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User manual Bitewing

1. Exercises where the tube head is to be positioned starts with displaying only the patient and the detector Tube head is not visualised Instead the user should turn the patient to a position where he she looks at the patient in the planned x ray beam direction After proceeding the tube head is visualised and the task continues Qbion ABT 2009 11 3 Interaction training The aim with the interaction training module is to acquire skills with which to navigate in and interact with the virtual environment VE where the radiology skill training is performed The module is comprised of three separate exercises which are designed for the acquisition of interaction skills necessary for successful performance of the exercises in the skill training module The exercises are Beam AutoAim Detector and Aiming device It is highly recommended that the exercises in the interaction training module be performed before entering the skill training module RP Bitewing qbio AL RADIOLOGY qbion com www Ob Select exercise Beam AutoAim E Detector Aiming device Interaction training Skill training Exar Quit Start page Repeat the exercises as many times as needed until you can easily control the tools for navigation and interaction The effect of skill training will be jeopardised 1f interaction training is neglected Navigation and intera
2. Nit lu Dele tor JE AN SEIN mace 2 Ihe rar arap a ratiert the tur sal DA of Une aye Fue ee Un deere Iraca 3 stat gt Imaje 21s T4orascapies y disp 2 30 s far ge v aleela pes jen sy unn SCH Contin sou sly updated DIL areas Tram sant Issbr seg pata D Aflr2ucht at Hut recica Ilint i 7 Dack X mara TS 6 LookThrough In this mode the patient is viewed from the focal spot The field of view is restricted by the aiming device Detector position is the same as it was before entering LookThrough mode Move the detector with the mouse Image 2 white frame is continuously updated and synchronised with detector movement Follow the changes in radiographic depiction Hint The detector can be rotated moved sideways and up down with the mouse buttons 7 Return to ordinary viewing mode the heir sal Une ave teue xm Un maca 3 stat gt Imzye 21s Ics y disp ay2d 3y ululis Ais at Inrage 2 3 Contin Jo sly updated Dika ar2as PRAnF Snt unaewncsed pata D kirch e Hut Push the Exit LookThrough button to return to ordinary viewing mode The exercise continues in the same mode as it started Detector position is the same as it was before exiting LookThrough mode Qbion AB 2009 11 21 Explore Aiming device Brief presentation of the exercise The aiming device can be pointed in any direction Focal spot position is fixed during aiming device moveme
3. The exercise starts with the tube head aligned for an orthoradial projection of the selected area Two identical radiographs are presented Image 1 gray frame is the resulting orthoradial radiograph and Image 2 white frame is fluoroscopically displayed Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window KH Sloe YH ima 1 AM Tu derw sgala mee b radie gre st desitje sir au by lube d meve ners vo ary change Ir bean Awara STM 7 ISITION The radic yrapr 3 retest tae Inc ic Ja pesiin cm the mea vead ard T duh Iis sluje inayet 3 q aorasscalcally dealayed fins Cour ge Libs swe d susiliue are dira Imag 2 3 cordr dok sly upastec DS areas rapg eser e aa ps ts SE Dh Sei KC Banslocners Pi Qbion AB 2009 11 17 5 Task Investigate how radiographic depiction is influenced by changes in focus position tube head position Change focus position by moving the tube head in any desired direction Image 2 white frame is continuously updated and synchronised with tube head movement Follow the changes in radiographic depiction Hint 1 Grasp the back of the tube head housing and move it in any direction Image 2 is continuously updated Hint 2 The task is easier to complete by zooming out with the navigation tools so the complete tube head is visible Z At Aur r Si by aye IS dt nover 3nts oO an
4. POSITI bion wr On Select exercise Expose AutoAim eam E H P i oe e O fag a c Oo S STAI OI Tr ac agrara a nag Ile e rafzrence 7g d im mens referer 3E K Ew 7 Ir Im rage feu As a pate gin ue he Ue leet ae S SC an tr voL dup zata ot E Wi Cast 32 egy core stty pos ice Prosesd 77 t t 1 ert Ihe arr wine at ainst Ir Le Prse3 FO t3 ac IECH swir y Aine stlor Pore Ensue 7 SAL CV4LUATION Buu dir ul ot ap gle eror Je ees A patient and a detector are presented in the scene The detector is correctly positioned for the reference bitewing The reference radiograph which is a correctly projected bitewing is presented in Image 1 gray frame Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window Qbion AB 2009 11 30 Bees Jog cp w ees 30 acquire zl mz Aty pina Leu et E Tar st Tae Dame 8 TaN E ilz lavra arimek wooing in Imat e Jat ant t3 z pest Verse a Ah te bam Ahn ger 3tor ar Jupie Dieu the etecor Is alrsady cotre 2ty 90s one Prereer iF7 hot 20 median geite juin aeterni Fres3 Jto adjus Memre dirzzton Ee ck FE En J IFT Foal SyaT EN raam directe Ayie am i EA ANNIA Aduz DE Hee 2 ik fy Baesa nerit 5 Task Try to duplicate the reference bitewing in Image 1 Start the exercise by ad
5. Skill training See t Detector Select area 3 Select Right e Molar Premolar Premolar Molar eam H AutoAim spot aM astrate Fow the radic graph gt x rate d Ktreg mhanga Ir elur ssil ar SG AR ICH he rad ae erste CHE ges 2 s Ube hezi zae he A Au ur rye Tis lalic memes Fis Wi Sech allyn SE po 5 SE decr pes Jar ay tatici c MACHTy3 mover ort CH 219 an itm mas by ap kal sd Shes arta 4 Starting position The exercise starts with the tube head aligned for an orthoradial projection of the selected area Two identical radiographs are presented Image 1 gray frame is the resulting orthoradial radiograph and Image 2 white frame is fluoroscopically displayed Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window a S DI GE dE Wace taba y disp ECH Jur yy wt ular pes SE Ze Se VME Itrage 2 3 contin AOL Sly UF SE Pee CH anat us Eir soi rale a Qbion AB 2009 11 20 5 Task Investigate how radiographic depiction is influenced by changes in detector position Change detector position by moving the tube head in any desired direction Image 2 white frame is continuously updated and synchronised with tube head movement Follow the changes in radiographic depiction Hint The detector can be rotated moved sideways and up down with the mouse buttons
6. a white ball respectively The central ray and focal spot for the radiograph you exposed blue line and blue ball are visualised inside the tube head housing Detector position for the reference bitewing is displayed as a white frame 6 Evaluation Observe the differences in radiographic depiction between the reference radiograph and the one you exposed Unexposed areas cone cuts are represented as blue fields on the radiograph Any differences in projection parameters between your and the reference radiograph are presented under the evaluation heading If an error is too great the parameter must be adjusted before the task is completed Hint 1 Adjusting beam direction Grasp the back of the tube head housing and move it until the tube head focal spot blue ball coincides with the focal spot position for the reference bitewing white ball Hint 2 Beam direction Angle error is calculated as the angle between the central ray when the reference radiograph was exposed represented by the white line and a line between the blue focal spot and the middle of the detector Hint 3 Adjusting aiming device Grasp the aiming device and redirect it until tube head central ray blue line coincides with the central ray for the reference bitewing projection white line Qbion AB 2009 11 36 Error analysis General information The aim is to acquire skill in analysing incorrect projected bitewing radiographs The philosop
