QIvus 3.0 User Manual
Contents
1. Qivus 3 0 Quick Start Manual February 4 2015 9 08 250 30 2 v3 0 Legal Notices Copyright Notice 2010 2015 Medis medical imaging systems bv All rights reserved This manual is copyrighted and is protected by worldwide copyright laws and treaty provisions No part of this manual may be copied reproduced modified published or distributed in any form or by any means for any purpose without prior written permission of Medis medical imaging systems bv Permission is granted to freely print unmodified copies of this document as a whole provided that copies are not made or distributed for profit or commercial advantage Trademark Acknowledgments Qlvus is a registered trademark of Medis Associated BV in the United States and in other countries iMap is a trademark of Boston Scientific Corporation VH and Volcano are registered trademarks of Volcano Corporation in the United States and in other countries Infraredx is a registered trademark of InfraReDx Inc TVC Insight Catheter TVC Imaging System and Chemogram are trademarks of InfraReDx Inc ST JUDE MEDICAL ILUMIEN OPTIS and the color gold are trademarks of St Jude Medical or its affiliates Terumo is a registered trademark of Terumo Medical Corporation Microsoft and Excel are registered trademarks of Microsoft Corporation in the United States and or other countries All other brands product and company names mentioned in this document are trademarks or registered trademark2. present in the images click Artif v You can view the uncorrected images in the Loop View window by clicking PREY Qlvus 3 0 Quick Start Manual 16 Working With Qlvus 6 a k n r If the image run must be corrected for cardiac motion click S diac_ The cardiac motion button will be disabled when the contour detection is started or when the OCT Analysis dialog is opened By default Qlvus creates 16 longitudinal images If you require fewer or more longitudinal images you can re create the longitudinal images before you start the analysis Click L View In the dialog window that opens select the number of longitudinal images you require Click OK 6 2 Performing Segment Analyses A quantitative analysis of a vessel segment of interest provides you with area diameter and volumetric analysis results for an entire segment Open an image run and make sure to start with the pre analysis actions E For detailed instructions we refer to section 3 2 and 6 1 To perform the segment analysis 1 Indicate your segment of interest using the blue segment marker in the longitudinal view You can select and drag the end points of the marker and you can move the entire marker by selecting and dragging the horizontal bar When you edit the position of a marker end point in the longitudinal view the transversal view will automatically jump to the corresponding transversal frame likewise the red cross sectional marke
3. Contour E Exclude or re include the current frame in the analysis Exclude Undo only the last manual transversal contour edit Undo After use the icon it becomes inactive until an additional manual edit is applied Open the Delete Contour dialog window in which you can choose to delete either the selected contour in the current frame or in all frames Delete Qlvus 3 0 Quick Start Manual 10 Working With Qlvus Working With Qlvus 5 Reviewing The large canvas gives you space to review the transversal and longitudinal views which you can tile horizontally or vertically You can also maximize the transversal view or the longitudinal view The following illustration shows a Qlvus window with maximized canvas and vertically tiled views 2 0 DATASETS 4 r T TES 16 For Help press F1 mm Monday July 26 10 15 52 To tile the transversal and longitudinal views e Select Window gt Tile Horizontally or Window gt Tile Vertically To maximize the transversal or longitudinal view e Double click the title bar of the view To return to the standard view click la in the upper right corner of the menu bar 5 1 Reviewing Image Runs When you review image runs you use the movie controls and sliders at the top of the transversal view and the longitudinal view The sliders are used respectively to select frames to change the speed with which the image run is played and to zoom in or
4. N gt Fibrotic Lipidic Necrotic Calcified Frame 10 out of 20 Frame 31 out of 61 VH tissue characterization iMap tissue characterization Qlvus 3 0 Quick Start Manual 23 Working With Qlvus If you are reviewing Infraredx TVC images the TVC Chemogram Analysis will display the Chemogram map in which you can automatically detect the maximal LCBI Lipid Core Burden Index The first of following images shows an example of a transversal view with Infraredx TVC tissue characterization with its chemogram Halo around the gray scale IVUS image In the center of the image inside the catheter artifact you can see the Block Index chemogram circle R ARCHIVE DATASETS TES TDATASETS STUDY DATA QIVUS INFRAREDX INFRAR F a gt J J R ARCHIVE DATASETSATESTDATASETS STUDY DATA QIVUS INFRAREDX INFRAREDX_VALIDATION CASE3 UNSPECIFIED8_UN K lal Frame 1539 out of 2389 F Frame out of 16 The second image shows an example of the longitudinal view with Infraredx TVC tissue characterization with in the middle of the image the Block Index chemogram bar that corresponds to the Block Index chemogram circle The colored bars at top and bottom of the image correspond to the chemogram Halo in the transversal view To view tissue characterization 1 Open the image run with tissue characterization In the File Browser the image run preview is marked iMap VH VH Revo or TVC if tissue characterizat
5. into Qlvus in the Image Subset Selection dialog window With large image runs limiting the number of frames ensures that the image run is loaded quickly and that analyses are performed efficiently You can do this in two ways under Enter Frame Number select a range of frames to be loaded or specify a subset selection number which loads just one frame out of the specified number of frames also known as subsampling In case of long pullbacks it is recommended to load sufficient frames to maintain a slice thickness of 0 1 mm or less If you are loading images with tissue characterization data the data set is limited by default to the frames that show tissue characterization Click OK 5 Qlvus now starts to load the image run and creates the longitudinal images 6 In the General Information dialog window check the DICOM properties Make sure to check the catheter type the pull back speed and the frame rate The correctness of this information is very important because it is used to accurately calculate the volume measurements and all other measurements in the longitudinal view Qlvus 3 0 Quick Start Manual 4 Introduction The changes you make to the DICOM properties are only stored with the Qlvus analysis results not in the original DICOM file Your changes are stored with the current analysis and shown in reports Click OK to close the General Information dialog window 9 For easy comparison it is possible to op
6. 020022204 38 Qlvus 3 0 Quick Start Manual Vil Introduction Introduction 1 About Qlvus Qlvus is the Medis software solution for reviewing and analyzing IVUS and OCT studies of the coronary arteries Qivus enables you to view and analyze both IVUS and OCT studies including tissue characterization as performed by the data provider Qlvus currently supports Boston Scientific Corporation s iMap Volcano VH Virtual Histology IVUS and Infraredx TVC True Vessel Characterization tissue characterization The tissue characterization and OCT features are only active in Qlvus if you have the appropriate license s For IVUS studies Qlvus features rapid automatic detection of lumen stent and vessel borders over the entire pull back run as well as powerful and intuitive editing which saves you valuable time Analysis results not only include 2D measurements but also provide 3D data lumen stent and vessel volumes You can print the results in a one page report or export them for further analysis For OCT studies Qlvus features fast automatic detection of lumen contours semi automatic detection of stent contours and manual detection of stent struts You can export stent strut data for further analysis Qlvus 3 0 Quick Start Manual 1 Introduction 2 Support For quick and easy Qlvus support you can go to the menu bar on top of the program click Help and choose one of the three options 1 UserManual for a
