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eFilm Lite™ 3.2 User's Guide Veterinary

1. The following notes pertain to both the 3D rotating and cropping tools e The left mouse button is used for 3D rotating and cropping Rotating is the default active tool As you move the cursor over the edge a cropping plane the cursor shape changes to the cropping symbol indicating that the cropping tool is now the active tool e When in crop mode the highlighted plane indicates the side of the cube that will be resized when you click and drag the mouse e The cropped volume cube appears in green e You can combine cropping rotating and windowing in any order At first you may find it easier to crop in one of the preset rotations Anterior Posterior Left Right Superior or Inferior which are outlined in Rotating 3D volumes on page 66 eFilm Workstation User s Guide 65 Creating 3D Images e While cropping all parts of the volume outside of the cropped volume are displayed at a reduced brightness to help you understand the context of what is in and what is out Once you have finished cropping toggle the crop icon to display only the cropped in volume Since the cropped volume is smaller it can be rendered faster To improve rendering speed once you have cropped your volume click to display only the cropped volume Note You can reset the crop by clicking Reset on the Crop Volume pop up menu Rotating 3D volumes There are two ways to rotate a volume manually or preset selection To rotate t
2. compare and contrast multiple studies see Comparing multiple studies on page 24 To view a study Select a study from the list and double click it to view it automatically or select a study from the list and click View The study appears in the main window and the toolbar is activated MOUNT Sinai Hoes peta PATIENTS M t siai Hospital Da TIENTS i970 Jan 01 hi DUDU Ft OUOU 2001 Jari OS Ar g Tm 09 36 13 E AEC LOLILILELILILELIL Ie 2001 Jarn 02 Ang Tin 093423 Mag Da Mag 03x 20 eFilm Workstation User s Guide Viewing studies Note Images appear side by side in a grid default setting 1x2 like the films mounted beside each other on a light box This grid configuration can be adjusted by following the procedure outlined in Adjusting the screen layout on page 23 Arranging study series in panes When viewing a study each series within the study is loaded into a separate pane The active series is outlined in orange and the active image in a series is outlined with a green line To place a series in a particular pane 1 Right click the pane where you wish to place the series A pop up menu appears The series that is currently occupying the pane is checked in this menu Note In the interests of speed when you load a study the right click context menu is first populated with a list of related studies The studies themselves are then loaded starting with the most rece
3. In anew document for the application press Ctrl V to paste the copied image Exporting images as graphic files Images can be exported in any of three formats JPEG jpg bitmap bmp or TIFF tif These files can be viewed using any standard image viewer or web browser To export images as graphic files 1 Select the images that you want to export by clicking the image marker in the lower right corner of each image The marker located at the bottom of each selected image fills in orange On the File gt Export menu click as Image s The Save As dialog box appears Select a file format from the Save as type drop down list Select the Windows directory in which to save the images and enter a filename If multiple images are selected the series and image number will be appended to the filename of each image file eFilm Workstation User s Guide 79 Exporting Images 5 Click Save Exporting images to AVI files You can export images to an AVI file for viewing with any media player To export images to an AVI video file 1 Select the images to be exported by clicking the image marker in the lower right corner of each image The markers located at the bottom of the selected images fills in orange 2 On the File gt Export menu click as AVI Video The Create AVI dialog box appears Create AYI X Compression Type Microsoft Video 1 Quality iS 100 Dimensions Image Width E 2
4. Selected labels mM Ph Mm D Lu LU LN LU LU uw m n Ls m UN Dl m LN Dl m J oo Click Go to start labeling If you selected Text only in Step 3 click in the image to insert the text label in the desired location If you selected Text and Arrow in Step 3 position the arrow head by the desired location then click in the image Note If the viewport is not currently displaying the desired image you can roll the mouse wheel to scroll to the desired image before inserting the label Note If you selected Enable Scroll Wheel in Step 5 scrolling the mouse wheel only changes the label attached to your cursor Scroll the mouse wheel until it displays the desired label then insert the label in the image Once you have inserted one label in the image the application attaches the next label to your cursor Repeat Step 6 until you have inserted all the selected labels Note The application attaches the labels to your cursor in sequential order e g T 9 then T10 then T11 and so on Note If you selected Enable Scroll Wheel in Step 5 double click to insert your last label You can do the following e Change the angle of the arrow see To change the angle of an arrow on page 59 e Reposition the label see To reposition a label on page 59 e Edit the label see To edit a label on page 59 58 eFilm Workstation User
5. Alpha Coherence Beta Black White Bias Magnification Pan Zoom Reset Image Settings Toggle Overlay Add User Annotation Cine Screen Layout Toggle Survey Explode Mode Show Study Information Image Fusion Label Using tools Opens a list of patient studies available for viewing on the CD Manually scrolls through images within a series You may define the sort criterion Adjusts the brightness and or contrast of the image You may specify whether this is done interactively or via LUTs included as part of an image header Adjusts the coherence and or black white bias settings of the image Magnifies the area of interest within the image You may define the percentage of magnification Repositions the images in the window Manually increases or decreases the image s field of view Resets the original image settings after manipulations except the window level settings Hides or displays the written study information and scale bar displayed in the window Allows the user to add and position text in the image Automatically cycles through the images in a series Redisplays series and images in various layouts on the screen Explodes images to fill the screen and returns to the former layout Displays more information about the patient and study Fuses CT PT images together Allows you to label the vertebrae of a spine using predefined annotations eFilm Lite User s Guide Chapter
6. Image Height 375 Frame Rate 7 Use DCOM Frame Fate Frames Per Second 25 Tatal Running Time 0 04 in seconds Select the compression preferences for Type and Quality Specify the Image Width and Image Height dimensions the size of the AVI image in screen pixels 5 Select the frame rate preferences the number of images or frames that display per second Note The Total Running Time value is calculated according to the frame rate If a DICOM frame rate has been encoded in the DICOM header the Use DICOM Frame Rate check box is activated If you select this option the Frames Per Second value will automatically be set according to the frame rate 6 Once you have set all of your preferences click Create The Save As dialog box appears 7 Select the directory to which images will be saved and enter a filename The new AVI file is saved to this location 8 If you wish to view the AVI image at this point click View Note When you open the AVI file in Windows the movie plays automatically on your computer s default media player 80 eFilm Workstation User s Guide Exporting volumes to AVI files Exporting volumes to AVI files You can export a 3D volume to an AVI file and view the resulting cine loop using your default media player To export a volume to an AVI video file 1 Select a volume to export 2 On the Tools menu click Cine or click Gil The Cine Control Bar dialog box appear
7. and window level an MIP e Volume Rendering this technique projects a volume onto a screen image pane assigning colors based on an opacity map The opacity map determines how opaque each intensity value should be rendered and which color the value contributes to the resulting image Note Volume rendering is only available on computers that have compatible video cards If volume rendering is not available you will instead be able to create an MPR view from a 3D volume e Simgram Image mode that uses Holorad s patented Simgram algorithm to simulate the appearance of a holographic 3D Voxgram image on your 2D screen You can rotate crop and window level a Simgram image eFilm Workstation User s Guide 61 Creating 3D Images Note 3D functionality is only supported for CT and MR studies because only these types of studies contain orientation information on slices WARNING MPRs MIPs Volume rendered and Simgram images are intended for use as adjuncts to two dimensional medical imaging display techniques The above techniques involve interpolation of data Reference should always be made to the original two dimensional images and the modality parameters when interpreting the data Caution To improve responsiveness the volume first displays at a reduced resolution as indicated by the Reduced Resolution message in the overlay Before interpreting the data please wait for the volume to refine to Full R
8. e On the Tools menu click Next Study e Click To go to the previous study e Choose one of the following options e On the Tools menu click Previous Study e Click Synchronizing series The Synchronizing tool allows you to bring all series in the same plane into alignment This tool uses the series slice location to line up image navigation for these series in panes With synchronization you can navigate through the images of one series i e scroll cine and all other series with images in the same plane will navigate accordingly This section shows you how to synchronize series e automatically see Synchronizing series automatically on page 31 e manually see Synchronizing series manually on page 31 30 eFilm Workstation User s Guide Locating points in 3D space synchronizing series automatically This method of synchronization is performed automatically it synchronizes images that are related to each other spatially and scanned during the same exam but it will not synchronize images from the same patient from different studies The series must be from the same patient or study otherwise you must perform synchronization of these series manually To synchronize series of the same plane automatically 1 Select the image plane with which you want all others to synchronize 2 Choose one of the following options e On the Tools menu click Auto Series Synchronization e Click If you detect an o
9. nenea eee nana 20 NSW SS i ia aaa sac a soi a aia alea ana ia 20 Arranging study series in panes ee nenea neeenanneenae nec al Viewmg study information asa oaia aaa aie ata a aloe 22 Setting the encryption password i e nenea nene en enaee 23 Adjusting the screen layo t soc caca iau at elita dat ia 23 Comparing multiple studies sauoacbuoattin aaa eta nea eleaoaa ii aaa ae 24 Viewing non DICOM OD EGIS ecosisteme da ie 25 Selectine TNASES ANC SEL IES cauza aaa iale due aaa oda load tu 25 SE OC NS TA ss pacar crate da iile a iati iad 25 SE JOCULUI E SE ICE 2s say Seamana a aa acasa a in taina 26 Navigating Images Moving through IMAgES e pateu nadie coada Bf bag oarba datat 27 eFilm Lite User s Guide Chapter 5 Chapter 6 Chapter 7 Using the toolbar to move through images eee eee 27 Using the scrollbar to move through images 0 eects 28 Stacking TVA CS vast oase taie aul ist oastea i da 29 Using THES INS TOON isaac pilda lat boa nicer tacea aid 29 NIG Vil through Series isa ste poa tatic taia na a adela a dl 30 MO trous i studies acca disc Pa dl aia anda ala adi cae 30 SV ACHCONI ZII 9 SOMES since aia Ba tacuta ci d a dale tu 30 Synchronizing series automatically oes nene eneeenee na eneeenee 31 Synchronizing series manual ziceai ace accea da d unda a a 31 LOCALS points IO Pace renie a dp ata aia 31 Manipulating Images Setting window level values size soapta bacau last eat clu tation 0 alea 33 Adjusti
10. 5 104 0 pixels Choose one of the following options e On the Tools menu click Calibrate Measurements e Click The Measurement Calibration control bar appears Enter the length in centimeters of the line you drew as measured by the scale on the image and click OK eFilm Workstation User s Guide 55 Annotating and Measuring Images All subsequent measurements on the image will be calibrated Note Due to variable scaling per image each image must be calibrated individually Once an image is calibrated you can change its measurement units back to pixels by entering 0 as the length value in the Measurement Calibration control bar Probing images Probing allows you to query the image intensity values To probe the area of an image 1 Choose one of the following options e On the Tools menu click Probe Tool Click 2 Click anywhere on the image and hold the mouse button down to view the value at that point The Hounsfield value for CT or pixel value for all other modalities is displayed lt F aR k 56 eFilm Workstation User s Guide Labeling a Spine Labeling a Spine You can label the vertebrae of a spine using predefined annotations x You can use text annotations or text annotations with adjustable Type Text only arrows The predefined annotations refer to the spinal column as er ersa follows Al Images This feature is only available for MR and CT images To la
11. lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite Profiles eFilm Lite runtime files Description Common routines Key Image Connector Library DICOMDIR library MergeCom3 Library eFilm Local Licensing Library eFilm Remote Licensing Library Direct3D Library Splash screen Titlebar Caption Help file Program executable LUT management library 3D rendering library Grayscale opacity preset for 3D rendering LUT management setting Language Utility Library End user eFilm Lite License Agreement DICOM library dependencies Licensing enabler Local Licensing Library Remote Licensing Library Transfer syntax list Logo bitmaps Microsoft MFC Runtime Required Microsoft distributions Toolbar properties for user interface eFilm Lite User s Guide 85 Chapter 9 Creating an eFilm Lite CD File Name ToolbarConfiguration xml ToolbarFullCfg xml ToolbarMinCfg xml File Location on CD lt ROOTDIR gt eFilmLite Profiles Default lt ROOTDIR gt eFilmLite Profiles Default lt ROOTDIR gt eFilmLite Profiles Default Description Default configuration for toolbars Configuration for all tools visible at once Configuration for minimal set of tools 86 eFilm Lite User s Guide
