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Synapse® MPR/Fusion

1. Closes the dialog box Patinet study Image information x Accession number 7011025320030416 Patient ID 0000043465 OO Patient Marne Fuji Hanako 00000000 Birth Date 0003 08 19 897N0599H Gender F Study Date 0004717 f2o Study Time 02 10 40 Acquisition Date Acquisition Time Modality Slice Number Slice Thickness 2005 04 14 14 13 54 Ps miri Slice Spacing 75 mrm Image Size x 413 413 Pixel Spacing 0 572000 rim 35 4 Stereo Viewer The Stereo Viewer visualizes the study images of the selected series mostly MIP images of MRA in a format specific useful for stereopsis In the MPR Viewer right click anywhere on the image plane to display the context menu click Stereo View and then click an option for the appropriate projection angle interval RenderingRotate Presets Interval 10 degree Stereo View Fusion siew Interval 8 degree Interval 6 degree Initialize Appraximate Orthogonal Interval Free degree Approximate Single Oblique Clicking the menu option to specify the projection angle interval displays a value entry box where you can enter a value Enter a projection angle interval value and then click OK The entered angle value must be an even number from 2 to 16 Cancel Cancels the current operation Stereo Angle Feree X Cancel 36 897N0599H 897N0599H The Stereo Viewer opens The Stereo
2. Studi Date 2 1 2007 Mod alit Fr D Sine with ove el ny Sele cred image iz saved in Sra amp FPRE OK Cancel lt Supplementary gt Selection of the Study ID and the Modality is possible only when there are two or more options An image is saved on the Synapse Server a study of the ID specified in the Study ID box as a modality image specified in the Modality box Additionally when you specify a save destination study ID the date of the associated study appears as reference information Next a confirmation message opens Verify the message and then click OK Cancel gt Returns to the image save dialog box 897N0599H 49 B Reading protocol The Fusion Viewer offers three image reading formats A layout is predefined for each of these formats Right click in an appropriate place to open the context menu and then click Next Format Clicking Back Format lets you to go back to the previous format w Show Overlay Back Format k B The three reading formats change alternately in the following sequence Format 1 Upper area CT Original PET Original Lower area CT Reformatted B PET Reformatted B CT Reformatted A PET Reformatted A PET Reformatted B whole MIP Click Next Format Y A Click Back Format Format 2 Upper area CT Original PET Original Lower area CT Original No Fusion processing is applied PET Reformatted B whole MIP Click Nex
3. Size 10 Color R 255 Linelnfo Set the ON or OFF status individually for the line width color and shadow of each overlay type Select an overlay type from the list Enter values for the width 1 to 10 color 0 to 255 for each of R G and B and shadow ON or OFF respectively Fontlnfo Set the ON or OFF individually for the size color and shadow of each font type Select a font type from the list Enter a value for the size color 0 to 255 for each of R G and B and shadow ON or OFF The following is an example of Lineinfo and Fontinfo based on settings you select Original Wi 230 WC 708 Reformatted A MFVR 327 0 mm 2003 04 17 Ag MPR 0 47 mm w a Z 2l 14 10 40 Oblique WW 280 WC 70 Reformatted B MPVR 32 0 mm se ey nt am Wiig Thickness line of the l EM Oblique plane A E k Center of rotation of Tu the Oblique plane Measure 60 897N0599H Appendix 1 Messages 1 Messages that may appear at image reading NN 1 540 You selected an image that is The Software cannot handle this not supported for processing for image example a color image 541 542 The size of the image is out of The Software cannot handle this the range that can be handled too image large or too small 543 544 The pixel spacing cannot be The Software cannot handle this handled For example the pixel image spacing value has not been defined in the image data 4 545 The slice spacing cannot be
4. 256 Cancel 23 24 Setting for a multiple image plane Applies rendering presets for mode slab thickness and flip rotation to each of the image s planes that are being displayed Flip Rotation see page 54 Right click the target image to open the related context menu Then from the sub menu of RenderingRotate Presets select a preset RenderingRotate Presets see page 59 NWARNING MIP k MinIP k PresetO Chrl NLIMPAD O RenderingRotate Presets C Vi z Presetl Ckrl MLIMPAD 1 5 Ru Pii Preset Cbhrl NUMPAD 2 ie ki Presets Chri NUMPAD 3 Fusion vw Ier Presek4 Chrl WUMPAd 4 CPR Setting plane e When setting the slab thickness select or enter a value that is appropriate to the image Setting an inappropriate slab thickness may result in a rendered image with insufficient information Visualization with MIP processing or MinIP processing may not render the context of blood vessels and the bronchi accurately due to the algorithm 897N0599H B Curved Planar Reformation CPR visualization This section describes the operation to draw a free curve in one of the three orthogonal image planes and display a Curved Planar Reformation image in the Oblique window Among the three orthogonal planes right click anywhere on an image to display the context menu and then click CPR Setting plane CPR Setting plane CPR Reset BPR Revise parit Select a group of images Ld Click p
5. Gradation preset CT m w w 2 Gradation preset MRI oo ome w o S Preset 3 Head MPRAGE 200 900 Preset 4 Head IR 1000 Preset 5 Head Diffusion 700 200 Preset 6 Head T2 eoi 2000 1100 Head GE T2 1000 1000 3 Gradation preset Other p me ww we 4 Monitor settings 1 and 2 BEEN EE Selectediine Jo 255 25 95 Orthogonal plane thickness line 1 OFF 255 255 0 Oblique plane thickness line 1 OFF 255 o Orthogonal lines Oblique line 897N0599H 63
6. MOT L To start IntelliLink processing move the pointer to an appropriate place on the image plane and then left click IntelliLink processing starts displaying cursors in the relevant places on other image planes 897N0599H E Saving an image to the Synapse Server A currently displayed image plane can be saved by uploading it to the Synapse Server Right click anywhere in the target image plane to open the context menu and then clic Save to SYNAPSE Bd Pot Yaire usw Ej Rebum to the MER ee An image save box then opens Enter a series name using single byte alphanumerics select a save destination server a save destination study ID and a modality and then click OK Save with overlay If this option is selected the image with overlay is sent Cancel gt Cancels the operation CAUTION When the server to which the image should be sent is not found the following message appears under the Save with overlay option in the Save dialog box Please make sure the server in the details of transfer field is correct If this message appears please contact your local authorized FUJIFILM dealer Z CAUTION When the servers where CT and PET exist are different the server where PET exists is selected first PE hm Berles Mare MPR Bel Ct zs maps eai IE Detail of En ce wer Pad dress 0 0 0 0 mansrer Part 104 SenderA ET tle S01 EW ER Fe ceverGeEvitleSynapsebic ore cF Study IP ana pae m
7. Return to the MPR view Rainbaw z 07 MENU Select the color table to be applied from among the seven different color tables consisting of 10 or fewer steps 10Steps Either Overlay or Blend can be selected as the fusion method to be applied 0 X a x 1 0 e Overlay a x PET CT e Blend ax PET 1 0 a x CT B Setting the fusion ratio and SUV value You can select a fusion ratio a with a slider bar at the rightmost end of the CT Original plane It is possible for you to specify the SUV Standardized Uptake Value value for the PET scan corresponding to the upper limit value of the color table by entering a value in the box at the top end of the color table which appears at the rightmost end of the CT Original plane 44 897N0599H B Adjusting the fusion position To open the context menu right click an appropriate location on the image and click Adjust Pet Volume Position You can then adjust the fusion position by performing the following procedure This adjustment is enabled only when the Fusion Viewer function is turned ON Synchro valome Center Adjust Pet Valume Position Shift Save to SYMAPSE 1 On a CT image press and hold the left mouse button until the adjustment 1s complete 2 Move the mouse in the direction the PET image is to be moved 3 Upon completion of adjustment release the left mouse button lt Supplementary gt Adjusting the fusion position will delete the VOI To revert t
8. a aae 36 M Setting the display Tor matier edu eanan EA 38 B Overlapped display of image plane eem 39 B Displaying patient study and image information 40 Da FUSO VIO WER conta blsdiute tdt bei inteddatpe caisson ei LoT died S ts iridis bali da 41 6 Operation Common to All Viewers eeeeeeeeee Henne 51 Eua processie Lone ctas ih sto nd INA RI ELI ai Acte 51 MD Pere VEC NC T T T T D DOE 55 Appendix 1 Error MesSOgE CS trus tu DE brutos uai ara n Po do en det baia eva E vada 61 Appendix 2 Details of Saved Images eese eene 62 Appendix 3 Initial Values of Gradation Preset and Monitor Settings 63 897N0599H Warnings and Cautions In this manual pay attention to particular situations and notices To use Synapse MPR Fusion safely observe the Warnings and Cautions Safety related cautions are divided into Warning and Caution as well as notes that carry important information regarding operation These have the following meanings respectively NWARNING Indicates hazardous situations which may lead to serious injuries or even death if the caution is not or could not be followed NCAUTION Indicates hazardous situations which may lead to injury or physical damage if the caution is not followed NWARNING When the contents of this manual are not appropriate to the software version installed to your equipment it may cause operation error