7. Tab To start the automatic stent strut detection in the target segment click All frame strut detection in the Struts box The struts are detected in all frames of the target segment of the transversal view 9 You can also detect stent struts in the current single frame Click Single frame strut detection to detect the stent struts in the current frame The first Single frame strut detection needs preprocessing and therefore will take almost as much time as the All frame strut detection However all next Single frame strut detections will go very fast Qlvus 3 0 Quick Start Manual 29 Working With Qlvus 4 All the detected stent struts are listed in the Struts table To manually add edit and delete stent struts 1 Click T and select the Stent strut points Tab 2 Use the Frame slider to scroll through the image run in the transversal view Browse to the image that you want to analyze 3 To adda stent strut marker point click Add struts manually in the Struts box of the Stent struts points Tab then click to place the new point or points in the transversal image Middle or right click to accept your strut point edits yellow color becomes light green 4 To edit the position of a stent strut marker point select the target point in the transversal image color becomes yellow and drag it to a new position Middle or right click to accept your strut point edits color becomes light green The t contour type needs to be
8. You can export your Qlvus results to Microsoft Excel for further analysis 1 Ls Click Eel This starts the export process and opens the Save As dialog window Type a name for the XLS file in the dialog window and click OK This creates the MS Excel spreadsheet and displays it By default the XLS file is saved in the corresponding analysis image subfolder in the Analysis Storage Folder 9 To make it easier to retrieve the saved XLS file you can select a different folder location in the Save in box Qlvus 3 0 Quick Start Manual 35 Troubleshooting Troubleshooting My Image Browser is slow When you click on a folder in the directory structure the Image Browser is immediately going to search for all files which Qlvus can open in all subfolders Therefore clicking on a folder high in the directory structure can make the Image Browser slow You can prevent this by clicking the and signs in the directory structure in order to go down through the folder structure See section 3 2 on page 3 My directory structure is not displayed In the Image browser you will see the directory structure If this is not present you should click Folders to display it See section 3 2 on page 3 How can I see the original dataset Open the Loop view mode The Loop view mode shows the non skipped and non filtered image run See section 5 1 on page 11 How can I change the scroll step In the settings you will find the option to se
9. a redetection of the longitudinal contour whereby the new longitudinal contour is obliged to go through all the added attraction point s a global editing effect You can take full advantage of this powerful editing option by starting with the longitudinal segment part that deviates most from what you expected Make sure to start in the middle section of this deviating part of the segment It is not necessary to extensively edit the transversal attraction points Make sure that the longitudinal areas that are most off are corrected Click Trans This detects all the transversal contours in the segment of interest 9 Click Sde when you only want to detect a single transversal contour in the segment of interest Review the transversal contours in the entire segment You can do this in three ways 1 drag the Frame slider in the transversal view 2 review the area graph in the longitudinal view or 3 click the arrow next to l and select e g Smallest vessel area in segment and then Largest vessel area in segment Edit the contours in the transversal view if needed gt For detailed instructions on editing contours we refer to section 6 3 To ensure that the analysis results are accurate all automatically detected contours must be reviewed and edited where necessary If needed repeat steps 4 through 9 to obtain analysis results for the stented area and for the lumen area 9 If you want to view tissue characterizatio
10. contains all the struts without a descriptions So when the struts are not labeled at all the None Number is equal to the Tot nr of struts Vice versa when all struts have a label the None Number is zero Qlvus 3 0 Quick Start Manual 33 Working With Qlvus 9 Creating Reports You can print a one page report for inclusion into a patient s file The report contains patient and Study details and analysis results It also provides fields for comments approval signature and date To print a one page report e Select File gt Print to open the Print dialog window Or e Click P tt to directly print the one page report You can customize how some of the image elements are displayed in images in the one page reports and in the MS Excel reports You can modify the colors used for the vessel lumen or stent contours and for the slice indicators that mark the proximal target and distal slices in the image You can also change the thickness of the contour lines and hide any of the detected vessel lumen or stent contours or show the slice indicators The changes you make only apply to the currently selected image run To customize image display in reports 1 Select Options gt Print Options 1 In the IVUS Print Options dialog window remove the check mark from the Visible check box for the Vessel Contour Lumen or Stent options The slice indicators that mark the proximal target and distal slices are hidden by def
11. e Click Install e Click Close You are now able to see the licenses with their correct expiration date in View available licenses Qlvus 3 0 Quick Start Manual 37 Reference Reference Shortcut Keys When you are working with Qlvus you can use a number of combinations of keys on your keyboard and mouse actions to quickly perform the following tasks ALT P print a one page report with patient and analysis data using the default printer CTRL S save the current image run or part of the current image run as an AVI file or save the currently selected frame as a BMP or JPG file Right click accept edits z5 move back the number of transversal slices defined in 3 gt Scroll Step aa move forward the number of transversal slices defined in 72 9 gt Scroll Step Qlvus 3 0 Quick Start Manual 38 Reference insert a correction point for the currently active contour move to the global minimum in the segment move to the global maximum in the segment move to the local minimum over a length of 21 slices move to the local maximum over a length of 21 slices look for a distal area difference of more than 10 SS I r look for a proximal area difference of more than 10f move to the slice with the maximal in stent re stenosis move to the slice with the minimal in stent re stenosis move to the slice with the maximal plaque area move to the slice with the minimal plaque area CTRL T rotate the
12. frames per second and your protocol or standard operating procedure Click OK This closes the Settings dialog window When you next use the Z and X keys or the left and right arrows on your keyboard the specified scroll step is applied To zoom in Drag the Zoom slider in the transversal longitudinal or loop view to the right Qlvus 3 0 Quick Start Manual 13 Working With Qlvus To zoom out e Drag the Zoom slider in the transversal longitudinal or loop view to the left To pan the image When the transversal longitudinal or loop view image is zoomed in you can re position pan the image in the image viewer to make sure the target area remains well in sight e Click somewhere in the image move the cursor hand to pan the image release to accept 5 2 Adjusting Contrast and Brightness You can manually adjust the contrast and brightness for the current image run These adjustments only affect the representation on the screen They do not affect the actual image properties or the outcome of the analyses To adjust contrast and brightness e Inthe transversal or longitudinal image click the right or middle mouse button or the wheel button hold the mouse button or wheel button down and drag Drag right to increase contrast Drag left to decrease contrast Drag down to increase brightness Drag up to decrease brightness To return to the original contrast and brightness settings e Double click the right or middle m
13. image in the longitudinal view Qlvus 3 0 Quick Start Manual 39
14. just outside the major ring down artifact Middle or right click to accept Check the whole image run to make sure that no lumen is present within the artifact circle to optimize the automatic contour and OCT stent strut detection results Vice versa enlarge when possible the artifact circle to include e g wire artifacts to prevent the detection of false OCT stent struts The catheter and artifact center points have the same position Repositioning of the artifact center point will result in the repositioning of the catheter center point and circle and vice versa When the catheter center point is correctly positioned there will be no need to reposition the artifact center point The following illustration provides an example In the Calibration dialog window click Ok 4 If the calibration markers are still shown in all images of the image run click Maker Under Horizontal line click Indicate Under Markers check the number of markers specified and correct it if necessary If needed adjust the size of the boxes to be drawn around the markers then click Draw markers This outlines the markers in the images Under Vertical line click Indicate and repeat the steps for the vertical markers Click Remove markers This removes the calibration markers from all images except the first Click Exit to close the dialog window 5 If digital artifact removal has not been performed already and digital artifacts are still
