and the position of the currently displayed slice image is shown by the localizer line To remove l
100. ted to the current study Image set rules are composed of a series of phrases or expressions that specify require ments regarding the DICOM tags that are present in image sequences Each phrase or expression presents a specific requirement for a DICOM tag for example that the tag shall have a certain value Figure 9 5 Editing of Image Sets v Hanging Protocol Editor Stress Echo 2 Stages Dual Head General Image Sets Display Javascript Put images where is is into the following time based image sets Image set 1 if the stu Image set 2 if the Image set 3 if the OK Apply Cancel It is possible to create new image set rules by pressing the Add button or to remove an image rule by pressing the wastebasket to the left of the rule To complete an image set it is necessary to define which image sequences are to be included in the hanging protocol Typically the sequences from the selected study are included along with various prior studies Display 45 Chapter 9 Before image data are displayed or presented the applicable Image Sets are divided into one or more Display Sets A Display Set specifies where and how images in an Image Set are shown on the screen and new display sets can be defined by pressing the Add button or can be removed by pressing the Remove button It is also possible to Copy the settings from one display set to another by pressing Copy Figure 9 6 Display Set Editing Tv Han
101. th The small flag before each Presentation State Object defines its state Green V indicates that the Presentation State is currently active red Y that the Presentation State is inactive and yellow X that the state is partially active Through the Context Menu Presentation is chosen locally for a single series This will activate presentations of more studies and the yellow flag will occur NOTE The 2D Compound Presentation is based on the DICOM standard Gray Scale Presentation State GSPS which means that it can be V used interchangeably with other vendors image displays However there is no standard covering the 3D usage so the 3D Softcopy Pre sentation States described here will only function with Medical Insight A S image displays 38 8 Help 8 Help A number of help features are provided in the EasyViz system which are described in this section Online Help The Online Help I function brings up an interactive online help application which pro vides comprehensive information regarding the functions and uses of the CAM and the EasyV iz system It opens in the section where the user is currently working and the appli cation 1s added as a tab to the Taskbar at the top of the main window The Online Help application is divided into several areas Index Contents Bookmarks and Search By clicking on either a bookmark a headline or a document in one of the four functions the Viewer Panel is opened The Online Help
102. the new filter and Image Filtering is performed with the new filter on the image but the processing of the previous filter is removed Image Filtering Configuration Expert Additional custom filters can be designed and added by activating the Filter Selection from the drop down menu under Edit From this dialog an existing filter can be edited or deleted or a new filter can be defined by activating the Filter Configuration by pressing New Figure 9 11 Filter Configuration 50 9 Introduction to General 2D CAM Choose afilter to use Default Gaussian Blur S DL Filter Name New Filter Choose Filter Type Unsharp Mask High Pass Gaussian Blur e Custom convolution Customize Filter OK Cancel Cancel To create a new filter name the filter and select the number of times that the filter should be applied consecutively to the image the maximum is 99 Specify the filter type along with the filter size and press OK If Custom Convolution is chosen as the Filter Type the Convolution Editor 1s brought up when the Customize Filter selection is made and the two default filters can be chosen to serve as templates from which to custom design the new filter The Reset selection of the Convolution Editor changes all Matrix Values to zero 9 4 4 Show Overview Function Single Display Set Function Single Image Func tion i These functions change the viewing mode of the 2D CAM so that either all Display Sets are shown as an
103. the print tool button to print the report A print dialog opens in which it is pos sible to select various print settings The View menu has three selections Toolbars Text Size and Refresh Document The Document menu has six selections Complete Verify Clear Verification Edit Report Addendum to report and History The Tools menu has six selections Customize Customize Keyboard Shortcuts Activate Shortcut Mode Preferences Template Management and DICOM Inspector The Report CAM Toolbar The default toolbar in the Report CAM consists of several tools some of which are known from the other CAMs such as the Undo Redo functions The new functions em T 13 Report CAM which are presented in more detail in this chapter are the Complete 1 Verify Clear Verification xl History 5l Edit Report and Addendum to Report functions See 13 below for the default Report CAM Toolbar BBa8 amp Mngsse 4 Refresh To refresh the report when needed click on the Refresh tool button in the toolbar This updates the report and shows changes Complete This function should be used to show other readers that the report has been completed This 1s the case when all information has been entered into the report and it 1s ready to be verified by a radiologist e Click on the Complete tool button in the toolbar This activates the Completion state which is one of several states which serve to show where the repo