9. click an image of interest from among three orthogonal image planes anywhere in the window to display the context menu and then click Copy to Oblique window CPR Setting plane CPR Reset GPR Revise a paint Select a group of images d MPR Information Save as BMP format Copy to Oblique window Save to SYNAPSE Perference Selecting from the Oblique image plane context menu Right click anywhere on the Oblique image plane to display the context menu and then click the option that corresponds to the image of interest Initialize Change bo Original Approximate Orthogonal Change to ReFormatked A Approximate Single Oblique Change to Reformatted B Synchronize with oblique rot center Show Oblique Tools lt Supplementary gt When using the Dragging an orthogonal image plane or Selecting from the orthogonal image plane context menus procedure to perform this operation the intersecting point of the two intersecting lines on one of three orthogonal image planes 1s the Oblique image plane s center of rotation 18 897N0599H B Shifting the Oblique plane into the depth direction This section describes how to shift the Oblique image plane into the depth direction for visualization As you move the Oblique plane in the depth direction the center of rotation moves as well Perform this operation using one of the following procedures Using the mouse wheel In the window click the Oblique pl
10. following message box SS x Noo many slices to display image normally Reduce image size and continue If yes click Reduction To cancel click Cancel If Reduction is selected image quality will be degraded because horizontal and vertical resolutions are reduced to half of the original Even if the original images are not compressed the images that went under Reduction are processed as lossy images Cancel aux Memory Amount 1334 Mbytes HS Memory Amount 1334 Mbytes In such a case however the resolution of an image to be visualized will decrease accordingly Note The release specification for Synapse V3 2 1 recommends a minimum of 2 Gbytes of physical RAM for a diagnostic workstation 1 Startup Shutdown B Startup 897N0599H This section describes how to start up the Software To start the Software the user must have the appropriate level of security to access Synapse Before starting operation log into Windows using a username and password combination which grants access to Synapse If you have logged into Windows with a username and password combination which does not grant access to the Software you cannot start the Software 10 MPR visualization is not possible for a series whose modality does not support MPR visualization or whose number of slices is below a certain value If you selected such a series the following error message appears OK Cancels the current oper
11. specify the stereo angle setting after the image plane 1s displayed Just as in the Stereo Viewer see page 36 select it from the menu as necessary 897N0599H B Overlapped display of image plane This section describes the operation to enable overlapped display of the image plane The overlapped display mode is effective only when the 2 by 2 or 3 by 3 format is being used Right click an appropriate location to display the context menu and click Overlapped display Overlapped display Skeren View Format Patient information Return to Ehe MPR view When overlapped display is enabled image planes are laid out as shown in the figure below lt When in the 3 by 3 format gt Overlapped display disabled Overlapped display enabled Displaying the context menu and then clicking Overlapped display again clearing the selection turns off overlapped display of image planes 897N0599H 39 B Displaying patient study and image information This section describes the operation to display patient study and image information This section describes the operation to display patient study and image information Right click anywhere on the image to display the context menu and then clic Patient information Overlapped display Stereo View d Format Fatient information Return to Ehe MPR view The information box appears OK Closes the dialog box Patinet study Image information X Accessi
12. the order of a physician This system is classified as a medical device under EC Directive 93 42 EEC Export Restrictions Applying to Synapse MPR Fusion For models to which export restrictions apply government approval obtained through due procedure is required in order to export or otherwise remove such models from Japan Note that the same restrictions apply not only to the main unit but also to after sale parts service manuals and service training for exporting or transferring technology when such items are dispatched or shipped to foreign countries and when service training is given for trainees from foreign countries 897N0599H 897N0599H Trademark Synapse is the registered trademark of FUJIFILM Corporation FCR is the registered trademark of FUJIFILM Corporation Other holders trademarks Windows 2000 is the registered trademark of US Microsoft Corporation in the U S A and other countries Windows XP is the registered trademark of US Microsoft Corporation in the U S A and other countries Windows VISTA is the registered trademark of US Microsoft Corporation in the U S A and other countries Windows 7 is the registered trademark of US Microsoft Corporation in the U S A and other countries Windows is the registered trademark of US Microsoft Corporation in the U S A and other countries All other company names and product names described in this manual are the trademarks or registered trademarks of the
13. 04 SenderAETitle SDVIEWER ReceiverAETitle SyvnapseDicomscP Study ID 100003 Study Date 2n t2007 Modality P E Save with overlay Selected image is saved in SYMAPSE OE Cancel A confirmation message appears Read the message and click OK Cancel Returns to the image save dialog box NENNEN Once you send an image to the server it cannot be deleted Press OK to continue ON 897N0599H B Switching among multiple scans This section describes the operation to switch from one scan to be displayed to another when a series that includes two or more scan items 1s selected Right click anywhere on one of the image planes to display the context menu click Select a eroup of images and then click the option that corresponds to the series you want to display CPR Setting plane LPR Reset GPR Revise a paint Select a group of images Rew 1 Scan f 32 Images 2003 04 17 14 15 54 2 Scan 34 mane U3 04117 14 21 56 MPR Information Save as BMP Farmat 3 Scan f 34 Images 03 04 17 14 22 26 4 Scan 39 Images 2003 04 17 14 22 56 Copy to Oblique window Save to SYNAPSE Perference You can select a scan group name although there may be only one scan name to select to view the information of the scan currently displayed B Reverting to the initial operating sequence This section describes the operation to revert to the system operating sequence immediately after so
14. FUJIFILM Synapse MPR Fusion USER MANUAL Software Version V2 3 0001 3rd Edition December 2010 Contact Information United States of America FUJIFILM MEDICAL SYSTEMS U S A Inc 419 West Avenue Stamford CT 67 USA EIC 01 23 European Authorized Representative FLHIFILM Europe GmbH Heesenstrasse 3L 40549 D sseldorf Berriari Manufacturer FUJIFILM eroration 26 30 Nishiazabu 2 Chome Minato ku Tokyo 106 8620 Japan FUJIFILM Corporation 897N0599H Introduction Thank you for purchasing Synapse MPR Fusion This Software product is an optional software package for use with Synapse It is designed to perform various types of image visualization including MPR Multi Planar Reformattint MIP Maximum Intensity Projection and Fusion This document Synapse MPR Fusion User Manual describes how to operate the Synapse MPR Fusion along with operating cautions in detail so that you can use the Software correctly and as efficiently as possible When using the Software for the first time be sure to read this document before actually performing any operation For information about the operation of Synapse see the Synapse Users Manual After reading this manual keep it near the image display device as a guide to using the Software optimally This User Manual is applicable to Software version V2 3 0001 The screen images shown in this manual unless specifically noted are those displa
15. The Software cannot handle this handled For example the image positional information has not been defined in the image data 546 The image cannot be processed Although the original image is because of a reason other than an ordinary axial image please reasons through 4 above This contact your local authorized message also appears when the Fujifilm dealer slice spacings are irregular 580 584 There is not enough memory Additional memory is required Please contact your local authorized Fujifilm dealer 593 As a result of analyzing imagery The Software cannot handle this contained in the series less than image 10 slices of scanning exist 2 Messages that may appear when image data is being saved to the Synapse Server If any of the following messages appear when image data is sent to the Server a problem may 2 3 5 7 exist with transfer settings Please contact your local authorized Fujifilm dealer No information for creating a DICOM file Failed to create a DICOM file Failed to create an image file Failed to open an error log file Failed to set AE title on the sending side Failed to set a time out value Error occurred during the process of starting data transfer Data transfer failed because of insufficient memory Error occurred during data transfer Error occurred during the process of ending data transfer 897N0599H 61 Appendix 2 Details of Saved Images The ta
16. Viewer visualizes images for stereopsis using the display format specified when the viewer was first launched For Setting the display format see page 38 Stereo Reformatted A WW 444 WC 331 Stereo Reformatted A WW 444 WC 331 MIP whole image MIP whole image Angle O Angle 8 lt Supplementary gt The image rotation angle appears in all the windows Angle degree Horizontally rotating the image Moving the mouse wheel toward you in the negative angle direction or away from you in the positive angle direction rotates an image horizontally Setting rendering mode slab thickness Just as in the MPR Viewer see page 23 displaying the context menu from an appropriate location and then selecting an option lets you set the rendering mode and slab thickness for the image plane Returning from Stereo Viewer to MPR Viewer Right click an appropriate location to display the context menu and then click Return to the MPR view GOverlapped display Stereo View Format Fatient information Return to Ehe MPR view 3 38 B Setting the display format This section describes the operation to set the image plane display format Right click an appropriate location to display the context menu click Format and then click the appropriate display format Qyverapped display Steren View Fatient information 1 x 2ZiLarge W 1 x 2 Middle PS E a Return to the MPR view exe 3x3 You can