7. basic structure Before starting the exercise the user selects an area for examination The exercises start by displaying the scene with the patient model a tube head and a detector positioned for a bitewing radiograph The aiming device is directed toward the detector for a bitewing projection of the selected area In addition two identical radiographs rendered from the individual positions of the detector and tube head relative to the patient are displayed One radiograph is fluoroscopically displayed When projection changes are made the fluoroscopic image is continuously updated One can therefore follow how changes in a projection parameter influences the radiographic depiction in real time Push the LookThrough button to enter LookThrough mode LookThrough In this mode the user looks at the patient from the focal spot through the aiming device The tube head housing is in the same position as it was before entering LookThrough mode This implies that viewing direction is identical with x ray beam direction The teeth are displayed as a transparent mesh giving an illusion of the radiographic depiction which can be compared with the fluoroscopically displayed radiograph Return to ordinary viewing mode by pushing the Exit LookThrough button The x ray beam direction is the same as it was before exiting LookThrough mode Qbion AB 2009 11 12 Explore Beam AutoAim Brief presentation of the exercise AutoAim Cent
8. be exposed is identical to the direction in which the patient is viewed Turn the scene to a position where you can look at the patient in the same direction the x ray beam direction was pointed when the reference radiograph was exposed Hint 1 When exposing the radiograph the x ray beam direction is identical with the viewing direction Hint 2 Use the tools for scene movement to change viewing direction Expose your radiograph by pressing the Expose button The exposed radiograph is presented as Image 3 blue frame The central ray and focal spot for the reference radiograph are displayed as a white line and a white ball respectively The central ray and focal spot for the radiograph you exposed blue line and blue ball are visualised inside the tube head housing 6 Evaluation Observe the differences in radiographic depiction between the reference radiograph and the one you exposed Any difference in beam direction between your and the reference radiograph is presented under the evaluation heading If the error is too great beam direction has to be adjusted before the task is complete Hint 1 Grasp and move the back of the tube head housing The central ray is always directed towards the middle of the detector when tube head is moved AutoAim Hint 2 The task is easier to complete by zooming out with the navigation tools so the complete tube head is visible Hint 3 Beam direction Angle error is calculat
9. dug ees EI a Detector pos 3 at t Hew ME Sachen 4 Starting position A patient and a detector are presented in the scene The detector is randomly positioned The reference radiograph which is a correctly projected bitewing is presented in Image 1 gray frame Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window Wine Beam and deter ior Lo CY BY HP mace 2 ee r uf Fu va 2207 ir Sege ere Sc Jilwir A radic Gase ahs ate 2 POSITIE D 9 a Tr c agra aa A mac ES enee KE D Ki S Skaeri 1a rantan ae GH cate ta ieeretgvaEt ree a ly a ps oe ack ain eer w seat ae Sen Sn voL dup EES R SC In the narr gt Se ep BEE EE Paren tt Heer Aire Back lucy A Qbion AB 2009 11 34 5 Task Try to duplicate the reference bitewing in Image 1 Both detector position and x ray beam direction must be adjusted for proper imaging Start the exercise by adjusting the x ray beam direction The x ray beam direction for the radiograph to be exposed is identical to the direction in which the patient is viewed Turn the scene to a position where you can look at the patient in the same direction the x ray beam direction was pointed when the reference radiograph was exposed Then move the detector to the position you think it had when the reference bitewing was exposed Adjustme
10. the aiming device moves around Hint 1 Grasp the aiming device and move it in any direction Tube head housing rotates around the focal spot Image 2 is continuously updated Hint 2 The task is easier to complete by zooming out with the navigation tools so the complete tube head is visible one d TI TI BESKIE ment a 6 LookThrough In this mode the patient is viewed from the focal spot The field of view is restricted by the aiming device Viewing direction is identical with x ray beam direction used when LookThrough mode was entered Change viewing direction by moving the tube head with the navigation tools Image 2 white frame is continuously updated and synchronised with tube head movement Follow the changes in radiographic depiction cone cut as the aiming device moves around Hint Move the aiming device with the tools you normally use for scene movement 7 Return to ordinary viewing mode Push the Exit LookThrough button to return to ordinary viewing mode The x ray beam direction is the same as it was before exiting LookThrough mode Qbion AB 2009 11 24 Expose General information The aim is to acquire skill in exposing correctly projected bitewing radiographs For that purpose three exercises with rising difficulty are available The exercises are Beam AutoAim Beam and Beam and detector Each exercise can be performed either in Ordinary mode or in
11. AB 2009 11 13 on VIRTUAL RADIOLOGY Interaction training Skill training Exa EEZ xam m geg area 3 S t Beam Ene Premolar Molar d AutoAim S i R i Select exercise ocal spo UR Explore Beam MEZ M AC 2 slale SE SE SE EH amp MLINA 2 07 zm Ui sli SE me POSIT ON 4 Starting position The exercise starts with the tube head aligned for an orthoradial projection of the selected area Two identical radiographs are presented Image 1 gray frame is the resulting orthoradial radiograph and Image 2 white frame is fluoroscopically displayed Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window Explore Beam EES E FR mace 1 Alb Te CSMcieYatS aow Me io are ANN ONL WR aner oynar EE rT ee N DNIH S apt 21 TENE wWividue th fue osc oplcally se chen a eae ene Teen SE Sen SE Se Lank hrag zl Hint mte Toca spc R PF foe ner air Si Qbion AB 2009 11 14 5 Task Investigate how radiographic depiction is influenced by changes in beam direction Change beam direction by moving the tube head Image 2 white frame is continuously updated and synchronised with tube head movement Follow the changes in radiographic depiction Hint 1 Grasp the back of the tube head housing and move it in any direction Image 2 is continuously updated Hint 2 The ta
12. AB 2009 11 32 Expose Beam and detector Brief presentation of the exercise A correctly projected reference bitewing is presented The radiograph is exposed over a randomly chosen area The task is to expose a bitewing identical to the reference radiograph The user therefore has to deduce the projection parameters detector position and x ray beam direction for the reference radiograph based on an analysis of how the teeth are depicted m the reference image In this exercise three projection parameters are to be transferred to the virtual environment e Positioning the focal spot from which the x ray beam emanates The focal spot is always situated along the central ray of the viewing direction upon the patient Therefore the patient must be turned to a position where you look upon the patient in the same direction as the x ray beam direction used for the reference radiograph e Positioning the detector e Directing the aiming device towards the detector so the collimated x ray beam hits the detector When moving the aiming device focal spot position is fixed Expose your bitewing by pressing the Expose button The exposed bitewing is displayed in Image 3 Evaluation The beam direction central ray used for the reference bitewing is visualised as a white line inside the tube head The white ball on the line represents the focal spot The blue line represents the central ray in your radiograph and the blue ball the
13. Aimin 3 Select Ing Right Left device Molar Premolar Premolar e Molar Select exercise Iming device pisans Himator E Tecs soea EE E aie Peal be Ge SE Si ao cures focal Ee SIE 52 TISITION Tre Oe Led Se ae HI Eis E rage 1 ft SC Hur mac pr TASI bs A SE ee ning es ds E GE ae ares rapra anser pan Lank hang sen Hint Evil um TT ut git en Hehe 4 Starting position The exercise starts with the tube head aligned for an orthoradial projection of the selected area Two identical radiographs are presented Image 1 gray frame is the resulting orthoradial radiograph and Image 2 white frame is fluoroscopically displayed Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window Gem Coltimator Jc PB bones Zen paeem Y redlagres K Kee dun by rum ARAI Ke eu wro Leal vus Jun PAA a aie Oo Eu se a e t 32 i SC Qbion AB 2009 11 23 5 Task Investigate how radiographic depiction is influenced by changes in beam direction without any changes in focal spot position Change beam direction by moving the aiming device in any desired direction Tube head housing rotates around the focal spot Image 2 white frame is continuously updated and synchronised with tube head movement Follow the changes in radiographic depiction cone cut as
