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Opal – RAD User Manual

1. Manage Template Save Update Enter Template Name xt The saved template will be associated with whichever modality was used to create it Opal RAD is a registered trademark of Viztek Inc 2009 75 Opal RAD User Manual 76 gt To load a saved template 1 Left Click the Transcription icon next to the study you are creating transcription for on the Study List to open the Transcription window Left Click on the Templates dropdown list and select a template The text of the template will automatically load into your text editor If you do not see your named template in the list place a check in the box labeled All and then repeat Step 2 gt To delete a saved template 1 CUAD Left Click the Transcription icon next to any study on the Study List to open the Transcription window Left Click on the Save Template button Left Click on the Delete tab Select the template from the dropdown list box Left Click on the Delete button gt To update a saved template o BO Pf O Left Click the Transcription icon next to any study on the Study List to open the Transcription window Enter your transcription into the text editor Left Click on the Save Template button Left Click on the Update tab Select the template you wish to have updated with the current transcription text from the dropdown list box Left Click on the Update button Opal RAD is a registered trad
2. Fig 2 x Patient ID Z1021 r Patient Name Hornblower Horatio Sources LDE 35 Num Images Scanned 0 AA Dell Laser MFP 1815 Cancel Fig 1 Fig 2 Opal RAD is a registered trademark of Viztek Inc 2009 85 Opal RAD User Manual 86 Importing JPG Files In some cases a patient may bring in a CD which contains medical images that are not in the DICOM format The Client Worklist has the ability to import saved JPEG images into a study on your PACS The only prerequisite for importing the image is that they are saved in a JPEG format gt To import a JPG image 1 Highlight the Study you will be adding the images to by Left Clicking on the record Left Click on the Import JPG button Select one or more images in the Open Import Image dialog and Left Click Open Fig 7 4 Enter a Series Description in the text box Fig 2 5 If you selected multiple images in Step 3 and would like all of the images in one series place a check in the checkbox 6 Left Click on the OK button oN Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Send Push an Exam Sending a study to another PACS server is very simple to do once you have configured your recipients gt To send a study to another server 1 Left Click on the study to highlight it 2 Left Click on the Send button at the bottom of the screen Client only or right click on the image an
3. gt To perform a pan Activate the Pan tool Place the cursor over the image Hold down the left mouse button Move the mouse in any direction the image will follow your movements When you are satisfied with the image s placement release the left mouse button a Ge Ng en Pan applies to all images in a series 136 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Actual Size i Actual Size Use this tool to display the image in its actual anatomical size NOTE The Actual Size tools will only work if the monitor has been calibrated gt To view the actual size 1 Left Click on the image or series 2 Select Actual Size from the Images menu To calibrate your monitor 1 On the Settings menu select Edit 2 Left Click on the Local tab 3 Enter your display s visible Width and Height in millimeters in the Monitor Calibration textboxes 4 Left Click on Apply or Left Click on the OK button to save your changes Actual Size applies to all images in a series 374 Please see the Image Viewer Settings chapter for more information on calibrating your monitor s Opal RAD is a registered trademark of Viztek Inc 2009 137 Opal RAD User Manual Window and Level Width amp Center Window amp Level tool This is the most basic and yet most important tool available as it adjusts the window and level also known as width and center or simpl
4. Overlay Configuration The Overlay Config Tab is use to customize the list of displayed DICOM element that appear when overlays are enabled in the Image Viewer gt To add a DICOM tag to your image overlays 1 On the Settings menu select Edit 2 Left Click on the Overlay Config tab 3 Left Click on the DICOM tag you wish to display from the Available Tags list 4 Left Click the Add button to in either the Left Overlay or Right Overlay panels to add the element to the list 5 Left Click the OK button to close the settings window gt To remove a DICOM tag from your image overlays 1 On the Settings menu select Edit 2 Left Click on the Overlay Config tab 208 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Left Click on the DICOM tag you wish to remove from the overlay panel Left or Right Left Click the Remove button from the overlay panel which contains the highlighted tag to remove the element from the list gt To update a DICOM tag on your image overlays e On the Settings menu select Edit Left Click on the Overlay Config tab Left Click on the DICOM tag you wish to modify from the overlay panel Left or Right Modify the value in the textbox directly below the overlay panel to adjust the display text being careful not to erase the S text string Left Click the Update button from the overlay panel which c
5. Opal RAD User Manual Series Right Click Options e View Notes Opens a window to show any notes that have been added to the study e View Related Exams Shows a list of prior exams that can be selected for viewing e Close Study Closes the current study VIZTEK INC BE Notes 4S View Related Exams ar Series Handle Right Click Options e Layouts Allows user to select a series layout view i e 1x1 or 1x2 etc e Close Series Closes the selected series 1x1 1x2 2x1 2x2 2x3 3x2 3x3 Custom Close Series 124 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Opal RAD is a registered trademark of Viztek Inc 2009 125 Opal RAD User Manual 126 Chapter Eight Image Viewing Tools The Opal RAD Image Viewer features a vast array of image manipulation tools to assist in diagnostic interpretation of medical images Most of the tools described in this chapter have easy one click toolbar buttons to activate them They are also available from Images or Tools menu Chapter Contents Iii AAA a2 a lA eit ie 128 Reset Image State oooooooocccccnccccccccccoconcccncncnnnnnnnannns 129 Invert Contrast cansa oa aia 130 Change Orientation Tools ooooonncnccccccnnnccccnnnccannncnos 131 PA cer ed tet ciara ea batt tia e es Seate 132 Fit To WV INA OW oes cc lade ne ii aia 133 Magniy Sieni a i a i a 134 ZOOM E A E A 135 A A 136 PIC Al SZE aio ii 137 Window and L
6. Ox0000 041022 T_0000_1022_failedSuboperation ipti 0x0000 0x1023 T_0000_1023_wamingSuboperation T_0008_0030_studyTime T_0008_0031_seriesTime T_0018_0015_bodyPartExamined T_0020_0110_temporalResolution T_0018_0081_echoTime T_0018_0082_inversionT ime T_0008_1030_studyDescription T_0020_0013_instanceNumber Qx0000 041030 T_0000_1030_moveDriginatorbeTitle T_0008_0050_accessionNumber 0x0000 0x1031 T_0000_1031_moveDriginatorMessageld T_0018_1314_flip ngle 00002 0x0000 T_0002_0000_groupLength T_0020_1041_sliceLocation da 0x0002 0x0001 T_0002_0001_fileMetalnformationVersion T_0018_0050_sliceThickness 0x0002 0x0002 T_0002_0002_mediaStoredSopClassUid T_0018_0088_spacingBetweenSlices Ox0002 0x0003 T_0002_0003_mediaStoredSopinstancellid T_0018_0094_percentPhaseFieldO View Ox0002 Ox0010 T_0002_0010_transferSyntaxUid T_0020_1310 00002 Ox0012 T_0002_0012_implementationClassUid T_0008_0032_acquisitionTime g 0x0002 0x0013 T_0002_0013_implementationVersionName T_0020_0060_laterality 0x0002 00016 T_0002_0016_sourceApplicationEntityTitle 00002 0 0100 T_0002_0100_privatelntormationCreatorUid Ox0002 0x0102 T_0002_0102_privatelntormation 0x0004 0x0000 T_0004_0000_groupLength y MAANA AAN TONO IIAN Cle ath 192 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Toolbox Options Tab The Toolbox Options contain controls which allow the enduser to build a customize
7. The study list itself is divided into many columns including Status Modality Patient Name Study Date Study Description etc Studies can be sorted by any of these columns and the column headers actually double as search fields All of these listing options enable you to quickly find your desired study among the thousands of exams in your database Next to each exam study in the study list are buttons which provide the user access to some of the advanced features of the Worklist including Patient Exam History Notification View Key Images Listen to Dictation and or Transcribe optional feature View Report optional feature Below the study list is the Patient Studies window which is used to view all of a patient s prior exams At the bottom of the screen is a toolbar which is used to open or compare exams filter the study list and navigate through your studies Opal RAD is a registered trademark of Viztek Inc 2009 11 Opal RAD User Manual 12 To view your study you simply double click it This will open the exam in the Image Viewer screen This will be explored in more detail in the next topic but for now lets look at just a few of the differences between the Client Study List and the Web Study List Client Worklist At the top of this screen are tabs separating the Study List from the Study Manipulation and Study Merge and Delete tabs The Study List screen also gives you access to other features of Clie
8. or select Magnify from the Annotations menu 2 Left Click on an area of the image to start the box 3 Move the mouse pointer and observe the box expanding 4 Left Click again to set the box Magnify Annotation at 2x If you would like to increase or decrease the magnification factor of the magnify annotation highlight the annotation must be in Edit mode and then press the or key Opal RAD is a registered trademark of Viztek Inc 2009 165 Opal RAD User Manual Print ROI Print ROI tool button This tool creates will allow you to create a Region of Interest on your image and then have that portion of the image printed to paper gt To print a region of interest On the Annotations menu select the Print ROI tool Left Click on the image to start the ROI box Move the mouse pointer and observe the box expanding Left Click again to set the ROI box Right Click on the image and select Add Image to Print Queue Left Click the Print Queue button in the bottom left corner of the screen to open the Print Queue window 7 Select a layout and adjust any other options and then Left Click on the Print button ig eee D x Only the first ROI placed on an image will be added to the Print Queue If you need to print a second ROI from the same image remove the first ROI 166 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Spine Labels some Spine Labeling
9. Inc 2009 69 Opal RAD User Manual 70 Transcribing Dictation After dictation has been added to a study you can transcribe it using the Transcription module Although Dictation can be access from from both the Web and Client Worklists the Transcription module is only accessible through the Web The Transcription module contains both a text editor and the Dictation control see previous section for usage The text editor is similar in design to many word processing application such as Microsoft Word There are controls for aligning resizing and reformatting your text O 2 CR CSPINE TRA x 4 CR CERVICAL SPINE LAT gt To transcribe your dictations 1 Left Click the Transcription icon above next to the study to open the Transcription window 2 Use the Dictation toolbar to listen to your dictation see previous section for instructions and enter your transcription into the text editor 3 Left Click on the Submit button to save xt Only users who are members of the Transcriptionist Group will have access to the Submit for Approval and Save Transcription functions Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual F http 199 227 180 244 opalweb S ba04j555avr0zp45qulgkr55 Trans aspx SID 4E6A67334E773D3D8 GR Microsoft Internet Explorer i JE Paragraph y Font Size y FontColor J Background Auto Correct y 4a G9 0 B7 Ue x SSBC CFE Re FE 7 S R V Refe
10. Left Mouse Button Almost all tasks are performed with this button A single click is used extensively throughout the software to select an item e g select a study in the Study List select an image in the Image Viewer select a recipient on the Send To dialog etc or activate a feature e g clicking the appropriate Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual toolbar button to activate the Zoom tool clicking the OK button on a dialog in response to a question etc Right Mouse Button A single click with this button reveals a pop up menu containing functions and options pertinent to the area of the software you are currently using Dragging hold the button down and move the mouse this button is used primarily for functions like windowing an image while you view it These behaviors described above are consistent with most other software packages designed to run on the Microsoft Windows platform so you will find that you use the same mouse skills across multiple software products and you will very quickly become accustomed to using the mouse 34 Please see Chapter 12 Windows Primer if you are new to the Windows operating system Opal RAD is a registered trademark of Viztek Inc 2009 17 Opal RAD User Manual 18 How to Use This Manual The next chapter offers a walkthrough for typical usage of the Client Worklist and Web Worklist which includes logging
11. Move the mouse around over the image and the magnifying window will follow your movements 5 Release the left mouse button and the magnifying window will disappear 34 By default the popup window uses a 2x magnification For more information on adjusting the magnification factor or the window s size please see the Chapter on Image Viewer Settings Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Zoom a Zoom toolbar button This tool is used to zoom the entire image in for closer inspection or out view the whole image at once The mouse cursor will change to the Zoom tool cursor once holding the left mouse button down To use this tool first activate the Zoom tool This is accomplished by clicking the Zoom option on the toolbar or in the Tools menu gt To perform the zoom Activate the Zoom tool Place the cursor over the image Hold down the left mouse button Move the mouse up to zoom in down to zoom out Release the left mouse button ARA NS 37 As you zoom images in it may no longer be possible for the entire image to fit in the window thus the Pan tool may be of some assistance in moving the image around Opal RAD is a registered trademark of Viztek Inc 2009 135 Opal RAD User Manual Pan ry Pan toolbar button Use this tool to move an image around within its display window To activate the Pan tool choose the Pan entry from the Tools menu
12. Y Patient New Study Add to Burn Queue Log Merge Studies Reading Physician Users Delete Study xt We will examine each of these menu options in the pages and chapters that follow 40 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Changing the Status of a Study Each study in the system is assigned a status The status acts as a marker to indicate at what point a study is at in its life cycle The valid status types are as follows Incomplete Studies are considered incomplete when either a the images are still coming into the system from the modality or another sender or b the technologist has not yet validated this study Studies of this type can be changed to Unread in a process known as validating Once a study has been validated it cannot be changed back Unread Unread studies have been validated by a technologist and are awaiting diagnosis by the Physician Radiologist Images can no longer be added to the study Studies of this type can be changed to Read Read Studies of this type have been already been diagnosed or read Studies of this type can be changed back to Unread Deleted Studies of this type have been marked for deletion from the PACS server This feature is only available from the Client Worlklist and should rarely be used Studies of this type can be changed back to Read or Unread STAT Marking a study STAT will highlight t
13. A sedyeccasussuceasdecedentpapeates 152 PRINS E 160 AS 158 Cervical and Lumbar Curve visas asii iaa sarna 168 Cobb Anales Ida 161 Edit ded shane E A yaaa easiest opened 169 A EE 156 Precio li 155 Menta a apa ias 154 Masi A A ce a E dees a 165 Ma dal 162 Ma e DOCS 159 PURO Lois 166 RECAE id 157 Region of Interest iRO Dt 163 O E E 171 A O 167 MA Mac ETE EE deste casane EE 164 Clhent Won 12 Columns Addn gesien erea a E E T 52 A O A E NENS 54 REMOVING iria KEES AIEE LaS 52 Comparing SUE ciati an aea aa agaito 90 Context TOON e a a og eqs E a eae eas 146 Creating a Patient DS C R s 81 ANTE A O A bS die 174 Opal RAD is a registered trademark of Viztek Inc 2009 223 Opal RAD User Manual Deletno Mares a doo 100 Dictation Module ds 67 image Overlays Tol O aii 145 Image Viewer peie ernennt NE 112 Context Men iene RI RS A os 122 Maze WI WA E E ies 114 Latin lios 118 IM Images cociente ci cede a a aA 121 Savine Images a n E A A EN 182 TIC SL AV A E A ACA 120 Image Viewer SONES isis 185 Annotation Color Settings iciisscc jssccsseeee ds cesecdeaeuendessnideetasncseasedesdactae 207 Annotation OPOSITOR 205 Auto ave OPIO ot caer dante lee aas dene 201 Creating Custom Toolbox 210 Creating Presea 202 Customizing Overlays ioi aE E E A E EAE E ET 208 Default Layouten a eae E E T E 204 Display Setti ig A A AN 194 External Tools Integration cscccssscsssssssessscssssccessesesenasesensasessecees 197 TO Cal CHOU eE EA E E
14. Cut lines are controlled via the option found in the View menu This option allows the user to toggle between cut lines on and cut lines off View MTS ier Ee Cutlines Overlays Layout Toolbars The cut line has been enhanced to show detail 1 Note that cut lines will only appear when the study contains intersecting images 174 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual The Linking Series The Image Viewer has a feature that will allow you to link multiple image series so that as you scroll through one series the other will follow This is very useful for comparing similar series from the same study gt To link or unlink a series 3 Left Click on the series in your image window to select it 4 Right Click on the series and select Link to activate the link or Unlink to deactivate the link You may also use the shortcut key L to achieve the same goal 5 Repeat steps 1 and 2 for each series that you wish to link or unlink The word Linked with the letter A or N will appear at the bottom of each series you have linked An A means that the series was linked successfully an N means that it was not If any of the series you have linked appear with an N then all of your previous links will not function until you have unlinked the invalid series l Je Linked Linked xt Series will only link correctly if they ar
15. Op study and then open the image to be added 2 Right Click on the image and select Add Image To UNQ Study 3 Enter a description for the image in the dialog that appears and click the OK button 4 Repeat steps 1 and 2 for each image to be added Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Presets The preset provide the user with a quick way to apply pre define Window Width and Level Center to an image These presets allow different types of tissue to be viewed depending on the modality Before using presets you must first define them through the Image Viewer Settings Please see Chapter 9 Image Viewer Settings for detailed instructions on creating presets gt To apply a Window Level preset to your image 1 Onthe Tools menu select a preset from the pop out Presets menu Or 2 Right Click on the image and select a preset from the pop out Presets menu Or 3 Press the number 1 9 which corresponds to the preset you wish to apply Alternately you can hold the CTRL key while pressing the number xt In order for your presets to work as designed they must first be defined in your Image Viewers Settings Opal RAD is a registered trademark of Viztek Inc 2009 179 Opal RAD User Manual Print to Paper Printing to paper prints to any local printer gt To print images to paper 1 2 180 Open an image in the Image Viewer Right click on the image a
16. Options Color Settings 207 Overlay Configuration ooooccccccccccnnnncoonocccnnnnncnnnannnns 208 Toolbox OPHIONS ccccocconccocococncncccnonananananccnnnnncnnnnnnns 210 Saving Your Settings cir 212 Opal RAD is a registered trademark of Viztek Inc 2009 185 Opal RAD User Manual 186 Settings Overview The Opal RAD Image Viewer OpalViewer contains a special section for the configuring your image viewer s settings Through the Image Viewer s Settings window the end user can Add and edit presets Modify the default screen layout Configure the workstations display settings Adjust the magnification window s size and zoom factor Change your auto save options e Configure any external tools for integration with OpalViewer To access the Image Viewer Settings window 1 On the Settings menu select Edit File Settings View Tools Images Annotations Help Once you have finished making your changes to the viewer s settings Left Click on the OK button to close the window If you press the Cancel button without first pressing Apply then all your changes will be lost Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Local Tab On the Locals Tab you will find the fields for adjusting your Display Auto Save Interface and External Tools Integration options Opal iewer Settings ic opal cache wiewer Opal RAD is a registe
17. Status of a Study eeesesssseesesseeseeeees Add Notes to a lA Y cooocococccccccccccccnnnanocccnnnnncnonnnnnnnn no ncnnnnnnns Columns in the Study LiSt oooooniccccccccnnncccccncnananoncnoncnonannnos Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Sorting the Study List oooonnnnncccnnnnnnnncccconoccccnnccnnnnnnnnnnos 45 The Study List Filter Searching oooooooccccccccccocinanaccccccnnnon 46 Refreshing the Study List ocoooocccnnnncccccncnnnnnccccnnancnnnos 48 Study List Settings issii cir 50 io A 51 Add Remove Study List COlUMNS ccccceeeeeeeeeeeeeeeeees 52 Rearrange Study List Columns eceeeeeeeeeeeeeeeeeeees 54 SUIS OWS cise ed 55 Changing Your Password edita di 56 Default Sort Column caera aa aaa 57 Audio Player Lag Time sitial deis 58 Auto Open Priors sah ccbatedecn ida iii 59 Filters WS cotos 60 Dictation and Transcription cocconnnnnnnccccncnenennnnnnanancncnnnnnnos 64 TPO CUD CTO coo a 65 Dictating a Study anisicrtin eiii dario 67 Transcribing Dictation sail 70 Approving Transcribed Reports cccccceeeeeeeeeeeeeeeeeeeees 72 POSTING PE E rra 74 Transcription Templates ooooconnnnnccccncnnncncnncnnnccccnnnnnnnnos 75 Auto COMO oo 77 Advanced Tools arica aaa ad 80 Creating a Patient Disc CD Burning cccccnnccccccccccnncccnnnnnn 81 MPOring STAIES ia A ds 83 Importing Scanned Document ccccccccnncccccccccncnccc
