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XC User Manual - T&K X-Ray Consultants, Inc.

1. When the View is select the Scan dialog will pop up Choose the desired plate size to initiate a scan l Selected View Scoli AP Roo CR iCRco IOR iCRco IDR L 2003 2014 Page 83 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 84 e For iDR select the 14x17 inches button from the Scan dialog to initiate a scan Selected View Wrist R PA iCRco CR iCRco iDR iCRco iDR L Selected View Scoli AP iCRco CR iCRco IDR iCRca IDR I Domains XC employs the concept of domain to distinguish between whatis being scanned Domains also include processing parameters enabled in the Applications Interface To choose a domain go to Configuration gt Admin gt Imaging Domain See maging Domain on page 76 XC has several domains Medical Mammography e Veterinary e Equine e Podiatry Medical Medical is the default domain in XC The Medical domain is aimed at general radiography Mammography The Mammography domain shows a pair of breasts at the Anatomy Selection screen and relevant mammography sub anatomies At the Scan Screen the Mammography domain shows mammography sized plates 18X24CM 24X30CM 2003 2014 Page 84 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 85 The Mammography domain changes at the following screens Veterinary The Veterin
2. Configuration 90 Opening the Applications Interface 1 Click the Configuration button on the Patient Worklist Screen 2 Go to Admin gt Settings In the Imaging Domain field click the Launch Applications Interface button The Applications Interface will open Add Category 1 Open the Applications Interface 2 Select the parent tree item that the new category will be placed under e g Exotics 3 Type the name of the new category in the text box Click Add 4 Click Save Repository to Disk The new category will appear under the parent tree item Add View 1 Open the Applications Interface 2 Select a category 3 Type the name of the new view in the text box Click Add 4 Click Save Repository to Disk The new view will appear under the category Note ic All views can have specific processing parameters applied to them See Section Processing Parameter Evaluation on page 90 for more information Processing Parameter Evaluation The processing parameters can also be clinically adjusted and evaluated through the image preview functionality of the App Manager The purpose of this feature is to allow the user to adjust the processing parameter to their liking and make the images better tailored to fit their specific needs Users can adjust the processing parameters to fit specific needs 1 Click the Configuration button on the Patient Worklist Screen 2 Go to Admin gt Settings In the Imaging Domain f
3. Setting the Scan Resolution Note If your facility is mandated by law to acquire with a specific resolution then disregard the information in this section These instructions are not a mandate to acquire at a specific resolution Click the Configuration button on the Patient Worklist screen Select the Device Settings tab Select the desired device Select the desired cassette size For general radiography scan resolution of 155 microns and 200 microns are the recommended setting AFER A qw s Click Close and Accept to save the changes Setting the Appropriate Language 1 Click the Configuration button on the Patient Worklist screen 2 Select the Settings tab 3 Under Language select the desired language 4 Select the Close and Accept button to confirm changes Setting the Imaging Domain The Imaging Domain determines the default anatomy available for selection The default can be toggled at scan time by clicking the imaging domain button on the Anatomy Selection screen For example if the site does mammography the Mammography imaging domain needs to be set This setting can only be modified by the Administrative Account 1 Click the Configuration button on the Patient Worklist screen 2 Select the Admin gt Settings tab 3 Under Imaging Domain select the correct domain from the drop down menu 4 Select the Close and Accept button to confirm changes Setting the Processing Parameters Library The processi
4. Removing a Referring Physician Institution 1 Navigate to Configuration gt Defaults tab 2 Select the desired information to remove by click the check box next to the name 3 Click the Remove button in the appropriate section Setting a Default Referring Physician or Institution 1 Check the box next to the desired default name 2 Click the Set button The entry will be set as the default selection XC Data Directory This directory contains application data and preferences 2003 2014 Page 82 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 83 To access the folder listed the operating system must be configured to Show hidden files and folders Important Editing any of these files by hand will result in data loss The path to this folder 1s Windows XP C Documents and Settings All Users Application Data XC Windows 7 C ProgramData XC Hardware Interfaces XC employs the concept of an interface to visually represent the methodology of selecting scan parameters For each iCRco hardware product there is one or more interfaces e Ifthere are multiple devices or a device with multiple scan functions such as the Fusion DCR or Fusion DCR Flat Panel XC will show a tab for each device or scan function on the Scan dialog e ForiCR 3600 3600M 3600 Chrome and VertX select a body part from the skeleton graphic Anatomy and View
5. Click the Add New AET button Enter the desired AE Title information then click the Finish button To ensure that the new AE Title is valid highlight the newly created AE Title in the List of known DICOM AETs then click the Test AET button If the test is successful continue to the next step If the test is not successful please ensure that the AE Title information is correct and try the test again Select the Worklist Inputs tab In the Worklist Inputs tab put a check mark in the box es for the AE Title s you want query OPTIONAL The Modality Worklist Query can be set to query on a timer and the query can be limited to Local AET Target Modality or Today s date To enable these features select the desired query constraints from the Query for new patients every drop down menu or the Filter query by check boxes 10 Click the Close and Accept button to save the changes Note For information on Querying a Worklist see Section Querying a Worklist on page 70 Creating a Procedure Creating a procedure in XC requires an XC administrative account L In the Patient List Window click the Configuration button and select the Admin tab Click Procedure to go the to Procedure Configuration Window Enter the Procedure s name and ID and click Add The procedure will be added to the list on the right Adding Views to a Procedure 3 Click on the procedure name in the Procedure List 2003 2014 Page 88 of 100 Doc HC XC 0
6. Enter the target system s AET IP address and port number Ensure the compression is set to none and the Target Type is DICOM Click OK 7 In the Image Targets window select the target you just created then select the OK button In the DICOM Print Settings window select the OK button 8 In the Advanced DICOM Printer window select the Printer 1 button or the applicable printer then select the Test Printer button to test the association to the printer 2003 2014 Page 64 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 65 Status and Icon Indicators XC has many status icons and status indicators The following section describes those indicators Hard Disk Indicator Disk Used M 8 i The hard disk indicator shows the user how much disk space has been used It can be located on the Worklist screen Wireless Indicator Wireless Signal enhl l The wireless indicator allows the user to see the strength of the computer s wireless connection It is positioned on the top right corner of XC s window when the computer is on wireless connection Note The wireless indicator is not displayed in the Image Display window Battery Indicator Battery Level ao 9 The battery indicator currently only shows with the Vmotion hardware is in use The battery indicator allows the user to see the strength of the computer s battery It i
7. The Cassette registration window will list all cassettes that are currently registered 2003 2014 Page 36 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 37 7 Using a barcode reader scan the cassette s barcode This will register the cassette to the selected patient and anatomy When a cassette is successfully registered it will appear in the registered cassette list Note To register another cassette select the anatomy laterality and view and then scan the cassette s barcode Note If you register a cassette that s already registered XC will ask if you want to re register the cassette Note Selecting a registered cassette in the list will highlight the selected anatomy on the screen Cassettes registered to different patients will be greyed out and inaccessible 51 8 When finished registering cassettes click the Finish Registration button s Note Images cannot be scanned while in the Cassette registration window 9 After the registered cassette s has been exposed scan the cassette s barcode XC will notify you that it s Ready to Scan 10 Insert the cassette into the bay to begin image acquisition Note Ifthe scan unit has two bays it s possible to scan two cassettes at the same time To start a second E scan using the other bay scan the barcode of another cassette and then insert the cassette into the avai
8. 2014 Property of iCRco Inc Acquiring an Image 28 Acquiring an Image for Imaging Procedure for existing patient 1 In the Patient List Window open the desired patient s Patient Information Bar This will open the Study Information Window 2 Create a new study by clicking the Schedule New Study button 3 Enter the patient information on the Schedule New Study Window Click the box called Procedure a drop down menu will show up and select the desired procedure Then click the Finish and Scan button This will open the Studies window mn In the Study Information Window the Study Thumbnail Gallery is preloaded with a series of scan orders and each thumbnail displays information of the anatomy view Click on the thumbnail and this will open the Scanner Option window Select an appropriate cassette size for acquiring an image As the image is acquired it will be displayed in the Image Display window dli E a Imaging Procedure is completed when all the scans are acquired Patient Information Reconciliation Imaging Workflow The Patient Information Reconciliation feature allows the user to enter patient demographic information after all of the images have been obtained In particular this feature is useful for handling unindentified or emergency patients Note E The Patient Information Reconciliation feature works as an extension of the general imaging workflow or the procedure based imaging workflow The fol
9. DVD into the drive 4 Click the BURN button 5 Depending on the number of flies being exported the speed of the system and the speed of the burning device this operation could take a few minutes Please be patient while the CD DVD burns Print Study 1 In the Export window click the Print Study button 2 The print application will open and load the images from the study to print Note E See Section Advanced DICOM Printer on page 58for more information about the Advanced DICOM Print application DICOM Send 1 In the Export window click the DICOM Send tab 2003 2014 Page 69 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Managing Patient Data 70 2 Select the check box next the desired AE Title s 3 Click the OK button to initiate the DICOM send Rejecting an Image When an image is unsuitable for a diagnostic reading the User should reject the image The image may be rejected for many reasons patient movement wrong image in patient folder operator error etc 1 Acquire or open an image 2 Click Reject button at the bottom left hand side 3 Select the reason for the the rejection and click Confirm The image will be removed from the study and added to the Image Rejection Report in XC and the QC Tool Removing Single Patients Note E A patient can only be removed if it contains ZERO studies Reject or move the images to remove them fr
10. Finger Tap Two Finger Swipe Two Finger Rotate Two Finger Pinch and Stretch Three Finger Drag Note E The user must have a touch screen with multi touch gesture support in order to utilize this feature One Finger Tap A one finger tap is used to select an object similar to how the user uses the mouse to click on an object One Finger Scroll A one finger scroll is used to scroll through the patient s list or study list in the Patient List Window or Study List Window A scroll is a vertical movement Two Finger Swipe A two finger swipe is used in the Image Display Window to navigate previous or next image in a series A swipe is a horizontal movement Two Finger Rotate A two finger rotate is used in the Image Display Window to rotate an image clockwise or anti clockwise Two Finger Pinch and Stretch A two finger pinch and stretch is used in the Image Display Window to zoom in or out on an image 2003 2014 Page 52 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 53 Three Finger Drag A three finger drag is used in the Image Display Window to pan an image Image Stitching The stitching operation allows you to stitch two images together vertically You can stitch together more images by repeating the process Note Before stitching acquire the two images to be stitched together One of the acquired images will be the top portion
11. Setup Installing XC xc Please wait while the Setup Wizard installs XC Completed the XC Setup Wizard Click the Finish button to exit the Setup Wizard 0x0000 0x0001 2003 2014 Page 95 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc XC Help 96 2003 2014 Page 96 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc XC Help 97 ERROR INVALID DEVICE SELECTED 0x0023 Adjusting MWL query filters If after creating and setting the DICOM modality worklist target XC is not populated with worklist entries the filters may need to be modified MWL filters are contained in the Query Constraints text file located in the XC Public Directory This directory is discussed at the bottom of this document In this file anything following a is a comment an is ignored by the application The first twelve lines of the file are solely comments Each additional line is a DICOM tag from the MWL entry to be queried for The tag line is format as Tag VR tag value Comment Any value present between the and of the tag line will act as a filter There are several tags inserted by the application when the MWL query is performed These tags are list in the comments on the top of the page For most of these tags XC will insert a value between the square brackets to filter the query results Fo
12. a specific patient and anatomic view After the cassette 1s exposed the user can scan the cassette s barcode and then insert the cassette into the bay to begin a scan Note Barcode Scan Mode is especially useful to facilities in which the x ray generator and the scan unit are not located within the same room To activate Barcode Scan Mode 1 Click the Configuration button on the Patient Worklist screen Select the Admin tab Select the Settings tab In the lower right settings filed labeled Chrome Settings set the Barcode button to On A G9 N Note E When in Barcode Scan Mode since the Auto Scan feature is always activated the Auto Scan button is disabled For information on the Barcode Scan Workflow see Section Barcode Scan Workflow on page 35 Configuration Image Screen Image Screen Maximum Zoom Value Sets the maximum value for the Zoom tool Options are 100 200 or 400 Magnification Box Size Sets the size of the Magnification tool as a value of total viewable size Options are 1 6 1 4 1 3 or 1 2 Predefined Crop Boxes The user can Add a new crop box size Edit and Remove the existing crop box size here Adding a new crop box size 1 Click Add 2 Enter the width and height of the crop box 3 Select the units 2003 2014 Page 81 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 82 4 Click Finish t