15. out _ l Frame Slider Speed Slider Zoom Slider To play an image run Qlvus 3 0 Quick Start Manual 11 Working With Qlvus Click to start playing the image run This plays the image run until the end of the pull back run and then restarts at the beginning Click Ki to play the image run backward This plays the image run from the end of the pull back run to the beginning and then restarts at the end To play the loop viewer Click PF in the toolbar to open the Loop Viewer window In the Loop Viewer window click This starts playing the image run forward and backward around the current frame shown in the transversal view over a number of frames specified in the settings To close the Loop Viewer window click PFY again 9 The loop view mode may be useful to get a clearer view of the lumen edge and of stent malapposition The loop view mode shows all frames of the original image run in the transversal plane So this is the non skipped and non filtered image run For the loop view mode of the raw OCT image runs click F The raw loop view shows all frames of the original image run in a stack of image lines For comparison with the transversal view the first image line starts at 3 o clock and is followed by the adjacent image line in a counterclockwise order eS KUOLEE uin l u gt IL Frame 67 out of 271 Re
16. selected to be able to edit the stent strut marker point position v Once the stent strut marker points are active i e yellow color you can add marker points or change the position of marker points without accepting them in between When a strut point position is edited from the Struts table the strut list data and order will be updated 5 To delete a stent strut marker point select its Strut nr in the strut list from the Struts table and click Remove strut When a strut point is deleted from the Struts table the strut list order will be updated so there are no gaps in the Strut nrs list 9 You can delete all stent struts in a single frame or in all frames at once Click Remove all struts in frame to delete the stent struts in the current frame or click Remove all struts in all frames to delete the stent struts in all target frames To add stent strut descriptions Strut descriptions are shown in the results pane and in reports By default there are five descriptions to choose from ApposedCovered ApposedUncovered MalapposedCovered MalapposedUncovered and Jailing e Inthe Stent strut points Tab select a Strut nr in the Struts table and then select a description from the drop down list next to the strut list or right click on a Strut nr in the list and select a description in the displayed menu 9 You can modify or add descriptions if needed To do this browse to the Qlvus application folder By default this is C Progr
17. simple explanation on all available Qlvus functions 2 Instruction Movies for a visual explanation on 1 Getting Started 2 Gui amp Buttons 3 Contour Detection 4 Results and 5 More Information 3 About for general package information like the Qlvus version number License Information Legal Notices and Contact Information see also below Medis is committed to offering high quality products and services If you have questions about the software or if you would like to make suggestions for improvements in the software or in the documentation please contact the Medis helpdesk If you contact the Medis helpdesk by e mail mention the name of the software and the version number in the subject field The Qlvus version number is displayed in the title bar North and South America Medis medical imaging systems Inc E mail support medis nl Telephone 1 919 278 7888 working days 9 00 17 00 EST Europe Africa Asia and Australia Medis medical imaging systems bv E mail support medis nl Telephone 31 71 522 32 44 working days 9 00 17 00 CET Qlvus 3 0 Quick Start Manual Introduction 3 Starting Qlvus and Opening Studies 3 1 Starting Qlvus Qivus must be installed and the licensing mechanism must be enabled before you can start For instructions on installing Qlvus and on enabling the license mechanism we refer to the Qlvus Installation Manual To start Qlvus e Double click on your desktop Or e Se
18. the pixels are characterized as belonging to a tissue type and you can mask specific areas If you are reviewing TVC data you can view the chemogram map and crosshair information and you can detect the mxLCBI One of these icons is active if you have the appropriate license if an image run set of the corresponding IVUS manufacturer is loaded and if tissue characterization data is displayed Open the OCT analysis dialog window This icon is only active if you have the appropriate license Open the Loop Viewer window Open the OCT Raw Loop Viewer window Analysis Toolbar a Vessel Indicate that you want to create or edit vessel contours Indicate that you want to create or edit stent contours Indicate that you want to create or edit lumen contours Qlvus 3 0 Quick Start Manual 9 Introduction Detect longitudinal contours in the segment s of interest Long z9 Detect transversal contours in the segment s of interest Trar s oa Detect a transversal contour in a single frame Single Place a correction point and correct the currently active contour in only the current C mert transversal image gt Undo your changes to the positions of the attraction points UndoLong Fal Open a dialog window with analysis results Results i Depending on the analyses performed area volume diameter and tissue results may be presented Fa Hide or show the transversal contour of the selected contour type
19. the right mouse button as your primary mouse button Press and release the right mouse button If you are left handed you may have set the left mouse button as your secondary mouse button Press and release the wheel button or the middle mouse button If you have a two button mouse press and release the left and the right mouse button simultaneously Press and release the left mouse button twice If you are left handed the right mouse button can be used Press and hold down the CTRL key on your keyboard while you click an object Press and hold down the CTRL key on your keyboard while you press O then release both keys This example opens the dialog window for opening a study Typographical Conventions On the Segment tab click Apply File gt Browse for DICOM Double click New analysis Qlvus 3 0 Quick Start Manual Names of buttons fields menus menu options and tab names are capitalized and in bold A sequence of menu options that you select to perform a specific task is indicated by angular brackets Text that you type or that appears on the screen such as file names and file locations is displayed in Courier New Symbols Used Pa e gt O Qlvus 3 0 Quick Start Manual Reference Points to related documentation or to related sections in the document that may be relevant in your situation Tip Provides helpful information or an alternative working method Note Brings additional informa
20. will be permanently deleted Qlvus 3 0 Quick Start Manual 22 Working With Qlvus 7 Viewing Tissue Characterization Qlvus can display tissue characterization overlays in image runs that provide this information Currently Qlvus supports Boston Scientific iMap Volcano VH IVUS and Infraredx TVC tissue characterization Viewing Boston Scientific iMap Volcano VH Eagle Eye IVUS Volcano VH Revolution IVUS and Infraredx TVC data sets requires special licenses Contact your Medis account manager or send a mail to sales medis nl for more information If you are reviewing iMap VH or VH Revolution data sets you can change the level of transparency of the tissue overlay and hide individual tissue types from the overlay In the transversal view you can also add a legend and a pie chart If you are reviewing iMap data sets you can display the confidence level of the tissue types with the brightness of the pixels color If you are reviewing iMap or VH Revolution data sets you can also filter out guidewire pixels low intensity pixels and exclude low or high confidence pixels from the tissue characterization results The following images show examples of a transversal view with Volcano s VH IVUS and Boston Scientific s iMap IVUS tissue characterization respectively C DATASETS DATASETS QIVUS 2 0 DATASETS OLCANO H DEMO DATA CASEG002 ILEGn R ARCHIVEWATASETS TESTDATASETS STUDY DATA QIVUS BOSTON SCIENTIFIC 1 1 49 1 H