18. The Web Worklist Screen Opal RAD is a registered trademark of Viztek Inc 2009 13 Opal RAD User Manual 14 The Image Viewer The second component of the Opal RAD suite is the Image Viewer screen Unlike the Study List component there is no functional difference between the Image Viewer of the Client Worklist and the Image Viewer of the Web Worklist The Image Viewer offers a vast array of powerful tools and functions for viewing and diagnosing medical images Images can be window leveled manually or automatically sharpened flipped rotated zoomed panned and inverted You can view cut lines image intersections Hounsfield Units for CT and DICOM elements tags Images can also be printed or combined with other images to create Pre Op Studies The Image Viewer screen also has a large number of image marking tools to assist in your diagnosis Various annotation tools are available ranging from simple arrows and text boxes to angle and distance measurements Please see the appropriate sections of this manual for more discussion of the features You will find that most of the features can be accessed quickly through a toolbar button or the dropdown menus Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual The Image Viewer screen With the Image Viewer as with most software applications development is an ongoing process The Opal RAD Image Viewer sometimes called Op
19. called the left mouse button and the right mouse button respective of their placement on the mouse The intended method of using the mouse is to rest your right hand on the top of the mouse with your index finger positioned over the left mouse button and your middle finger positioned over the right mouse button If you look at the computer screen you should notice a small white arrow This is called the mouse pointer With your hand resting on the mouse as described above move the mouse over the desk or mouse pad and observe that the mouse pointer will mimic your movements Move the mouse up down left and right in a circle etc and observe the mouse pointer Practice trying to place the mouse pointer on a certain area of the screen perhaps one of the icons you see on the screen The buttons are operated but simply pushing down and releasing the button For example to operate the left mouse button with your hand resting on the mouse as described earlier you simply push the button down with your index finger then release This is called clicking the mouse named for the little click noise this action produces Opal RAD is a registered trademark of Viztek Inc 2009 215 Opal RAD User Manual 216 Thus to click the mouse means to push one of the buttons The vast majority of mouse click operations in any Windows program are performed with the left mouse button Thus whenever you are dire
20. create filters for themselves e Hold down the CTRL key to make multiple selections in any of the list boxes i e Body Parts Modalities e To deselect an item from your list simply hold down the CTRL key and Left Click on the item e f you would like to deselect all items in your list Left Click on the first entry in the list This entry will appear as a blank space 62 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Opal RAD is a registered trademark of Viztek Inc 2009 63 Opal RAD User Manual 64 Chapter Five Dictation and Transcription This chapter explores Opal RAD s built in Dictation and Transcription module We will examine in detail the process of created radiology exam reports for the studies loaded on the PACS Chapter Contents A A yar a reer Dictating a Udaondo rada Transcribing Dictation ooooocccccnncccccnccconcoccncnnncnonannnos Approving Transcribed Reports cccceeccccee A de earcesenseicarse tend vadeiend iateede Transcription Templates cocooccccnnnnncccccnnnnnnnnnnnnnn AUTO COM o o thee thie is Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Introduction The Dictation Transcription Module of Opal RAD allows the Reading Physician and Transcriptionist to work in unison to create and approve radiology exam reports for study s loaded on the PACS As mentioned earlier in Changing the Sta
21. dictation toolbar has a play pause stop and record button for creating and listening to your dictations There is also a status window and counter for providing feedback to the user The Dictation control works seamlessly with the Philips Speechmike handheld recorder The play pause stop record fast forward and rewind functions can all be accessed through the Speechmike control gt To record dictation 1 Open your study in the Image Viewer or Left Click on the study s Transcription button from the Web Worklist 2 Left Click on the Record button circle 3 Speak clearly into the microphone To pause the recording Left Click Record again 4 When you have finished dictating Left Click on the Stop button square gt To listen to your recorded dictation 1 Open your study in the Image Viewer or Left Click on the study s Transcription button from the Web Worklist 2 Left Click on the Play button triangle 3 Any recorded audio will begin to play Opal RAD is a registered trademark of Viztek Inc 2009 67 Opal RAD User Manual 68 4 When you have finished listening Left Click on the Stop button Square After dictation has been created it is important that it be uploaded back to the PACS server If you have recorded your dictation using the Transcription module you simply need to Left Click on the Save Dictation button to save the current audio file and upload to the PACS If you have used th
22. expand the Study List column sort settings Select a column from the Default Sort Column dropdown list box Select a sort order Ascending or Descending from the sort type dropdown list box Left Click on the Save button to save your changes and return to the Study List xt See Chapter 3 The Study List Screen for more information on manually sorting columns in the Study List Opal RAD is a registered trademark of Viztek Inc 2009 57 Opal RAD User Manual Audio Player Lag Time The Dictation Audio Control will automatically rewind a predefine amount of time every time the Play Foot Pedal is release and re depressed Your Transcriptionist User Group might benefit by adjusting the amount of time the audio file automatically rewinds This can be done through the Web Worklist Settings Tab gt To modify the default sort column 1 Left Click on the Settings tab 2 Left Click on the Audio Player Lag Time node to expand the Audio Player Lag Time settings 3 Select a value from the dropdown list box 4 Left Click on the Save button to save your changes and return to the Study List 58 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Auto Open Priors All users with permission to view studies have the ability to manually open a patient s prior studies through the Image Viewer interface If you would like to have a patient s prior study automatically opened when
23. for the same patient or for a new patient We can also move an entire series of images into another study At which point we can leave the series intact or combine it with a pre existing series The following chart displays the methods by which you may reassign images in the merge module Object Can Be Reassigned to Study Studies or Patients Series Patients Studies or Series Images Patients Studies or Series Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual To further illustrate the PACS object hierarchy we have included another sample outline for the fictitious Jonn Doe patient In this example John Doe has two studies one X RAY and one CT These studies contain two series each Both X RAY series contain only one image each while both CT series contain many images each John Doe Chest X RAY PA Image 1 LAT Image 1 Chest CT Axial Image 1 Image 2 Image 3 Image Coronal Image 1 Image 2 Image 3 Image xt If you move a study into a study or a series into a series the objects contained within will be combined Opal RAD is a registered trademark of Viztek Inc 2009 103 Opal RAD User Manual Merging Images Step By Step To avoid confusion in the step by step instructions that follow we will henceforth refer to the object to be moved as Source and the object s final resting place as Destination The merge pro
24. may automatically refresh your study list based on a predefined interval gt To automatically refresh the study list 2 Left Click on the Auto checkbox on your toolbar 34 The study list s auto refresh interval can be modified using the OPAL RAD Local System Configuration program from your Opal RAD folder on the Start Menu Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Opal RAD is a registered trademark of Viztek Inc 2009 49 Opal RAD User Manual Chapter Four Study List Settings This chapter will explain how to modify your user account s Worklist settings These settings include adjusting the column order and visibility number of displayed rows default sort column Additionally through the Settings tab we can also change the user s password Chapter Contents OCN a SAA heathen lsh cei sages 51 Add Remove Study List CoIUMMNS sseeeee 52 Rearrange Study List CoIUMNS cceeeeees 54 Study List ROWS ccccceeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeees 55 Changing Your Password ccceeeeeeeeeeeeeeeeeees 56 Default Sort COlUM ooccnccnnnnnnnnnninininnninnnnnininininininnns 57 Audio Player Lag Time cecccceccceeeeeeeeeeeeeeeeeees 58 Auto Open PO Sr aaa 59 Filters Menu cccccccccceceeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeess 60 50 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User M
25. menu drops down with entries To activate an entry just click it To hide close a menu until you need it again simply click the menu name again e g click File again Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Context Menus Context menus are pop up menus that appear when you right click in certain areas For example if you right click on an image in the Image Viewer the Image Context Menu appears To cancel a context menu simply move the mouse cursor off of the context menu and single click the left mouse button Context menus are designed to provide quick access to functions or operations that are relevant to that part of the program For more information on the Study List and Image Viewer context menus please see the appropriate sections of this manual Opal RAD is a registered trademark of Viztek Inc 2009 219 Opal RAD User Manual Toolbars Toolbars are collections of shortcut buttons that generally appear near the top of a program window usually under the menu bar These buttons are designed to give quick one click access to functions and operations in the program For example many Windows programs have toolbar buttons for Cut Copy and Paste operations that people use quite frequently In Opal RAD Image Viewer many toolbar buttons also serve as an indicator regarding whether certain tools or options are enabled For example below are pictures of the Magnif
26. of the magnifying glass window that appears as well as the magnification factor You can adjust the size by entering a new value in pixels in the textbox labeled Magnify Glass Size You can adjust the magnification factor by clicking the up or down arrows on list box labeled px Factor The magnification factor ranges from 1 to 5 e Windows Level Acceleration This represents the speed with which an image s Window and Level are adjusted when using the Window Level tool The Opal RAD is a registered trademark of Viztek Inc 2009 195 Opal RAD User Manual 196 higher the number the faster your image s Window and or Level will change when using the W L tool The lower the number the slower the changes Ignore Windows Bar When active this feature forces the Image Viewer to load in the entire viewable screen area If the Windows Taskbar is visible it will likely obscure the very bottom of the viewer One Click Annotations Annotations such as the Line or Angle tool will normally only work once before having to be reactivated If you would like to disable this default behavior simply remove the checkbox for this item After disabling this feature you will then have to manually deactivate each annotation tool when you have finished using it Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Local Options External Tools Integration In order to integrate your image viewer with
27. on another For example if you select a point on a coronal image slice the context tool will automatically scroll to that slice ona related axial series gt To use the Context tool Open at least two series in the image viewer On the Tools menu select the Context tool Place your cursor over one of the images then click and hold the left mouse button As you drag the mouse across the image any related series will automatically scroll to the correct slice N gt A The context tool has been enhanced to show detail 146 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Hounsfield Pixel Value D Hounsfield Unit tool The Hounsfield Pixel Value tool will give the viewer a Hounsfield units reading if viewing a CT image and a pixel reading if viewing any other type of image The tool activates a cross hair that will give you a temporary density reading at that precise point gt To use the Hounsfield tool 1 On the Tools menu select Hounsfield Pixel Value 2 Move your mouse over the area to be measured and Left Click to display the Hounsfield Pixel value Opal RAD is a registered trademark of Viztek Inc 2009 147 Opal RAD User Manual 148 3D Cursor 3D Cursor tool The 3D Cursor is similar in functionality to the Context tool When active this will show you your relative position on one series with the series that currently has focus This position is indi
28. or Remove All feature Opal RAD is a registered trademark of Viztek Inc 2009 53 Opal RAD User Manual Rearrange Study List Columns The columns that appear on the study list may be rearranged in any order desired The order in which they appear in the Selected list from top to bottom will be the order in which they appear on the Study List from left to right For example if the Status column is the first on the list it will be the first column on your Study List gt To rearrange the Study List columns 1 Left Click on the Settings tab 2 Left Click on the Column Order node to expand the column settings 3 Left Click on the column to be moved in the Selected list 4 Left Click on either the Up or the Down arrow circled below 5 When you are done sorting columns Left Click on the Save button to save your changes and return to the Study List UnSelected Selected Status Series Count Station Patient ID DOB Accession Institution Description Recieved Date zl 54 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Study List Rows By default when the Study List contains more records than will fit on the screen you will need to use the record navigation toolbar to page through all of the records see the section on Record Navigation for more information However you can adjust the number of records which appears on each page of
29. previous exams in the region just below the Study List The Toolbar sits below the Patient Studies window On this toolbar you will find the controls necessary for opening and comparing studies printing studies burning CDs importing JPEG images and scan documents and record navigation Opal RAD is a registered trademark of Viztek Inc 2009 33 Opal RAD User Manual Web Worklist Screen 34 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Patient Studies Window When you single click on a study in the study list it becomes the selected study The Client Worklist will quickly search through the study list to find every other study for this selected patient and after a moment displays these studies in the Patient s Studies window To perform this same search using the Web Worklist Left Click on the P icon located to the left the study entry This search is based on the patient s ID This enables you to quickly see all studies for the patient you are interested in You can also select the study to view from this window just as you do from the Study List window The P located to the left of a Study List entry is another indication that the patient has other exams in PACS Opal RAD is a registered trademark of Viztek Inc 2009 35 Opal RAD User Manual 36 Study List Buttons The Study List buttons appear at the bottom of the Study List screen and
30. study s status to Read upon close e Auto Upload Dictation on Close This will save any dictations to the Study upon close e AutoSave Viewer Settings on Close This will automatically save any changes to your Image Viewer Setting upon close e Auto Open Next Study The next study on the Study List regardless on the status will be opened in the viewer When the current study is closed e Auto Save Study DM The layout of the current study will be automatically saved as the Default display setting for the study e Overwrite Current Study DM on Auto Save Study DM If Auto Save Study DM is active and there already exists a Default display setting the setting will be overwritten when the current study is closed Modality Options Creating Presets 202 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual A preset is a pre defined Window and Level setting which can be applied to an image by way of a Hot Key or through the Image Viewer s context menu The Window and Level presets settings can be found on the Modality Options tab gt To define a preset 1 On the Settings menu select Edit 2 Select a Modality i e CT MR and then a Key i e 1 2 ctrl 1 3 Enter the Description Window Width Window and Window Center Level in the provided textboxes Left Click on the Set button Repeat steps 3 5 for each preset you need to define Left Click t
31. study information e f while editing a study s details you do not see your desired entry in the dropdown list boxes you may click Add to activate the manual text entry feature Any newly added entries will then be available the next time the Study Editor is opened e f you attempt to change a patient s ID while using the Patient Editor be aware that the ID must be unique If the ID is in use by another patient you will receive a warning dialog 96 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Merging Patient Studies Each study in the study list is associated with a patient name There may come a time when one of your patients has studies in the system under two different names such as a maiden name and married name Ideally you would want to consolidate or merge these studies under the one patient By doing this it would then be easier to locate a patient s previous exams using the Patient Studies Window Merging studies is simply a matter of associating the correct Patient ID to your study gt To merge studies under one patient 1 Right Click on the study and then Left Click on Edit Study from the context menu 2 Enter the Patient ID for the patient you are assigning the study to in the Patient ID textbox 3 Press the TAB key on your keyboard or Left Click on any other field or object in the editor window A dialog box will appear asking you to confirm your choice 4 To c
32. that the ability to move the position of the measurement text allows you to leave the measured area uncovered and in full view Opal RAD is a registered trademark of Viztek Inc 2009 161 Opal RAD User Manual Left and Right Marker Left Marker tool 8 Right Marker tool These tools are used to label the image left or right To use the Left or Right marker tools 1 Select the Left Marker or Right Marker tool button on the Annotations toolbar or select the marker from the Annotations menu 2 Left Click on an area of the image to start the label 3 Move the mouse pointer and observe the label expanding 4 Left Click again to set the label 162 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual ROI Region of Interest Ror Region of Interest tool button This tool creates an ellipse on the image which is used to focus on a specific region of interest This tool is used to highlight a specific region and to compute information about the area inside of the ROI box This information includes not only the Length are Area but also the Minimum Maximum Mean and Standard Deviation in Hounsfield Units gt To use the ROI tool 1 2 3 Move the mouse pointer and observe the ellipse Left Click on the ROI tool on the Annotations toolbar or select ROI from the Annotations menu Left Click on an area of the image to start the ROI ellipse expanding Move the mouse such that th
33. the sort 3 Double Click the column again to change the sort E gt To sort a column in Web Worklist 1 Left Click on either the Up Arrow or Down Arrow printed on the column header Alphanumeric fields will be sorted as follows e Ascending will sort from A to Z e Descending will sort from Z to A Date Time fields will be sorted as follows e Ascending will sort from oldest to newest e Descending will sort from newest to oldest Opal RAD is a registered trademark of Viztek Inc 2009 45 Opal RAD User Manual 46 The Study List Filter Searching Sorting the study list by any column is handy enough but once you begin to accumulate hundreds of studies the list becomes quite long and more time consuming to navigate by scrolling through it Filtering what is displayed in the list becomes essential Once a filter is applied the list will be updated to display only the studies that match the search criteria making it easier to find your desired studies There are a number of techniques for filtering or searching your studies gt To filter the study list with a search phrase 1 Enter a search phrase in the textbox below the column header For example enter Smith under the column header labeled Patient Name You may also enter a partial search phrase such as Sm 2 Press ENTER to apply the search filter Smith 3 Some columns in the Study List window are pre popula