17. ane view and then roll the mouse wheel toward you to move forward or away from you to move backward Or while pressing and holding the mouse wheel anywhere in the Oblique plane move the mouse toward you or away from Or right click anywhere in the Oblique plane to open the context menu and click Stack in Place Then while pressing and holding the mouse wheel left click and move the mouse toward you or away from you Using the keyboard Using the mouse click the Oblique plane and then on the keyboard press the Page Up or 1 key to move forward or Page Down or key to move backward Dragging an intersecting line From one of the three orthogonal planes drag plane up and down or to the left and right the movable direction varies depending on the operation window the center of rotation marked with e of the intersecting line indicating the Oblique plane The Oblique plane moves along the drag direction Dragging any point other than the rotation center of the intersecting line causes a rotational movement If any of the three orthogonal planes is in the same position as the Oblique plane coincidentally having the same image plane the intersecting line indicating the orthogonal plane may overlap the intersecting line indicating the Oblique plane Careless manipulation may cause the orthogonal plane to move For such overlapping intersecting lines you can interchange the positions of the upper an
18. assing points along a line you want to draw one by one in order Clicking CPR Revise a point from the context menu lets you cancel the last passing point you specified i d EM i DE When you complet these steps click CPR Setting plane again to clear the selection A Curved Planar Reformation image appears in the Oblique window Orientation markers A P L R H F S E appear in the Curved Planar Reformation image S represents the start point and E represents the end point of the line For a Curved Planar Reformation image just as for other types of image planes you can move the image in the depth direction and set its rendering mode and slab thickness Rotational movement is not possible To close the Curved Planar Reformation image display open the context menu and click CPR Reset The original screen reappears N WARNING When specifying a passing point be sure not to make the angle too sharp If a curve is drawn with an angle that is too acute interpolations between points fail to make a smooth line resulting in an unnatural image NCAUTION 897NO599H When a CPR image was saved as a BMP file or saved to the server save the screen capture image so that the three orthogonal image planes for which the CPR image plane was specified are saved appropriately It is possible to save such screen capture images to the Synapse Server For saving an image in BMP format see page 27 For saving an image to the Synap
19. ation E This software only supports the following series types CT MR or PET Series with 10 or more slices Depending on the Synapse version installed you can start up the Synapse MPR Fusion by right clicking the image to bring up the popup menu and select MPR View If two or more scan items exist among the selected series the scan selection box appears The mark at the start of each scan name item 1 indicates that the scan is currently selected Clicking the symbol changes to which indicates that the scan is currently not selected Select the required scan a maximum of 4 scans and click OK item 2 SliceSpac Acquisition Date Time 1 Scan 34 Images 5 0mm 04 17 2003 02 21 56 PM 2 Scan 34 Images 5 0mm 04 17 2003 02 22 26 PM T 3Scan 39 Images 7 5mm 04 17 2003 02 22 56 PM 1 897NO599H 897N0599H When you complet the above procedure image reading starts and while the loading is in progress the progress bar appears You can stop image data reading by clicking Cancel in the dialog box The image data that has already been read becomes invalid and the Viewer provisionally opens In this case close the Viewer and return to the study list of the Synapse folder to perform the operation from the beginning If you only go back to the patient information window that was displayed at the time of series selection you cannot redo the operation from the beginning When image data r
20. ay Switches between show and hide modes of the overlay which provides various information Right click an appropriate location to display the context menu and click Show overlay or Erase Overlay Clicking Show Overlay with Thickness Line shows auxiliary lines that indicate the slab thickness in addition to the ordinary overlay Erase Overlay alternately switches between the show and hide modes of the intersecting lines that indicate the positional relationship of image planes and auxiliary lines which indicate the slab thickness measurement elliptical ROI rectangular ROI measure Or you can alternately switch between show and hide modes of the overlay by pressing the X key It is possible to use Show Overlay with Thickness Line and Erase overlay in the MPR Viewer display format but not in the Stereo Viewer display format Apply to all images When the image processing operation mentioned above is performed the processing is applied to all image planes that are currently displayed Before starting image processing right click to display the context menu and click Apply to all images Clicking the option again clears the selection and cancels image processing to all image planes 897N0599H B Preferences You can customize Synapse MPR Fusion by setting various options according to your preferences In the MPR Viewer right click to display the context menu and click Preferences MPR Information Sav
21. ble below shows the processing results and status that will be reflected when images are saved oaved as a BMP file Saved to the Drag amp drop Synapse Server Grdaion O O O zomin x O J L xX moe x L0 X Both patient inf ti d stud e t Only orientation Only orientation information are saved l uu markings are saved markings are saved and line information not saved Output size Results of highlighted gradation will not be saved Un 2 on O c Un ep D Lum O amp U a D O O au 2 Saved in a square with the size of vertical side or horizontal side whichever is longer for the image plane to be saved Note however that the minimum size is 512x512 3 Magnify reduce the size of a rectangular image plane to be saved so that its longer side becomes 512 Also increase decrease the shorter side using the same magnification ratio 4 Saved in a square with the size of vertical side or horizontal side whichever is longer for the image plane to be saved Note however that the minimum size is 256x256 NWARNING An MPR image generated from another image read by reducing its size may lack in sufficient resolution It is the user s responsibility to make judgments if quality of the generated image meets the usage purpose 62 897N0599H Appendix 3 Initial Values of Gradation Preset and Monitor Settings 1
22. cedure within the VOI you want to delete To delete the VOI right click the mouse within the label of the VOI When the context menu opens click Delete Or click the VOI and then press Delete lt Supplementary gt e The maximum SUV value within the VOI is not applied to PET rendering mode It always shows an MPR mode value e While the VOI is determined it is not possible to measure ellipses or rectangles 897N0599H E Calculating the SUV value from the PET scan The SUV value is calculated using the formula below SUV RescaleSlope Pixel Value PatientWeight 1000 DecayCorrectionDose The DecayCorrectionDose value used in the formula above for calculation of the SUV value is obtained based on the tag information items presented in the table below Radionuclide Total Dose 1074 Radionuclide Half Life 1075 Radiopharmaceutical Start Time 1072 AcuisitonTime AT CdS DecayCorrectionDose RTD exp In 2 RST AT RHL lt Supplementary gt When any tag information items presented in the table above is not available a value equivalent to 1 1000 of the data value is presented In such cases Max Pixel Value 2 5 0 001 is shown B Editing the VOI While the VOI is determined you can change its size and shape on the Original image plane 897N0599H 47 48 B intelliLink Right click in an appropriate place on the target image plane to open the context menu and then click IntelliLink Color Type k
23. d lower planes by clicking the intersecting lines Therefore place the intersecting line indicating the Oblique plane in darker color in the upper position before moving an image Reformatted A WW 280 WC 70 MPR 0 57 mm 897N0599H 19 20 Supplementary The e a black circle appearing on the three orthogonal planes shows the center of rotation and the o a white circle shows the center of rotation projected to the intersecting point with the Oblique plane 897N0599H B Rotating the Oblique plane 897N0599H This section describes the operation to visualize the Oblique image plane in a rotated position Before operation be sure that the rotation center point e of the intersecting line in dark color indicates that the Oblique plane is located at an appropriate position on each of the three orthogonal images If it is not located at an appropriate position perform the operation described under Shifting the Oblique plane into the depth direction see page 19 However when it is necessary to move the rotation center point e displayed on the Oblique plane drag the center of rotation or perform the operation under Using Oblique tools see page 22 Perform this operation using one of the following procedures Dragging the Oblique plane Drag the cursor over the Oblique plane in any direction The relationships between the drag direction and the rotational direction are as follows Dragging up or down ca