13. contains all of XC s preference amp User settings Only Users with Administrative privileges can access the Configuration gt Admin tab Figure 3 XC s Configuration Screen Configuration DICOM The DICOM tab holds all the DICOM target information as well as configuration settings for DICOM Modality Work List Query and DICOM Auto Send DICOM Setup The DICOM Setup tab contains a list of AET s known to XC From the DICOM Setup tab the User may add remove edit and test AETs using the appropriate button Work List Inputs The Work List Query tab allows the User to easily set DICOM Modality Work List Query Check the box next to the desired AET then choose the query interval Auto Send Targets The Auto Send Targets tab allows the User to easily set DICOM Auto Send Check the box next to the desired AET and when an image is accepted it will be automatically send to the checked target s 2003 2014 Page 73 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 74 Pending The Pending tab provides the User with a list of files that have been scheduled to DICOM Send but have not actually been sent yet This is only a list of files the User may not interact with anything on this tab Click Clear to remove all items from the Pending DICOM Sends list To DICOM Send ensure the computer has the proper network connection and the
14. courtesy of Freelmage via the FIPL httpz freeimage sourceforge net Local DICOM handling courtesy of GDCM via the BSD license http sourceforge net projects gdcm DICOM networking handled by domtk http dicom offis de Page 66 of 100 Doc HC XC 0028 05 Rev E 02 February 26 2014 Chapter 5 Managing Patient Data Creating Patients 1 From the Patient List window click the Schedule Patient button 2 Fill in the desired patient information Note E Required fields are marked with an asterisk Last Name First Name Referring Physician Patient ID date of birth and Institution are required fields Note Fields with green titles can be used as Modality Worklist Query fields For more information on Modality Worklist Query see Section Setting Up Modality Worklist Query on page 88 3 Click the Finish button to return to the Patient List window or click the Finish And Scan button to begin the process of scanning an image III IIIT I LILAA T a Figure 2 XC s Patient Data Entry Screen 2003 2014 Page 67 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Managing Patient Data 68 Editing Patient Information 1 Locate the desired patient in the Patient List window 2 Click the desired patient s Patient Information Bar 3 In the Study Information window click the Patient Information Bar again 4 Edit t
15. field in the application 4 Use the Left Alt and Shift to toggle through the available languages Note E Optionally the User may also left click on the language code in the Language toolbar to select from the available languages Using Hotkeys with the Windows XP Input Method Editor Table 3 Input Method Editor Hotkeys Switch between languages or keyboard layouts left Alt Shift When Japanese is the input language select the Hiragana Ctrl Caps Lock character set When Japanese is the input language select the Alt Caps Lock Katakana character set Showing Hidden Files and Folders in Windows The following instruction is applicable to both Windows XP and Windows 7 1 OpenMy Computer then click on Folder Options 2003 2014 Page 99 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Windows Help 100 2 In the Folder Options dialog select the View tab 3 Check the box labeled Show hidden files and folders then click OK 2003 2014 Page 100 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc
16. file name for the Layout Image Page Layout Printers Overlay Templates Logo Label Click here to save current layout Click here to save current layout Click here to save current layout Click here to save current layout Click here to save current layout Load Template from File Save Current Template dent Local Dok C If only a single procedure was loaded all of the images are from the same procedure and a layout was applied to the print of the procedure then the layout will be saved when the user prints the image The next time the user loads this procedure Print Tool will apply the saved layout Note Images will be positioned based on anatomy and laterality Adding Patient Demographics Select the Overlay tab to bring up the patient demographic layout options From here the User can select Text position includes top left top center top right bottom left bottom center bottom right e Text size includes small medium large 2003 2014 Page 61 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 62 Text color includes white on black black on white Image Page Layout Printers Overlay Templates Logo Label Text Position Patient Demographics Overlay EJ m ps Text Pasi n Top Righi v _ Medium XJarge Text Soe Text Color Coni SE f Medum White on Black C
17. m a MEME E 68 Pditine Study TnfortidilO 2c soto ione tense eoroR Td etuer E ated oa a UD opieS 68 IE qe erue Dio 69 ING ecne dt Dd Oisein S EP eU Mateo eO TED Rota dae casdo E opi saan bt ge sus odid Dod dup Md Eta SED eas 70 ISCmovite sine le POI BE eiie e Pm M tiM MEME IM D MM RM D 70 Remo vane All TP Ae MS oai qo cU etr eiue ta euuepiq i odas ema SbelUmstutbe cito uam pau aoe 70 QueryIinp WOEDKDIISE ii OTt ai isis oido edo edicti sme es 70 2003 2014 Page 3 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Contents 4 Chapter o ConlicuratiO ree Cono UPIH OPI ooi cedo ed identitate a ette dou up uer ea eee Masse eee ee E 73 Conero DIC ONE aei Meccan a a il nnt esta kadualese Dae asque de mulae Races 73 Contmeurdton Device Se bI S ccs ii re PR eru tm bu vacuus Ede So EM 74 Connora 2 SEMN S d do iip pides bunte etu a aheldall eaten ot eiui aum 75 Conmemoran Ad sira a E A E T Vasa iPad ue iios 76 Comme uration Imao e SOT Ci eni e e NE eo 81 COnmMOUEAT ON De Mul o obti oq ae nde meta Mane dd 82 AC Data Directo ya i ndm tero D ested alata tela el ial ib lal lm aol eaten teil desde D At ly 82 Hardware TOEIC CS eedan crannies aiawinslaa dd bud antes deu gdbaDaeheah do vie dues meen una pde Dao aduti teda niea corset tup Sa aeenaewataatasts 83 DOn acest PR rr RUN RN 84 Serine UP Modality Work list ONE ssc nderit eR antt ae ee
18. of rejected images an option to enable auto purge and emptying a virtual trash bin Purge Constraints The Purge Constraint feature allows the user to set the threshold value of XC s disk usage relative to the computer s total disk s capacity for saving data Higher threshold value means the user allows XC to keep more studies in the hard disk and inversely true XC will keep less studies if the user sets the threshold value to a lower value To set the disk usage s threshold value slide the Disk Usage Percentage slider to the desired value By turning on the Only Remove Sent Image option XC will only remove a sent image from the study after a study has reached a specified age and the threshold value is met When the setting is turned off XC will delete all images contained in a study regardless of their status after a study has reached a specified age The Minimum Image Age Days slider allows the user to set the minimum age of a study Any study older than the minimum age will be removed from the folder once XC s disk usage has reached the set threshold value To set the minimum image age value slide the Minimum Image Age slider to the desired value Note ES The Purge Constraints can be modified if the user is in need of more disk space however this will delete studies based on the constraint criteria iCRco recommends that the user backup all studies on a regular basis Purge Enabling the auto purge option will automatically t
19. plate instead it will use an image from the Demo images library X ray Tubes Allows the User to choose which generator interface and COM port to use The Exposure Count section lists the number of exposures taken with the generator interface Click the Reset button to set the exposure count back to zero Exposure Count The Exposure Count lists the number of exposures trigged via the generator interface Click Reset to change the exposure count to zero Configuration Settings The Settings tab contains general application settings such as language and units of measurement Data Representation The bit depth of the DICOM file when it is DICOM sent or exported out of Current options are 16 12 10 or 8 bit Look Up Table Type The type of Look Up table that is embedded in the DICOM file when it is DICOM sent or exported out of Current options are Linear or Sigmoid If Sigmoid is selected the DICOM Value of Interested Look Up Table VOI LUT entries are generated and stored in the DICOM header Data Conversion Clipping Level The level of noise removed from the data when the 16 bit data is scaled to a lower bit resolution using the Data Representation drop down menu A lower number means more noise will be included when the data is scaled A higher number means that some useful information will be clipped when the data is scaled Only a certified Applications Specialist should adjust this parameter Language Sets the langua
20. pur uris 1 1 Wetw Lewes Corres Toe Gand Gog iwe a lone Emart Bas 7 You may modify the processing parameters If you do click Process to reprocess the image Note E You can maximize the window zoom in or use any of the provided image manipulation features like Smart Box to evaluate the image Note ES Click Save Image to save the current images for comparison later 8 After processing or saving an image click the Comparison Tool button to compare the manipulated images side by side 9 Load the DICOM image into the Image Comparison Window by clicking Processed Image Saved Image Raw Image Gold Image or Browse Note Clicking Processed Image will load the last images you processed while clicking Saved Image will load the last images you saved Note E If you reprocess an image in the App Manager window click Processed Image to reload it into the Image Comparison Window Note E The processing parameters used for each image during the comparison can be seen in the comparison window by clicking View Processing Params l MERGER ERR HN bem uer ee m iem baee me bem jlo Lees am oae Ha im rez ES AT ANE A pee aa numen Lx mure Mc PRG ducas ge ucc Duca ee Corer De cep eee tan oo 2003 2014 Page 91 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 92 10 I
21. units 1 In the Patient List window click Schedule Patient 2003 2014 Page 31 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 32 SMITH WANA Test Captera TEST DICOM SEND ASLAN Hatisia Jos Name TEST TRADITIONAL 3 Select the scheduled study This will bring up the Study Overview 4 Insert a cassette into a bay This will bring up the Device Overview dialog The scan unit will begin scanning the cassette E Note Clicking the Add View button will also bring up the Device Overview dialog 2003 2014 Page 32 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 33 5 The Device Overview informs you of the status of the bay s While the cassette is scanning select the anatomy laterality and view of the image being scanned Note Ifthe scan unit has two bays it s possible to scan two cassettes at the same time To start a second E scan using the other bay insert the cassette into the available bay Select the image information while the cassette 1s scanning z Note Click the image being scanned to view the image in the Image Display window 2003 2014 Page 33 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 34 6 Click OK to close the Devi
22. version of the software as soon as it is practical after the consumer has notified 1CRco of any nonconformity 1CRco does not warrant that the operation of any software will be uninterruptible glitch or error free or that functions contained in the software will operate in the combinations which may be selected for use by the user or meet the user s requirements This limited software warranty will be void if the software is modified without the written approval of iCRco or is used outside of the recommended parameters or equipment iCRco does not provide any warranty or support for any other software iCRco agrees to provide one 1 year of telephonic and or e mail based support for QPC XSCAN32 Captera XC and or Clarity PACS software originally provided with any new iCRco product from the date of original shipment from 1CRco All software support shall be limited to making reasonable efforts to resolve iCRco software issues and shall be limited to iCRco s regular business hours In addition 1CRco will provide revisions and upgrades to its software upon request when available during the first year after the software was originally shipped from the iCRco factory The initial support period will include support via remote login software only if the customer has access to the Internet from that PC and only if the customer agrees 1CRco shall have no liability in connection with its support efforts Remote login software allows 1CRco technical support t
23. 028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 89 4 Select the anatomy from the drop down menu This will open a list of views for the selected anatomy 5 Drag and drop the view s onto the Procedure The view s will be added to the Procedure 6 Save the changes by clicking Close and Accept Editing a Procedure In the Patient List Window click the Configuration gt Admin gt Procedure to go the to Procedure Configuration Window To add views to the procedure click on the procedure name in the Procedure List Select the anatomy from the drop down menu This will open a list of views for the selected anatomy Drag and drop the view s onto the Procedure The view s will be added to the Procedure To delete a procedure or view click the Delete red x button positioned next to the procedure or view name To edit a procedure s name click on the pencil icon located to the left of the procedure s name and ID Adding Categories and Views It is possible to add or remove anatomy and sub anatomy categories using XC s Application Interface For example it is possible to add a Lizard category to the Exotics anatomy type or add a Gecko view to the Lizard category Note E The Exotic anatomy type is represented by an image of a bird 2003 2014 Page 89 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc
24. Auto Send Targets tab has been correctly configured Configuration gt Device Settings The Device Settings tab holds the settings for the scanner hardware and X ray generator optional Device Settings The Device Settings tab allows the User to know the serial number and scanner model attached to the computer system the specification of the spot size for normal and high resolution scans enable demo scans deep erase IP Plates and provides access to the hardware EEPROM dialog For This Device This drop down menu allows the User to select the scanner model If you have multiple scanners or multiple capture devices such as the Fusion DCR or Fusion DCR Flat Panel there will be multiple selections in the drop down menu Each device in the drop down menu can have it s own Alias Plate Size and Spot Size Settings Alias For each device the User may assign it an alias or another name to call the device This name will show up as the device name in the Scan tab This feature is useful 1f more than one scanning device or a multiple capture device such as the Fusion DCR or Fusion DCR Flat Panel is plugged into the computer For example if the User has one Fusion DCR Flat Panel and one iDR Long Bone plugged into the same computer the user could alias the Fusion CR as CR Scanner the Fusion DR Flat Panel as DR Scanner and the iDR Long Bone as DR Long Bone Each would show the alias name on it s respective tab on the Scan scree