34. the viewer launches you simply need to enable the Auto Open Priors feature Which study opens automatically will depend on the Auto Open settings which can be found in your Image Viewer Settings control panel For example we can have the last study from the same modality opened or the last study of the same body part gt To enable the auto open priors feature 1 Left Click on the Settings tab 2 Left Click on the Auto Open Priors node to expand the Auto Open Priors settings 3 Select On dropdown list box 4 Left Click on the Save button to save your changes and return to the Study List xt See Chapter 11 Image Viewer Settings for more information on configuring your Auto Open Priors settings Opal RAD is a registered trademark of Viztek Inc 2009 59 Opal RAD User Manual Filters Menu Through this interface the user can create modify and delete search filters Users will typically apply their filters search criteria to the study list one at a time This can become cumbersome if the user is constantly filtering the list for multiple criteria such as date modality and referring physician Client Worklist and Web Worklist have a saved search filters feature These saved search filters make is easy for the user to apply a complex set of search criteria to the study list with the click of a button See Chapter 3 The Study List Screen for details on applying your saved search filters xt In o
35. to the left of the Study entries The buttons will change depending on which version of the Opal RAD software you are using Client Worklist or Web Worklist Jump To Page E 4 4 gt OM oe Rec 221 import CO import JPG Client Worklist buttons soc DEI 901 seran Web Worklist buttons PreK amp x8 R RS Study List buttons e P Patient Exam History Notification When highlighted this icon will indicate that the patient has multiple exams in the system e Select Study Check Box Check this box to compare or open multiple studies K Key Image When highlighted this icon will indicate that key images exist for the study A Transcription Opens a window for adding a transcription to the study e X xMLData Displays a study s DICOM data in XML format e Add Note This is used to add notes to a study Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual e R View Report This displays a study s completed exam report e Ri3 RIS Docs This will open a list of any documents scanned in using your integrated Opal RIS package e Open This feature will allow you to consecutively load up to five studies e Compare This feature allows loading of two studies for comparison e Prefetch This allows users to download studies to their local hard disk e On Call This uses a pre defined search filter in conjunction with Prefetch feature to download studies e View Report Opens
36. tool button With the exception of C1 and S5 each of the Image Viewer s Spine Labels has a menu option for labeling Up or Down the spine The labels include the following Cervical C1 C2 C3 C4 C5 C6 C7 Thoracic T1 T2 T3 T4 T5 T6 T7 T8 T9 T10 T11 T12 Lumbar L1 L2 L3 L4 L5 Sacral S1 S2 S3 S4 S5 gt To use the Spine Labeling tool 1 Left Click on the Spine tool on the Annotations toolbar or select Spine Labels from the Annotations menu 2 Hover over one of the 4 sub menus and then select a marker from the pop out menu 3 Left Click on the image to place the first label 4 Continue Left Clicking on the image until all of your labels have been placed When you begin the labeling process you must continue until you reach either C1 or S5 depending on the direction you have chosen For example if you select L2 Down you will label your spine from L2 to S5 34 Unlike most other annotations the spine labels will appear on all slices in a series Opal RAD is a registered trademark of Viztek Inc 2009 167 Opal RAD User Manual Cervical and Lumbar Curve Cervical and Lumbar Curve tool gt To use the Cervical Curve tool 1 On the Annotations menu select the Cervical Curve tool from the Chiropractic sub menu Left Click on the image to set your first point Left Click again to set your second point Move your mouse to either side of the axis that is created between
37. vast amounts of DICOM and patient information There are two basic functions in the viewer selecting a patient and viewing that patient s images As such the program is divided into two interfaces the Study List screen for selecting patient studies and the Diagnostic Quality Image Viewer screen for viewing and manipulating the images As you use the viewer you will find that you alternate between these two screens quite frequently In this chapter we will look at a sample user session of the Viewer This session includes the following steps Logging In Study List screen Sorting and Searching the Study List Installing the Image Viewer software Opening a study in the Image Viewer Image Viewing screen Closing a study 22 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Step 1 Logging In In order to begin using either the Client Worklist or Web Worklist applications you must first log in to the system Logging in will allow you access to the list of patient studies The Log In Screen contains of two fields that must be filled in prior to logging on User Name and Password gt To login to the Client Worklist 1 Double Click on the Opal RAD Client Worklist icon on your desktop 2 Enter your User Name and Password and then click LOG IN gt To login to the Web Worklist 1 Open Internet Explorer or your Internet service provider 2 Type the web address to the Opal RAD web se
38. window 2 Use the Dictation toolbar to create to your dictation see previous section for instructions 3 Left Click on the Save Dictation button to save gt To add a transcription addendum 1 Left Click the Transcription icon next to the Approved study to open the Transcription window 2 Left Click on the Add Transcription Addendum button 3 Enter your transcription into the text editor 4 Left Click on the Addendum Submit For Review button to save the transcription and close the window Once a dictation addendum is saved the study will revert back to the Dictated status Once a transcription addendum is submitted the study will revert back to the Transcribed status Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Transcription Templates To make the job of entering long or repetitive sections of transcription easier users can utilize the templating feature of the Transcription module Templates are especially useful when dealing with what are referred to as normal reports To create a template 1 Left Click the Transcription icon next to any study that is of the same modality as the type of template you would like to create i e CR CT Enter your transcription into the text editor Left Click on the Save Template button circled The Manage Template window will appear 4 Enter a name for your template in the textbox and Left Click the Save button wo N
39. 2 After the images have loaded Left Click on the Mammography Layout Toolbar button that corresponds to the view you would like displayed 34 The currently selected layout s name will appear at the top left corner of the toolbar control Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual When viewing multi image layouts such as a Processed Right and Left MLO on a single monitor system both images will display inside the viewing pane ina 1 x 2 windows layout When viewing multi image layouts on a dual monitor system each image will display in its own viewer Monitor 1 Monitor 2 Opal RAD is a registered trademark of Viztek Inc 2009 143 Opal RAD User Manual Mammography Tools When viewing a Mammography study you will notice that the behavior of some of the tools you are already familiar with has changed slightly The Tools affected include the Zoom Pan Window and Level and Magnify tools The use of each of these tools on an open Mammography image results in a mirror like effect which can be seen on its corresponding sister image For example if you adjust the Window and Level of the right breast in a CC view the Left breast s W L will adjust as well The tools and their affected changes are as follows e Window and Level The W L of both images will be adjusted simultaneously as the tool is used e Magnify Tool When this tool is used a second magnifying window w
40. 2009 Opal RAD User Manual Importing Studies There are three options for importing studies images into your PACS server You can import a folder individual files or a DICOM directory structure To access any of these import options you must first click on the Import CD button to open the Opal Import dialog pictured below E Opalimport aj Sainct Fur to Import Select Fies to Import Open Domi Do NA Comores Sol MA Frame D0 Oriy Ro Save He Unt F isate Fade I Save Before Encode Open Fin int No Fles Fokiers Selected lor Import zi 4 f 2 0 1 46 Bum Agr 1 2000 11 00 51 Ingot hear List G gt To import a folder containing DICOM images 1 Left Click on the Select Folder to Import button 2 Locate the folder you wish to import in the Browse for Folder dialog and select OK gt To import individual DICOM images 1 Left Click on the Select Files to Import button 2 Locate and then highlight the DICOM files you wish to import in the dialog and select Open Opal RAD is a registered trademark of Viztek Inc 2009 83 Opal RAD User Manual gt To import a DICOM directory structure 1 Left Click on the Open DICOMDir button 2 Left Click the Open DICOMDir button in the dialog that appears pictured below 3 Locate and then highlight the DICOMDIR file in the dialog and select Open The Open dialog will close 4 Highlight the Patient Study Series or Image node in the text box and c
41. AD is a registered trademark of Viztek Inc 2009 91 Opal RAD User Manual 92 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Chapter Six Patient Study Administration This chapter will explore the set of tools used by the administrator that will allow him or her to manage studies in the PACS These tools and functions are only available from the Client Worklist not the Web Worklist In order for the user to perform the functions described in this chapter he she must have the appropriate permissions These permissions are created and assigned by the administrator through the Web Worklist Administration control panel Chapter Contents Edit Patient and Study Information 0 ee 94 Merging Patient Studies cccooccccnnnnncconcccncccccnnnnnnn 97 Creating a New Study cccccccccnonncccccccccccncnncanananonnos 98 Deleting and Purging Studies cceeeeeeeeee 99 Deleting Study IMages ooooooccccccccccccccconncccccccnnnnnn 100 Merging Images Overview oooccccccccccnccocancccnnncnon 102 Merging Images Step By Step ooocooninicccccccnccccos 104 Opal RAD is a registered trademark of Viztek Inc 2009 93 Opal RAD User Manual 94 Edit Patient and Study Information From time to time it may become necessary to edit the information contained within PACS to more accurately reflect contents of the data and or images contained within This may require modi
42. Annotations Options Interface Options 00ceee 205 Annotations Options Color SettingS ooooonnoccccccncnco 207 Overlay ConfiguratiON ococcccnnnnncccccnnncnnnnncnannncncnncnnnnnn 208 TOODO LOPIN S ae h en aes Sa cate ee ade see ede ate 210 Savind YOUESCtIAOS ca oia 212 Windows Piel ccccccceeeeeeeeeeeeeeeeeeeeeeeeeeeeeseeseeseeeeeeeeeeeeeeeeees 214 Using the MoOuUS8S ooooccccccccccccoooccccccccncnnncnnnannnnnnnncnnnnnnnnnnnnns 215 Using the Keyboard cccccccnnnnoccccnnnccccccncnonnncccnnccnnnnnnnnnnnns 217 Menu bars MEUS Tui 218 Context Mens comicios 219 Tolba S toto taclal do olla Nna 220 SOFrOlDAS usa ii la il 221 NAEK A O 223 Opal RAD is a registered trademark of Viztek Inc 2009 5 Opal RAD User Manual Viztek Inc 6491 Powers Avenue Jacksonville FL 32217 904 730 0446 800 366 5343 Opal RAD User Manual 4rd Edition Rev 1 Feb 2009 Author Kristen Tabone and Douglas Bretton 6 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Chapter One Welcome to Opal RAD This chapter officially welcomes you to Opal RAD Client Worklist and Web Worklist The chapter covers mouse button fundamentals introduces the two main screens the Study List and the Image Viewer and offers a brief look at what else is available in this and other applications in the Opal RAD suite of medical imaging tools We will also detail the minimum hardware and software require
43. EE a ees 195 Savins Your Setin son E A A AN 212 User Opt ons iaa ii debe shee ii 199 Windows Task Dato ida theta did 196 Image Viewing Doo ia iaa 126 IDU A ee eee ade eae 148 Actual Sizer ld 137 Change Orientation eessen ernn s n iS 131 Display Nana Met ads 140 LETONIA 133 Hounsfield Units 0000 aia 147 A eia Seatac a a atc a a eiiis 130 Masmi iyaa iS EE ced ae o 134 224 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual OD EBAY Fo sagan Miceli tice gaa E Cee Ankita ead Sal wea Ole RG 150 DAN os casted esac a rd iaa 136 OCS pret ie A 129 Spani Scroll IMAGES ia ia 139 TELUS Size Cl te ce e EN EON ASIA e SMT 132 Unsharp Maskini pee Gti dd E acne ee ees 149 Window and Level cisi24 t 2c sce tei etal bal idee 138 ZOOM es ie cts e de oi sa eal een o edo do 135 Importing JPG Files in a A Denied 86 Importing Scanned Document s ii A is i 85 A e e E E aS ENE EES 176 Linking Series ieun n e e tii 175 Mammography Layouts Ri 141 Mammography Tools a 144 Merging AA IN 97 Study Images A noses meson a 102 Study Images Step By Step ici 104 Notes AGING eisie inn iaa E E E a a 43 Viewing From the Image VIS es 124 Openins ma se e e 117 Opening Images in an External Application ooococnnococnoncccnoncnonnncconnnnnos 183 PreOp MUS ii acada ad 178 Printineito Pl ia 88 A esas Sec lac ag cnsesss AT este tase oc scans eeos nea eases 180 SECULAR 19 Series Stacks Window suscitar id diras alada 115 Status PES
44. Opal RAD User Manual Opal RAD User Manual Table of Contents Welcome to Opal RAD cccccseseeseeeeeeeeeeeeeeeeeeeeneeeeeeeeeeeseneees Welcome to Opal RAD 0ooooccccccccccccnonanonoconcncccnnnananannnccnnnnnnn Features of the Client and Web Worklists TG Study A AN The Image Viewer cuore Easy TO USE ne E stab ates How to Use This Manual cccccccncnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnos Minimum RequireMentS oooooccccccccccccccnnnnonoooccnnnnncnnnananannnnnos Security Statements si Basic Workflow of Opal RAD eeeeeeeeeeeeeeeeeeeeeeeeeeees o cisshcidisiissiaiiiawiaiehniadsiashaiadhaiaehaians Step 1 Logging Min nnna n Step 2 The Study List SCree n eseesesseeeessesesseeeeees Step 3 Sorting and Searching Your Studies Step 4 Installing and Updating the Image Viewer Step 5 Opening a Study in the Image Viewer Step 6 The Image Viewer screen ssssesessessseeeees Step 7 Closing a Study ccccccnonncccccnnncccnncnanancccnnncnnnnnnnnnnns COMO RU a cada The Study List Screen ooooccccccnnnnnnccncccncnononennnnnnnaccc cnn nn nena An Overview of the Study List Screen ooooccninnccccccccccccccs Study LIStButONS iii Study List NavigatiON ooooccnnnnnccccccccnncccnnnnnnanancncnnnccnnnnnos Opening a Study in the Image Viewer oooooooooccccccccococcnnnnnooo Study List Context Mensual Changing the
45. RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Fit To Window B A Fit To Window toolbar button Use this tool to expand or shrink an image so that it fits in the Image Viewing window This tool is of assistance when viewing large images in multiple columns as it shrinks images to fit in these smaller windows and allows you to view the whole image at once gt To resize an image to fit in the viewable window 1 Left Click on the image or series 2 Left Click on the Fit To Window tool on the toolbar or select Fit To Window from the Images menu Fit applies to all images in a series Xx Fit to Window is the logical opposite of True Size previous page Opal RAD is a registered trademark of Viztek Inc 2009 133 Opal RAD User Manual 134 Magnify a Magnify toolbar button Use this tool to magnify parts of an image This is in contrast to the Zoom tool which will magnify the whole image The magnifying tool creates a temporary pop up window that you can move over the image as you would a magnifying glass To activate the Magnify tool click the Magnify button on the toolbar or click the Magnify option from the Tool menu To turn Magnify off click the None option or another tool from the Tool menu To use the Magnify tool 1 Activate the Magnify tool 2 Place the cursor over the image 3 Hold down the left mouse button Observe the pop up magnifying window 4
46. a PDF version of the radiology report e CD Burn This feature allows the user to burn patient studies to a CD e Send This is used to DICOM send a study to another PACS e DICOM Print This is used to print a study to film e Scan Paper This allows the user to attach a scanned document to the selected study e Import JPG This allows the user to attach a JPG image to the selected study e Import CD This feature allows the user to import DICOM images from a CD e Refresh This button performs a manual refresh of the study list 34 CD Burn Import JPG Delete Study Purge Study and Scan Paper are only available from the Client Worklist Opal RAD is a registered trademark of Viztek Inc 2009 37 Opal RAD User Manual 38 Study List Navigation As the number of studies or records in your database grows it will be necessary to use the Study List s record navigation toolbar to browse through the entire list This toolbar shown below can be found at the bottom of the Study List screen The number of records number of pages jump to page and page forward backward buttons are available from the bottom left corner of the screen Jump To Page m K4 44 DD DO REC 68 Pages 4 First Previous Next Last gt To move through your records 1 Left Click on the First or Previous button to move backwards through your records 2 Left Click on the Next or Last button to move forwards through your records gt T
47. a series 130 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Change Orientation Tools a Rotate Images Left toolbar button Rotate Images Right toolbar button Flip Images Vertically toolbar button Flip Images Horizontally toolbar button These tools are available from both the toolbar and the Images menu These tools apply to all images in a series To undo one of these tools use the Restore Image State button Opal RAD is a registered trademark of Viztek Inc 2009 131 Opal RAD User Manual 132 True Size 1 1 1 1 10 One To One View toolbar button Use this tool to display the image in its true size i e 1 1 ratio When in 1 1 mode you can view every pixel that makes up the image gt To view an image in its true size 1 Left Click on the image or series 2 Left Click on the 1 1 View tool on the toolbar or select One to One from the Images menu Note that the image may be too large for the viewing window especially if you are viewing in multiple columns In this case you may wish to change the number of columns use the Zoom tool to shrink the size of the image within the window or use the Fit To Window tool One To One applies to all images in a series xt True Size refers to the actual size needed to display every physical pixel stored in the image data MR images will typically shrink while larger images like CT and CR will expand Opal
48. acks window For each series or stack of images that is currently loaded there is a thumbnail picture of the first image in that stack A patient study may contain many series all of which are loaded when the study is opened To view a series simply move the mouse cursors over the series thumbnail in the Series window you wish to view and Double Click on the thumbnail or you may drag and drop images from the Series Stack to the main Imaging Viewing window To move from one series to the next you may use the Previous Series and Next Series buttons located at the bottom of the viewing screen foes cos The top of the Series Stacks window contains study information Right Click on the information panel to view study notes prior exams or close the study KI VIZTEK INC e Notes 4s fw Related Exams a Close Study DO 2 Zi Opal RAD is a registered trademark of Viztek Inc 2009 115 Opal RAD User Manual Note that only a limited number of thumbnail images may be shown in the series window at one time gt To scroll through the available series 1 Left Click on the up arrow pictured or down arrow provided above and below the thumbnails If the up arrow is gray in color you have reached the top of the list If the down arrow is gray in color you have reached the bottom of the list When the arrow is gray then they are not usable 116 Opal RAD is a registered trademark of Viztek Inc 2009 O
49. ains an interface which is used to adjust the appearance and content of the Image Viewer s overlay text Opal iewer Settings Local Options User Options Modality Options Annotations Options Chiropractic Options Overlay Config ToolBox Options Available Tags r Left Overlay Add Remove Update T_0008_0080_institutionN ame T_0010_0010_patientName T_0010_0030_patientBirthD ate T_0020_0020_patientOrientation ES T_0008_0020_studyD ate 0x0000 00000 T_0000_0000_groupLength 0x0000 00001 T_0000_0001_lenathToEnd 00000 0 0002 T_0000_0002_affectedSopClassUid 0x0000 00003 T_0000_0003_requestedSopClassUid 040000 00100 T_0000_0100_command 0x0000 020110 T_0000_0110_messageld Ox0000 0 0120 T_0000_0120_messageldRespondedTo 0x0000 00200 T_0000_0200_sendereTitle 0x0000 00300 T_0000_0300_receiverAeTitle 0x0000 0x0600 T_0000_0600_moveDestination4eTitle 00000 00700 T_0000_0700_priority Ox0000 0x0600 T_0000_0800_dataSetType 0x0000 00900 T_0000_0900_status 0x0000 00901 T_0000_0901_offendingElement Ox0000 O 0902 T_0000_0902_errorComment 0x0000 00903 T_0000_0903_erronld 0x0000 01000 T_0000_1000_affectedSopinstanceUid 0x0000 0x1001 T_0000_1001_requestedSoplnstanceUid Ox0000 041002 T_0000_1002_eventTypeld 0x0000 0 1005 T_0000_1005_attributeldentifierList 0x0000 01008 T_0000_1008_actionTypeld m Right Overlay 0x0000 0x1020 T_0000_1020_remainingSuboperation Add A Update Ox0000 041021 T_0000_1021_completedSuboperation
50. al Viewer is constantly being enhanced to include additional functionality or simplify complex tasks New releases of the software can be downloaded and installed via a link on the Web Worklist s Study List screen For instructions on how to upgrade your Image Viewer please see Chapter Two Installing and Updating the Image Viewer Opal RAD is a registered trademark of Viztek Inc 2009 15 Opal RAD User Manual 16 Easy To Use Opal RAD is designed to combine a multitude of powerful tools with an intuitive and configurable interface With any software package there is an initial learning curve that must be surmounted Trial and error will lead to familiarization and efficiency First time users of Microsoft Windows often become accustomed to it within a week or two of regular use Opal RAD builds on this by using menus shortcuts and operations that are similar to most other Windows programs thus decreasing the learning curve and familiarization period The Opal RAD applications make extensive use of toolbars context menus drag and drop functionality menus and shortcut keys to provide even more efficiency to your busy schedule The computer s mouse has two buttons some newer models also have a third the middle button and or a scroll wheel in the center The behavior of these two buttons referred to as the left and right buttons respectively is consistent throughout Opal RAD software