104. those rights 2 2 The Workflow Manager After logging in the Workflow Manager WFM window is typically displayed It gives access to patient data and images in an easy rapid and flexible manner Figure 2 4 The Workflow Manager 212 Chapter 2 start General 2D pacs WFM Fille Edit Help Profiles F Expandto Study gle Patient Name Patient ID Modality Date Tim Q Study 23 images 4 Study 49 images Qt 4 9Study Stress Echo 95 images Q 01524637 maal tjj 4 9Study i CAT Study 1330 images Q OLSEN JAN 4 4Study LUMB 1170 images 12 12 4 9Study NEURO MONT CRANE 1636 images 112756 Q 18Y WORAWANNA MISS _ S9Study Breast 4 images Study Right Ankle Complete Study Min 3 View 10 06 2004 11 14 38 11 11 2004 10 34 10 11 16 2004 15 09 53 908 140339 0905 10 01 20 12756 2878415 KO SC US PR SR KO SC US PR SR KO SC US PR SR KO SC PR CT SR KO SC PR MR SR KO SC PR MR SR KO PR CR SR SC US PR General 2D General 2D General 2D General 2D General 2D General 2D General 2D General 2D 10 6 04 11 11 04 11 16 04 5 3 07 11 17 04 1 20 10 8 17 11 7 17 06 AW1767881647 496 11476 PT KO SC PR CT SR AW1644609337 884 11476 PT KO SC PR CT SR Q 217 efter PACS 4 Study WB MED KONTRAST HV
105. tool is activated the 1 1 Pixel mode is activated along with the Zoom Pan Viewer and the Text overlays Zoom Rotation and Flip functions are deactivated The view of the image automatically starts from the upper right corner of the image To go through the image systematically by viewing the large image tile by tile in 1 1 Pixel mode press Space on the keyboard Each tile overlaps the next both in horizontal and vertical direction to insure that border regions can be viewed in context To go back to the previous tile use the shortcut Shift Space and to deactivate the Easy Mammo Survey tool press Escon the keyboard Toggle Zoom Pan Viewer When zooming an image it 1s easy to loose track of the precise zooming area in the large image The Zoom Pan Viewer 9 thus displays a thumbnail image of the large image with a red frame in it to show which part of the image is displayed in the image pane To toggle the Zoom Pan Viewer on off press the corresponding icon in the toolbar WARNING A The FDA recommends that only monitors and printers specifically cleared for Digital Mammography use by FDA s Office of Device Eval uation ODE are used 61 Chapter 9 9 Introduction to General 3D CAM The General 3D Clinical Application Module CAM is one of the main tools for viewing and processing patient image data in three dimensions The 3D CAM is designed to vis ualize volume datasets such as CT or MRI series In contrast to the 2D C
106. troduction to General 2D CAM Hanging protocols are ranked with respect to the following criteria Definition of appli cability definition of environment and the author or owner of the hanging protocol NOTE V Standard users can only define DICOM Hanging Protocols for them selves while system administrators can define DICOM Hanging Pro tocols for all users 9 2 1 Changing Hanging Protocols It is possible to choose another hanging protocol after a study is opened If the auto matically selected hanging protocol is not the one desired it is possible to invoke another hanging protocol instead To select another Hanging Protocol click the Select Hanging Procedure in the right corner of the window This will bring up a dialog that contains a short description of each hanging protocol the owner or author of the hanging protocol and the rank of the hang ing protocol This selection dialog can also be activated via the Ct r1 h key combination or from the File Menu The name of the active DICOM hanging protocol is shown in the right corner of the win dow 9 2 2 Automatic HP Layouts The 2D CAM contains a Default Hanging Protocol for automatic layout of image data This is accessible from Select Hanging Protocols in the File Menu or from the short cut in the right corner of the window The Default Hanging procedure creates a display set for each series in the study being viewed The default window layout for default hang
107. with the same username and password this time tick ing off Roam in the login dialog Share Session 11 2 Introduction and Login Two or more users are also able to view the same session in EasyViz at the same time The first user signs in and presses Share in the login dialog The next users now log in also pressing Share in the dialog After logging in the first user is presented with a dialog where it 1s possible to create an optional SessionID 1 When users subsequently log in to a shared session the same dialog 1s shown and the user now types in the created name of the SessionID under Join 2 To start the shared session press Join Figure 2 3 Share Session 1 Creat SessionID 2 Join Existing Session Collaboration Create or Join Create 1 Join 2 Session ID 659 163 806 Session ID Po Create When a shared session has commenced the users are able to use the system as usual It is also possible for all users to interact in the window at the same time The name of the user who has last interacted in the window is shown first in line of names in the upper right corner of the window If a user wishes to leave a shared session it is important to press Disconnect Me in the Start Menu and not Logout as this will terminate the session for all users WARNING N Note that rights belonging to the user who first logs into a shared ses sion will be available for all users of the session even for users who normally do not have