12. 1 eFilm Lite Overview Next Previous tools Previous Study Loads the previous study from the CD Next Study Loads the next study from the CD Previous Series Loads the previous series within the selected exam Next Series Loads the next series within the selected exam Previous Image Loads the previous image of the series Next Image Loads the next image of the series Measurement tools Probe Tool Gives a pixel or a Hounsfield unit value for a given point Measurement Tool Arrow Draws an arrow Measurement Tool Line Measures linear distances Measurement Tool Ellipse Measures an elliptical region of interest Measurement Tool Show Angles Measures an angle between two intersecting lines Ea E 30 m Ag Clear Measurement Tools Erases all measurements from all images in a selected series anem Calibrate Measurements Manually calibrates images 6 eFilm Lite User s Guide Multiplanar tools E e tu al AWS ie Show All Reference Lines Show First and Last Reference Lines Show Current Reference Line Auto Series Synchronization Manual Series Synchronization 3D Cursor Measurement Tool MPR Auto Generate Orthogonal MPR Tools Image Manipulation tools BO ee ee Flip Horizontal Flip Vertical Rotate Left 90 Degrees Rotate Right 90 Degrees Invert Using tools Shows the location of all the images with reference lines Shows the location of the first and last images Shows the
13. MPRISIADS aicea alpi ta 8 aaa lg Cata dea die 77 Saving and deletine MPR VIEWS moca ceai aaa a dala e idile 77 Exporting Images Copying and Pasting Images siisi oma cana aot pica atita bani bati cai teas 79 Exporting images as graphic files sccssids caos atroce anal soc ea ae d da 79 Exporting mages to ANL TICS ziua mia sotia ie ui sa eta anana 80 Exporting volumes to AVI GIES nicio tat manat ba data a 81 PENTO Nag ce c cicee Renee Re E ORE terre CESE PR NETA rete acre tree cee Re e errata 82 Creating an eFilm Lite CD DICOMIDIK directory structure neo eat alta a at t ai 84 efilr Late PUN HM e LES 4a cesscanteaaceu aia nodul daia oa Ba aa i aa id 84 eFilm Lite User s Guide vil viii eFilm Lite User s Guide Chapter 1 eFilm Lite Overview eFilm Lite is a more basic version of eFilm Workstation which is an application used for viewing and manipulating medical images Digital images and data from various sources including CT MR US RF units computed and direct radiographic devices secondary capture devices scanners imaging gateways or imaging sources can be displayed on workstations and laptops using this software When viewing images users can perform adjustments of window width and level image stacking annotation and measurement of regions of interest and various image alterations In this section you will learn how to e meet minimum system requirements see System requirements on page 1 e und
14. Merge Healthcare Web site at www mergehealthcare com for the most up to date system requirements eFilm Lite window The main eFilm Lite window is a workspace where you can view and manipulate DICOMDIR images stored on a CD i cfilm Lite AHOMOD00 2005 Jud 20 00 00 00 Ele Edit tity Toons Tools window Hep BIR alel 55 fs et p aa A O EY ca ca 3 gt gt BN E We dp sp 00 OB e 3 chy e e rev RD PN 3 gt mea Nl A MictodMrr A Institubortarree MictModMrri Ex ANC ITI Ex 146 Se asc 1870 Jan l g fi ne BEL eee va ji WS 200 sa p mpi AUS Mul Ul Ua JU AU Seo Tra ULUI Aco rm UAOO Y in DEM Lin bean aon wapi Lt J Ov 75 Ox Ws For Help prett FI MH Note eFilm Lite should launch automatically when you insert a CD with DICOMDIR images burned on it If it does not launch navigate to your CDROM directory and double click eFilmLt exe This window can contain more than one image at a time each in a separate pane arranged in a grid The menu bar appears at the top of the window and the status bar will appear at the bottom if enabled By default the tool bar appears at the top of the window directly beneath the menu bar but you can move it by following the procedure outlined in Moving the toolbar on page 3 2 eFilm Lite User s Guide Using the toolbar Using the toolbar Additional tools in the toolbar are displayed based on the customized toolbar settings and activated
15. ROOTDIR gt File Name File Location on CD dimpl8 dll lt ROOTDIR gt eFilmLite ColorOpacityPresetList xml lt ROOTDIR gt eFilmLite ColourMapping txt lt ROOTDIR gt eFilmLite efCmprss dll lt ROOTDIR gt eFilmLite Description Image rendering library Color opacity preset for 3D rendering Color mapping preset for image fusion Decompression library 84 eFilm Lite User s Guide File Name efCommon dll efKeyImgConnector dll efl CPDirLt dll efMC3DICOM dll efSheriffLocal dll efSheriffRemote dll eFilmD3DX dll efSplash BMP efTitle txt eFilmLt chm eFilmLt exe efLUTMer dll efVolume dll efVoxel dll GrayscaleOpacityPresetList xml ereyscale xml LangUtil dll License rtf mc3adv dll MC3DICOM dll mrgcom3 msg picn20 dll picn6920 dll SlsApi dll SlsLocal dll SlsRemote dll SyntaxLists ini VoxLogo bmp MFC71 dll MSVCP71 dll MSVCR71 d1l msxml4 dll msxml4a dll msxml4r dll OLEacc dll ToolBarProperties xml File Location on CD lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite lt ROOTDIR gt eFilmLite
16. To 23 Total E Reset Selection Interpolation i Interpolation Level Auto Memon Required 59 8MB Please select a subset of images Axial Set 23 Images Memon Available 1000 8MB Create Volume Cancel Note The selected 3D mode becomes the default mode until you choose another This 30 3 means you can access the Advanced Volume Loading dialog box directly by clicking ae the View 3D button or selecting Tools gt View 3D 4 Adjust the loading parameters see Adjusting loading parameters for 3D volumes on page 64 and click Create Volume The 3D image appears in the main window 5 Optional Export the 3D volume in AVI format see Exporting volumes to AVI files on page 81 Note If you are creating a volume rendered image you may want to adjust the color or grayscale opacity mappings and recreate the volume See Adjusting mapping settings for 3D volumes on page 68 for information on working with opacity maps eFilm Workstation User s Guide 63 Creating 3D Images Adjusting loading parameters for 3D volumes The Advanced Volume Loading dialog box allows you to alter the default volume loading parameters that would normally be hidden or automatically chosen by the software For example you can specify the amount of interpolation to be used or select to load only a subset of images from a series Advanced Volume Loading Sika ino Index E Pos
17. a z J fe d J i I J J SHE Lap Wall Lace Sar i OAS Ee ri i i To redisplay the written information select the series and click again Note If you applied lossy compression to the image its identifier and compression ratio will not be hidden even when this tool is off Lossy compression information where relevant is always visible Annotating images The annotation tool allows you to add text to images and then edit or delete the text Annotations can be added to an image to describe certain features in more detail You can copy your annotations and measurements to other images in the study To add an annotation 1 Select an image 2 Choose one of the following options e On the Tools menu click Add User Annotation e Click 3 Click the area in the image where you want to add the annotation A text field appears 4 Type the annotation in the text field When completed press Enter or click again The annotation is set in the image Note Loading a different series into the series window after adding an annotation causes the annotation to be lost unless you have saved the image to a scrapbook or as a key image 50 eFilm Workstation User s Guide Making linear measurements To edit an annotation e You can edit an annotation by selecting it and then editing the text as necessary You can drag and drop the annotation anywhere on the image Annotations can be removed from
18. according to the selected modality type To view the description of a tool hold the cursor over its icon Full descriptions of the tools can be found in Using tools on page 4 In this section you will learn how to e move the toolbar see Moving the toolbar on page 3 e configure the toolbar see Customizing the toolbar on page 3 e access the Mini Bar see Accessing the Mini Bar on page 4 Note By default the application displays the minimal toolbar Moving the toolbar The toolbar does not have to remain at the bottom of the window it can be moved to the top to the left or to the right of the window in order to accommodate your preferences To move the toolbar e Choose one of the following options e Select the toolbar and drag it to a new location e On the ToolBars menu click one of the default locations e Right click anywhere in the toolbar and select one of the default locations The new location becomes the default for the toolbar Customizing the toolbar There are a number of features available in eFilm Lite that allow you to customize the look and feel of your toolbar All of these features are accessible via either the ToolBars menu or the pop up menu that appears when you right click anywhere in the toolbar region Note All tools are also found in the Tools menu however not all tools listed in this menu are available on the toolbar To customize the number of toolbar icons di
19. arbitrary viewing plane through a 3D volume see Creating MPRs from 3D volumes on page 73 e interact with the MPR series you have created see Interacting with MPR series on page 74 e adjust your view of the MPR see Adjusting the MPR view on page 74 e create a slab from the MPR view see Creating MPR slabs on page 77 e save or delete the MPR view see Saving and deleting MPR views on page 77 eFilm Workstation User s Guide 71 Creating 3D Images Creating Orthogonal MPR viewing planes The Auto Generate MPR tool allows you to automatically create three MPR views two orthogonal MPR views that are perpendicular to the image plane and an oblique view that is at 45 to the other two views Note The oblique view is optional you can set eFilm Lite to create or omit this view in the Edit Properties dialog box see Customizing volume settings on page 15 To automatically create MPR views 1 2 3 Select the appropriate series Choose one of the following options e On the Tools menu click Auto Generate Orthogonal MPR Tools e Click The MPR views are generated and the screen layout is automatically adjusted to 2 x 2 unless four viewports are already configured displaying the original series in the top left corner and the three MPR series in adjacent viewports The oblique view if generated is shown in the lower right viewport NB om eae Note Yo
20. for a good compromise between speed and quality e Select Bicubic Slowest highest quality to minimize the effects of aliasing in your images e While Stacking if cleared no interpolation will be done while stacking which will improve performance but may result in reduced image quality Once the stacking operation ends the current image will be re displayed using the selected interpolation method e Separate multi echo sequences select to automatically split multi echo sequences into separate series e Automatically split multi phase multi frame indicate whether to automatically split a multi phase or multi frame series into separate series eFilm Workstation User s Guide 11 Setting User Preferences Note The Automatically split multi phase multi frame option is selected by default for Ultrasound US images Split multi phase multi frame select whether eFilm Lite will display the original series after splitting it into individual phases e display original series as well e donot display original series as well 6 The following settings are available under Tools Allow window leveling of individual images select if you want to be able to alter the window level settings independently for each image for this modality Clear the check box to have window level settings apply to the entire series Auto Window amp Level algorithm e Simple select to have the window and level values set to a mid point between
21. location of the currently active image Synchronizes images that are related to each other spatially and scanned during the same exam For example it will not synchronize images from the same patient from different studies Locks series belonging to the same patient together by image location Synchronizes points between images and planes Creates an MPR from a 2D image Creates two orthogonal and one oblique MPR series from a 2D image Flips the selected image from left to right about the vertical axis Flips the selected image from top to bottom about the horizontal axis Rotates the selected image 90 degrees counter clockwise Rotates the selected image 90 degrees clockwise Inverts the color of the images so that they are displayed either as black on white or white on black eFilm Lite User s Guide Chapter 1 eFilm Lite Overview Volume tools E Le a View 3D Crop Volume Rotate Volume Toggle Stereo Volume MPR Opacity Settings Renders the selected series using the specified 3D mode Crops away unwanted parts of a volume Rotates the volume about the screen s horizontal and vertical axes Toggles the stereoscopic display mode Generates an MPR superimposed on the face of a volume Allows you to assign colors to pixels in a volume eFilm Lite User s Guide Chapter 2 Setting User Preferences You can customize your user system and DICOM preferences from the Edi
22. objecis on the media 1 From the eFilm Lite viewer see To access the eFilm Lite viewer on page 19 click Browse Other Files 2 Inthe Other Files dialog box select the file you want to open and click OK Other Files On The Media File and Folder Hame Type Tip You can also drag a DICOM file from Windows Explorer into the main eFilm window selecting images and series This section shows you how to select e asingle image or multiple images see Selecting images on page 25 e asingle series or multiple series see Selecting series on page 26 Selecting images These procedures allow you to select a single image multiple images or all images in a series To select a single image 1 View the image that you want to select in any pane eFilm Workstation User s Guide 25 Viewing Images 2 Select the selection box in the lower right corner of the image The selection box fills in orange to indicate that it is selected Selection Box To select multiple images 1 View the first image that you want to select in any pane 2 Select the selection box in the lower right corner of the image The selection box fills in orange to indicate that it is selected 3 Continue this procedure to select additional images Note Selected images remain selected as you scroll through the series You can select every other image in the series by clicking Select Every 2nd Image In Series on t
23. preferences Customizing system preferences The Preferences tab in the Edit Properties dialog box allows you to customize your monitor setup To access the Preferences tab 1 On the Edit menu click Properties The Edit Properties dialog box appears 2 Click the System Preferences tab Edit Properties a x Modality Settings System Preferences Volume Settings Image Markers Template Settings Cancel Help To configure your monitor setup e Select either the Single or Dual option for the setup of your monitors Using image markers For mammograms the Image Markers tab in the Edit Properties dialog box allows you to display image markers and position them as required in the image WARNING eFilm is not approved for FFDM diagnostic review All digital mammography images are for reference only eFilm Workstation User s Guide 13 Setting User Preferences To access the Image Markers tab 1 On the Edit menu click Properties The Edit Properties dialog box appears 2 Click the Image Markers tab By default the Show marker on Mammogram MG images check box is selected Edit Properties x Modality Settings System Preferences Volume Settings Image Markers Template Settings he Show marker on Mammogram MG images Previews By pixel offsets By percentage offsets Horizontally 25 pixels Vertically 25 pixels From Top Left comer Top Right comer C Bottom