14. Fluoroscopic mode Ordinary mode resembles the way radiographic exams are performed in real situations In fluoroscopic mode the task is made easier as the user can continuously follow changes in radiographic depiction based on adjustments influencing the radiographic image All exercises start by displaying a patient and an intraorally positioned detector In addition a correctly projected bitewing exposed over a randomly chosen area 1s presented as a reference The task for the user is to duplicate the reference bitewing by positioning the object or objects for example tube head aiming device and detector influencing the radiographic projection to achieve the same result The position of the focal spot from which the x ray beam emanates for the radiograph which shall be exposed is always situated along the central ray of the user s viewing direction upon the patient When preparing an exposure of a radiograph the user therefore has to adjust the viewing direction to find the proper position of the focal spot In the exercises where the aiming device is automatically aligned toward the detector AutoAim x ray beam direction and viewing direction are identical Changing viewing direction causes a synchronised change in focal spot position The detector position is always identical to the displayed detector position In fluoroscopic mode the user gets immediate feedback of projection changes in a separate window In ordinary mode no fluoro
15. Grasp the back of the tube head housing and move it The central ray is always directed against the middle of the detector Hint 2 The task is easier to complete by zooming out with the navigation tools so the complete tube head is visible Qbion AB 2009 11 5 The exercise step by step 1 Select Interaction training in the program menu Beam AutoAim 3 Use the navigation tools to change the view of the scene so that you can see the relation between the blue central ray from the x ray tube head and the white line from different directions 2 Select 4 Use the conventional mouse right button to position the x ray tube head so the blue central ray and ball coincide with the corresponding white line and ball When the balls touch each other a beep is heard indicating a successful attempt Short instructions and feedback are presented in the dialogue window Qbion AB 2009 11 VIRT I Ol OGY een A Interaction training Skill training arn E Bitewing kag x Select exercise Beam AutoAim HEEL 2 Detector HE Aiming device TEN gi y fe e Quit Start page Ah The aim of the exercise is to acquire skill in navigation and interaction with the virtual environment STARTING POSITION A white line is randomly directed against the detector 4 corresponding blue line Inside the tube head housing representing the central ray and focal
16. Mu ke Beam and detector SE yra d aL Vs Try Gs up Gaile defer uk cea it be HE EE were E bo SS 33 Be thy aren Preze2d H t v 1 ert the ap device ac ainst ths EE Press FO to ac dery swr y re stor Baka Eww A CySLUATION Band Alan apye eror de ees Aue ag Ae KM t Maes allal 27 Each lu resiu F3 4 Starting position A patient and a detector are presented at the scene The detector is correctly positioned for the reference bitewing The reference radiograph which is an incorrectly projected bitewing is presented in Image 1 gray frame Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window Wir analyse Ream EJN a 5 Ls ae quire ill d ince DER Wi E Saken Qbion AB 2009 11 42 5 Task Try to duplicate the reference bitewing in Image 1 Start the exercise by adjusting the x ray beam direction X ray beam direction for a radiograph to be exposed is identical to the direction in which the patient is viewed Turn the scene to a position where you can look at the patient in the same direction the x ray beam direction was pointed when the reference radiograph was exposed Hint 1 When exposing the radiograph the x ray beam direction is identical with the viewing direction Hint 2 Use the tools for scene movement to change viewing di
17. QBION ORAL RADIOLOGY PACKAGE User manual BITEWING Contents ernea bas e E 7 aura teuer EE 9 SCENE 11 ED a ee ek ee ee eee een ee en ere 12 Qbion AB 2009 11 2 Program overview Bitewing is one of four programs in the Qbion Oral Radiology Package QORP The overall aim of the program is to provide an environment for skill training in bitewing radiography without the use of ionising radiation Training 1s accomplished by performance and analysis of radiographic examinations of a virtual patient qbion ORAL RADIOLOGY PACKAGE VIRTUAL veer www qbion com BITEWING PERIAPICAL PANORAMIC OBJECT LOCALISATION Start the program by clicking on the BITEWING icon The Standard edition of the program contains the two modules Interaction training and Skill training Simulator training philosophy Radiology simulator training is performed in a radiation free environment Radiographic examinations can therefore be repeated without any radiation risks By adding features normally not available in the real world learning can be improved Look in the x ray beam direction Prior to any intraoral radiographic examination the oral cavity must be examined in order to find the proper horizontal and vertical angulation of the tube head and the detector position Viewing the patient in the planned x ray beam direction and then pointing the aiming device in the same direction will align the x ray correctly
18. ansferred to the virtual environment e Positioning the focal spot from which the x ray beam emanates The focal spot is always situated along the central ray of the viewing direction upon the patient Therefore the patient must be turned to a position where you look upon the patient in the same direction as the x ray beam direction used for the reference radiograph e Positioning the detector e Directing the aiming device towards the detector so the collimated x ray beam hits the detector When moving the aiming device focal spot position is fixed Expose your bitewing by pressing the Expose button The exposed bitewing is displayed in Image 3 Evaluation The beam direction central ray used for the reference bitewing is visualised as a white line inside the tube head The white ball on the line represents the focal spot The blue line represents the central ray in your radiograph and the blue ball the focal spot position Feedback is given as visual comparison and as angulation error If the error is too great the user must correct it before the exercise is complete The exercise can be performed in fluoroscopic mode or in ordinary mode In fluoroscopic mode a fluoroscopically displayed bitewing is presented in Image 2 during the whole exercise The x ray beam direction in fluoroscopic mode is identical to and synchronised with the users viewing direction This function facilitates finding the correct projection I
19. ction User interface components and how to navigate in and interact with the VE are described in a separate manual called Qbion Oral Radiology Package User manual General information Qbion ABT 2009 11 Interaction training Beam AutoAim Brief presentation of the exercise AutoAim Central ray is automatically directed towards the middle of the detector The central ray keeps hitting the middle of the detector even when x ray tube head focal spot or detector is moved in any direction The VE presents a scene with a patient model an x ray tube head and a detector in random positions for intraoral imaging The central ray is visualised as a blue line that hits the middle of the detector A white line with a different inclination crosses the blue line on the detector surface The focal spot is represented by a blue ball positioned on the central ray blue line A corresponding white ball is visualised on the white line The tube head can be moved up down and sideways with the conventional mouse The central ray is fixed to the centre of the detector independent of the tube head movement AutoAim The scene is controlled with the interaction tools and the tube head with the conventional mouse right button TASK The task is to move the tube head so the blue and white balls coincide A beep indicates when the task is completed The time for completion of the task is presented in the dialogue window Hint 1