25. C 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc XC Help 98 Table 2 Table of Devices Cassete Plate Size 3600 8 x 10 inches 10 x 12 inches 14 x 14 inches and 14 x 17 inches 3600 SF 8 x 10 and 10 x 12 inches 3600 M 18 x 24 cm and 24 x 30 cm VertX 10 x 12 inches and 14 x 17 inches Chrome 10 x 12 inches and 14 x 17 inches Fusion DCR 10 x 12 inches and 14 x 17 inches iDR 14 x 17 inches iDR L 14 x 51 inches iDR L 17 17 x 51 inches Vmotion AMX 10 x 12 inches and 14 x 17 inches Chrome Mammo Duo 18 x 24 cm and 24 x 30 cm Air DR 14 x 17 inches 2003 2014 Page 98 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Appendix B Windows Help Installing and Using the Microsoft Windows XP Input Method Editors Installing the Desired Language Note E The User may need the Windows XP installation disk to install new languages Go to Start gt Control Panel gt Regional and Language Options Click on the Advanced tab In the section labeled Code page conversion tables select the languages to install oe ee Click the Apply button to install the selected languages Using the Windows XP Input Method Editor 1 In the Taskbar right click then select Toolbars gt Language Bar The Language bar will become visible in the Taskbar 2 Open the desired application ad Place the cursor in a text entry
26. La f Black on White Lai Black on White h Enable Overlay Enable Overlay Edt Field E to all Apply lo mage he user has the option to apply the current settings to every image in the print view or only in the currently selected image via the Apply to all images button or the Apply to image button By selecting the Enable Overlay check box the user can turn patient demographics overlay on and off for all images The user can also edit the fields that are available on patient demographics overlay by clicking on the Edit Fields button From here the User can e Select a field and determine what kind of a delimiter following the field includes none space tab comma newline custom Change the position of the fields with the up and down arrows e Remove or display a field by selecting the Print Field check Print the title for the field 1 e the title Date would be printed in front of the date field After editing the fields click the Done button Print Preview To see a print preview click the Print Preview button 2003 2014 Page 62 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 63 Printing Images to a DICOM Printer When the user has finished dragging and dropping the desired images onto the preview window and manipulating size position and window level if necessary then press the Print button in the bott
27. MH MH Ed E Warning A WARNING indicates a potentially hazardous situation which if not avoided could result in death or serious injury Caution A CAUTION indicates a potentially hazardous situation which if not avoided may result in minor or moderate injury It may also be used to alert against unsafe practices Note A NOTE indicates important information that helps you better utilize your CR Unit and Software Important An IMPORTANT indicates either potential damage to hardware or loss of data and tells you how to avoid the problem Malfunctioning Equipment If any 1CRco software product shows signs of malfunction try restarting the computer if the problem persists or is reproducible discontinue the use of the product immediately and contact Technical Support at 310 921 9559 2003 2014 Page 9 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Safety Information 10 2003 2014 Page 10 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc iCRco Warranty iCRco Inc 1CRco values your business and always strives to provide high quality products and services All iCRco products are provided with an initial warranty so that the hardware and software are covered from the date of purchase This limited warranty solely applies to new products manufactured by or for 1CRco and originally purchased f
28. Worklist Inputs tab 5 Select the target s whose DICOM MWL the user would like to query 6 Select the interval for the automatic query and any desired search constraints 2003 2014 Page 19 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc System Requirements and Initial Configuration 20 7 Select the Close and Accept button to confirm changes Setting the Institution Address 1 Click the Configuration button on the Patient Worklist screen 2 Select Defaults tab 3 Enter the address in the Institution Address field 4 Click Close and Accept to save the changes Setting the Default Referring Physician 1 Click the Configuration button on the Patient Worklist screen Select Defaults tab In the Referring Physician box click Add Enter the Referring Physician s name then click Finish wem ee Put a check in the box next to the default Referring Physician s name then click Set The default Referring Physician 1s set 6 Click Close and Accept to save the changes Setting the Institution Name 1 Click the Configuration button on the Patient Worklist screen Select Defaults tab In the Institution box click Add Enter the Institution name then click Finish pede equ Put a check in the box next to the default Institution name then click Set The dealt Institution name is set 6 Click Close and Accept to save the changes OPTIONAL Enable t
29. XC User Manual Introduction 2 2003 2014 Page 2 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Contents 3 Contents Copyricht and Proprictary NOEIGR 2 5 eiii o tetuer ceci Eo D AAE E ES Raan 5 Contact and Product InfOrmiatlOn eiiis eed ee ee eo coenae ek Renee eec oue eee eere coco dae FER Ne Es ep Up Ugo aia eure 7 Safety Informatiol tei PEE IU tite e D tni utate o D tere ns txestede 9 Gc P lY M M 11 Revision History e E ae EE EE E EA 15 Chapter 1 System Requirements and Initial Configuration 17 Zw SV SUC ad Ie quide meN Sonani button didis ct sak eh Ma ele tance aaa ee Lic PU UE 17 Initial COnN pura 0 v0 a E R 17 Chapter 2 Launching Logging In and Out and Quitting 21 USETE Fan ilere T rr 21 Losgine M Administrator Accon ria a A E aE aT 21 Loco ne irena e a A E eet QM 21 Logging Out Quitting and Worklist Commands oreinen ea Eaa e A A A EAE aa aee at 22 Chapter 3 Acquiring an m 3ge ood th I E eEe ee I ho eei in RR ESTA Manual Tma imnme Wy cdi rcc X 23 Proceduresbased Imao me WOERTION unitario a duae bel n dui ea tetova ue n etl eR ds 26 Patient Information Reconciliation Imaging Workflow esses nnne 28 JO IS CHEN OE Fst LO Wiest es aqido sims sott nea
30. a Joe Ir OOS DOE 8 11 1964 47v Mame TEST TRADITIONAL DOR 1 1 1980 37 2 Enter the patient and study information then click Finish and Scan Note E Before you can proceed to the next step you must input the Patient ID Last Name Birth Date Referring Physician and Institution If you are limited in time you can check the Reconcile Later box which will only require you to input the Patient ID and Last Name 2003 2014 Page 23 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 24 3 Select the region and if necessary laterality of the anatomy by clicking on the appropriate body region then select the anatomy and view by clicking on the appropriate buttons Selected View Chest PA Portrait Chrome CR Control Deep Erase iif High Resolution Cassette Size 10 x 12 inches 14 x 17 inches Cassette ID 5 As the image is acquired it will be displayed in the Image Display window 2003 2014 Page 24 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 25 Scanning 6 When the image is finished scanning make the desired manipulations and annotations All XC manipulation and annotation tools are selected in th
31. ages The Pan tool allows the User to move the image to different positions on the screen To use the Pan tool first select it from the pop up menu on the left hand side of the screen Then click and drag the image until the desired region is visible Magnify z P The Magnify tool provides a small window that displays a region of the image at increased magnification To use the Magnify tool first select it from the pop up menu on the left hand side of the screen Move the mouse over the desired region of interest then click and hold the mouse button and the region of interest will be magnified While holding the mouse button the User may drag the magnified box to different areas of the image Image Invert 7 at i I h le m E The Invert Image tool allows the User to transpose the image data invert black white To use the Image Invert tool first select it from the pop up men on the left hand side of the screen Then click the Image Invert button The image data will be inverted Rotate Clockwise and Counter Clockwise gt gh 2003 2014 Page 42 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 43 The Rotate tools allow the User to rotate the image in 90 increments To use the Rotate tools first open the pop up menu on the left hand side of the screen Then click either Rotate Clo
32. allows an administrative User the right to add manage User names and passwords for accessing the XC application The Require Login toggles the User Login box functionality If users must authenticate before using XC turn this feature on If user accounts are not desirable turn this feature off Adding a User Account 1 Open XC 2 Login with the Administrator User name and password 3 Click the Configuration button in the Patient Information window If prompted enter the appropriate password to access the configuration settings 4 Click on the Admin gt Users tab Click on the Add button The Add User dialog will pop up 6 Enter the desired User name and password the password will need to be entered twice once in the Password text field and again in the Confirm Password text field then click the Finish button 7 Ifthe new User account is to have administrative privileges select the button Allow Access To Configuration Settings m 8 The new User account will be created Changing a User s Password Open XC Login with the Administrator User name and password Click the Configuration button on the Patient Information window Enter the appropriate password to access the configuration settings Click on the Users tab Select the User account to modify by selecting the desired User account from the list Click the Edit User button oe LE ae a The Edit User dialog will pop up 8 Enter the new password in the P
33. allows the user process mammography images without skin line detection The tool is available only when a mammography image is displayed in the Image Display Window To use No Skin Line Detection Processing first open the pop up menu on the left hand side of the screen Then click the shaded breast button Depending on the computer speed the process may take a minute The progress is shown in the image thumbnail on the right hand side of the screen while the image is being processed it will say processing in the lower left hand corner of the image thumbnail Horizontal Grid Line Removal Q2 a A al If a grid has been used in the horizontal orientation click Horizontal Grid Line Removal to run the grid line removal processing Vertical Grid Line Removal he E If a grid has been used in the vertical orientation click Vertical Grid Line Removal to run the grid line removal processing CR Markers Le R i CR Markers allow the User to place an L or R marker on the image to indicate the laterality To use a CR Marker first open its pop up menu from the left hand side of the screen Then click where the marker should be There are three different sizes of marker The User may toggle through the size by clicking on the marker again At any time the User may click hold and drag to reposition the marker Measurement 12 3 d a The Measurement tool allows the User to draw a line with a linear measuremen
34. ane 1 Processing Complete 2003 2014 Page 39 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 40 2003 2014 Page 40 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Chapter 4 Tools and Processing Image Manipulation Tools All XC image processing manipulation and annotation tools are selected in the Tools Menu Bar on the left side of the Image Display window Window Level The Window Level tool allows the User to adjust the brightness and contrast of the image To use the Window Level tool first select it from the pop up menu on the left hand side of the screen Then move the mouse over the image Moving the mouse vertically while holding down the mouse button will adjust the brightness while moving the mouse horizontally will adjust the contrast Smart Box Window Level The Smart Box Window Level tool allows the User to automatically adjust the brightness and contrast of the image with a user selectable box The optimal window level settings will be determined by the user defined selection To use the Smart Box Window Level tool first select it from the pop up menu on the left hand side of the screen Then mouse click and drag until the Smart Box is the desired size Upon releasing the mouse button the Window Level setting will be automatically calculated The User ma
35. ary domain shows a pair of small animals at the Anatomy selection screen and remaps fields on the Schedule Patient screen as appropriate for Veterinary The Veterinary domain changes at the following screens 2003 2014 Page 85 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 86 Patient Info Equine The Veterinary domain shows a horse at the Anatomy selection screen and remaps fields on the Schedule Patient screen as appropriate for Equine Veterinary The Equine Veterinary domain changes at the following screens Page 86 of 100 Doc HC XC 0028 05 Rev E 02 2003 2014 February 26 2014 Confidential and Proprietary Property of iCRco Inc Configuration 87 a Patient Info Owner Study Info Podiatry The Podiatry domain shows a foot at the Anatomy selection screen It does not change other parameters The Podiatry domain changes at the following screens 2003 2014 Page 87 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 88 Setting Up Modality Worklist Query 35 2 1 2 m Double click on the XC short cut on the desktop to open XC In the Patient Information window click the Configuration button In the Configuration window select the DICOM tab In the DICOM tab select the DICOM Setup tab
36. assword text field then enter the new password again in the Confirm Password text field amp click the Finish button 9 The User s password will be changed Removing a User Account Open XC Login with the appropriate User name and password Click the Configuration button on the Patient Information window Enter the appropriate password to access the configuration settings Click on the Admin gt Users tab Select the User account to remove by selecting the desired User account from the list Click the Remove button The Remove User dialog will pop up oe E deu ae T Confirm the removal of the User account by clicking Yes in the Remove User dialog 2003 2014 Page 78 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 79 9 The User account will be removed Procedure Procedures allow you to create a pre defined set of image views The procedure can then be selected on the study portion of the Scheduling screen To create a procedure see Creating a Procedure on page 88 Data Management The Data Management tab allows an administrative user to configure XC s disk usage The goal of the Data Management tool is to help XC minimize disk usage by removing old images The features available for the user to configure include setting a threshold value for overall use of disk capacity an option to remove sent images after a specified image age deletion