51. an external application you must first register the application with the Image Viewer gt To Add Register your application On the Settings menu select Edit Left Click on the Locals tab Enter a Title and Description Enter the path and name of the application s executable in the Command textbox You can browse to the file by clicking the button to the right Enter DICOM in the Arguments textbox Optionally enter the path to the working directory in the Initial Dir textbox 7 Left Click on the Add button 8 Left Click the OK button to close settings AON D o Opal RAD is a registered trademark of Viztek Inc 2009 197 Opal RAD User Manual 198 External Tools Integration AutoCad Templating Title IrFan Description iranview Command C Program Files IrFanView i_view32 f Arguments orom Inital Dir DLO o Add Update Remove gt To update your application registration 1 Select the application in the large list box 2 Modify the fields as necessary 3 Left Click on the Update button 4 Left Click the OK button to close settings gt To remove your application registration 1 Select the application in the large list box 2 Left Click the Remove button 3 Left Click the OK button to close settings XX Currently the only argument the OpalViewer supports is DICOM The DICOM argument is merely a pointer back to t
52. and layout options are modality dependent which means that you can configure different settings for each modality in your Modality list Opal iewer Settings Local Options User Options Modality Options Annotations Options Chiropractic Options Overlay Config ToolBox Options r Modalities r Layout Screen Layout 2x2 Hanging Protocols Identify Study By Body Part E None Identify Series By Series Match 80 Series Match 100 Series Match Count ABD SOFT TISSUE 1 ABD SOFT TISSUE 2 1 2 3 4 DY BO 5 CHEST MEDIASTINUM 6 HEST LU 7 8 9 Series Layout 1x1 z M Mouse Buttons 3 CE E Rist wona El Middle Content y Left Right Pan Ez Presets HEAD SOFT TISSUE NECK SOFT TISSUE _wawieth weee 2 20 350 400 40 160 70 1500 150 643 35 1600 600 150 40 578 93 JT Auto Next Series JT Auto Red Blue Swap ome wow SINUSES 40 514 Description Window Width Window Center r Options Auto Split Rules Allow Auto Linking T Always JT Assume Color Study I Isolate MPEG Isolate Multiframe J Differing Echo Time J Differing Series Number I Differing Series Time Opal RAD is a registered trademark of Viztek Inc 2009 189 Opal RAD User Manual 190 Annotations Options Tab On the Annotations Option Tab you will the settings necessary to adjust t
53. anel Left Click on the series which contains the image s to be deleted The series should now be highlighted 4 Inthe Images panel Left Click on the checkbox next to the image you wish to delete 5 Left Click on the Delete Image button 6 To confirm your choice click Yes Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Modolity CR Date 22 12 2001 11 36 00 series Ma DESCRIPTION Cervical Extension Cervical AP Cervical LAT Ty He r7 13 51 0 7 1324365586065409 525 Delete Series Delate Image Delete Series or Image Utility E To preview an image prior to deletion Left Click on the image in the Images panel After a brief moment the image will load inside the preview window as shown above Opal RAD is a registered trademark of Viztek Inc 2009 101 Opal RAD User Manual 102 Merging Images Overview Every study which appears in your study list is assigned to a patient These studies may contain one or more series which in turn may contain one or more images each This hierarchy of ownership is illustrated in the outline below Patient e Study Series gt Image The Client Worklist contains a utility that will allow the end user to quickly and easily move images from one study to another thereby reassigning ownership of the images This Merge Utility allows us to move Studies Series or Images We can individually move images into a study
54. anual Ellipse 2 Ellipse tool button This tool creates a hollow ellipse on the image This is often used to circle an ROI region of interest gt To use the Ellipse tool 1 Left Click on the Ellipse tool on the Annotations toolbar or select Ellipse from the Annotations menu 2 Left Click on an area of the image to start the ellipse 3 Move the mouse pointer and observe the ellipse expanding Move the mouse such that the ellipse will enclose the ROI 4 Left Click to set the ellipse in place It is generally best to click a spot that is above and left of the ROI as you will then drag the ellipse down and to the right to enclose the ROI It generally takes a few practice ellipses to master the technique 156 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Rectangle Box El Rectangle Box tool button This tool creates a hollow box on the image You can create a square or a rectangle of any ratio tall long etc and is often used to indicate an ROI region of interest To use the Rectangle Box tool 1 Left Click on the Rectangle tool on the Annotations toolbar or select Rectangle from the Annotations menu Left Click on an area of the image to start the box Move the mouse pointer and observe the box expanding Left Click again to set the box ar Your first click will set a corner of the rectangle in place Generally make your first click above and left of th
55. anual Introduction The Web Worklist Setting Tab pictured below is where users of all types not just administrators can adjust their display settings and passwords It is important to understand that all changes to a user s display settings and password will apply to both the Client Worklist and Web Worklist The Settings tab includes the following sections Column Order This will allow you to enable disable and sort the columns on your study list Rows to Display This is the number of records that will be displayed per page on your study list Change Password This is where the user may change his or her password Default Sort Column This is the column that will be used to sort the study list Audio Player Lag Time Used to adjust the automatic rewind feature of the dictation control Auto Open Priors Activates the auto open feature Filter Menu This control panel will allow the user to create edit and delete pre saved study list filters 3 After any of these options have been changed it is important to remember to Left Click on the Save button Opal RAD is a registered trademark of Viztek Inc 2009 51 Opal RAD User Manual 52 Add Remove Study List Columns You may find that you prefer to have certain columns listed in the Study List This may be because the information is unnecessary or not available e g many institutions do not use an Accession Number gt To add Study List columns 1 Lef
56. ature 1 On the Settings menu select Edit 2 Left Click on the Locals tab 3 Place a check in the box marked Auto Save Settings on Close 4 Left Click the OK button to close settings XX Please see Auto Save Options in this chapter for more information on all your auto save features Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Opal RAD is a registered trademark of Viztek Inc 2009 213 Opal RAD User Manual 214 Chapter Tweleve Windows Primer Opal RAD software is designed to run like many other Microsoft Windows programs in order to facilitate its use If you are unfamiliar with Windows in general please use this chapter to get an understanding of basic concepts in Windows Chapter Contents Using the Mouse coccccccncononccccnccccnnnnnnnnnancncncnnnnnnn Using the Keyboard cccceeeeeeeeeeeeseeeeeeeeeees Menu bars Menus ano oeste nai Context MenUS oooooococococnnnncnnnnnnnnnnonnnnnnnnnnnnnnnononnnnns TODAS AUD isos diet os dnins haba tanta staid Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Using the Mouse The mouse is your basic interface with the computer It has two large buttons on top sometimes three sometimes a mouse wheel in the center and a ball on the bottom that detects movement Go ahead pick the mouse up and look at the bottom side to see the ball The two large buttons are
57. aw an angle and display the measurement of that angle To use the Angle tool 1 2 Left Click on the Angle tool on the Annotations toolbar or select Angle from the Annotations menu Left Click on the image to set the vertex center point of the angle Move the mouse to where the end point of the first vector should be and Left Click to set it in place Move the mouse to where the end point of the second vector should be and Left Click to set it in place The angle s measurement will then be displayed Move your mouse to reposition the angle and Left Click a final time to set it in place 3 Note that the ability to move the position of the measurement text allows you to leave the measured area uncovered and in full view 160 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Cobb Angle Eg Cobb Angle tool button This tool is used to find the angle where two lines intersect gt To use the Cobb Angle tool 1 MAaARWN Left Click on the Cobb Angle tool on the Annotations toolbar or select Cobb Angle from the Annotations menu Left Click to set the first point for the first line Left Click to set the last point for the first line Left Click to set the first point for the second line Left Click to set the last point for the second line A measurement now appears showing the angle where these two lines meet Left Click to set the angle measurement in place Note
58. cated by a small circular marker that will grow and shrink as we move the mouse across the images For example assume we have both an axial and coronal series displayed If you move the mouse cursor up and down over the coronal the corresponding marker on the axial series will grow or shrink in size As your position on the coronal moves further away from the slice that is displayed in the axial window the circular marker will increase in size Conversely the marker will shrink in size as you move closer to the displayed axial slice gt To use the 3D Cursor tool 1 On the Tools menu select 3D Cursor 2 Move your mouse over an image As you do so you will a circular marker appear over any other open related series Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Unsharp Masking Unsharp Masking is a technique which processes an image into a clearer and more defined image In general sharp parts of an image are sharpened and less defined areas become clearer It is a better technique than simply sharpening the image because the results are much less harsh Unsharp Masking is most effective on large CR images To use the Unsharp Masking tool 1 Right Click on the image or Left Click on the Tools menu 2 Select an entry from Unsharp pop out menu 3 Wait a moment for the system to process the image To undo the effects of unsharp masking and return the image to its origi
59. cess begins by selecting either one or two patients studies from the client work list To merge images 1 From the Client Work List Left Click on the patient who owns the Source object 2 Hold down the CTRL key and Left Click on the patient who will be receiving the Source object optional HUTT Ty Mi f f j A g o gisja omo g e id 17 csm RE AE i TARIE i Client Worklist 3 Right Click on a selected patient and choose Merge Studies from the pop up menu 104 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual The Merge Studies window will appear If you selected two studies in the previous step then the first patient will appear in the top most panel and the second selected patient will appear in the bottom panel Merge Studies Window If you only selected one patient prior to opening the merge window then the bottom panel will not have a patient listed In order to proceed with the merge process you will first have to perform a patient search XX For instructions on searching please see the topic on searching for patients immediately following this topic Opal RAD is a registered trademark of Viztek Inc 2009 105 Opal RAD User Manual 106 To the left of each patient name will appear a symbol If you click on the symbol a hidden list of that patient s studies will appear directly below the patient And next
60. cted to click or select something it is implied that you click with the left mouse button If the right mouse button is required to perform a function the instructions will explicitly direct you to Right Click or click the right mouse button The right mouse button is generally not used as frequently as the left and is generally used to call up context menus pop up menus that appear when right clicking in certain areas or contexts The other clicking term you hear about is to double click This means to click the left mouse button twice in quick succession This is often a difficult technique to master for a beginning computer user so practice makes perfect Thankfully Opal RAD Client and Web Worklist only makes use of the Double Click in one place selecting a study to view from the Study List This manual uses the common notation e Left Click or Click This refers to clicking the left mouse button once e Right Click This refers to clicking the right mouse button once e Double Click This refers to rapidly clicking the left mouse button twice Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Using the Keyboard While most tasks utilize the mouse there are operations requiring the keyboard such as typing in search terms or annotation text The keyboard is laid out much like a typewriter If you are familiar with a typewriter you will feel rig
61. d choose Print 3 Left Click on the button that corresponds to the destination Web Worklist or select a location in the Locations dropdown Client Worklist and click the Send button Web Worklist Client Worklist After selecting the appropriate recipient the screen disappears and the transfer of the exam is initiated in the background No further user interaction is needed to complete the transfer and it is not necessary to wait for one transfer to finish before initiating another XX Please see Chapter 11 Web Worklist Administration for details on creating your send destinations Opal RAD is a registered trademark of Viztek Inc 2009 87 Opal RAD User Manual 88 Print to Film Printing to film is available through both the Client and Web Study Lists When printing from the Client the user has the ability to select which images will be sent to the printer and which will not When printing through the Web the entire study will be sent to the printer gt To print images to film 1 2 From the Study List screen Right Click on the study and choose Print Select a DICOM printer from the Available Printers list box at the top of the dialog Place a Left Click the checkboxes next to any series and or images you wish to print Client Study List only Configure any other options as desired see next page for available options Left Click on the Print button Client Study List DICOM Pri
62. d set of Image Viewer tool and annotations Opal iewer Settings Opal RAD is a registered trademark of Viztek Inc 2009 193 Opal RAD User Manual Local Options Display Settings The Opal RAD Image Viewer includes support for multiple displays In most cases the pre configured display settings should be sufficient for most hardware configurations However If you would like to reconfigure these settings you can do so through the Display Settings section of the Settings control panel gt To modify your display settings 1 On the Settings menu select Edit 2 Left Click on the Locals tab 3 Left Click on the Display Settings dropdown list box and select your display 4 Select one of the 4 display types i e Color Gray 5 Optionally you can disable your selected display or promote it as your Main Monitor 194 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Local Options Interface Options Use these options if you wish to modify the behavior of the Image Viewer s Magnifying Glass tool or Windows and Level acceleration Please see the Chapter 5 Image Viewing Tools for more details on the use of these tools E caia Ume figner tat ms arnes Cs Cee Cite Cat Ys Sete ana i amaa Set A er The Interface Options include the following settings e Magnifying Glass This allows you to control the size
63. d tl ene one aud aes cate rio 164 Media cosa oa 165 A e N eect atta t 166 Spine Label isaac il ates ttc tarot tietas 167 Cervical and Lumbar Curve ccccceeeeeeeeeeeeeneeeeeeeees 168 Editing and Deleting Annotations eeeeeeeeeeeeeeees 169 Saving AMMOLAUONS avid ds 171 Advanced TOO S a aaeeea eraen asena aeaaaee meaane nanasan esada aaan 173 G LENE Smenn E ciel ttt ete od 174 The Linking SerieS ccccceeceeeeeseeeceeeeeeeeeeeesecseeeeeeeeees 175 REINAS A Tios 176 Creating a Pre Op Study ceicocionicinici ita 178 Presets acordada 179 PritttlO P Precisa 180 Saving Images to a File ooooonnniccccccccnnnnccccnnccnancncccnnncnns 182 Sending an Image to an External Application 183 Image Viewer SettidgS oooncoonnnoccccnnnnnanccononanacccnnnnanacccnnnnns 185 Settings OVEWesas nto pe 186 Local Options Display SettingS ccooonncccccccccnnnnccnnnnnnns 194 Local Options Interface Options occoconcccccccccccncccccnancnns 195 4 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Local Options External Tools Integration 197 User Options Interface Options ccceeeeeeeeeeeeeeeeees 199 User Options Auto Save OptiONS ccccccnccccccccccccccccnnnnnnns 201 Modality Options Creating Presets occccccccccnnnnnos 202 Changing the Default LayOUt oooooooccccccccncnccccnnncconaccconononon 204
64. default state on or off of the Annotation Edit Mode button when the Image Viewer is launched Opal RAD is a registered trademark of Viztek Inc 2009 205 Opal RAD User Manual 206 Use Dot Cursor Activating this will change your Annotation Edit Mode cursor into a dot rather thana crosshair Show Annotation On Thumbnails When this is on all annotation drawn on an image will also appear on the images thumbnail in the Series Stack window Allow Drag Create Normally annotations are drawn by using a series of Left Click operations With this on you will be able to Left Click and Drag to draw many of your annotations ROI Show Size When this is on the Length and Area values of a Region Of Interest ROI annotation will display along with the Min Max Mean and STD Deviation values Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Annotations Options Color Settings In this section of the Annotations Option Tab you will find the settings necessary to adjust the colors of your annotations fro both color and grayscale monitors Using the dropdown color palettes you may adjust the default color of all saved annotations that have been drawn on your images You may also adjust the color of the annotation when the user either hovers the mouse cursor over it or Left Clicks on it Opal RAD is a registered trademark of Viztek Inc 2009 207 Opal RAD User Manual
65. demark of Viztek Inc 2009 27 Opal RAD User Manual Step 6 The Image Viewer screen After opening the selected study you will be taken to the Image Viewer screen On the left side of the screen is the Series Window which displays thumbnails for each series in the study The largest window in the workspace is the viewing window where the image s are displayed To display an image in the viewing window double click on the thumbnail or drag and drop a thumbnail to the viewing window After the image has been opened you will then have access to an array tools for modifying or annotating your image 28 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Step 7 Closing a Study When you are finished viewing the study there are two methods of closing the study to return to the Study List screen gt To close a study 1 On the File menu Left Click on Exit or Left Click on the X in the upper right corner of the Image Viewer 2 A Close Study dialog box will appear Select the appropriate options and Left Click the OK button Close Study r Close Study Options TT Save Image Changes W L Rotation J Save Annotations 7 Mark Study Read Open Next Study TF Upload Dictation iF applicable If you are not prompted or if you wish to have your changes automatically saved please consult the topic Auto Save Options in Image Viewer Settings Chapter for more de
66. e Image Viewer to create the dictation you simply need to close the Image Viewer to save and upload the dictation Please note that if the user has disabled the Ask on Close feature then they will be prompted to upload the dictation To do so simply select Yes in the dialog box The uploaded dictation will be sent back to the PACS server where it will be saved If you chose No in the previous step you will then be given a second chance to save the dictation Rather than saving the dictation on the PACS server your file will be saved on the local hard drive If the study is then reopened on the computer with the saved dictation the user will be prompted to load the dictation into memory Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual gt To start a new dictation 1 Open your study in the Image Viewer or Left Click on the study s Transcription button from the Web Worklist 2 Left Click on the New Dictation button down arrow and select New Dictation from the menu Left Click on the Record button circle Speak clearly into the microphone To pause the recording Left Click Record again 5 When you have finished dictating Left Click on the Stop button square o9 xt If you start a New Dictation any previously unsaved dictation will be erased Please see previous topic for more information on closing and saving dictation Opal RAD is a registered trademark of Viztek
67. e ROI This will set the top left corner of the box You then move the mouse down and right to draw the box and enclose the ROI Opal RAD is a registered trademark of Viztek Inc 2009 157 Opal RAD User Manual Arrow ia Arrow tool button This tool creates an arrow or pointer that will point at an area of the image gt To use the Arrow tool 1 Left Click on the Arrow tool on the Annotations toolbar or select Arrow from the Annotations menu 2 Left Click the mouse on an area of the image to set the pointer end of the arrow 3 Move the mouse and observe the trailing end of the arrow following your movements You can rotate the arrow around and shorten or lengthen the trailing end 4 Left Click the mouse to set the other endpoint of the arrow 158 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Measure ES Measure tool button This tool is used to measure straight line distance in millimeters of an area in the image gt To use the Measure tool 1 Left Click on the Measure tool on the Annotations toolbar or select Measure from the Annotations menu 2 Left Click on the image to set the first end point of the ruler 3 Move the mouse to where the end point of the measurement will be and Left Click to set the end point Opal RAD is a registered trademark of Viztek Inc 2009 159 Opal RAD User Manual Angle A Angle tool button This tool is used to dr