21. OCT image run By default St Jude Medical OCT image runs are displayed in gold color You can change this to grayscale or inverted By default Terumo OFDI image runs are displayed in grayscale You can only change this to inverted e Click to open the OCT Analysis Dialog window and select the Stent strut points Tab Go to the View Mode box at the bottom of the window select Grayscale Inverted or Color and then click Close Qlvus 3 0 Quick Start Manual 26 Working With Qlvus 8 1 OCT Analysis Settings To change the strut thickness You can change the strut thickness default 0 0000 mm to make sure that the detected stent contour will be detected at a certain distance behind the stent struts The strut thickness will only influence the location of the stent contour 1 Click to open the OCT Analysis Dialog window and select the Settings Tab 2 Go to the Strut thickness box and fill in a value for the Strut thickness for stent contour position in mm Be aware that changing the strut thickness will have an influence on the stent area measurements To change the interval setting for detection You can change the frame interval for the detection of stent struts stent and lumen contours when these are not needed for all frames 1 Click T and select the Settings Tab 2 Go to the Interval setting for detection box and fill in a value for the Detection interval for stent struts and stent contour and for
22. ady Frame 67 out of 271 The raw OCT loop view The transversal view z5 To adjust the loop view interval click 519 and after Loop interval in the top right corner specify the number of frames forward and backward that you want to view in the Loop Viewer Qlvus 3 0 Quick Start Manual 12 Working With Qlvus To change the movie speed Drag the Speed slider to the right to increase movie speed drag it to the left to decrease movie speed To change image selection Or Or Or Or Drag the Frame slider in one of the views Use M and i kto scroll the image run image for image in one of the views In the longitudinal View drag the red line to scroll through the images of the transversal image run Use the left and right arrow keys or the Z and X keys to step through the images of the transversal image run at a specified interval known as the scroll step By default the scroll step is 1 image by image gt You can modify the scroll step For instructions we refer to the following section Use the arrow up and arrow down keys to step through the images of the transversal image run five images at a time To modify the scroll step To change the number of frames skipped in the scroll step A Click Setting i This opens the Settings dialog window Fill in the scroll step in the Scroll step field in the top right corner The scroll step value can be based upon the pull back speed the number of
23. al calibration and check the catheter and artifact circles Calibr Semi automatically remove calibration markers Automatically remove artifacts Correct for cardiac motion Cardiac Re creates longitudinal images lil Specify the segment s and or subsegments of interest for contour detection and Se za er reporting lil Hide or show the area graph in the longitudinal view Graph Jump to the frame with the minimum lumen area in the selected segment Click the arrow next to this icon to select other types of frames For example you can select the frame with the smallest or largest lumen area in the current segment the largest calcium area in the current segment or the largest area of malapposition in the current segment Export the results of the selected analysis to Microsoft Excel Qlvus 3 0 Quick Start Manual 7 Introduction Open the General Information dialog window in which you can view and edit basic Info details about the patient intervention catheter and stent The changes you make to the properties are only stored with the Qlvus analysis results not in the original DICOM file Your changes are stored with the current analysis and shown in reports gt Open the Settings dialog window T Ea In this dialog window you can specify the scroll step and the loop interval The other settings in this dialog window show the characteristics of the image run as detected by Qlvus The contour detection is o
24. am Files Medis QIvus 3 0 or C Program Files x86 Medis QIvus 3 0 Open the file OCTAnalysis xml and edit it using a XML or text editor to make the necessary changes Qlvus 3 0 Quick Start Manual 30 Working With Qlvus 9 Multiple strut numbers can be selected in the strut list by pressing CTRL discrete selection or SHIFT continuous selection A selected description will be given to all selected strut numbers at once To show or hide stent strut descriptions in the transversal view You can show the stent strut descriptions you have added in the image or hide them again e Inthe Stent strut points Tab click Show Labels in the Graphics box This changes the text on the button to Hide Labels e Click Hide Labels to hide the descriptions from the view Hiding descriptions from the view does not remove them from the results or the report To lock or unlock strut points You can lock the positions of the stent strut points to make them un editable during the stent contour editing process In the Stent strut points Tab check Lock strut points in the Struts box e To enable the editing of the stent strut points un check Lock strut points To detect the stent and lumen contours For the stent and lumen contour detection in OCT images use the OCT specific Detect contour buttons from the OCT Analysis Dialog window for an improved detection amp Although the IVUS longitudinal and transversal contour detection buttons are active
25. arch use only in and is not to be used for diagnostic purposes in the United States VH IVUS Module The VH IVUS module of Qlvus is intended for research use only and is not to be used for diagnostic purposes The VH IVUS module of Qlvus is based on a library that is verified for Intel processors only TVC Chemogram Module The TVC Chemogram module of Qlvus is intended for research use only and is not to be used for diagnostic purposes OCT Module The OCT module of Qlvus is intended for research use only and is not to be used for diagnostic purposes Medis medical imaging systems bv Schuttersveld 9 2316 XG Leiden the Netherlands http www medis nl Medis medical imaging systems bv Medis medical imaging systems Inc Schuttersveld 9 9360 Falls of Neuse Road Suite 103 2316 XG Leiden Raleigh NC 27615 2484 P O Box 384 USA 2300 AJ Leiden the Netherlands Telephone 31 71 522 32 44 Telephone 1 919 278 7888 Fax 31 71 521 56 17 Fax 1 919 847 8817 E mail support medis nl E mail support medis nl Web www medis nl Web www medis nl Qlvus 3 0 Quick Start Manual IV Conventions Used The following conventions are used throughout this manual to indicate mouse and keyboard actions and to refer to elements in the user interface Mouse Click Right click Middle click Double click Keyboard CTRL click CTRL O Press and release the left mouse button If you are left handed you may have set
26. ault Under Print Color you can select another color for the various contours After Line you can select a different contour line thickness 2 Click OK This instantly applies your changes Qlvus 3 0 Quick Start Manual 34 Working With Qlvus 10 Exporting Results You can export the current image run or part of the current image run as an AVI file or export the currently selected image or multiple images as a BMP or JPG file You can export transversal and longitudinal image runs You can choose to save contours with the images and gray scale or tissue characterization images To export an image or image run 1 Select the transversal or longitudinal view to specify image view frames that need to be exported 2 Click Save or select File gt Save This opens the Save As dialog window The directory shown by default is the directory in which the image run is stored Type a name for the image or image run in the File name field select the file format from the Save as type field and click Save This opens a dialog window in which you can indicate if you want to save a single image or the entire image run BMP or JPG or part of the image run or the entire image run AVI You can also choose to save contours or tissue characterization with the images The final file name of the BMP or JPEG image will consist of the noted File name plus the concerning frame number Click Save To export results to MS Excel