20. d a EE PR noes 1 au Te SO te oe ce EWES E hy ann Cup A fal ASEN Tie Gier apa a mage Tisa ET a we de Ar ai THEN A A eden s jen fins EE vrun LAxvm ai r bw pe della a ua E Dh e 2 ste b s Se ou 771 ETA EE EK g ea cee gail oe sir SACK 9g OC hor c ders stor Ge Ze Bakes omen at Eva UAT AN Bes mn Act m Ancam Jegzes iri 3 davit EI Caer pasica Zait A e z Lenster Desk D new irs Qbion AB 2009 11 46 5 Task Try to duplicate the reference bitewing in Image 1 Both detector position and x ray beam direction must be adjusted for proper imaging Start the exercise by adjusting the x ray beam direction The x ray beam direction for the radiograph to be exposed is identical to the direction in which the patient is viewed Turn the scene to a position where you can look at the patient in the same direction the x ray beam direction was pointed when the reference radiograph was exposed Then move the detector to the position you think it had when the reference bitewing was exposed Adjustment of beam direction and detector position can be made at any time before the radiograph is exposed Hint 1 When exposing the radiograph the x ray beam direction is identical to the viewing direction Hint 2 Use the tools for scene movement to change the viewing direction Hint 3 The detector is rotated moved sideways and up down with the mouse buttons FP ror analyn Beam a
21. direction to find the proper position of the focal spot In the exercises where the aiming device is automatically aligned toward the detector AutoAim x ray beam direction and viewing direction are identical Changing viewing direction causes a synchronised change in focal spot position The detector position is always identical to the displayed detector position In fluoroscopic mode the user gets immediate feedback of projection changes in a separate window In ordinary mode no fluoroscopic guidance is available Exposing radiographs in ordinary mode resembles the clinical conditions at a bitewing exam Task performance is easier in fluoroscopic mode The exercises have defined goals If the image exposed by the user departs too much from the ideal projection parameters 1t has to be corrected Qbion AB 2009 11 3 Error analysis Beam AutoAim Brief presentation of the exercise AutoAim Central ray is automatically directed towards the middle of the detector The central ray keeps hitting the middle of the detector even when x ray tube head focal spot or detector is moved in any direction An improperly projected reference bitewing is presented The radiograph is exposed over a randomly chosen area The task 1s to expose a bitewing identical to the reference radiograph The user therefore has to deduce the beam direction for the reference radiograph based on an analysis of how the teeth are depicted in the reference image Detecto
22. e aim attr See ce to 520 AS SH In exprs Car EI arr ertar regel 8 ap Vs STARTING DSITION Tre redicgrapr mee 11s a re sreace keeling T gi E er ta F ewa hitew mir Oh aie il yuvilivr EEN eak ar seth Ir tre earen Eztio tyu duplicate ee eT Tre GE 15 alaa 2y CC mec acsitic aparaire Dr EVAL TE Dear dire DC AV OIF ent CAG RAS Hr Wem F Buck a meru iFa 4 Starting position A patient and a detector are presented at the scene The detector is correctly positioned The reference radiograph which is a correctly projected bitewing is presented in Image 1 gray frame Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window WW Expose Beam Autoaim ka ER PP image 1 au The 2 NC t1e exesise Ie to acyulra sk megar g IL HAL A vile fedloc aprs E7ARTING POSITION The rading at 9 rage 1 Isa ratare ae bilewir J Boe Ans dek ca iral Ha reln b awy i e R Turid spal at s u pesiliur ln you locat he teer Ire comae osam warar atar ww Luplicate hitswine pe dees ders KE E E DES Ka cH kel Evs HS ON Kean ert al ori ee ees a a Sc aaen n Desk newirs Qbion AB 2009 11 27 5 Task Try to duplicate the reference bitewing in Image 1 Start the exercise by adjusting the x ray beam direction X ray beam direction for a radiograph to be exposed is
23. e you exposed Unexposed areas cone cuts are represented as blue fields on the radiograph Any differences in projection parameters between your and the reference radiograph are presented under the evaluation heading If an error is too great the parameter must be adjusted before the task is completed Hint 1 Adjusting beam direction Grasp the back of the tube head housing and move it until the tube head focal spot blue ball coincides with the focal spot position for the reference bitewing white ball Hint 2 Beam direction Angle error is calculated as the angle between the central ray when the reference radiograph was exposed represented by the white line and a line between the blue focal spot and the middle of the detector Hint 3 Adjusting aiming device Grasp the aiming device and redirect it until tube head central ray blue line coincides with the central ray for the reference bitewing projection white line Qbion AB 2009 11 48
24. ed as the angle between the central ray when the reference radiograph was exposed represented by the white line and a line between the blue focal spot and the middle of the detector Qbion AB 2009 11 40 Error analysis Beam Brief presentation of the exercise An improperly projected reference bitewing is presented The radiograph is exposed over a randomly chosen area The task is to expose a bitewing identical with the reference radiograph The user therefore has to deduce the projection parameters for the reference radiograph based on an analysis of how the teeth are depicted in the reference image Detector position for the reference radiograph is displayed in the scene In this exercise the x ray beam direction is transferred to the virtual environment in a two step procedure e Positioning the focal spot from which the x ray beam emanates The focal spot is always situated along the central ray of the viewing direction upon the patient Therefore the patient must be turned to a position where you look upon the patient in the same direction as the x ray beam direction used for the reference radiograph e Directing the aiming device towards the detector so the collimated x ray beam hits the detector When moving the aiming device focal spot position is fixed Expose your bitewing by pressing the Expose button The exposed bitewing is displayed in Image 3 Evaluation Beam direction central ray used for the refere
25. edback are presented in the dialogue window Qbion ABT 2009 11 8 P Bitewing VIRTUAL RADIOLOGY veww qbion com Interaction training Skill training Exam Select exercise Beam H AutoAim D Detechor S L D Aiming device L D Qut C Start page RP Interaction Detector keng nl AM The aim of the exercise is to acquire skill in navigation and interaction with the Virtual environment STARTING POSITION A white frame is displayed in a random position close to the detector TASK Move the detector into the white frame New attempt Fei Back to menu FY Interaction training Aiming device Brief presentation of the exercise The VE presents a scene with a patient and tube head A detector is positioned inside the mouth The aiming device is pointed in a random direction When changing the direction the tube head rotates around the focal spot Movement of the aiming device is performed with the left mouse button TASK The task is to move and direct the aiming device toward the detector so an imaginary x ray beam covers the entire detector area A beep sounds signal when the task is completed The time for completion of the task is presented in the dialogue window Hint 1 Grasp the aiming device and direct it toward the detector Hint 2 Tube head housing rotates around the focal spot which has a fixed position Hint 3 Look along the aim
26. focal spot position Feedback is given as visual comparison and as angulation error If the error is too great the user must correct it before the exercise is complete The exercise can be performed in fluoroscopic mode or in ordinary mode In fluoroscopic mode a fluoroscopically displayed bitewing is presented in Image 2 during the whole exercise The x ray beam direction in fluoroscopic mode is identical to and synchronised with the users viewing direction This function facilitates finding the correct projection In ordinary mode no fluoroscopically displayed bitewing is available The exercise step by step Purpose To acquire skill in exposing correctly projected bitewings The task is to create a correctly projected bitewing identical to a reference image The exercise can be performed in either fluoroscopic mode or in ordinary mode as described above The following information describes the exercise in ordinary mode In fluoroscopic mode an additional fluoroscopically displayed radiograph is presented in Image 2 Qbion AB 2009 11 33 1 Select Skill training in the program menu bion wns On 2 Select Expose 3 Select Beam and detector ve 3 CO oooOcaC oO zs T TASK IS p SE Cats F2 efe erze k Ewag Ir ae aia pe ivoil lu u po voL Kate the feet Ir E we SE c mans sut ae zata ottzing O Pees o Peed SC Zen RE E EE Baken mme tc x CVALUSTION e Ar gle vru