24. save the series For local exams the Store MPR Series box appears in a new pane 3 Type a series description for the MPR view and click OK eFilm Workstation User s Guide 77 Creating 3D Images Note If you right click a series that contains an MPR line and select a different series to load into that pane you will be prompted as described above to save or delete the corresponding MPR view 78 eFilm Workstation User s Guide Chapter 8 Exporting Images eFilm Lite can output images in a variety of formats In this chapter you will learn how to e copy and paste an image into a Microsoft Windows document see Copying and Pasting Images on page 79 e export images as JPEG files see Exporting images as graphic files on page 79 e export images as AVI files see Exporting images to AVI files on page 80 e export volumes as AVI files see Exporting volumes to AVI files on page 81 e print images see Printing images on page 82 Copying and Pasting Images You can copy and paste an image from a viewport into a Microsoft Windows application e g Microsoft Word The copied image retains all applied annotations and measurements To copy and paste an image 1 Select the viewport with the image you want to copy 2 Choose one of the following e On the Edit menu click Copy e Press Ctrl C to copy the image 3 Open the desired Microsoft Windows application e g Microsoft Word
25. slab 1 Left or right click one of the circular nodes on an MPR line The line changes from orange to green 2 Drag and drop the node to the new location This specifies the thickness of the slab LightSpeed Plus Ah Princess Margaret Hospital Ex 2565 Autre hiac i hi 28520 CC S OMNISO0 Ace 40071 Se 2 9 2002 Jun 10 Im 117119 Acg Tm 1 DAA 1 Ax S0 a 7 Mag 0 0 512 At STANDARD L 140 0 ke 250 0 mA 4 5 0 mm es Tilt 0 0 i ET 1 7 3 SP 0 8 s TS 7 50 mmis SPR Liri DGA Lin DCA Id ID W400 L 40 DFOW 23 4 x 23 4c Note As you are changing the thickness of the slab that defines the MPR plane the corresponding MPR view is dynamically updated The MPR view is now an MIP of the portion of the stack defined by the slab saving and deleting MPR views You can choose to delete an MPR view or save it as an additional series in the study Once saved the new MPR series can be sent to another device or reopened for viewing as you would any other eFilm Lite series To save or delete an MPR view 1 Select the MPR line and press Delete A message box appears Note You can delete all MPR lines and views from a series by selecting the series and clicking You will be prompted to delete each MPR view you can click No to all in the message box that appears to avoid multiple prompts 2 Choose one of the following options e Click No to delete the MPR line and the MPR view e Click Yes to
26. the minimum and maximum values in the image e Histogram Analysis select to have the window and level values automatically adjust based on image characteristics This feature only works if the scanner sending the image does not define the window and level settings Hide stacking scrollbar select to hide the scrollbar for multi image series see Stacking images on page 29 This is recommended for modalities such as CR DX and MG for use with Hanging Protocols only Select the Preserve Presentation Intent in Viewports check box if you want to preserve the presentation intent of the following image manipulation tools e Zoom see Zooming on page 41 e Pan see Panning on page 40 e Rotate see Changing image orientation on page 39 e Flip see Changing image orientation on page 39 e Toggle Overlay see Overlaying text on page 49 e Annotation see Annotating images on page 50 e Window Level see Adjusting window level settings manually on page 33 e Arrow see Drawing arrows on page 53 e Line see Making linear measurements on page 51 e Ellipse see Making elliptical measurements on page 52 In Hardcopy suppress the scale marker select to prevent the scale marker from appearing on images you print Note This option cannot be deactivated for the MG modality 7 Click OK to save your changes 12 eFilm Workstation User s Guide Customizing system
27. the screen printed or exported from eFilm The quality of the data is dependent on the correctness of the input data the user s interaction with the data the quality characteristics and settings of the display device or printer and the necessity to interpolate the data for display purposes For example measurement values in eFilm are dependent on the calibration information provided by the modality in the DICOM header While eFilm and eFilm Lite have been tested extensively it is impossible to completely test any piece of software and errors may remain in the software It is possible that an error could manifest as an incorrect measurement or image Users must be aware of the potential for errors eFilm saves images together with patient information both when saving to the local database and when exporting from eFilm It is important to protect this data from access by unauthorized persons Users should be aware that certain views make use of interpolated data This is data that is created by eFilm or eFilm Lite based on the original data set Interpolated data may give the appearance of healthy tissue in situations where pathology that is near or smaller than the scanning resolution may be present On occasion interpolated data may also include image artifacts which should not be interpreted as real pathology The image scrapbook function is intended to preserve annotations on images Scrapbooked images should not be used for primary d
28. to move through images on page 28 e Stacking allows you to quickly and easily move through the images of a series see Stacking images on page 29 e Cine dynamically displays the stacked images for a video display viewing see Using the Cine tool on page 29 Using the toolbar to move through images The Next Previous Image buttons move through the images in a series one at a time To go to the next image in a series 1 Select the required series 2 Choose one of the following options e Click e Press PgDn To go back to the previous image in a series 1 Select the required series 2 Choose one of the following options e Click e Press PgUp eFilm Workstation User s Guide 27 Navigating Images To go to the beginning or end of a series 1 2 Select the required series Choose one of the following options e Press Home to go to the beginning of the series e Press End to go to the end of the series To go to a specific image in a series 1 2 Select the required series Choose one of the following options e On the Tools menu click Stack Options e Click the arrow to the immediate right of The Stack pop up menu appears Select Goto Image The Goto Image dialog box appears x i ea Enter the image order number and click Goto to display the required image Using the scrollbar to move through images The scrollbar allows you to both move through images one at
29. Ensure that the red lens goes over your left eye You can view the stereo effect with anaglyphic glasses that have the red lens over the right eye by entering a negative value for the Stereo Angle on the Volume Settings tab of the Edit Properties dialog box see Customizing volume settings on page 15 Important You cannot rely on this mode when making clinical decisions Stereo effect has significant limitations depending on your position relative to the screen As you move left or right up or down the stereo volume will warp As you move closer or further away the stereo volume will shrink or expand respectively If you turn your head so one eye is above the other the stereo effect will vanish To view the volume in stereo mode 1 Choose one of the following options e On the Tools menu click Toggle Stereo e Click 2 To change the strength of the stereo effect adjust the stereo display settings by following the procedure outlined in Customizing volume settings on page 15 3 To toggle the stereo display off click again Note You cannot activate the volume MPR tool while in stereo mode see Creating MPRs from 3D volumes on page 73 Using the black outside window setting This setting causes all pixel values above and below the conventional window to be set to 0 for the purpose of 3D rendering and appear black in the 3D image This feature can be useful in soft tissue CT images to remove the sk
30. Left comer Bottom Right comer M Show border around marker he Allow marker to calculate dimensions automatically Upper information C Lower information Font Cancel Help Note Digital mammography scanners attach image markers to their studies so that breast images can be properly identified The default setting for this tab is set to display image markers If you do not want image markers then clear the Show marker on Mammogram MG images check box To position image markers 1 Select the corner on which to display the image marker i e Top Left Corner Bottom Left Corner Top Right Corner or Bottom Right Corner 2 Additionally you can offset the image marker from the corner by pixels or percentage e Select either the By pixel offsets or By percentage offsets radio button which will position the image marker either by pixels or by percentage respectively e Move the position of the image marker by inserting values in the Horizontally and Vertically fields Note The preview screen updates according to your selection 3 Click OK to save your changes 14 eFilm Workstation User s Guide Customizing volume settings To format image markers 1 Choose one of the following options e Ifyou want to remove the border clear the Show border around marker check box e If you want to keep the border but change its size select the Show border around marker check box and
31. Options e Click the arrow to the immediate right of The Magnification pop up menu appears 2 Select one of the following percent magnification values 200 400 600 or 800 Note This value becomes the default until it is changed again 40 eFilm Workstation User s Guide Zooming Adjusting image viewing options Click and drag the mouse over the area of the image you want to magnify The magnifying window appears and follows the cursor as it magnifies the selected area Release the mouse button to close the magnifying window There are three methods of performing zooming manual preset and custom zooming Pixel for pixel mode which treats each pixel in the DICOM image as one pixel on your monitor is also available in this section Important Images with a 1 1 pixel aspect ratio look normal when pixel for pixel mode is applied however for images with a different pixel aspect ratio will look compressed in one direction as this feature represents actual pixels but not presentation intent In these cases you must exit pixel for pixel mode by selecting another zoom value To zoom in and out of an image manually 1 3 Choose one of the following options e On the Tools menu click Zoom Click Position the cursor over the image and right click and drag Dragging up increases the image zoom and dragging down decreases it Release the mouse button to keep the image at the new zoom setting To set Z
32. PR views of an existing data set from either 2D images or 3D volumes From a 2D image the MPR view you generate creates a viewing plane that is perpendicular to the image plane From a 3D volume the MPR view you generate creates a viewing plane that can be rotated to any angle relative to the original image plane Note You can only generate MPR views of a 3D volume if your system does not meet the hardware requirements to support volume rendering You can construct e MPRs of the two orthogonal viewing planes from a 2D image e an MPR ofan arbitrary perpendicular viewing plane from a 2D image e an MPR of an arbitrary viewing plane through a 3D volume Once created an MPR series behaves the same as a regular eFilm Lite image series You can use most of the eFilm Lite tools such as window level stack zoom pan measurements and reference lines on the MPR series However you cannot apply any 3D image tools to the MPR series until it is saved to the database Note Once an MPR series has been saved and closed you can reopen it and apply 3D image tools to it see Saving and deleting MPR views on page 77 In this section you will learn how to e create MPRs of the two orthogonal viewing planes from a 2D image see Creating Orthogonal MPR viewing planes on page 72 e create MPRs of an arbitrary perpendicular viewing plane from a 2D image see Creating MPRs from 2D images on page 73 e create MPRs of an
33. The Pan options become available once you zoom in 5 Adjust the Sensitivity value by entering it manually or using the spinbox arrows The Sensitivity value specifies the increment by which the Window Level and Opacity eFilm Workstation User s Guide 69 Creating 3D Images spinbox values will change when adjusted You can also set this value by following the procedure outlined in Adjusting manual window level control sensitivity on page 34 6 Adjust the Window and Level values by entering them manually or using the spinbox arrows Select the Invert check box to switch the Window value from white to black Clear the Invert check box to switch this value from black to white 7 Adjust the Opacity Slope and Position values by entering them manually or using the spinbox arrows Select the Invert check box to switch the Slope value from white to black Clear the Invert check box to switch this value from black to white 8 Click Auto Opacity Setting to automatically create a straight opacity angle or DICOM Setting to revert to the Window Level settings defined in Specifying custom window level values on page 35 Note To save these settings to the Preset menu follow the procedure described in Editing color grayscale mappings on page 70 9 Click the X in the upper right hand corner to close the Grayscale Opacity Settings dialog box The image is updated according to the new grayscale mapping Loading colo
34. a pair of range lines The MPR line defines the slice through the volume shown by that line s MPR view and the range lines define the number of images in the view LightSpeed Plus A Princess Margaret Hospital x 2566 Autre Mac MM 26520 Ace 40071 2002 Jun 10 Acg Tm 1 0 44 11 Mag DB 140 0 k s 250 0 mA 5 0 mm Tilt 0 0 ET 1 7 6 GP 0 8 s TS 7 50 mmis SPF Lin DEM Lins DOM Id ID L i l ADO L 40 a DFO 23 4 x 23 4cen You can adjust the MPR view in several ways eFilm Workstation User s Guide e rotate and resize the MPR line this adjusts the size and angle of the MPR view allowing you to focus on a particular area of the screen e reposition the MPR line e adjust the range lines to restrict the number of images in the MPR view To rotate or resize the MPR line 1 Left or right click either end of the MPR line The cursor changes to a and the line changes color from orange to green 2 Drag and drop the end to the new location Princess Margaret Hospital Autre Mac hi 26520 Ace 40071 2002 Jun 10 Acg Tm 1 O44 11 i iE Ts Dax a 512 x912 STANDARD L 140 0 k s 250 0 mA 5 0 mm i Tilt 0 0 i ET 1 7 8 GP 0 8 s TS 7 50 mms SPF Lin DCM d Lin Dii Id ID E W400 L 40 T a DFOW 23 4 x 23 4c n To move the MPR line 1 Left or right click anywhere on the MPR line The cursor changes to a four headed arrow and the
35. a time and scroll easily though the images of a stacked series To scroll through images one at a time Click the Up or Down scrollbar arrow once to move to the next or previous image in the series To scroll through images of a stacked series Click and hold the Up or Down scrollbar arrow to scroll forward or backward through the stack or click and drag the scrollbar bubble up or down 28 eFilm Workstation User s Guide Moving through images Stacking images Stacking allows you to move quickly and easily through the images of a stacked series To stack images in a series 1 pa Select the required series Optionally choose one of the following options to define how you want the images to be sorted e On the Tools menu click Stack Options e Click the arrow to the immediate right of The Stack pop up menu appears Optionally select how you want to sort the images in the stack You can sort by Image Number Slice Location Reverse Slice Location Acquisition Time or Image Time Position the mouse pointer over the series and click and drag it up or down within the pane Note Stacking becomes faster once you have loaded all images in a series into memory by viewing them To automate this you might consider using the Cine tool see Using the Cine tool on page 29 Using the Cine tool The Cine tool allows you to view stacked images dynamically in a movie like display format To use the C