68. e any additions deletions or alterations to your image s annotations you must Save them to the database There are two options for accomplishing this You can use the auto save feature of the viewer see Chapter 9 Image Viewer Settings for more details or you can manually save your changes gt To manually save your annotations 1 Onthe Annotations menu select Save XX If the auto save feature is disabled and you do not manually save your annotations all of your changes will be lost upon closing the study Opal RAD is a registered trademark of Viztek Inc 2009 171 Opal RAD User Manual 172 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Chapter Ten Advanced Tools This chapter explores some of the more advanced viewing features found in the Opal RAD Client Worklist Some features are in the Web Worklist Chapter Contents Cut Lines ered da as ce ect ard ci sabe tar a 174 A coed tads tsieaiesciaedeecessed once 175 Key IMAGES secs conser sees oia 176 Creating a Pre Op Study ceeeeeeeeeeeeeeeeeeeees 178 Pr Suicida 179 Print to Paper sisi cir 180 Saving Images to a File ccsccceeeeeeeeeeeeeeeeeees 182 Sending an Image to an External Application 183 Opal RAD is a registered trademark of Viztek Inc 2009 173 Opal RAD User Manual Cut Lines Cut Lines are simply white lines that depict the intersection between images in a study
69. e ellipse will enclose the area for study Left Click to set the ROI ellipse in place Opal RAD is a registered trademark of Viztek Inc 2009 163 Opal RAD User Manual 164 Text rex Text tool button This tool allows you to place typed text on the image Many doctors use this in conjunction with other tools such as the arrow or ellipse to explain the ROI or indicate opinions readings gt To use the Text tool 1 Left Click on the Text tool on the Annotations toolbar or select Text from the Annotations menu 2 Enter your text in the dialog box that appears 3 To move your cursor to a new line hold down CTRL and press ENTER the text dialog box can support up to 3 lines of text 4 When you are done typing click the OK button or press ENTER to close the dialog box 5 Left Click on the area of your image where you wish the text to appear gt To edit the text annotation h Enter Annotation Edit Mode see next section 2 Double Click on the textbox and the text dialog box will appear 3 Change the text as necessary and click the OK button or press ENTER when finished Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Magnify C Magnify tool button This tool allows you to draw a box around on an image which will then magnify the contents of the enclosed area To use the Magnify tool 1 Left Click on the Magnify tool on the Annotations toolbar
70. e of the same body part and on the same plane i e axial coronal but they do not have to contain the same number of images Opal RAD is a registered trademark of Viztek Inc 2009 175 Opal RAD User Manual 176 Key Images The Key Images feature is designed to allow the quick identification of particularly important images in a study The doctor reading the exam marks images as key that are prominent in the study A copy of each of these images is then placed in a separate thumbnail in the Series Stacks window so that all of the key images in the study can be viewed quickly Additionally when key images have been marked the series description will appear to be highlighted The power of this tool is that although the key images may reside in many separate series the key image stack brings all of these images together into one stack providing a more efficient read gt To show or hide a study s key images 1 Left Click on Key Images just below the series description pictured above 34 The Key Images button inside the Image Viewer and the K button on the Study List will be highlighted when present Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual gt To Mark Create a Key Image 1 Right Click on the image and select Set Key Image or press the K key on the keyboard View Dicom Values View HISTORY Add Image To Print Queue Pr
71. e report will be faxed to the referring physician s fax number 72 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual 3 http 199 227 180 244 opalweb S kpfagk55htctg4453tofjwzq Trans aspx SID 4E 7A41324F413D3D amp GR Microsoft Internet Explorer Paragraph y Font z size y Font Color Background Auto Correct 7 am B Z Ue x EE SSE EFF Be 0 7 al RIY Referring Physician Dicom Name DR THEODOR S GEISEL Address Phone E 904 555 9999 Specialist E First Gracie Last Aien mu Sex F DOB 211 1979 12 00 00 AM SSN Desc RT KNEE COMPARE vonrey PDICOMID 21009 Body Part KNEE Modality MR Facility Templates Transcription X NONE z Fa T approve NOW approve Approve amp Next Do Not Approve Do Not Approve amp Next Save Dictation Transcription window Radiologist user Opal RAD is a registered trademark of Viztek Inc 2009 73 Opal RAD User Manual 74 Addendums Even after approval the physicians and transcriptionist have the ability to go back to the report and create addendums Addendums are used to either correct a mistake that may have been overlooked in the approval process or to insert information that may have been unavailable at the time the report was initially constructed gt To add a dictation addendum 1 Left Click the Transcription icon next to the Approved study to open the Transcription
72. emark of Viztek Inc 2009 Opal RAD User Manual Auto Correct When active the Auto Correct feature of the Transcription window will automatically replaced one word or phrase with another pre defined word or phrase For example you can have the word USA replace with the phrase United States of America gt To create an auto correct entry 1 2 Open a Transcription window Enter the word s you wish to use as your auto correct phrase into the Transcription window s text editor Using the mouse highlight the entire auto correct phrase While holding the CTRL key press the E key The Auto Correct window will appear Enter your replacement text in the Expansion textbox Left Click the Update button to save your entry and close the window Add to Auto Correct Library Text jus ultrasound Expansion F Global Opal RAD is a registered trademark of Viztek Inc 2009 77 Opal RAD User Manual 78 gt To remove an auto correct entry 1 2 Open a Transcription window Enter the word s you wish to use as your auto correct phrase into the Transcription window s text editor Using the mouse highlight the entire auto correct phrase While holding the CTRL key press the E key The Auto Correct window will appear Delete the replacement text from the Expansion textbox Left Click the Update button to save your entry and close the window 3 By default all auto correct entries a
73. esets gt Set Keylmage gt To Unmark Remove a Key Image 1 Right Click on the original image that has a Key Image and select Unset Key Image or press the K key on the keyboard View Dicom Values View HISTORY Add Image To Print Queue Presets gt Unset Keylmage xt The Unset option is only available when the correct image is right clicked on Opal RAD is a registered trademark of Viztek Inc 2009 177 Opal RAD User Manual 178 Creating a Pre Op Study A Pre Op study is a special type of study which is created from one or more studies for a given patient Creating one is simply a matter of opening a study in the image viewer and adding images Once it s created additional images from any of that same patient s previous studies may be added Pre Op studies will appear on your Study List screen under the Modality of UNQ short for unique These studies will appear at or near the top of the study list If the new study does not immediately appear you may Left Click on the Study List s Refresh button gt To add an image to a new Pre Op study 1 Right Click on the image and select Add Image To New UNQ Study 2 Enter a description for the study in the dialog that appears and click the OK button 3 Enter a description for the image in the dialog that appears and click the OK button gt To add an image to an existing Pre Op study 1 Open a study from the patient with the existing Pre
74. evel Width amp Center 138 Span Scroll IMages coocnnonnccccnnnnncnnncnananccnos 139 Display Management ccccceeeeeeeeeeeeetteeeeeeees 140 Mammography Layouts cccceeeeeeseeeeeteeeeeeeees 141 Mammography Tools ccceceeeeeeeeeeeeeteeeeeeees 144 Image OverlayS oooocooonncccccnnccccocnnanannccnnncncnnncnananns 145 CONTENT TOO hs Sates cain a ica at 146 Hounsfield Pixel Value oooooooooccccccccccccccooncccccccnnnnnns 147 SD CUSO iaa iia 148 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Unsharp Masking cceeeeeeeeeeeeeeeeeeeeeteeeeeeeees 149 Show or Hide Study Overlays oooooccccccccccccnccccnncoo 150 Opal RAD is a registered trademark of Viztek Inc 2009 127 Opal RAD User Manual 128 Introduction e 130 11 O6 mW Image Viewing Tools buttons Each topic in this chapter will define each of the viewing tools that are available in the Image Viewer list the ways to activate it toolbar button menu entry etc and explore its usage Some of the tools such as the Magnify Zoom and Span tool must be enabled to use After you have finished using the tool you can disable it by To deactivate an active tool 1 Left Click on another tool Or 2 On the Tools menu Left Click on None Or 3 Left Click that same tool again from either the menu or the toolbar xt If you disable a too
75. flow of blood toward or away from the Transducer Caliper Zoom When active this feature will allow the user to Left Click and drag on the measurement overlay to zoom into an image Focus In On Zoom Point As images are magnified using the Zoom tool the image will reposition itself to center on the cursor position Fill Empty Cells If there exists any remaining available Image viewer panes after a pre saved display setting has been applied they will be filled with additional series Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual User Options Auto Save Options The Auto Save options control how the Image Viewer responds when closing your study By default you will be prompted to save any changes to your images and setting on close You may however disable this prompt or even select which options are saved when the prompt appears The Auto Save Options include the following setting e Askon Close This will provide you with a dialog box each time you close the viewer e AutoSave Image Properties on Close This will save any changes to your images window level rotation or orientation to the database e AutoSave Image Annotations on Close This will save any added removed or modified annotations to the database Opal RAD is a registered trademark of Viztek Inc 2009 201 Opal RAD User Manual e Auto Mark Read Study on Close This will automatically change the
76. fying a Patient s demographics i e Name DOB or Gender or a Study s details i e Description Referring Physician or Body Part When a patient s demographics are modified all of the patient s associated studies will be updated to reflect the new changes If a study s details are modified only that study will be updated gt To edit the a patients demographics 1 Right Click on any study for the patient to be modified on the Client Study List screen and then Left Click on Edit Patient from the context menu 2 Modify the information as needed and then Left Click on the Save button when finished gt To edit a study s details 1 Right Click on the study to be modified on the Client Study List screen and then Left Click on Edit Study from the context menu 2 Modify the information as needed and then Left Click on the Save button when finished Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Opal RAD is a registered trademark of Viztek Inc 2009 95 Opal RAD User Manual gt To reassign a study to a new patient 1 Right Click on the study and then Left Click on Edit Study from the context menu 2 Enter the new Patient ID in the Patient ID textbox and press the TAB key Enter values for the patient s Name DOB and Gender Modify any other information as needed and then Left Click on the Save button when finished O Notes on editing patient and
77. gt To add notes to a study 1 Left Click on the Add View Note button to the left of the Study Entry 2 Type the note in the bottom portion of the Note window 3 Left Click on the Add Notes button to save the note or Left Click the X in the upper right hand corner of the window to cancel TYPE NOTES HERE 34 To view notes from the Image Viewer Right Click on the Series Stack Header and select View Notes Opal RAD is a registered trademark of Viztek Inc 2009 43 Opal RAD User Manual Columns in the Study List The data that comprises your studies are displayed ina columnar format To facilitate the the finding of studies most of these columns can be sorted searched rearranged and removed The columns available in the Study List are Status Modality Series Count Image Count Patient Name Patient ID Description Body Part Study Date Referring Physician Gender Date of Birth Age Accession Number Institution Name Reading Physician Received Date Department Station Fax Number Approved Date 44 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Sorting the Study List Most of the columns in both the Client and Web Worklists can be sorted to make finding data in a large study list easier gt To sort a column in Client Worklist 1 Double Click the column to be sorted 2 The direction of the arrow that appears on the column will indicate the direction of
78. has four arrows pointing in all directions the user can reposition or move the annotation When the cursor is an upward pointing arrow the user can resize the annotation Opal RAD is a registered trademark of Viztek Inc 2009 169 Opal RAD User Manual 170 gt To edit a selected annotation 1 2 3 Select an annotation see previous section Move your mouse over the top of the selected annotation If the cursor changes to an up arrow you may Left Click to grab the handle Move your mouse to resize the annotation and then release the button when you are done If the cursor changes to a four way arrow you may Left Click to grab the annotation Move your mouse and then release the button to drop the annotation in place gt To delete an annotation 1 2 Select the annotation see previous section Right Click anywhere on the image and choose Delete Current Annotation from the context menu or press DELETE on your keyboard gt To delete all annotations 1 Right Click on the image 2 3 If the annotation persists across multiple slices such as Select Delete All Annotations from the context menu the Spine Labels then select Delete All Annotations for Series 3 Deleting all annotations from an image or series does not require that you first be in Annotation Edit Mode Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Saving Annotations In order to sav
79. he OK button to close settings oe Opal RAD is a registered trademark of Viztek Inc 2009 203 Opal RAD User Manual 204 Changing the Default Layout The ability to change the viewers default layout is available on the Modality Options tab This pre configure layout is modality specific For example you could configure all CTs to be displayed in a 2x2 format and all MRs to be displayed in a 1x3 format gt To change your Screen or Series layout 1 On the Settings menu select Edit 2 3 From the Screen Layout or Series Layout dropdown Left Click on a Modality i e CT MR list select an option i e 1x1 2x2 3x4 Left Click the OK button to close settings Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Annotations Options Interface Options In this section of the Annotations Option Tab you will find the settings necessary to adjust the behavior of the annotation tools and toolbar The Interface Options include the following settings e One Click Annotations When active annotations will automatically turn themselves off after they have been drawn If this is disabled annotations will remain active until they are manually disabled e Show One Click Annotations Button This will place the One Click Annotation toggle button on the toolbar e Annotation Edit Mode This option sets the
80. he Study List Screen 33 Study List BU LONS ooooooooocooococoooocnnnnnnnnnnnononnnnnnnnns 36 Study List Navigation soi ii 38 Opening a Study in the Image Viewer 39 Study List Context MenuS sseeeeseeeeeeeeeeees 40 Changing the Status of a Study ee eeeeeeeeeeeeeee 41 Add Notes to a Study ccccccccncnonncccccnccconncncnnanannnnos 43 Columns in the Study LiSt ooooooonoccccccccccnccccanancncnos 44 Sorting the Study LiSt oooononnnnccccnnnnnnnnnnncnanncccnnos 45 The Study List Filter Searching coocccnninnnncn 46 Refreshing the Study LiSt oooooonincccccnnnnnnnccnnnnn 48 32 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual An Overview of the Study List Screen Let s start by identifying this screen s distinct parts The Study List is the largest and most important part of this screen holding the actual listing of studies in your database The list is divided into several columns to organize all of the information available like patient name sex and birthdate the study s status number of series and number of images etc The Patient s Studies window works in conjunction with the study list to quickly show you all of the studies associated with the selected patient When a study in the Study List is selected highlighted the Patient Studies window will show that patient s
81. he behavior of the annotation tools and toolbar Opalviewer Settings x Local Options User Options Modality Options Annotations Options Chiropractic Options Overlay Config ToolBox Options r Interface Options r Color Settings I One Click Annotations Color Grayscale IM Show One Click Annotations Button Ese E b h Annotation Edit Mode Color Set2 al I Use Dot Cursor Color Set MO y lr IT Show Annotations On Thumbnails ColorSet4 A LC I Allow Drag Create Color Set 5 F Y ROI Show Size Color Edit e TA Color Hover r Misc Options Annotation Font Scale by Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Chiropractic Options Tab On the Modality Option Tab you will find the fields for adjusting you Modality Presets Screen Layout and Series Layout defaults Both the presets and layout options are modality dependent which means that you can configure different settings for each modality in your Modality list Opal iewer Settings xj Local Options User Options Modality Options Annotations Options Chiropractic Options Overlay Config ToolBox Options Upper Cervical Options JT Auto Nassium Cale Flip IT Auto Vertex Calc Flip Cancel Apply Opal RAD is a registered trademark of Viztek Inc 2009 191 Opal RAD User Manual Overlay Config Tab The Overlay Config Tab cont
82. he originally saved DICOM Image on your server Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual User Options Interface Options The Auto Save options control how the Image Viewer responds when closing your study By default you will be prompted to save any changes to your images and setting on close You may however disable this prompt or even select which options are saved when the prompt appears The Interface Options include the following settings e Auto Display on Stream By default streamed studies will not auto display in the viewer This feature disables that behavior e 2 Column Thumbnails Displays 2 rather than 1 column of thumbnails in the Series Stack window e Show W L On Toolbar This will create a Window and Level tool button on the Image View toolbar e Hold For Record This option will reconfigure the Philips Speechmike recorder to only record dictation if Opal RAD is a registered trademark of Viztek Inc 2009 199 Opal RAD User Manual 200 the Record button is depressed By default the Record button operates as a toggle Open Key Images as Single Image This will stack key images in the Series Stack window rather than separating them into individual thumbnails Show Red Blue Swap Button For Color Images This will create a Red Blue Swap tool button on the Image Viewer toolbar Note the red and blue areas of color Ultrasounds indicate the
83. he study and move it to the top of the study list A study that has been marked STAT implies that it is of great importance and should be attended to first Opal RAD is a registered trademark of Viztek Inc 2009 41 Opal RAD User Manual 42 Unlike the other statuses mentioned the STAT status is independent of the other types So for example you could have a study marked both Unread and STAT simultaneously gt To change the status of a study 1 Right Click on the study to be changed 2 Select the appropriate status such as Unread or STAT from the context menu that appears below Print Log Web Worklist context menu The statuses that are displayed in the context menu will change depending on the current status of the study being changed For example if a study has been marked as Read then the Unread option will appear in the context menu 3 Marking a study as Deleted is only available from the Client Worklist Please see the Chapter 8 Patient Study Administration for more details on deleting studies Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Add Notes to a Study D Add View Note button If a note exists the Add View Note button will be highlighted The typed notes will appear when the Add View Note button is pressed You can attach as many notes as necessary to a study with the last note being the most recent Once created these notes cannot be removed
84. hose but this may not be sufficient for finding a particular study if the list is very large Our next step is to filter the list by performing a quick search gt To search filter the study list 1 Type in the white space directly below the column heading For example you might enter Smith under the column header labeled Patient Name 2 Press ENTER to apply the search filter The Patient listing is updated to display only the patients that match the search criteria From this reduced listing we can see our desired patient Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Step 4 Installing and Updating the Image Viewer This step is optional Only update your image viewer if you do not have the latest version Only users with administrative rights on the computer being used will be able to install the viewer gt To Install or Update your Image Viewer 1 Left Click on the Download Viewer link in the top right hand corner of the screen 2 Click the Open button on the dialog box that appears to begin the Image Viewer installer see below 3 When it s completed simply click the OK to return to the Study List Step 5 Opening a Study in the Image Viewer Once we have located the study Exam that we would like to view we can open it in the Image Viewer gt To open a study in the Image Viewer 1 Double Click on a study in the study list Opal RAD is a registered tra