37. ce Overview dialog The Image Display window will appear showing all of the acquired images Note The images will automatically arrange themselves displaying a maximum of four images at the E same time wer asdi 10001 REC FIL a D wer asdi 10000 REC d Lia 7 When the image s is finished scanning make the desired manipulations and annotations All XC manipulation and annotation tools are selected in the Tools Menu Bar on the left side of the Image Display window The Window Level Zoom Pan and Crop tools are shown in the graphic below Processing Complete 8 When finished manipulating the image click the Accept and Send button in the lower left hand corner of the Image Display window When the Accept and Send button is clicked it will save the current image manipulations and DICOM Send the image Note E If DICOM auto send is not enabled the Accept and Send button will read Accept The Accept button will save current manipulations to the image but will not DICOM Send 2003 2014 Page 34 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 35 Barcode Scan Workflow The following steps represent a generalized workflow utilizing the Barcode Scan functionality To set XC to Barcode Scan mode see Section Barcode Scan Mode on page 81 Note U Barcode Mode requires a handheld barcode reader Note U Barco
38. ce of each scan and the scan parameters Note Ec For North American users XC provides the user with a default set of Imaging Procedure Type that is associated with its respective CPT code Acquiring an Image for Imaging Procedure for a new patient 1 In the Patient List Window click the Schedule Patient This will open the Schedule Patient Window e xc c a Q9 8 Nene es TH DIANA US re Test Coptera nix ID ERE a E sai Name TES Dicom SEND XSCAN E ARR Mame Batista Joe Ir SO Mame TEST TRADITIONAL SOE 1 1 1980 37 2 Enter the patient information in the Patient Info box 2003 2014 Page 26 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 27 Click Procedure then select the desired procedure Click Finish and Scan The Scan dialog will open Atem i m 3 If necessary select the laterality Click the cassette size button to initiate a scan CR Control Deep Erase High Resolution Cassette Size 10 x 12 inches 14 x 17 inches 1 t As the image is acquired it will be displayed in the Image Display window Tesi test CERE scanning 5 Ifitis a multi view procedure select the next procedure from the thumbnail The Image Procedure is completed when all the scans are acquired 2003 2014 Page 27 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26
39. ce to any product that is not shipped in an 1CRco approved shipping container that is damaged from incorrect packaging or that is damaged during shipping Additional Warranty Limitations and Extent of Warranty This warranty does not apply if the product has been damaged by accident misuse or abuse In addition warranty service does not include the repair of failures or defects caused by unauthorized attachments to any 1CRco product unsuitable physical or operating environment maintenance or repair by anyone other than 1CRco or the 1CRco authorized dealer that sold the product operation of a product beyond its duty cycle use of the product outside of its specifications the use of supplies parts materials software or interfaces not furnished authorized or recommended by 1CRco If the product including any software has been opened tampered with modified or altered in any way without written authorization by iCRco the warranty will no longer apply This warranty applies only to products manufactured by or for iCRco products can be identified by an 1CRco serial number as originally affixed to the product Any modification to the 1CRco serial number tag or its attachment to the product shall immediately void the warranty This warranty is non transferable and subsequent owners must contact iCRco to establish if the equipment is eligible for an extended warranty THERE ARE NO WARRANTIES EXPRESS OR IMPLIED WITH RESPECT TO ANY iCR
40. ckwise or Rotate Counter Clockwise until the desired rotation 1s achieved A single mouse click on the Clockwise or Counter clockwise button will rotate the image 90 Flip Vertical and Horizontal LI E y E i AN The Flip tools allow the User to invert the image either horizontally or vertically To use the Flip tools first open the pop up menu on the left hand side of the screen Then click either Flip Vertical or Flip Horizontal until the desired orientation is achieved Crop The Crop tools allows the User to discard unwanted information around the edges of the image usually collimation When the crop is confirmed the image is copied then cropped resulting in the new cropped image Additionally the image can be reprocessed after being cropped Note Mammography images cannot be cropped To use the Crop tool 1 Select the Crop tool from the menu on the left hand side of the screen 2 Click hold and drag the box to the desired size 3 Click the Confirm button to apply the crop The image is cropped Predefined Crop age The Predefined Crop tool allows the user to discard unwanted information around the edges of the image similar to the Crop tool Selecting the tool allows you to select a specified crop size entered into the scan software beforehand This will create a crop box that can be dragged and repositioned When satisifed with the crop position the user can select Confirm The user also has
41. co PRODUCT OTHER THAN AS SPECIFICALLY SET FORTH HEREIN AND iCRco SPECIFICALLY DISCLAIMS ANY IMPLIED WARRANTIES OR CONDITIONS OF MERCHANT ABILITY FITNESS FOR A PARTICULAR PURPOSE AND SATISFACTORY QUALITY ANY WARRANTIES THAT MAY NOT BE DISCLAIMED UNDER APPLICABLE LAW ARE LIMITED IN DURATION TO THE INITIAL WARRANTY PERIOD AND NO WARRANTIES EXPRESS OR IMPLIED WILL APPLY AFTER THIS PERIOD ALL INFORMATION SPECIFICATIONS PRICES AND SERVICES ARE SUBJECT TO CHANGE AT ANY TIME WITHOUT NOTICE Limitation of Remedies and Liability Exclusion of Damages The exclusive remedy for any defective product is limited to the repair or replacement of the defective product iCRco shall have a reasonable time after determining that a defective product exists to repair or replace a defective product iCRco s entire liability for any product is limited to the actual purchase price for the product This limitation applies even if iCRco cannot or does not repair or replace any defective product IN NO EVENT WILL iCRco BE LIABLE FOR ANY GENERAL SPECIAL CONSEQUENTIAL OR INCIDENTAL DAMAGES including but not limited to damages related to the loss of use loss of recorded product the installation of replacement product or any inspection testing or redesign caused by defect or by the repair or replacement of any product arising from a defect in any product This exclusion of damages applies even if the 2003 2014 Page 12 of 100 Doc HC XC 0028 05 Rev E 02 Confide
42. de Scan mode can only be used with Chrome and Chrome Duo units 1 In Barcode mode cassette barcodes must first be registered to XC before they can be scanned This usually occurs prior to exposure but can be done at any point before image acquisition 2 To register a cassette go to the Patient List window and click Schedule Patient xc oi NI n E 1 ool Oe ee Name Mark Foster F DOB 8 11 1964 Are Last Shady Dieser amp 28 2012 GOI PIE Pe F icin Dr Chase Lo Name SMITH DIANA ID 7645 DOR 10 10 1980 31Y ari Procediune ETA Scere Persici bet test Last Shady Date 4 19 2012 807 Phi Mame Test Captera CNS DOB 1 1 2017 5M Last Sharky Date 41 A 3724 P Procedune zi a peor Or Test DOR 1 1 2017 5M Prayssciar Dr Tevi Name TEST Dik SEND XSCAN DOR 1 1 2017 5M List Suay Date 1716 2012 11 18 AM Fees Pymin Dr Tet Name Batista Jaa DOB R 11 1964 47Y L PPan ast Shaf Daie Hame TEST TRADITOMAL ID 227873 DOR 1 1 1980 37Y P P une Pruitt Las Sheehy Daie OL Schedule Patent 3 Enter the patient and study information then click Finish 2003 2014 Page 35 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 36 4 Select the scheduled study This will bring up the Study Overview 5 Click the Cassette registration button to open the Cassette registration window E Note
43. e Tools Menu Bar on the left side of the Image Display window The Window Level Zoom Pan Zoom and Crop tools are shown in the graphic below e test 90023 j Processing Complete EL r mnmm 7 When the User is finished manipulating the image click the Accept and Send button in the lower left hand corner of the Image Display window When the Accept and Send button is clicked it will save the current image manipulations and DICOM Send the image Note E If DICOM auto send is not enabled the Accept and Send button will read Accept The Accept button will save current manipulations to the image but will not DICOM Send 2003 2014 Page 25 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 26 Test test 90023 Chest AF Portrait 1 P Processing Complete L3 Fuere uen baie ech id r 5 PH ee Wrs ook Chet Ta uk i DE Tate LT Mez ETANIMA Bd 1 iret a Rn We L Tea TAE p A Nr 4 xam D La L4 rz n Tin TEN 2 sta gs k Ton BESDO TT ie Capers TU i2 ERES 8 OPTIONAL To add another View to the study click Add View Procedure based Imaging Workflow The Imaging Procedure Type provides the user with a template for ordering a sequence of scans for a particular study The user is allowed to create their own Imaging Procedure Type in which they can specify the ordering sequen
44. ecrease the exposure energy by an Exposure Index factor of 1 100 double or half the mAs mA or exposure time EXPOSURE MATH Roo The values of mA mAs and exposure time Sec are exponential To increase or decrease the exposure energy by a factor of 1 step double or half the mAs mA or exposure time The values of kVp follow the 15 rule In other words to double or half the exposure energy with kVp add or subtract 15 of the total kVp For example to increase or decrease the exposure energy by an Exposure Index factor of 1 100 add or subtract 15 of the kVp 100kVp 15 85kVp 60kVp 15 69kVp EXPOSURE MATH The value of kVp follows the 15 rule To increase or decrease the exposure energy by a factor of 1 step 100 add or subtract 15 of the kVp Example 100kVp 15 115kVp 85kVp TOkVp 15 80kVp 60kVp Deviation Index The Deviation Index is used specifically for mammography To follow ACR guidelines MQSA guidelines and ALARA optimal image quality and limited exposure is required for all mammography images The Deviation Index provides a reference to the user on the acceptability of the imaging plate dose in relation to the type of exposure Like the Exposure Index the Deviation Index can help a user develop a technique chart for the user s X ray machine How It Works The Deviation Index is a predetermined factory calibrated energy level sweet spot based on the exp
45. en if it is within 0 0 to 0 9 positive or negative EXPOSURE INDEX ARo Reading The Exposure Index 0 0 1 0 Step Under 1 0 Step Over Exposed Exposed Optimum Adjusting Exposures Based On the Exposure Index Data Users should consider the exposure index value equivalent to steps in conventional film density or a percentage of exposure technique values For example a value of 1 5 is equal to 1 5 steps in conventional film density or 150 more than the ALARA optimal exposure energy for CR Conversely a value of 1 5 is equal to 1 5 steps in conventional film density or 150 less than optimal exposure energy for CR Exposure Index values of 0 to 0 9 are within the target range for energy exposure to the IP 2003 2014 Page 55 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 56 Note As indicated above the ALARA requirement does allow for some image noise to maintain minimal exposure values therefore users will note decreased noise levels in the positive ranges of the exposure index 0 3 to 0 9 while avoiding the pit falls of Dose Creep that is often associated with CR and DR Conversely users will note increasing levels of image noise in the lower negative ranges of the Exposure Index values 0 3 to 9 A Word on Exposure Math The values of mAs mA and exposure time are exponential for example to increase or d
46. er Login dialog enter a User name and password Note E Alternatively the User may select from a drop down list of previously entered User names by clicking the drop down menu on the right hand side of the User name text field 2 Click Log In to log in Figure 1 XC s User Login Screen 2003 2014 Page 21 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Launching Logging In and Out and Quitting 22 Logging Out Quitting and Worklist Commands The user can log out of XC from the Worklist screen by clicking the Log Out button 8 a The user can quit XC from the Worklist screen by clicking the Quit button The user can launch the default web browser from the Worklist screen by clicking the Web Browser button The user can condition deep erase a loaded cassette from the Worklist screen by clicking the Condition button 2003 2014 Page 22 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Chapter 3 Acquiring an Image Manual Imaging Workflow The following steps represent a generalized workflow and are meant to walk the user through using XC Every workflow varies in process 1 In the Patient List window click Schedule Patient G5 xXc commos 9 8 O 1D 90005 DOR 1 1 2012 5M I o0Q04 TARRIEOPEL Mame TEST DICOM SEND XSCAN ID 10000 Mame Batist
47. f needed you can set an image to fill the whole screen by clicking the Maximize Image button To view the images in two separate windows click the Split Windows button on the top left side of the screen Aa OP Os 3 11 Click Save Current Selection as Gold to store the image for image processing evaluation in the future Images stored this way can be retrieved later by clicking the Gold Image button 12 Click Save Repository to Disk to save the image processing parameters Note Image Processing Parameter changes need to be clinically validated either through the Image Comparison Window or through the standard XC workflow 2003 2014 Page 92 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Appendix A XC Help Installing XC These instructions describe how to install XC USB drivers for 1CRco hardware are installed automatically with the installation of XC 1 Insert the media containing the XC installer in the computer 2 Double click Setup exe to begin the installation process 3 Click Next at the Welcome screen i XC Setup Elo x L L Welcome to the XC Setup Wizard The Setup Wizard will install XC on your computer Click Next to continue or Cancel to exit the Setup Wizard gp XC Setup nici End User License Agreement Please read the following license agreement carefully TERMS AND CONDITIONS OF AGREEMENT
48. f the screen Ca Test test 90023 l Chest AP Landscape Right fat M E i le ES i IE i ao Jus TUN 5 2 Sop yim PW 3 PEG Pree eH Pw Lr LESE Dv ID T T BO 3 similarly to activate a 2x2 multi tile display drag both buttons to the center of the Image Display Window e To resize the multi tile window click on the horizontal line or vertical line seen on the Image Display Window and drag to the desired position To perform image acquisition select one of the multi tile window and the window border will turn green Click the Add View button to perform image acquisition for the selected window 2003 2014 Page 51 of 100 Doc 4 HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 52 To display an image select one of the multi tile window and the window border will turn green Then click on the desired image from the image thumbnail gallery to load the image onto the window Test test 30023 Processing Complete Test 18 Chest AP Landscape Right Ches P7 P Note EG If XC is connected to two scanners the user can select another multi tile window and succesionally perform side by side image acquisition Multi Touch Gestures For touch screen interface users XC employs multi touch gestures to ease the user in navigating through the software and perform actions The available multi touch gestures for XC include One