27. conventional manual tracing of boundaries which suffers from high intra and inter observer variability Qlvus can be used to control stent placement and to assess in stent restenosis Qlvus software package enables the automatic calculation and the display of various parameters such as areas and diameters in individual slices volumes over the segment of interest Simpson s Rule for the vessel lumen and stent contours plaque and in stent restenosis parameters Qlvus analytical software is intended to support all clinicians i e cardiologists radiologists and referring physicians involved in the assessment of ultrasound images When interpreted by a trained physician these parameters may be useful in supporting the determination of a diagnosis European Regulations Qlvus is qualified as a class Ila medical device It complies with the requirements of the Dutch Medical Devices Decree Besluit Medische Hulpmiddelen Stb 243 1995 and the European Medical Device Directive 93 42 EEC CE North American Regulations 0120 Qlvus has been cleared for market in the United States by the FDA Food and Drug Administration under the provisions of Section 510 k of the Food Drug and Cosmetic Act Qlvus complies with the requirements of the Canadian Medical Devices Regulations and has been licensed as a Class ll medical device Qlvus 3 0 Quick Start Manual HI Limitations iMap Module The iMap module of Qlvus is intended for rese
28. during OCT analysis the user should be aware that the processing of the IVUS and OCT contour detection is very different e g with respect to attraction points kernels contour smoothing etc Therefore it is not advised to use the IVUS contour detection for the OCT analysis Fag The adjust detection parameters of the IVUS g button have no influence on the OCT contour detection e Click T and select the Stent strut points Tab e Click Detect stent contour in the Contours box This creates a spline fit contour through the stent strut markers e Click Detect lumen contour This performs the contour detection and adds the analysis results to the Struts table 9 You can detect lumen and stent contours in multiple frames at once Click Detect all stent contours to detect stent contours in all frames in the target segment that have stent Qlvus 3 0 Quick Start Manual 31 Working With Qlvus struts Click Detect all lumen contours to detect lumen contours in all frames of the indicated segments 9 You can redetect lumen and stent contours again by clicking Detect all stent contour s once more When lumen and stent contours are re detected manual contour corrections will be lost You can re use the indicated correction points when you want to redetect the stent contour s e Inthe Stent strut points Tab check Keep correction points in the Contours box To edit the stent and lumen contours The OCT stent and
29. eee 14 6 Performing Analyses in IVUS IMAGES nenesie eienen nk R EEEE EEO E O K 15 6 1 Pre A NalySiS ACONS sial y xuy a E e yA Wa l 15 6 2 Performing Segment Analyses cccccescccccccceccccensccesecceescceesccessccesescees 17 6 3 zelal COMLOUMS DK KK BK bg escuchar 20 7 Viewine Tissue Characterizatioh cots sl yela ka k rka Kedi beka ka kla kal w k a kw ka ka Kalk Eka ka kua 23 8 Performing Analyses in OCT IMAGES yii 445545532424 yaya a kek W k S wa ku ka Ma M Pk b k win aka a kl b k ka 26 8 1 QCLADA VS S Se L silk n y ya ken w y k n w ka ee W k kla Ke ek Wwe W re e k We kk ee W Wwe tress 27 8 2 Pre Analysis Actions OCT eee xe ee eee ee ee eee ee ee ee eee ee eeeeeeeeeeeeeee se 28 8 3 Performi no3 O0CB Afla yS ES senarna Kan V VD SENA XUM GERA W SA WENA S NENA W M N E SK WD k l 29 9 Creating REDOUUS ay kuc la kab k ub ek Vu b k k mad ARE K kulk k K k a Xu b k k Xu bake b Vu bek k d k a 34 10 EXDBOLLINO RESUS oree ku ah n da A004 000 KERRAN D W DN AE VE KURDAN E 20 AN De camnad es W0 D00 O0 00 A 00K0 35 TROUBLESHOOTING say x y n ya yey naka an G Ea E coy bey 0 k neve dan 40an a n 0 ka 2a y n W k A2 Ab 36 REFERENCE 4 4xayd e k n er an n n qaba a 2E 2051445508052255 00 5522550202014924 202 02550 2n 2580005245554205 5
30. ell Select the longitudinal contour start re tracing the contour in fact you reposition the contour points attraction points and release to accept Because the positions of the corresponding attraction points in the transversal view are changed the transversal contours will be redetected Be aware that the contour edges in the longitudinal view are less easy to read than the contour edges in the transversal view and therefore less easy to edit accurately To delete contours You can delete all IVUS or OCT contour types in the transversal and when applicable in the longitudinal view eS A 8 1 Click esse Stent or lumen to specify the contour type you want to delete lll 2 Next click to open the Delete contour window The opened Delete contour window shows the selected contour type 3 Specify if you want to Delete current transversal contour Delete multiple contours or Cancel When you select Delete current transversal contour the contour of the selected contour type will be removed from the current transversal image When you select Delete multiple contours mark whether you want to delete contours of the selected contour type in the frames of a Subsegment or All contours of the selected contour type in all frames e Incase of a Subsegment fill in the Start and End frame e Incase of All contours it is possible to mark Delete longitudinal contours as well 4 Click Delete contours and the specified contours
31. en multiple pullback at the same time Repeat step 1 to 6 to add additional image runs 3 3 Closing Image Runs r e Click W when you are done reviewing and or analyzing the Image file e During the closure procedure all analysis settings and results are automatically saved In both cases whether it was opened for reviewing or analysis an additional analysis will be added to the existing list of analyses Qlvus 3 0 Quick Start Manual 5 Introduction 4 The Qlvus Workspace and Toolbars The Qlvus main workspace consists of a menu bar a set of toolbars and a canvas that presents the transversal and the longitudinal views MENU BAR Medis Qivus 2 2 6 0 Alpha Varsion RURCHIVEWATASETSITESTOATASETSIS TUDY DATA QIVUSIBOSTON SCIENTIE K LONGITUDINAL VIEW Ready Frame Ook of 16 The version number of Qlvus is displayed in the title bar The name of the user currently logged on to Windows is displayed in the status bar File Toolbar Browse for all types of image data that can be read in by Qlvus and start analysis Browse Close the currently active image file Save the current image run or part of the current image run as an AVI file or save the currently selected frame or multiple frames as a BMP or JPG file Qlvus 3 0 Quick Start Manual 6 Introduction Hide or show the DICOM info Dicom Print a one page report with analysis results Print General Toolbar E Perform manu
32. en the lumen and the struts In the transversal view you can also display lines that run from each stent strut to the lumen e Inthe Stent strut points Tab click Show lumen strut in the Graphics box This adds the lines to the transversal view It also changes the text on the icon to Hide lumen strut e Click Hide lumen strut to hide the lines from the view again To show or hide the strut lines of the area between the struts In the transversal view you can display strut lines that run from the struts to the center of the stent contour e Inthe Stent strut points Tab click Show strut lines in the Graphics box This adds the lines to the transversal view It also changes the text on the icon to Hide strut lines e Click Hide strut lines to hide the lines from the view again To view stent strut statistics 1 Click T to open the OCT Analysis Dialog window and select the Stent strut statistics Tab 2 When stent struts are detected the following data will be shown the Nr of frames with struts the Tot nr of struts and the Average nr of struts per frame 3 When the lumen contours are detected the following data will be shown the Nr of struts with positive distance and the Nr of struts with negative distance 4 When strut descriptions are added the Nr of struts per label table will show the Number of struts per strut description and the Percentage of struts per strut description The strut description None
33. ick on the headings and select or deselect the headings in the displayed menu o You can change the order of the headings in the right hand pane Click a heading slide it to the left or right and release it at its new position Qivus supports DICOM and AVI image runs You are recommended to use only DICOM image runs for analyses as they contain necessary calibration catheter and patient study information If you use an AVI image run you must make sure to enter this necessary data in the General information dialog window 3 Inthe next step in the lower pane select New analysis and click OK or double click New analysis To resume the last analysis select Last analysis in the lower pane and click OK or double click Last analysis To review or continue an older analysis select the analysis in the lower pane based on the date time and analyst name and click OK or double click the analysis of your choice Das location of the new analyses you can select the Image Folder or the Analysis Storage Folder from the drop down menu 9 To save new analyses to a different Analysis Storage Folder click Change Analysis Storage Folder This opens a new dialog window Browse the directory structure and select the directory where you want to store the analyses Click OK The Analysis Storage Folder functionality is not available for raw OCT image data 4 If you are loading grayscale images you can limit the number of frames that are loaded