36. ace 32 eFilm Workstation User s Guide Chapter 5 Manipulating Images This section covers manipulating image display functionality such as orientation magnification field of view and colorization In this chapter you will learn how to adjust window level settings for images see Setting window level values on page 33 invert image color see Inverting images on page 36 overlay reference lines on an image see Overlaying reference lines on page 37 change image orientation see Changing image orientation on page 39 adjust your view of an image see Adjusting image viewing options on page 39 reset image settings see Resetting the original image settings on page 42 adjust your view of a series see Adjusting series viewing options on page 42 fuse multi modality images see Using image fusion on page 44 split multi phase series into separate series see Splitting a series on page 47 setting window level values Window leveling allows you to adjust the brightness and contrast of images This section shows you how to adjust window level settings manually see Adjusting window level settings manually on page 33 adjust window level settings using window level presets see Using window level presets on page 35 use non linear window leveling see Using non linear sigmoidal window leveling on page 36 Adjusting window level settings manuall
37. ality 1 On the Edit menu click Properties The Edit Properties dialog box appears 2 Click the Modality Settings tab and then click the Advanced tab 3 Select a modality from the Modality drop down list 10 eFilm Workstation User s Guide Customizing modality settings 4 Adjust the settings as required by selecting the options provided in the Advanced User Settings pane Edit Properties ria x Modality Settings System Preferences Volume Settings Image Markers Template Settings Modality MA z Layout Advanced None Fastest lowest quality 2 Bilinear Bicubic Slowest highest quality While stacking Separate rnulti echa sequences C Automatically split multi phase multi frame ot Split multi phase rmulti frarne Display original series as well Lia not display original series O Allow window leveling of individual images ot Auto Window amp Level algorithrn 2 Simple Histogram analysis Hide stacking scrollbar Preserve presentation intent in viewports Q In Hardcopy suppress the scale marker DE Cancel Help The defaults for each modality are Bilinear Interpolation and Simple Window amp Level algorithm Note Adjusting these defaults will affect the image processing time 5 The following settings are available for Interpolation e Mode e Select None Fastest lowest quality to disable interpolation entirely e Select Bilinear
38. an image if it is affecting the clarity of the image To delete an annotation 1 Select the annotation 2 Right click and select Delete Note To remove an annotation from all images in a series to which it was copied select Delete All instead Making linear measurements eFilm Lite allows you to make straight line measurements on displayed images On ES OT RF SC US and XA images measurements are displayed in pixels until calibration is performed In all other modalities they are displayed in centimeters WARNING Measurements performed on CR DX and MG images may be inaccurate unless you calibrate the measurement tools see Calibrating images on page 55 To make a linear measurement 1 Choose one of the following options e On the Tools menu click Measurement Tool Line e Click 2 Position the cursor at the starting location and right click and drag the cursor to the ending location 3 Release the mouse button A line with a distance measurement appears in blue You can stretch the line or move it to a new location You can also move the measurement caption to a new location To stretch the line e Left click either end of the line and drag it to a new location To move the line e Left click anywhere on the line except at the ends and drag it to a new location eFilm Workstation User s Guide 51 Annotating and Measuring Images To move the measurement caption e Left clic
39. ay the angles between intersecting lines To display the angle measurements 1 Draw intersecting lines on the image 2 Choose one of the following options eFilm Workstation User s Guide 53 Annotating and Measuring Images e On the Tools menu click Measurement Tool Show Angles Click The angles between any intersecting lines appear in orange Note To toggle the display of the angle measurements off click zl Note In cases where lung bases are not horizontally aligned the CTR calculation uses a horizontal diameter of the thorax rather than the diagonal measurement displayed WARNING Due to limitations in data acquisition the calculations are approximate Copying annotations and measurements Once you have annotated and measured an image to your satisfaction you can copy those annotations and measurements to other images in a multi image study This section describes how to e create a duplicate of an annotation or measurement on the same image e copy an annotation or measurement to all images in a multi image series To duplicate an annotation or measurement 1 Right click the annotation or measurement and select Copy A copy of the selected annotation or measurement appears on the current image 2 Reposition and edit the new annotation or measurement To copy an annotation or measurement to another image 1 Mouse over the annotation or measurement you want to copy It will t
40. bel a spine 1 PA v Enable Scroll Wheel C1 to C7 Cervical vertebrae 1 to 7 T1 to T12 Thoracic vertebrae 1 to 12 L1 to L5 Lumbar vertebrae 1 to 5 j xo i _ o _ S1 to S5 Sacrum vertebrae 1 to 5 Select a series n uw Choose one of the following options uw Gi e re mr a Si ojl y alla ol mie F e On the Tools menu click Label e Click E In the Type section select the type of labeling Text only or Text and Arrow Text only Text and Arrow T11 In the Scope section select how the application should apply the labels e One Image Select this option if you want the application to only apply the labels to the current image e All Images Select this option if you want the application to apply the labels to all images within the series Choose one of the following e Select the Enable Scroll Wheel check box if you do not want to preselect the labels This option allows you to access all labels by scrolling the mouse wheel After you select this check box click C1 and click Go Note If you select this option you cannot scroll through the images in the series using the mouse wheel eFilm Workstation User s Guide 57 Annotating and Measuring Images e Click the desired labels to select them Once you are finished click Go x Type Text Only fe Text and Arrow Scope One Image All Images w Enable Scroll Wheel xl mr
41. clear the Allow marker to calculate dimensions automatically check box The Width and Height fields are activated so that you can enter your custom border dimensions Note You can change the upper information font select the Upper information option and select a font from the drop down list To change the lower information font repeat this step with the Lower information option 2 To change the font size clear the Use default size check box This activates the Size drop down list so that you can select a different font size 3 Click OK to save your changes Customizing volume settings The Volume Settings tab in the Edit Properties dialog box allows you to customize your volume and stereo display settings see Viewing 3D images in stereo display mode on page 67 To access the Volume Settings tab 1 On the Edit menu click Properties The Edit Properties dialog box appears eFilm Workstation User s Guide 15 Setting User Preferences Click the Volume Settings tab Edit Properties xX Modality Settings System Preferences Walume Settings Image Markers Template Settings MFA Settings Slice separation for MPA series mm E Initial location of range limit of MPRE from 20 ar ap IY Suppress creation of oblique MPR view 3D Settings T Hide bounding box when not cropping Stereo Settings Angle jo Z Offset 3178 Restore Defaults Cancel Help To customize your stereosc
42. dit Properties dialog box allows you to customize the default image layout for each modality Note This feature is useful for CR skeletal surveys where eFilm Lite loads the images in survey mode You can then follow the procedure outlined in Exploding series on page 42 to move between individual images and the survey mode eFilm Workstation User s Guide 9 Setting User Preferences To change screen layout settings for a modality 1 On the Edit menu click Properties The Edit Properties dialog box appears 2 Click the Modality Settings tab and then click the Layout tab Edit Properties i x Modality Settings System Preferences Volume Settings Image Markers Template Settings Modality MA 7 Layout Advanced Seres AutoFormat Rong Columns fsa ek Image TO AutoFormat Rows Columns Cancel Help Select the required modality from the Modality drop down list Adjust the layout as required Note If you want eFilm Lite to automatically create as many viewports that are necessary to display all the series in an exam select the AutoFormat check boxes 5 Click OK to save your changes Customizing advanced user settings for a modality The Advanced tab in the Modality Settings tab of the Edit Properties dialog box allows you to customize the settings for image display interpolation and tool behavior for each modality To change advanced user settings for a mod
43. e following options e On the Tools menu click Show First and Last Reference Lines eFilm Workstation User s Guide 37 Manipulating Images To display the location of the currently active image 1 Select an image 2 Choose one of the following options e On the Tools menu click Show Current Reference Line e Click Note As you scroll through the images of a series the current reference line on other images changes accordingly You can view the first and last reference lines and current reference line at the same time 38 eFilm Workstation User s Guide Changing image orientation Changing image orientation For both 2D and 3D images the following four procedures can be used to change image orientation Note For additional 3D specific rotation procedures refer to Creating 3D Images on page 61 To flip an image 180 about the horizontal axis 1 Select the image to flip 2 Choose one of the following options e On the Tools menu click Flip Horizontal e Click To flip an image 180 about the vertical axis 1 Select the image to flip 2 Choose one of the following options e On the Tools menu click Flip Vertical e Click To rotate an image 90 counterclockwise 1 Select the image to rotate 2 Choose one of the following options e On the Tools menu click Rotate 90 Degrees Counter Clockwise e Click To rotate an image 90 clockwise 1 Select the image to rotate 2 C
44. e template Note To return the template settings to their default values click Restore Defaults Click OK to save your changes 18 eFilm Workstation User s Guide Chapter 3 Viewing Images A study is a set of related images which can be displayed and manipulated in eFilm Lite You retrieve images stored on CDs and DVDs In this chapter you will learn how to e use the eFilm Lite viewer see Using the eFilm Lite viewer on page 19 e view and arrange a study see Viewing studies on page 20 e select individual or multiple images and series see Selecting images and series on page 25 Using the eFilm Lite viewer The eFilm Lite viewer allows you to select a study to view in the eFilm Lite window To access the eFilm Lite viewer e On the File menu click Search or click E x M RGE eFilm TM Lite Th software Healthcare Copyright 1990 2007 Merge Healthcare All rights reserved This software is protected by copyright law and is used under the terms of the license agreement provided on this COROM lf there is no license agreement please contact Merge Healthcare Getting started 1 Click on the exam you wish to view and click an the View button 2 Move the mouse up and down over an image while holding down the left mouse button to scroll through images 3 Move the mouse left to right over an image while holding down the right mouse button to adjust contrast up and down to adjus
45. eFilm Lite 3 2 Users Guide Veterinary M RGE Healthcare This document has been prepared by Merge OEM for its customers The content of this document is confidential It may be reproduced only with written permission from Merge OEM Specifications contained herein are subject to change and these changes will be reported in subsequent revisions or editions It is prohibited to use the software described in this document as a substitute for the knowledge skill and experience of the competent medical personnel who are its intended users eFilm Workstation and eFilm Lite are trademarks of Merge OEM The names of other products mentioned in this document may be the trademarks or registered trademarks of their respective companies Copyright 2009 by Merge OEM All rights reserved Unauthorized use reproduction or disclosure is prohibited Merge OEM 6509 Airport Road Mississauga ON Canada L4V 1S7 Tel 1 905 672 2100 e Fax 1 905 672 2307 Toll free in North America 1 800 724 5970 Part Number 2009 01820 Rev 1 0 eFilm Lite User s Guide ii Considerations prior to use The software is not intended to replace the skill and judgement of a qualified medical practitioner and should only be used by people who have been appropriately trained in the software s functions capabilities and limitations The user should be aware of the limitations in the accuracy and correctness of the output data displayed on
46. eeeseeseeeseeeseceeeeseeeseeaes 52 DT AW pa ode ina 4 0 IRONIE RER RR RE NES RI RARA DR N SR a te a Sa SR ERE 53 Displaying angle measurements cena nenea enaenaenaaenee 53 Copying annotations and measurements 2 0 0 nenea eneeenae na enaee 54 ANDRA TINS TACOS sorin sui A tii aa ea E 55 PEO DIAG TIA e e NIRO RE IRA IRI SR DR DI RR E RR RN ED DOI ONCE PRR e 56 Labeling a Sp UE issa oo si arcade deo Data aie dar nui aia aa 57 Clearine Measurements e esis iosaensoresnctaltaaanest Dea to dela ela aid 59 Creating 3D Images DIINO CS zis late automobile dt led ei da 61 NSIS Ol MMAR OS INI TE ROC RR A R 62 Creatine SAM AES eio inta lana Bt aflat ta alta 62 Adjusting loading parameters for 3D volumes sses 64 CrOppIinie 9 DV ONLINE Saca etosul BC it tul iti lada 65 vi eFilm Lite User s Guide Chapter 8 Chapter 9 Rotating SD VOLI ES isaac ca ea cance dates eg a pad 00 a al Do ab 66 Viewing 3D images in stereo display mode cecene 67 Using the black outside window setting 0 0 cee eeeeeseeeeeeeeees 67 Adjusting mapping settings for 3D volumes seese 68 Lea UL UVTI VIC WS shared cuie oaks cate tants aus cen le ai ao Rabi 71 Creating Orthogonal MPR viewing planes eee 72 Creatine MPRS from 2D image Seanair aaa 73 Creating MPRS from 3D volumes nice ao dela dauna e ea due 73 Interacting With MPR Series ic pavat toata ea at di 74 Acljui stiti the MER VIEW au ceia catusi aaa lalea a ua 74 Creatine