49. for the user to add more images to a study that was created twenty four hours prior to the image addition When it is turned on the user will not be able to add more images to a study that is 24 hours old or more Only an administrative user is able to change the setting of 24 Hours Study Limit Embedded Computer The Is Embedded option allows for the scan software to control the computer restart and shut down commands This option is enabled if the scan software is installed onto a computer embedded with the scan unit When this option is on the upper right power button in the software allows the user to restart or shut down the computer File Reader The File Reader option allows for the scan software to import image files into the program When the option is enabled and the user clicks scan the software will ask for the location of the image to be imported and the user can select from multiple image rules DICOM Note This option should only be enabled and utilized by qualified personnel 2003 2014 Page 77 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 78 Imported File Processing The Processing option determines if images will undergo post processing when imported When the option is enabled the scan software will process imported images Note This option should only be enabled and utilized by qualified personnel Users The Users tab
50. g Categories and Views on page 89 and Section Processing Parameter Evaluation on page 90 Image Rejection Report XC generates a report which contains all the information about the rejected images such as Patient ID Anatomy View Date Time when the image was acquired Date Time when the image was rejected Reason for the image rejection and Username The user can save this report as a PDF The following steps explain the procedure to generate an image rejection report 1 Click Configuration and select the Admin tab 2 Click Image Rejections button 3 The user can search a particular rejection report by selecting the options available in Sort by From Date To Date Reason User and Anatomy 4 The user can choose a particular font style for the report by selecting Font 5 To save the report as a PDF click on Save to PDF and save the file at the desired destination Apply Fine Removal Drop Down Menu This menu allows the user to select the number of times the fine line removal needs to be applied to the image Data Location The data location is the folder on the file system where XC will store settings and patient data The default is the location on Windows 7 is C NProgramData XC There should not be a need to alter this location unless the hard disk 1s running out of space and the user does not have archival storage PACS 24 Hours Study Management The 24 Hours Study Limit option disables the ability
51. ge of the User interface Current supported languages are e English US e Spanish German e Chinese Traditional e Chinese Simplified e Italian e Portuguese Brazil e French e Polish Croatian e Romanian Czech e Ukrainian 2003 2014 Page 75 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 76 Displayed Name Component For Japanese language users only The Displayed Name Component allows the user to choose between several different Japanese character representations Character Set Allows the user to choose which character encoding 1s embedded in the DICOM header ISO IR 192 is UTF 8 This should be sufficient for the majority of systems Default Unit System Sets the units of measurement for the measurement tools Supported units of measurement are Imperial and Metric Graphics Acceleration Controls whether the graphics rendering is done by the software or the video card If the User notices problems with the display of the graphics this option should be disabled On Screen Keyboard Toggles XC s built in on screen keyboard Automatically generate IDs Allows for the automatic generation of Patient and Study IDs This feature if useful if you are not using a RIS HIS EMR Show Task bar Shows the Windows task bar when set to on Hides the Windows task bar when set to off Auto Sort Patients Automatically sorts pa
52. he X ray Generator Interface 1 Click the Configuration button on the Patient Worklist screen Select Device Settings tab then X Ray Tubes tab Select the correct X ray generator from the drop down list labeled Attached X ray Tube xd dios Select the Close and Accept button to confirm changes OPTIONAL Disabling Log In Requirement Note Disabling the log in should only be performed 1f specifically required by the site administrator Click the Configuration button on the Patient Worklist screen Select the Admin tab then the Users tab Under Require Login select the Off button Select the Close and Accept button to confirm the changes Do 2003 2014 Page 20 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Chapter 2 Launching Logging In and Out and Quitting User Manual This manual covers information related to the XC software For information regarding a specific product please read that product s user manual Logging In Administrator Account After running the Installer the User should double click on the XC short cut on the desktop to open XC Note E The first User account created 1s the administrator account The administrator account is able to access the program configuration dialog create new Users grant User privileges and quit the application For more information see the Section Configuration on page 73 Logging In 1 In the Us
53. he desired information 5 Click the Finish button to save the changes and return to the Study Information window Editing Study Information 1 Locate the desired patient in the Patient List window 2 Click the desired patient s Patient Information Bar 3 In the Study Information window click the Study Information Bar 4 Edit the desired information 2003 2014 Page 68 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Managing Patient Data 69 5 Click the Finish button to save the changes and return to the Study Information window Exporting Data 1 In the Patient Information window click the desired patient 2 In the Study Information window locate the study to export Click the Send Study button This will bring up the Export window 3 From the Export window the User may Export to Disk Write Study CD Print Study or DICOM Send Export to Disk 1 In the Export window click the Export to Disk button 2 Select the drive USB drive or other system partition to export to in the Select Drive drop down menu 3 Select DICOM JPEG or TIFF as the export image format If necessary select the Anonymize button 4 Select the drive to export to 5 Click the OK button to export the study Write Study CD 1 In the Export window click the Write Study CD button 2 In the Select Device drop down menu select the CD DVD drive 3 Load a CD
54. idential and Proprietary February 26 2014 Property of iCRco Inc Copyright and Proprietary Notice 6 2003 2014 Page 6 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Contact and Product Information Contact Information iCRco Inc Americas Address 2580 West 237 Street Torrance CA 90505 Phone 1 310 921 9559 Fax 1 310 542 7236 Email info icrcompany com Web http www icrco com iCRco Inc Europe Address Paderborner Str 21 44143 Dortmund Germany Phone 49 231 92733669 iCRco Inc Middle East India Address Ist Floor Manohar Varsha Y 7 Green Park Main New Delhi 110016 Phone 011 40522979 Information Please enter the details of the system here Interface Type USB 2 0 2003 2014 Page 7 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Contact and Product Information 8 2003 2014 Page 8 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Safety Information Read and understand the installation and operating instructions before starting the software Lud C E ox US Headquarters European Office iCRco Inc iCRco Europe GmbH FDA 2580 West 23 th Street Paderborner Str 21 Torrance CA 90505 44143 Dortmund Accepted USA Germany 310 921 9559 49 231 92 33669 Conventions
55. ield click the Launch Applications Interface button The Applications Interface will open Select the appropriate library file in the combo box Select the appropriate imaging modality e g Medical anatomy e g Chest and view e g AP Portrait Select the Processing option from the Project Params group in the second column of the window E d Es A list of the processing parameters will be displayed showing their current value If you click the expanding arrow on the right side of the window you can select a patient study series and image Selecting an image will load an image into the image preview window Images in the image preview window can be temporarily reprocessed with the parameters in the second column Note The images that will populate in this list originate from XC If there are no images present in the list this means that there have been no images of that anatomy type and view acquired using XC 2003 2014 Page 90 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 91 pe Manage File Dese Clase Sob Drens Handedness Required a Far aeta Library Fie Vrragarsa Orr Keds Medical Anm Leg 4 Thorax 2 Chest AP Partrait AP Landscape PA Portrait PA Landscape Lateral Otbhique L5pine Taine Puls Peds Chest 3Lbs Peds Chest Head Hand Pelvis 5x WES am lel Proc Vana Sans imap hares
56. indow region to split it A pop up menu will appear with these division buttons as the image to the right shows 2003 2014 Page 58 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 59 Deu Taepkades Log Label a Fit ac wem Ie dn es LOL ET em MA ee hei tir RG GA TIS irri eee Berr Jarin Select one of the image division buttons and the preview window will be divided into regions To split one of these regions again select the specified region and again select one of the image division buttons The user can drag and drop images at any stage If the user has an image in the region that is desired the interface will automatically move the image into the split regions To remove a division click in the region that has been split and click on the no division button The user can show and hide the image divisions by clicking on the Page Layout tab then click Show and Lock under Image Divisions The user can view the current print settings by looking at the left hand side of the Advanced DICOM Printer dialog To change these settings or to view more settings click on the Printers tab 2003 2014 Page 59 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 60 Manipulating Image in the Preview Window Overlay Templates Logo Label Image Page Lay
57. l TERM This Agreement commences on the Commencement Date and expires on the Expiration Date unless terminated earlier in accordance with this Agreement the Term 2 LICENCE un Grant of licence On and from the Commencement Date Licensor gt em p we cet 5 Click Next at the Custom Setup screen to continue 2003 2014 Page 93 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc im XC Setup Custom Setup Select the way you want features to be installed 6 Choose XC s data location This is where XC will store images and patient data Click Next to continue iim XC Setup Destination Folder Click Next to install to the default folder or click Change to choose another 7 Click Next to continue im XC Setup Select Additional Tasks Which additional tasks should be performed 8 Click Install to begin the installation 2003 2014 Page 94 of 100 Confidential and Proprietary Property of iCRco Inc Doc HC XC 0028 05 Rev E 02 February 26 2014 XC Help 94 XC Help 95 fe XC Setup lolx Ready to install XC xc Click Install to begin the installation Click Back to review or change any of your installation settings Click Cancel to exit the wizard 9 Please be patient while XC installs Depending on the speed of the computer and available RAM this process could take a few minutes jie XC
58. l elena et een ad cud uen e 88 Creatine a TOC S QU Cass Sas pe alerts a e the Sos E RN 88 Edino d Procedure I naues er ote hees ent ee used d lem nO Renn ee ne ee ere eer oer ee Reena eer E 89 PANO Categories and Vie WS a iege titt debe abate Metu Bre Ee Ee em rud qo e AU 89 Processinp Parameter Fy alta Oss oto do ds des o tutu tdm oes ut 90 Appendix A XC Help aussceeedveesa ee esvesuz ce e ev do suo eere deve ases coss eu eve esten avec a M Installine XC ente en ii uM MM EE ME I LM MM Id ULM IM E 93 Device SCC iC BITOE 4 4343 nates eestor DR meist gusano ted E MCI nti ce m nU Situs Dare 95 Adusia M Wigury tels ph soe pi EE DT Ioas tum cs ped nwa la awa sua ag owe 97 List or Devices Supported Oy XG tT mt 97 Appendix B Windows Help iiei nici eiie eed eins Lodo eee Ieri iie JI Installing and Using the Microsoft Windows XP Input Method Editors sss 99 Showing Hidden Files and Folders in WindOwS ccccccccsscccccessccsecccceeeeeeesseeeesssssseeeeeeeeeeeeeeeeseeeeeeeseeeeeeeeeaas 99 2003 2014 Page 4 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Copyright and Proprietary Notice Proprietary Notice and Disclaimer The information herein disclosed is the property of iCRco Inc Information in this document is subject to change without notice and does not represent a commitment by 1CRco to incorporate changes or improvements in units pre
59. lable bay 2003 2014 Page 37 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 38 ss lop i m Doe Jane 10000 11 Click OK to close the Device Overview dialog The Image Display window will appear showing all of the acquired images Note The images will automatically arrange themselves displaying a maximum of four images at the E same time wer asdi 10001 1 4 Ts pE 1 RCC X 2003 2014 Page 38 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 39 12 When the image s is finished scanning make the desired manipulations and annotations All XC manipulation and annotation tools are selected in the Tools Menu Bar on the left side of the Image Display window The Window Level Zoom Pan and Crop tools are shown in the graphic below Processing Complete 13 When finished manipulating the image click the Accept and Send button in the lower left hand corner of the Image Display window When the Accept and Send button is clicked it will save the current image manipulations and DICOM Send the image Note E If DICOM auto send is not enabled the Accept and Send button will read Accept The Accept button will save current manipulations to the image but will not DICOM Send Doe Jane OOO ee a e a Doe J
60. lowing steps represent a generalize workflow on how the user can utilize the Patient Information Reconcilation feature for acquiring an image for an unidentified patient 1 In the Patient List window click Schedule Patient D xc zum 3 8 O adea Mak ton i HARSA O EEEE O Mer ipis uad 3 p D utei I ooa 1 Am 5 ee Hs xd beth antec a na Mame Batista Joe Ir 9000 DOE B 11 1964 47v Mame TEST TRADITIONAL DOR 1 1 1980 37 2 Enter known patient and study information then check the Reconcile Button checkbox Click Finish and Scan 2003 2014 Page 28 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 29 3 Select the region and if necessary laterality of the anatomy by clicking on the appropriate body region then select the anatomy and view by clicking on the appropriate buttons Selected View Chest PA Portrait Chrome CR Control Deep Erase iif High Resolution Cassette Size 10 x 12 inches 14 x 17 inches Cassette ID 5 As the image is acquired it will be displayed in the Image Display window 2003 2014 Page 29 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 30 Scanning 6 To reconcile the study go to t
61. mage To erase all annotations click Erase Selected button from the pop up menu on the left hand side of the screen Arrow 9 The Arrow tool allows the User to draw an arrow on the image To use the Arrow tool first select it from the pop up menu on the left hand side of the screen Then click hold and drag out the arrow to the desired length and position Release the mouse button when the arrow is sufficient 2003 2014 Page 48 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 49 Text Annotation The Text Annotation tool allows the User to write text on an image To use the Text Annotation tool first select it from the pop up menu on the left hand side of the screen Then click in the where the text should appear on the image and enter the desired text Press the Enter key to finalize the entered text Pre defined Text Annotation The Pre defined Text Annotation tool allows the User to apply pre set text to the image To use the Pre defined Text Annotation tool select it from the pop up menu on the left hand side of the screen then select the desired pre defined text Click in the desired location on the image and the pre defined text will be applied Line The Line tool allows the User to draw a line on the image To use the Line tool first select it from the pop up menu on the left hand side of the screen Then click hold and drag ou