34. ion is available The following illustrations show examples Preview Preview Qlvus 3 0 Quick Start Manual 24 Working With Qlvus Oo r e 2 When the gray scale images are loaded in Qlvus click MaF bad H or beadTv This displays the tissue characterization in the transversal and longitudinal views If no lumen and vessel contours were previously detected on Qlvus this also loads contours that were created on the acquisition system not applicable for TVC In case the contours were created on the Boston Scientific s iLab system the labels iLab Lumen in red and iLab Vessel in green are displayed in the top left corner of the transversal view In case the contours were created on the Volcano VH IVUS imaging system the labels s5 Lumen in red and s5 Vessel in green are displayed in the top left corner of the transversal view a gt If the tissue characterization is not displayed no lumen and vessel contours from the acquisition system were available Detect lumen and vessel contours in Qlvus first We refer to section 6 2 for instructions To hide or show tissue characterization You can temporarily hide the tissue characterization to view the underlying images e Click 3howIM Shew H or ShewTV to hide the tissue characterization Click the icon again to show the tissue characterization 9 To hide the tissue characterization briefly just press the middle or right mouse to hide and
35. lect Start gt All Programs gt Medis Qivus gt Qlvus 3 0 3 2 Opening Image Runs After starting Qlvus you open the image run that you want to analyze in the two step File Browser as follows To open an image run al az 1 Click P or select File gt Browse for DICOM 2 Inthe Image Browser browse the directory structure on the left and select the directory in which the image run is located In the right hand pane select the image run and click Next or double click the image run 9 When you click on a folder in the directory structure the Image Browser is immediately going to search for all files which Qlvus can open Therefore clicking on a folder high in the directory structure can make the Image Browser slow You can prevent this by clicking the and signs in the directory structure in order to go down through the folder structure 9 When the directory structure is not displayed click Folders to display it To assist in the search for a specific image run you can o Click Preview to display an image of the selected image run at the right o Click Screenshots to display available screenshots of the selected image run at the bottom Qlvus 3 0 Quick Start Manual 3 Introduction o Check the Only tissue box to display the image runs with tissue characterization only So not the gray scale only image runs o You can add or remove the headings searchable items of the right hand pane Right cl
36. lumen contours can be edited only manually The manual re tracing of the contour works on a single frame e 1 Click Se or men to specify the contour type you want to edit 2 Select the transversal contour and start re tracing the contour using the left mouse button and release to accept the manually corrected part of the contour a To undo your manual correction in the transversal view one step back you can click shucks once To delete the stent and lumen contours The OCT stent and lumen contours can be deleted e 1 Click gt or Wmen to specify the contour type you want to delete lil 2 Next click to open the Delete contour window The opened Delete contour window shows the selected contour type 3 Specify if you want to Delete current transversal contour Delete multiple contours or Cancel For detailed instructions we refer to section 6 6 To show or hide the areas inside and the areas outside the stent You can show all the plaque areas inside the stent and the lumen areas outside the stent in the transversal view Qlvus 3 0 Quick Start Manual 32 Working With Qlvus e Inthe Stent strut points Tab click Show lumen stent in the Graphics box This marks the areas inside in green and the areas outside in red in the transversal view It also changes the text on the icon to Hide lumen stent e Click Hide lumen stent to hide the areas from the view again To show or hide lines betwe
37. n make sure to create vessel and lumen contours if these are not already present After editing the vessel and lumen contours using o attraction or correction points you must click ap LeadVH gor leadT C to update the tissue characterization Qlvus 3 0 Quick Start Manual 19 Working With Qlvus 11 You can define specific frames of interest The user defined frames of interest are included in the Excel report in which they replace the by default used frames The five default frames are 1 The middle frame between start and end frame of the transversal distal reference segment 2 MLA when lumen contours are present or the middle frame between start and end frame of the transversal target segment 3 The middle frame between start and end frame of the transversal proximal reference segment 4 The longitudinal frame number 0 5 The longitudinal frame perpendicular to frame number 0 e g 4 in case of 16 frames e Select Options gt Define frames of interest to open the Frame navigation dialog window e Select a specific transversal frame and press D Define on the corresponding Go To transversal frame type i e Distal Segment and Proximal to retain You can select a specific longitudinal frame as well by pressing D on the corresponding Go To longitudinal frame type i e Long 1 or Long 2 retain Press R Remove to release the corresponding specific frame e Press on one of the Go to but
38. nd then click Close 9 You can modify or add subsegment names if needed To do this browse to the Qlvus application folder By default this is C Program Files Medis QIvus 3 0 or C Program Files x86 Medis QIvus 3 0 Open the file SubSegmentNames xml and edit it using an XML editor to make the necessary changes 4 Select the type of contour for which you want to obtain analysis results vessel stent or lumen contours Make sure to create the contours in the order in which the icons are shown first the vessel contour then the stent contour and finally the lumen contour An exception to the previous note is a Volcano Eagle Eye data set which s contours can be better created in the following order first the stent contour then the vessel contour and finally the lumen contour Vessel Stent Lumen By default the vessel contour is selected Qlvus 3 0 Quick Start Manual 18 Working With Qlvus 5 10 Click 9 This detects the longitudinal contour in the segment of interest Review the attraction points in the transversal view by dragging the cross sectional red marker line through the entire segment in the longitudinal view An attraction point represents the cross section of the longitudinal contour You can move an attraction point by picking it up in the transversal view and dragging it to its new location At the same time an attraction point is added to its new location in the longitudinal view and followed with
39. ouse button or mouse wheel Qlvus 3 0 Quick Start Manual 14 Working With Qlvus 6 Performing Analyses in IVUS Images 6 1 Pre Analysis Actions In order to perform an accurate analysis all analyses should start with a precise calibration and a suitable artifact removal of image structures that might diverge the automatic contour detection To check the calibration and remove obstacles for automatic detection Normally the calibration factor is included in the DICOM file You must check if this information is available and in the range you expect and perform manual calibration if needed If automatic calibration was performed you must verify that it was performed correctly and that any obstacles for the automatic detection have been removed marked for exclusion or corrected Next you must position the catheter circles over the catheter and the artifact circle This ensures that the catheter the calibration markers and the artifact areas do not affect the automatic contour detection wa 1 Click Salt and check if the Average calibration factor field shows a calibration factor If it does click Close and continue with step 3 of this instruction If there is no calibration factor or when the calibration factor is not correct you must now manually calibrate the image run Browse to the first image that shows the calibration markers You can do this using the Frame slider which is the first slider in the image control