47. eferences are set click Create The Save As dialog box appears Select the directory to which the volume will be saved and enter a filename The new AVI file is saved to this location If you wish to view the AVI volume at this point click View Note When you open the AVI file in Windows the volume will play automatically on your computer s default media player Printing images You can print images on a regular printer To print images to a paper printer 1 Select the images you want to print by clicking the image marker in the lower right corner of the image The marker fills in orange On the File menu click Print Format and select a page layout Tip You can preview the print job by clicking Print Preview on the File menu On the File menu click Print to begin printing the images 82 eFilm Workstation User s Guide Chapter 9 Creating an eFilm Lite CD This section describes how to create an eFilm Lite CD This section also includes a description of the DICOMDIR file structure and a listing of the files required to run eFilm Lite Note You must have the ability to create a properly formatted DICOMDIR file set in order to create an eFilm Lite CD In other words your process or software must be able to act as a File Set Creator in the General Purpose CD R Interchange profile STD GEN CD for both the Basic Directory and Composite Storage amp Stand alone Storage categories For more informati
48. erstand the layout of the eFilm Lite workspace see eFilm Lite window on page 2 e customize the eFilm Lite toolbar and access the Mini bar see Using the toolbar on page 3 e understand the functions of the tools in the eFilm Lite toolbar see Using tools on page 4 System requirements This section describes the hardware and software required to run eFilm Lite Required hardware eFilm Lite must run on a computer that meets the following hardware requirements e Pentium II processor e 256 MB RAM e Minimum display resolution 800 x 600 When choosing computer hardware users should note that the most substantial performance gains result when RAM is increased In order to prevent poor performance of the software Merge Healthcare does not recommend that eFilm Lite be run on a less powerful system than that listed above Required software and operating systems eFilm Lite requires the following software programs and operating systems in order to operate properly e Windows 2000 Windows XP Professional or Windows Vista eFilm Lite User s Guide Chapter 1 eFilm Lite Overview Note Windows 95 Windows 98 and Windows NT are no longer supported by Merge Healthcare e Microsoft Internet Explorer IE 6 0 or higher Required hardware for 3D volume rendering A video display adapter with at least 128 MB of video RAM that fully supports DirectX 8 1 or later Refer to the product help files and the
49. esolution Using 3D images This section describes how to create configure and manipulate Maximum Intensity Projection MIP volume rendered and Simgram images In this section you will learn how to e create a 3D image see Creating 3D images on page 62 e adjust the loading parameters for 3D images see Adjusting loading parameters for 3D volumes on page 64 e crop 3D images see Cropping 3D volumes on page 65 e rotate 3D images see Rotating 3D volumes on page 66 e view 3D images in stereo display mode see Viewing 3D images in stereo display mode on page 67 e set all pixels outside the conventional window to black see Using the black outside window setting on page 67 e adjust mapping settings for volume rendered images see Adjusting mapping settings for 3D volumes on page 68 Creating 3D images This method allows you to create an MIP volume rendered or Simgram image as a 3D volume To create a 3D image 1 Select the required series 2 Choose one of the following options e On the Tools menu click View 3D Options The View 3D pop up menu appears 62 eFilm Workstation User s Guide Using 3D images 3 Select either MIP Volume or Simgram Image as the 3D mode The Advanced Volume Loading dialog box appears Advanced volume Loading E X Slice Info Index 14 PR Position 26 58 5 W Include in volume Seres Subset From f
50. ettings dialog box appears Color Opacity Settings X Jim 1567 Zoom Pan gt B W Setting Click the or buttons to zoom in or out on the graph and the lt or gt buttons to pan left or right Load Presets Opacity 0 Save Presets Add Preset Sharpness 10 Add Preset Delete Preset Left Bound z JAbdomen_Skin Right Bound 891 Bands 5 Note The Pan options become available once you zoom in Select the number of bands for the series Bands define the range of values in a data set to which specific colors can be assigned This is useful in highlighting different types of tissue for diagnostic purposes The number of bands is limited to 20 68 eFilm Workstation User s Guide Using 3D images 5 Select a band range between the blue dashed lines The current range bounds appear in white Double click the selected range The Color dialog box appears Select a basic color or create your own custom color to use as the new color mapping To create a custom color use the color selector on the right or adjust the RGB values directly and then click Add to Custom Colors 9 Click OK to save your changes or click Cancel to exit without saving any changes 10 Adjust the Left Bound and Right Bound values by entering them manually or using the spinbox arrows These values define the boundaries for each band range 11 Adjust the Opacity and Sharpness values b
51. ffset in the images you can manually synchronize the images see Synchronizing series manually on page 31 synchronizing series manually This method allows you to perform synchronization manually If the new series is from a different patient or study than the original you can still perform manual synchronization if the series are related To manually synchronize series of the same plane 1 Scroll through each series and display the images you want to synchronize 2 Choose one of the following options e On the Tools menu click Manual Series Synchronization e Click Locating points in 3D space The 3D Cursor tool allows you to locate a point in space in all planes To locate a point in space in all planes 1 Choose one of the following options e On the Tools menu click 3D Cursor e Click 2 Right click on any displayed 2D image This same point will be indicated on all other 2D images regardless of the plane by a In order to find the point in another series eFilm Lite may need to display different slices in those series Not all points in the eFilm Workstation User s Guide 31 Navigating Images current images necessarily exist on other series In this case the sign will not be displayed You can drag the point around the image and the corresponding points in the other images will move accordingly You can navigate through the images i e stack cine and you will still see the point in 3D sp
52. he Alpha setting see Adjusting the Alpha setting on page 45 configure the image fusion pipeline see Configuring the image fusion pipeline on page 45 Fusing images from two modality image series You can fuse two series from the same study together to combine CT images with PT images To fuse images from a two modality image series together 1 2 Open a study taken with CT and PT modalities Choose one of the following options e On the Tools menu click Image Fusion e Click The Fusion Series Generator dialog box appears which indicates the progress of the image fusion stage Fusion Seres Generator x Preparing fusion series Loading image information Ea Once generated the fused series appears in the right hand pane of the main window while the background series appears in the left hand pane and the foreground series appears in the middle pane Note The default settings of image fusion are that the PT images appear in the foreground and CT images appear in the background eFilm Workstation User s Guide Using image fusion Adjusting the Alpha setting The Alpha setting determines the blend value for the foreground and background of the fused image To adjust the Alpha setting 1 Choose one of the following options e On the Tools menu click Image Fusion e Click the arrow to the immediate right of The Image Fusion pop up menu appears Select Alpha Blend from
53. he Edit menu Selecting series These procedures allow you to select a single series multiple series or all series in a study To select a single series e Click a series in any pane in the window The border around the selected series turns green To select multiple series e Hold Ctrl and click a number of series in any pane in the window The borders around all of the selected series turn green or in conjunction with a visualization services server Lite 26 eFilm Workstation User s Guide Chapter 4 Navigating Images This section covers selecting and moving through images and series In this chapter you will learn how to e navigate through images in a series see Moving through images on page 27 e navigate through series in a study see Moving through series on page 30 e navigate between studies see Moving through studies on page 30 e synchronize series see Synchronizing series on page 30 e locate points on an image in 3D space see Locating points in 3D space on page 31 Moving through images There are four different ways in which you can navigate through the images in a series e Next Previous Image allow you to move through the images of a series one at a time see Using the toolbar to move through images on page 27 e Scrollbar allows you to either move through images one at a time or easily scroll though the images of a series see Using the scrollbar
54. he volume manually 1 si Choose one of the following options e Onthe Tools menu click Rotate Volume e Click Position the cursor over the volume left click and drag the cursor over the volume The volume rotates in the direction of the mouse movement Release the left mouse button to set the volume at the new rotation To use the preset rotations 1 p Sy Select the volume Choose one of the following options e On the Tools menu click Rotate Volume e Click the arrow to the immediate right of The Rotate Volume pop up menu appears Select either Anterior Posterior Left Right Superior or Inferior to rotate the volume to one of the standard anatomical orientations The cube in the bottom right corner of the image pane shows the current rotation of the volume 66 eFilm Workstation User s Guide Using 3D images Note You can also use the Flip Horizontal Vertical and Rotate 90 Degrees Clockwise Counter Clockwise tools to change the orientation of the image as outlined in Changing image orientation on page 39 Viewing 3D images in stereo display mode By default the rendered volume displays as a monoscopic image Displaying the image in stereoscopic mode removes ambiguity between front and rear anatomical structures All 3D operations can be done in stereo mode including rotating cropping and windowing You will need a pair of red blue anaglyphic glasses to view the stereo display
55. hoose one of the following options e On the Tools menu click Rotate 90 Degrees Clockwise e Click Note These functions are applied to all selected series and images in the selected series To restore the original image orientations click Adjusting image viewing options eFilm Lite includes tools for adjusting the active image view This section shows you how to e pan around an image see Panning on page 40 e magnify an image see Magnifying on page 40 e zoom in and out on an image see Zooming on page 41 eFilm Workstation User s Guide 39 Manipulating Images Panning Panning allows you to position images within the pane This feature is especially useful when the image is larger than the pane as it usually is after zooming To move an image within the pane 1 Choose one of the following options e On the Tools menu click Pan e Click 2 Position the cursor over the image you want to move and click and drag the cursor around the pane to move the image 3 Release the mouse button to drop the image in its new position Note To restore the original image display value except window level click Magnitying Magnifying allows you to magnify an area of interest within a small separate magnification window that moves in conjunction with the cursor To magnify an area of interest 1 Choose one of the following options e On the Tools menu click Magnification
56. iagnosis eFilm Lite User s Guide ili eFilm Lite User s Guide Table of Chapter 1 Chapter 2 Chapter 3 Chapter 4 Contents eFilm Lite Overview VS DSO CONS cotate oana oa este iat aaa lead 1 SP ali LE SAUDI CLOV oreore ne O EER E Ero r Eor 2 Usikae the COON Ai a ta ri ce Gata dada E E TE 3 Moving the toolbar coca gocuiseoa iata dedau add ala ia aifaa 3 CUSLOINIZING the TOOL DAL sssrini rnein dale i 3 Accessing the Mini Bar nenea nenea nene ennae ne enaeee 4 USG OO NS autointitulat loga i si 4 DVI Ei IE DC zicea atata aaa tera uct dia art detasat acacia 5 OTANI OTOL Sects ter hee eset yc E O II IO MN ISA IN RR 5 NextPrevious 10015 a seaca taca vana e redirectat du aut 6 Measurement LOOMS ssie ela lata la dida 6 M l plinar 010 lS etate aaa oaia Aa aber atlet tie a ta 7 Image Manipulation tools se c nea act nea oda balan lait 7 VORE TOO aenea E eliade aut 8 Setting User Preferences Customizing modality settings eeeseeseseseeereserserrersesrerresresrrsresersresess 9 Changing modality LA VOUS srira pata unt A 9 Customizing advanced user settings for a modality 10 Customizing system preferenc s seriinin eni 13 DSAI T O e E E S 13 Customizing volume seng Sesser nnana luati dna rit 15 Customizing template Settings sirrini enr an nE oaza iad 17 Viewing Images Usine the eril LIIE VIC WEL ana m aan iz ant r 9 az a Oa fi 19 Customizing the eFilm Lite viewer
57. ick Adjusting series viewing options eFilm Lite includes tools for adjusting the selected series view This section shows you how to increase or decrease the size of the image panes used to display a series see Exploding series on page 42 Exploding series The explode mode changes the layout of a selected series so that it fills the entire main window while the survey mode reverts to the original series display This function is especially useful for skeletal surveys or any study that has multiple series 42 eFilm Workstation User s Guide Adjusting series viewing options To explode the series 1 Select the required series 2 Choose one of the following options e On the Tools menu click Toggle Survey Explode Mode e Click 3 The selected series explodes to fill the entire main window Note To return to the survey mode click again The same functionality can be achieved for images within a series Select an image and double click it so that it fills the entire series pane Double click it again to return to the survey mode eFilm Workstation User s Guide 43 Manipulating Images Using image fusion eFilm Lite assumes image sets are registered in space they will not adjust position to ensure alignment This section shows you how to fuse images from a two modality image series together see Fusing images from two modality image series on page 44 adjust t
58. ine tool 1 rA Select the series you want to view Choose one of the following options e On the Tools menu click Cine e Click The Cine Control Bar dialog box appears Cine Control Bar Slower Faster Shuffle al a i Volume Eine Botation Aws Sweep Angle zc AE Ea Ty Aris Step Size E TZ Avis I Tumble Export to ii Adjust the speed of the cine using the slider Select the play mode Loop repeatedly displays the sequence from the first to the last image in a series Shuffle moves back and forth through the images between the first and last one in a series eFilm Workstation User s Guide 29 Navigating Images 5 Click m to move forward to move backward or to stop the cine Moving through series You can move through different series of images using the Next and Previous Series tools Note You can also right click on any image to open a pop up menu from which you can select the required series To go to the next series in an open study e Choose one of the following options e On the Tools menu click Next Series e Click To go to the previous series in an open study e Choose one of the following options e On the Tools menu click Previous Series e Click Moving through studies After viewing a study you can go to the next or previous study in your Local Exams list To go to the next study e Choose one of the following options