27. he detector on radiographic depiction can therefore be followed in real time In LookThrough mode using the navigation tools changes the viewing direction The exercise step by step Purpose To demonstrate how the radiographic depiction is influenced by changes in focus position tube head position without change in beam direction The simulator exposes two identical radiographs One radiograph is fluoroscopically displayed The fluoroscopically displayed radiograph is synchronised with tube head movements By moving the tube head you can follow how radiographic depiction is influenced by changes in focus position RP Bitewi ng Dion CC MAIUAL RADIOLOGY tia n qbion com 1 Select Skill training and then Explore in the program menu Interaction training Skill training Exam Explore Expose Error analysis Select area Right Molar e Premolar Premolar Molar Select exercise Beam Detector AutoAim Focal spot Aiming device Quit Start page 2 Select area to be examined Right Left O Molar O Premolar O Premolar O Molar Qbion AB 2009 11 16 Focal spot S Molar e Premolar O Premolar Molar 3 Select Select exercise Beam AutoAim TASK changes Lae reac te jc In ary Aire or Image Z Is scat ataust ape ta ARS ane nt MAL fUr eerie run FT Setz EN 4 Starting position
28. hy behind this section is that skill in analysing projection errors implies good knowledge in radiographic projection principles Therefore training in error analysis will improve knowledge and skill in radiography The task is to duplicate erroneously projected bitewing radiographs For that purpose three exercises with rising difficulty are available The exercises are Beam AutoAim Beam and Beam and detector Each exercise can be performed either in Ordinary mode or in Fluoroscopic mode Ordinary mode resembles the way radiographic exams are performed in real situations In fluoroscopic mode the task is made easier as the user can continuously follow changes in radiographic depiction based on adjustments influencing the radiographic image All exercises start by displaying a patient and an intraorally positioned detector In addition a reference image is presented which is an erroneously projected bitewing exposed over a randomly chosen area The task for the user is to duplicate the reference bitewing by positioning the object or objects tube head aiming device and detector influencing the radiographic projection to achieve the same result The position of the focal spot from which the x ray beam emanates for the radiograph which shall be exposed is always situated along the central ray of the user s viewing direction upon the patient When preparing an exposure of a radiograph the user therefore has to adjust the viewing
29. identical with the direction the patient is viewed Turn the scene to look at the patient in the same direction the x ray beam direction pointed when the reference radiograph was exposed Hint 1 The x ray beam direction is identical to the viewing direction Hint 2 Use the tools for scene movement to change viewing direction W Expose Beam Autoaim IEG PA imace 1 aM Expose your radiograph by pressing the Expose button The exposed radiograph is presented as Image 3 blue frame The central ray and focal spot for the reference radiograph are displayed as a white line and a white ball respectively The central ray and focal spot for the radiograph you exposed blue line and blue ball are visualised inside the tube head housing 6 Evaluation Observe the differences in radiographic depiction between the reference radiograph and the one you exposed Any difference in beam direction between your and the reference radiograph is presented under the evaluation heading If the error is too great beam direction has to be adjusted before the task is complete Hint 1 Grasp and move the back of the tube head housing The central ray is always directed towards the middle of the detector when tube head is moved AutoAim Hint 2 The task is easier to complete by zooming out with the navigation tools so the complete tube head is visible Hint 3 Beam direction Angle error is calculated as the angle between the cent
30. ing device towards the detector to find the appropriate direction Hint 4 Try viewing the scene from different directions and distances Qbion AB 2009 11 9 The exercise step by step 1 Select Interaction training in the program qbion d se i RW 2 Select 3 Use the navigation tools to change the view of the scene if needed 4 Use the conventional mouse right button to direct the aiming device over the detector 5 The aiming device shall be directed so that an imaginary x ray beam covers the entire detector area 6 When you have succeeded a beep is heard Short instructions and feedback are presented in the dialogue window Qbion AB 2009 11 10 RP Bitewing Weu Ob Interaction training Skill training Exar Select exercise Beam H AutoAim D Detechor S L D Aiming device L D Quit Start page _ FF Interaction Aiming device m AM The aim of the exercise is to acquire skill in navigation and interaction with the Virtual environment STARTING POSITION The aiming device is randomly directed TASK Direct the aiming device aqainst the detector New attempttF ei Back to menu F9 Skill training The aim of the skill training module is to acquire the skills to perform high quality bitewing examinations and to analyse and interpret projection errors in bitewing radiographs The skill training is organised under the following th
31. inside the tube head The white ball on the line represents the focal spot The blue line represents the central ray in your radiograph and the blue ball the focal spot position Feedback is given as visual comparison and as angulation error If an error is too great the user must correct it before the exercise is complete The exercise can be performed in fluoroscopic mode or in ordinary mode In fluoroscopic mode a fluoroscopically displayed bitewing is presented in Image 2 during the whole exercise The x ray beam direction in fluoroscopic mode is identical to and synchronised with the users viewing direction This function facilitates finding the correct projection In ordinary mode no fluoroscopically displayed bitewing is available The exercise step by step Purpose To acquire skill in exposing correctly projected bitewings The task is to create a correctly projected bitewing identical to a reference image The exercise can be performed in either fluoroscopic mode or in ordinary mode as described above The following information describes the exercise in ordinary mode In fluoroscopic mode an additional fluoroscopically displayed radiograph is presented in Image 2 Qbion AB 2009 11 29 1 Select Skill training in the program menu 2 Select Expose 3 Select Beam 4 Starting position PP rp Bean leg Theo stint uf be exec seb quir 7 l Lu seit lb pn A vilewir 3 dic yrzans START 52
32. justing the x ray beam direction X ray beam direction for a radiograph to be exposed is identical with the direction the patient is viewed Turn the scene so you can look at the patient in the same direction the x ray beam had when the reference radiograph was exposed Hint 1 The x ray beam direction is identical with the viewing direction Hint 2 Use the tools for scene movement to change viewing direction wan Hir 2 Sir se nine d aye el tS gestart fa su FE lu uj sl vivedr Je eel Cac lt iro Fanrae SE Deznr ert 4 Au Au LE Aur Au Ting ervoris2 c Jagr2es OK Som eter cir EG nent CA By pressing the Proceed button the x ray tube head becomes visible The focal spot is positioned along the viewing direction in the previous step The aiming device is directed in a random direction and must now be directed towards the detector for exposure of a radiograph without any cone cut The focal spot remains in its original position when aiming device direction is adjusted Qbion AB 2009 11 31 Hint 1 Grasp the aiming device and direct it against the detector Hint 2 Tube head housing rotates around the focal spot which has a fixed position Hint 3 Look along the aiming device towards the detector to find the appropriate direction Hint 4 Try viewing the scene from different angles and distances The Back button returns to starting view X ray beam direction can be readjusted Ex