40. point In the longitudinal image the edited transversal attraction point will be displayed as a colored point orange for vessel dark blue for stent and light blue for lumen contours v The longitudinal attraction point can be dragged to a new position in the same frame or another frame as well 2 To undo your manual attraction point change in the transversal view one by one click x UndoLong To insert a correction point The correction point of the transversal contour works on a single frame 1 Click Set or press C and then click in the transversal view to place the correction point The contour snaps to the correction point 2 If you are not satisfied with the new transversal contour you can pick up the correction point and drag it to a new location You can selectively remove the correction point by clicking it with the left and right mouse button simultaneously To manually re trace part of a contour The manual re tracing of the transversal contour works on a single frame of the longitudinal contour on multiple frames 1 Select the transversal contour and start re tracing the contour using the left mouse button and release to accept the manually corrected part of the contour Qlvus 3 0 Quick Start Manual 21 Working With Qlvus To undo your manual correction in the transversal view one step back you can click un Undo once 2 The longitudinal contour can be manually corrected as w
41. ptimized for each specific catheter type amp Open the guidewire detection dialog window for iMap or VH Revolution IVUS Guidewire images Hide or show iMap VH or TVC IVUS tissue characterization One of these icons is active if you have the appropriate license if an image run set of the corresponding IVUS manufacturer is loaded and if tissue characterization data and contours are available Shave or Show T wc Display iMap VH or TVC IVUS tissue characterization data or re perform tissue characterization One of these icons is active if you have the appropriate license if an image run set of the corresponding IVUS manufacturer is loaded and if tissue characterization data is available for the image run Qlvus 3 0 Quick Start Manual 8 Introduction Tool Icon A Captions ll or gt Options or Chemogr LoopRew RawRew Description Open the tissue characterization options of the iMap Analysis VH IVUS Analysis or TVC Chemogram Analysis dialog window respectively Using the options in this dialog window for iMap or VH you can add a pie chart and a legend to the transversal view you can change the transparency of the tissue characterization overlay and you can select the tissues that must be shown in the overlay If you are reviewing iMap or VH Revolution images you can also filter out black pixels using this dialog window you can display the level of confidence with which
42. r Shortest distance between strut point and lumen contour 3 The distance values in the Struts table will be updated immediately You can only view distance values when the stent and lumen contour are present You can have a negative distance value when the stent strut is within the lumen 8 2 Pre Analysis Actions OCT To perform z offset correction In OCT image runs the z offset in the transversal images can change over the length of the image run You can correct for this change using the z offset correction Preferably the z offset correction needs to be applied on the acquisition system before the image data is exported and becomes available for analysis in Qlvus The z offset correction needs to be applied as a pre analysis action 1 Select Options gt Change Z offset This opens the z offset dialog window 2 Go to the first distal frame of the image run 3 Usually the appropriate sheath size is given by default However if it is necessary change the sheath size at Size of the sheath into the appropriate one and click Change circle to accept The red circle borders can be used to resize the sheath size into its appropriate size 4 Inthe transversal view pick up and move the red circle displaying the Size of the sheath over the guiding sheath in the image until they coincide Qlvus 3 0 Quick Start Manual 28 Working With Qlvus 9 Use the red circle point for repositioning of the circle Click Update Thi
43. r line in the longitudinal view The frame numbers shown in the status bar of the transversal view differ from those in the original data set if the number of frames has been limited To view the original frame numbers open the Loop View window by clicking PRe If you also want to obtain analysis results for the edge segments and for the reference segments you can add more vessel segments to the analysis Click Segment Qlvus 3 0 Quick Start Manual 17 Working With Qlvus In the Segment Definition dialog window select the check boxes of the segments you want to add Click Apply and then click Close The longitudinal view now looks similar to the following MIN dab O 3 If you want to obtain analysis results for subsegments of the segment of interest you can define the subsegments Results for the subsegments are included in the MS Excel report E For detailed instructions on exporting the MS Excel report we refer to section 10 2 Click WRA In the Segment Definition dialog window click Define subsegments and select the check boxes of the subsegments you want to add Enter the start frame and end frame of each subsegment You can also enter a name for each subsegment or select it from the drop down list All sub segments are allowed to overlap with other sub segments A When identical frames are used as start and end frame the sub segment can have a segment length of 0 00mm Click Apply a
44. release to show the tissue and all other overlays again Qlvus 3 0 Quick Start Manual 25 Working With Qlvus 8 Performing Analyses in OCT Images Currently Qlvus can read display and perform manual analyses on St Jude Medical formerly known as LightLab Optical Coherence Tomography OCT and Terumo Optical Frequency Domain Imaging OFDI raw and DICOM image data Additionally Qlvus can automatically detect stent struts in raw St Jude Medical OCT and raw Terumo OFDI image data Performing analyses in OCT images requires a special license Contact your Medis account manager or send a mail to sales medis nl for more information The following image shows an example of an OCT analysis Medis Qlvus 3 0 File View Options Window Help RN ja a amp Browse Close Se ve Dicom Print a a Vessel Stent Lumen Long Trans Single RAARCHIVE DATASETS TESTDATASETS STUDY DATA QIVUS OCT LIGHTLAB TEST_OCT DCM KOSK M Lock strut points Contours Angle Anti clockwise starting from 3 o clock around stent contour Distance Strut point lumen contour measured towards stent Detect stent contour Detect all stent contours m Graphics Show strut lines Detect lumen contour Show lumen stent Detect all lumen contours le Se WETA Keep correction points Show labels User Joan NUM Friday October 18 13 15 44 7 To change the display color of the
45. s of their respective owners Regulatory Information Intended Use Qivus has been developed for the objective and reproducible analysis of intravascular ultrasound images Its intended purposes are e supporting clinical diagnoses concerning stenoses and or placement of interventional devices e supporting subsequent clinical decision making e supporting clinical research trials that study changes in vessel condition over time as a result of interventions and or medication Qlvus 3 0 Quick Start Manual lI WARNINGS Qlvus must be used by cardiologists radiologists or trained technicians who are qualified to perform IVUS and OCT analyses If the analysis results are used to reach a diagnosis the results must be interpreted by a qualified medical professional Qlvus should not be used for purposes other than those indicated in the section Intended Use Users must make sure to read this manual to become familiar with the software and be able to obtain reliable analysis results Indications for Use Qivus has been developed for the objective and reproducible analysis of tomographic images of both lumen and arterial wall of a coronary or vascular segment in particular the assessment of a stenosis or artherosclerotic plaque This information supports the possible placement of intervention devices in these vessels Qlvus enables an advanced assessment of vessel lumen and stent morphology It also avoids the very time consuming
46. s updates all images from the first frame to the end frame of the image run with the present z offset factor zero Scroll through the image run from start to end and check whether the sheath keeps fitting the red circle Stop scrolling when there is no fit anymore Enter a z offset correction factor at Z Offset and click Test to show the correction in the current frame or drag the slider to change the z offset correction factor until there is a perfect fit of the outer edge of the guiding sheath against the circle again Click Update This updates all images from the current frame to the end of the image run with the new z offset factor Be aware that it is possible to have multiple z offset correction factors within one image run Click Close when the end frame is reached 8 3 Performing OCT Analyses To automatically detect stent struts This option can only be used for raw St Jude Medical and Terumo image runs Open an image run and make sure to start with the z offset correction and the required OCT Analysis Dialog gt Settings a gt For detailed instructions we refer to section 8 above 1 Indicate your segment of interest stent segment by using the blue segment marker in the longitudinal view or use the Segment Definition dialog window to fill in the start and end frame For detailed instructions we refer to section 6 4 Click T to open the OCT Analysis Dialog window and select the Stent strut points