24. de and slab thickness on the image E Returning from Fusion Viewer to MPR Viewer To open the context menu right click an appropriate location and then click Return to the MPR view Results of processing performed in the Fusion Viewer are not saved Save ka SYMAPSE Return to Ehe MPR view E Displaying patient information This section describes the operation to display patient study and image information To open the context menu right click an appropriate location on the target image plane and then click Patient information MinIP Patient information w Fusion The information box appears DK gt Closes the dialog box Patient Study Image information Accession number Patient ID Patient Name Birth Date Gender Study Date Study Time Acquisitian Date Acquisitian Time Modality Slice Number Slice Thickness Slice Spacing Image Size Pixel Spacing x 7243100820070122 0000353757 6 27 1929 M 201 2007 24 2007 10 32 00 cT 265 375 mm s27mm 0 x 512 Sle 0 976500 mm 897NO599H B Fusion method and color table To open the context menu right click an appropriate location in the window and then click Color Type Color Type Hj y Overlay IntelliLink I Elend Fusion method VOI y CRIMES Initialze Position z M Synchro valame Center ED Adjust Pet Volume Position Shift asteps Color table Save to SYMAPSE Fire 1 Oe Rainbaw 1
25. e as BMF Fformat Copy to Oblique window Save Co SYMAPSE The Configuration box appears After setting your preferences for the options click OK Cancel Cancels the current operation Configuration 1 Version Cancel Base Setting windowing Preset cT windowing Preset MEI Th Initial Gblique Ob Hi Speed mode retcrmase Hi Speed J Main Menu wr 4 rmm E wi 8 0mm wi 52 0mm About FhimahprView3z2 dll Below the dialog box title Configuration is the version number of the software In the About box at the bottom of the window is the version number of individual components of the software The following sections describe individual tabs in the Configuration window 897N0599H 55 Environment settings Specify settings for the software operation environment as follows Click Base Setting and perform the following operation Configuration X Version Cancel Initial Oblique Ob Hi Speed mode remesas Hi Speed Main Menu mevr 128 0mm Set wir 128 0mm Set i minir 128 0mm Set About aah Initial Oblique Sets the type of image plane to be displayed initially in the Oblique window of the MPR Viewer Select a type of imagery from the list Ob Hi Speed mode Sets the rendering speed of an Oblique image plane Select a speed from the list Selecting Hi Speed gives priority to the rendering speed deteriorating a
26. e dialog box opens E x ww 280 wc 70 You can perform gradation magnification move processing on the image before saving it You can perform this operation only by right clicking the image while pressing the left mouse button For image processing see page 51 You can perform the following operations by opening the context menu right click anywhere on the image while in the image save dialog box WW WC reset Resets any gradation processing that was performed in the dialog box Revert zoom Resets any image zoom in zoom out processing that was performed in the dialog box 897N0599H 27 28 Save as BMP format Saves the image bitmap Selecting this option opens the Windows Save As dialog box Enter the location where you want to save the file and the filename Click Save See Appendix 2 Details of Saved Images on page 62 Add overlay while saving Adds image information to the bitmap image When no image information 1s to be saved clear the selection x Closes the dialog box Saving images using the drag and drop functionality Right click the target image in the MPR Viewer and drag and drop the image to the desired folder You can then save the bitmap file of the target image The filename is automatically added See Appendix 2 Details of Saved Images on page 62 In addition on each Viewer you can save an image in the bitmap format by dragging and dropping the image to a destination d
27. eading is complete the Software starts up and a Viewer appears By repeating the startup procedure to this step it 1s possible to open two or more Viewers Repeat the operation as required After starting the Software it 1s also possible to add series as necessary to the MPR Viewer using the drag and drop operation of any study image derived from Synapse w 280 1 1 WC 7 R eformatted 4 7 2003 MPR 0 57 mm 4 21 56 n Immediately after startup of the Software the screen initially displays the MPR Viewer as shown above For the subsequent operation of each Viewer instructions are given in the sections devoted to the respective Viewers follows Read the section appropriate to your purpose For operation that is common to all viewers refer to page 51 MPR Viewer Visualizes a study image of the selected series in four types of image planes Original Reformatted A Reformatted B and Oblique Page 13 Compare Viewer Visualizes study images of two or more selected series in a way that lets you visually compare the images Page 31 Stereo Viewer Visualizes a study image of the selected series mostly MIP images of MRA in a format that permits the use of stereopsis Page 36 Fusion Viewer Fuses selected PET and CT images to each other and visualizes the fused image Page 41 11 12 NWARNING Images at inappropriate slice thicknesses or images that have undergone lossy compression are no
28. emperature high humidity or direct exposure to the sunlight place Additionally there are other warnings and cautions in Synapse Synapse warning and caution marks can be found in the Synapse Users Manual in the section titled General Safety Notification for Synapse Please reference this document 897N0599H T PRODUCT CHARACTERISTICS Indications for Use Intended Use Synapse MPR Fusion enables the display of 3D Multi Planar Reformatting Maximum Intensity Projection MPR MIP visualization of CT MR and PET studies and blending of CT and PET studies Typical users are radiologists technologists and clinicians Synapse MPR Fusion is not intended for Mammography use Contraindications None known Intended Users Synapse MPR Fusion is intended to be used by trained medical imaging professionals including Radiologists Clinicians and Radiological Technologists Training Requirements The users of Synapse MPR Fusion must be properly trained for use based on the user manual Please ask the local FUJIFILM representative or the FUJIFILM distributor from who you purchased Synapse MPR Fusion for training availability Significant Physical Characteristics Synapse MPR Fusion is a software medical device runs on Windows operating system Hardware computer disk storage monitor and network and software type of Windows operating system and database software for Synapse MPR Fusion shall be selected within the specification descr
29. essing the Ctrl key the image plane will keep moving until clicking an image in the viewer Or press and hold the mouse wheel anywhere on the image and then move the mouse toward you to move forward or away from you to move backward Or right click anywhere in the image to open the context menu and click Stack in Place Next while pressing and holding the left mouse button move it toward you to move forward or away from you to move backward Using the keyboard Click the image of interest in the window and then on the keyboard press the Page Up or 1 key to move backward or Page Down or key to move forward Click anywhere in the image plane of interest and then press Page Up 1 or Home to move backward or Page Down or End to move forward Dragging an intersecting lines Drag either a horizontal or vertical intersecting line displayed on any image plane other than the image plane of interest drag a vertical intersecting line to the left and right or a horizontal intersecting line up and down The image plane linked to the line moves along with the drag movement Or drag the intersection point of the intersecting line displayed on any image other than the image plane of interest in the desired direction The remaining two images move according to the drag direction If any of the three orthogonal image planes 1s in the same position as the Oblique image p
30. ftware startup Press the F5 function key on the MPR Viewer keyboard This operation is disabled on the Stereo Viewer display format When you select multiple series a dialog box similar to the one shown below opens When clicking OK the system operation reverts to the sequence immediately after software startup It is not possible to get a specific series back to the operation sequence immediately after software startup ESE xl All series will be reset Press OK En continue Cancel 897NO599H Compare Viewer 897N0599H In the Compare Viewer you can select and view multiple series of study images up to four series in a way that lets you make visual comparisons In the MPR Viewer right click any of three orthogonal image planes you want to compare anywhere in the window to display the context menu and then click Compare View An Oblique image plane cannot be selected for Compare View w MPR MPVR k MIP MinIP RenderingRotate Presets Stereo View k k Fusion VIE 31 32 The Compare Viewer opens The Compare Viewer consists of four windows each of which shows images of one series If you selected Compare View from the Original image plane in the MPR viewer Original image planes are initially displayed The order in which the series are placed is as follows based on study data and time Upper left 1 Upper right 2 Lower left 3 Lower right 4 scan Gr Orginal