85. ht at home on the keyboard in a short time A notable addition on a computer s keyboard is the set of arrow keys These are four keys grouped together on the right side of the keyboard between the main letter keys and the numerical keypad which are labeled with arrows pointing up down left and right The arrow keys can be used to move the cursor around while typing in text Opal RAD Client Worklist makes use of these keys as shortcut keys to scroll through series of images Pecking the right arrow key will take you to the next image the left arrow key will take you to the previous image Immediately above the arrow keys is a group of six keys also used as shortcut keys The DELETE key sometimes labeled DEL for short can be used to delete annotations The HOME and END keys are used in navigating a series of images HOME will take you to first image END to the final image The PAGE UP and PAGE DOWN sometimes labeled PgDn and PgUp will take you to the previous series or next series respectively Opal RAD is a registered trademark of Viztek Inc 2009 217 Opal RAD User Manual 218 Menu bars Menus Menu bars are found along the top of most Windows program and are useful for concealing large menus while not in use Common menus seen in Windows programs are File Edit and Help To pull down a menu from the menu bar simply click the menu title For example click File A
86. iewer LayOUt ooooooocccccccnccccnoconccccccccnonnnnnannns 118 Moving Images Between Panels 0ceeee 121 Image Viewer Context MenUS cccccnncccccccccccccccnnnnnns 122 Opal RAD is a registered trademark of Viztek Inc 2009 111 Opal RAD User Manual An Overview of the Image Viewer Screen Let s start by identifying this screen s distinct parts The Image Window constitutes the largest portion of the Image Viewer This section of the screen is reserved for displaying the images and can be modified to display the images in a variety of columns rows configurations This is also the area where you will manipulate the properties of the images and create annotations The Series Stacks Window is the smaller section on the leftmost side of the screen The window displays a thumbnail image for every series also referred to as a stack in the study These thumbnails also act as buttons allowing you to quickly navigate between series The Toolbar and Menus are located at the top of the Image Viewer screen and sets up the remainder of the screen to aid in diagnostic viewing The functions accessible from the menus and toolbar are relevant to manipulating images 3 The individual toolbar functions will be discussed in greater detail in Chapter 5 Image Viewing Tools 112 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual The images are displayed in rows and columns according to yo
87. iewing these Mammography studies in the Image Viewer you will have access to a special set of tools and features that are not available with other study types The tools include a custom toolbar pictured below which allows the user to quickly display various mammography images simply by selecting the corresponding layout button Mammography Layout Toolbar In the sample toolbar above we are displaying a total of four layout buttons They are as follows Processed CC and MLO Raw CC and MLO Processed R L MLO and Processed R R MLO for comparison The layout buttons that are displayed are image dependent For example if your study only contains the CC view of the breasts then only CC specific layout buttons will appear Opal RAD is a registered trademark of Viztek Inc 2009 141 Opal RAD User Manual 142 Below is a list of additional Mammography Layouts This list is not comprehensive as it does not show all possible permutations of the views available Processed R L CC Raw R L CC and MLO Processed R L MLO Processed R L CC and MLO Processed R CC To conserve space on the Image Viewer Toolbar the Mammography Layouts Toolbar will be limited in length If more layouts exist than can be shown the Left and Right Arrows will allow you to scroll through the list of buttons gt To apply a mammography layout 1 Open a Mammography study by Double Clicking on the study s entry on the Study List
88. ill appear over the same region on the adjacent image e Magnify Annotation When this annotation is placed on an image a second magnifying box will appear over the same region on the adjacent image e Pan Tool Both images will pan in the same direction i e anterior posterior left right e Zoom Tool Both images left and right will zoom to the same location on the breast 34 To learn more about the use of the tools listed above please consult the appropriate topics within this chapter 144 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Image Overlays fal Image Overlays tool Certain types of studies such as CT or Mammograms can contain embedded overlays These overlays are actually saved as part of the DICOM header of the image files The overlays once visible will appear as text or annotation on the images they are saved into gt To view embedded overlays 1 Left Click on the image which contains the overlay 2 Left Click on the Images Overlay tool from the toolbar to turn on overlays a The overlays have been enhanced to show detail 34 The Overlays button will only be visible if overlays have been detected for the image being viewed Opal RAD is a registered trademark of Viztek Inc 2009 145 Opal RAD User Manual Context Tool AP Context tool The Image Viewer s Context Tool allows the user to locate a slice in one or more series by selecting a point
89. l applications must be configured through the Opal RAD Image Viewer settings control panel see Image Viewer Settings for more information gt To send your image to an external application 1 Right Click on the image to be sent 2 Select an application from the External Tools pop out menu 3 Your 3 party application should launch automatically and the DICOM data will be sent View Dicom Yalues View HISTORY Add Image To Print Queue Save Image As gt Presets gt Unsharp gt IrFan NATA AutoCad Templating Set KeyImage Add Image To New Pre Op Study Close Study Opal RAD is a registered trademark of Viztek Inc 2009 183 Opal RAD User Manual 184 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Chapter Eleven Image Viewer Settings This chapter will explore in detail the options available through the setting window of the Opal RAD Image Viewer Chapter Contents Settings OvervieW aan 186 Local Options Display Settings cee 194 Local Options Interface Options ccee 195 Local Options External Tools Integration 197 User Options Interface Options eeeee 199 User Options Auto Save Options cceee 201 Modality Options Creating Presets 202 Changing the Default Layout eee 204 Annotations Options Interface Options 205 Annotations
90. l with Method 3 then your default tool will be enabled automatically For CR and US studies the Magnify Tool is the default tool For MR and CT studies the Span Tool is the default tool Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Reset Image State Reset Image State tool The Reset Image State is one of the most important tools because it allows the user to set the image back to its original state The Reset Image State tool is on the toolbar and is also an option in the Image menu gt To reset an image back to its saved state 1 Left Click on the image or series 2 Left Click on the Reset Image State tool on the toolbar or select Reset from the Images menu Resetting an image applies to all images in a series Opal RAD is a registered trademark of Viztek Inc 2009 129 Opal RAD User Manual Invert Contrast E Invert toolbar button Use this tool to invert the black and white pixel data giving the image a negative appearance Activate the Invert Contrast tool from the toolbar or go to the Images menu and choose the Invert option gt To perform invert contrast 1 Left Click on the image 2 Left Click on the Invert Contrast tool on the toolbar or select Invert from the Images menu gt To reset the image back to normal contrast 1 Left Click on either the Invert Contrast tool or the Reset Image Properties tool Invert contrast applies to all images in
91. le Rows This sets the number of rows displayed when the toolbox is created e Button Size This value represents the size of the toolbox buttons in pixels e Button Separation This value represents the amount of space in pixels that is placed between the buttons in the toolbox e Orientation Set the position of the toolbox to either above or below the Series Stack window Custom Toolbox with 5 tools You may optionally move your tools up or down the list to changed their position left to right within the toolbox control This can be done by Left Clicking on the tool to be moved and then Left Clicking on the or buttons Opal RAD is a registered trademark of Viztek Inc 2009 211 Opal RAD User Manual 212 Saving Your Settings Unless they are saved any changes you make to your Image Viewer s settings will only be temporary In other words they will only apply to the current study that you are viewing and once you close the study those changes will be lost But there is a way to ensure your viewer s settings are saved permanently gt To save your Image Viewer settings 1 On the Settings menu select Save If you would prefer to have your viewer s settings saved automatically you can do so through the Auto Save feature of the settings window When using this feature it is not necessary to manually save your settings before closing the image viewer gt To enable the Auto Save Settings fe
92. lick the Add To List button 5 Repeat steps 2 3 and 4 for each DICOM structure you wish to import and then click OK when you are finished The DICOMDIR file contains the directory structure for your DICOM data This includes Patient Study Series and Image data Be aware that when selecting a node Step 4 only those nodes and their child nodes will be added to your import list Add to Lint Adi Ertre Domde E or E Carcel Cow 84 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Importing Scanned Documents The Client Worklist has a feature which will allow you to import a scanned document into a study on your PACS server This is useful for attaching exam reports or other medical documents to their corresponding exams All that is required for the scanning feature is for a document scanner to be connected to and installed on the machine running the Client Worklist application gt To import a scanned document 1 Highlight the Study you attach the document to by Left Clicking on the record 2 Left Click on the Scan Paper button Fig 1 3 Load your document into the scanner and Left Click on the Scan button 4 When you are finished scanning documents Left Click on the Finished button If the Client Worklist detects that you have more than one scanner installed on the computer you will be prompted to select the correct scanner from the Select Source dialog
93. ments to run Opal RAD as well as security considerations Chapter Contents Welcome to Opal RAD eeeeeeeeeeeeeeeeeeeeeeeeeeeeanees 8 Features of the Client and Web Worklists 9 ME SUS eee a tee ted ha he de dake 11 The Image ViOWEl cccceeeeeeeeeseeeeeeeeeeeeeeeeeeees 14 Easy TO USG utili 16 How to Use This Mantal cccceeeeeeeeeeteeeeeeeees 18 Minimum Requirement oooocccccccccccccccccnnncnanaanccnnnonon 19 Security Statements iii id 19 Opal RAD is a registered trademark of Viztek Inc 2009 7 Opal RAD User Manual Welcome to Opal RAD The Opal RAD suite of PACS applications was developed specifically to handle the DICOM protocol for both transmitting and viewing DICOM images and data elements The applications were developed so that access to the PACS can occur from any Microsoft Windows computer with Internet capabilities and offer an interface that users find to be quite intuitive after some initial learning The Opal RAD applications deal with all manner of DICOM images and modalities including MR CT CR US and many others These images can be viewed manipulated annotated transmitted to other facilities printed animated and stored using the Opal RAD suite This manual is concerned primarily with the Opal RAD Client Worklist Web Worklist and Image Viewer applications The basic functionality of the Client Worklist and Web Worklist alternates between findi
94. n systems with multiple monitors each image viewer window will have its own set of image layout buttons as described above but there will also be a second set of layout buttons This set of buttons pictured below will apply a selected layout to ALL monitors at once gt To modify your image layout of all monitors 1 Left Click on one of the layout buttons on your toolbar Monitor 1 Monitor 2 The example above shows a single study being opened across dual monitors Note that the Series Stack window for the second monitor is empty Had we opened up two studies for comparison on a dual monitor system the studies would have loaded on separate screens with their own Series Stack windows Opal RAD is a registered trademark of Viztek Inc 2009 119 Opal RAD User Manual The series layout options allow you to specify the number of rows and columns viewable within a series Rather than splitting the window up into multiple panes for displaying multiple images series you are splitting up a pane so that you can display multiple slices from a given series gt To modify your series layout 1 Right Click on the series handle that is in the upper right hand corner of the windowpane 2 Select a layout i e 2x2 from the pop up menu XX Please see Chapter 9 Image Viewer Settings for instructions on setting your default image or series layout 120 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Ma
95. nal state select the Unsharp Masking tool again and choose Reset from the pop out menu Unsharp Masking applies to all images in a series 3 Unsharp Masking is strictly a viewing tool therefore images cannot be saved with the unsharp masking enhancement Opal RAD is a registered trademark of Viztek Inc 2009 149 Opal RAD User Manual 150 Show or Hide Study Overlays Overlays are the patient study or image data that appears on the image This is not to be confused with the Image Overlays which are saved in the DICOM header of some image files gt To show or hide overlays 1 On the View menu select Overlays A check indicates that they are enabled or press the O key on the keyboard Tools Images A Cutlines Linking Bis Overlays Layout Toolbars jus ME Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Opal RAD is a registered trademark of Viztek Inc 2009 151 Opal RAD User Manual Chapter Nine Annotations The Opal RAD Image Viewer also features a large number of image annotation tools to futher assist in the diagnosis of your images Most of the annotation tools described in this chapter have easy one click toolbar buttons to activate them They are also available from the Annotations menu Chapter Contents MOULIN eo 153 O 154 Freehand aprenia tetckerskae Gas a kena 155 BND SO akae beet oie 156 Rectangle Box ccocccccconocccccncccc
96. nanananann nono 85 Importing IPG Fl scoiasonasodsodaadaoadeias 86 Sena Push an EXAM sti ld iid 87 A A state ted 88 Comparing SIE a oa RRA A as eats 90 Patient Study Administration cccssseeecceeeeeeeseeesseeeeeeeeeees 93 Edit Patient and Study Information ccceeeeeeeeeeeteees 94 Merging Patient Studies oooooooccccccncccccncnononcccncncccnnnnnanann non 97 Creating a New StuUdY ccccccccnonnccccccccccnncncnnnncncnncnnnnncnananos 98 2 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Deleting and Purging Studies cocccccnncccoccccnnccccnnnnanannnonos 99 Deleting Study Images coooocccoccccccnncccccnnnnnnanancnononononanannns 100 Merging Images OvervVieW ooooococnnnncccccccnonnccnccnccnnnnnnnnnnnns 102 Merging Images Step By Step coccccccnnccccccccccccccccnnananns 104 The Image Viewer SCreen s s seeceeeeeeeesseseeeeeeeeeeeeenenees 111 An Overview of the Image Viewer Screen 0 112 The Image WindOW ccccceeesesseeccceeeeeeeeeeeeseneeeeeeeees 114 The Series Stacks WindOW ccceeeeeeeeeeeeetteeeeeeeees 115 Opening Images in the Image Viewel ceeeeees 117 Image Viewer LAayOUt cccceeeeeeeesssseceeeeeeeeeeeeneeeeeees 118 Moving Images Between Panels eeeeeeeeeeeeeeees 121 Image Viewer Context MenuG 2 eeeeeeeeeeeeeeeeeeeeees 122 Image Viewing Tools
97. nd then Left Click on Add Image to Print Queue 3 Repeat steps 1 and 2 for all images to be printed 4 Left Click the Print Queue button in the bottom left corner of the screen to open the Print Queue window Select a layout and adjust any other options and then Left Click on the Print button Print Que Image Options Image View Spacing gt r Image View Attriubutes ae Tae a Neate 0 i jals Header T Annotations Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual The Print Queue window offers many options for defining the layout of the printed page There is also a preview of what the printout will look like Print to Paper Options Set Layout You can choose a layout for the printed images by adjusting the column and row values with the text boxes After configuring your values click the Set Layout button The supported layouts include common configurations such as 2 X 4 indicating 2 columns by 4 rows Landscape Select this checkbox to change the view from Portrait default to Landscape Header Prints Institution name at top of each page Footer Prints patient data at bottom of each page Annotations Prints any annotations that have been place on the image Image Spacing Adjusts the spacing between images when printing multiple images per page Actual Image Increase image to actual size If the viewing area is too small the image will be cro
98. ne of several compatible scanners such as the Orex PcCR line of CR scanners the VIDAR Diagnostic Pro film digitizer Lumisys Film digitizers frame capture devices and any acquisition device that uses DICOM Film printing For those instances where film is essential Client Worklist provides advanced capabilities and control over the final appearance of the printed film and is compatible with virtually all film cameras Opal RAD User Manual Feature Client Web Acquiring Images Printing to Film CD Burning Deleting Studies Merging Studies Importing JPEGs Importing Scanned Documents Importing Images CD Edit Study and Patient Data Custom Study List Filters Comparing Exams Sending Studies Adding Study Notes Transcription User Group Administration DICOM Printer Creation DICOM Print Queue DICOM Send Queue Product Comparison DK OK DK DK DK DK DK OX OK DK DK X lt X lt XX XX OK lt DK OX gt X lt 10 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual The Study List As stated earlier Opal RAD Client Worklist and Web Worklist consist of two interfaces screens each with a separate function The first interface you will see after logging on to Client Worklist or the Web Worklist will be the Study List screen This interface is used for searching and selecting patient studies and sending studies to other users
99. ng a study and viewing the images it contains Thus the Client and Web Worklists have been divided into two different screens The first is the Study List which is used for searching and managing your studies The second screen is the Image Viewer which is used for viewing and manipulating the images contained in the study 8 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Features of the Client and Web Worklists Opal RAD Client Worklist and Web Worklist are highly configurable and modular but there are some functional differences between them The Web Worklist includes most of the advanced Study List features and the entire Image Viewing features but cannot create Patient CDs or importing images and scanned documents The Client Worklist includes all of the advanced Study List and Image Viewing features mentioned above Available modules in the Client Worklist add to this functionality by providing Opal RAD is a registered trademark of Viztek Inc 2009 Sending and Receiving images over phone line local area networks and the Internet The Opal RAD suite features truly impressive teleradiology capabilities including DICOM transmission receive and a proprietary format for transmissions between two Opal RAD machines utilizing compression encryption and auto resume functions Acquisition of images Client Worklist can be configured as a QC quality control Acquire station and connected to o
100. nnnnnnnnnncncnncnnnnnnnnnnnns 157 A A 158 Mens ocres 159 A E O A A Cone te are 160 CODD AIG is italia 161 Left and Right Marker ccceceeesssseseeeeeeeeeees 162 ROI Region of Interest oooocccccnnnccccccccnnccccnnnnnns 163 OMe Roane cae ar ni A eS 164 Magniy sires a aha e a aa aa a ooze 165 Prnt ROL ieis nioa o aae a eiaa 166 Spine Labels cias oracle ri siii 167 Cervical and Lumbar Curve coooooocccccccccccccccnnanaannncnos 168 Editing and Deleting Annotations ccee 169 A tees ipeteeeusned anes 171 152 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Introduction Annotation buttons Annotations Annotating in Opal RAD Image Viewer Edit consists of adding text and graphical objects to enhance or isolate regions of interest within an image Annotations Line do not permanently alter the image but Freehand are stored separately from the image data and are held in a transparent layer atop the image Think of a transparency sheet with writing that is Arrow placed over a picture Measure Save Ellipse Rectangle It is not possible for annotations to damage the original image data and they can be hidden at any time to allow Left Marker full analysis of the image Most of the Right Marker annotation tools described over the ROL next several pages have easy one click toolbar buttons to activate them and are also available from the Print ROI Annotati