47. t the Scroll step the number of frames that are skipped using the Z and X or the left and right arrow keys on your keyboard See section 5 1 on page 13 Where can find the original frame number if loaded a subset Open the Loop view mode The Loop view mode shows the non skipped and non filtered image run The original frame number is displayed in the status bar See section 5 1 on page 12 and section 6 2 on page 17 My subsegment has a length of 0 00 mm When identical frames are used as start and end frame the subsegment can have a length of 0 00 mm See section 6 2 on page 18 How can I change the images in the Excel report Go to Options gt Define frames of interest Here you can change the default images that are included in the Excel report See section 6 2 on page 20 My tissue characterization and or OCT analysis is unavailable You need a separate license for the tissue characterization and or OCT analysis See chapter 7 on page 23 and chapter 8 on page 26 The automatic stent strut detection does not work You need to load raw OCT data to be able to use the automatic stent strut detection See chapter 8 on page 29 Why can t I calculate the remodeling index in the Excel sheet You will need both the proximal and distal reference segments to be able to calculate the remodeling index Qlvus 3 0 Quick Start Manual 36 Troubleshooting Floating license error after a crash of the software In a floating license set
48. the Detection interval for lumen contours Note Value 1 every frame is detected default setting value 2 1 out of 2 frames is detected value 3 1 out of 3 frames is detected etc Be aware that when detecting all struts or stent contours the first frame will be the first frame of the target segment The last frame will be the last frame of the target segment This last frame might not correspond with the nt frame of the interval In such a case the distance between the last two detection frames is smaller than the interval step To change the numbering of the struts You can change the start position and numbering direction of the detected stent struts 1 Click T and select the Settings Tab 2 Goto the Numbering of the struts box and check the Use anti clockwise angles starting from 3 o clock or the Use clockwise angles starting from 12 o clock option 3 The strut numbers in the transversal view and corresponding parameters in the Struts table will be updated immediately Qlvus 3 0 Quick Start Manual 27 Working With Qlvus To change the strut to lumen distance definition 1 Click T and select the Settings Tab 2 Go to the Distance calculations box and check the wanted definition option You can choose from Strut point lumen contour measured towards stent contour center Strut point lumen contour measured towards lumen contour center Stent contour lumen contour measured towards stent contour cente
49. tion to your attention Caution Tells you to be careful when performing a task Warning Warns you for a potentially dangerous situation in the image representation or analysis which may lead to incorrect results You are advised to follow the instructions to avoid this VI Table of Contents hane ls AP cr ll r _ _l_r_rlr l_ r_ rh _ r _e ew rrr 1 1 ADOUC ONU SERAN N KO ON bilan a a EO A N RN a a N N O NN 1 2 SUDDOL S gt 535825500 55450520 0500 00 DE AP 0K A924 Seater K E00 An D RE NAN OL ENO En KORAN K ODAN Y KERO DE KE 000K n D2 KER 2 3 Starting Qlvus and Opening Studies keke eee eee ee eee ee eee eee eee eee eee eee eeeeee se 3 3 1 SLA L OMS y a ye n k tales N NEK WR KNC KAN Ke S00 KV KK A A090 ea n KA 3 3 2 Openino Mace RUNS osre nee k y Wy 0 000y K0 k0 a 0 00 n y 006 2000 09000020202000 594 3084 an4 3 3 3 Closino Nase RUNS iw luce kn Kela Ka k N a ki a la Ka W SON Ke a eel a eae ee ee eae 5 4 The Qlvus Workspace and Toolbars ccccccncccccecccenscccesccceescceessceseccesescceessceeeccs 6 WORKING WITH Q IV Ss i lt 4 4 451444544454123 0415 84001052 ZAWA NA RA ZE WA VE A A Md ek d0 a DA a WSE n W ka kad R 11 5 REVIEW dln O PR N N E A qian neem E E re et E e Da a 11 5 1 REVIEWING Image RUNS menis 05x5 raene EE AEE E ERARA 11 5 2 Adjusting Contrast and BrightnesS sssssessssessesesescesesceceseecesesoecesescee
50. tons to immediately go to the retained transversal or longitudinal frame ka 12 You can view the analysis results by clicking Pu The contours and analysis results are saved automatically with the current image run You can export a frame part of the image run or the entire image run as a BMP JPG or AVI file You can also print a report or export the results to MS Excel 6 3 Editing Contours There are three ways to edit e you can move an attraction point e you can insert a correction point that forces the contour through a specific location e you can manually re trace part of the contour Moving an attraction point is the most powerful editing option This redetects the longitudinal and transversal contour Qlvus 3 0 Quick Start Manual 20 Working With Qlvus The first and second editing option override edits at a lower level Make sure to start with the first editing option then apply the second if needed or apply the third if needed Keep in mind that it is not necessary to manually edit the contours to perfection to obtain accurate results You can check the analysis results in the meantime and see the impact of your Results editing by clicking To move an attraction point The attraction point of the transversal view works on multiple frames 1 Pick up and drag the attraction point in the transversal view to its new location This redetects all longitudinal and transversal contours near the attraction
51. toolbar Check the horizontal or vertical marker line in the transversal view to see how long the maximum distance is that you can mark 2 Inthe Calibration dialog window fill in the distance in mm under Actual diameter and click Indicate distance Click and drag in the transversal view to draw a marker line from the first marker to the last marker Mid or right click in the image to accept the calibration line In the Calibration dialog window click Accept Repeat this step for the other marker line so that the calibration factor is based on two distances one in the horizontal and one in the vertical direction 3 Then in the transversal view click on the red catheter circle or circle center point to activate the catheter circle in the image for editing Subsequently you can click and move the circle center point to reposition the catheter circle and or you can click and move the catheter circle itself towards the inner or outer border to resize the catheter circle until the catheter circle is just around the black catheter circle on the white edge Middle or right click to accept Make sure that the circle center point is positioned at the center of the catheter Qlvus 3 0 Quick Start Manual 15 Working With Qlvus Next click on the green artifact circle or circle center point to activate the artifact circle around the area with artifacts for editing Subsequently resize the artifact circle until the artifact circle is
52. up licenses will be returned to the license server when Qlvus is closed In case of a Qlvus software crash the licenses will not be returned and remain locked on the license server Restarting Qlivus will give a warning that the licenses are not available To solve this issue you have to wait at most 2 minutes before you can start the software again The license server checks every 2 minutes if the claimed licenses are still in use on the client machine If the licenses are not in use the license server will release the licenses Expiration date not updated after install non expiring license When you install a temporal license with CMS License Manager the license will be given an expiration date You can see this expiration date in View available licenses in CMS License Manager When you install a non expiring license after you installed the temporal license the expiration date is not updated To see the correct expiration date of your licenses you have to delete the expiring license before you install the non expiring license You can do this with the following steps e Start CMS License Manager click Start All Programs Medis System Tools CMS License Manager 2 5 e Click Advanced e Click Delete licenses e Select all the expiring licenses e Click Delete e Click Close e Click Close e Click Install an additional license e Browse to the license file with the non expiring license e Make sure all licenses are selected
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