62. n Scan Preview If checked XC will display portions of the image as the plate is scanned If unchecked the program will wait until the scan is finished before displaying the entire image Plate Size and Spot Size Each plate size can hold it s own spot size settings for both normal and high resolution scans To set a plate and spot size 1 Select the desired plate size from the Plates sized drop down menu 2 Select the desired spot size for both normal and high resolution using the Spot Size drop down menus 3 Click the Close and Accept button to save the changes CHR Settings Only certified technicians should alter the CR Settings Entering improper values may damage the hardware The CR Settings allows the User to view the Exposure Index information System Speed Alpha and Mu values The Advanced button reads in the settings from the scanner s EEPROM and allows the User to edit these values 2003 2014 Page 74 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 75 Demo Settings Turning on the Enable Demo CR option will allow the User to mock scan an image without a scanner attached to the computer An image from the demo images library will appear when scanned Turning on the With CR Motor option will also the user to cassetteless scan in demo mode a with a scanner attached The scanner will then run the motor but will not acquire an image from the
63. ng Exposure Index Since light or dark images optical density are no longer a factor with CR users are often unsure of exactly what exposure factors to use The calibration of a good exposure index can clear that confusion by indicating when optimal energy exposure is acquired by the IP Imaging Phosphorus Plate The iCRco Exposure Index is a user friendly guide to help users develop a working technique chart that 1s specific to the output of the x ray machine 2003 2014 Page 54 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 55 How It Works The iCRco Exposure Index is a pre determined factory calibrated energy level sweet spot that is a compromise between signal exposure factors and noise image grain in other words the greater the signal the lesser the noise and vice versa Hence observing the exposure index allows the user to work to an ALARA as low as reasonably achievable exposure requirement while keeping image noise to a tolerable level CR EXPOSURE CRco Effect of Exposure on Image Quality ce to IMAGE QUALITY HIGH NOISE OPTIMUM VERY GOOD e a 9 o Eee a oo PHOSPHOR STORAGE PLATE IP EXPOSURE Reading the Exposure Index The exposure index is documented in the Patient Information Overlay as a positive or negative number that is red if it is over the value of 1 0 positive or negative and gre
64. ng parameters library enable different groups of processing presets This setting generally does not need to be changed Altering the settings can result in poor image processing This setting can only be modified by the Administrative Account To evaluate or adjust the Processing Parameters see Section Processing Parameter Evaluation on page 90 for more information To set the new library 1 Click the Configuration button on the Patient Worklist screen 2 On the Admin gt Settings tab under Imaging Domain click the Launch Applications Interface button The Applications Interface will open Click the down arrow of the Library File combo box Select the name of the new file Click the Save Repository To Disk button Close the Applications Interface Se Select the Close and Accept button to confirm the changes 2003 2014 Page 18 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc System Requirements and Initial Configuration 19 Setting up DICOM Targets L pe 19 5 6 Click the Configuration button on the Patient Worklist screen Select the DICOM tab Add a DICOM target by clicking the Add New AET button Enter or choose the following information on the Add DICOM AET screen TCP Port The DICOM receive port of the target application 104 is the default port Modality The DICOM tag the sending images should be identified as Target Type The anno
65. ntial and Proprietary February 26 2014 Property of iCRco Inc iCRco Warranty 13 customer advises iCRco or an iCRco dealer of the possibility of such damages This limitation of remedies also applies to claims against any suppliers or dealers of 1CRco 1CRco and its suppliers and dealers limitations of remedies are not cumulative Such suppliers and dealers are intended beneficiaries of this limitation 1CRco is not liable for any claim by or against the customer arising from a third party claim 2003 2014 Page 13 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc iCRco Warranty 14 2003 2014 Page 14 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Revision History Manual Be Updated for XC 1 8 Updated for XC 1 10 Deviation Index Update 2003 2014 Page 15 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Revision History 16 2003 2014 Page 16 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Chapter 1 System Requirements and Initial Configuration XC System Requirements Minimum Hardware Requirements Intel Core 13 CPU or greater e 4 GB RAM or greater e 7200 RPM Disk with 500GB Software Requirements Genuine Microsoft Windows Operating System e Wind
66. nto the LAST NAME search box To query by Accession Number enter the Accession Number into the ACCESSION NUMBER search box To query by a combination of values enter the desired search criteria into more than field 2003 2014 Page 70 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Managing Patient Data 71 Patient info lt y Study Info Patient Ie Procedura Accession a ob last Hamy mn GE Gam 2 Click the Query Worklist button to initiate the query If there are multiple matches the results of the query will be displayed in the Worklist Query Results dialog Then select an entry from the results and click Use Selected The information from the selected entry populates the Schedule Patient date fields E Note In the Query Results dialog the list can be sorted by clicking column headers and the columns can be reorder by clicking and dragging The new column order is saved e fthere is only one result that entry is automatically used to populate data fields 2003 2014 Page 71 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Managing Patient Data 72 2003 2014 Page 72 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Chapter 6 Configuration Configuration The Configuration window
67. o remotely access the customer s PC via the Internet for the purposes of rendering technical support Please note that this warranty including software support does not include computer hardware third party software or operating system or network issues which are outside the control of ICRco Warranty Product Technical Requirements iCRco requires that all DR CR Scanner and or products requiring PCs be fitted and installed with a 1300VA 780W uninterruptible power supply UPS 1CRco recommends the APC 1300 specification UPS or equivalent For warranty evaluation and service 1CRco requires the customer to provide an Internet connection DSL or Dial up or the minimum of a phone line accessible by an extension cord to the product enabling iCRco technicians to perform remote diagnostics on installed equipment In addition each 1CRco product must be installed maintained and operated in accordance with the respective product manual Failure to comply with these requirements will result in a voided warranty claim 2003 2014 Page 11 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc iCRco Warranty 12 Requesting Warranty Service For information on obtaining warranty service call iCRco s customer support at 310 921 9559 In order to evaluate a warranty service request 1CRco requires the following information the 1CRco serial number of the product a detailed description
68. o save the selected size Editing an existing crop box size Select an existing crop box size Click Edit Enter the required width and height of the crop box Select the units C DNUS Click Finish to save the selected size Removing a crop box size 1 Select the crop box size that needs to be removed 2 Click Remove Predefined Text Annotations The Text Annotations tab allows the User to add a list of terms that can be automatically chosen when making a text annotation on the image To add an annotation click the Add button enter the desired term then click the Finish button To remove a term from the list check the check box next to the desired term then click the Remove button Configuration Defaults Defaults The Defaults tab allows the User to predefine the Referring Physician and Institution names so that when the User is scheduling a patient the only action needed is selecting the desired Referring Physician Institution name and Institution address instead of having to manually enter the names each time Institution Address Enter your facility s address in the text field Click Close and Accept to save the changes This will embed your facility s address in the DICOM file Adding a Referring Physician Institution 1 Navigate to Configuration gt Defaults tab 2 Click the Add button in either the Referring Physician or Institution section 3 Enter the desired name 4 Click the Finish button
69. o the Study Information window and click the Study Information Bar Sia E F SS Studies EMI Dos 1 1 0987 TM p as 7 Ifthe study was marked for Reconcile Later a button labeled Reconcile will appear Click the Reconcile button Pur I M 7 CY T 8 A worklist query dialog box will be displayed Select the desired entery and click the Use Selected to confirm a selection 2003 2014 Page 30 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Acquiring an Image 31 Description Patient ID V Ring Lynsey R X Ray 72100 Lumbasacral Spine Limited RINLYOOO 22996 C Ring Lynsey R X Ray 72220 Sacrum Coccyx RINLY0OO 22997 7 13 2012 11 54 1 Batista Joe J 1234003 9 27 2010 1 01 C L m RICK 99 900199 123400992 2 21 2011 1 01 Cancel 9 A confirmation dialog will appear Click Yes to complete the reconcilation procedure Are you sure you would like to reconcile this study and patient 10 XC will automatically update the displayed study and patient information and the workflow 1s completed Auto Scan Workflow The following steps represent a generalized workflow utilizing the Auto Scan functionality To set XC to Auto Scan mode see Section Auto Scan Mode on page 80 E Note Auto Scan mode can only be used with Chrome and Chrome Duo
70. of the problem customer name and contact information product location and operating conditions a copy of the purchase documents and sufficient information and authorization including a liability release as to any loss of data that should always be backed up software or network injury or downtime allowing iCRco technicians remote access to the product Product may not be returned to 1CRco without first obtaining a Return Material Authorization RMA number from iCRco Prior to providing an RMA iCRco may require remote access to the product If 1CRco determines that the product may be defective is under warranty and necessitates a return to 1CRco for service an RMA number and instructions for return of the product will be given 1CRco is not responsible for any unauthorized returned product i e one for which an RMA number has not been issued by iCRco Warranty service requires all authorized returns be shipped to the 1CRco factory prepaid and insured All such authorized returns are the customer s responsibility For products sold and located within the United States 1CRco will pay for return shipping Products being returned are only to be shipped in 1CRco approved shipping containers The original box and packaging materials are approved and should be kept for moving and or shipping the product Approved packaging may also be purchased from 1CRco for an additional charge 1CRco shall have no liability nor responsibility for warranty servi
71. of the stitched image and the other will be the bottom portion 1 Open the Study in XC 2 Load the two images in the viewing window by dragging and dropping them in the window Place the images in the appropriate display region Note You can adjust the grid positions by dragging the grip handle tabs found at the right edge and bottom of the screen 3 Click on the Crop and Mask icon 3rd from top from the main menu and then click the stitch icon The stitching tool dialog box will appear Note E If the dialog box does not appear you will need to go back to Step 1 and load the images in the correct positions 2003 2014 Page 53 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 54 4 u 5 Ifthe images are not aligned properly use the Stitching Tool Coordinate System to adjust the stitching location Note E To adjust the stitching location use the four directional buttons Down Up Left Rigth to shift the image Alternatively adjusting the sliders or entering coordinates in the text fields will move the image When the image has been shifted to the desired location click Stitch to redo the image stitching Note Uc It is possible to move the Stitching Tool Coordinate System window D Note Do Not click Done until you are satisfied with the stitching location 6 Click Done to finalize the image stitchi
72. om left hand corner of the DICOM Printer dialog Please ensure all the printer settings are correct first Patient Demographics for Icons When the cursor is over the icon bank Advanced DICOM Print will display the demographics for the image test test 10006 1 1 2013 test a test 9 19 2013 10 32 13 AM Abdomen 2 views ABDOMEN AP F 9 19 2013 10 32 13 AM AP Multiple Icon Pages Advanced DICOM Print has an unlimited number of icons that can be loaded However the PC s memory is a restriction To clear the current page of icons click on Clear Current Page button To clear all the pages of icons and preview window click on Clear All Pages button To move between pages and move to first and last pages click on the arrow buttons 2003 2014 Page 63 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 64 Configuring a Printer with the QPC Print Tool The following section demonstrates how to setup a DICOM film printer with the QPC Print Tool 1 Open the QPC Print Tool 2 On the Printers tab select the Settings button The DICOM Print Settings window will appear 3 Select the printer make and model from the Printer drop down menu If the make and model of your printer is not available select Standard Printer 4 Select the next to AET The Image Targets window will appear 5 In the Image Targets window select Add New 6
73. om the study 1 From the Patient List select the patient to be removed 2 In the Study Screen click the Patient Information bar to open the Edit Patients screen 3 In the Edit Patient screen click the Remove Empty Patient button A conformation dialog box will open To remove the patient click Yes If successful the User will be returned to the Patient List window Removing All Patients i Important Once removed patient data is not recoverable Perform a back up before removing any patient data 1 Ensure that Hidden Files and Folders are viewable as covered in Showing Hidden Files and Folders in Windows on page 99 2 Navigate to the iCRco XCfolder e On Windows XP the path is C Documents and Settings All Users Application Data XC e On Windows 7 the path is C Program Data XC 3 Inthe XC folder delete the folders Patientsand Studies and the content of both folders Querying a Worklist XC can be configured to automatically query a DICOM Modality Worklist Server See Section Setting Up Modality Worklist Query on page 88 for more information on configuration The worklist can then be queried by any green field on the Patient Scheduling screen The query can be based on any of the green fields or a combination of green fields 1 In the Worklist Query fields at the top of the Patient Information screen enter the desired search criteria For example to query by Patient Name enter part or all of the patient s name i