101. nod tn id 41 Studies Changing The Status auroras 42 Creatina New Study ii ds 98 A ek a eg a as 99 Opal RAD is a registered trademark of Viztek Inc 2009 225 Opal RAD User Manual Editing Patients and SUISSE ean eae ne 94 IMPOR ta eee 83 DO e e dd 39 PI si 99 Ad A ARA oys 87 Study List BUON iia aislada ise 36 CO e a e td es a e a di 44 C ntext Men s ao 40 Filters SEARCININS A N 46 Navigatio esite das 38 Patient Studies Window vais csccsaaveejsccssseteaa ds desecasasvendesvendeeea er ticas 35 O R 48 Study Eist Settings a S EG 50 System A a R E A e Ra 19 TEAM CAPO odia 70 Po A A A ERE RT 72 PUNO OIC CLs 30 ct aa o cua sedeegauaettasaggssieadunen E E A EN 71 IEE OCU CHOU A E 65 Templates ii 75 IE 12 Web Worklist Settings Adding Editing Filters sy3 3 cisaseisssesssaseaa aie saeacashaa niin 60 Audio Player Las iD cidad ae 58 Auto Open Porse a A 59 Changing the User s Pass Oi e aii 56 Default Sort Cola ida 57 Study List ROWS saeia setia dd R E 55 Window and Level Presi tt 179 WV INO WS 2 oy Stes ca ota E 214 Context Menus ao 219 MEDI ind 218 O 221 226 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual A a es og oa dish tad es Oa nash ie A 220 sine the Keyboard td 217 Using THe MOUSE A ian scsatuts a da seas a a acciaedeauethers 215 Worklist Features iras 9 Opal RAD is a registered trademark of Viztek Inc 2009 227
102. nt Window Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual The Print to Film window offers many options for defining the layout of the printed images Print to Film Options Layout Choose a layout for the printed images by clicking any one of the layout buttons The supported layouts include common configurations such as 2 X 4 indicating 2 columns by 4 rows Copies The number of copies of the film Priority Change the priority of the print job A higher priority job will be completed first Orientation Print in portrait or landscape Actual Size Prints image in actual size rather than taking up the entire piece of film Trim Box Border around image This is a printer specific feature Smart Rotate When this option is selected a landscape image will always print landscape A portrait image will always print portrait Burn in Overlays Select this option to burn in the overlay information into the images so that they print to film Burn in annotations Select this option to burn in any annotations you ve made so that they print to film This includes markers text and measurements 1 Please note that the Web Worklist DICOM Print window does not contain an image preview feature Opal RAD is a registered trademark of Viztek Inc 2009 89 Opal RAD User Manual Comparing Studies By using the Client or Web Worklist you have the ability to compare one study
103. nt Worklist such as sending images to other doctors creating Patient CDs and acquiring images from film and plate scanners not included in the Web Worklist Web Worklist At the top of this screen are tabs separating the Study List from the Settings and Administration sections and a main window With the Settings tab users can modify their Study List s display settings With the Administration tab your administrator can add edit and delete user and group accounts They can also create DICOM printers and send destinations and manage the print queue 34 The specifics of all of the features described above will be covered in greater detail in the chapters that follow Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual peca s senn a nacoo s smm ecoa s aean neces s sph empen trde naco somn vans vero y ann on ee te paren s are e Pu s Geom trams sia recone tonse becos saton sers on Taceo e SR od nave este ane Lan an e er nao sar o ai os je reco y SaR arim ya vaxa DER at vw tsoen esson vama snamemo UR 1102 de vax AUER Cae on CA 1290 vente saanen enm ev ne sa ase re vea sanana poon se me WA a ene pares irm a vana nmmr me vaa a as mI ven eter eet vine a en eoa nt vom WOEL CUCA 1 51 20 mue PATRON CATIA ATA ikay ae ves A naan sm va es o oa ven aoe cane rw EEKE TEETER eo a a a a a a a a a a gt a a a a a oe a a a a ges
104. nual Moving Images Between Panels The Series Handle may be dragged and dropped to move images If a handle is dragged and dropped into another panel the image will move from the original panel over to the new panel If there is an image already loaded in that panel then this image will swap places with the one that was dropped as in the example below Before After 3 Images may also be dragged from a panel on one monitor to a panel on another Opal RAD is a registered trademark of Viztek Inc 2009 121 Opal RAD User Manual Image Viewer Context Menus Within the Image Viewer there are a number of areas for which there is a Right Click context menu The contents of the menu that appear upon Right Clicking will depend on the item that was clicked For example if you Right Click on an open image you will see the following menu appear View FullScreen FS jew Maximized View Dicom Values View HISTORY Add Image To Print Queue Add Series To Dicom Print Queue Save Image As Presets Unsharp Annotations bel St ISA Se Se External Tools Set KeyImage Add Image To New UNQ Study Cine Tools Close Study Image Right Click Options e View FullScreen Hides the menus and toolbar controls to increase the viewable area of the viewer e View Maximized Temporarily shows the selected image in a one by one window panel e View DICOM Values Shows a list of DICOM tags and desc
105. o go toa specific page 1 Left Click on the Jump To Page dropdown list 2 Select a page number from the list Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Opening a Study in the Image Viewer When you have located your desired study you may open it for viewing one of two ways To open a study in the Image Viewer 1 Double Click on the study in the Study List window or 1 Left Click on the check box to the left of the study in the Study List window 2 Left Click on the Open button OLEEL RS 3 You may open up to five studies at a time by using the Open button method Simply select all five studies prior to clicking the Open button The studies will open one at a time As each study is closed the next in line will open Opal RAD is a registered trademark of Viztek Inc 2009 39 Opal RAD User Manual Study List Context Menus Both the Client and Web Worklists have a Right Click context menu which can be accessed by Right Clicking on a study in the Study List The contents of the context menu will depend on whether you are using Client Worklist or Web Worklist For example if you Right Click on a study while using the Web Worklist the following menu will appear Send Print Log If you Right Click on a study while using the Client Worklist the following menu will appear Y Read Stat Remove Stat Send DICOM Print Edit Study Edit Patient
106. on locating a study in the Study List screen viewing and basic manipulation of the study s images in the Image Viewer screen and returning to the Study List The rest of the chapters explore individual sections of the Client Worklist and Web Worklist in greater detail including the Study List and Image Viewer screens The following feature are available for the Client Worklist advanced image viewing and manipulation tools operations printing to paper and film creating Patient CDs CD burning sending and receiving exams and acquiring exams from a supported acquisition device Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Minimum Requirements Opal RAD PACS Viewer Minimum Requirements e Window s XP Operating System e 1 Gigabyte RAM e 20 Gigabytes of free space on hard drive Security Statements Opal RAD will be accessible from any computer with internet access In order to keep the Opal RAD database secure there are several steps you should take to ensure the security of your data and the confidentiality of your records Since all Internet communication is subject to malicious attacks from outside sources it is highly recommended that your organization purchase a 128 bit SSL Certificate from a trusted authority such as Verisign or Thawte and install it on your web server By using a SSL Certificate you can ensure that all Internet access to your server is encrypted and pr
107. on menu in the menu bar Angle HAB Cobb Angle e Text Each topic below names an image annotation tool lists the ways to activate it toolbar button menu entry etc and explores its usage Opal RAD is a registered trademark of Viztek Inc 2009 153 Opal RAD User Manual Line Y Line tool button This tool creates a straight line on the image gt To use the Line tool 1 2 3 154 On the Annotations menu select the Line tool Left Click on an area of the image to set the line s first endpoint Move the mouse pointer to where the second endpoint will be notice that a preview of the line is drawn while you move the mouse Left Click on an area of the image to set the line s second endpoint Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Freehand A Freehand tool button This tool is used to draw freehand on the image With the tool you are able to draw any shape or figure that you desire gt To use the Freehand tool 1 On the Annotations menu select the Freehand tool 2 Move the mouse over the image to where you would like to start drawing 3 Hold down the left mouse button and drag the mouse As you move the mouse the drawing will mimic your movements 4 Continue to draw as necessary 5 Release the left mouse button to end the freehand drawing Opal RAD is a registered trademark of Viztek Inc 2009 155 Opal RAD User M
108. onfirm your choice click Yes in the dialog box 5 Left Click the Save button to save your changes and close the study editor Opal RAD is a registered trademark of Viztek Inc 2009 97 Opal RAD User Manual 98 Creating a New Study Periodically you may want to create a new empty study in the PACS With these empty studies you can then import graphics scanned documents or acquire images from a CR scanner To create a new study 1 On the Study menu select Create New Study 2 Enter values for all require fields those marked with an asterisk 3 Left Click the Save button If you would like to create a study for a preexisting patient and do not wish to reenter the patient s demographics simply Right Click on a study for the patient and then Left Click on Patient New Study Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Deleting and Purging Studies In order to remove a study from your study list it must first be marked for deletion This process is comparable to placing items in the Recycle Bin on a Windows based system In order to permanently remove a study it must be purged In Windows parlance this would the equivalent of emptying the Recycle Bin gt To mark a study for deletion 1 Right Click on the study in your Study List 2 Left Click on Delete Study from the pop up menu gt To purge your deleted studies 1 On
109. ontains the highlighted tag to save your changes You may optionally move your tags up or down the list of displayed tags by Left Clicking on the tag to be moved and then Left Clicking on the or buttons 3 It is critically important that you do not modify or remove the S text when adding or updating your overlay tags If this text is removed then no value will appear in the designated spot on the overlay text regions Opal RAD is a registered trademark of Viztek Inc 2009 209 Opal RAD User Manual 210 Toolbox Options The Toolbox Options Tab is use to build a customized list of image tools and annotations This benefits the user by giving him her the ability to quickly locate and use tools that they frequently use are Ns 009 Seve gts ers Cr 0 gt To create a custom toolbox _ ook On the Settings menu select Edit Left Click on the Toolbox Options tab Left Click on the tool or annotation in the list on the left Expand the list of tools by Left Clicking on the icon Left Click the button to add the tool to your toolbox Repeat Steps 3 and 4 for each tool you wish to add Adjust your other options as needed and then Left Click the OK button to close the settings window Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual The Toolbox Options include the following settings e Number Of Visib
110. otected from outside sources Each user will have a personal user name and password with which to access the Opal RAD Worklist Your Opal RAD administrator will be responsible for determining those user s rights and defining security protocols such as user the time out duration password length and permissions Opal RAD is a registered trademark of Viztek Inc 2009 19 Opal RAD User Manual 20 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Chapter Two Basic Workflow of Opal RAD This chapter offers a walkthrough for typical usage of the Client Worklist and Web Worklist The walkthrough includes locating a study in the Study List screen viewing and basic manipulation of the study s images in the Image Viewer screen and returning to the Study List Chapter Contents INTOU COn ios 22 Step 1 Logging A O a 23 Step 2 The Study List SCreeN ooooooooocoocccccccccnnnnnnoo 25 Step 3 Sorting and Searching Your Studies 26 Step 4 Installing and Updating the Image Viewer 27 Step 5 Opening a Study in the Image Viewer 27 Step 6 The Image Viewer SCreeN ooooooococccccccnnnnnoo 28 Step 7 Closing a Study oooooooocccococococononnonononnnnnnnnns 29 E A A IO 30 Opal RAD is a registered trademark of Viztek Inc 2009 21 Opal RAD User Manual Introduction Opal RAD Viewer a k a Viewer for brevity is an application that allows users to view and manipulate
111. ottom panel can only be dropped into the top panel Opal RAD is a registered trademark of Viztek Inc 2009 107 Opal RAD User Manual Below are two screenshots taken before and after a patient s series was merged into another patient s study After Merge 108 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual gt To search for a patient using the merge utility 1 Left Click inside the blank space below the column you wish to search by For example if you wish to search for the patient by name then Left Click below the Patient Name column 2 Enter a value and press Enter Before Hepburn After Opal RAD is a registered trademark of Viztek Inc 2009 109 Opal RAD User Manual 110 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Chapter Seven The Image Viewer Screen The Opal RAD Image Viewer is a Diagnostic Quality image viewer where you will perform all of your image viewing and manipulation The Image Viewer has a wide range of tools at your disposal to aid in the reading and diagnosis of images This chapter will explore in detail the viewer its tools and their usage Chapter Contents An Overview of the Image Viewer Screen 112 The Image Wind OW sotana 114 The Series Stacks WindOW 2 ceeeeeeeeeeeeees 115 Opening Images in the Image Viewer 117 Image V
112. pal RAD User Manual Opening Images in the Image Viewer There are two methods for opening images series in the Image Viewer gt To open an image Method 1 1 Double Click on a thumbnail image on your series stack window When you open an image or series in this manner it will open up in the first available window panel If there are no panels available then it will open in whichever panel currently has focus gt To open an image Method 2 1 Drag and Drop the thumbnail image from the series stack window onto the image window The drag and drop method will load your series in whichever pane you drop it into whether there is already a series loaded or not If after placing your images on your panes you wish to view only one image at a time simply Double Click it The rest of your panes will disappear temporarily Double Click the image again to bring back your original layout Opal RAD is a registered trademark of Viztek Inc 2009 117 Opal 118 RAD User Manual Image Viewer Layout The image layout options allow you to specify the number of windowpanes that constitute your image window gt To modify your image layout 1 Left Click on one of the layout buttons on your toolbar 2 On the View menu choose Layout and then select a layout i e 2x2 from the pop out menu Example of a 2x2 image layout Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual O
113. pped Use the dropdown list to position cropped image in frame This is the number of pages to display in the preview window Clear Clears all images out of the print queue Opal RAD is a registered trademark of Viztek Inc 2009 181 Opal RAD User Manual Saving Images to a File The Opal RAD Image Viewer has the ability to save any image in your study to an external file This save feature supports the following file formats Bitmap JPEG GIF and PNG gt To save an image to a file 1 Right Click on the image and select either With Annotations or Without Annotations from the pop out Save Image As menu See below 2 The Save As dialog box will appear Select the location where you wish to place your saved image Enter a file name in the File Name textbox Select file type from the Save as Type dropdown list Left Click on the Save button O po View Dicom Yalues view HISTORY Add Image To Print Queue With Annotations Without Annotataions Presets Unsharp Set KeyImage Add Image To UNQ Study Add Image To New UNQ Study Delete All Annotations Link Close Study 182 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Sending an Image to an External Application The Opal RAD Image Viewer contains a feature which allows the end user to pass a DICOM image to an external 3 party application Before using this feature your externa
114. rder to create saved search filters you must be logged into the Web Worklist application 60 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual gt To add create a study list filter 1 2 3 4 5 6 Left Click on the Settings tab Left Click on the Filter Menu node to expand the filter menu settings Enter a name for your filter in the New Filter Name textbox Enter criteria in the remaining fields as needed Select a user name in the Save For User dropdown list only the Admin users will have this option Left Click on the Add Filter button gt To edit a study list filter _ 5 Left Click on the Settings tab Left Click on the Filter Menu node to expand the filter menu settings Select a filter in the Filter Name dropdown list Modify your fields as necessary If you make a mistake and would like to cancel you changes Left Click on the Cancel Changes button Left Click on the Update Filter button gt To delete a study list filter h Left Click on the Settings tab Left Click on the Filter Menu node to expand the filter menu settings Select a filter in the Filter Name dropdown list Left Click on the Delete Filter button Opal RAD is a registered trademark of Viztek Inc 2009 61 Opal RAD User Manual Notes on adding and editing filters e Only the Admin Group will be able to save filters for other users All other groups can only
115. re available to all transcription users If however you wish to create an entry for only yourself uncheck the Global checkbox before clicking Update Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Opal RAD is a registered trademark of Viztek Inc 2009 79 Opal RAD User Manual Chapter Six Advanced Tools This chapter explores some of the more advanced viewing features found in the Opal RAD Client Worklist Some features are in the Web Worklist Chapter Contents Creating a Patient Disc CD Burning 0 81 Importing Studies casi rias 83 Importing Scanned DocuMentS ccocoocccccnnocancccnonnnos 85 Importing JPG Files ooooooooooccccccccccccnnnananaccnononcnnnnnno 86 Send Push an EXAM xcrcte cit encstcesieiiietesttconi cs 87 Print to FU isidro 88 Comparing Studies oie sis 90 80 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Creating a Patient Disc CD Burning gt To burn a patient study to a CD 1 Launch the Client Worklist Study List screen 2 Highlight the Study you intend to burn to a CD by Left Clicking on the record 3 Left Click on the CD Burn button which appears at the bottom of the Study List screen 4 The Opal CD Burn window see the following page will then appear In this window select the study you wish to burn by Left Clicking on the check box in the left most column 5 Left Click on the Star
116. red trademark of Viztek Inc 2009 187 Opal RAD User Manual User Options Tab On the Modality Option Tab you will find the fields for adjusting you Modality Presets Screen Layout and Series Layout defaults Both the presets and layout options are modality dependent which means that you can configure different settings for each modality in your Modality list x Local Options User Options Modality Options Annotations Options Chiropractic Options Overlay Config ToolBox Options r Interface Options AutoS ave Options I Auto Hang On Stream I AutoSave Image Properties on Close TT 2 Column Thumbnails JT AutoSave Image Annotations on Close Y Show WAL On Toolbar JT Auto Mark Read Study on Close IT Hold For Record I Auto Upload Dictation on Close I Open Key Images As Single Image IV AutoSave Viewer Settings on Close Auto Open Next Stud IV Show Red Blue Swap Button For Color Images SAND eee SNe i I Auto Save Study HP Y Caliper Zoom A J Overwrite Current StudyHP on AutoSave StudyHP I Focus In On Zoom Point 7 Fill Empty HP Cells Advanced IM Reset W L For Individual Images r Re Sort Images DoNot Slice Location Cancel Apply 188 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Modality Options Tab On the Modality Option Tab you will find the fields for adjusting you Modality Presets Screen Layout and Series Layout defaults Both the presets
117. riptions sent from the modality e View History Shows clinical history saved in the DICOM header 122 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual e Add Image To Print Queue This adds the currently selected image to the paper print queue e Add Series To DICOM Print Queue Adds the series for the currently selected image to the DICOM print queue e Save Image As This allows you to save an image to a an external file e Presets Applies a preset Window Level to the current image e Unsharp Applies an unsharp mask to the current image e External Tools Sends the image to a pre defined external application e Set Key Image Creates a key image for the study e Add Image To New UNQ Study Adds current image to Pre Op Study e Delete Current Annotations Deletes the currently selected annotation e Delete All Annotations Deletes all annotations on current image e Delete All Annotations for Series Deletes all annotations that persist across multiple slices such as the Spine Tool e Link Links the selected series to any other series of the same view i e Coronal Axial e Cine Tools Opens or closes the Cine Toolbar control e Close Study Closes the current study 34 The contents of this menu may change from image to image depending on whether or not there are Annotations Presets installed External Tools and so on Opal RAD is a registered trademark of Viztek Inc 2009 123