31. guration settings made in MPR Preferences Base Setting 2 tab the operation mode changes from Window Level to Zoom to Pan to Stack in Place Pixel value You can display the pixel value of any point on the image plane Right click anywhere on the image to display the context menu and then click Pixel value Move the pointer to any point on the image plane and press and hold the left button A pixel value appears in the upper right corner of the window only while the left button is held down Or pressing the left mouse button while simultaneously pressing the D key displays a pixel value in the upper right corner of the window NCAUTION If you perform the Pixel value operation on an image plane that has undergone rendering in the MPR mode the original image s signal value appears However if you perform the Pixel value operation on an image plane that has undergone rendering with the slab thickness defined MPVR MIP or MinIP mode the pixel value after the image processing is displayed an asterisk appears next to Pixel Value Va 4 0 0 il Js 5 0 Pixel s alue 139 897N0599H Ruler Shows the distance between two points on the image plane Right click any point on the image plane to display the context menu and then click Ruler Press the left mouse button on the image plane to determine the start point While pressing the left mouse button drag the pointer to a desired position Releasing the left button dete
32. i A WW OSBO WC 708 7 scan 11 Original WW 250 Wo Fra X 96 00 Y 26 00 7 104 29 2003 04 1 78 X 134 390 Y 146 50 Z 105 93 003 04 1F MPR 2 50 mm MPR 7 30 mm 14 1040 4 scan I7 Original X 34 30 EST e EN X j WIFI MPR 5 00 mm lt Supplementary gt e Scan number location slice position and DFOV Displayed Field of View appear in all four windows e DFOV indicates the window size converted using the same reduced scale of measure shown in the windows e t is possible to add series as necessary to the Compare Viewer by dragging and dropping any study image derived from Synapse Synchronously displaying images Just as in the MPR Viewer see page 16 operation with the mouse wheel or keyboard lets you move the same slice position images of a different series in a synchronous manner Synchronizing display setteings page 34 897N0599H Setting rendering mode slab thickness Just as in the MPR Viewer see page 23 displaying the context menu and then selecting an option lets you set the rendering mode and slab thickness settings of the image Returning from Compare Viewer to MPR Viewer Right click to display the context menu and then click Return to the MPR View Results of the processing performed in the Compare Viewer are not saved Synchronize with the active image mm Patient information Return En Ehe MPR view B Switching among three orthogonal image planes for display 897N0599H This sect
33. ibed in the Synapse MPR Fusion product specification Synapse MPR Fusion needs to be installed with Synapse Workstation which is a separately controlled software medical device and is integrated with Synapse Workstation Operating Principle Synapse MPR Fusion is installed and integrated with Synapse Workstation which 1s a separately controlled software medical device and used with Synapse Workstation Synapse MPR Fusion accepts DICOM compliant medical images acquired from CT MR and PT applies MPR MIP processing for these images or perform Fusion processing on CT and PT images When the targeted studies are specified on Synapse Workstation these data are loaded on Synapse MPR Fusion A user may apply MPR MIP processing to view any cross section of these images in 2D form or fuse CT and PT images with user selected ratio and view the blended image to see both information at the same time Fusion processing Newly created images are displayed on a monitor printed or saved on a server Significant Performance Characteristics Performance of Synapse MPR Fusion depends on the following elements CPU performance Number of CPUs GHz Cache memory size etc e Size of memory e Speed of disk storage Network performance Other devices connected to Synapse MPR Fusion when importing or exporting data The requirements for hardware computer disk storage monitor and network and software type of Windows operating system and da
34. increase the contrast Or right click the image plane to display the context menu click Window Level and then perform the same drag operation as mentioned above You can perform gradation processing by right clicking the image plane of interest to open the context menu and then clicking Input WW WC to enter WW WC Window Level Window Center values Zoom Performs zoom processing on an image plane Anywhere on the image plane press and hold the left mouse button while pressing the Ctrl Alt keys Drag up to zoom in or down to zoom out Or right click the image plane to display the context menu click Zoom and then perform the same drag operation as mentioned above Move When you display a zoomed in image plane move the image plane so that the area of interest can be viewed Anywhere on the image plane press and hold the left mouse button while pressing the Shift Alt keys Then drag the image plane in any direction you choose Or right click the image plane of interest to display the context menu click Pan and then perform the same drag operation as mentioned above 897N0599H 51 52 Switching Image Manipulation Tools You can switch among the Window Level Zoom and Pan modes using the left right mouse operation While pressing and holding the left mouse button on an image plane right click multiple times to change the operation mode from Window Level to Zoom to Pan Depending on the confi
35. ion describes the operation to switch among three orthogonal image planes for on screen comparison Right click to display the context menu and then select the option that corresponds to the image of interest wv MPR PIPVE k MIP k MinIP d w Display original Display reformatted 4 Display reformatted B Synchronize with Ehe active image mm While a comparison view of Reformatted A and B image planes can be presented by the Compare Viewer as its specific feature a comparison view of an Original image plane can be displayed as a standard feature of Synapse 33 B Synchronizing display settings This section describes the operation to synchronize the display for each series Right click the image plane to display the context menu and click Synchro display to select it Erase Overlay w Show Overlay w Synchro display w MPR MIPYR k MIP k MinIP k After selecting the option images of each series move in the depth direction synchronously while maintaining the same slice positions Results of setting the gradation image size increase move and image processing conditions as well the rendering mode and slab thickness are also synchronized The gradation processing is not synchronized among modalities Pressing the S key alternately turns synchronization ON and OFF To adjust image slice positions on a particular series 1 Right click to display the context menu and click Synchro display to clear
36. ir respective holders Copyright 2006 2010 FUJIFILM Corporation All rights reserved CONTENTS Warning and Cautions 4 PRODUCT CHARACTERISTICS 8 OPERATIONS 9 1 Oar up ruta saa waits DUE Ct L me ls LTEM ELE 9 BS 6 E E o E ES 9 I Sd EOONWE oon ion Or Dade aoi enda M Oeo aus sive MI SaP oda Ode itu 12 2 DNV M OWO oo Seer uod iit alan ica cannes penta Lotes ca aids et tO o OL COa tse LR DoL Ace RE Df Ens 13 B Moving three orthogonal image planes in the depth direction 16 B Resetting Oblique image plane eee 18 B Shifting the Oblique plane into the depth direction 19 B Rotating the Oblique plane eee 21 B Setting the rendering mode and slab thickness 23 B Curved Planer Reformation CPR visualization 25 B Displaying MPR nor mation i Dott onsite cra de m bl reta 26 E Saving an image in BMP format eee 27 B Saving an image plane to the Synapse Server 29 B Switching among multiple scans eem 30 B Reverting to the initial operating sequence eee 30 0 COMPIE VIe WOE ostensis testet is e tutosssebitetu sett acaba cic DED AE a 31 B Switching among three orthogonal image plane for display 33 B Synchronizing display settings eee eene 34 B Displaying patient study and image information 35 Aotr V IEW ornina
37. irectory A unique filename is automatically assigned to the saved file Depending on the configuration settings performed during installation a message box similar to the one below opens after dropping the image into a destination directory OK Closes the dialog box After images are dropped to the Report be sure to upload the images to the Server 897N0599H B Saving an image plane to the Synapse Server This section describes uploading the currently displayed image plane and saving it to the Synapse Server Right click anywhere on the image to display the context menu and then clic Save to SYNAPSE Select a group of images d MPR Information Save as BMP format Copy to Oblique window Save to SYNAPSE Perference The Save dialog box opens Enter a series name and select a server where the image is to be saved and then click OK Save with overlay If this option is selected the image with overlay 1s saved Cancel Cancels the current operation NCAUTION When the server to which the image should be sent is not found the following message appears under the Save with overlay option in the Save dialog box Please make sure the server in the details of transfer field is correct If this message appears please contact your local authorized FUJIFILM dealer SAE UU xl Series Marne hl PR Select mess H Detail af ReceiverlPA ddress d 0 0 0 transfer Port 1
38. lane coincidentally having the same image plane the intersecting line indicating the orthogonal plane may overlap the intersecting line indicating the Oblique image plane and inadvertent dragging may cause the Oblique image plane to move For such overlapping intersecting lines you can interchange the positions of the upper and lower planes by clicking the intersecting lines Therefore placing the intersecting line for the orthogonal plane in lighter color in the upper position before moving an image Reformatted A WW 280 WC 70 MPR 0 57 mm 897N0599H 897N0599H Selecting the Oblique image plane context menu Right click any point on the Oblique image plane to open the context menu Click Synchronize with Oblique rot center in the pop up menu that opens The three orthogonal image planes move to a location that includes the Oblique image plane s center of rotation Initialize d Approximate Orthogonal Approximate Single Oblique Synchronize with oblique rok center k 17 B Resetting Oblique image Plane This section describes how to reset the Oblique image plane which resets the Oblique view to the same plane as the orthogonal view planes Perform this operation using one of the following procedures Dragging an orthogonal image plane Drag and drop one of the three orthogonal image planes of interest anywhere in the window into the Oblique window Selecting from the orthogonal image plane context menus Right