33. n ordinary mode no fluoroscopically displayed bitewing is available The exercise step by step Purpose To acquire skill in analysing incorrect projected bitewing radiographs The task is to duplicate an improperly projected bitewing The exercise can be performed in either fluoroscopic mode or in ordinary mode as described above The following information describes the exercises in ordinary mode In fluoroscopic mode an additional fluoroscopically displayed radiograph is presented in Image 2 Qbion AB 2009 11 45 1 Select Skill training in the program menu 2 Select Error analysis Select exercise Error analysis peam 3 Select Beam and detector I moie seme Beam AutoAim H Beam and H Kg Dr mI bei ti ey an t fo ay Lil Oiler or mI TASI Try SC e cata t2 ete erse k Ewag ir Ire eh ER HI Ta a paT O ite sae ie aha Ue Lew a i acd on tar you tes ae tee Ae Z Post on the catacxc mae Da F8 t3 ac E airy Aincztlor aositior Bucks 4 Starting position A patient and a detector are presented in the scene The detector is randomly positioned The reference radiograph which is an incorrectly projected bitewing is presented in Image 1 gray frame Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window KI Error analysis Beam an
34. nce bitewing is visualised as a white line inside the tube head The white ball on the line represents the focal spot The blue line represents the central ray in your radiograph and the blue ball the focal spot position Feedback is given as visual comparison and as angulation error If an error is too great the user must correct it before the exercise is complete The exercise can be performed in fluoroscopic mode or in ordinary mode In fluoroscopic mode a fluoroscopically displayed bitewing is presented in Image 2 during the whole exercise The x ray beam direction in fluoroscopic mode is identical to and synchronised with the users viewing direction This function facilitates finding the correct projection In ordinary mode no fluoroscopically displayed bitewing is available The exercise step by step Purpose To acquire skill in analysing incorrect projected bitewing radiographs The task is to duplicate an improperly projected bitewing The exercise can be performed in either fluoroscopic mode or in ordinary mode as described above The following information describes the exercises in ordinary mode In fluoroscopic mode an additional fluoroscopically displayed radiograph is presented in Image 2 Qbion AB 2009 11 41 1 Select Skill training in the program menu 2 Select Error analysis Select exercise Error analysis Beam z 3 Select Beam AA moie P rmz Beam AutoAim be NR UE e
35. nd EY WM JEE HF image 2 dba xi By pressing the Proceed button the x ray tube head becomes visible The focal spot is positioned along the viewing direction in the previous step The aiming device is randomly directed and must now be directed towards the detector for exposure of a radiograph without any cone cut Focal spot remains in its original position when aiming device direction is adjusted Hint 1 Grasp the aiming device and direct it against the detector Hint 2 Tube head housing rotates around the focal spot which has a fixed position Hint 3 Look along the aiming device towards the detector to find the appropriate direction Hint 4 Try viewing the scene from different angles and distances The Back button returns to the starting view Detector position and x ray beam direction can be readjusted Expose your radiograph by pressing the Expose button The exposed radiograph is presented as Image 3 blue frame The central ray and focal spot for the reference radiograph are displayed as a white line and a white ball respectively The central ray and focal spot for the radiograph you exposed blue line and blue ball are visualised inside the tube head housing Detector position for the reference bitewing is displayed as a white frame Qbion AB 2009 11 47 6 Evaluation Observe the differences in radiographic depiction between the reference radiograph and the on
36. ne cuts are represented as blue fields on the radiograph Any differences in projection parameters between your and the reference radiograph are presented under the evaluation heading If an error is too great the parameter must be adjusted before the task is completed Hint 1 Adjusting beam direction Grasp the back of the tube head housing and move it until the tube head focal spot blue ball coincides with the focal spot position for the reference bitewing white ball Hint 2 Beam direction Angle error is calculated as the angle between the central ray when the reference radiograph was exposed represented by the white line and a line between the blue focal spot and the middle of the detector Hint 3 Adjusting aiming device Grasp the aiming device and redirect it until tube head central ray blue line coincides with the central ray for the reference bitewing projection white line Qbion AB 2009 11 44 Error analysis Beam and detector Brief presentation of the exercise An improperly projected reference bitewing is presented The radiograph is exposed over a randomly chosen area The task 1s to expose a bitewing identical to the reference radiograph The user therefore has to deduce the projection parameters detector position and x ray beam direction for the reference radiograph based on an analysis of how the teeth are depicted m the reference image In this exercise three projection parameters are to be tr
37. nt Aiming device movement and radiographic depiction is synchronised The influence of changes in beam direction on radiographic depiction can therefore be followed in real time Unexposed detector areas are displayed in blue colour in the rendered radiograph In LookThrough mode the viewing direction is changed by using the navigation tools The exercise step by step Purpose To demonstrate how the radiographic depiction is influenced by changes in beam direction without any changes in focal spot position The simulator exposes two identical radiographs One radiograph is fluoroscopically displayed The fluoroscopically displayed radiograph is synchronised with tube head movements By moving the tube head you can follow how radiographic depiction is influenced by changes in beam direction 1 Select Skill training and then Explore in PBitewing aj the program menu Mik qbion ss QRTUAL RADIOLOGY qbion com Interaction training Skill training Exam Explore Expose Error analysis Select area Right Molar gt Premolar Premolar Molar Select exercise Beam Detector AutoAim Focal spot Aiming device Quit Start page 2 Select area to be examined Right Left O Molar O Premolar O Premolar O Molar Qbion AB 2009 11 22 qbion we e ech Interaction training Skil training Skill training Exam Se Select area
38. nt of beam direction and detector position can be made at any time before the radiograph is exposed Hint 1 When exposing the radiograph the x ray beam direction is identical to the viewing direction Hint 2 Use the tools for scene movement to change the viewing direction Hint 3 The detector is rotated moved sideways and up down with the mouse buttons D xi A Lei By pressing the Proceed button the x ray tube head becomes visible The focal spot is positioned along the viewing direction in the previous step The aiming device is randomly directed and must now be directed towards the detector for exposure of a radiograph without any cone cut Focal spot remains in its original position when aiming device direction is adjusted Hint 1 Grasp the aiming device and direct it against the detector Hint 2 Tube head housing rotates around the focal spot which has a fixed position Hint 3 Look along the aiming device towards the detector to find the appropriate direction Hint 4 Try viewing the scene from different angles and distances The Back button returns to the starting view Detector position and x ray beam direction can be readjusted Qbion AB 2009 11 35 Expose your radiograph by pressing the Expose button The exposed radiograph is presented as Image 3 blue frame The central ray and focal spot for the reference radiograph are displayed as a white line and