118. rring Physician 7 Dicom Name DR THEODOR S GEISEL Address Phone 904 555 9999 Specialist First John Last Wayne MI Sex M DOB 11 1 1903 12 00 00 AM SSN Desc Shoulder Montre PDICOMID 21002 Body Part SHOULDER Modality cr Facility Templates Transcription Y NONE al Fa TU approve now Observation Impression Submit for Review Submit for Review amp Next e 3 pr es Transcription window Transcription user Opal RAD is a registered trademark of Viztek Inc 2009 71 Opal RAD User Manual Approving Transcribed Reports Once the reports have been transcribed it is then up to the physician to approve the reports Approving the report is then simply a matter of opening the Transcription module reading the report and selecting the Approve button gt To approve a report 1 Left Click the Transcription icon next to the Transcribed study to open the Transcription window 2 Make any changes to the text as needed 3 Left Click on the Approve button to approve the report and close the Transcription window 4 Optionally you may select the Approve amp Next button to approve the current report and open the next Transcribed study in the Transcription window Once approved the report will be electronically signed with the approving physician s signature and the study s status will be changed to Approved xt If Auto Fax feature is enabled a copy of th
119. rver into the address bar and press ENTER 3 Enter your User Name and Password and then click LOG IN 3 The User Name and Password are both case sensitive Opal RAD is a registered trademark of Viztek Inc 2009 23 Opal RAD User Manual 24 The Log In Screen Please consult your PACS administrator or similar authority to receive your username and password Requiring a valid username and password is an effective security measure for protecting the records of your patients Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Step 2 The Study List screen The first interface you will see after logging on will be the Study List screen Web Worklist pictured This interface is used for searching and selecting patient studies and sending studies to other users Above the study list are tabs separating the study list from the settings and admin sections Below the list you will find your toolbar and page navigation controls Opal RAD is a registered trademark of Viztek Inc 2009 25 Opal RAD User Manual 26 Step 3 Sorting and Searching Your Studies The Study List window is divided into columns such as Status Modality Patient Name etc The data contained under these columns can be both sorted and searched gt To sort the study list 1 Left Click on either the up or down arrows next to the column name The listing will now be sorted by whichever column you c
120. ser Manual 140 Display Management DM Display Management tool button Many physicians prefer to display images a certain way each time they open a study To expedite this process of displaying images you can use Display Management The display settings once defined can be saved for the current study or for all studies of a certain type i e MR CT US gt To save your display settings for all studies 1 Left Click on the Display Management tool and select Save gt To save your display settings for a single study 1 Left Click on the Display Management tool and select either Save For Study or Save As 2 If you selected Save As enter a name in the textbox and select OK gt To apply your display settings to the current study 1 Left Click on the Display Management tool and select your saved display setting from the list If the display setting was saved using the Save For Study option select Default from the list Any display setting using the Save option will be applied automatically the next time studies of this type are opened Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Mammography Layouts In a typical mammography screening exam four X Rays of the breast are acquired In conventional practice two views are obtained for each breast The first is the Cranio Caudal CC view The second view is called the Medio Lateral Oblique MLO view When v
121. t Burning button to commence the burning process Please note that CD burning is a system intensive process and requires the entire computer s processing to achieve It is therefore necessary to wait while until the CD is complete before continuing to use the Client Worklist With current recording technology and speeds most discs are complete within three minutes Particularly large exams may take more time to complete Also note that Patient CDs can only be created one at a time in the Client Worklist Opal RAD is a registered trademark of Viztek Inc 2009 81 Opal RAD User Manual 82 mon aim PationtNema bese etudyoate Bee 4 Buck Rogers Leg Bone 24 10 2006 d per Sl Buck Rogers KNEE 16 01 2007 d Clore a JPEG 2000 hd d With VIEWER Ml Anonymize CD BURN Start Burning Close If this is not sufficient for your institution s needs perhaps you need to create large numbers of CDs or cannot have your reading interrupted by the CD burning process please consider either purchasing a separate workstation devoted to creating CDs or purchasing an Opal RAD CDR Server to automate the process For more information please contact Viztek Inc 3 Burning a CD is only available through the Client Worklist and requires that the workstation have a CD Recordable drive installed and configured Please contact your Viztek support staff for any questions Opal RAD is a registered trademark of Viztek Inc
122. t Click on the Settings tab 2 Left Click on the Column Order node to expand the column settings 3 Left Click on a column in the Unselected list 4 Left Click on the Add button to move the column to the Selected list 5 When you are done adding columns Left Click on the Save button to save your changes and return to the Study List When a column is added to the Selected list box it will automatically appear at the bottom of the list For instructions on moving the column on the list please see the next topic Rearrange Study List Columns gt To remove Study List columns 1 Left Click on the Settings tab 2 Left Click on the Column Order node to expand the column settings 3 Left Click on a column in the Selected list 4 Left Click on the Remove button to move the column to the Unselected list Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual 5 When you are done removing columns Left Click on the Save button to save your changes and return to the Study List You may add or remove all columns at once by clicking the Add All or Remove All buttons these are the bottom two buttons circled below Selected Status Image Count Modality Patient Narne UnSelected Institution Description Recieved Date g Add Selected Remove Selected p Add All p Remove All XX It is not necessary to select a column from either list box when using the Add All
123. tails Upon returning to the Study List you will notice that your previous sort and search filter are still in place To bring back the entire patient list delete everything from the search fields and press ENTER or Left Click the ALL button Opal RAD is a registered trademark of Viztek Inc 2009 29 Opal RAD User Manual 30 Going Further This completes our sample session using Opal RAD Client Worklist Web Worklist We have only looked at the most basic functionality of the software selecting and viewing a study The both the Study List and Image Viewer contain many useful and specialized functions designed to increase efficiency and the quality of reading patient studies Please consult the more advanced sections of this manual to familiarize yourself with those features Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Opal RAD is a registered trademark of Viztek Inc 2009 31 Opal RAD User Manual Chapter Three The Study List Screen This chapter explores in detail the first of two screens you will alternate between while using the Client Worklist or the Web Worklist This screen lists all of the exams in the database s you are connected to allowing you to filter and sort the listing as you navigate the list From this screen you can also change a study s status send it to another site create Patient CDs and view study histories Chapter Contents An Overview of t
124. ted dropdown lists To search by one of these fields simply select a value from the dropdown list To remove this value just select the blank entry or the ALL option at the top of the list Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual gt To remove a filter from your study list 1 Erase the search phrase from the search field and press ENTER gt To remove all filters from your study list 1 Left Click on the All button on your toolbar gt To display only Unread studies 1 Left Click on the Unread button on your toolbar Client Worklist Web Worklist gt To use a Saved Search Filter 1 Selecta filter from the Filters dropdown menu MEA vy CR Fiter I xt In order to use Saved Filters you must create them through the Web Worklist Settings window Please see Chapter 10 Web Worklist Settings for more details Opal RAD is a registered trademark of Viztek Inc 2009 47 Opal RAD User Manual 48 Refreshing the Study List Depending on his her permissions a user from one workstation could potentially add remove or modify a study on the study list If there are other users operating from other workstations they may not see these changes immediately To ensure that your study list is showing the most current and up to date data you may refresh the list gt To refresh the study list 1 Left Click on the Refresh button on your toolbar Through the Web Worklist you
125. the Study menu select Purge 2 In the Purge Study window that appears select each study you wish to purge 3 Left Click on the Purge Study button 4 To confirm your choice click Yes We can distinguish deleted studies from other studies on the list by their status type i e Unread Read We can un mark a study for deletion by changing the status just as we can restore items placed in the Recycle Bin gt To un mark a study for deletion 1 Right Click on the study in your Study List 2 Left Click on Unread from the pop up menu Opal RAD is a registered trademark of Viztek Inc 2009 99 Opal RAD User Manual 100 Deleting Study Images Using the Client Study List the end user can delete individual images or entire series of images from a study To do this you must first open the Delete Series or Image dialog utility see following page for screenshot gt To delete a series of images 1 Left Click on the study in your Study List so that it is highlighted 2 On the Study menu select Delete Study Image The Delete Series or Image Utility will open 3 In the Series panel Left Click on the checkbox next to the series you wish to delete 4 Left Click on the Delete Series button 5 To confirm your choice click Yes gt To delete individual images 1 Left Click on the study in your Study List so that it is highlighted 2 On the Study menu select Delete Study Image 3 In the Series p
126. the two points and Left Click to place the curve AON gt To use the Lumbar Curve tool 1 On the Annotations menu select the Lumbar Curve tool from the Chiropractic sub menu Left Click on the image to set your first point Left Click again to set your second point Move your mouse to either side of the axis that is created between the two points and Left Click to place the curve AOD 168 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Editing and Deleting Annotations ma Annotation Edit Mode button The Image Viewer includes the ability to select edit and delete previously created annotations Before you are able to edit or delete an annotation you must first select it and to do this requires that you enter into Annotation Edit Mode gt To enter Annotation Edit Mode 1 Left Click on the Annotation Edit Mode tool on the toolbar or select Edit from the Annotations menu gt To select an annotation Enter Annotation Edit Mode see above Move the mouse over an annotation Observe the annotation will light up when the mouse moves over it 3 Left Click the annotation to select it It will change colors and several little filled boxes called handles will appear on the annotation 4 The annotation is now selected N Now that our annotation is selected we can edit it i e reposition or resize it There are two types of editing cursors When the cursor
127. to these studies will also appear a symbol which once clicked will expose the list of series contained within the selected studies Once a node is expanded the symbol will be replaced with a i Merge Window expanded 4 Expand or collapsed the nodes as needed until you locate the Source object 5 Left Click on the Source object so that it is highlighted Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual 6 Left Click again and drag the object As you drag the object your cursor will appear to be dragging a tiny rectangular box with it 7 Drop the object on top of its destination 8 A dialog box will appear asking you to confirm your action The Source and Destination types will dictate the dialog box that appears Below are two examples CONFIRM xi P Moving Series wy Cervical LAT into patient study Rubble Betty 1 3 51 0 7 11810466624 13421 47692 45354 34176 29419 38200 Are you sure you wish to continue e Series to Study CONFIRM xj Merging series E Cervical LAT with series 0 Thoracic LAT Are you sure you wish to continue Cele Series to Series 9 Left Click on the Yes button to confirm your choice 10 When you are done moving images Cleft Click on the Done button to close the Merge Studies window 34 Objects moved from the top panel can only be dropped into the bottom panel Conversely objects in the b
128. tus of a Study each study loaded on the PACS is initially assigned a status of Incomplete For those users who do not use the built in Dictation Transcription module the incomplete studies will be validated to Unread and then eventually marked as Read by the reading physician But when the Dictation Transcription module is used the study s life cycle does not end after the study has been read Rather it ends after a study s exam report has been approved and electronically signed by the physician It is through the Dictation Transcription module that we will reach that goal We start by recording a dictation file and saving it with the exam Then a transcriptionist will listen to the saved file transcribe it and send it back to the physician for approval The physician will then determine the accuracy of the transcribed report and choose to approve or not approve it In the following pages we will explain how this multi stage process works But first please refer to the diagram on the next page as it illustrates the workflow process defined above Opal RAD is a registered trademark of Viztek Inc 2009 65 Opal RAD User Manual INCOMPLETE DICTATED TRANSCRIBED APPROVED Lt Lt Lt Opal RAD Workflow 66 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Dictating a Study Dictation may be created from both the Image Viewer and the Transcription module The
129. unicidad 126 es Mes n nra a a a 128 Reset Image Malena 129 Invert COMMAS a5 ora ttaetitalcl etal Nese order o 130 Change Orientation TOols cccceeeeeeeeeeeeeeeeeeeeeeeees 131 TUS Size TA aa 132 PaO WU OW ces ccs cede apes eyiigacetnnds envtancusgietancetnet eeceisied ade 133 Magme eae eR Tema ete Re teeny ere Tey 134 Loo A a PENAT TEET Tenner Tien reer Ty eneyere eri 135 PM a ie Datel ictal othe 136 ACI LG k ss serge set aiee sat seca asic cients asap 137 Window and Level Width amp Center oooocccnnnnnncccccncccc 138 A A ea he tea 139 Display Management asada daa 140 Mammography Layouts cccccnccnccccccnccccccononnnanannncnnnnnnnnanannns 141 Mammography ToOOIS eecceeeeeeeeeeeeeeeeeneeeeeeeeeeeeeee 144 Image Overlays scala a Ae ea eR ae 145 GOMUOXE TOON 2c focuses tii 146 Houngsfield Pixel Vall acacia copas 147 OOO sepelio tds 148 Unsharp MaskiNd cuisine 149 Opal RAD is a registered trademark of Viztek Inc 2009 3 Opal RAD User Manual Show or Hide Study OverlayS ccccceeeeeeeeeeeteeeeeeeees 150 ANOTA ON S csi nc pas ud 152 INTOdUCUON wisin claras 153 O a 154 A A 155 Elie E Sabie inutile cad 156 Rectangle BOX usaste 157 A EE 158 A n ena eet cae ade erature aes eke aen iA 159 O 160 CODD AMONG io oso 161 Left and Right Marker oooococoncccccocccccccccccnnncnanannncnnncncnanannnns 162 ROI Region of Interest oocccccnconnnccccncnnccnccnccnancnnnnos 163 V
130. ur selected layout which can be changed by selecting one of the column layout buttons The viewer can be changed to display your open images in a variety of configurations including 1x1 1x2 2x1 2x2 2x3 3x2 and 3x3 Please see the topic Image Viewer Layout in this chapter for more information Opal RAD is a registered trademark of Viztek Inc 2009 113 Opal RAD User Manual The Image Window The largest area of the Image Viewer and your central workspace is the image window This is where image viewing and manipulation occurs Note that only a limited number of images may be shown in viewing area at one time only so many will fit thus arrows above each series pointing left and right will allow you scroll through the images in the series The scroll wheel and Span button discussed later will also accomplish this Navigating through a series You can navigate through the images in a study by any of these methods e Use the scroll bar at the top of the Image window e Use the UP ARROW and DOWN ARROW keys e Use the Span button on the toolbar The horizontal scrollbar at the top of the image will display the location of the image that is being viewed in relation to the number of images in the series i e 9 12 VIZTEK INC l Image 9 Name An Flip 114 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual The Series Stacks Window Leftmost on the screen is the Series St
131. with a previous study from that same patient This will require that you select two studies one from the Study List and one from the Patient Studies Window gt To compare two exams 1 90 Left Click on a study in the Study List The study will appear highlighted and any previous exams for this patient will appear in the Patient Studies Window Left Click on a study in Patient Studies Window Left Click on the Compare button This will bring up the Viewing Window On single monitor systems you will see two groups of thumbnail images in the Series Stacks window Each group will have its own study header as in the example below On dual monitor systems each of your studies will open on its own monitor Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual 5 Choose the vertical or horizontal split view which is in the top right corner of the screen or the View menu View Tools Images Annotations Help Toolbars gt 1x2 2x1 2x2 2x3 3x2 3x3 Custom 6 Double click or drag and drop the first image or series into the first pane 7 Left Click on the header information of the second study to bring up the second studies images 8 Double click or drag and drop the second image or series that you want to view in the second pane Now both images can be manipulated 9 To return to the Worklist screen Left Click on the X in the upper right corner of the screen Opal R
132. y toolbar button The image on the left shows this button when the Magnify tool is not selected the one on the right indicates the Magnify tool is selected Notice that the button on the right appears lit up On grayscale monitors and in this manual the button will appear lighter in color than its deselected counterpart 220 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Scrollbars Use of a scrollbar is quite simple and there are a few different methods of using one Use the end cap arrow buttons To scroll down click the down arrow button at the very bottom of the scrollbar To scroll up click the up arrow button at the very top of the scrollbar Move the slider up or down by dragging it Position the mouse cursor arrow over the smaller gray bar contained inside the scrollbar While holding the left mouse button down move the mouse up or down to move the slider accordingly Click in the empty area of the scrollbar in an area where the inner gray slider is not located above or below the inner gray slider to move the bar up or down accordingly This is similar to the operation of the PAGE UP and PAGE DOWN keys on the keyboard Opal RAD is a registered trademark of Viztek Inc 2009 291 Opal RAD User Manual 222 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Index FS COE CUEING estos ias 74 AMOS ii
133. y brightness and contrast of an image Adjusting the window and level of an image allows for viewing different levels of an image e g moving from bone to soft tissue gt To perform the Window amp Level 1 Place the mouse cursor over the image 2 Hold down the right mouse button 3 Move the mouse horizontally and or vertically the image is adjusted as you do so 4 When satisfied with the image release the right mouse button Vertical movement of the mouse adjusts the window and horizontal movement adjusts the level Window amp Level applies to all images in a series 138 Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Span Scroll Images ia Span Scroll Images tool The Span Scroll Images tool is useful when looking at a study that contains series with multiple images CT MR US The tool allows the viewer to move through the images in a series The Span Scroll Images tool can be found in the toolbar and also as an option in the Tools menu gt To use the Span tool 1 Left Click on the Span Scroll tool on the toolbar or select Span Scroll Images from the Tools menu 2 Move the mouse cursor on top of a series 3 Hold the left mouse button down and move the mouse to the left to go up a series towards the beginning or to the right to go down a series towards the end Opal RAD is a registered trademark of Viztek Inc 2009 139 Opal RAD U
134. your Study List gt To adjust the number of rows records to display 1 Left Click on the Settings tab 2 Left Click on the Rows to Display node to expand the row settings 3 Left Click on the dropdown list box and select a value 10 20 30 40 or 50 4 Left Click on the Save button to save your changes and return to the Study List Opal RAD is a registered trademark of Viztek Inc 2009 55 Opal RAD User Manual Changing Your Password In order to log in to the Opal RAD PACs server you need to pass the system a username and password see Logging On in Chapter 2 Basic Workflow of Opal RAD for more information If you would like to modify the password you can do so through the Web Worklist Settings Tab gt To change the user s password 1 2 3 56 Left Click on the Settings tab Left Click on the Change Password node to expand the password settings Enter your new password in the textbox Left Click on the Save button to save your changes and return to the Study List Opal RAD is a registered trademark of Viztek Inc 2009 Opal RAD User Manual Default Sort Column By default The Study List is sorted on the Study Received Date column If you would like to modify this default behavior you can do so through the Web Worklist Settings Tab gt To modify the default sort column 1 2 3 Left Click on the Settings tab Left Click on the Default Sort Column node to

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