39. m external devices and other factors It is therefore the user s responsibility to make judgments about the results of measurements NWARNING When using a mode based on a reduced number of pixels see page 9 the resolution of an image might become insufficient It is therefore the user s responsibility to make judgements about them NCAUTION Do not turn off the power to the personal computer while the Software is running on it NCAUTION Do not change any settings in the Display Properties dialog box of Windows while this Software is running NCAUTION Do not open Control Panel from the Start menu of Windows while this Software is running CAUTION In extended uses of the system set aside 10 to 15 minutes after every hour to rest your eyes and hands NCAUTION When installing servicing and administrating SYNAPSE MPR Fusion 1 Set and install medical imaging equipment connected to this software properly using installation specifications If not some errors may occur 2 The installation upgrade system maintenance system administration and administration only be performed by trained personnel 3 Training materials must be created or updated using the correct version of service manual user manual or other formal documents released as a part of the SYNAPSE MPR Fusion product NCAUTION Product media disc of Synapse MPR Fusion must be stored into media case The media should not be stored at a high t
40. mage plane in the MPR Viewer These presets appear on the RenderingRotate Presets menu Click RenderingRotate Preset and perform the following operation Configuration E xj Version Cancel a PresetNum Preset 0 Target Original Rendering MPVR T mm E BED Rotate Vertical Flip vertical Flip Horizontal Flip Rotate Clockwise 90 Rotate Counter clockwise 90 Delete PresetNum Select the Preset box and then select the Preset Number you want to set If the box 1s not selected the selected Preset Number does not appear on the menu Target Select a plane you want to set Rendering Select a rendering mode and a slab thickness If you selected xxx value mm click Set to enter a specified Rotate Click the flip rotation type to add it to the Rotate list Selecting multiple flip and rotation types lets you combine different patterns of flips and rotations To delete a flip or rotation type under the Rotate heading select it from the list and then press Delete 59 Monitor Settings You can perform settings for the overlay and font as follows Click MonitorTypel or MonitorType2 and then follow the instructions below Settings are enabled only for the monitor type selected in Base Setting 2 Configuration xj Wersion Cancel RenderingRatate Preset MonitorTypel j i KILA Linelnfa Selected Line width 3 Color F p EB Fantlnfa Ruler and Rol
41. n Original is Coronal Synapse MPR Fusion generates Original Reformatted A and Reformatted B assuming the original image was taken while a patient was standing on the bed The following page shows the positional relationship of a patient and Original and Reformatted A and Reformatted B R stands for Right L for Left H Head F for Foot A for Anterior and P for Posterio 14 897N0599H 897N0599H E The original is Axial Foot comes to the front H S SLY RA OBLIQUE R A p l A The original is Coronal Anterior comes to the front Reformatted A shows an image viewed from the Head side and the AP direction is opposite the radiological convention Reformatted B is Sagittal where the image is rotated 90 degrees The original is Sagittal The left side view comes to the front Reformatted A shows an image viewed from the Head side and the AP direction is rotated 90 degrees Reformatted B shows a Coronal image viewed from the Posterior side 15 B Moving three orthogonal image planes in the depth direction This section describes the operation of visualizing any of the three orthogonal image planes at a position shifted in the depth direction Perform this operation using one of the following procedures Using the mouse wheel In the window click the image of interest and then roll the mouse wheel toward you to move forward or away from you to move backward Note If you roll the mouse wheel while pr
42. ndow Center values and a ruler graduated in 1 cm increments In Original Reformatted A and B intersecting lines appear showing relative positions of images In addition orientation markers A P L R H F appear to show the orientation of the patient Two orientation markers appear according to the direction of the image The Original window displays the study date time To switch between showing and hiding the information see page 54 The three orthogonal image planes referred to in this section represent Original Reformatted A and Reformatted B image planes 897N0599H 13 When selecting two or more series images from the first series initially display To display images for another series see page 30 Double clicking any point on the three orthogonal image planes or Oblique image plane changes the display such that only one plane appears in full screen mode Double clicking the image plane again restores the original layout The figure below shows the viewing angle of images in each of the Original Reformatted A and B windows Reformatted A Reformatted B Original Supplementary The following describes the relationship among patient views and Original Reformatted A and Reformatted B Synapse MPR Fusion generates Reformatted A and Reformatted B images based on a general model front view top view and left view regardless of the orientation of cross section of an input image Whe
43. o the initial position for fusion processing right click an appropriate place to open the context menu and then click Initialize Position Initialze Position 7 Synchro valome Center h vol y To have the center of a PET study image and that of a CT study image coincide with each other right click an appropriate place to open the context menu and then click Synchro Volume Center Initialze Position Z Synchro Yolome Center Adjust Pet Valume Position Shift h B Fusion ON OFF To turn the Fusion Viewer function ON or OFF right click an appropriate place to open the context menu and then click Fusion Fatient information Color Type k k 897N0599H 45 46 B Determining the Volume of Interest VOI Determine the VOI on the image plane as follows Right click in an appropriate place on the target image plane to open the context menu and click VOI Move the pointer to an appropriate place on the image plane and then left click The VOI will then be determined IntelliLink I Initialze Position z The following operations are performed as soon as the VOI is determined e The maximum SUV value of the PET image within the VOI appears on the Original image plane All other image planes except the Reformatted B whole MIP image are changed to image planes passing through the VOI center e The intersecting line between the VOI and each plane is displayed To delete the VOI perform the VOI setup pro
44. on number 7011025320030416 Patient ID 0000043465 O Patient Mame Fuji Hanako 0000000 Birth Date ono3 o8 19 Gender F study Date 0004 17 20 Study Time 02 10 40 Acquisition Date 2003 04 17 Acquisition Time 14 13 54 Modality er Slice Number eT Slice Thickness 75 mrm Slice Spacing 7 5 mrm Image Size x a5 Y 275 Pixel Spacing 0 572000 mim 40 897N0599H 5 Fusion Viewer The Fusion Viewer makes it possible to fuse selected PET and CT images to each other and display the resulting fused image In the MPR Viewer right click anywhere on the image plane to open the context menu and then click Fusion View on the menu that opens This is applicable only when CT and PET study images were read for each study image group Skeren View k CPR Setting plane When the Synapse MPR Fusion software is started from a CT study and a PET study is added from Synapse by dragging and dropping the system automatically switches to Fusion Viewer mode Additionally if you right click anywhere in Fusion Viewer mode to open the context menu and then click Help the procedure on how to use the Fusion Viewer function appears Return to Ehe MPR view WARNING An image fused with this Software appears on a display monitor for reference purposes only and does not prove any event Images may be improperly fused particularly due to an error occurring in fusion position It is therefore the user s responsibility to f
45. option is selected the related menu options in those viewers are activated when this software is started Sets the measurement results and display unit of the Ruler Elliptical ROI and Rectangular ROI Selects Monitor Type 1 or Monitor Type 2 Monitor Type 1 is the monochrome monitor and Monitor Type 2 is the color monitor Sets the Add Stack in Place Mode toggle option If this option is selected Stack in Place mode is added to switching modes by the left right mouse operation 57 58 Windowing Preset You can preset image processing conditions up to eight sets for each modality that are to be displayed in the image processing condition menu Click Windowing Preset xxx where xxx is CT MRI or Other Depending on the modality to which preset values are to be applied select a checkbox Enter the values under the Title WW Window Level and WC Window Center headings If the checkbox is not selected the item does not appear on the main menu Configuration X T Mersion Preset O Jf Preset 1 M Preset 2 M Preset 3 Preset 4 Preset5 Preset amp Preset Title VE WC Bone 2000 400 Abdomen 476 55 Lung 1800 585 LE Head 150 er m LC pe I 897NO599H 897NO599H RenderingRotate Preset Presets the rendering mode slab thickness and flip rotation settings up to four sets for each of three orthogonal image planes and the Oblique i