74. osure of an ACR MAPP phantom that results in optimal image quality that passes testing at the lowest possible dose 2003 2014 Page 56 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 57 Reading the Deviation Index The Readout of the Deviation Index serves as an image quality metric generally a positive value indicates over exposure while a negative value indicates under exposure Note If exposing a breast that is larger or smaller than a 4 0 4 2 cm breast positive and negative values may not correspond to over exposure and under exposure respectively A site is required to develop its own technique chart upon installation of the system so that a user can reference the expected DI value for various dose readings Below is an example of a Technique Chart Note The example chart and data should not be used for clinical interpretation Table 1 Example Technique Chart Breast Composition Target Filter Density Optimal DI Thickness Readout The installation site can determine how precise the thickness composition and exposure settings should be in the Technique Chart The user should check the Optimal DI Readout for all clinical exposures A DI is considered acceptable if it is within one step of the Optimal DI Readout For example if XC outputs a DI value of 4 for a 5 7 cm breast at 29 kVp and the Optimal DI Readout value is 2 then
75. out Printers Selected Image Width SE Window 7662 Height 1496 Level 48565 Zoom 164 Update Max Zoom Level 20055 vi eltira I E 11 A The Advanced DICOM Printer allows the user to flip rotate zoom pan invert and window level images To manipulate the images select the image in the preview window the selection will be shown by the green box surrounding the image The user can flip rotate and invert by using the buttons on the left hand side of the DICOM Printer dialog The user can zoom by using the right mouse button on the selected image To pan the image use the left mouse button on the selected image Note E The User can only pan the image when it is zoomed in To window level the user can either use the middle scroll button on the mouse or type the required window level into the edit boxes on the left hand side of the Advanced DICOM Printer dialog Then press the Update button to change the window level for the image The user can also press the 1 1 button to print images at 1 1 resolution The user can use the Orientation button to change from landscape to portrait view Changing Margins The margin tab permits the user to specify in English or metric units the size of the borders on the printed image The top and bottom borders on the page can be adjusted independently of the borders for the left and the right hand side of the page Overlay Templates Logo Label Image Page Layout Printers Page Praper
76. ows XP SP3 32 or 64 bit e Windows 7 32 or 64 bit e Windows 8 32 or 64 bit with Microsoft Net 4 x Initial Configuration Verifying the Region Locale Date and Time 1 Go to Start gt Control Panel gt Date and Time Ensure the date time and time zone are accurate for your region 2 3 Go to Start gt Control Panel gt Region and Language gt Location 4 Ensure the Current Location is accurate for your region Setting the Administrative Account The first time the application is run you will be prompted to Create An Administrative Account Enter the desired username and password for the Administrative Account Have the clinical administrator write the Administrative username and password down Store the password somewhere where it will be safe When the administrative account is successfully created the Login dialog will appear Login with the Administrative Account Note ic If the Administrative Account is not created XC will not launch Verifying the Application is not in Demo Mode 1 Click the Configuration button on the Patient Worklist screen 2 Select the Device Settings tab 2003 2014 Confidential and Proprietary Property of iCRco Inc Page 17 of 100 Doc HC XC 0028 05 Rev E 02 February 26 2014 System Requirements and Initial Configuration 18 3 Under Demo Settings the Enable Demo CR button should be set to Off 4 Select the Close and Accept button to confirm changes
77. r example the tag 0040 0002 DA ScheduledProcedureStepStartDate will be given the current date so that only worklist items schedule for today are retrieved Adding one of these tags to the tag list will stop XC from adding the value on its own This should be done if the customer does not want the query to be filtered by these values In particular some worklists will use a default value for Scheduled Station AET where as XC will use the configured local AET This means a query will fail to return any items since the values don t match If XC isn t being populated by the worklist try adding the Scheduled Station AET to the tag list in QueryContstraints txt This tag will be placed within the Scheduled Procedure Step Sequence Adding a Sequence tag and tags that belong in the Sequence Sequences require at least four tags First is the tag for the sequences itself Then Begin Item and End Item tags for each item in the sequence Followed by the End Sequence tag A Sequence can have multiple Items and an Item can contain multiple tags Though have only one Item with all relevant tags is fairly standard Example CO PDSINDIOD EE OMIM NES cde EIRecceumca ep csuenmcc E iic EET c Item All tags that belong in this sequence should be placed here gd SUC cs lhiacl Iie OBSS ES acl gt ja Kime SEXO D eM List of Devices Supported by XC This section provides a list of hardware devices supported by XC 2003 2014 Page 97 of 100 Doc HC X
78. rigger XC to move studies that have met the purge constraints to the virtual trash bin The user can also move studies to the virtual trash bin manually by clicking the Purge Now button All studies that have met the purge constraints will be moved to the virtual trash bin Note Ec If Auto Purge is enabled it is not necessary to use the Purge Now button XC will automatically purge images based on the Purge Constraints Virtual Trash Bin When data is automatically or manually purged by XC it will be moved to the virtual trash bin The virtual trash bin indicates the size of data that will be permanently deleted from the computer and allows the user to permanently empty the trash bin by clicking the Empty button Delete Images When Rejected Turning on the Delete Images When Rejected option enables XC to automatically moves rejected images to the virtual trash bin 2003 2014 Page 79 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 80 Chrome Workflow Modes In addition to the standard Manual Scan workflow modes the Chrome and Chrome Duo can operate with XC using an Auto Scan Mode and Barcode Mode Each mode offers a different workflow The user should choose the mode that best matches their preferred workflow Note Modes can be activated in Configuration Manual Scan Mode The user can begin a scan by selecting the bay holding
79. rmation is displayed on screen Reset Image The Reset Image tool allows the User to remove any Window Level magnification and rotation from the image To use the Reset Image Tool left mouse click the button in the pop up menu on the left hand side of the screen Processing Parameters The Processing Parameters are various selected settings used for image processing To view the processing parameters of a specific image double click on the white study description text located to the right of the image tools Z Art Test 346154 Ed AP Portrait ne PEN BES ES This will display the processing parameters which will appear on the right side of the screen 2003 2014 Page 50 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 51 spine Dr B 11092055 ea ae ae EE Sen Dr B 11092055 Processing Complete o gt MEE Lh 2 T 4 EE To modify the Processing Parameters see Section Processing Parameter Evaluation on page 90 Multi Tile Mode for Side by Side Image Acquisition and Comparison XC employs a feature called multi tile display which allows the user to perform side by side image acquisition and comparison The multi tile display is available in the Image Display Window e To activate a 2 x 1 multi tile display drag one of the gray buttons located on the edge of the image thumbnail gallery to the center o
80. rom iCRco or an authorized dealer of 1CRco products for your own use In addition an extended warranty is available for most new and recently purchased 1CRco products for an additional charge Hardware Limited Warranty iCRco warrants its hardware products to be free of defects in materials and workmanship for a period of one 1 year from the date of original shipment from 1CRco subject to the limitations set forth herein If a product proves to be defective in material or workmanship during the warranty period 1CRco will at its sole option repair or replace the product with a similar product Repaired and replacement products may be or include refurbished or remanufactured parts Any replacement item assumes the remaining warranty period of the original product 1CRco provides no warranty for any third party hardware or software included with any product or later acquired Software Limited Warranty Support iCRco warrants that its QPC XSCAN32 Captera XC and or Clarity PACS software originally provided with any product will substantially conform to 1CRco s specifications and that the media not including hard drives on which the software is furnished will be free from defects in materials and workmanship under normal use for a period of one 1 year from the date of original shipment from iCRco 1CRco s sole obligation under this warranty is limited to making reasonable efforts to ensure such conformity and to supply the consumer with a corrected
81. s is known as the 15 Percent Rule Increasing the kVp by 3 75 percent will increase the exposure level by 25 percent and decreasing the kVp by 3 percent will decrease the exposure level by 20 percent Advanced DICOM Printer Selecting Studies for Printing 1 In order to launch Print Tool Select a patient from the worklist 2 On the Studies screen click Send Study gt Print Study gt Send Images to Print Tool button The Print tool will be launched Alternatively it is possible to print using a paper printer by selecting the Paper Print button in the Print Study tab Drag and Drop Images To drag images into the print region hold the left mouse button down on one of the image icons on the right hand side and drag it into the preview window A dragging cursor will appear a the user drags the image from the image icon window to the preview window If the user is out of the accepted region for dropping a cursor O will appear letting the user know that this is not a correct region to drop the image into Preview Images Po 1f 1 Split the Preview Window into Regions To split the preview window the user needs to first select the region to split For example if there are currently no divisions in the preview window then click anywhere in the preview window and a green line will appear around the window This will enable the image division buttons Alternatively the user can press Shift right mouse click inside the preview w
82. s positioned on the top right corner of XC s window to the right of the wireless indicator when the computer is powered by battery When the battery is critically low the computer will be shutdown Note The battery indicator is not displayed in the Image Display window Patient Status Icons The Patient Status icons quickly tell the user what phase the patient study is in The Status icon can be one of 1 Scheduled 2 Stat 3 In Progress 4 Finished v The user may cycle through the available status by clicking the Status button in the Studies window 2003 2014 Page 65 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc License and Version Information Tools and Processing 66 The user can find the XC version number and licensing information by clicking iCRco The About window will pop up Thus ts version 0 10 31 Software license ts set to expire 11 XC is copyright iCRco 2008 2012 Clicking License Info shows what modules are enabled on the USB security dongle Enabled Feature True True True True True True True True True Software license is set to expire 6 26 2013 2003 2014 Annotations Write Study CD Print Dicom Send Worklist Query ICE Medical Mammography Podiatry Confidential and Proprietary Property of iCRco Inc Default font provided by SIL http www SiLorg Non DICOM image handling
83. se when the first leg is sufficient Click the mouse again at the point where the second leg of the angle should end The second leg of the angle will be drawn and the measurement displayed at the vertex At any time the User may click the end of either leg or the vertex and readjust the position of the angle Cobb Angle The Cobb Angle tool allows the User to draw a Cobb Angle with an angle measurement on the image To use the Cobb Angle tool first select it from the pop up menu on the left hand side of the screen Then click hold and drag out the first line of the Cobb Angle to the desired length and position Release the mouse button when the length and position are sufficient For the second line of the Cobb Angle click hold and drag out the line Release the mouse button when the length and position is sufficient At any time the User may click the end of either line and readjust the position of the angle Center Point The Center Point tool allows the User to define two points on the image with a third point the center mark To use the Center Point tool first select it from the pop up menu on the left hand side of the screen Click once where the first point should be and once where the second point should be A third point will appear marking the center point on the line At any time the User may select either end point and readjust the position 2003 2014 Page 47 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietar
84. t evt ae aede bk sabor f odi bao tele mate ntu tao Seco focim depu oen dus 3l Barcode Sca Work HOW a nec taste tase tea cia RR ERU enero eod Uds ud etu ita Maa ut Cii uad Lom rd UU DD UC REED 35 Chapter 4 Tools and PrOCOSSIDS iu eei ten e ore e Ree ry Ey a EnYa aen a eov ooa ae serae sis eta e A Imate Manippldtonm Tools 54x cries anen enit t ee eoi eveomi ole beatag enl e ite tie do ue odeteiimituse e ete en URN ees 4 Processing PAPA CLOTS korde tonio ei teo pedet raenr Gd adhue inteses boca epi onte e oed caedes biete 50 Multi Tile Mode for Side by Side Image Acquisition and Comparison sssssssesesseeeee 5 Muli loci GIUM RTT TEE TNT 22 Imate SEC podio a dea catehostonanlesetay acini seite a tos tates EN 53 OS UG HOC once piatti bebes scd T Aiuto Exe cuadra icc pne ee a fadia ies 54 B Yen s BG TRE YS op dE RETE ESTER 56 PAN CG DG IVIL PIle fore oh Bae canescens ac Uae ytoateae as a a 58 Coniteurine a Printer withthe OPC Print Io0lLstieten i phe ulus a boe E Order bus 64 SARIS dro Te opc Od T6 3E OES eoo th be oec poe ome co pide b buie adotta addunt taeiesiecs bicatuba s usted nad Ice eo 65 Licensesaud Version IDTOTEHEIOPI esera beu el etre mde oar tetau lota onda in de Deae dee ecex 66 Chapter 5 Managing Patient Data ce eece eee e ee eee eee ee eee eee eeeesssssseee 7 Crena PAMC IS uude PNIS Bt MEMMIUS PIU N etd es editt pants Tu OUI dE pups 67 Editing Patient Informabloliso pc