39. ntral ray used for the reference bitewing is visualised as a white line inside the tube head The white ball on the line represents the focal spot The blue line represents the central ray in your radiograph and the blue ball the focal spot position Feedback is given as visual comparison and as angulation error If the error is too great the user must correct it before the exercise is complete The exercise can be performed in fluoroscopic mode or in ordinary mode In fluoroscopic mode a fluoroscopically displayed bitewing is presented in Image 2 during the whole exercise The x ray beam direction in fluoroscopic mode is identical to and synchronised with the users viewing direction This function facilitates finding the correct projection In ordinary mode no fluoroscopically displayed bitewing is available The exercise step by step Purpose To acquire skill in exposing correctly projected bitewings The task is to create a correctly projected bitewing identical to a reference image The exercise can be performed in either fluoroscopic mode or in ordinary mode as described above The following information describes the exercise in ordinary mode In fluoroscopic mode an additional fluoroscopically displayed radiograph is presented in Image 2 Qbion AB 2009 11 26 1 Select Skill training in the program menu me wm EE 2 Select Expose 3 Select Beam AutoAim Brust Ream Puia L EES Ak Ir
40. pose your radiograph by pressing the Expose button The exposed radiograph is presented as Image 3 blue frame The central ray and focal spot for the reference radiograph are displayed as a white line and a white ball respectively The central ray and focal spot for the radiograph you exposed blue line and blue ball are visualised inside the tube head housing 6 Evaluation Observe the differences in radiographic depiction between the reference radiograph and the one you exposed Unexposed areas cone cuts are represented as blue fields on the radiograph Any differences in projection parameters between your and the reference radiograph are presented under the evaluation heading If an error is too great the parameter must be adjusted before the task is completed Hint 1 Adjusting beam direction Grasp the back of the tube head housing and move it until the tube head focal spot blue ball coincides with the focal spot position for the reference bitewing white ball Hint 2 Beam direction Angle error is calculated as the angle between the central ray when the reference radiograph was exposed represented by the white line and a line between the blue focal spot and the middle of the detector Hint 3 Adjusting aiming device Grasp the aiming device and redirect it until tube head central ray blue line coincides with the central ray for the reference bitewing projection white line Qbion
41. r position for the reference radiograph is displayed in the scene AutoAim is active In this exercise the x ray beam direction will be transferred to the virtual environment This is accomplished by turning the scene to a position where you look upon the patient in the same direction as the x ray beam direction used for exposing the reference radiograph Expose your bitewing by pressing the Expose button The exposed bitewing 1s displayed in Image 3 Evaluation Beam direction central ray used for the reference bitewing is visualised as a white line inside the tube head The white ball on the line represents the focal spot The blue line represents the central ray in your radiograph and the blue ball the focal spot position Feedback is given as visual comparison and as angulation error If the error is too great the user must correct it before the exercise is complete The exercise can be performed in fluoroscopic mode or in ordinary mode In fluoroscopic mode a fluoroscopically displayed bitewing is presented in Image 2 during the whole exercise The x ray beam direction in fluoroscopic mode is identical to and synchronised with the users viewing direction This function facilitates finding the correct projection In ordinary mode no fluoroscopically displayed bitewing is available The exercise step by step Purpose To acquire skill in analysing incorrect projected bitewing radiographs The task is to duplicate an imp
42. ral ray is automatically directed towards the middle of the detector The central ray keeps hitting the middle of the detector even when x ray tube head focal spot or detector is moved in any direction The tube head can be moved up down and sideways Tube head movement and radiographic depiction is synchronised The influence of changes in beam direction on radiographic depiction can therefore be followed in real time In LookThrough mode using the navigation tools changes the viewing direction The exercise step by step Purpose To demonstrate how the radiographic depiction is influenced by changes in beam direction The simulator exposes two identical radiographs One radiograph is fluoroscopically displayed and is synchronised with tube head movements By moving the tube head you can follow how radiographic depiction is influenced by changes in beam direction 1 Select Skill training and then E Bitewing kl Explore in the program menu GES q b Ol 2 VIRTUAL RADIOLOGY www gbion com Interaction training Skill training Exam Explore Expose Error analysis Select area Right Left Molar Premolar Premolar gt Molar Select exercise Beam 4 Detector L AutoAim Focal spot d Aiming device Quit Start page 2 Select area to be examined Right Left O Molar O Premolar O Premolar O Molar Qbion
43. ral ray when the reference radiograph was exposed represented by the white line and a line between the blue focal spot and the middle of the detector Qbion AB 2009 11 28 Expose Beam Brief presentation of the exercise A correctly projected reference bitewing is presented The radiograph is exposed over a randomly chosen area The task is to expose a bitewing identical to the reference radiograph The user therefore has to deduce the projection parameters for the reference radiograph based on an analysis of how the teeth are depicted in the reference image Detector position for the reference radiograph is displayed in the scene In this exercise the x ray beam direction is transferred to the virtual environment in a two step procedure e Positioning the focal spot from which the x ray beam emanates The focal spot is always situated along the central ray of the viewing direction upon the patient Therefore the patient must be turned to a position where you look upon the patient in the same direction as the x ray beam direction used for the reference radiograph e Directing the aiming device towards the detector so the collimated x ray beam hits the detector When moving the aiming device focal spot position is fixed Expose your bitewing by pressing the Expose button The exposed bitewing is displayed in Image 3 Evaluation Beam direction central ray used for the reference bitewing is visualised as a white line
44. rection PPro analyn Beam eR BP me i MEIR ICES ee E Au 7 ut Fr van 2 il E By pressing the Proceed button the x ray tube head becomes visible The focal spot is positioned along the viewing direction in the previous step The aiming device is randomly directed The aiming device must now be directed towards the detector for exposure of a radiograph without any cone cut Focal spot remains in its original position when aiming device direction is adjusted Hint 1 Grasp the aiming device and direct it against the detector Hint 2 Tube head housing rotates around the focal spot which has a fixed position Hint 3 Look along the aiming device towards the detector to find the appropriate direction Hint 4 Try viewing the scene from different angles and distances The Back button returns to starting view X ray beam direction can be readjusted Expose your radiograph by pressing the Expose button The exposed radiograph is presented as Image 3 blue frame The central ray and focal spot for the reference radiograph are displayed as a white line and a white ball respectively The central ray and focal spot for the radiograph you exposed blue line and blue ball are visualised inside the tube head housing Qbion AB 2009 11 43 6 Evaluation Observe the differences in radiographic depiction between the reference radiograph and the one you exposed Unexposed areas co
45. ree headings e Explore e Expose e Error analysis The Explore exercises have no defined goals They demonstrate how radiographic depiction is changed when single projection parameters are altered ge Bitewing Interaction training Skill training Exar VIRTUAL RADIOLOGY www gbion com Explore Expose Error analysis Select area Right Molar Premolar Premolar gt Molar Select exercise Beam Detector AutoAim Focal spot Aiming device Start page The exercises under the headings Expose and Error analysis present tasks with clearly defined goals The user s performance is evaluated and the simulator presents immediate feedback Thorough investigation of the content in each exercise 1s recommended There are no restrictions concerning training order Qbion AB 2009 11 11 Explore General information The exercises are for demonstration and investigation of the association between x ray beam direction detector positioning and radiographic depiction The goal is to demonstrate how changes in projection parameters influence radiographic depiction There are four exercises under this heading called Beam AutoAim Focal spot Aiming device and Detector The aim is to demonstrate how the radiographic depiction of a bitewing radiograph is influenced by changes in projection parameters The exercises have a common