59. ing these images using DirectX 8 1 To apply window level presets 1 2 Select the required series Click the arrow to the immediate right of e The Window Level pop up menu appears Note The Window Level pop up menu differs per modality Select a preset from the menu Alternatively you can use the Function keys as specified in the menu at the top of the keyboard or press F2 to scroll through all the window level presets Available presets Chest Abdomen Pelvis Lung Brain Bone Head Neck Low Contrast Medium Contrast and High Contrast Abdomen Pelvis T2 Brain Head Neck Spine Abdomen Pelvis T1 Specifying custom window level values You can specify custom window level values using the following procedure To specify custom window level values for a series 1 2 Select a series Choose one of the following options e On the Tools menu click Window Level Options e Click the arrow to the immediate right of The Window Level pop up menu appears Select Custom from the Window Level pop up menu The Custom Window Level control bar appears Adjust the Window and Level values by using the spin arrows or by entering the values manually These specifications will appear in the lower left hand corner of each pane e g W 50 L 100 Click Apply to save the changes or click Cancel to exit without saving any changes Note Custom specifications only apply to the selected series eFi
60. ins multiple orientations or phases select a different orientation or phase to use to create the volume 2 Select a different Interpolation Level to use to create the volume By default Auto is selected This option automatically selects the best interpolation pixel spacing that can be handled by your current memory availability 64 eFilm Workstation User s Guide Using 3D images Note The Memory Required box displays the memory required to load the volume with the currently selected slices and interpolation settings Compare this value to the Memory Available box which displays the total memory currently available on your system If the Memory Required exceeds the Memory Available you cannot load the volume using the current settings In this case you must reduce the number of slices you are attempting to use Select the sort by Acquisition Cropping 3D volumes Cropping allows you to crop a volume in all three dimensions This feature allows the user to identify a volume of interest and remove the other parts of the volume from the display To crop a volume l Choose one of the following options e On the Tools menu click Crop Volume e Click Using the sides of the blue volume cube as your cropping planes position the cursor over the edge of the cube you want to crop Click and drag the cursor in the direction you want to crop Release the mouse button to set the new boundary of the cropped volume cube
61. it menu click Properties The Edit Properties dialog box appears 2 Click the Template Settings tab Edit Properties A sul x Modality Settings System Preferences Volume Settings Image Markers Template Settings Template Colors Template oe Drop Shadow RI Change Selected Change Rotation Axis L Change Locked Change Attachment Pointa sd Change selected amp Locked Cd Change Connected Point Charge e Show rotation aris e Show attachment points he Show drop shadow Restore Defaults OF Cancel Help To customize the template display colors 1 Click Change beside the template color you want to customize The Color dialog box appears 2 Select a basic color or create your own custom color to use as the new template color Note You can create custom colors either by using the color selector on the right or by adjusting the RGB values directly Once you have created a new color add it to the Custom colors list by clicking Add to Custom Colors 3 Click OK to save your changes eFilm Workstation User s Guide 17 Setting User Preferences To customize the template display properties 1 2 Select the Show Rotation Axis check box to display the rotation axis of the template Select the Show Attachment Points check box to display the attachment points of the template Select the Show Drop Shadow check box to display a drop shadow in th
62. k anywhere on the measurement caption and drag it to a new location Note A line that appears in blue indicates that the line is selected and can be manipulated An unselected line appears in orange Making elliptical measurements The Ellipse Measurement tool allows you to measure the area of a region of interest ROI WARNING Measurements performed on CR DX and MG images may be inaccurate unless you calibrate the measurement tools see Calibrating images on page 55 To make an elliptical measurement 1 Choose one of the following options e On the Tools menu click Measurement Tool Ellipse e Click 2 Position the cursor at the starting location and right click and drag the cursor to the ending location 3 Release the mouse button An ellipse with Area Mean and Standard Deviation measurements appears in blue Area 17 6 Sq cm Mean 149 1 Std Dev 3 3 E a You can stretch or move the ellipse to a new location You can also move the measurement caption to a new location To stretch the ellipse e Left click one of the corner markers and drag and drop it to a new location To move the ellipse e Left click anywhere on the ellipse and drag and drop it to a new location The ellipse will turn blue and the cursor will change to a four pointed arrow when the mouse is in position to move the ellipse To move the measurement caption e Left click anywhere on the measurement captio
63. line changes color from orange to green 2 Drag and drop the line to the new location Princess Margaret Hospital Autre Mac hi 28520 Ace 40074 2002 Jun 10 Acg Tm 1 O44 11 i Mag 0 9 a 512 x512 STAN DAR D af L 140 0 kV 250 0 mA 5 0 mm Tilt 0 0 i if ET 1 7 8 GP LE s TS 7 50 mms SPF Lin Ly d Lin Dii Id ID WADO L40 ag i DFO 23 4 x 23 4cm Creating MPR views eFilm Workstation User s Guide 75 Creating 3D Images Adjusting the MPR range 1 Left or right click anywhere on one of the range lines the dotted lines on either size of the MPR line The line changes from orange to green 2002 Jun 10 Acg Tm 1 0 44 11 Mag DB 140 0 ki 250 0 mA 5 0 mm Tilt 0 0 ET 1 7 8 GP 0 8 s TS 7 50 mms SPR Lin DCM Lin DCM ld ID W400 L 40 BF DFOW 23 4 x 23 4c n Princess Margaret Hospital 2002 Jun 10 Acg Tm 1 0 44 11 i 512 x12 STANDARD L 140 0 kV 250 0 mA 5 0 mm Tilt 0 0 r ET 1 7 8 GP LE s TS 7 50 mms SPF Lin Ch d Lin DCM Id ID e AADO L A i DFO 23 4 x 23 4cm You can also move the MPR line by stacking through the slices on the MPR view As you stack through the slices the MPR line is dynamically updated to reflect the new viewing plane on the original image 76 eFilm Workstation User s Guide Creating MPR views Creating MPR slabs MPR slabs add depth to MPR slices To create an MPR
64. lm Workstation User s Guide 35 Manipulating Images Using non linear sigmoidal window leveling You can use non linear window leveling to compensate for any inherent non linearities in an image Sigmoidal window levelling applies a wider range to the ends of your windowing range thus giving the image values in the middle range greater contrast and resolution To select non linear window leveling 1 Select a series 2 Choose one of the following options e On the Tools menu click Window Level Options e Click the arrow to the immediate right of The Window Level pop up menu appears 3 Select Sigmoidal from the Window Level pop up menu The non linear window leveling function is applied to the image and is automatically activated setting aloha and beta values The alpha beta tool allows you to adjust the coherence and or black white bias settings of the images in a series To adjust the coherence and black white bias settings of an image or select Tools gt Alpha Coherence Beta Black White Bias 2 Position the cursor over the image to be adjusted and click and drag the cursor left or right over the image to adjust its coherence Alpha 3 Position the cursor over the image to be adjusted and click and drag the cursor left or right over the image to adjust its black white bias Beta 4 Release the mouse button to apply the new value to all images within the series This value is displayed on the lower left co
65. n and drag it to a new location 52 eFilm Workstation User s Guide Drawing Drawing arrows Note An ellipse that appears in blue indicates that the ellipse is selected and can be manipulated An unselected ellipse appears in orange If the measurement caption has been moved independent of the ellipse moving the ellipse no longer moves the measurement caption as well arrows You can draw arrows to point to an area of interest on the image To draw an arrow 1 Choose one of the following options e On the Tools menu click Measurement Tool Arrow e Click 2 Position the cursor at the source the arrow tail and right click and drag the cursor to the destination the arrow head 3 Release the mouse button An arrow appears in green with an annotation box in which you can enter notes aL 4 You can stretch the arrow or move it to a new location To stretch the arrow e Left click either end of the arrow and drag and drop it to a new location To move the arrow e Left click anywhere on the arrow and drag and drop it to a new location Note An arrow that appears in green indicates that the arrow is selected and can be manipulated An unselected arrow will appear in orange When moving the arrow the annotation box does not move with it To move the annotation box click and drag the annotation to a new position on the image Displaying angle measurements Angle measurements allow you to displ
66. n the active series Screen Layout Seres Rows Columns Paf 3 Select a layout for the series image or define the values for rows and columns and click Apply 4 Click OK to close the Screen Layout dialog box Note Different series may have different image formats For example a CT exam with two series one scout one axial may be displayed using a 1x2 series layout Furthermore the images in the scout series may be displayed in a 1x1 format and the axials in a 2x2 format multiple studies Multiple studies can be compared either by preselecting all studies or by selecting additional studies while viewing a study Note The Study Manager window will flag the first selected study with an asterisk To pre select studies for comparison 1 Select the first study from the Local Exams list 2 Press Ctrl and select each additional study When finished selecting release Ctrl 3 Click View to load the selected studies 4 Change the screen layout as required see Adjusting the screen layout on page 23 24 eFilm Workstation User s Guide Viewing non DICOM objects Viewing non DICOM objects If the CD or DVD includes non DICOM objects e g Microsoft Word documents you can view a list of these objects from the eFilm Lite viewer To access these non DICOM objects on the media you must use Windows Explorer and browse to the location of these objects on the CD or DVD To view a list of non DICOM
67. ng window level settings manually seee 33 Using window level presets secs scaanea toi cotata dac a aa alo 35 Using non linear sigmoidal window leveling ee 36 Setting alpha and beta values scccsai agale baia dada aa 36 VN VOT UNS Ma SES estate mai ui Bai ali letale bas i dara dai 36 Overlayine reference MNES savu cana ea oa daia a a a a dada daia 37 Changing image orientation apc canon oct tai 0 poale te e dedat 39 Adjusting image viewing Options nana nenea eee enae na ennaenae 39 PANO dessa NEED II RER PTR E ARD N sac RE ses PRIN RN AREA ee NIC 40 IVE AOU TINO sasa coala 300 die dea aa eases ota ad lu aaa 40 ZOO IILE Sap airs dai Da id otet aa 9 i aut Salata acne 41 Resetting the original image Settings 0 ee eeeeseeeeeeseeeseeeseseseeees 42 Adjusting series viewing Options ou nenea neena ne enae ee 42 Exploding Series arerin aula 3 oa 500 aula oii a aa 42 Using immage TUSION seaca ea ao od aaa 9 Cite ai ae a 44 Fusing images from two modality image series seese 44 Adjusting the Alpha Set cisien 45 Configuring the image fusion pipeline eee eeeeeee 45 SPUNE a SERIES raorto doara Sadat dacia oo od e aiba tate 47 Annotating and Measuring Images VCE Ay INO LEK cass a omecnecas aci alu aa fa E E 49 Puglia oz Meila foaia ps e OPRIRII ORI BRE Re N RE OCR NIN RR n RR RR RR 50 Making linear measurements een nenea nenea ne enannaenaaenne 51 Making elliptical measurements cece eec
68. nt studies and working backward to the oldest studies 2 Select a series from the menu using the left mouse button Note The pop up menu displays all the studies belonging to a patient as long as they are available as local or Image Channel exams that correspond with the Patient ID 3 If the series is currently displayed and you want to move it to another pane hold Shift select the series you wish to move and drag and drop it in a different pane eFilm Workstation User s Guide 21 Viewing Images Viewing study information Study information can be requested while viewing the study Note If confidential patient data is encrypted you can decrypt it by entering the encryption password see Setting the encryption password on page 23 To view study information 1 Open and view a study 2 Click E The Study Information dialog box appears W Study Information xX Patient Hanne PATIENTS WRN fo000005 Age Sex History zoo Jan D Time os 32 23 Description ESOPH Contrast Machine Admitting Diagnosis M D s Technologist Referring MD PHYSICIAN Radiologist fee Performing NI Technologist P 3 Click OK to close the Study Information dialog box 22 eFilm Workstation User s Guide Viewing studies Setting the encryption password You can enter an encryption password that will be required to decrypt confidential patient informati
69. on Using an encryption password prevents unauthorized users from viewing sensitive patient data on your computer Note Currently only the patient name is encrypted To set an encryption password 1 On the Utility menu click Set Password The Encryption Password dialog box appears Encryption Password xX The password pou enter acts az the key to encrypting and decrypting confidential patient information Please remember it Password Confirm P Password Cancel 2 Enter a password and then confirm the password by entering it again Note The length of this password must be at least five characters Note Do not forget your password eFilm customer support cannot retrieve your password 3 Click OK to set the encryption password or click Cancel to exit without setting it Adjusting the screen layout Images that appear on the screen are laid out in a side by side 1x2 grid configuration by default This configuration can be adjusted to suit your preferences To adjust the screen layout 1 Choose one of the following options to access the Screen Layout dialog box e On the Tools menu click Screen Layout e Click eFilm Workstation User s Guide 23 Comparing Viewing Images 2 The Screen Layout dialog box appears The Series layout determines the format of the panes in the window Each pane can contain one series The Image layout determines the format of the images withi