85. t on the image To use the Measurement tool first select it from the pop up menu on the left hand side of the screen Then click hold and drag out the measurement line to the desired length and position Release the mouse button when the measurement line 1s sufficient The measurement will appear next to the line True Size Calibration Tool Es 2003 2014 Page 46 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 47 The True Size Calibration Tool allows the user to calibrate image measurements based on an object of known size in the image To use the True Size Calibration Tool 1 Place an object of known size at the level of the anatomy for calibration 2 Expose the cassette and scan the image 3 Select the True Size Calibration Tool from the tool from the pop up menu 4 Click hold and drag out the line over the object of known size The Calibration dialog box will appear 5 Enter the size of the known object in the Calibration Value input field then click Confirm button All measurements on the image will be calibrated to the true size Angle The Angle tool allows the User to draw an angle with the interior measurement on the image To use the Angle tool first select it from the pop up menu on the left hand side of the screen Then click hold and drag out the first leg of the angle to the desired length and position Release the mou
86. t the line to the desired length and position Release the mouse button when the line is sufficient Extended Line The Extended Line tool allows the User to draw a line on the image that extends all the way through the image To use the Extended Line tool first select it from the pop up menu on the left hand side of the screen Then click hold and drag out the line to the desired position Release the mouse button when the line is sufficient A line will be drawn all the way through the image Hide Show Annotations O gt The Hide Show Annotations tool allows the User to show or hide the annotations for the current image To use the Hide Show Annotations tool first open the pop up menu on the left hand side of the screen Then click the Hide Show Annotations button to hide or show the annotations on the current image Note E 2003 2014 Page 49 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 50 If annotations are hidden no new annotations can be made on the image To make a new annotation make sure the annotations are not hidden Information Overlay my The Overlay tool allows the User to show hide the patient information associated with the image currently being viewed To use the Overlay tool first open the pop up menu on the left hand side of the screen Then click the Overlay button until the desired amount of patient info
87. tation type the sending images contains Graphics Object is the newest followed by Overlay then Embed If you can t see annotations at the target application change this setting For Processing Enable if the target application 1s going to do image processing For example a dedicated Mammographic CAD application This sends the image from XC without processing it XScan QPC Enable only if sending to the QPC XSCAN32 application Select the Finish button Click the Close and Accept button to confirm the changes Setting Auto Send Targets The auto send targets feature will DICOM Send an image to a predefined target Enable the feature as follows 1 eS a I Create a DICOM target as covered in Setting up DICOM Targets on page 19 Click the Configuration button on the Patient Worklist screen Select the DICOM tab Select the Auto Send Targets tab Select the target s the user would like to automatically send their images to by placing a check mark in the check box Select the Close and Accept button to confirm changes When the Accept and Send button is clicked at the Image widow the image will send to the specified targets Setting Worklist Targets If you need XC to query a DICOM modality worklist the feature can be enabled as follows 1 Create a DICOM target as covered in Setting up DICOM Targets on page 19 2 Click the Configuration button on the Patient Worklist screen 3 Select the DICOM tab 4 Select the
88. the cassette Note E When in Manual Scan Mod XC considers the two bays of the Chrome Duo as two separate units connected to a single computer To activate Manual Scan Mode 1 Click the Configuration button on the Patient Worklist screen 2 Select the Admin tab 3 Select the Settings tab 4 In the lower right settings filed labeled Chrome Settings set the Barcode and Auto Scan buttons to Off Barcode For information on the Manual Scan Workflow see Section Manual Imaging Workflow on page 23 Auto Scan Mode When in Auto Scan Mode XC allows you to start a scan without needing to select a specific bay or cassette size The user can simply insert a cassette into the bay and the scan will begin automatically To activate Auto Scan Mode 1 Click the Configuration button on the Patient Worklist screen 2 Select the Admin tab 3 Select the Settings tab 4 In the lower right settings filed labeled Chrome Settings set the Barcode button to Off 2003 2014 Page 80 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 81 5 Set the Auto Scan button to On For information on the Auto Scan Workflow see Section Auto Scan Workflow on page 31 Barcode Scan Mode With Barcode Scan Mode XC allows the user to separate the registration process from the scanning process The user scans a barcode on a cassette then registers the cassette to
89. the option of reprocessing the image after it is cropped Note E The user can set crop sizes in Configuration See Predefined Crop Boxes on page 81 2003 2014 Page 43 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 44 Image Masking Tool za The Image Masking tool allows the User to hide any collimation or undesired artifacts around an image without discarding image data Note The way the mask is embedded in the DICOM file depends on the Target Type setting Edit AET ET screen located at Configuration gt DICOM If the mask does not show up when sending to PACS adjust this setting 1 Select the Masking tool from the pop menu on the left hand side of the screen Fi A Fa EM E 4 There is the option to select one masking box two masking boxes U three masking boxes A or polygon masking ew 2 Click and drag the Masking Box to the desired size Upon releasing the mouse button the outer portion of the Masking Box is masked out testing testing 195313717 Sternum Lateral z To use the tool the User simply clicks sequentially the corners of the polygon the User wishes to create Additionally the User can change the placement of a corner by holding and dragging it To finish the shape the User should click on the original starting point 2003 2014 Page 44 of 100 Doc HC XC 0028 05 Rev E 02 Confiden
90. the plate was over exposed since the DI value is two steps away from the Optimal DI Readout value Adjusting Exposure Based On the Deviation Index Data Deviation Index 10 log 9 Measured Dose Expected Dose Each 1 increment of the Deviation Index indicates a 25 percent increase in dose while each 1 increment indicates a 20 percent decrease in dose For Example Let s say the Expected Dose is 20 mR An exposure gives us a plate dose of 40 mR and a DI readout of 3 If a DI of 4 is needed 1 Increase the exposure by 25 percent 40 0 25 40 50 mR total If a DI of 2 1s needed 1 Decrease the exposure by 20 percent 40 40 0 2 32 mR total If a DI of 0 is needed the calculations will need to be performed one step at a time 1 Decrease the exposure by 20 percent 40 40 0 2 32 mR DI of 2 2 Decrease the Step 1 exposure by 20 percent 32 32 0 2 25 6 mR DI of 1 3 Decrease the Step 2 exposure by 20 percent 25 6 25 6 0 2 20 48 mR DI of 0 2003 2014 Page 57 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 58 A Word on Exposure Math It s possible to adjust the level of exposure delivered to the plate by modifying the kVp mAs or exposure time Increasing the mAs by 25 percent will also increase the exposure level by 25 percent Increasing the kVp by 15 percent will increase the exposure level by 100 percent thi
91. tial and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 45 To hide the Masking Box click the Forbidden Mask button in the tool bar To remove a mask click the Reset button Image Stitching See Section mage Stitching on page 53 ICE2 Processing aeQ y d E E E 5 n E m The ICE2 Processing allows the User to apply different image enhancements to the image By default every image receives Standard processing If the Standard processing is not adequate the User may reprocess the image to suit their needs The Soft process O will yield a more film like image 1 e finer tonal gradation with less sharpness while the Sharp process will yield an image with more contrast and greater edge sharpness To use ICE2 Processing first open the pop up menu on the left hand side of the screen Then click the desired processing button Depending on the computer speed the process may take a minute The progress is shown in the image thumbnail on the right hand side of the screen while the image is being processed it will say processing in the lower left hand corner of the image thumbnail No Skin Line Detection Processing 2003 2014 Page 45 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 46 The No Skin Line Detection Processing
92. tients within the selected date range Available date ranges are Within One Year Within One Month Within One Week Yesterday and Today or Today iDR L Full Erase Allows the User to choose whether to erase the whole iDR L plate after every scan If set to ON the whole IP plate regardless of region selected will be erased If set to OFF only the scanned region will be erased Show Default Smart Box Toggles whether the Smart W L tool should be automatically applied after scanning an image Configuration Admin The Admin tab is only available to Administrative users and contains user accounts and data management options Imaging Domain Sets the scan interface for Medical general radiography Mammography Podiatry Specials Veterinary small animal or Equine Note Available Imaging Domains are enabled disabled on the USB Security Dongle Key 2003 2014 Page 76 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Configuration 77 Launch Application Interface The Applications Interface allows the User to change image processing libraries define custom anatomy projections define and edit default processing parameters automatically rotate and flip images assign laterality adjust auto Window and Level values enter exposure factors for supported generator models and restore defaults For more information on the Applications Interface see Section Addin
93. ties Orientation Image Divisions e Portrait Show 2003 2014 Page 60 of 100 Doc 4 HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 61 Additionally the user has the option to control the internal margins which define the amount of space left between individual frames on a page with multiple images Internal margins are defined as multiples of the print page border size By default internal margins are the same size as the borders with image margins on the left and right hand side of each frame are equal to the left and right hand borders Margins on the top and bottom of each frame are equal to the top and bottom borders of the printed page If the user intends to cut individual frames out of the printed page it is recommended that internal margins are set to twice that of the page which will give a uniform border size on the individual image segments If it is necessary to maximize the amount of space on the printed page the internal margins can be turned off altogether Saving and Loading Print Layouts The Templates tab allows the user to save and load pre defined print layouts There are five user defined layouts Set up the layout on the preview window and then select one of the buttons labeled Click here to save current layout The user will be prompted for a title To save more layouts click on the Save Current Template button Here the user can set a
94. viously sold or shipped No part of this document may be reproduced or transmitted in any form electronic or mechanical including photocopying and recording for any purpose other than the purchaser s own use without the express written permission of iCRco Copyright Copyright iCRco Inc 2003 2014 All rights reserved Trademarks iCR 1000 iCR 1000 Dual iCR 2600 iCR 2600 Dual iCR 2600SF iCR Vet iCR Vet Dual iCR Mobile iCR 1 D iCR Chiro iCR Chiro Dual iCR 3600 iCR 3600SF iCR VERTX iDR Fusion DCR Chrome Chrome Duo Air DR Air DRc Fusion DR Mobile QPC XSCAN32 Captera XC and www icrco com are the trademarks of 1ICRco All other trademarks are the property of their respective owners and are hereby acknowledged Terms Any one of the following iCR products will be referred to as the CR unit throughout this document iCR Vet iCR Vet Dual iCR Mobile iCR 1 D iCR Chiro iCR Chiro Dual iCR 3600 iCR 3600SF iCR VERTX iCR Fusion Chrome Chrome Duo Any one of the following iCR products will be referred to as DR unit throughout this document Air DR Air DRc Any one of the following iCR products will be referred to as ICR desktop unit throughout this document iCR VERTX The iDR and Fusion DR Mobile will be referred to as the DR unit throughout this document 2003 2014 Page 5 of 100 Doc HC XC 0028 05 Rev E 02 Conf
95. y February 26 2014 Property of iCRco Inc Tools and Processing 48 Heart to Lung Ratio om LI DB A Es The Heart to Lung Ratio tool allows the User to measure the heart to lung ratio on an image To use the Heart to Lung Ratio tool first select it from the pop up menu on the left hand side of the screen Then click hold and drag out the first line of the Heart to Lung Ratio to the desired length and position Release the mouse button when the length and position are sufficient For the second line of the Heart to Lung Ratio click hold and drag out the line Release the mouse button when the length and position is sufficient At any time the User may click the end of either line and readjust the position Units of Measurement NH EL The Units of Measurement allow the User to toggle the displayed unit of measurement between inches millimeters and pixels To change the unit of measurement open the pop up menu on the left hand side of the screen Then click the desired unit of measurement The unit of measurement will change to reflect the selection Erase Annotations The Erase Annotation tool allows the User to erase a single annotation at a time To erase an annotation first select it then click Erase Selected button from the pop up menu on the left hand side of the screen Erase All Annotations F lt 2 The Erase All Annotations tool allows the User to erase all annotations made on an i
96. y resize the box at any time by selecting the Smart Box by one of the corners and dragging to the desired size The User may also move the Smart Box around the image to yield different Window Level settings by clicking and dragging from the middle of the Smart Box To hide the Smart Box and apply the settings click the Smart Box button in the tool bar The User may re draw the Smart Box at any time by deselecting then re initiating the tool Zoom The Zoom tool allows the User to alter the on screen magnification level of the image To use the Zoom tool first select it from the pop up menu on the left hand side of the screen Then move the mouse cursor over the image and 2003 2014 Page 41 of 100 Doc HC XC 0028 05 Rev E 02 Confidential and Proprietary February 26 2014 Property of iCRco Inc Tools and Processing 42 move towards the top of the image to increase the zoom level or towards the bottom of the image to decrease the zoom level Synchronized Zoom The Synchronized Zoom tool allows the User to match magification levels when viewing multiple images side by side in multie tile mode In multi tile mode the currently selected image in the group is highlighted When you select this tool all other images will magnify to the same level of magnification as the highlighted image Additionally when this tool 1s selected any magnification changes on the highlighted image will also modify the magnification level of all other im

XC User Manual - T&K X-Ray Consultants, Inc.

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XC User Manual - T&amp;K X-Ray Consultants, Inc.

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XC User Manual - T&K X-Ray Consultants, Inc.