46. roperly projected bitewing The exercise can be performed in either fluoroscopic mode or in ordinary mode as described above The following information describes the exercises in ordinary mode In fluoroscopic mode an additional fluoroscopically displayed radiograph is presented in Image 2 Qbion AB 2009 11 38 1 Select Skill training in the program menu 2 Select Error analysis 3 Select Beam AutoAim Th scaer IT CNN ELW qe e tale Hefe rage d IY pant x z pastan pee et SE ds zait D SSES GE Ee age 77 D Pest HOM Dean dirsct on Jr ieern JA ees Se New aant Fark ta new a 4 Starting position A patient and a detector are presented in the scene The detector is correctly positioned for the reference bitewing The reference radiograph which is an incorrectly projected bitewing is presented in Image 1 gray frame Use the navigation tools to change the position of the scene to any desired view Brief instructions are presented in the instruction and feedback window m Du LIES DEU ZP Ge GE Es sale vileine ean core estty Roe Iene Osa oa St Jet ep E Gel Neve san ZC d Fark ta pea z 39 Qbion AB 2009 11 CA DER Wines Ce 5 Task Try to duplicate the reference bitewing in Image 1 Start the exercise by adjusting the x ray beam direction X ray beam direction for a radiograph to
47. scopic guidance is available Exposing radiographs in ordinary mode resembles the clinical conditions at a bitewing exam Task performance is easier in fluoroscopic mode The exercises have defined goals If the image exposed by the user departs too much from the ideal projection parameters it has to be corrected Qbion AB 2009 11 25 Expose Beam AutoAim Brief presentation of the exercise AutoAim Central ray is automatically directed towards the middle of the detector The central ray keeps hitting the middle of the detector even when x ray tube head focal spot or detector is moved in any direction A correctly projected reference bitewing is presented The radiograph is exposed over a randomly chosen area The task is to expose a bitewing identical with the reference radiograph The user therefore has to deduce the beam direction for the reference radiograph based on an analysis of how the teeth are depicted in the reference image Detector position for the reference radiograph is displayed in the scene AutoAim is active In this exercise the x ray beam direction shall be transferred to the virtual environment It is accomplished by turning the scene to a position where you look upon the patient in the same direction as the x ray beam direction used for exposing the reference radiograph Expose your bitewing by pressing the Expose button The exposed bitewing 1s displayed in Image 3 Evaluation Beam direction ce
48. sk is easier to complete by zooming out with the navigation tools so the complete tube head is visible Cp wu bean ceed a by ehn Ue tuka ei 1 any direstior Imzye 2 le CT Im Ir ste 6 LookThrough In this mode the patient is viewed from the focal spot The field of view is restricted by the aiming device Viewing direction is identical with the x ray beam direction used when LookThrough mode was entered Change viewing direction with the navigation tools Image 2 white frame is continuously updated and synchronised with viewing position focal spot Follow the changes in radiographic depiction Hint Change viewing position with the tools you normally use for scene movement 7 Return to ordinary viewing mode ratar ivane 11s static Deem fluc ust spivully di slayer LAK Cp waan veel a by mei Ue tuka 124 3 any direstior Imzye 2 Ie ara Int ape ata Cst oc lt Tr ou gn eri d Beck a n in F3 Push the Exit LookThrough button to return to ordinary viewing mode The exercise continues in the same mode as it started X ray beam direction is the same as it was before exiting LookThrough mode Qbion AB 2009 11 15 Explore Focal spot Brief presentation of the exercise The tube head can be moved up down and sideways Tube head movement and radiographic depiction is synchronised The influence of changes in focus position without simultaneous alignment of the aiming device towards t
49. spot is also directed against the detector TASK Move the tube head so the blue line and focal spot coincides with the white Hint FP Interaction Beam Auto m New attempt F7 Back ta menu F9 Interaction training Detector Brief presentation of the exercise The VE presents a scene with a patient with a detector positioned inside the mouth The detector is randomly positioned in the vicinity of the dental arches A white frame slightly larger than the detector is displayed close to the detector The frame plane coincides with the detector plane The detector can be rotated and moved sideways and up down Rotation is performed with the left mouse button and sideways up down movement IS performed with right mouse button TASK The task is to move the detector into the white frame by means of the conventional mouse A sound signal indicates when the task is completed The time for completion of the task is presented in the dialogue window Hint The detector can be rotated moved sideways and up down with the mouse buttons Qbion AB 2009 11 7 The exercise step by step menu 3 Use the navigation tools to change the view of the scene if needed 1 Select Interaction training in the program y oon 4 Use the conventional mouse right and left button to position the detector into the white frame 5 When you have succeeded you will hear a beep Short instructions and fe
50. xplore Detector Brief presentation of the exercise The detector can be moved up down and sideways and rotated Tube head position is fixed Detector movement and radiographic depiction 1s synchronised The influence of changes in detector position on radiographic depiction can therefore be followed in real time Unexposed detector areas are displayed in blue colour in the rendered radiograph The exercise step by step Purpose To demonstrate how the radiographic depiction is influenced by changes in detector position The simulator exposes two identical radiographs One radiograph is fluoroscopically displayed and is synchronised with tube head movements By moving the detector you can follow how radiographic depiction is influenced by changes in detector position 1 Select Skill training and then Explore in the program menu 2 Select area to be examined Right O Molar O Premolar Qbion AB 2009 11 ge Bitewing Don QRTUAL RADIOLOGY qbion com Interaction training Skill training Exam Explore Expose Error analysis Select area Right e Molar gt Premolar Left Premolar Molar Select exercise Beam AutoAim LS TSE Focal spot wr Je ae a Detector Aiming device Quit Start page Left O Premolar O Molar 19 qbion ea ech Interaction training Skil training
51. y Sranga ir kaar em STARTING OGITION vr diuyraph a Teel Lie ir diie ral aost In of the tuka Sac 21d t72 detector wage 11s stat mate mp De sie seupivully Jr TASK cranes uke es 99 101 1 ayy meint nafa 4 a CT WC ashy Apeated JIL2 areas reorese vt INFYANSAM pat SES Back lu rwr a F9 hi Fz 6 LookThrough By pressing the LookThrough button LookThrough mode is entered In this mode the patient is viewed from the focal spot The field of view is restricted by the aiming device The viewing direction is identical with the x ray beam direction used before entering LookThrough mode Use the navigation tools to move tube head Image 2 white frame is continuously updated and synchronised with tube head movement Follow the changes in radiographic depiction Hint Move the tube head with the tools you normally use for scene movement 7 Return to ordinary viewing mode Wrabu Fam Seg Ti wu 317 mee bie radit gie 7 Ue vit jut sir au by lus eed meye ners vo ary change Ir bean gras 1 ET ARTINIG 7 ISITION The radic yrapr 3 retest tae Inc ic 42 pratar co the hira wad ard ta du hau Iis sluje nu 3 V KEEENSCIEE EEGCK Hr Dat LaokTrougn Bact ner rey S Push the Exit LookThrough button to return to ordinary viewing mode The exercise continues in the same mode as it started The tube head has the same position as before exiting LookThrough mode Qbion AB 2009 11 18 E

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