46. ormulate proper judgments about a fused image NWARNING This Software displays a VOl Volume of Intrest for reference purposes only Its display position may contain an error The VOI may be improperly displayed particularly due to different pixel intervals of an image group input from an external device It is therefore the user s responsibility to formulate proper judgments about the accuracy of VOI display position NWARNING Color images shown on a monochrome monitor display may not be displayed in a proper gradation Therefore always show color images on a color monitor display device 897N0599H 41 42 Activating the Fusion Viewer function opens an initial window like the following example Images are displayed from the left in the order indicated below A CT image is fused with a PET image before being displayed Upper area CT Original PET Original Lower area CT Reformatted A PET Reformatted A CT Reformatted B PET Reformatted B and PET Reformatted B whole MIP Supplementary You can rotate the PET Reformatted B whole MIP image with the mouse wheel The Fusion Viewer cannot be used to read images Different exposure orientations may have been applied or tilted exposure may have been performed to shoot CT and PET images 897N0599H E Setting rendering mode and slab thickness Just as in the MPR Viewer displaying the image s context menu and selecting an option from the menu lets you set the rendering mo
47. precise appearance of the image is dependent on the characteristics and settings of the hardware including monitors used The notes and cautions in this document related to the interpretation of displayed images apply equally to these exported images NCAUTION For studies to be used Users must be fully conversant with the limitations of the basic imaging modality and of ensuing image processing This includes understanding the limitations of the initial series acquisition image processing technology used and image display methods Also be aware that medical imaging is valid only when appropriate measures have been taken to obtain optimal images with correct orientation and correct patient identifiers NWARNING When performing measurements using this Software pay attention to specified coordinates Incorrectly specified coordinates will yield incorrect measurement results To prevent errors follow the instruction below e Specify the coordinates on the display correctly 897N0599H NWARNING The accuracy of this Software s measurement capabilities will depend on interpolation operation on pixels of the images input from external devices It is therefore the user s responsibility to make judgments about the results of measurements NWARNING Images generated by this Software may contain errors from actual lengths caused due to inaccuracy in interpolation operation on pixels inaccurate slice intervals of images input fro
48. rmines the end point and displays the measured line and distance values Or pressing the left mouse button while pressing the R key lets you draw a measured line To delete the measured line right click the label for the line and then select Delete or press the Delete key Tools Performs measurement of area maximum pixel value minimum pixel value and average pixel value as well as standard deviation of any region ROI on the image plane Right click any point on the image plane to display the context menu and then click Elliptical ROI or Rectangular ROI a sub menu item of Tools Press the left mouse button on the image plane to determine the start point upper left of the ROI While pressing the left mouse button drag the pointer to a desired position Releasing the left button determines the end point lower right of the ROI and displays the measured line and various measurement results Or pressing the left mouse button while pressing the E key lets you draw an elliptical ROI To delete the ROI right click the ROI and the select Delete or press the Delete key NCAUTION 897N0599H Measured line elliptical ROI and rectangular ROI can be deleted if any of the following operations are performed e Moving in the depth direction or rotating the Oblique image plane e Changing the visualization Scan Horizontally rotating an image plane in the Stereo Viewer display format changing the format or
49. s To prevent such errors from occuring follow the instruction below e Synapse MPR Fusion software version V2 3 Verify that the Software installed for your equipment is V2 3 NWARNING Before using this workstation please read Precautions Before Use carefully so that you can operate it correctly Whenever you operate this workstation be sure to Observe all precautions Failure to do so may subject you to injuries or cause property damage NWARNING The medical institution where the equipment is installed is responsible for its use and maintenance This workstation should not be used by persons other than suitably trained physicians or staffs NCAUTION oynapse MPR Fusion software must operate on the specified computers and monitors that satisfy the Safety Standards and Regulations Electromagnetic Interference Standards and Regulations as well as Environmental Regulations valid in each country or region where this software is used When discarding the hardware the user must comply with environmental regulations valid in each country or region The environmental regulations include but not limited to the EC directive 2002 96 EC of the European Parliament and of the Council of 27 January 2003 on waste electrical and electronic equipment WEEE Directive 897N0599H 5 NCAUTION Computers and monitors used with the Synapse MPR Fusion software must comply with IEC60950 or equivalent standards for general electrical equipmen
50. s a result the image quality while the Oblique image plane is being rotated dragged After the Oblique mage plane has stopped rotating the rendering process is performed in normal quality Main Menu Lets you preset up to three rendering mode and slab thickness combinations that are most frequently used from the main menu select a checkbox and then select an option from the list If the checkbox 1s not checked the item does not appear on the main menu If you selected a menu option to specify the slab thickness clicking Set displays an entry box In this box enter a slab thickness value and then click OK Cancel Cancels the current operation About Displays the version number of the Image Visualization Software 56 897N0599H 897N0599H Click Base Setting 2 and perform the following operation Lonfiguration X wersion Base Setting Base Setting 2 windowing Freset er windowing Preset k 4 P Synchro Synchro Unit of measurement Monitor Type Toggle This setting is applied from the next time MPE Vie Apply to All Images Compare view Synchro display Stereoview aval rea iniines Add Stack in Place Made cancel Unit of measurement mm inch Monitor Type MaonitarType MaonitarTypez Toggle Turns on the Apply to All Images option of the MPR Viewer and Stereo Viewer If this
51. se Server see page 29 25 B Displaying MPR information This section describes the operation to display MPR information of each image plane Right click anywhere on the image to display the context menu and then click MPR Information CPR Setting plane CPR Reset GPR Revise a paint Select a group of images k Save as BMP Farmat Copy to Oblique window Save ka SYMAPSE Perference The MPR Information dialog box opens Cancel Closes the dialog box x Reformat conditian Patient Study Image infarmatian Accession number 7011025320030416 Patient ID 0000043465 Patient Mame Fuji Hanako Birth Date 0009 08 19 Gender SSS Study Date ooanz 20 0 Study Time IE Acquisition Date zosphapT 0 Acquisition Time 41394 000000 Modality mcm Ice ae Slice Number MPR Plane information Morrmrial Slice Thickness Slice Spacing Image Size Pixel Spacing 0 572000 mm 26 897N0599H B Saving an image in BMP format This section describes the operation to save each image plane in a bitmap format to a specified folder Saving images from the image save dialog box Right click anywhere on the image plane to display the context menu and then click Save as BMP format Select a group of images k MPR Information Save as BMP Format Copy to Oblique window Save ko SYMGPSE Preferences The image sav
52. switching to the MPR Viewer display format e Switching to the MPR Viewer display format e Changing rendering mode and slab thickness 53 54 Operation lock When you perform gradation zoom move and pixel value processing operations the locking function keeps the processing mode from being cancelled or turned off after the operation Right click the image to display the context menu and click Lock Tools Clicking this option again clearing the selection or pressing the Esc key cancels the processing mode Selecting image processing conditions You can use preset image processing conditions to perform image processing Right click anywhere on the image plane to display the context menu click Image Presets and then click a preset menu Or enter the number that is assigned to the preset menu from the keypad and then perform image processing See Presetting image processing conditions on page 56 Resetting image processing Cancels the results of gradation processing or preset image processing and returns the image plane to its original state Right click anywhere in the image plane to display the context menu and then click Revert Flip Rotation Flips or rotates an image plane Right click anywhere in the image plane to display the context menu click Rotate and then select a flip or rotate menu option This operation is possible only in the MPR Viewer and not in the Stereo Viewer Switching overlay displ
53. t If this software is used in the patient environment where a patient may accidentally touch the equipment the hardware used with this product must comply with IEC60601 1 which is for medical devices In order to comply with IEC60601 1 standard additional safety measures for the hardware are necessary please consult the computer dealer or manufacturer for measures to be taken NCAUTION Synapse MPR Fusion is intended for use only as a supplement to traditional methods for interpreting radiological images Synapse MPR Fusion is only an aid or adjunct to processes or decisions that can be made without the use of Synapse MPR Fusion No diagnostic or treatment decisions or other decisions that may affect patient care should be based exclusively on Synapse MPR Fusion NWARNING Images generated by the processing functionality of this Software are displayed strictly for reference purposes only and not for proving the visualized phenomena to be true Especially visualization with MIP processing or MinIP Minimum Intensity Projection processing may not render the context of blood vessels and the bronchi accurately by nature of the algorithm It is the user s responsibility to interpret generated images and make judgments about them NCAUTION For exported images For images exported from Synapse MPR Fusion using e mail printing or any other mechanism users must ensure that recipients of exported images are familiar with this material The