108. wn the Ct r1 key and press the selection handle or press space again The selection of windows is indicated by a yellow border that surrounds the window along with the Selection Handle becoming yellow If a Display Set is selected via a Selection Handle 41 Chapter 9 and that Display Set contains a sequence of slice images then all the images in the sequence are selected It is possible to move a window to a new location by clicking with a left mouse button on a Selection Handle and drag the window to a new location on the screen To show a single display set or a single image in full screen double click on it To minimize it again double click again Groups in 2D CAM If a study contains more series display sets these are displayed in groups in the General 2D CAM A hanging protocol may define more display sets than the available screen space can accommodate To avoid that the image panes become too small hanging pro tocols can be configured so that display sets are split up into Presentation Groups which are shown one at a time The tabs at the bottom of the 2D CAM window controls which Presentation Group is displayed To change between presentation groups click on the desired group tab at the bottom of the 2D CAM window or press the key combinations CLDrISPQgUSOLPCUrILRPgDI Figure 9 2 Groups in 2D CAM PID 41 A2392429 Saved AS LAST SEEN H A Group 1 Group 2 Group 3 It is also possible to drag series between the
109. y Captures are not merely screen shots of the images selected for storage Lay outs are preserved and if selected display sets contain multiple images all the images are contained in the Secondary Capture After a Secondary Capture has been successfully saved the new series is available from the Workflow Manager in the same manner as any other patient data except that the modality listed as generating the series is Secondary Capture SC The Secondary Cap ture series 1s placed within the same study or exam from which the series originated LUE 7 Compound Presentations 2D and Softcopy Presentations 3D 7 Compound Presentations 2D and ooftcopy Presentations 3D Compound presentation states for 2D and Softcopy presentations for 3D allow the user to store an object in the PACS archive that describes how a particular set of images 1s intended to be presented by that CAM Along with information about the desired hang ing compound and softcopy presentations are derived from DICOM structured reporting initiatives A Compound Presentation is a standard method for communicating clinical information regarding patient data and images All presentations are associated with an existing Study and are stored along with that Study In the Workflow Manager it 1s pos sible to view the Compound Presentations that are associated with any studies if this func tion is activated This is done via the Show GSPS and Key Object tab in the edit menu in WFM
110. yViz system is used for primary reading interpretation and diagnosing of patient image data and the EasyViz Mammo system 1s likewise used for interpretation and diag nosing of mammography data Conceptually the system consists of a central Workflow Manager which provides search functions and navigation features for accessing patient data and images that are stored in the system From the Workflow Manager users can choose one or more items of patient information or images Once this 1s done the patient information or images are shown in new windows The visualization of images is provided by Specialized Clinical Appli cation Modules CAMs that are used to display common 2D images or 3D images along with 3D reconstructions and Multi Planar Reformatting MPR Currently five imaging or visualization CAMs are available in EasyViz the General 2D Cam the Gen eral 3D CAM Fusion 3D CAM Virtual X Ray CAM and Report CAM 2 1 Logging In To log in to EasyViz click on the EasyViz icon on the desktop and the login dialog opens Figure 2 1 The EasyViz Login Dialog Medical Insight 9 l Easyviz D ease type username and password Session Username admin ki New Password Roam J Share Preferences 10 Chapter 2 From within the Login dialog it 1s possible to set different preferences for the use of EasyViz The Preference dialog opens when pressing the Preferences button in the Login dialog Figure 2 2 Set Pr
111. z system should always be shutdown via the Logout function If the window in which the system is operating is closed this does not necessarily terminate the session on the Easy Viz server EasyViz On EasyViz Work Station the Start Menu is not located at the top of the screen but at the bottom Taskbar as part of a normal Windows layout The functions in the WS startmenu are similar to those in the Easy Viz Enterprise startmenu Figure 2 8 Start menu EasyViz WS Leg in Change user Preferences Local workstation settings About License info e 09 12 2011 te Chapter 2 Quick launching of CAMs is available only when a CAM is opened If applicable for a specific image the CAMs are shown in the upper right corner of the window This applies to both EasyViz Work Station and Easy Viz Enterprise _17 3 Workflow Manager 3 Workflow Manager The aim of EasyVis 1s to provide easy and fast access to patient and image data Infor mation shown in the Workflow Manager is structured as a list of patients that each holds another list of studies Each study can contain one or more series which again can contain one or more images In the column named CAM in the WFM it is possible to choose by which CAM a study is shown Note that not all CAMs allow viewing of more than one study at a time Figure 3 1 Workflow Manager 1 Taskbar for choosing between open CAMs 2 WFM Menubar 3 Profile Selector 4 Collapse and expansi

10 Fusion 3D CAM - Medical Insight

Contents

Download Pdf Manuals

Related Search

Related Contents