70. on refer to the DICOM Standard version 3 Part 11 To create an eFilm Lite CD 1 Create the DICOMDIR file set including the DICOMDIR Basic Directory file and place them into a temporary directory See DICOMDIR directory structure on page 84 for details on the directory structure of the file set Copy the Autorun inf file into the root of the temporary directory In the temporary directory create a folder called eFilmLite and copy all of the eFilm Lite runtime files into that folder See eFilm Lite runtime files on page 84 for details on the runtime files 4 Ifrequired in the temporary directory create a folder called Other Files and place any additional files you want copied into that folder 5 Write the entire temporary directory contents to the root directory of the CD R eFilm Lite User s Guide 83 Chapter 9 Creating an eFilm Lite CD DICOMDIR directory structure The general structure of the DICOMDIR file set is as follows DICOM PATIENTU STUDYO SERIESO IMAGEO IMAGE1 IMAGE2 SERIES1 SERIES2 STUDY 1 hat Fi 2 a I Tm rr i UJ IF hi Fis Ed iy PATIENT PATIENT2 DICOMDIR eFilm Lite runtime files The following table shows a listing of the files required for eFilm Lite to run and where the files should be located on the CD Note lt ROOTDIR gt is the root directory of the CD Note Ensure that the Autorun inf file is in the root directory of the CD lt
71. on User s Guide 59 Annotating and Measuring Images 60 eFilm Workstation User s Guide Chapter 7 Creating 3D Images This section covers the creation of Maximum Intensity Projection MIP volume rendered Multi Planar Reformatting MPR and Simgram images which allow you to view and manipulate volumes in three dimensional display In this chapter you will learn e about the volume rendering techniques supported by eFilm Lite see 3D modes on page 61 e how to create 3D volumes see Creating 3D images on page 62 e how to create MPR images see Creating MPR views on page 71 Note Some 3D operations require specific hardware 3D modes eFilm Lite includes several 3D imaging techniques e Multi Planar Reformatting MPR reformatting technique that passes a plane through a data set so that you can view the volume along a different direction than that of the original images In effect you can view the image data from different viewpoints without having to rescan the patient Note MPR views are normally only created from a 2D dataset however if volume rendering is not available see below you will be able to create an MPR view from a 3D volume e Maximum Intensity Projection MIP interpolation technique that passes rays through a data set that finds and displays the maximum intensity pixel value along each ray This value is used as the final pixel value for the ray You can rotate crop
72. ooming specifications 1 2 Select the required series Choose one of the following options e On the Tools menu click Zoom Options e Click the arrow to the immediate right of The Zoom pop up menu appears Note You can select one of the preset zoom values or create a custom value Select Custom from the Zoom pop up menu The Custom Zoom control bar appears eFilm Workstation User s Guide 41 Manipulating Images 4 Adjust the zoom value either by using the spin arrows or by entering the value manually 5 Click Apply to save your changes Note To restore the original image display value except window level click To set pixel for pixel spacing 1 Select the required series 2 Choose one of the following options e On the Tools menu click Zoom Options e Click the arrow to the immediate right of The Zoom pop up menu appears 3 Select Pixel for Pixel from the Zoom pop up menu The image is adjusted to its true pixel for pixel setting Resetting the original image settings The Reset Image Settings tool restores the original values of an image You can reset the image settings after measuring zooming panning changing orientation annotating or matching field of view However the reset will not affect changes due to filters or window level settings To reapply original image settings e Choose one of the following options e On the Tools menu click Reset Image Settings e Cl
73. opic display settings 1 3 Change the Angle value to increase or decrease the strength of the stereo effect Note Increasing the angle increases the shift between the red and blue images Change the Z Offset value to make the stereo volume appear to float in front of or behind the display surface The default value places the stereo volume at the center of the screen s surface Note To return the stereo settings to their default values click Restore Defaults Click OK to save your changes To customize your volume display properties 1 Select the Hide bounding box when not cropping check box to hide the wire frame surrounding the volume when it is not in crop mode Select the Suppress creation of oblique MPR view to keep eFilm Lite from generating this view when Auto Generate MPR is selected Change the Slice Separation for MPR Series mm value to adjust the slice spacing used to create your MPR views Change the Initial location of range limit settings to adjust the default MPR range limits Click OK to save your changes 16 eFilm Workstation User s Guide Customizing template settings Customizing template settings The Template Settings tab in the Edit Properties dialog box allows you to customize your orthopaedic template display colors Note These settings are not applicable to eFilm Lite as the Templates feature is not available To access the Template Settings tab 1 On the Ed
74. or any inherent non linearities in an image use non linear window leveling see Using non linear sigmoidal window leveling on page 36 Adjusting manual window level control sensitivity The sensitivity of the manual adjustment is set by a relative number If the change between window levels is too sensitive and changes too much while you are moving the cursor over the image then lower the sensitivity value If the change between window levels is not sensitive enough then increase the sensitivity value To adjust the sensitivity 1 Choose one of the following options e On the Tools menu click Window Level Options e Click the arrow to the immediate right of The Window Level pop up menu appears 2 Select Sensitivity from the Window Level pop up menu The Window Level Sensitivity control bar appears 3 Adjust the sensitivity value either by using the up or down arrows or by entering the specification manually The specification is a relative number that you define 4 Click OK Note When you change the sensitivity the new value becomes the default and is applied to all images and studies until it is changed again 34 eFilm Workstation User s Guide Setting window level values Using window level presets This method allows you to perform adjustments to window level settings using the presets Note Avoid pressing the window level key presets repeatedly while viewing 3D images unless you are view
75. ound as varying shades of the color specified by clicking Select Color and selecting a color from the Color dialog box e Color Mapping displays the color range of the foreground as varying shades of the color specified by selecting a mapping from the drop down list e g Rainbow Note The colored bar on the right offers a preview of the blend that will be applied to the fused series All settings will be saved in the current user s profile The following table shows the default color mappings and corresponding colored bar that can be applied to the foreground image Color Mapping Color Range Bar HotMetal Rainbow Rainbow16 Rainbow65 Bronson 6 Click OK Note Advanced users can add new color mappings or modify existing ones from the ColourMapping txt file in the installation folder We recommend that you save a backup copy before editing this file 46 eFilm Workstation User s Guide Splitting a series Splitting a series eFilm Lite can split a series that has overlapping images such as a multi phase series into multiple series one series per phase You can set eFilm Lite to do this automatically see Customizing advanced user settings for a modality on page 10 eFilm Workstation User s Guide 47 Manipulating Images 48 eFilm Workstation User s Guide Chapter 6 Annotating and Measuring Images This section describes the annotation and measurement tools which allow yo
76. r grayscale mappings A number of predefined color and grayscale mappings grouped by anatomical regions are available which you can load from the Preset menu To load color or grayscale mappings from the Preset menu 1 Choose one of the following options e On the Tools menu click Opacity Settings e Click The Color Opacity Settings dialog box appears 2 Select the color mapping name from the drop down list and click Load Presets Note If you are using B W Setting the presets displayed will produce grayscale images see Assigning grayscale mappings to 3D volumes on page 69 Editing color grayscale mappings To edit color or grayscale mappings 1 Load the color or grayscale mapping that you want to edit see Loading color grayscale mappings on page 70 2 Click Add Preset The Edit Dialog dialog box appears 3 Modify the Opacity Name and click OK 4 Click Save Presets The color or grayscale mapping is added to the Preset drop down list Note To remove a color or grayscale mapping select it and click Delete Preset 70 eFilm Workstation User s Guide Creating MPR views Creating MPR views Multi Planar Reformatting is a technique that passes a plane through a data set so that the user can view the volume from a different direction than that of the original images In effect you can view the image data from different viewpoints without having to rescan the patient You can create M
77. rner of each image e g A 4 00 B 5 00 Inverting images Inverting allows you to invert the sense in which the brightness of displayed pixels is calculated By default low intensity pixels are dark on the screen and high intensity pixels are bright Using the Invert tool will change this so that low intensity pixels are bright and high intensity pixels are dark Applying this tool again restores the previous pixel intensity setting To invert the color of images in selected series 1 Select the image to invert 2 Choose one of the following options e On the Tools menu click Invert e Click 36 eFilm Workstation User s Guide Overlaying reference lines Overlaying reference lines Overlaid reference lines allow you to indicate the location of an image slice on another image of an intersecting plane Reference lines are only available for CT and MR studies You can show any or all of the following with this function e Location of all image slices of the selected series on all intersecting planes or e Location of the first and last image slices or e Only the current image slice To display the location of all image slices 1 Select an image 2 Choose one of the following options e On the Tools menu click Show All Reference Lines e Click Note The number at the end of each line is the image number To display the location of the first and last image slices 1 Select an image 2 Choose one of th
78. s The controls in this dialog box allow you to preview and fine tune the settings for the video file before exporting the volume Cine Control Bar x Slower Faster al a i Volume Cine Rotation Axis O Axis O Y Axis O Z Axis sweep Angle sa Step Size i l Tumble Export to AX Adjust the speed of the cine using the slider Click to move forward to move backward or to stop the preview of the cine 5 Specify the Sweep Angle degree of rotation and Step Size degrees per frame Note Select the Tumble check box if you want the sweep angle to be 360 6 Select one or more of the Rotation Axis check boxes to rotate the volume about the corresponding axes 7 Click Export to AVI The Volume AVI Creation dialog box appears Volume AVI Creation yg X Compression 100 Dimensions Image Width 256 Image Height 256 Frame Rate Frames Per Second 24 Tatal Running Time 0 75 in seconds 8 Select the compression preferences for Type and Quality eFilm Workstation User s Guide 81 10 11 12 13 14 Exporting Images Specify the Image Width and Image Height dimensions size of the AVI image in screen pixels Select a frame rate the number of images frames that display per second Note The Total Running Time value is calculated according to the frame rate Specify the number of repetitions in the cine Once all of your pr
79. s Guide Clearing Clearing measurements To change the angle of an arrow e You can change the angle of the arrow at any time e To change the angle of an arrow click and either endpoints of the arrow its new position e To insert and change the angle of the arrow at the same time position the arrow head at the desired location then click and drag to draw the angle of the arrow To reposition a label e You can reposition both the location of the arrow and the text annotation e Point your cursor over the arrow or the text annotation e When your cursor changes to ae click and drag the item to its new location To edit a label 1 Double click the text annotation 2 When the background of the text annotation changes from black to white and the cursor is a blinking I beam in the text annotation type the new annotation 3 When you are finished click outside the text annotation measurements If you do not want any measurements on the images of a series you can remove them all at once To delete all the measurements from every image in a series 1 Select a series 2 Choose one of the following options e On the Tools menu click Clear Measurement Tools or Click X To delete a single measurement from the current image 1 Select the measurement you want to remove 2 Right click and select Delete Note To remove the measurement from all images in a series select Delete All eFilm Workstati
80. splayed e Select one of the following options e Minimal displays only the toolbar icons common to all modalities e Standard displays all of the toolbar icons relevant to the modality of the study displayed in the eFilm Lite window e Full displays all of the toolbar icons available in eFilm Lite To customize the size of the displayed toolbar icons e Select one of the following options e Small displays only the toolbar icons common to all modalities eFilm Lite User s Guide 3 Chapter 1 eFilm Lite Overview e Medium displays all of the toolbar icons relevant to the modality of the study displayed in the eFilm Lite window e Large displays all of the toolbar icons available in eFilm Lite To convert the toolbar icons to grayscale e Select Grayscale To automatically hide the toolbar e Select AutoHide Accessing the Mini Bar In addition to the main toolbar you can also use the Mini Bar for quick access to commonly used tools Mini Bar gt ele Sh By default the Mini Bar includes the following six tools Stack Pan Zoom Window Level Measurement Tool Line and Reset Image Settings This tool set is predefined tools cannot be added to the Mini Bar but if you remove a tool from the toolbar it will also not appear in the Minibar i e a tool will only appear on the Minibar if it is part of the eFilm toolbar If the toolbar is customized not to display any of the tools in this set then those
81. t Properties dialog box The following procedures are performed from the various tabs in the Edit Properties dialog box Note Once you have changed your preferences you must re select the study in eFilm Lite for the changes to take effect to the image you are currently viewing Note Your changes will be saved when you exit and your new preferences will be the default the next time that you use eFilm Lite In this chapter you will learn how to e change the default display settings for each modality see Customizing modality settings on page 9 e change your monitor setup see Customizing system preferences on page 13 e specify where and how to display image markers on images see Using image markers on page 13 e specify settings for images displayed as volumes see Customizing volume settings on page 15 e change your template color and display settings see Customizing template settings on page 17 Customizing modality settings The Modality Settings tab allows you to change the default layout window level presets and image display settings for each modality This section shows you how to change e the default layout for a modality see Changing modality layouts on page 9 e advanced image display settings for a modality see Customizing advanced user settings for a modality on page 10 Changing modality layouts The Layout tab in the Modality Settings tab of the E