54. t Format Y A Click Back Format Format 3 Upper area CT Reformatted B PET Reformatted B CT Original Lower area PET Reformatted B whole MIP CT Original No Fusion processing is applied B Other To change the PET image gradation enter a value in the box at the top end of the color table at the rightmost corner of the CT Original plane It is not possible to subject a PET image to gradation change by dragging the mouse 50 897N0599H 6 Operation Common to All Viewers This section describes operation procedures that are common to the MPR Viewer Stereo Viewer Compare Viewer and Fusion Viewer B image processing Images visualized by this Software can be subjected to image processing described below and most can be performed as they are performed in Synapse This document provides only a brief description of these processing operations For detailed information see the Synapse Users Manual Annotation functions provided with Synapse are not supported in this Software When such processing is required to be performed save the image plane to Synapse and then annotate the image in Synapse For saving an image page 29 Gradation Performs gradation processing on any image plane Anywhere on the image plane press and hold the left mouse button while pressing the Alt key Drag up to increase the density down to decrease the density to the left to decrease the contrast or to the right to
55. t suitable for MPR visualization Note that if such study images are selected for MPR visualization the resulting images may be of insufficient resolution B Shutdown This section describes how to shut down the Software Upon performing one of the following operations the software terminates Exit Synapse Return to the Synapse folder listing Update the Synapse display Exit Synapse MPR Fusion Viewer 897N0599H 2 MPR Viewer The MPR Viewer consists of four windows each of which displays an image plane Original Shows the original image study This image 1s shown in the upper left window Reformatted A B Images that are labeled Reformatted A or Reformatted B are orthogonal reconstructions computed from the original image data Image A is shown in the upper right window and image B is shown in the lower right window If the original image is an axial the Reformatted A 1s the coronal plane and Reformatted B is the sagittal plane Oblique Shows an oblique image reconstruction using any direction specified by the user This image is located in the lower left of the window For resetting the visualized image page 18 For initially displayed image settings page 56 Supplementary The patient information of a study image appears on the title bar located at the top of the Viewer e Each window shows rendering mode information MPR MPVR MIP MinIP and slab thickness WW Window Width and WC Wi
56. t the position and direction of the Oblique planes are appropriate To move the rotation center point click and then click any point on the Oblique plane Closes the Oblique toolbar window z Rotate 897N0599H B Setting the rendering mode and slab thickness 897N0599H This section describes the operation to set the rendering mode and slab thickness of each plane Setting for each plane Right click anywhere on the image to display the context menu and then click the option that corresponds to the desired rendering mode slab thickness For presetting a menu of frequent use see page 55 MPR MPVR MIP MinIP Clicking the menu option to specify the slab thickness displays a value entry box where you can enter a value Enter a slab thickness within an effective range from 0 1 to 256 and then click OK Cancel Cancels the operation For displaying the slab thickness overlay see page 54 MFYR k MIF 2 0mm MinIP Ld 4 nmm RenderingRotate Presets Mea MIF 16 0mm Gomnpare viet Ds MIF 32 0mm Stereo View a MIP 64 0mm Fusion viet MIP 128 0mm MIP whole image CPR Setting plane CPR Reset 2ER Revise a paimt MIF Free mm Image plane with no slab thickness Image plane averaged over the slab thickness Image plane rendered by Maximum Intensity Projection Image plane rendered by Minimum Intensity Projection Free input xl MIP Free
57. tabase software for Synapse MPR Fusion shall be selected within the specification described in the Synapse MPR Fusion product specification 897N0599H OPERATIONS The Software described in this documentation Synapse MPR Fusion lets users display MPR Multi Planar Reformatting visualization of any study image being displayed in Synapse making four viewers available for the user MPR Viewer visualizes imase planes in four different ways Compare Viewer facilitates visual comparison among multiple series Stereo Viewer presents images for stereopsis MRA s Magnetic Resonance Angiography MIP images in particular Fusion Viewer displays fused CT PET mages in the various formats The maximum allowable number of slices for which images can be visualized 1s 10 000 However an attempt to visualize a large number of slices may decrease system performance The number of slices to operate the system smoothly depends on the memory capacity of the computer being used As a rough measure 1 Gbyte of main memory can handle about 600 slices of normal CT images When there is a need to handle a series of 600 slices or more expand the memory to a total of approximately 2 Gbytes Although there may not be sufficient memory capacity it is possible to visualize images using a mode based on a reduced number of pixels the number of pixels reduced to one half respectively for both vertical and horizontal sizes by clicking Reduction on the
58. the selection Synchronization is turned off 2 After clicking the image of interest change the 1mage s slice position using the mouse wheel or the keyboard 3 Right click to display the context menu and click Synchro display to turn on synchronization If you want to adjust the image slice positioning right click anywhere on any image plane to display the context menu and then click Synchronize with the active image mm With that image used as a reference images for other series at the same slice position appear NWARNING In the Compare Viewer assuming that the image of the series to compare against is showing nearly the same anatomical region synchronization is performed while considering the slice interval and so on The above mentioned same slice position does not mean that they have been recognized as being at the same position accurately before they are displayed It is the user s responsibility to make judgments about whether the slice positions coincide with each other 897N0599H B Displaying patient study and image information This section describes the operation to display patient study and image information Right click anywhere on the image to display the context menu and then click Patient information w Display original Display reformatted 4 Display reformatted B Synchronize with the active image mm Patient information Return En the MPR view The information box appears OK
59. uses vertical rotation dragging left or right causes horizontal rotation and dragging in an Oblique direction causes Oblique rotation While performing this operation reference the intersecting lines that indicate the Oblique plane on three orthogonal image planes to be sure that the position and direction of the Oblique planes are appropriate Dragging intersecting line Drag the intersecting line indicating the Oblique plane in a rotational direction on one of the three orthogonal image planes The Oblique image plane moves along the drag direction Dragging the rotation center point moves the line in the depth direction Reformatted A WW 280 WC 70 MPR 0 57 mm 21 22 Using Oblique tools Right click anywhere on the Oblique plane to display the context menu and then click Show Oblique Tools Oblique Tools Initialize k Approximate Orthogonal Approximate Single Oblique Synchronize with oblique rot center Select 4 group of images The Oblique toolbar window opens To make a rotational movement click an arrow button click gt gt for a large angle or gt for a small angle For relationships between arrow buttons and rotational directions the up and down buttons are for vertical rotations and the left and right buttons are for horizontal rotations While performing this operation reference the intersecting lines that indicate the Oblique plane on three orthogonal planes to be sure tha
60. yed on a Windows XP operating system No part or all of this manual may be reproduced in any form without prior permission 2 The information contained in this manual may be subject to change without prior notice FUJIFILM Corporation shall not be liable for malfunctions and damages resulting from installation relocation remodeling maintenance and repair performed by other than dealers specified by FUJIFILM Corporation FUJIFILM Corporation shall not be liable for malfunctions and damages of FUJIFILM Corporation products due to products of other manufacturers not supplied by FUJIFILM Corporation FUJIFILM Corporation shall not be liable for malfunctions and damages resulting from remodeling maintenance and repair using repair parts other than those specified by FUJIFILM Corporation FUJIFILM Corporation shall not be liable for malfunctions and damages resulting from negligence of precautions and operating methods contained in this manual FUJIFILM Corporation shall not be liable for malfunctions and damages resulting from use under environment conditions outside the range of using conditions for this product such as power supply installation environment etc contained in this manual FUJIFILM Corporation shall not be liable for malfunctions and damages resulting from natural disasters such as fires earthquakes floods lightning etc Rx only in the United States Federal law restricts this device to sale by or on

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