82. t brightness 4 To view another study click on the Search button and repeat step 1 PatientID Name Accession Modality Description Date 55 JOHNS OMAR CR 2006 05 02 1153 Browse Other Files The pane lists the studies that are stored in DICOMDIR format on your CD eFilm Workstation User s Guide 19 Viewing Images Customizing the eFilm Lite viewer You can customize the eFilm Lite viewer to suit your preferences by re sorting the columns and repositioning the fields in the CD exam list To customize the eFilm Lite viewer 1 Click a header to sort the list according to that heading For example click Name to sort the list alphabetically or click Patient ID to sort the list numerically Tip Clicking the header field again will sort the list in the reverse order Click and hold the header you want to move and drag and drop it to a new location Note These changes cannot be preserved Viewing studies This section provide a general reiteration of those procedures In addition to learning how to view a study this section will also show you how to arrange study series in the main window see Arranging study series in panes on page 21 view information for a study see Viewing study information on page 22 set an encryption password see Setting the encryption password on page 23 change the layout of the screen see Adjusting the screen layout on page 23
83. the Image Fusion pop up menu The Alpha control bar appears See 5 Adjust the Alpha setting by dragging the scroll bar up or down Note Any Alpha setting greater than 50 means more of the foreground image than the background will be contributed to the fused image whereas any Alpha setting less than 50 means more of the background image will be contributed to the fused image than the foreground The blend value will be saved in the current user s profile Click X in the upper right corner to hide the Alpha control bar Configuring the image fusion pipeline You can change the displayed color range of the fused image by configuring the image fusion pipeline To configure the image fusion pipeline 1 2 Select the fused series viewport Choose one of the following options e On the Tools menu click Image Fusion e Click the arrow to the immediate right of The Image Fusion pop up menu appears eFilm Workstation User s Guide 45 Manipulating Images 3 Select Image Fusion Pipeline from the Image Fusion pop up menu The Image Fusion Pipeline dialog box appears Image Fusion Pipeline Foreground PT t CT Method Grayscale C Color Color Mapping HotMetal Specify the foreground as either PT or CT In the Method section choose one of the following options e Grayscale displays the color range of the foreground as white to black e Color displays the color range of the foregr
84. tio I P incida in Volare Senes Subset Fon fi Te E Total E n Ela t a lect a subset of images interpolation Interpolation Levet auto 5 Mema Required ee 2ME Maritap Svadable 1153 5B Corcel The top left window provides a graphical representation of the slice distribution of the series and indicates which slices are available for inclusion in the volume White slices are included red slices are excluded and the green slice is the currently selected slice in the thumbnail display The top right window displays thumbnails of the slices in the series You can drag the slider to browse through all available slices As you adjust the slider to browse through the slices the thumbnail Slice Info and which slice is highlighted in green are updated to correspond with the selected slice To select only a subset of slices to include in the volume 1 In the Series Subset area use the From and To spinners to narrow the range of images that are used to create the volume 2 To exclude only a particular slice instead of a range browse through the available slices until you reach the one you want to exclude Under Slice Info clear the Include in Volume check box 3 Click Reset Selection to return to the default setting of including all the slices in the volume Note The following parameters can optionally be adjusted to improve the result To adjust the loading parameters 1 Ifaseries conta
85. tools will not be displayed in the Mini Bar All of the tools on the Mini Bar can be assigned to either the left or right mouse button except the Reset Image Settings tool To access the Mini Bar e Hold the right mouse button and then click the left mouse button The Mini Bar pops up in the area of the window where you clicked both mouse buttons Using tools eFilm Lite includes a large selection of tools to help you navigate and manipulate study images In this section you will learn about the tools located on the toolbar The tools are grouped as follows e Main access studies see Main tools on page 5 e Common apply to all modality types including window level settings layout settings and other image viewing tools see Common tools on page 5 e Next Previous navigate between studies series and images see Next Previous tools on page 6 e Measurements measure regions of an image see Measurement tools on page 6 e Multiplanar work with MultiPlanar Reformatting MPR images see Multiplanar tools on page 7 e Image Manipulation rotate flip and invert images and related functions see Image Manipulation tools on page 7 e Volume view and manipulate images in three dimensions see Volume tools on page 8 4 eFilm Lite User s Guide Main tools Common tools L m 1 J Ea O e H a sil gt E e LI je b 4 4 Search Stack Window Level
86. u can adjust your MPR view by manipulating the MPR lines see Adjusting the MPR view on page 74 With the original series selected click again to remove these lines and corresponding views 72 eFilm Workstation User s Guide Creating MPR views Creating MPRs from 2D images The MPR tool allows you to create an arbitrary MPR view from a two dimensional image To create an arbitrary MPR view from a 2D image 1 pa Select the appropriate series Choose one of the following options e On the Tools menu click Measurement Tool MPR e Click Position the cursor at the starting location and right click and drag the cursor to define the viewing plane Release the mouse button A line appears in green which represents a perpendicular plane passing through the data set to create the MPR viewing plane Creating MPRs from 3D volumes The MPR Volume tool creates an MPR view from a three dimensional volume Note You can only generate MPR views of a 3D volume if your system does not meet the hardware requirements to support volume rendering Note You cannot enter stereo mode while the volume MPR tool is active see Viewing 3D images in stereo display mode on page 67 To create an MPR view from a 3D volume 1 Follow the procedure outlined in Creating 3D images on page 62 to create a MIP or Simgram image Choose one of the following options e On the Tools menu click Vol
87. u to write on and measure images in a number of ways In this chapter you will learn how to overlay text on an image see Overlaying text on page 49 annotate an image see Annotating images on page 50 make a linear measurement see Making linear measurements on page 51 make an elliptical measurement see Making elliptical measurements on page 52 draw an arrow on an image see Drawing arrows on page 53 measure the angle between two lines on an image see Displaying angle measurements on page 53 copy annotations and measurements to other images in a series see Copying annotations and measurements on page 54 calibrate the measurement tools see Calibrating images on page 55 determine the pixel or Hounsfield value of a point on an image see Probing images on page 56 label a spine see Labeling a Spine on page 57 clear the measurement annotations from an image see Clearing measurements on page 59 Overlaying text Toggling the overlay hides or shows the displayed study information for a series and the scale marker To hide the written study information and scale marker 1 Select a series 2 Choose one of the following options e On the Tools menu click Toggle Overlay eFilm Workstation User s Guide 49 Annotating and Measuring Images LTR FEE LBB FHE HF PEEL UCR LOFCULCGOEREL RC H bitr H dl lia PH bsc Tie Pe I y
88. ull or ribs from the display To zero all pixel values outside the conventional window 1 Choose one of the following options e On the Tools menu click View 3D Options The View 3D pop up menu appears 2 Select Black Outside Window eFilm Workstation User s Guide 67 Creating 3D Images Adjusting mapping settings for 3D volumes You can assign either color and grayscale mappings to 3D volumes as well as load edit and delete mappings of both types Note These settings only apply to volume rendered 3D images not MIP or Simgram images This section shows you how to assign color mappings to a 3D volume see Assigning color mappings to 3D volumes on page 68 assign grayscale mappings to a 3D volume see Assigning grayscale mappings to 3D volumes on page 69 load either color or grayscale mappings see Loading color grayscale mappings on page 70 edit or delete either color or grayscale mappings see Editing color grayscale mappings on page 70 Assigning color mappings to 3D volumes The Opacity Settings tool allows you to assign color mappings to ranges within a CT or MR study This feature is only available for volume rendering it will not function with Simgram or MIP images To assign color mappings to a range in the study 1 PA Select the required study Choose one of the following options e On the Tools menu click Opacity Settings e Click The Color Opacity S
89. ume MPR e Click eFilm Workstation User s Guide 73 Creating 3D Images Note With the original series selected click again to remove the MPR plane and the corresponding MPR view If you want to save the MPR view remove the MPR plane Interacting with MPR series The following notes pertain to creating an MPR view from both a 2D image and a 3D volume e The MPR series that you created are added to the right click context menu for the selected study To view an MPR series right click in an open pane and select the MPR series e If you right click on the series that contains the MPR line and select a different series to load into that pane you will be prompted to save or delete the corresponding MPR as a series view e If you close the study prior to saving the MPR series the MPR series will be lost and will need to be recreated when you reopen the study e You can adjust your MPR view by manipulating the MPR lines for 2D images or by manually rotating the plane independent of the volume by highlighting the plane to select which item you want to rotate for 3D volumes For details see Adjusting the MPR view on page 74 e You can adjust the slice separation used to create your MPR view on the Volume Settings tab of the Edit Properties dialog box see Customizing volume settings on page 15 Adjusting the MPR view Each of the two MPR views is represented by three lines the MPR line itself and
90. urn blue once you can select it 2 Right click and select Copy To All The annotation or measurement should now appear on all images in the series Note By default Move All is selected In this mode moving an annotation or measurement on one image will move it on all images in the series Select Move to be able to adjust annotations or measurements individually If you reselect Move All the other images in the series will be changed to match the current image 54 eFilm Workstation User s Guide Calibrating images Calibrating images Calibrating allows you to manually specify the image pixel size for images which are not automatically calibrated or which you want to recalibrate due to magnification errors Only CT and MR studies are automatically calibrated accurately all other studies should be calibrated manually WARNING Measurements performed on CR DX and MG images may be inaccurate unless you first calibrate the measurement tools To calibrate an image 1 Select the image you want to calibrate and follow the procedure outlined in Making linear measurements on page 51 to create a line overlaying a bit of the scale to the right of the image Count how long the line is according to the scale in this example the line is 4 hashmarks long Note Ultrasound image scales correspond to 1 cm between each hashmark Select the line by right clicking anywhere on it The line appears in blue
91. y This method allows you to perform manual adjustments to window level settings quickly and easily Adjusting brightness The level setting controls the brightness of an image To adjust the brightness of an image 1 Choose one of the following options e On the Tools menu click Window Level eFilm Workstation User s Guide 33 Manipulating Images o From here you can adjust the brightness of the selected image 2 Position the cursor over the image to be adjusted and right click and drag the cursor up or down over the image 3 Release the mouse button to apply the new values to all images within the series These values are displayed on the lower left corner of each image e g W 33 L 777 Adjusting contrast The window setting controls the contrast of an image To adjust the contrast of an image 1 Choose one of the following options e On the Tools menu click Window Level From here you can adjust the contrast of the selected image 2 Position the cursor over the image to be adjusted and right click and drag the cursor left or right over the image 3 Release the mouse button to apply the new values to all images within the series These values are displayed on the lower left corner of each image e g W 33 L 777 Note To achieve a finer resolution with window leveling use the arrow cursor keys up and down to adjust brightness and right and left to adjust contrast To compensate f
92. y entering them manually or using the spinbox arrows Opacity illustrates the intensity of the color value Sharpness illustrates the clarity of the color value 12 Click the X in the upper right hand corner to close the Color Opacity Settings dialog box The image is updated according to the new color mapping Note To save these settings to the Preset menu follow the procedure described in Editing color grayscale mappings on page 70 Assigning grayscale mappings to 3D volumes The Opacity Settings tool allows you to assign grayscale mappings to ranges within a CT or MR study This feature is only available for volume rendering it will not function with Simgram or MIP images To assign grayscale mappings to a range in the study 1 Select the required study 2 Choose one of the following options e On the Tools menu click Opacity Settings e Click The Color Opacity Settings dialog box appears 3 Click B W Setting The Grayscale Opacity Settings dialog box appears Grayscale Opacity Settings X Window Level Window 860 Level 923 E Invert Auto Opacity Setting DICOM Setting Load Opacity Preset Save Opacity Preset Opacity Slope 430 Ne Delete Preset Position 1204 i 27296 Invert 46domen_Muscle oe ne ali Eira Sensitivity 22 Color Setting 4 Click the or buttons to zoom in or out and the lt or gt buttons to pan left or right Add Preset E Note

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